Test during pregnancy.

What you should know about procedures during pregnancy.

 

Childbirth, especially the first time around, is always full of emotions. Fear, excitement, doubt, joy and more. Many women are unaware of the sheer volume of decisions that they will have to make during this relatively short period of time. The purpose of this series of article is to display the pros and cons of procedures and tests offered during pregnancy, labour, birth and post partum to enable parents to make the best decision possible for their family.

During pregnancy you can anticipate the following test:

 

Triple Screen Test: This blood test tests for the presence of alpha fetoprotein (released form the fetus), human chorionic gonadotropin (hCG) and estriol (a form of estrogen used to indicate possible neural tube defect (spina bifida).  
These tests can also indicate the presence of trisomy 18 or Down syndrome. This test gives no certainty of the existance of any of these chromosomal abnormalities or birth defects. In fact the Harvard Medical School Family Health Guide states that only one in sixteen women who get "the worst combination of results" will end up with a Down syndrome baby.1
Pros: The results from this test could give couples who are over the age of 35 (at an increased risk for Down syndrome) peace of mind when the results come back negative for abnormalities. It can also allow parents with abnormal results to prepare for life with a disadvantaged child.
Cons: A false positive can lead to parents aborting a normal fetus. This could be disastrous as the tests are not a positive indication of Down syndrome etc. An amniocentesis (see below) may be indicated here.  

 

 Amniocentesis (Chorionic Villi sampling is a very similar procedure): In this procedure a long needle is inserted through the abdomen into the amniotic sac. It withdraws cells from the amniotic fluid which is then grown in a lab and used to test for genetic or chromosomal abnormalities such as Down syndrome, Tay-Sachs disease, or sickle cell anemia.2

 

Pros: There are very little pros to this procedure. It does allow you to spot genetic abnormalities before birth better than an ultrasound. The upside is that it can help to emotionally prepare parents who are expecting a Down syndrome child or the like.

 

Cons: The down side is that this can lead to more abortion requests. This procedure slightly increases your chance of a miscarriage.3

 

Gestational diabetes screen (Glucose Tolerance Test): This procedure consists of drinking a very sugary drink, remaining in a sedentary state for about an hour and then taking a blood test which is then used to test blood glucose levels. Some women become diabetic during pregnancy and this, depending on the severity of the diabetes, can result in birth defects or miscarriage4 as well as premature labour or respiratory distress for the fetus.5 The drink tastes like an orange pop without any fizz.
Pros: It can spot a problem before it hurts the mother and child. If a positive test results, the mother may need to go on insulin.5
Cons: The test represents unrealistic circumstances and is therefore not necessarily accurate. It doesn't hurt anyone to do the test but it can result in a false positive as the average person does not usually consume that much sugar in such a sedentary state.6 Simply avoiding over-consumption of sugary foods could potentially resolve a mild gestational diabetes diagosis.7

 

Ultrasound:  A transducer is used to beam high-frequency sound waves into the uterus. These sound waves reverberate back to the transducer and are transformed to create an image of the baby.8
Pros: Ultrasounds allows the parents to see their child, resulting in better bonding and sometimes cementing the fact that they are really going to have a baby. It acts as a general check on health and can be used to determine position of the baby (or the possibility of multiple babies) as well as the position of placenta. When the placenta is covering the cervix (placenta previa is rare), your chances of having a c-section is 75%.9 Be cautioned that an ultrasound used to determine gestational age can be off by up to three weeks. The dates can be off by five to seven days in very early pregnancy.10 This gap increases with your baby's age. They are more accurate for determining age when they are done earlier in the pregnancy. Ultrasounds can also be used to identify the gender of the baby after 20 weeks gestation.
Cons: The overuse of ultrasounds is not clearly documented. It would be wise to use ultrasounds only as needed.

 

 Group B Streptococcus (GBS) swab: This is a vaginal/anal swab that test for GBS.
Pros: If you have GBS, you can potentially give your baby the infection during birth. It can also cause bladder infections, womb infections and still birth (1/1000)12.11 To prevent transmission during birth you would be put on an IV drip with antibiotics so that the baby can fight the infection during birth (as antibiotics cross the placental barrier). An infected baby can suffer from pneumonia, sepsis or meningitis.11 A carrier may not show any symptoms so testing is important.13

 

Cons:  The test is slightly uncomfortable but it could save your baby's life.

 

Various blood work: These tests test for a variety of factors including, but not limited to, iron levels, blood sugar, blood type and RH factors. There are not really any cons to speak of, unless you have anxiety with needles. Note: many of the tests do occasionally give false positives. Make sure to talk to your doctor about the precision of the offered tests. A false positive could result in unnecessary interventions

Article 1 of 3

Article 2: Labour and Birth: http://www.squidoo.com/birthrisks/

Article 3: After birth: http://www.squidoo.com/birthprocedures/

I have also written a story about my first days home with the baby: http://www.squidoo.com/firstweek