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First trimester, provider appointment #2 (week 12)

You’ll only need to visit with your healthcare provider a couple times during the first trimester, but he or she can act as an invaluable resource for you from the start.

As always, the healthcare provider will take your weight, blood pressure, and have you leave a urine sample, which they will check for sugar and protein levels, as elevated quantities of these can indicate gestational diabetes and preeclampsia respectively. And if you did not undergo a physical examination at your first appointment, you will almost certainly have one done now. Your healthcare provider may also offer two other forms of testing at this appointment:

  • Fetal doppler: Using a fetal doppler, a hand-held ultrasound device, your healthcare provider will check Baby’s heart rate to make sure all is going smoothly.
  • First Trimester Combined Screening: Although this screening process cannot diagnose chromosomal abnormalities, healthcare providers can use the information obtained to determine whether further testing is necessary. The screening is basically divided into two parts:
    • Using an ultrasound, your healthcare provider will measure the amount of fluid behind Baby’s neck, which can be a sign of Down Syndrome or other abnormalities when the amount is too high. This is known as Nuchal Translucency Screening.
    • You will have blood drawn, which healthcare providers will check for levels of Pregnancy-associated plasma protein A (PAPPA) and human chorionic gonadotrophin (hCG), as lower or higher than normal amounts, respectively, can indicate chromosomal abnormalities.

Although these screening tests can identify about 85% of abnormalities, they also have an approximately 5% false positive rate. And because the amount of babies with abnormalities is so much smaller than the amount of healthy babies, the 5% of false positives represent a significant portion of those whose tests raised red flags. This means that only about 1 out of every 200 First Trimester Screening positives are actually cases of chromosomal abnormalities. So although all babies who screen positive will be referred to further, more conclusive diagnostic testing like amniocentesis or chorionic villus sampling, a positive result on the First Trimester Screening is not a sure-fire indicator of a genetic condition.

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