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Pregnancy - prenatal tests

Summary

The different kinds of tests available to pregnant women include tests to confirm pregnancy, pregnancy screening tests such as ultrasound to check the baby's health, and pregnancy diagnostic tests such as chorionic villus sampling.

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A range of tests are available if you are pregnant. These tests can confirm your pregnancy and also monitor your baby’s development in the womb. No medical test is ever 100 per cent accurate, but most pregnancy tests are very reliable.

Regular check-ups with your doctor and/or midwife are an important part of pregnancy care, including information and advice about what tests you and your baby will need.

The different kinds of tests available to pregnant women include:

  • Tests to confirm pregnancy
  • Routine pregnancy screening tests
  • Pregnancy diagnostic tests – for pregnancies at increased risk.

Tests to confirm pregnancy


A missed menstrual period is usually the first sign of pregnancy. Tests to confirm pregnancy detect a pregnancy hormone called human chorionic gonadotropin (βhCG). The various tests include:
  • Home test kit – these are available from pharmacies. A typical kit includes special paper that is sensitive to the presence of βhCG in urine. It is important to use a home test kit according to the manufacturer’s instructions or false results can occur. Always confirm your results with your doctor. Pregnancy tests taken by your doctor are rarely inaccurate.
  • Urine test at the doctor’s office – the doctor can test your urine for βhCG.
  • Blood test – a test of the βhCG levels in your blood can be accurate within one week or so of conception.

Pregnancy screening tests


Pregnancy care involves regular appointments with your doctor or midwife to monitor your pregnancy and the baby’s growth. Care includes pregnancy screening tests that check on the health of both you and your baby, and help to identify any problems with the pregnancy.

Pregnancy screening tests may include:
  • Routine blood tests at different stages of the pregnancy, such as blood group, iron levels, checks for maternal diabetes and infections
  • Ultrasound (first trimester) – a painless, non-invasive scan done within the first three months of pregnancy. This can be used to confirm the number of babies and helps to calculate the date you are due to give birth. This is known as your estimated due date
  • Nuchal translucency test – this test is performed during the first trimester ultrasound. A measurement is taken of the baby’s nape (back) of the neck. A larger than normal measurement may suggest Down syndrome, but further tests would be required to confirm this.
  • Ultrasound (second trimester) – this is usually performed between 18 and 20 weeks. It is used to check the baby’s development, and monitor the size and location of the placenta. The baby’s sex can often be determined (if you wish to know), however it is important to note this may not be 100% accurate.
  • Ultrasound (third trimester) – in the last three months of pregnancy, an ultrasound may be offered to check the baby’s growth, fluid levels around the baby and the positioning of the placenta.
  • Maternal serum screening test (MSST) – a blood test that helps to determine the risk of some defects that may affect your unborn baby, such as Down syndrome or neural tube defects such as spina bifida. The MSST can be done in the first or second trimester.

Diagnostic tests for pregnancies at increased risk


Some pregnancies are at increased risk of problems. For example, there may be a family history of an inherited disorder or the mother may be older or may have already given birth to a baby with chromosomal or other disorders. In other cases, the pregnancy screening tests may have picked up an abnormality. Some tests may be invasive and carry a small risk of complications including miscarriage.

Test options include:
  • Ultrasound – may be used to check the health of the baby in the case of unusual pregnancy symptoms, such as vaginal bleeding or lack of fetal movement.
  • Chorionic villus sampling (CVS) – a test that checks the baby for genetic or metabolic abnormalities. The placenta is made of the same cells as the baby, so testing a small sample of placenta also tests the baby. To harvest the sample, the doctor inserts a slender needle through your abdomen. The tissue (chorionic villi) is then examined in a laboratory.
  • Amniocentesis – the doctor may offer this test if your CVS results are unclear. The doctor inserts a slender needle through your abdomen and withdraws a small amount of amniotic fluid. The needle is guided with the help of ultrasound. The fluid sample contains cells, which are then examined for chromosomal abnormalities.

Making the decision for further testing


About one woman in 20 is told that there may be something a complication in her pregnancy. The decision to have further tests to confirm the abnormality is up to you and your family after discussion with your doctor and/or midwife.

Tests for a higher risk pregnancy may be worthwhile even if you have already decided against termination. For example:
  • Certain abnormalities may be surgically corrected while the baby is still in the uterus.
  • You and your baby may need specialist care before, during and after at the birth
  • Knowing in advance that the baby has particular special needs will give you time to prepare for the life changes you and family must face.

Where to get help

  • Doctor
  • Midwife
  • Obstetrician
  • Paediatrician
  • Local hospital/maternity service
  • Pharmacist
  • Family planning clinic
  • Family Planning Victoria Tel. (03) 9257 0100 or 1800 013 952
  • The Maternal and Child Health Line (24 hours, 7 days) Tel. 132 229
  • NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
  • Genetic Health Services Victoria, Royal Children’s Hospital Tel. (03) 8341 6200
  • Genetic counselling services – available at most large public maternity hospitals.

Things to remember

  • A range of tests is available to pregnant women, including tests to confirm pregnancy, pregnancy screening tests and pregnancy diagnostic tests.
  • Tests to confirm pregnancy check for the presence of a pregnancy hormone called human chorionic gonadotropin (hCG).
  • It is important to note that pregnancy diagnostic tests for higher risk pregnancies are sometimes invasive and carry a small risk of complications including miscarriage.

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Fact sheet currently being reviewed.
Last reviewed: February 2012

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The different kinds of tests available to pregnant women include tests to confirm pregnancy, pregnancy screening tests such as ultrasound to check the baby's health, and pregnancy diagnostic tests such as chorionic villus sampling.



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