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Antenatal testing and screening tests in pregnancy: Why are they beneficial for women?
Bub Hub E-Newsletter, February 2005, Issue 32 - Article 2
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The aim of antenatal care is to safeguard the health and well-being of both mother and baby during pregnancy. It enables obstetricians to identify potential problems in the early stages of pregnancy which, if not addressed or treated, could result in increased risk for mother and baby. |
The initial antenatal visit is often the first time a woman has a detailed medical history and physical examination recorded with specific laboratory testing. The visit can provide information about the woman which may alter the management of her pregnancy and provide for her long-term health care. Prior knowledge of a woman's medical history or family background can also assist the obstetrician.
As with any test or procedure, antenatal screening is undertaken following informed consent of the woman after adequate and appropriate counselling with regard to the implications, limitations and consequences of each investigation.
Tests recommended at the first antenatal visit of each pregnancy
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- Full blood examination. This test measures the amount of haemoglobin in the red blood cells. A white cell count will also be conducted. This test will give some information about anaemia and iron deficiency
- Rubella (German measles). The blood is tested for antibodies from a previous rubella infection or vaccination
- Syphilis. If detected, syphilis needs to be treated in the mother for her health and well-being and to protect the baby from infection
- Midstream urine test, which tests for urinary tract infection
- Human Immunodeficiency Virus (HIV). If a woman tests positive for HIV, treatment during pregnancy can reduce the risk of infection being passed to the baby
- Hepatitis B and Hepatitis C screening tests
- Cervical cytology if there has not been a recent Pap smear
Other tests that may be considered and discussed are:
- Haemoglobinopathy screening (Thalassaemia) in at risk women
- Varicella (or chicken pox). Screening for varicella antibodies where there is no history of previous infection
Tests that are recommended after the antenatal visit
- Obstetric ultrasound at 18 to 20 weeks' gestation for growth and well-being
- Screening for Down syndrome: This depends on timing: a) At 11 to 13+6 weeks gestation, a first trimester ultrasound scan for nuchal translucency and maternal serum screening, known as the combined test. b) At 15 to 17 weeks gestation, a second trimester maternal serum screening blood test can be performed
- Further testing for Rh(D) positive antibodies at 28 weeks in Rh negative women
Other tests that may be offered
- Screening for gestational diabetes, eg testing for glucose tolerance
- Screening for Group B streptococcal disease (GBS). Testing for GBS is usually conducted at 35 to 37 weeks. If GBS is present, antibiotics are prescribed as a preventative treatment to protect the baby from infection during labour
- Full blood examination or iron deficiency assessment in the third trimester
The above is a list of recommended tests for women without specific additional risk factors. Other tests may be discussed
during a woman's antenatal care. The list is not exhaustive and further reading and information is required to gain a more
thorough understanding of how they are considered during pregnancy. Some additional information can be seen at the
Royal Australian and New Zealand College of Obstetricians and Gynaecologists' website
| This article was kindly provided by Royal Australian and New Zealand College of Obstetricians and Gynaecologists ph: (03) 9412 2918 fax: (03) 9419 0672 website: www.ranzcog.edu.au email: ranzcog@ranzcog.edu.au |
back to topReferences Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Antenatal care and routine tests during pregnancy: A guide for women. Edition No. 2. Mi-tec Publishing, Melbourne, July 2002. Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Antenatal screening tests. Revised March 2004. http://www.ranzcog.edu.au/publications/statements/C-obs3.pdf Guidelines for the use of Rh (D) immunoglobulin. Australian Red Cross Blood Service http://www.transfuse.com.au/RhD/default.asp College Statements ?The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, 2005. The College Statements are intended to provide general advice to practitioners. Each statement should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. The College Statements are prepared with regard to general circumstances. It is the responsibility of each practitioner to have regard to the particular circumstances of each case, and the application of a statement in each case. In particular, clinical management must always be responsive to the needs of the individual patient and the particular circumstances of each case. Each College Statement is prepared with regard to the information available at the time of its preparation, and each practitioner must have regard to relevant information, research or material which may have been published or become available subsequently. Whilst the College endeavours to ensure that College Statements are accurate and current at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material that may have become available after the date of the Statements.
College Statements
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has passed three position
statements on antenatal testing which it strongly recommends its members to follow:
These statements can be viewed on the RANZCOG website at
http://www.ranzcog.edu.au/womenshealth/collegestatements.php
Each statement is reviewed and revised by the RANZCOG's women's health committee and the revisions endorsed by the
RANZCOG Council every two years. Statements C-Obs 3, C-Obs 4 and C-Obs 5 were reviewed and revised in the period March
through to November 2004.
The College has also published two patient information pamphlets, which women can request from their obstetricians:
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