Prenatal Blood Tests on Your First Visit

First visit prenatal tests

Most people associate the word "pregnancy test" with an initial test to check if you are pregnant or not, either a urine or a blood test. However, there are many more tests done during pregnancy, once you know that you are pregnant.  As part of routine prenatal care, certain blood and other tests are usually done, some routinely, others based on your history. These tests are done to detect certain conditions and to decide whether you need additional tests or whether treatment is indicated. For example, some tests detect sexually transmitted diseases that could affect the fetus and baby if untreated. Below is a list of tests done during pregnancy: 

  • Urine Pregnancy Test - Checks for the presence of the pregnancy hormone hCG in your urine
  • Blood Pregnancy Test - Checks for the presence of the pregnancy hormone hCG in your blood
  • Complete Red Cell Blood Count (CBC) - Checks for anemia, blood diseases, platelet count
  • Blood Type - A mother is either O, A, B, or AB
  • Rh-Factor - The test shows that the Rh-factor is either positive or negative. A mother's negative Rh Factor may be a problem if she develops antibodies against the baby's red cells
  • Antibody (Coombs test) - Certain antibodies like Rh (Rhesus) or Kell antibodies can harm the fetus
  • Hemoglobin electrophoresis - Tests for abnormal hemoglobins associated with genetic conditions  (eg sickle cell, thalassemia) 
  • Hepatitis B antigen - If there is Hepatitis B antigen present then the baby can become infected at birth. If you have HepB antibody then you are immune. Getting immunization against HepB prevents an infection.
  • Hepatitis C screening - This is the newest recommendation by the CDC.
  • Syphilis screen - Syphilis is a sexually transmitted disease that can harm the mother and can infect the fetus. It can be treated with antibiotics to prevent fetal and newborn infection
  • HIV screen - HIV can be treated in pregnancy to prevent the baby from becoming infected
  • Rubella (German measles) - A positive test shows that the mother is immune against rubella
  • Varicella (Chickenpox) antibody - A positive test shows immunity against varicella unless you recently had chickenpox in which case it shows a recent infection.
  • Genetic screen - Testing for Cystic Fibrosis is done routinely. Other tests are done for patients in certain ethnic groups
  • Rubeola (measles) antibody - A positive test shows immunity
  • Fifth Disease (parvovirus antibody) (optional) - A positive test shows immunity
  • Toxoplasma antibody (optional)  - A positive toxoplasmosis test shows either partial immunity or a new infection. A new infection is more likely if the toxoplasma IgM is also positive in addition to the toxoplasma IGG 
  • Cytomegalovirus (CMV) antibody (optional) - A positive test shows partial immunity 
  • Urine test for protein, ketones, leukocytes, urine culture - Tests are usually done by dipping a test strip into the urine. In addition, urine is also often sent to the laboratory for culture for bacteria. Treatment is indicated if tests are abnormal
  • Pap (Papanicolaou) cervix smear - An abnormal pap smear result needs to be further evaluated
  • Cervix or urine screen for Gonorrhea and Chlamydia - Gonorrhea and Chlamydia infections can be treated with antibiotics
  • Tuberculosis (PPD) screen (if at risk) - Tuberculosis testing and treatment is important
  • Early first visit ultrasound - Determines pregnancy viability; checks position and location of pregnancy; measures gestational age and determines the due date
  • Cell-free DNA test - Done from mother's blood as early as 9 weeks to screen for chromosomal anomalies in the fetus 

Read More:
What Happens at Your First Prenatal Appointment?
Laboratory Values During Pregnancy