Do you need all those tests???

[I Need Coffee]

It seems there are so many tests they do during pregnancy.
Which ones should I avoid and why? Which ones are dangerous?

[honeybee]

I have a homebirth midwife. This time around (4th baby) I started prenatal visits with her at about 20 weeks. We talk about how I'm feeling, I pee on a stick, she checks heart tones, palpitates my uterus, measures fundal height, and checks my blood pressure. That's it. I don't do any other tests.

Now, with my first I had a family practitioner, and I did do the early bloodwork, which is in my charts. I do think it is important to at least know your blood type, get tested for STDs if you have risk factors, etc. I did not do the triple screen, or have an u/s. I permited the glucose test and the group B strep tests mostly because I didn't know enough about them. I no longer feel they are necessary. But others who are informed make different decisions. It's really a very individual decision.

As for which tests are "dangerous," I tend to look at it more from a risks/benefits viewpoint, and it's important to know what the various results will mean and how they are used. I would consider amniocentesis potentially dangerous... but it is still a very small miscarriage risk. The full ramifications of ultrasound and doppler use are unknown, but I am still okay with using a doppler once a month for a short period of time to check heart tones. I choose not to get u/s because the research shows it does not really affect outcomes for low risk women.

I think the biggest "danger" is introducing anxiety into a pregnancy because a screening test shows a possible problem... which leads to further testing, more anxiety, and a snowball effect, the choice between a procedure with a risk of miscarriage (amnio) and constant worry for the whole pregnancy.

JMO.

[dejagerw]

I think it's important to know what the tests are for, and what would be done with the results. That helps me decide which tests I'd get. I do not do any genetic testing, or will not do an amnio. I personally don't see the point with the genetic testing, because no matter what results I'd get, I would still most definitely have my baby.

[lillymonster]

I am not sure what is dangerous - just risk versus benefits. I opted out of amnio or cvs because I didn't want to take that risk, but I did all genetic testing. No matter what the result, I would still keep the baby, but after have a difficult child, I wanted to be prepared for any problems that I could get help and support with as soon as possible, since I basically had no support with DD and spent 2 years of our lives trying to get a diagnoses for her.

I like to do sonograms because my mother had placenta previa and almost lost my brother, it's something I want to be aware of. Plus I felt the sonogram was helpful since I won't get the amnio and I am almost 40.

Glucose test, I am not sure, probably won't do it. Or do some alternative type of testing in it's place

I think it's all personal

[homemademom]

Talk to your practitioner about what tests are recommended and then, research each one individually to see what you're comfortable with. Off the top of my head, there is pap smear, blood test (stds, blood type, rubella immunity), afp test, ultrasound, glucose (gestational diabetes) tolerance test, gbs test, etc. And then, there are the procedures offered to the baby: erythromycin eye ointment, vitamin K, hep b shot, etc.

IMO, there is no blanket "which ones to avoid," and "dangerous" is also subjective. It entirely depends on you, your health history, the place your birthing, your practitioner, and your values. For example, I have no problem with a couple ultrasounds per pregnancy. Others feel that even one is unnecessary. Still others have no problem getting one at each prenatal. Good luck with your research!

[MaerynPearl]

For the most part the only tests I had were ones that were relevant to me... Thyroid test (because I do have a history of thyroid issues)
iron levels (family history of anemia)
hcg/progesterone levels and early viability ultrasound(due to previous missed miscarriage)
GBS test (never been positive but I want to know what my risks are if somehow my water broke earlier this time than it has the past two times)
anatomy ultrasound (doing a homebirth I wanted to rule out placenta previa... which I ended up having at my first ultrasound but it corrected itself at the second... or any sort of birth defect such as heart problems that would require baby to be born in a hospital with a good NICU for best survival chance)
diabetes test (family history of gestational and non-gestational diabetes) though for the diabetes test we just had me eat a bunch of protein for breakfast and tested me on a glucometer afterward. I do not do glucola, it is so much worse than anything I eat on a regular basis that it would make me sick!


Thats it, have not had any other tests done... but dont really feel that I need any of the others. I got what I needed due to my own risk factors.

[I Need Coffee]

Thank you all so much!!! There are just so many things, to think about!

