Trimester wise common tests during pregnancy| Zyla Health

 Pregnancy is one of the most unique phases of a woman’s life. Bringing a new life into this world is such a beautiful creation.

Pregnancy also comes with a huge bag of responsibilities. Earlier, you had to only take care of yourself, but during pregnancy, you have to take care of two lives.

If it is your first time, then getting curious is obvious. Some of the common questions that cross our minds are, “What are the common tests during pregnancy?”, “When should I get these prenatal tests done?” or “What is the importance of blood tests during pregnancy?”

Various types of lab tests are part of routine care during pregnancy. These tests can be done by either taking your blood sample, taking a tissue sample from the vagina, cervix, or rectum or by doing a scan.

Various types of lab tests are part of routine care during pregnancy.

These tests help in finding out various diseases and disturbed parameters that should be treated during pregnancy. Getting lab tests done on time is very important to keep a check on the baby’s growth as well as your health.

Sometimes, we are not aware of certain symptoms or we do not experience any difficulty in our body during day to day activities. But with the help of these prenatal tests, we come to know about nutritional deficiencies or some abnormal parameters which may impact the growth of your baby or may affect your health as well.

The list of blood tests during pregnancy varies from trimester to trimester. Now we will discuss in detail these common tests during pregnancy in the following blog.

Tests in the first trimester of pregnancy (1 to 12 weeks)

It is the beginning phase of this roller-coaster journey. Regular testing and screening help in the early detection of any kind of disease or abnormality.

During the first trimester, your doctor may advise some blood tests or basic scans based on your health history. Following tests are performed during the first trimester of pregnancy:

1. Complete blood count (CBC)
2. Blood type and Rh factor
3. Urine routine
4. Urine culture & sensitivity
5. Screening based on family history
6. Pap smear or physical examination
7. Ultrasound: Screen for down syndrome
8. Invasive or non-invasive prenatal testing

Apart from these prenatal tests, pregnant women are also tested for a specific disease in early pregnancy like

• Hepatitis B & Hepatitis C
• Rubella
• Sexually transmitted virus (HIV)
• Tuberculosis (TB)
• Syphilis

Let’s examine these common tests during pregnancy in detail…

1. Complete blood count (CBC)

Let’s start with CBC tests which evaluate the different types of cells that circulate in the blood. Ideally, this test is done on an empty stomach.

Lab range would be specified as per your age, gender, and pathological condition. CBC can help in diagnosing a wide range of conditions from anaemia to infection. This test contains a wide range of subtests out of which we will discuss important parameters in the following section:

Haemoglobin

• Haemoglobin is found in every Red Blood Cell (RBC) and it is responsible for the red colour of the blood.
• Haemoglobin helps in binding oxygen to the RBC in the lungs then transports oxygen from the lung to tissue and other body parts.
• A decrease in RBC and haemoglobin level leads to anaemia.
• In anaemia, the body does not get the required amount of oxygen and you may experience fatigue or weakness.
• A low level of haemoglobin could be due to

1. Severe blood loss
2. Deficiency of iron, folate, or vitamin B12
3. Bone marrow damage, because bone marrow produces RBC
4. Kidney failure
5. Excessive destruction of RBC
6. Reduced production of haemoglobin

To increase haemoglobin, it is important for you to have an iron and folic acid-rich diet. Read, “Importance of folic acid in pregnancy” to know more. You can also enrol in Zyla’s pregnancy program which will help you take care of your nutritional needs.

We are constantly using the term RBC, you must be wondering what it actually means. Let’s evaluate RBC and the rest of the major components of blood in detail.

Red blood cells (RBC)

• RBC: It stands for Red blood cells and its normal range varies around 3.9–5.05 mil cells/ mcl.
• A low level of RBC indicates anaemia and iron deficiency. Further testing is required to confirm the specific condition.
• Iron deficiency anaemia can increase the chances of premature birth or low birth weight. It is a condition in which the weight of a baby is less than 1.5 kg during birth.

White blood cells (WBC)

• They represent fighting cells present in the body. They are commonly known as leukocytes.
• There are several types of WBC present in our body, which includes, neutrophils, lymphocytes, eosinophils, monocytes, and basophils.
• To find out the exact reason for low or high WBC levels, your doctor will consider various factors like medical history, symptoms, or medicine intake other than the common tests during pregnancy.
• Reasons for low WBC count are:

1. Autoimmune disorder
2. Infection
3. Lupus
4. Intake of antibiotic

• Reasons for high WBC count are:

1. Smoking
2. Stress
3. Pregnancy
4. Allergy
5. Inflammation

After finding the exact reason for the abnormal WBC count, treatment would be planned accordingly by your healthcare professional.

Another major component of CBC is platelet count. Let’s examine platelets in the following section.

Blood tests are important in pregnancy.

Platelets

• Platelets help in controlling bleeding by forming clots. A low level of platelet count may result in uncontrolled bleeding which may be life-threatening.
• The normal range of platelets varies from 1.5 to 4.5 lakhs.
• A condition of low platelet count is called thrombocytopenia. The reasons for the low platelet count are:

1. Enough platelet cells are not made in the bone marrow
2. Platelet get destroyed in blood circulation or in liver
3. Autoimmune disorder
4. Intake of some medicines (like cancer)
5. Viral infection

• A condition of high platelet count is called thrombocytosis. The reasons for the high platelet count are:

1. Surgery or some infection
2. Anaemia
3. Bone marrow disease
4. Iron deficiency

We have discussed all the major cellular components of blood. Now we will look at the various types of blood groups which is one of the common tests during pregnancy.

2. Blood type and Rh factor

• It helps in determining the type of blood group. It is considered important when you need some sort of blood transfusion or planning to donate blood.
• Knowing blood group makes it easy for your Dr to plan other routine tests during pregnancy.
• There are 4 types of blood groups, namely

1. Blood group A: Having A Antigen
2. Blood group B: Having B antigen
3. Blood group AB: Having AB antigen
4. Blood group O: Having no antigen, neither A nor B antigen

Let’s discuss these blood groups in some more detail.

• Blood group O: People with blood group O can donate their blood to anyone because they do not contain any kind of antigen in the blood. But they can receive blood from an individual with blood group O only.
• Blood group A: People with blood group A can donate blood to an individual with blood group A or AB. They can receive blood from an individual with blood group A or O.
• Blood group B: People with blood group B can donate blood to an individual with blood group B or AB. They can take blood from an individual with blood group B or O.
• Blood group AB: People with blood group AB can donate blood to an individual with blood group AB. But they can take blood from an individual with any blood group either A, B, or O.

These were the basic categories of blood groups. For further advanced identification of blood group, the following classification is done, based on the presence of Rh antigen.

There are two classes for Rh-antigen

• Rh-positive: People with Rh-positive blood groups contain Rh antigen over the surface of RBC. They can take blood either from Rh positive or negative person.
• Rh-negative: People with Rh-negative blood groups do not contain any Rh antigen over the surface of RBC. They can take blood only from Rh-negative people.

So, with the help of these classifications, we can determine the exact type of our blood. Possible blood groups are A+, A-, B+, B-, AB+, AB-, O+, and O-.

So far we have discussed various types of blood tests included in the list of common tests during pregnancy. Let’s take a closer look at some other prenatal tests.

3. Urine routine

This test helps in detecting and managing a wide range of conditions related to diabetes and urinary tract infections (UTI). It includes analysis of appearance, concentration and various other components of urine.

Let us consider an example of a UTI. Urinary tract infection (UTI) makes the appearance of the urine cloudy. Similarly, increased levels of protein in urine could be a sign of kidney disease which further needs other tests for disease verification.

If you want to know more about UTIs during pregnancy, read our blog, “Treatment of UTIs in pregnant women”.

As such, no special preparation is required for this test. You can eat and drink normally before this test and give a mid-stream of urine. Make sure the collecting container is new and clean.

Examination of Urine sample: The urine sample is evaluated on the basis of three parameters, which includes appearance, dipstick test, and microscopic examination.

• Appearance: A urine sample is evaluated for its transparency, smell, and colour.
• Dipstick test: In this test, a stick coated with some chemical is dipped into the urine sample. It is a qualitative test and helps in determining the presence of sugar, protein, ketones, bilirubin, and blood.

Urine samples are collected for urinalysis.

• Microscopic examination: In this examination, a few drops of urine sample are evaluated under a microscope. It is a quantitative test and helps in determining the numerical count of parameters.

After performing these tests, the results are analyzed in the following manner:

• WBC (leucocytes): The presence of these cells indicates a sign of infection.
• RBC: The presence of these cells in urine indicates a sign of kidney damage.
• Bacteria or yeast: The presence of bacteria or yeast indicates urinary tract infection.
• Crystals: The presence of crystals are indicative of kidney stones.
• Glucose: It can be present in urine due to gestational diabetes which develops during pregnancy.
• Proteins: The presence of proteins in urine indicates urinary tract infection or kidney disease.
• Pus cells: The presence of pus cells indicates urinary tract infection.

The presence of these above-mentioned parameters can be harmful to you or your baby but early testing, diagnosis, and treatment can prevent any harmful effect. That is why we say, prevention is better than cure.

If you are seeking help for common tests during pregnancy or any sort of medical assistance, you can download the Zyla app or visit our website Zyla.in and can check out the healthcare program which is suitable for you.

Let’s discuss another common test related to urine.

4. Urine culture and sensitivity

This test comes into the limelight in the following cases:

• When we have to confirm the type of urinary tract infection.
• To calculate how much bacteria is present and is sensitive to which antibiotic.

Based on the sensitivity of the organism towards antibiotics, the doctor will further plan for the treatment.

Mostly, these tests are performed during the first trimester of pregnancy checkups. In some cases, additional tests are also required based on the family history.

5. Screening on the basis of family history

• During the first few consultations with your gynaecologist, you have to answer several questions related to family history which helps in screening or finding out a risk factor for the baby.
• There are certain diseases or disorders which pass from generation to generation. They need to be ruled out.

Your answers will help the doctor to rule out the diseases which may affect your pregnancy or your baby’s health.

We have discussed most of the common tests during pregnancy. But during pregnancy extra care is required for the baby. So, besides these tests, a few advanced tests are also added to this list. Let’s discuss another set of advanced tests.

6. Pap smear or pelvic examination

• Pap smear stands for “Papanicolaou test”. During the first trimester, a pelvic examination is very important to ensure the health of cervical cells.
• Pap smear also helps in the detection of cervical cancer or any Sexually Transmitted Disease (STD).
• The Centers for disease control and prevention (CDC) recommended that all pregnant women should be tested for Hepatitis C, Hepatitis B, HIV (Human Immunodeficiency Virus) & Syphilis in early pregnancy, to check for Sexually Transmitted Infection (STI).
• Whereas, some STIs need blood tests along with Pap smear for diagnosis.
• During a Pap smear test, a speculum (a medical device) is inserted into the vagina and the health practitioner will rub the cervix to collect cervix cells. These cells are sent to a lab for further analysis or examination.

7. Ultrasound

• It is one of the most common tests during pregnancy.
• This test uses high-frequency sound waves and captures images of internal body parts.
• It helps in checking the growth, size, and location of the baby.
• It also helps in determining the specific number of fetuses and also calculates weeks of gestation (pregnancy).
• It is a non-invasive technique to check birth defects and also do not harm your baby.

If you want to know more about ultrasounds performed during pregnancy, read our blog, “How many ultrasounds are really needed for healthy pregnancy?”

Ultrasound is important during pregnancy.

8. Invasive or Non-invasive genetic testing

Various techniques are used to detect genetic abnormalities which can be either invasive or non-invasive. It helps in the screening of genetic diseases like down syndrome.

Non-invasive prenatal testing (NIPT):

• Genetic screening done through a non-invasive method is called NIPT. A blood sample is taken from the pregnant woman for the analysis. It is generally done between 10–12 weeks of pregnancy.
• This test is highly efficient and can detect 99% of down syndrome in pregnancy and other genetic abnormalities as well.
• If you get a positive result in NIPT, then your doctor may advise you to get invasive genetic testing done.

Chorionic villus sampling (CVS):

• The invasive technique is CVS, in which a catheter is inserted through the cervix to collect the sample from the placenta.
• This technique is highly efficient in detecting a genetic birth defect or a birth defect of the brain or spinal cord.
• It can also detect openings in the baby’s abdomen through which abdominal organs can come out.
• But this technique has 1% chance of inducing miscarriage.

So, always consult your healthcare professional before getting these common tests during pregnancy done. He/ she will consider your medical history, lifestyle, medicines and various other factors before suggesting these prenatal tests.

After discussing the first trimester of pregnancy tests, we will now move to the common tests performed during the second trimester of pregnancy.

Tests in the second trimester of pregnancy (13–26 weeks)

During the second trimester, you can feel various physical changes like increased belly size and breast size. You can also experience normal vaginal discharge but if it is smelly or unusual in colour then contact your doctor.

Apart from this, you can experience urinary infection which is quite common during pregnancy. But if it is severe and left untreated then it can infect kidneys as well.

