List of tests prescribed during pregnancy. Mandatory tests and examinations during pregnancy Measuring hemoglobin levels

When a woman finds out about an interesting situation, she has a huge responsibility to maintain the pregnancy and successfully give birth to a healthy little man. The mother’s first task is to visit the gynecologist and register with the housing complex. Numerous diagnostic studies are required at various stages of gestation. Every woman is recommended to know what tests are required during pregnancy, why and when they are prescribed, what the results say, etc.

The very first test a woman encounters during pregnancy is a home pregnancy test from a pharmacy, which will show two characteristic lines after the first day of the delay. After such a primitive confirmation of conception, it is necessary to undergo an examination by a qualified gynecologist who will confirm the fact of pregnancy.

• If there are any doubts, the doctor will prescribe a blood test for the patient to determine the content of gonadotropic chorionic hormone, which can be performed as early as 8-14 days of expected conception. The levels of this hormonal substance at conception will exceed 25 mU/ml.
• Also, to determine pregnancy, you need to undergo ultrasound diagnostics, which can be performed as early as 3-6 days of delay. The fertilized egg with an embryo inside will be visible during ultrasound diagnostics at approximately 5-7 weeks; the heartbeat will also be heard at this period, but only during an intravaginal examination.

It is necessary to make a visit to the consultation for registration no later than 7-10 weeks. At the appointment, the doctor will create a card, indicating the necessary information about the pregnant woman, the beginning of sexual relations, the first and last menstruation, the duration of the cycle, etc. Two cards are created, individual and exchange, the first is kept by the doctor, and the second is given to the pregnant woman. The exchange card contains the results of all studies and tests that a woman undergoes during pregnancy. During the initial examination of a pregnant woman, the obstetrician-gynecologist takes smears and tells you which tests will need to be taken first during pregnancy, writing out the appropriate directions.

Laboratory tests and other studies by trimester

While under the supervision of a gynecologist during the entire period of pregnancy, in addition to a pregnancy test, a woman periodically undergoes mandatory laboratory tests. The obstetrician-gynecologist will draw up a specific observation program for each pregnant woman, according to which the patient will be monitored over a 9-month period. From conception to childbirth, a woman has to undergo many tests. Some are appointed several times, while others are carried out once. The list of tests depends on the gestation period.

First trimester

During the first trimester, the patient needs to undergo quite a lot of diagnostic procedures, since it is during this period that she is registered. It all starts with pregnancy testing, which often involves conducting a urine test for hCG. Such a study is prescribed at 5-12 weeks of gestation; as a rule, it is during this period that a woman learns about conception and contacts the LCD. With the help of such a diagnostic procedure, the onset of conception is confirmed.

When registering for gynecology, swabs are taken for vaginal microflora and latent sexually transmitted infections, bacterial culture and Papanicolaou test (PAP test), and a biosample from the cervical canal. If signs of cervical erosion are detected, a colposcopic examination is performed. Then the doctor prepares a whole range of laboratory and instrumental diagnostic prescriptions for the pregnant woman, and issues appropriate orders for tests, which are extremely important to undergo in the first trimester of pregnancy. This list necessarily includes a general urine test, and an extensive blood test is prescribed, which includes:

1. Biochemistry;
2. A general analysis is required at 5, 8, 10 and subsequent weeks, when you come to see an obstetrician-gynecologist;
3. For rhesus and group;
4. For HIV and syphilis;
5. To detect hepatitis B;
6. For sugar;
7. For TORCH infections;
8. Hemoglobin level to detect anemia;
9. Coagulogram to determine blood clotting.

In addition, the pregnant woman is prescribed an ultrasound examination of the ovaries and uterine body, an ECG and clinical examination, which includes dental and endocrinological consultation, examination by an ophthalmologist, neurologist and surgeon.

At 10-13 weeks, the patient may be prescribed a double test or prenatal screening, in which blood is donated from a vein in the elbow for the hormonal levels of β-hCG and PAPP-A. Chorionic indicators reach maximum values ​​at approximately 11 weeks, and PAPP-A protein is produced specifically during pregnancy and, if deficient, indicates the presence of problems. Using these indicators, specialists will be able to determine the baby’s risk of developing congenital pathologies or defects such as Down’s disease, etc.

Progesterone levels are also determined. This hormone ensures the safety of the fetus, having a beneficial effect on pregnancy, and if it is deficient, a threat of miscarriage is diagnosed. In such situations, to preserve the fetus, the woman is prescribed to take this hormone in the form of medications. At approximately 11-12 weeks, a repeat ultrasound examination will be scheduled to detect possible developmental abnormalities such as neural tube defect, Edwards, Down pathologies, etc.

