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The tests healthcare providers recommend during the first trimester

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During the first trimester, your healthcare provider will recommend a number of different tests. Some of these might remind you of tests you may have taken prior to pregnancy like blood draws and urine tests. Others might be rather new like ultrasounds. But all are meant to ensure that you and your baby are healthy and that your pregnancy is progressing well.

Some of the tests that will be recommended to you may include:

  • Blood tests involve a simple blood draw, and can screen for a number of things, including your blood type, blood count, Hepatitis B, HIV, Rh factor, syphilis, and rubella.
  • Urine tests are used to check for signs of preeclampsia, gestational diabetes, and bladder or kidney infection. This sort of a test involves providing a urine sample.
  • The First Trimester Combined Screen is, as the name suggests, a combination screening that involves both a blood test and an ultrasound, and it’s performed between weeks 11 and 14. The blood test is a Maternal Serum Screening Test (MSS), and it tests for pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (hCG), as abnormal levels of both can indicate a chromosomal disorder. The Nuchal Translucency ultrasound (NT) is performed to determine the size of space at the back of a fetus’ neck, which can indicate a risk of Down Syndrome (trisomy 21) or other developmental conditions. The First Trimester Combined Screen is called a screen because it merely screens for an increased likelihood of having certain chromosomal disorders and is not diagnostic – meaning it can’t tell for certain if a fetus has these disorders. So if there is a positive indication during this screen, further testing will be recommended.
  • Noninvasive prenatal testing (NIPT), or cell-free fetal DNA testing, is another blood test that can be done as early as weeks 9-10 of pregnancy. The test screens for chromosomal fetal abnormalities (such as risk of Down syndrome and extra sequences of chromosome 13 [trisomy 13] or chromosome 18 [trisomy 18]) and involves a simple blood draw. Because some of a fetus’ DNA crosses the placenta and enters a pregnant individual’s bloodstream, this can be analyzed to determine if the fetus might have any chromosomal abnormalities. This testing is safe for all pregnant individuals, and it’s often recommended for anyone at increased risk for having a fetus with a chromosomal abnormality, including women who will be 35 or older by their baby’s due date, individuals who had an abnormal MSS test, a fetal ultrasound finding suggestive of chromosomal abnormalities, or with a personal or family history of chromosomal abnormalities. This is a highly accurate test, but it is a screening test, so positive indications during the screen may lead to recommendations for diagnostic testing. And, fortunately, normal results can eliminate the need for more invasive testing. This test can also tell you a baby’s sex.
  • Chorionic villus sampling (CVS), by comparison, is a more invasive diagnostic procedure that is used to detect chromosomal abnormalities in a pregnancy, like down syndrome and muscular dystrophy (though not neural tube disorders, such as spina bifida and anencephaly). The procedure involves obtaining a tissue sample from the placenta by threading a small catheter through the cervix or inserting a needle into the abdomen. This optional test is usually reserved for women over 35, and most people are not recommended this unless their first trimester screen showed that their fetus might be at risk for chromosomal abnormalities. It’s most commonly performed between weeks 10 and 13 of pregnancy.
  • Other tests may be recommended as needed. Tests for genetic diseases like cystic fibrosis and sickle cell anemia, for example, will only be recommended if a pregnant individual is likely to be at risk of having a child with these diseases based on family history. Some individuals also have their hCG and progesterone levels checked often if a provider indicates that would be beneficial.

Keep in mind that all of these tests are meant to help your provider learn more about the health of you and your baby. And even if there’s a lot to take in as you start on your pregnancy journey – and a lot of new terminology to learn – your healthcare provider is there to make sure that you understand what these tests will mean for you. So be sure to speak with your provider if you have questions and to learn more about what tests are right for you.

To learn more about NIPT, tap the link below.

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Noninvasive prenatal testing (NIPT) is a screening test; it is not diagnostic. Results should be confirmed by diagnostic testing prior to making any pregnancy management decisions.

  • Mayo Clinic Staff. “First trimester screening.” Mayo Clinic. Mayo Clinic, January 10 2018. Retrieved December 19 2018. https://www.mayoclinic.org/tests-procedures/first-trimester-screening/about/pac-20394169.
  • Mayo Clinic Staff. “Prenatal care: 1st trimester visits.” Mayo Clinic. Mayo Clinic, November 10 2018. Retrieved December 19 2018. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044882.
  • “FAQ165: Prenatal genetic screening tests.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, July 2017. Retrieved December 19 2018. https://www.acog.org/Patients/FAQs/Prenatal-Genetic-Screening-Tests#first.
  • “FAQ133: Routine tests during pregnancy.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, September 2017. Retrieved December 19 2018. https://www.acog.org/Patients/FAQs/Routine-Tests-During-Pregnancy?IsMobileSet=false/.
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