During this period, your doctor will suggest some tests for a routine checkup. He can also advise some specific tests based on your symptoms, past medical condition or abnormality detected in previous reports.

Following tests are mostly performed during the second trimester:

1. CBC is advised to detect anaemia and platelet count.
2. Urine test
3. Pelvic examination

These three tests are common tests during pregnancy and are performed in all three trimesters. Let’s examine some additional tests performed during this trimester.

4. Fetal heart monitoring: To check the functioning of the fetal heart.

5. Blood pressure (BP): It helps in detecting preeclampsia. It is very important to keep a check on BP because in the later phase of pregnancy there are chances of developing preeclampsia (development of hypertension during pregnancy).

6. Blood glucose and glucose tolerance test (GTT): It is used to detect gestational diabetes. During pregnancy, some women develop diabetes due to some hormonal changes which is known as gestational diabetes.

Although, it can develop at any time of gestation. In most cases, it develops during the last phase of pregnancy.

It is important to take proper medical guidance in such cases. Elevated blood sugar levels are harmful to the mother as well as the fetus. Mostly these tests are done between 24–28 weeks of pregnancy.

7. Thyroid-stimulating hormone (TSH) level: This hormone plays an important role in the development of the fetus. It is necessary to keep an eye on the level of TSH and take medical assistance if any kind of deviation occurs in its normal range.

To know more about TSH and thyroid disease, read our blog, “Thyroid disease: Development During Pregnancy, Its Impact On Pregnancy And How To Treat It”.

8. Amniocentesis: The test is mostly conducted between 15 and 20 weeks of gestation (usually around week 16). It is performed in the following cases:

• If the pregnant woman is 35 years or older.
• If she is having a family history of a genetic disorder.
• If a pregnant woman and her husband both have a gene for an inherited disorder.
• Previously conducted screening tests indicated an increased risk of fetal abnormality.
• In the family, the previous child had a birth defect.

9. Percutaneous Umbilical Blood Sampling (PUBS): In this test, the sample is taken from the baby’s blood to analyze blood parameters or genetic abnormalities. This test is also called cordocentesis.

You can sit back and relax a bit because now you are aware of the majority of common tests during pregnancy. Let’s move to the last and most curious trimester of pregnancy.

Tests in the third trimester of pregnancy (27 weeks to end of pregnancy)

This trimester comes with a mixed bag of emotions. On one side, women are excited about childbirth but on the other side, they are worried about complications related to the pregnancy.

So, some tests are conducted in this trimester to check the chances of certain complications or preterm birth. Following tests are performed during the third trimester of pregnancy:

1. Complete blood count (CBC)
2. Urine routine

As we discussed, earlier these are vital tests advised in every trimester.

3. TSH level

4. Group B strep screening: Group B streptococcus (GBS) are bacterias present in the vaginal flora and gastrointestinal areas of about 25% of women. But, if they are present in the vagina at the time of delivery then they can infect the uterus, amniotic fluid or urinary tract system.

During delivery, the baby can inhale or ingest this bacteria while coming through the birth canal. In such cases, babies can show symptoms within 6 hours of birth to 2 months after birth.

5. Fetal fibronectin (fFN): This test is conducted in those women who have symptoms of premature labor and are 22–35 weeks pregnant. It helps in determining the potentially serious health complications of a preterm baby.

A cervical or vaginal fluid sample is collected for this test. High levels of fFN results do not very accurately tell about preterm labor and delivery. Whereas, a negative fFN result highly accurately tells us that preterm delivery will not happen within the next 7–14 days.

6. Amniocentesis: This test may be conducted after 32 weeks of gestation to check the lung development of babies who are at risk of premature delivery.

Pregnancy is a beautiful phase of life.

Common tests during pregnancy performed at a fixed interval of time helps in assessing health of mother and baby. They also prevent severe complications related to childbirth and play an important role in detecting genetic abnormalities.

Pregnancy is an unexpected experience that every woman cherishes for the rest of her life. Although, it comes with certain complications but with proper healthcare assistance and guidance, you can make your journey a bit smoother.

If you want personalized nutritional and medical guidance, Zyla can help you. You can download the Zyla app or visit our website Zyla.in and can enrol in our Ova Pentacare Pregnancy Program.

At Zyla, we have doctors, physiotherapists, nutritionists and psychologists to provide a holistic approach to your health.

Stay strong! Stay healthy!

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