Weeks of the second trimester

During the middle period of gestation, at each scheduled appointment with an obstetrician, the pregnant woman will be required to measure her weight and pressure, the height of the uterine fundus and abdominal circumference. At 14-27 weeks, a pregnant woman must undergo a general urine and blood test, as well as an ultrasound examination, during which the exact period of gestation is determined, physical abnormalities in fetal development are identified, etc.

At 16-18 weeks, a second screening is proposed, which is often called a triple test, since it involves measuring the levels of the hormones AFP, EX and hCG. The triple test is performed to detect chromosomal abnormalities and birth defects. If mommy takes hormonal medications, the indicators may be distorted. In addition, the reason for the uninformativeness of the study may be ARVI, low weight of the pregnant woman, etc. If a pathology is detected or some suspicion of it arises, it is recommended to carry out prenatal screening in an invasive way, i.e., cordocentesis or amniocentesis is performed. Such studies may pose a risk to the fetus, since they cause termination of pregnancy in 1% of patients.

Gynecologists also strongly recommend that all mothers take a test to determine glucose tolerance. With its help, you can determine the likelihood of developing latent gestational diabetes. This testing is scheduled at approximately 24-27 weeks. At 21-27 weeks, a second ultrasound examination is scheduled.

Third trimester 28-40

With the beginning of the third trimester, the frequency of visits to the LC increases; now you will have to visit an obstetrician-gynecologist every couple of weeks. During the appointment, standard procedures will be carried out such as weighing, monitoring blood pressure, uterine height or abdominal volume. Before each scheduled appointment with a gynecologist, you need to donate urine and blood.

What tests need to be done at this time? At about 30 weeks, the pregnant woman is prescribed almost all the tests that she already underwent in the weeks of the first trimester, i.e.:

Usually a healthy pregnancy ends at 39-40 weeks, but sometimes it can be delayed a little. In such a situation, the mother may additionally be prescribed an ultrasound, CTG, urine testing for acetone, etc. These studies are important for determining the safety of such a long wait for delivery and calculating its approximate date.

If the tests are bad

Sometimes it happens that some tests do not show very good results. Usually, mothers in such a situation begin to feel uncontrollable panic, they worry, become very nervous, and harass both themselves and their household. Such behavior is categorically unacceptable for a pregnant woman, because psycho-emotional experiences and stress overload are much more dangerous for the baby than not-so-good tests. By the way, they are taken in order to promptly detect non-compliance with standards and prevent the development of complications, and not so that the pregnant woman pronounces a verdict on herself and the baby.

Sometimes the mother herself does not comply with the requirements for preparation for diagnostic laboratory procedures. For example, they do not donate blood on an empty stomach, as doctors require, or they do not follow a diet on the eve of the tests, that is, they eat fatty and sweet foods, too spicy or fried. All this distorts the results of laboratory tests and causes false indicators.

In such a situation, you first need to calm down and discuss all the nuances with the doctor. If training violations occurred, then they must be reported. If the mother complied with all the requirements of pre-procedure preparation, then you need to discuss with the doctor the possible causes of deviations and ways to eliminate them.

The main thing is to undergo the prescribed tests in a timely manner and visit an obstetrician-gynecologist, because the health of the unborn child completely depends on the correct course of pregnancy. And finally... Do not try to interpret the research results yourself. Only a specialist can do this correctly. Without medical education, you can easily make a mistake in deciphering the results, which will cause unnecessary worries and worries that the expectant mother, and especially the child growing inside, has absolutely no need for.

During pregnancy, a woman and her unborn child are under close medical supervision. The gynecologist with whom you are registered draws up an individual examination program for each of his patients, which the woman must adhere to for 9 months.

This program includes mandatory tests for pregnant women, which we will talk about in more detail today.

Tests taken in the first trimester of pregnancy

The very first analysis in the first trimester, of course, is pregnancy test. This can be either a home test or a laboratory urine test. on hCG hormone levels . It is carried out at 5-12 weeks of pregnancy, because it is at this time that the woman begins to suspect that she is pregnant. This test allows you to confirm that pregnancy has indeed occurred.

After receiving the results, the expectant mother should, as soon as possible visit your gynecologist to register for pregnancy monitoring. During this visit, the doctor should conduct full physical(measure height, hip bones, blood pressure) and gynecological examination.

During vaginal examination Your doctor should take the following tests from you:

• Pap smear – detects the presence of abnormal cells;
• Microflora smear vagina;
• Bacterial culture and a smear from the cervical canal - detect sensitivity to antibiotics;
• Smear to detect hidden sexually transmitted infections .

