When you’re pregnant you might have to undergo a series of medical tests – blood test, urine tests, genetic testing, etc. Some of these tests are mandatory and others are prescribed to you if your doctor suspects a specific problem like a chromosomal abnormality in the fetus. Here is a list of the tests that you might have to undergo during your pregnancy. You can also try these three simple tests that can help you confirm your pregnancy.
The preliminary tests
There are two tests that you might have to do at first to confirm your pregnancy.
Home pregnancy test: A simple over-the-counter pregnancy test kit can help you confirm your pregnancy at home. Ideally, this should be done 10 days after you miss your period.
How it is done: This is done by putting a few drops of your urine on the test strip. If you are pregnant, the colour of the lines marked on the kit changes to either pink or red. However, read the instructions carefully as it is different for different brands. Here is a step by step guide to using a home pregnancy test kit.
The cost involved: Rs 100 to Rs 300 and is available at every pharmacy.
Blood test: It is done to check for the hCG or human chorionic gonadotropin hormone levels in the blood, that is secreted once the fertilised egg attaches itself to the uterine wall. Normally, the level of hCG in a woman is less than 5 mIU/ml. However, during pregnancy it increases consistently. In fact, a large amount of hCG in the blood or urine is the first sign of your pregnancy. Here are six early symptoms of pregnancy that you should know.
How it is done: This is done at the doctor’s clinic by drawing blood from the arm. In case of a normal pregnancy, the value is between 20 to 7500 mIU/ml. The test is done five weeks after the last menstrual period. Higher values indicate either multiple pregnancies (more than one fetus) or molar pregnancy, i.e., an abnormal one where the fetus grows outside the uterine wall and requires a medical termination. On the other hand, lower values could indicate a spontaneous abortion. In both the cases, a repeat test is done after 24 or 48 hours to confirm the diagnosis. Simple tips to deal with seven common pregnancy problems.
The cost involved: Rs.500 to Rs.1500
The ultrasounds
Viability scan: This is the first scan done between the 6th and 10th week of pregnancy to assess the development of the fetus, monitor fetal heart rate and number of babies the mother is carrying. It also helps the doctor to calculate the expected delivery date, which is usually after nine months and one week post the last menstrual period. Know more about this scan here.
How it is done: It is usually done either abdominally or transvaginally. If done abdominally, you need to drink plenty of water before the test as it is done with a full bladder. It means you might have to control the urge to pee till the test is over, which could be a bit uncomfortable. However, in case of a transvaginal ultrasound the instrument or probe is inserted vaginally on an empty bladder. It is certainly more discomforting, but this ultrasound is more sensitive and is done along with a transabdominal scan. Both the procedures last not more than 15 minutes.
The cost involved: Rs.500 to Rs.1500.
Nuchal translucency scan: Ideally, done during the 12th week of the pregnancy this helps to determine the fetal health and pick up signs if the fetus has any chromosomal abnormalities like Down’s syndrome. Know more about this scan over here.
How it is done: It is done abdominally. If the nuchal translucency (neck fold thickness) is thicker than normal, it may indicate that the baby might be born with Down syndrome. Ideally, a measure of less than 3.5 mm is considered normal.
The cost involved: Rs.1500 to Rs.2000.
Anomaly scan: This scan is done between the 18th and 20th week and gives a detailed anatomy of the fetal body and position of the placenta. It gives a fair idea of how the brain, face, spine, heart, stomach, kidney, limbs and other parts of the body are growing. Here is more you need to know about this scan.
How it is done: It is done abdominally.
The cost involved: Rs.3000 to Rs.4000
Fetal echocardiography: A detailed examination of the fetal heart and connecting vessels is carried out usually between 20 or 22 weeks with this scan. It is done if the anomaly scan raises any concern regarding the fetal heart. Know more about this scan over here.
How it is done: This scan is also done in the conventional manner, i.e., abdominally.
The cost involved: Rs.4000 to Rs.5000.
