What antenatal tests will you have in pregnancy

From blood tests to ultrasounds, an amniocentesis to scans - are your antenatal screenings safe?

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Given the range of tests and check ups you are offered during your pregnancy, you might be wondering if they are all safe to take – both for you and your baby. To put your mind at ease, we’ve put together a summary of what tests you can expect and what they will be like. Many of the tests are routine and generally very safe but remember, it’s up to you if you want to have the tests.

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Diagnostic tests

Weighing up the risks

“All tests – even the early monitoring of urine and blood pressure – are really important for ruling out bigger things, and highlighting potential risk later down the line,” says independent midwife and nurse Pam Wild. “So it is very important to have them, but also to talk to your doctor or midwife about any worries and fears you might have about them.”

Most of the checks and screenings you will be offered are very safe and will not have any risk associated with them – either for you or your baby, although there are some specific tests such as invasive procedures for Down’s syndrome or genetic conditions do carry a small risk of miscarriage. 

“All the routine antenatal tests are perfectly safe,” says midwife Pam. “But sometimes, psychologically they can seem much more worrying than they actually are.” 

You decide!

Remember, it is always up to you to decide which tests you want to have. You can discuss any questions or concerns with your doctor or midwife, and also with your partner so you can make an informed choice about what is right for you. There will be no fears or anxieties that your midwife will not have heard before! 

Guide to antenatal tests

“It’s completely normal to be worried about every aspect of pregnancy testing,” Pam says. “And your midwife might be able to help minimise the anxiety and help make you more relaxed about certain procedures, perhaps by arranging for some of them – blood tests, blood pressure etc – to be done at home if being in the surgery environment causes you more worry.”

Blood tests

Routine blood tests during your antenatal visits check whether you’re at risk of certain infections or conditions such as anaemia, rhesus disease or diabetes. Blood tests themselves are perfectly safe – there is absolutely no risk to you or your baby just from having the needle in your vein. Fear of blood tests (both the procedure and potential outcomes) is very common! If you are anxious around needles or worried about the results, they can be something of an ordeal. Here are some tips that may help:

  • Always tell the person taking your blood that you are nervous. They will be able to help alleviate your fears and reassure you.
  • Ask to lie down for the sample to be taken if you are worried you might feel faint or dizzy. 
  • If you are very frightened, midwife Pam suggests asking for a local anaesthetic cream to be applied to numb the area before the needle is inserted.

“I used to be terrified of having blood taken, and always went to the hospital for it from choice! I would always take someone in with me and squeeze their hand (not with the arm they’re taking blood from!) and  really concentrate on their friends face. It really helps me.” – MyBs

Blood pressure

Your blood pressure will be measured at all your antenatal appointments. High blood pressure could be a sign of gestational hypertension or pre-eclampsia and will require you to be monitored more closely during your pregnancy. Some people find blood pressure tests a little claustrophobic, and do not like the sensation of having the cuff pumped up around their arm. This in itself can cause anxiety which could even cause your blood pressure to rise! Some mums to be can find the procedure leaves them feeling a little light-headed too – even more so if they are anxious. As always, the advice is to be open about your fears and worries, and let your midwife know you are a little fretful. But as for any risks to you or your baby…none at all! 

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Urine tests

You’ll be asked for a urine sample at all of your antenatal checks. This is to test for protein, albumin and sugar which could impact your pregnancy – for instance, it may be an indication of gestational diabetes or pre-eclampsia. The giving and testing of urine is perfectly safe for both you and your baby; however, there is a chance of bacterial contamination if you don’t do it properly which can affect the results. Some people find them a bit undignified, unhygienic or suffer from performance anxiety. Here’s how to collect a urine sample:

Make sure you use a completely sterile container.Your midwife or the clinic’s front desk should have a stash of sterile sample bottles. 

  • Label the container wiht your name, DOB and the date.
  • Wash your hands.
  • Make sure you collect the mid-stream urine and not the first or last bit as there’s a greater chance of contamination from bacteria on your hands or from the skin around your urethra.
  • Start to urinate but don’t collect the first bit of wee that comes out.
  • Take the urine mid-stream and then screw the lid of the container on securely.
  • Wash your hands.
  • Put the container in a sealed plastic bag.
  • Store it in the fridge if you can’t get it to the surgery within the hour (but for no longer than 24 hours).

