What are the standard prenatal testing?

[Lisa1970]

I am not talking stuff like amnios. I am talking just the normal stuff everyone gets. All my OB did was the initial prenatal blood work. There was nothing else after that. I even asked about the glucose tolerance test and was told it was not needed. I am unsure of why I even went to a doctor while pregnant when the only testing the entire pregnancy was the initial blood work. Even when I had symptoms of a UTI, there was no testing. (I ended up having to go to an emergency room and being treated there for the UTI because my OB would not test for it).

So I want to know, what is normal for testing in pregnancy. What does your doctor test for?

(my baby was already born, I am asking because when I did have the baby, there were signs that I had gestational diabetes and turned out that I also had high blood pressure, something the OB missed because he did not check my blood pressure or weight or anything in the last couple weeks prior to the birth).

[Thesan83]

My doctor did an initial blood work panel at my first visit (7 weeks) which included things like hormone levels, thyroid function, iron levels, HIV status, blood-type, and an A1C. She also ordered a urine culture at my first visit to look for an asymptomatic UTI. And she did an ultrasound to check for a heartbeat and to confirm my due date.

We did a second ultrasound at my second visit (9 weeks) to recheck heartbeat and size.

At 11 weeks I did the nuchal translucency screening with combined blood work at about 15 weeks (I think?) to check for Down's Syndrome and Trisomy 18. This ultrasound also included a "maternal health" survey where they looked at my ovaries, etc.

At 20 weeks I did an anatomy scan.

Somewhere around this time my doctor also began testing my urine for glucose and protein at each visit.

At 25 weeks I was sent for a glucose tolerance test. They also re-checked some of my blood work along with this test. Iron levels and thyroid function, I think.

At 34 weeks I had an ultrasound to check baby's position and size.

And at 36 weeks I had a GBS swab done.

At every appointment I also get my blood pressure taken and get weighed. And once I was far enough along, my doctor began checking baby's heartbeat with a doppler at every visit, too.

I've had some additional testing done here and there as things came up. Like when I thought I had a UTI, and when we had a small baby scare thanks to the results of that 34 week size-check. (Which snowballed into getting frequent non-stress tests for a while!) But the above are what my doctor's office suggests for every woman. I think they're probably pretty standard among OBs.

[Lisa1970]

My OB only did visits every 6-8 weeks. So I went at 8 weeks, 14 weeks, 20 weeks, 28 weeks, then 32, 36, 37, 38, and 40. I snuck in the 37 week visit as he does not usually go weekly. I am not sure how I managed to get the visits so close toward the end. Anyway, there was initial blood work. That was it. Oh, I was offered a sonogram at 28 weeks, which I did. 

My OB was a failure. I ended up having high blood pressure and possible gestational diabetes. I only found this out when a different doctor delivered me. I explained to my DH that normally, OBs see you weekly toward the end, every 4 weeks in the beginning and they usually do things like urine checks and blood pressure every visit, as well as a glucose tolerance test. This is not something that is supposed to be different from Ob to OB. This is something that should be across the board for every OB to do. I am wondering if any other OBs out there actually skip all that, even when you ask for it, like my OB did.

[curious&eager]

I've been to three different practices and here's my experiences...

8weeks- urine, tons of bloodwork (8 to 14 vials), ultrasound to confirm dates, pap

12weeks- urine, more bloodwork to recheck some numbers, I was offered the NTscan that had to be done before this visit but I declined

16weeks- urine, quadscreen (almost a requirement at one doctor, optional at another)

20weeks, urine, big anatomy scan

24 weeks, urine, iron test

28 weeks, urine, gloucose test, iron test

30 weeks, 32 weeks, 34 weeks, 36weeks- I'm not there yet again so I may not remember, urine test, another iron test (I was low)

37, 38, 39, 40weeks- Group B strep at 37 weeks, urine tests, some check dilation,

I believe it is standard to check weight gain, urine for protein, and blood pressure at every visit because missing things like you experience- gestational diabeties or preeclampsia can be serious.  Even nontraditional natural birth midwives check for these things.  They check the baby's heart rate and the height of the uterus at each visit as well.  Later on they check for positioning of the baby.

Yes, there are lots of other tests offered as well, but I think I listed the standards and the normals that most places would do, the tests that both my obs and midwives did.

[adoremybabe]

Originally Posted by curious&eager 

I've been to three different practices and here's my experiences...

8weeks- urine, tons of bloodwork (8 to 14 vials), ultrasound to confirm dates, pap

12weeks- urine, more bloodwork to recheck some numbers, I was offered the NTscan that had to be done before this visit but I declined

16weeks- urine, quadscreen (almost a requirement at one doctor, optional at another)

20weeks, urine, big anatomy scan

24 weeks, urine, iron test

28 weeks, urine, gloucose test, iron test

30 weeks, 32 weeks, 34 weeks, 36weeks- I'm not there yet again so I may not remember, urine test, another iron test (I was low)

37, 38, 39, 40weeks- Group B strep at 37 weeks, urine tests, some check dilation,

I believe it is standard to check weight gain, urine for protein, and blood pressure at every visit because missing things like you experience- gestational diabeties or preeclampsia can be serious.  Even nontraditional natural birth midwives check for these things.  They check the baby's heart rate and the height of the uterus at each visit as well.  Later on they check for positioning of the baby.

Yes, there are lots of other tests offered as well, but I think I listed the standards and the normals that most places would do, the tests that both my obs and midwives did.

8 - 14 vials of blood for initial bloodwork????  I've never even had 8 taken at my first appointment!