Fetal well-being: This scan is carried between 28 to 39 week of pregnancy to check on the obvious, well being of the fetus – its weight, growth, and placenta and also the position of the fetus. A Doppler, which determines the blood flow through the blood vessels, is also done to see that the blood flow to your baby is adequate, because an insufficient blood flow may hamper the growth of your baby. Here is all you need to know about this scan.
How it is done: It is done abdominally.
The cost involved: Rs.1000 to Rs.3000.
Blood tests
You might have to go for a blood test in every trimester. During the first trimester, your blood test is done to get an idea of the following things:
Complete blood count or CBC: A complete blood count or CBC gives a detailed account of the number of different types of cells present in the blood — white blood cells, red blood cells, and platelets. The results help the doctor to interpret if you are suffering from an underlying condition like anemia, or an infection or any other blood-related disorders. If your hemoglobin level is less than 12 mg/dl, it could indicate anemia. The total white blood cells are normally in the range of 4000 to 11000 cells/cu mm. It is not uncommon to find a mild rise in the count during pregnancy. Your platelets should be in the normal range, that is between 150000 to 400000/cu mm. Here are 10 superfoods for pregnant woman.
Blood grouping and Rh factor: Rh factor is a type of protein present in the surface of the red blood cells. If your blood has a Rh factor, then you are Rh positive, if not you are Rh negative. If the mother is Rh-negative and carries a Rh positive baby, Rh factor can cross her placenta and result in the formation of Rh antibody in the child. This causes the red cells of the RBCs to get destroyed and can result in serious complications.
Blood glucose test: This test is done to rule out pregnancy-induced diabetes. Fasting blood glucose test is done after fasting overnight, or at least 8 hours, and the postprandial blood glucose test is done after two hours of consuming food.
HIV I & II: It is done to check if the mother is afflicted with this sexually transmitted disease. STDs can be transmitted to the baby while in the womb through the placenta. Hence the screening is necessary.
Hepatitis B: It is caused by a virus that can be passed from the mother to the baby. So a routine blood test is done to screen for the same. If detected positive, special care needs to be given to the pregnant mother and the baby needs to be vaccinated after birth. You will also be screened for hepatitis C for the same reasons.
Thyroid: Every pregnant woman needs to undergo a thyroid test to check for the level of thyroid hormone as it affects the child’s brain development. A range less that 3mlU/L says that your thyroid is functioning properly or else one needs to be monitored closely to see if thyroid problems interfere with the pregnancy. An abnormally high level of T4, another hormone secreted by the gland, definitely indicates a problem and could lead to complications. Here are 5 facts you should know about thyroid during pregnancy.
VDRL: This test is done to screen mothers for syphilis, another sexually transmitted illness that can reach the baby if the mother is found to be positive for the same. Under normal circumstances, this should be negative for an expecting mother.
HPLC: A blood test to check if the mother has any blood-related disorder like thalassemia. If the mother turns out to be a carrier, then the father is also checked for the same.
The cost involved: A simple blood test to check for all these parameters will cost you around Rs 500. Remember, you might have to go for a repeat blood test during your second and the third trimester to check for the same.
Other tests
Urine test: A urine test is routinely done during every trimester. The urine sample is collected early in the morning after cleaning the area and discarding the first few drops of urine. Protein and sugar should be absent in urine and if present, warrants the need to rule out diabetes and pre-eclampsia. If the number of white blood cells in the urine is more than normal, the doctor may ask for a urine culture to figure what’s causing the infection before starting antibiotic treatment.
The cost involved: Routine urine test costs around Rs.500 and urine culture may cost between Rs.500 to Rs.1000. These tests are done at all laboratories.
Oral glucose tolerance test: A glucose challenge test is done at 24th or 28th week of gestation, wherein a woman is given 75g of oral glucose, and a blood sample is taken after 2 hours to screen for gestational diabetes. If a mother develops gestational diabetes at any point during the pregnancy, it can lead to overly large babies, difficult deliveries and also lead to other health problems related to the baby. If the test value shows a reading more than 140 mg/dl, it denotes gestational diabetes.
