Patient Resources

Procedures Performed During Your Pregnancy

At either your first or second OB visit you will begin having your routine OB lab work.  This will include a urine culture, cultures for Chlamydia & Gonorrhea, a Pap smear, and blood work. This blood work will include your blood type, antibody screen, a complete blood count, immunity to German Measles, a screen for Syphilis, HIV and Hepatitis B.  If you are African-American, you will be tested for Sickle Cell anemia (if there is no previous history of this test having already been done ).  You will also be given information concerning Cystic Fibrosis screening.  Your doctor will review this information with you.  Should you desire this testing, the blood work may be drawn as soon as you decide.

During your first trimester of pregnancy your doctor will review information with you regarding 1st trimester screening for genetic defects (Down’s syndrome, Trisomy 18).  This screening is an ultrasound done in conjunction with a very specific blood test.  The two combined will give the risk ratio for these genetic occurrences.  (Remember, this is only a screening test.)  If your result puts you at an increased risk your physician will discuss the possibility of further testing.

Between 16-18 weeks of pregnancy your doctor may recommend the Alpha-Fetoprotein (AFP)/Triple screen.  This blood test helps to identify neural tube defects (defects involving the development of the baby’s brain and spine).  If you have elected to have the 1st trimester screening this test may not be necessary.  Your doctor will discuss this with you.

Between 18-22 weeks you will have your OB ultrasound.  Please remember to schedule this appointment IN ADDITION to your routine monthly OB visit.  While we will gladly provide you with ultrasound pictures after your visit, we do not videotape the ultrasound. This ultrasound is considered routine and is done to assess all of the fetal organs and diagnostic measurements will be taken.  If you are asked to return for an additional ultrasound do not be alarmed, sometimes the baby will just not position themselves where every area can be evaluated!

At 27 weeks you will be screened for Gestational Diabetes.  This test involves drinking a measured amount of a glucose drink.  After 1 hour your blood sugar will be checked.  Your hematocrit (anemia screen) will be tested at this time also.  You do NOT need to be fasting for this procedure. You may eat a regular diet, but do try to avoid sweets the day before and the day of your test.  At this time you will also be screened again for HIV (as required by law).  If your blood type is Rh negative you will have another antibody screen drawn at this time as well.  Please plan to return to the office 2 days after this antibody screen for your Rhogam injection.  Depending on your insurance plan, this testing will either be done in our office or an outside reference lab. The nurse will give you written information regarding where your test will be performed.

Between 29-30 weeks of pregnancy you will have the opportunity to schedule a “Bonding Ultrasound”.  This ultrasound is completely elective and done just for fun.  Since this is just for fun we do not file insurance and the cost is $200.  Your sonographer will give you additional information on this 4-D ultrasound but basically it is a 30 minute scan of your baby for you and others you invite to watch your unborn baby in motion!

Finally, at 35 weeks you may be screened for Group B Streptococcus (GBS).  If you were treated for GBS early in your pregnancy as detected by the urine culture results you will not have this screen.  GBS is a bacteria that is sometimes found in the reproductive tracts of women and can possibly be passed to the baby during delivery.  The screen consists simply of a vaginal culture done in conjunction with your routine pelvic exam.  If this result is positive (or your urine culture was positive), your doctor will advise you of precautions that will be taken during labor including intravenous antibiotics.  

Screening Tests Due at 27 Weeks Gestation

You will have your testing done in our office.  They may be scheduled at one of the following times:

• Regular monthly OB visit: When our office assistant instructs you when the appropriate time of screening is due you may have this testing done at your regular monthly visit.  You will be in our office for at least one hour, so please schedule this visit prior to 2:30 P.M. to insure that adequate time is allotted for these tests.

• Lab only appointment: If it is more convenient or your regular OB visit does not occur during this time period you may schedule a lab only appointment.  During this visit, you will not see your physician; our lab personnel will administer the testing.

You will be given the results of your tests and recommendations prior to leaving our office.

Hematocrit -  This blood test evaluates for the possibility of anemia.  Certain levels of anemia are not uncommon during pregnancy.  Your physician may recommend adding an iron supplement along with your prenatal vitamins if this count is low.  

HIV -  During the 3rd trimester an additional screening test is required by law.

Antibody Screen - If your blood type is RH Negative (and your spouse is RH Positive) you will be screened to evaluate for the possibility of RH incompatibility.  The Rhogam injection that protects against this will need to be given within 2 days after this test is drawn.  Please contact our office to make an appointment for this injection to be given.  Since this 2 day window is necessary, your testing should be done on a Monday, Tuesday, or Wednesday.

Modified Glucose Testing -  This blood test screens for the possibility of gestational diabetes.  

• It is not necessary to be fasting for this test to be performed.  Any food/drinks that are ingested prior to testing should be low in sugar, carbohydrates are okay.
• You will be at the laboratory for at least one hour.  You will be given a controlled amount of glucose to drink.  This should be consumed within a 5-minute period.  One hour after beginning the glucose drink, your blood specimen will be collected.  During this hour, it is best for you to sit quietly because excessive movement may cause the blood sugar to elevate.
• Our office should receive these results within one week.  If the blood sugar level is 140 or greater, you will be instructed to have further testing done.  A full glucose tolerance test would then be necessary. 

Full Glucose Tolerance Test - This is the definitive test that will evaluate for gestational diabetes.  You will be in our office for at least 3 hours.  You should sit quietly for the duration of the test because excessive movement may cause blood sugar to elevate.

1. Schedule a lab only, morning appointment. 
2. Follow 2000 calorie diabetic diet for 3 days prior to test.
3. Do not eat or drink anything (except water) after 9:00 P.M. the night prior to testing.  You must be fasting to begin this test!
4. Remember to take your laboratory request form with you!
5. Upon admission to the lab, a fasting blood sugar will be checked.  You will then be given a measured amount of glucose to drink.  This drink should be consumed within a 5-minute time span.  From the time you began drinking the glucose, your blood sugar will be checked at 1 hour, 2 hours and 3-hour intervals.
6. Call our office within one week if one of our nurses has not already contacted you for these results.
   
   Gestational Diabetes 2,000 Calorie Diet/Meal Planning Guide