If a pregnant woman has, the doctor should conduct colposcopy.
After all these manipulations, the doctor will give you directions for tests that need to be taken in the first trimester of pregnancy:

1. :
   • general;
   • blood biochemistry;
   • blood group and Rh factor;
   • for syphilis;
   • for HIV;
   • for viral hepatitis B;
   • for TORCH infections;
   • on sugar levels;
   • to identify anemia: iron deficiency and sickle cell;
   • coagulogram.
2. General urine analysis
3. Direction to undergoing medical examination: ophthalmologist, neurologist, dentist, surgeon, therapist, endocrinologist and other specialists.
4. Electrocardiogram;
5. Ultrasound of the uterus and its appendages

In addition to the above mandatory tests, your obstetrician-gynecologist at 10-13 weeks of pregnancy may appoint first perinatal screening , the so-called “Double Test”.

You will need to donate blood for two hormones (beta-hCG and PPAP-A), which store information about the baby's risk of developing birth defects and diseases (for example, Down syndrome).

Second trimester of pregnancy: tests

At 13-26 weeks, during each visit to the antenatal clinic, the doctor must measure your weight, blood pressure, abdominal roundness and fundus height.

In the second trimester of pregnancy, you must take the following tests:

1. General urine analysis– allows you to identify urinary tract infections, signs of preeclampsia and other abnormalities, such as sugar or acetone in the urine;
2. General blood analysis;
3. Fetal ultrasound, during which the child is checked for physical developmental disorders, and a more accurate gestational age is determined;
4. Glucose tolerance test– prescribed at 24-28 weeks, determines the presence of latent gestational diabetes.

In addition to all the above tests, at 16-18 weeks your obstetrician-gynecologist will suggest you undergo second perinatal screening , or "Triple Test". Your levels of hormones such as hCG, EX and AFP will be checked.

This test will help identify the risks of developing birth defects and chromosomal abnormalities.

List of tests in the third trimester of pregnancy

In the third trimester of pregnancy, you will need to visit the antenatal clinic once every two weeks. During the visit, the doctor will perform standard manipulations: weighing, measuring blood pressure, abdominal roundness, and fundus height. Before each visit to the doctor's office, you must take a general blood and urine test .

At 30 weeks, you will need to take all the tests that were prescribed during your first perinatal visit in the first trimester of pregnancy. You can see their full list above.

In addition, you will need to pass next research:

• Fetal ultrasound + dopplerography- prescribed at 32-36 weeks. The doctor will check the baby's condition and examine the placental-umbilical canal. If during the study low placentation or placenta previa is revealed, then the ultrasound will need to be repeated at a later stage of pregnancy (38-39 weeks) so that labor management tactics can be determined;
• Fetal cardiotocography– prescribed at the 33rd week of pregnancy. This study is necessary to check the intrauterine condition of the child. The doctor will monitor the baby’s motor activity and heart rate, heart rate, and find out if the child is oxygen deprived.

If you have a normal pregnancy, but its term is already more than 40 weeks, your obstetrician-gynecologist will prescribe the following tests:

1. Full biophysical profile: Ultrasound and non-stress test;
2. CTG monitoring;
3. General urine analysis;
4. 24-hour urine test according to Nicheporenko or Zimnitsky;
5. Urine test for acetone.

These studies are necessary so that the doctor can decide when to expect labor to begin, and whether such an expectation is safe for the child and mother.

Each trimester of pregnancy is strictly monitored by doctors through various studies and laboratory tests. The third trimester is no exception, especially since childbirth is coming soon, and you need to make sure that your body is ready for it. What tests are done in the third trimester of pregnancy?

Blood tests during pregnancy in the third trimester
In the third trimester, you will have to take a general blood test several times, which will show your blood sugar levels. A coagulogram is also necessary - a study of the blood coagulation system, which is also carried out in the maternity hospital, before the actual birth.
Once again you will have to donate blood for HIV, hepatitis, and the presence of antibodies to rubella and cytomegalovirus. In addition, it is necessary to evaluate other blood parameters that deserve special attention.

Hormones

Special glands or individual cells are responsible for the production of hormones. And during pregnancy, their main task is to support it, ensure the full development of the fetus and prepare for childbirth. Particular importance in the 3rd trimester of pregnancy is given to the following hormones:

• Estradiol, responsible for the normal course of pregnancy. The peak of its concentration is reached before the birth itself. A decrease in its concentration may indicate a threat of miscarriage;
• Free estriol. Based on its concentration, the state of blood flow in the placenta is assessed, whether there is a delay in fetal development and whether the pregnancy is post-term;
• Alpha fetoprotein. It is produced by the fetus, and one can judge its condition, with the ability to identify malformations;
• Testosterone. In the 3rd trimester of pregnancy it increases significantly. Some pathological syndromes are determined by its quantity;
• TSH (thyroid-stimulating hormone) - its decrease can cause miscarriage and stillbirth.