Test for toxoplasmosis and antiphospholipid antibody (APLA): These are done by taking blood samples and are recommended if you have a history of previous abortions.
Genetic testing:
Sometimes the routine tests are not enough, and one might have to undergo genetic testing as well. Genetic counseling and tests are recommended in the following cases:
a. If the mother is over 35 years of age
b. If there is a family history of genetic defects
c. If there is a previous child born with genetic defects
d. If the parents have a genetic abnormality
e. If there is a history of repeated abortions
f. If the mother has been detected with diabetes
g. If any defect has been detected during the ultrasound
If any of the above are true for you, certain biochemical tests are done to see if your baby is at risk of being born with a genetic defect. Your blood is checked for hormones or proteins that come from the baby. These tests are only done at specialised centers. Here are a few tests:
Maternal serum alpha-fetoprotein (MSAFP): It is a blood test done at the 15-18 week of pregnancy to check for MSAFP factor. This chemical is produced mainly by the developing baby’s liver and if the values are found to be elevated it could indicate genetic diseases and kidney abnormalities in the fetus. Also, the value could be elevated if you are carrying twins or triplets. In such cases, other marker tests are conducted to confirm the same.
The cost involved: Rs.1000.
Triple marker and Quadruple marker test: It is also done between 15 to 18 weeks of pregnancy to detect Down syndrome. It measures three entities – Maternal serum alpha feto protein ( MSAFP), human chorionic gonadotropin (hCG), and unconjugated estriol (UE3). If the MSAFP and UE3 levels are low and hCG is high, the risk ratio is considered to be 1:250 and the test are considered positive. It means that one in 250 pregnancies with this result will have a baby with Down’s syndrome. The Quadruple test is more sensitive than the triple test and also detects inhibin, a hormone secreted by the ovary and the placenta. An elevated level of inhibin could point towards a baby with Down syndrome.
The cost involved: Rs.2500 to Rs.3500 depending upon the lab and is carried out at most sophisticated labs. The Quad test costs around Rs.4000.
Acetylcholine esterase ( AChE): This is done between 15 to 18 week of pregnancy as well, raised values of AChE is a marker of genetic disorders.
Inhibin A: Another marker test done to check for genetic abnormalities like Down’s syndrome during the 15th to 18th week of pregnancy.
If the above-mentioned tests are found to be positive one of the following test is done to confirm the genetic abnormality:
Amniocentesis: This is an invasive test done between 14th to 16th weeks of pregnancy.
How it is done: Under ultrasound guidance, a thin needle is inserted in your belly, and the fluid that surrounds your baby (amniotic fluid) is drawn and processed. The genetic analysis takes 3 to 4 weeks, and conditions such as Down syndrome, cystic fibrosis, Tay-Sachs disease can be diagnosed. It is very accurate and is said to be safe (though there is around 1% chance of abortion).
The cost involved: Rs. 7000 to Rs. 9000. It is available at all hospitals that have a fetal medicine center.
Chorionic villus sampling (CVS): It can be done either through the vagina (transcervical) or your abdomen (transabdominal). The transcervical CVS is done between 10th to 12th weeks of pregnancy and transabdominal CVS anytime from week 10 to the time of delivery.
How it is done: A small piece of placenta is acquired with the help of a needle and tested for genetic abnormalities. The result can be obtained in 24 hours and an action for termination of pregnancy can be taken. It carries a higher risk of damage to the baby as compared to amniocentesis and is less accurate.
The cost involved: Rs.10,000.
You may also like to read:
Tests you should do during the first trimester
Second and third trimester tests you can’t ignore
Note: All prices are approximate
Image source: Getty Images
For more articles on pregnancy, visit our Pregnancy section. For daily free health tips, sign up for our newsletter.
