As you begin care with Kathy, you will be given opportunities to discuss options for a wide variety of prenatal screening that is currently available through the standard medical maternity model of care. Most tests or procedures that are available to pregnant women today carry with them likelihoods for further testing, treatments, or interventions that we will encourage you to consider prior to making your decisions. Risks and benefits usually exist for the choice to test or treat a condition as well as the choice to decline testing or treatment. Our goal is to provide you with all the information you need to make an informed decision that makes sense or is appropriate for you and your baby.

 

Lab Work (OB Panel)

Basic laboratory work-ups can be elaborate, expensive, and sometimes unnecessary. It is important to understand why every test is done, to determine your individual needs or risk factors.

•  Complete blood count (CBC): A complete blood count includes a red blood count, white blood count, differential (counts different types of white cells), hemoglobin, hematocrit, and platelet count. It is done to rule out anemia and infection and other hidden problems in the mother.

•  Blood type and Rh factor with antibody screen. When a mother is Rh negative and the baby is Rh positive there is a slight chance that a blood transfer could take place during pregnancy or at birth which could negatively affect subsequent pregnancies. Because of this possibility a RhoGAM shot is administered after any miscarriage or birth. In recent years, RhoGAM has also been given at 28 weeks gestation (in addition to after the birth or miscarriage), although it has not been proven safe for the unborn child. Parents should also be aware that RhoGAM is a blood product.

•  Rubella/German measles: If a previously unexposed woman contracts rubella in pregnancy, the effects on the unborn child can be devastating. If the mother has already had the disease, she is protected with lifetime immunity. If she was immunized before, she may or may not be immune and needs to be checked during each pregnancy. If she has lost her immunity she should take precautions during pregnancy (e.g. avoid working in nurseries, avoid changing the diapers of children recently immunized) and she should be immunized again after the pregnancy. A titer screen can determine if she has either the immunity or a primary infection.

•  Hepatitis B: You are at risk for contracting this disease if you have a history of STDs, immorality, tattoos, working in a medical environment, blood transfusions, infection in a family member, drug use, prison, previous liver disease, or ingested contaminated foods. The incubation is 6–26 weeks.

•  Syphilis: This is a sexually transmitted disease and testing is not necessary if you and your spouse have been morally pure. You are at a greater risk of contracting syphilis if you have the HIV virus or another STD, or have had past blood transfusions or drug use. This test is required by law in most states, but you can sign a waiver.

•  Human immunodeficiency virus (HIV): Risk factors are same as for hepatitis.

•  Liver and Chemistry profile: This test is often done early in pregnancy to give a basis for evaluation should problems arise in the future (i.e. pre-eclampsia). It can be done if symptoms arise later in pregnancy.
Tuberculosis Screening: The need for this test depends on individual risk factors such as the countries you have lived in or visited. Asia, Mexico, Central America are countries at high risk.