Screenings/Tests « Back to Group Discussions

[JonesiesGirl]

I just got back from my first midwife appointment and have a list of screenings and tests that I'm being offered. I thought it would be nice for us to have a chat thread to discuss the pros/cons of different screenings and tests to help decide which ones we would like to do.

I will offered a bunch of blood tests like blood group, blood count, rubella, syphilis, hepatitis B, HIV, haemoglobinopathies, and blood glucose. I haven't decided which ones to do yet. DH says hep B/HIV/syphilis tests are pointless but I figure it can't hurt to do the tests, so might do them anyway even though I doubt I have any of those things and was actually immunised against hep B anyway. I'm immune to rubella (despite not being "up to date" according to US vaccine schedule!) as of November, so not sure if that is necessary either. I definitely do want to know my blood group and to do the full blood count as well. I'm still thinking about doing the dating scan (around 12 weeks) and nuchal translucency. 

Is anyone else deciding about screenings and tests at this point? I would love to hear what other mamas are deciding to do :)

[Sienna-forever]

Ive been offered so many scans, I dont think I want them. I'd be happy with one early scan and one late scan, as I really don't see the point in being offered all the extra 'reassurance' scans as they don't leave me reassured! Will have all routine bloods. Our dd had down syndrome but it doesnt particularly increase chances of it happening again, we wouldn't want invasive testing. I really dont want to be treated 'high risk, I just want to enjoy this time as much as poss, I actually got a bit upset lastnight as I feel everything is being so clinical and it just causes me more worry. x

[Sleepymama]

I think if you're young & in good health most of these aren't going to be very useful for you.  If you're older, have had losses/other complications, might be useful.

With DS I was 27 and I had the one 20 week u/s, the standard bloodwork, and the triple screen.  They did not catch his heart defect on that scan and should have.

With DD I was 30 and I had a midwife, but I saw a perinatologist because 1) had lost 2 babies in between and 2) wanted lots of u/s to check the heart.  I refused all the blood work and chromosomal testing because that doesn't show any heart related stuff.  I had 3 early u/s, including one at 16 weeks with the perinatologist to check heart formation, then a fetal echocardiogram at 27 weeks.  27 weeks was a long time to wait :(  I had her at home.  She's fine.

This time I am 38, and I think I am going to start with OB care so I can get early u/s and the screenings.  I am thinking about CVS as well.  I like to have information so I can plan. 

My one suggestion is to make sure that your mid term 20 week u/s is done by a doctor, not just a u/s tech.  Heart defects are more common than you would think and knowing in advance strongly improves the outcome.  I wish we had known.

[jjh5351]

I'm just so overwhelmed, just by researching, about all of the screenings offered and I am really glad to have "veteran" mommas around to get info from. I'll probably skip a lot of the "unnecessary" (As your DH said, Jonsies) tests because I feel confident that I don't have syphilis haha. What are you guys thinking about the blood glucose type things though? I have been on a track to being healthy for the past couple months and I do feel healthier but I am so scared of gestational diabetes and things like that...

[Sleepymama]

With DD my midwife gave me the option of testing my glucose at home on her monitor for a full day, before and after eating.  She said that gives much more accurate data to judge than that one time disgusting orange sugar bomb drink test.  I know most OBs don't offer that, but I do think it's important to screen for GD.

[jjh5351]

I agree. I think that's much easier and definitely accurate.

[JonesiesGirl]

Thanks for the responses, it's nice to hear what other mamas are doing. I've been finding it helpful to think about the risks and benefits of each screening to help me decide. Like the syphilis test is very unlikely to give me useful information, but it's even less likely to cause me harm, so I think I will do it. 

Regarding the glucose test, I don't think I will be doing the one where you drink the glucose solution and have your blood tested afterwards. If my midwife wants to test my urine for sugar or do an ordinary blood glucose test then I would consent to that. Here in the UK I think only women who are higher risk for GD are offered the GTT. Supposedly I would fall into this category because my mother has type 2 diabetes, but I don't think that's a useful classification to make as my mother has a very unhealthy lifestyle and is obese and I am normal weight and have a very healthy lifestyle. So I don't think that "family history" is a good reason to assume that I am higher risk of GD--unless maybe I lead a similarly unhealthy lifestyle to my mother.  

[fourlittlebirds]

I only do what's required and skip all the "extra" stuff. My last pregnancy I just did the basic blood work and had one ultrasound at 31 weeks. I declined the glucose test, as I'm not high risk for GD. So far, I plan to do the same for this one.

[Amila]

This is baby #4, 3rd homebirth, and I think this pregnancy will be the least invasive yet. With DD I had the whole gamut, from betas, to a few USs, to routine bloodwork, triple screen, glucose yuck, etc. With #2 I had 2 US, and bloodwork, with #3 I actually had a lot of crazy worries erupt from stupid testing- the early US I had at 7 weeks, which I just got because I got early ones with the other two, they found a subchorionic hemmhorage, which led to another 3 or 4 US, until it spontaneously disappeared. Bloodwork picked up some weird antibody, which led the nurse practitioner to scare me into thinking I had Lupus- MORE tests...my platelets were low, continues bloodwork and stress...everything was fine. 

This time around I will have my TSH tested since I have hashimotos, and a 20 week u/s and thats probably it. I was tested for sensitization last time and she was -, so thats not a concern. though i am dying to see the bean sooner than 20w!

[Kamiro]

Well...I am thinking I will use a doppler to hear the heartbeat around 10 weeks. Prob do a medical u/s around week 18 - maybe a gender one the following week (its a quick check)...As for tests, I decline all except for urine and I should just go do a blood lab now so its documented. I will monitor for GD by blood glucose monitor.

I still need to call my midwife.

[mamaecho]

I will do the regular blood test. I need to get it in case anyone wants the results since I'm a doula in training.

I won't be doing the first ultrasound, but I'll do the 20 week ultrasound. Will do "natural" glucose testing.. meaning I'll eat a banana and juice or whatever.

[maggiemay81]

I will be getting regular bloodwork, urine testing and ultrasound at 20 weeks. Around week 27 probably the glucose blood test. Is this test different in the USA? Or what is normal glucose testing? Onemore and mamaecho... Can I get around having this done?

[hapersmion]

I turn down most tests, I think they're useless, or worse than useless if they cause you to worry or even have interventions you don't need.

I thought the HIV/etc tests were silly, but then my midwife said that even though I know I don't have any STDs, if she has all of her patients tested, then I know she hasn't caught anything from any of the other people.  So that makes sense, I guess.  Blood tests are safe for the baby, anyhow, so I don't mind those as much. 

We just do the most basic stuff, and this time we'll have an ultrasound later on to check gender.
 

[Sleepymama]

I have to put in my plug right now (and I am going to bug you all about it when we get to our 5th months) but please please do have a 18-20 week u/s to check your baby's heart. Heart defects are way more common than you think and almost all of them are fixable. And if you know in advance you and the baby's docs will be prepared and it will go so much more smoothly. Trust me on this. This u/s should be done by a doctor and I have a list of questions that you should ask that I will post when we get closer.

We didn't know about our son's heart before he was born and it would have made a huge difference. Our 20 week u/s was not done by a doctor and the tech was rushing and missed it. I do not want to scare anyone--but it's worth it to know.