Tests During Pregnancy
Pregnancy involves a lot of tests, not only to find out right at the start whether you are really pregnant or not but also to check your health, and your baby's health, throughout your pregnancy. The results are entered on your antenatal notes, which you will probably be asked to carry with you. It can therefore be helpful to know what the results mean.
Pregnancy test kits are readily available in supermarkets or chemists. They often come in a double pack so that you can do a repeat test a few days later if the result is negative but your period is overdue.Tests nowadays are more than 99 per cent accurate if used correctly.
Some tests can be used from the day your period is due; these detect human chorionic gonadotrophin (HCG) in your urine; this hormone is produced by the embryo. However, you need to be sure when your period is due. If you have conceived a few days later than you thought, this will affect the point at which the test will show positive, which will be 2 weeks following conception. A positive result is nearly always correct, whereas a negative result may need checking.
It is also possible to go to your family planning clinic, doctor or midwife for a pregnancy test. HCG in a urine or blood sample will indicate that you are pregnant.
Throughout your pregnancy your midwife or doctor, who will be monitoring the wellbeing of you and your baby, will see you regularly. The first check will usually be the longest because your midwife will need to take details of your medical, obstetric and family history and current circumstances. At the first visit you will be weighed and you will be given a series of checks during later visits.
You will also get the opportunity to ask questions, for example, about the availability of antenatal classes or how to get comfortable at night. The midwife or doctor will give you general advice on health, for example, diet and exercise, and take blood tests as necessary.
Understanding antenatal notes
At each visit, the details of your check-up will be recorded in your notes. You may be given many of these to carry with you, so that you can present them at other check-ups. You will obviously read them so it is useful to understand what the tests are for, what they involve and how to interpret the results.
You will be advised to have blood tests that check what blood group you are, and if any antibodies are present in your blood. They will also check whether you're immune to rubella, and will check for hepatitis and syphillis. Your haemoglobin will be checked to see whether you have anaemia. Some screening tests will also be offered to you as well as an HIV test.
High blood pressure (hypertension) can affect the growth of your baby and can also develop into a life-threatening condition called eclampsia, which is one of the reasons for checking your blood pressure at every visit. Approximately 10 per cent of women develop pre-eclampsia during their pregnancy but, with careful monitoring, it does not become a problem.
You should take a urine sample to every check-up, where it will be tested for: Sugar which can show up if you have recently consumed a lot of sugary foods or drinks. It can also be a sign of diabetes.
Protein which can be a sign of pre eclampsia when accompanied by a rise in blood pressure or oedema. It can also sometimes be a sign of an infection.
Ketones which indicate that your body is short of sugar. These are often found in women who have severe pregnancy sickness.
The results may be entered on your notes as NAD (nothing abnormal detected), or trace or + (meaning that small amounts of the substance are present).
Your midwife will ask if you have any swelling, although a certain amount of swelling around the feet and hands is normal, particularly towards the end of your pregnancy. If you have no other signs of pre-eclampsia, such as high blood pressure or protein in your urine, there is no need to worry.
Position and presentation
This refers to the way your baby is lying in the uterus and which way up he is. Results are shown as Ceph. (or VX), meaning head down; Br., meaning breech; orTr., meaning transverse, or lying sideways across the uterus.
Fundus refers to the height of your uterus. If you are 28 weeks pregnant and the midwife feels that the growth of your baby is right for the gestation, she will write: = dates, or = 28 weeks. 'Weeks' refers to the duration of your pregnancy on the day of your check.
The midwife will examine you and listen to the fetal heart using a hand-held Doppler or a pinnard, which looks like an ear trumpet. She will record the results as FMF (meaning fetal movements felt) and FHHR (meaning fetal heart heard and regular).
Relation to the brim
Towards the end of your pregnancy the midwife will record how much of your baby's head can still be felt above the brim of the pelvis and how much has descended into the pelvis. This is expressed in terms of fifths (see left). With a first baby, the head usually engages before labour starts, and this can happen at any time from six weeks beforehand. With subsequent pregnancies this often doesn't happen until the contractions are established.