Procedures Performed During Pregnancy
At either your first or second OB visit you will begin having your routine OB lab work. This will include a urine culture, cultures for Chlamydia & Gonorrhea, a Pap smear, and blood work. This blood work will include your blood type, antibody screen, a complete blood count, immunity to Rubella (German Measles), a screen for Syphilis, HIV and Hepatitis B. If you are African-American, you will be tested for Sickle Cell anemia (if there is no previous history of this test having already been done ). You will also be given information concerning Cystic Fibrosis screening. Your doctor will review this information with you. Should you desire this testing, the blood work may be drawn as soon as you decide.
Influenza is caused by a virus that spreads from infected persons to the nose and throat of others. The “Flu Season” starts in October or November and lasts through March or April of every year. Pregnant and postpartum women are at higher risk for severe illness and complications from influenza than women who are not pregnant because of changes in the immune system, heart, and lungs during pregnancy. Vaccination during pregnancy has been shown to protect infants from influenza. The ACIP and American College of Obstetricians and Gynecologists (ACOG) recommends that all women who are pregnant or who might be pregnant during influenza season receive the Influenza vaccine because of this increased risk for serious illness and complications from influenza . Influenza vaccination can be administered at any time during pregnancy, before and during the influenza season.
During your first trimester of pregnancy your doctor will review information with you regarding 1st trimester screening for genetic defects (Down’s syndrome, Trisomy 18). This screening is an ultrasound done in conjunction with a very specific blood test. The two combined will give the risk ratio for these genetic occurrences. (Remember, this is only a screening test.) If your result puts you at an increased risk your physician will discuss the possibility of further testing.
Between 16-18 weeks of pregnancy your doctor may recommend the Alpha-Fetoprotein (AFP) test. This blood test helps to identify neural tube defects (defects involving the development of the baby’s brain and spine). If you have elected to have the 1st trimester screening this test may not be necessary. Your doctor will discuss this with you.
At 16 weeks, we offer a "gender only" ultrasound for those patients that wish to find out the sex of their baby before their anatomy ultrasound. This is not covered by insurance, so there is a fee for this service.
Between 18-20 weeks you will have your fetal anatomy ultrasound. Please remember to schedule this appointment IN ADDITION to your routine monthly OB visit. While we will gladly provide you with ultrasound pictures after your visit, we do not videotape the ultrasound. This ultrasound is considered routine and is done to assess all of the fetal organs and diagnostic measurements will be taken. If you are asked to return for an additional ultrasound do not be alarmed, sometimes the baby will just not position themselves where every area can be evaluated!
At 26-28 weeks you will be screened for Gestational Diabetes. This test involves drinking a measured amount of a glucose drink. After 1 hour your blood sugar will be checked. Your hematocrit (anemia screen) will be tested at this time also. You do NOT need to be fasting for this procedure. You may eat a regular diet, but do try to avoid sweets the day before and the day of your test. At this time you will also be screened again for HIV (as required by law). If your blood type is Rh negative you will have another antibody screen drawn at this time as well. If your blood type is Rh Negative and your partner is Rh Positive (or unknown) you will also receive a Rhogam injection at this visit. Be prepared to be in the office for at least 1.5 hours. At this visit, your physician also recommends you receive a Tdap (Tetanus, Diphtheria, Pertussis) vaccination. The CDC & ACOG recommend that all pregnant women be vaccinated with EACH pregnancy because receiving this vaccination in the third trimester actually gives your baby immunity for the first two months after they are born. Pertussis (whooping cough) is extremely dangerous for infants and young children.
Between 28-32 weeks of pregnancy you will have the opportunity to schedule a “Bonding Ultrasound”. This ultrasound is completely elective and done just for fun. Since this is just for fun we do not file insurance and the cost is $200. Your sonographer will give you additional information on this 4-D ultrasound but basically it is a 30 minute scan of your baby for you and others you invite to watch your unborn baby in motion!
Finally, at 35-36 weeks you may be screened for Group B Streptococcus (GBS). If you were treated for GBS early in your pregnancy as detected by the urine culture results you will not have this screen. GBS is a bacteria that is sometimes found in the reproductive tracts of women and can possibly be passed to the baby during delivery. The screen consists simply of a vaginal culture done in conjunction with your routine pelvic exam. If this result is positive (or your urine culture was positive), your doctor will advise you of precautions that will be taken during labor including intravenous antibiotics.