If you’re worried about giving a sample at the surgery, you can do it before you leave home as long as your sample is recent.

Ultrasound scans

Ultrasound scans check how your baby is growing and can detect any serious abnormalities. Many parents are most excited at the prospect of seeing their baby on the ultrasound, and look forward to each of their scans. However, some parents choose not to have scans during their pregnancy for various reasons including not wishing to know information about possible abnormalities. So are there any risks to mum or baby from having them? The NHS clearly states that there is ‘no known risk’ from external ultrasound scanning during pregnancy and that they are ‘painless’. You can also have scans to screen for Down Syndrome, which may be part of your dating scan or done separately.

Carolyn3B had a nuchal fold scan and says, “The scan was really good and it was so reassuring to see the baby and for the ultrasound operator to go through from head to toes, but first of all checking the nuchal fold and then looking for a nasal bone.”

Trans-vaginal scans

Some women may have to have an internal (trans-vaginal) scan during early pregnancy, where the scanner probe is put in the vagina to transmit images back to the screen. As this is internal, it can cause some anxiety about discomfort or modesty issues, and some women worry that it could cause bleeding or damage the baby. However, the Miscarriage Association says that there is ‘no evidence that having a vaginal or an abdominal scan will cause a miscarriage or harm your baby. If you bleed after a vaginal scan, it will most likely be because there was already blood pooled higher in the vagina and the probe dislodged it’. The NHS does caution that if you are having an internal scan and you are allergic to latex, you should inform the person doing the test so they can pop a latex-free cover on the probe. 

MFMer Bristol says, “I had a transvaginal scan at 5 weeks and one at 7 weeks. No need to worry at all. Didn’t feel a thing and was good to have reassurance all was ok and I got a scan photo of a little bean which is great to look at now compared to my 20 week scan I had last week.”

While Charrz91 says, “At my dating scan they needed to do an internal scan, which was weird and uncomfortable at first but a much clearer picture of baby.

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Diagnostic tests

If screening tests indicate a higher risk that your baby might have a serious genetic condition, you will be offered diagnostic tests to get a definitive answer. There are two diagnostic tests – CVS (chorionic villus sampling) or an amniocentesis – to test for genetic disorders like Downs Syndrome, or spina bifida and sickle cell anaemia. Both tests do come with a very slight risk of miscarriage, but your midwife and consultants will talk you through all the possible outcomes, and why they think it is important for you to undergo the procedure. Although it can be a very worrying time, it is important to remember that the risk factor for miscarriage arising as a result of the tests are low – 1-2% from CVS, and about 1 in 100 for amniocentesis.

CVS

The CVS test involves removing and testing a small sample of cells from the placenta and can lead to some discomfort. According to the NHS, there can be some risk of infection although severe infection occurs in less than 1 in every 1,000 procedures.

Dinx says of her CVS experience, “It didn’t take long at all. I lay on my back in a scan room – one midwife kept scanning me so the other could do the procedure and check baby wasn’t in the way. It was uncomfortable, but not painful, it just kind of took my breath away a bit – and that was because my placenta was in a difficult position.”

Another MFMer Gbutterfly says, “It was uncomfortable mostly but the worst pain was when they were scraping for a sample. Nothing worse than period pain though.”

Amniocentesis

An amniocentesis has a slightly lower risk of miscarriage and involves inserting a needle inside the belly to take a sample of amniotic fluid. There’s also a less than 1 in 1,000 risk of getting a bacterial infection. 

Little_Buggaroo says, “I had an Amnio (even though it made absolutely no difference to me and my husband whether we would keep the baby) but I just needed to know so I could be prepared. I was ok but did need to rest for a few days but it was a very emotional time.”

MFM mum Smitch76 says, “My consultant was v. experienced and I was his 5th that morning!!! The chance of miscarriage actually drops below 1% if it’s a skilled obs. who has done the procedure. It is not painful as such, but very strange sensation very uncomfortable but bearable.” 

In the end, the risks involved in taking these tests are very small, but a risk is still a risk. You need to weigh up the benefits of the tests against the risks and decide what is the right choice for you. For tests that indicate or identify genetic disorders, you may also want to consider whether knowing if your baby has a genetic condition or not will impact whether you will keep the baby or whether knowing will help you prepare for the birth.

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