[curious&eager]

My first pregnancy they took 6-8.  The tech told me it wasn't six because the minumium they do is eight but I don't remember eight.  But, I know this time they took 14.  I am a healthy, thin, exercising person with no medical issues.  I think they are blood sucking happy at Kaiser.  The tech just kept pulling out vials.  At least almost everything came back fine and they had to retest for one thing and then that was fine.  I'm not even sure what all the tested for.  I do know- Rubella, Chicken Pox immunity (since I haven't had chicken pox), Hep B, blood type, CBC, HIV, ...  that's all I know and it doesn't add up to 14.  But, it did make for a great facebook picture all those vials, it made my little brother squirm a little.  And yeah, my husband left the room while they filled them all up.

[Just1More]

Yes....I now refuse all that early bloodwork for that very reason.  I nearly passed out from all they took my first pregnancy.  And I could be wrong, but I was interested to see someone say 14 vials, because that is what I remember, but thought surely not.   With dd1, they also took a LOT.  Made my heart race, and took me days to recover.  With ds, I just didn't go in until much later.  The tech remarked that it was unusual how little blood they had requested (4 vials!).  I just smiled and said, "I know."  With dd3 and dd4, I just refused to do it. 

This pg I am refusing, too.  I have too many issues getting my blood volume up, and staying hydrated to let them have any of that precious stuff, lol.

[lizsky]

Last pregnancy and this one I've been seeing a MW group that delivers at a hospital.  They do the following:

1st trimester: 3 vials of blood and urine sample

2nd trimester: 20 week anatomy scan, 28 week GD test

3rd trimester: GBS swab around 36 weeks

They told me I could have additional genetic testing if I wanted it, but I declined.  And at every appointment we check my weight, protein in urine, fundal height, fetal tones, and BP.  They only see me about every 5-6 weeks until 3rd trimester, but then it becomes the standard- every 2 weeks, then every week from 36 weeks on.  

I'm no expert, but in my opinion, my MWs cover the basics but don't go overboard with extras.  I'm sorry you were given such lousy care from your OB.    

[jeninejessica]

Originally Posted by lizsky 

Last pregnancy and this one I've been seeing a MW group that delivers at a hospital.  They do the following:

1st trimester: 3 vials of blood and urine sample

2nd trimester: 20 week anatomy scan, 28 week GD test

3rd trimester: GBS swab around 36 weeks

They told me I could have additional genetic testing if I wanted it, but I declined.  And at every appointment we check my weight, protein in urine, fundal height, fetal tones, and BP.  They only see me about every 5-6 weeks until 3rd trimester, but then it becomes the standard- every 2 weeks, then every week from 36 weeks on.  

I'm no expert, but in my opinion, my MWs cover the basics but don't go overboard with extras.  I'm sorry you were given such lousy care from your OB.    

This is closest to mine. I'm seeing an OB, but wanted a very hands off pregnancy and delivery. My DH is a paramedic, so we've been keeping an eye on things at home as well, and if I had any concerns I'm confident she would follow up-- it sounds like your provider dropped the ball if you were concerned about something and he shrugged you off. 

I had blood and urine taken initially around 8 weeks (happened to have a regular GP visit and didn't have an OB yet, so she did it to get it out of the way for me. 

20 week anatomy scan, and the 28 week GD test, same as above. 

35 week GBS swab (which she allowed me to do myself, she just left the room, I swabbed, and returned it to her). 

And yes, I was offered additional genetic testing, but did not feel the need for it. 

Every visit we check weight, BP, fundal height, a quick doppler check, and position. She hasn't requested any additional bloodwork or urine samples, and I'm ok with that because I haven't been worried about anything else. 

[Adaline'sMama]

US and initial bloodwork at 12 weeks
Quad screen at 16 weeks
US at 22 weeks
GD test at 28 weeks
US at 30 weeks
GBS swab at 37 weeks
US at 38 weeks

Every time: Pee sample, listen to heartbeat, check weight, temp, and bp.

Appointments are as follows:
12 weeks
16 weeks
22 weeks
26 weeks
28 weeks
30 weeks
32 weeks
34 weeks
35,36,37,38,39,40weeks

Totaling 14 appointments, 2 blood tests, a GD test, and a GBS swab. I went to all 14 with DD, I will only go maybe 10 times with this one. I see no reason to go to the doctor every two weeks between 28-35 weeks. I might go twice. I will probably skipped my 26 week appointment, and Im sure Ill skip at least one of the appointments in the last six weeks. OB already knows this, its hard to take DD and hard to get someone to watch her.

[llwr]

Sounds like you already know this, but I'd look for a new OB.  I'm all for infrequent testing, but blood pressure is pretty basic. 

With the military:

I had U/S at 10 and 20wks

bloodwork at 10 wks

heartbeat, fundal height, BP and weight every appt

GTT and iron around 6 or 7mo

GBS at 8mos

They never tested my urine and had a less frequent appt schedule than most.  I had one more than standard and still only had 8 appts when I delivered on my due date.

Quad screen, HIV, and cystic fibrosis tests were offered and declined. 

With my very laid back midwife practice:

bloodwork at 9 weeks

heartbeat, fundal height, BP, weight and urine every appt starting at 13 weeks

U/S at 17 wks

GTT and iron around 6 or 7mos

GBS at 8 mos (did the swab myself)

I had 11 appts delivering 3 days before my due date and I missed one and had another a week late so that should have been atleast 12.

Quad screen, HIV, and cystic fibrosis tests were offered and declined. 

I did have an extra U/S at 30wk to check placenta, but that was because I had a previa earlier, not standard.