First Trimester Tests In Pregnancy

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Overview

Pregnancy is one of the most beautiful phases of a woman’s life. Pregnancy occurs when a sperm fertilizes an egg after it’s released from the ovary during ovulation. The fertilized egg then travels down into the uterus, where implantation occurs. A successful implantation results in pregnancy.

The typical pregnancy has three trimesters and lasts around 40 weeks from the first day of a woman's last period.

What happens during the First Trimester?

The first trimester is the most crucial to the baby's development and lasts from weeks 1 to 12. During this period, the baby's body structure and organ systems develop. Most miscarriages and birth defects also occur during this period.

The women’s body undergoes major changes and these changes often cause a variety of symptoms, including nausea, fatigue, breast tenderness, and frequent urination.

What are the important First Trimester Tests?

First Trimester tests are necessary to determine the risks for the mother and baby and depending upon the expected mother’s age, past history, and health conditions, doctor will recommend various tests at certain intervals. Many conditions confirmed by these tests can be treated during pregnancy.

● Pregnancy Test (hCG): A pregnancy test may be done to confirm that a woman is pregnant. It measures human chorionic gonadotropin (hCG), a hormone that is produced by the placenta when a woman is pregnant. The amount of hCG produced during pregnancy increases steadily during the first trimester of a normal pregnancy. There are two types of blood pregnancy tests:

○ Qualitative hCG test: Qualitative tests can be done on either urine or blood. This type of evaluation checks to identify the presence of hCG. The test is generally taken to confirm pregnancy as early as 10 days after conception.

○ Quantitative hCG test: This pregnancy test measures the precise amount of hCG in the blood. It may help track problems during pregnancy and also rule out an ectopic pregnancy. Ectopic pregnancy is a condition in which a fertilized egg settles and grows in any location other than the inner lining of the uterus.

● Glucose Fasting Test: This simple blood test is done to determine if the expected mother has or is at risk of developing diabetes. High sugar levels during pregnancy can be very harmful to the baby’s health and may cause complications.

● Blood Group ABO and Rh Factor Test: This test identifies Rh type and ABO incompatibility in pregnant women. Rh type is needed during pregnancy to assess the risk of hemolytic disease of the fetus and newborn (HDFN). In this condition, fetal red blood cells are destroyed by antibodies that are formed in the pregnant woman and that are able to cross the placenta into the fetal blood. ABO incompatibility between the pregnant woman and fetus is the most common cause of HDFN.

● 17 - HYDROXYPROGESTERONE: 17-hydroxyprogesterone (17-OHP) is often used as a screening or monitoring tool for patients with Congenital Adrenal Hyperplasia. In some cases, the blood test is ordered as part of a series of tests to rule out certain medical conditions.

● Urine Examination Routine: This test is used to detect a range of medical conditions such as kidney infection, diabetes, and urinary tract infection. It also detects protein, which could indicate the presence of preeclampsia, a pregnancy-induced disease that is accompanied by high blood pressure.

● TORCH Panel: TORCH Panel comprises Toxoplasmosis, Rubella, Cytomegalovirus(CMV), and Herpes Simplex virus (HSV). It is used to screen for certain infectious diseases that can cause birth defects in a baby if the mother contracts them during the pregnancy.

● Thyroid Profile (T3, T4, TSH): This test determines the levels of thyroid hormones. The thyroid gland, which produces thyroid hormones such as thyroxine (T4) and triiodothyronine (T3) are critical to the healthy development of a fetus as well as the health of the mother.

● Maternal Serum Screening Test – Dual Marker(added test name): This test is used to check the levels of two hormones in the mother's blood that change during pregnancy (free Beta hCG and PAPP-A). Changes in these levels can indicate a serious chromosomal condition. This is an effective screening method for the detection of major birth defects such as Down Syndrome, Edwards Syndrome, and Patau Syndrome in the first trimester of pregnancy.

● Ultrasound: First trimester ultrasound examination is done to evaluate the presence, size, and location of the pregnancy, determine the number of fetuses, and estimate gestational age. Ultrasound can also be used for first trimester genetic screening, as well as screening for abnormalities of a woman’s uterus or cervix.

● CBC (Complete Blood Count): This blood test is done in the early stages of pregnancy to determine any health issues a woman may have developed. It monitors the red blood cells that carry oxygen throughout the body and also determines the count of red blood cells, white blood cells, and platelets.

● Test to check Immunity to Rubella: If a woman becomes infected with rubella during the first 3 months of her pregnancy and does not have immunity to the Rubella virus, the baby is at risk of having serious birth defects.

● