First Trimester Tests During Pregnancy in Mangalore

When you visit your doctor for the first time in the first trimester of your pregnancy, the initial step is to confirm your pregnancy. If your pregnancy is suspected and not confirmed, then a test named Beta-hCg level be conducted. In this test, level of a hormone called HCG (Human chorionic gonadotropin) is tested. The level of this hormone produced by placenta increases during pregnancy. This can be done by collecting your urine.

Once your pregnancy is confirmed your doctor will do a detailed physical examination. The physical examination which includes your body weight, breast examination and blood pressure. 

Due Date Calculation: Your due date will be calculated based on your last menstrual period.

Your healthcare provider might ask you to go through different tests based on your health needs. If you need any assistance in prescriptions for these tests, learning more about these tests or reviewing test reports with your doctor, you can book an online consultation with experienced doctors here and also book your tests instantly online for sample collection from the comfort of your home.  

First Trimester Physical Examination Details

Body weight assessment is done as Maintaining a healthy body weight is crucial in pregnancy. Gaining excess weight can cause pregnancy complications like gestational diabetes, high blood pressure which might lead to complications during pregnancy. Gaining too little may indicate a small baby with issues like developmental delay. Hence your health care provider makes sure you have a healthy body weight.

Breast Examination - Together with your weight, your breast examination will be done to determine whether there are any possible complications that may arise during breastfeeding. This also allows you and your doctor to have some discussion and clarity on the topic of breastfeeding.

Blood Pressure assessment - Your blood pressure will also be tracked as a part of physical examination as during pregnancy it is crucial to maintain normal blood pressure. Increased blood pressure can cause complications like preeclampsia or preterm birth.

Prenatal Tests During Pregnancy

You will undergo a list of routine prenatal tests that you need to take every trimester until you deliver. It includes,

Complete Blood Count - Complete Blood Count (CBC) or Complete Hemogram test is done to rule out any blood related problems in pregnant women. This test measures the levels of haemoglobin and haematocrit, which determines your iron levels and checks whether you have developed health conditions like anemia, thalassemia, iron-deficiency, infections or leukemia. If you have developed such conditions, then you are at risk of preterm delivery. You might require frequent blood transfusion during your delivery for your and your baby’s health. These risks can be avoided by early detection and treatments.

HbA1c- HbA1C is a blood test which measures the level of glucose or sugar in the blood of pregnant women. Being diabetic increases your chances of miscarriage. It also has a negative effect on your baby’s health like breathing issues, preterm delivery etc. to avoid these complications blood sugar has to be maintained at normal level.

Hepatitis B Surface Antigen (HBsAg)-Hepatitis B Surface Antigen is a blood test recommended to screen active infection caused by Hepatitis B virus. If you are positive to HBsAg, then there are chances that your baby will get an infection during delivery. This situation can be avoided by early detection and giving shots to the baby during delivery.

Pap Smear- A Pap test is used to screen a woman's cervix for cervical cancer. This test is done to check any abnormal cells in your cervix. If there are any abnormal cells in the cervix, then close monitoring is required to plan treatments. It doesn't have effect on your pregnancy outcomes.

TORCH (Toxoplasmosis, rubella cytomegalovirus, herpes simplex, and HIV)- TORCH test or Birth Defect Screening test is used to screen for certain infectious diseases that can cause birth defects in a baby if the mother contracts them during the pregnancy. If you are diagnosed early with infection, your healthcare provider will give you required medication to treat the infection.

VDRL screening test (syphilis)-The venereal disease research laboratory (VDRL) test is designed to assess for syphilis, a sexually transmitted infection (STI). This test is a part of prenatal check-up. Syphilis infection needs to be identified and taken precautionary measures as this infection can cause miscarriage or still birth.

HIV I & II-HIV test is a blood test recommended by your doctor once in each trimester to ensure no HIV infection to mother and risk to fetus. Diagnosing HIV infections early can help you to avoid passing the infection to the baby.

First Trimester Blood Tests, Scans

There are certain prenatal tests done in the first trimester to know your overall pregnancy health status and to eliminate any risk factors possible for you and the baby. It includes,

Blood grouping or Rh factor. If your blood is Rh positive during pregnancy, there are chances of complications. If your partner’s blood is Rh positive and your blood is Rh negative, then there will be antibodies formed in your body. This can attack the red blood cells of the fetus. During the blood group Rh factor is identified. It is done during the 7th week of pregnancy. If you are Rh positive, an injection will be given to you at 28th week of pregnancy which will prevent your body from making antibodies that attack your fetus’s red blood cells.

Dating Scan-The 'Dating scan' is mainly done between the 8th-11th week of pregnancy to determine the estimated date of delivery (due date) and to establish the foetal heartbeat. This scan also helps to check if the fetus's skull, limbs, organs, and umbilical cord are developing normally.

Vitamin D Status-Vitamin D test is a blood test recommended to measure vitamin D during antenatal assessment. Vitamin D is a very important vitamin for both mother and baby, to keep the body functioning well. During pregnancy you should take at least 10 microgram of Vitamin D every day. This Vitamin D is essential for your baby’s initial few months of life.

Iron studies (SERUM IRON, TIBC & TRANSFERRIN SAT.)-Iron test or Iron efficiency test is a blood test that evaluates the amount of iron by measuring several substances in the blood. Your baby needs enough iron to supply oxygen to your baby hence during pregnancy the need of iron in your body increases. Iron deficiency can cause your iron levels to be low; your healthcare provider will help you to increase iron levels by taking necessary measures like dietary changes or recommending supplements.

Thyroid Profile - Thyroid profile test or Thyroid Function test is the series of blood tests recommended as initial tests for evaluating and screening levels of thyroid hormone in pregnant women. During pregnancy there would be normal changes in the function of endocrine glands, but it has a marked effect on thyroid gland, which produces hormones that are critical to the healthy development of both fetus and mothers’ health. Untreated thyroid problems can cause preterm birth or miscarriage.

Anti-HCV -Hepatitis C or Anti Hepatitis C Virus screening is a blood test recommended for screening for any contagious liver disease caused by Hepatitis C Virus in pregnancy. By diagnosing the infection early, treatment can be planned. It also allows healthcare providers to prevent the baby from getting infected.

Vitamin B 12-Vitamin B12 test is a blood test recommended to test the amount of Vitamin B12 in blood. Vitamin B12 is important for maintaining health of the brain and nervous system. Vitamin B12 deficiencies are rare, but if they occur it increases the risk of neural tube defects and other neurological problems in infants.

First Trimester Screening Tests

Together with the routine tests there will be a First trimester screening test given based on your age, family medical history and various factors. These screening tests help to identify risks of carrying a baby with chromosomal disorder or genetic defects. It includes 

Nuchal translucency- The Nuchal Translucency scan or NT scan is normally performed between the 11th-14th week of pregnancy. The purpose of this scan is to measure the amount of fluid in the base of the baby's neck. This measurement of the fluid at the back of your baby's neck can give you an indication of your baby's risk of Down's syndrome. Nuchal scanning is not the only test that will be used to detect birth defects. The results from all other tests will be combined to come to a conclusion.

Chorionic villus sampling (CVS)- In Chorionic villus sampling, a sample of chorionic villi is removed from the placenta for testing. Chorionic villus sampling is done between 11^th and 14^th  weeks of pregnancy. This Chorionic villus sampling helps to reveal whether a baby has a chromosomal condition, such as Down syndrome, as well as other genetic conditions, such as cystic fibrosis. This test is usually recommended along with other screening tests as a way to confirm or look deeper into an abnormal screening report.

Double marker test- Double marker test also known as Dual marker test or Test for chromosomal formation is a blood test to determine the risk of carrying a baby with genetic abnormalities. Small fragments of DNA from placenta circulate in women’s blood during pregnancy. DNA from the fetus and mother is extracted from maternal blood samples. Double marker test is used to detect chromosomal disorders like down syndrome, trisomy 18, trisomy 13 and missing sex chromosomes. Double marker tests can also reveal the gender of the baby. It is mostly done in women who are at higher risk of carrying a baby with birth defects, usually after the 10th week of pregnancy. 

Ultrasound Scan-Ultrasound scans are done to measure the size of clear space in the tissue at the back of the baby's neck. It is also done to evaluate the size, location and determine the number of fetuses. Usually, first trimester screening is done between the 11th and 14th week of pregnancy. It also helps you to evaluate your baby's growth and how long you have been pregnant. It is the best way to assure that your baby is developing normally.

By assessing the results of blood tests, ultrasound scans and maternal age, the doctor can predict the risk of the developing fetus to have chromosomal abnormalities.

If the risk is high, you will be given a counselling. In this counselling your counsellor will tell you what will happen if you continue your pregnancy journey, what preparations you need to do, what are the struggles you might face. This will help you to be clear in your decisions.  You may also be asked to do a further first trimester screening test that might be even more definitive in predicting risk. Detecting the abnormalities earlier will help you to decide whether to continue with pregnancy

Your healthcare provider might ask you to go through different tests based on your health needs. If you have any doubts regarding the test, it is better to discuss with your healthcare provider and get clarity on it. You can ask about why and how the test is done, what are the pros and cons, what happens if the test is not done or you miss any test.