And it's scary that a lot of the genetic testing they do, they say there is a high chance of a false positive. So basically you might be worried for nothing. Ugh, I wish I had X-Ray vision at times like these

[WifeofAnt]

Pap smear - I had it done like RIGHT before ovulation so no need to repeat.
Blood Tests - I did all the basic ones. Both high and low iron run in my family.
'Genetic' screenings - I didn't do any of them. The only condition I was worried about didn't show up when they checked my irons. I also didn't want to have to make the amnio decision if it showed anything.
Dating Ultrasound - without it I'd be stuck with my incorrect LMP EDD that was over a week off.
Anatomy Ultrasound - I wanted to know that the baby was still as perfect looking as he was at 10 weeks. My placenta was low-lying but he's still perfect.
Placenta re-check ultrasound - Since it was low lying at 18 weeks I had it rechecked (today actually) at 28 weeks. Its moved so I hopefully won't need any more ultrasounds for other issues.
Glucose Screening - Just did it today because I have a risk factor (PCOS) and I've had blood sugar issues in the past. Plus it was the only test DH really asked me to get and its his baby too.
GBS test - I plan on doing it but I'm going to ask him to delay it until 38 weeks to make it more accurate. I doubt I'll have GBS though because I have to spend until 6 weeks PP on antibiotics for a kidney infection.

[myk]

Originally Posted by I Need Coffee

Thank you all so much!!! There are just so many things, to think about!

And it's scary that a lot of the genetic testing they do, they say there is a high chance of a false positive. So basically you might be worried for nothing. Ugh, I wish I had X-Ray vision at times like these

the thing is, it's not a genetic test. it's a SCREENING TOOL. it doesn't say something's wrong with the baby, so it's not a "false positive". it gives you a statistical analysis. for example, the average person my age has a 1 in 350 chance of a child with down syndrome. according to the bloodwork, one in 175 people with my results has a child with down syndrome. the other 174 don't. it doesn't tell you something's wrong with the baby, it merely gives you an idea if further investigation is warranted.

some people opt out of it for various reasons, but it's not like the test is "wrong". it doesn't tell you if you're the one with a DS kid, or if you're one of the hundreds who have a chromosomally normal kid. people seem to misunderstand this ALL THE TIME. i think if you're going to decide on a test, truly look into what the test does (and does not) tell you.

[NewMoonMum]

like most of the Mammas said, I think it depends on your potential risk factors, knowing what you would do if faced with a hard decision, and if you are willing to *potentially* create a risk to find out. I think above all, listen to your gut.

I'll start out by saying that you seem to hear millions of terrifying disorders and can begin to think it rare to have a perfectly healthy baby. That is not true. So the examples I think of are not common-so I don't want to scare you-just help you think through the *possibilities*.

I second the advice on learning about each test before you get it, as much as possible. Weigh risks versus benefits. Obviously genetic testing could reveal a special needs child-maybe not necessary if you would not terminate a pregnancy either way. But if that is the case, would you still want time to prepare? And what exactly is involved in the test itself...ultrasound? Definitely overused in the US, but in reasonable amounts is safe. CVS? Quite a bit riskier, and the risks vary according to how experienced the doctor performing it is. You see in many practices women of "advanced maternal age" will be advised to have CVS...I *personally* feel this test is too invasive to suggest based on age alone.

Some tests could reveal an entirely treatable, but otherwise risky condition.

What if you are screened and found a condition from which a child would be unlikely to survive through birth? Unable to live with for more than a few months? Years? Again these are rare problems, but food for thought.

Best of luck on a healthy pregnancy and baby!!

[lillymonster]

Originally Posted by I Need Coffee

Thank you all so much!!! There are just so many things, to think about!

And it's scary that a lot of the genetic testing they do, they say there is a high chance of a false positive. So basically you might be worried for nothing. Ugh, I wish I had X-Ray vision at times like these

As someone else said they is no right or wrong answer. For example. normally for my age, the risk with downs is 1 in 90 (I am almost 40). My risk from blood tests and n/t scan was 1 in 700. However, something could be missed and my baby still could have downs. I opted for the 20 week ultrasound to double check. But I know still then it's possible to miss something, my baby might not cooperate, etc.

I read somewhere that now they do genetic testing in ALL age groups, not just for advanced maternal age because while the risk is higher for older women, more younger women are having babies with genetic issues simply because they have more babies (which seems odd - I guess in the general population more younger women are having babies and not more babies in general) anyway that is why they are offered to women of all ages now.

That is the testing I have looked into mostly because of my age.