What Is Gestational Testing?

Pregnancy is typically one of the most exciting times in a mother’s (or soon to be mother’s) life. It can also be one of the most stressful times of uncertainties about the health of the baby are a part of the experience.

There have been many advances in the field of women’s reproductive health and testing over the past fifty years. It wasn’t until the 1970’s that women had access to at-home pregnancy testing. Before then, women who thought they might be pregnant would have to go see their doctor and ask to be tested in his office and they would have to do a urine or blood test there.

Modern over-the-counter pregnancy tests test the female’s urine for the presence of HCG (Human Chorionic Gonadotropin) This hormone should be found in the urine or blood of a recently impregnated woman because it is the chemical responsible for the formation of the placenta. Once pregnancy has been confirmed, there are other tests that mothers-to-be will want to do along the way.

In the first trimester of pregnancy expectant mothers are normally given two types of tests. The first is an ultrasound known as an NT (Nuchal Translucency) scan. This will give the doctor a view of the fluid that develops on the back of a fetus’ skull and neck. If the fluid appears to be too thick, the baby is at higher risk for being born with serious medical conditions.

The second test requires a blood sample from the mother to be and will be inspected for the presence of abnormal levels of HCG and Pregnancy-associated Plasma protein. If the levels of either do not fall within normal range, the developing baby could have a greater chance of having chromosomal irregularity.

If the results of either test are abnormal, the mother may request additional ultrasounds or two of the most invasive tests known as CVS (Chorionic Villus Sampling) and Amniocentesis. CVS requires a sample of material taken from the placenta to be tested. The obstetrician will look at an ultrasound to determine which of two routes to take to get the sample.

The most common way is by sticking a needle through lower abdomen of the mother to get to the placenta. If that isn’t an option, the doctor can insert a tube from the vagina, to scrape away a placental specimen, very similar to having a PAP smear. Amniocentesis can be done at the end of the first trimester and is one the most accurate, but risky ways to test for potential genetic problems in the fetus.

If any of the tests has not been performed already, almost any screening test can be done in the second trimester. By the fifteenth to the twentieth week of pregnancy most, obstetricians will recommend a Maternal Serum Alpha-fetoprotein screening (MSAFP.) This a multiple-marker screening test that also identifies abnormal levels of this particular protein, which could indicate chromosomal irregularities or birth defects.

The multiple marker screening tests that can determine chromosomal abnormalities or potential birth defects include checking for serious health issues such as Down Syndrome, Spina Bifida, Muscular Dystrophy, or Polycystic Kidney Disease.

Blood tests and ultrasounds are typically the only fetal genetic diagnostic tests performed during pregnancy unless a test comes back negative or the pregnancy is considered high risk. A pregnancy may be considered high-risk if the mother is outside of the normal gestational age range of 18-35, has serious medical conditions, is drastically over or under weight, has had a prior miscarriage, or is carrying multiple babies.

These normal screening tests are very accurate, but not perfect. The most reliable results will come from amniocentesis, but it is recommended as a last result to testing. There is a rare but real possibility of harming the fetus since the needle penetrates the amniotic sac that surrounds the baby to retrieve amniotic fluid.

mother and infant

After the baby is born, doctors will usually perform a few tests before sending them home. One common test is the Heel-stick Test. A nurse will prick the newborn’s heel to draw blood for testing of anything that pre-birth examinations may have missed. If anything shows up abnormal, the hospital will contact the parents.  Something that is monitored in the hospital is the Bilirubin level.

Usually, a hearing exam is performed before the mother and newborn are discharged. Either of two methods is usually performed, and can be done while the baby is sleeping.

The Otoacoustic Emission (OAE) test will use a microphone and earphone placed in the baby’s ears to play a sound and identify if there is an echo. If there is no echo detected, the baby has a high risk of hearing deficiency.

The other popular hearing test is the Auditory Brain Stem Response (ABR) test. In this exam, small electrodes are placed on specific areas of the baby’s head and an earphone is placed in each ear. When a sound is played, the doctor will look for the appropriate brain activity for the baby in response to the sounds.

mom and baby

The latest innovations in medical care for unborn and newborn babies is amazing. Parents can now have a better understanding of their child’s health care needs, usually before they are even born!

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