Progesterone

This is the hormone that is necessary at all stages of pregnancy and ensures its preservation. Normally, the concentration of progesterone increases in the 3rd trimester of pregnancy. The peak of its concentration occurs at 37 - 38 weeks, and is about 219 nmol/l.
As a rule, determining this indicator in the 3rd trimester is necessary only to exclude or confirm a post-term pregnancy.

ESR

During the entire pregnancy, the erythrocyte sedimentation rate (ESR) test is carried out 4 times. In the third trimester of pregnancy from 29 - 30 weeks and immediately before birth. This study helps to identify the presence of an inflammatory process in a woman’s body. Normally, ESR during pregnancy in the 3rd trimester does not exceed 7 - 45 mm/h, but before birth, this figure may change. Before the birth itself, there is an increase in these indicators, which is a variant of the norm.
High ESR during pregnancy in the 3rd trimester may indicate inflammatory diseases, hormonal dysfunction, anemia, and bleeding. Additional studies will be needed to make a correct diagnosis.

Hemoglobin

Hemoglobin is a special protein that carries oxygen to cells. During pregnancy, its amount may decrease - in the second half of pregnancy after 20 weeks, which is due to physiological changes in the body.
The hemoglobin norm during pregnancy in the 3rd trimester is 100 - 140 g/l. A decrease in blood levels will threaten the development of anemia - iron deficiency. Due to the fact that hemoglobin cannot fully perform its functions and carry oxygen, the body of the mother and fetus begins to suffer. The resulting hypoxia can cause a delay in its development.
As a treatment, doctors recommend reconsidering your diet - including foods rich in iron in your diet. Vitamin complexes and pharmaceutical iron preparations are often prescribed.

Fibrinogen

Fibirnogen is a special protein synthesized by the liver and converted into fibrin. It is this substance that will be the “foundation” of the blood clot during coagulation. Simply put, by determining the concentration of fibrinogen in the blood, doctors are able to judge the correct functioning of the blood coagulation system. These indicators become especially valuable on the eve of childbirth.
The normal level of fibrinogen during pregnancy in the 3rd trimester is 4.95 - 6 g/l. And this is its highest concentration during the entire pregnancy. If the level of fibrinogen is elevated during pregnancy in the 3rd trimester, this can cause premature birth, placental abruption, thrombosis of umbilical cord vessels, preeclampsia, etc.

D-dimers

This is a fibrin breakdown product and components of a blood clot. This analysis is prescribed to all pregnant women, especially with increased fibrinogen concentrations. D-dimer levels in the 3rd trimester will allow you to judge the degree of risk of thrombosis.
Indicators may fluctuate depending on the stage of pregnancy, so in the 3rd trimester, the D-dimer rate should not exceed 1500 ng/l. An increase in its concentration occurs with diabetes mellitus, pathology of the kidneys, liver, gestosis, infections, placental abruption.

The third trimester of pregnancy begins at 25 weeks of gestation and ends with the onset of labor. This stage is the most difficult for a woman. All this time, the expectant mother is under the supervision of a specialist. And a mandatory part of it is passing the necessary tests. Some of them are repeated, others are done for the first time.

If the baby’s health and development are normal, the expectant mother visits the gynecologist twice: at 30-32 and 36 weeks. During this period, the doctor decides what kind of research the woman needs in a particular case.

Mandatory tests

Every woman must undergo mandatory tests in the third trimester of pregnancy. Here is their list:

4. Repeated tests for hepatitis B and C, HIV, syphilis

At 30 and 36 weeks. All of these diseases are very serious and require proper treatment. In its absence, there is a high risk of infection of the child in utero or during childbirth.

Sometimes tests for infections in the third trimester of pregnancy can give false positive results. Therefore, they can be reappointed in this case.

Detection of syphilis in the 3rd trimester is not an indication for termination of pregnancy. The woman is undergoing treatment. In its absence, there is a high risk of stillbirth or miscarriage (about 40%).

Equally important is the analysis of the presence of HIV infection in a pregnant woman. Having information that the expectant mother suffers from this disease, you can protect the child from contact with infection from the woman’s biological fluids. For example, she cannot perform some diagnostic techniques, such as amniocentesis, chorionic villus biopsy, and cordocentesis. The likelihood of transmitting HIV to your baby can be reduced by choosing the right delivery tactics - cesarean section before the amniotic fluid breaks. If the doctor does not have information about the woman's infection, he will not be able to do the right thing.

If the mother has hepatitis B or C, there is a risk of a negative impact of viruses on the development of the embryo, since profound disruption of the liver is often the cause of the development of fetoplacental insufficiency. Therefore, timely treatment will prevent negative consequences. The issue of delivery in this case is decided on an individual basis: natural birth is possible, and sometimes doctors perform a caesarean section.