Prenatal Blood Tests? What are they for, which ones to get and why?

[IdentityCrisisMama]

I just met with the MW I'll probably go with and she asked about blood tests. I want to be more proactive and involved in the decisions of this pregnancy and birth so I told her I would look into which ones I wanted.

She mentioned that she would recommend the RH antibody test because I'm negative. Is this something you would have done?

What other options are there for testing? Would you have these done? Why or why not? I haven't been to a doctor in a million years and I declined testing during my annual with my last midwife so maybe I would take this time to get some general health tests done?

I'm 35 and relatively healthy if that matters.

Thanks for your help. Links also more than welcome!

[IdentityCrisisMama]

Oh, and I'm also considering a mid-way ultrasound for sex determination so I could have some sort of evaluation then.

[SuzieQ3417]

I would definitely get a "complete blood count" or CBC done, since this will tell you whether you're anemic or not. It's straightforward and will help you to know if whatever symptoms you might experience could be relieved with something as simple as an iron supplement. I would also do the Rh antibody, since to my knowledge this can pose problems for the baby if not treated appropriately (though others on here may know more about that test than I do).

I skipped the quad screen because I'm at low risk and didn't want to deal with the anxiety of false positives. I also skipped any early ultrasounds (like nuchal translucency) for the same reason, but did opt for the 20-wk anatomy ultrasound just to make sure everything was ok (didn't find out sex, but if you wanted to know it's good for that as well).

Other than that I've had most of the recommended blood work done, but I was on the fence about a lot of it. For instance, a lot of the STD screening seemed kind of pointless considering I've been in the same relationship for almost 10 years with a very faithful partner, get my pap smear every year (where they routinely test for chlamydia and gonorrhea) and have zero risk factors for HIV or syphilis...but I kinda figured if they're going to draw blood anyway for some of the other tests I might as well just get those done at the same time and be able to say with concrete proof that I don't have those diseases. I also debated about the glucose tolerance test (lots of false positives if you have no risk factors), but ended up getting that as well, and passed (yay!).

In the end, it's definitely up to you to decide. I recommend looking up specifics for some of those tests, particularly the genetic screening and also the glucose stuff, and seeing what risk factors you might have and what the likelihood that a "positive" test result actually means you have the disease. For that matter, you need to decide how you would use any of that info if it did come back positive. If you don't think it would change how you behave or help you to prepare differently for the pregnancy, then it might not be worth it. Good luck!

[Plummeting]

I did the STD tests, including HIV and Hep B. Those are good to have if you are planning on birthing at a hospital or just in case you have to transfer. I don't know that they're necessary, but IMO it's easier to have that "negative" in your pocket should you wind up in the hospital. I skipped the quad screen for signs of birth defects, but also did the 18-20 wk u/s to check for defects. It's not 100% accurate or anything, but at least we know baby probably has normal kidneys, normal heart, normal brain, etc. The false positive rate on the quad screen tests are really high, and once you get a false positive, the only way to absolutely rule out many of the defects it indicates your baby might have is amnio or cvs, so I didn't think it was worth it. I did do the glucose tolerance test, but that was also just in case I have to transfer care for any reason. I don't want to be treated like I'm high risk if I'm not.

[AustinMom]

This is based off a sheet given to me by an MW I interviewed with

OB Panel-Blood type/Rh, blood count, antibody test, Heb-B, Syphilis, Rubella
I am not getting this one, because I know all this, and of what I know, I am O- and had a +baby last time and got the pp rhogam, and the antibody just shows whether or not you have the antibodies to a + blood type baby, I don't think they can do anything about the baby's blood type or what CAN (like 2% of the time) occur with different blood types

HIV-I'm not getting, because I know I'm neg

Urine culture-usually tests proteins and confirms prego

Chalydia/Gonorrhea-not going to

regular pap-had one recently, all have been normal

quad test-optional birth defect screening (15-20 weeks) we aren't going to get because it's a screening test and not a diagnostic test. It will only cause stress

Varicella-immunity for chicken pox-not getting

toxoplasmosis-tests for immunity-not getting

fifths disease-tests for immunity

cystic fibrosis-tests to see if you are a carrier

Jewish Disease Panel- tests to see if carrier of cystic fibrosis, tay sachs and canavans

at 28wks-
1 hr glucose-test for diabetes, you don't have to drink the sugar drink, just get blood drawn on empty stomach, then eat a hearty breakfast, then come back, or just get it if you show signs of diabetes

hematocirt/hemoglobin-tests for anemia-I may get as I usually have low iron, but this is the only one I may get

Antibody screen-same as above

36 weeks-GroupB strep cutlture-it's only recommended, and there are ways to prevent it and symptoms to look for.

If you don't do the HIV or Heb B or Blood type and have to go to hospital, they do them all again at birth anyway, so there is no point in getting them prenatally for this reason alone.

We don't plan on having an U/S mid term, they are only recommended for medical reason/concerns, a normal healthy mom doesn't have any. If you want to find out the sex, then of course, that's up to you, and they can look at blood flow and heart, brain, cleft lip, etc.

Hope this helped!

Also Pregnancy, Childbirth and the Newborn is a good book that goes over all this

[IdentityCrisisMama]

Thanks, everyone. I've decided to go ahead with the RH antibidies test because I do think I had an early MC about a year back. I'll also do the iron work because of a PP hemmorhage last birth. Maybe the toxoplasmosis (sp?) if it's an immunity test too just out of curiosity because we have to outdoor cats. Thanks a lot for your help.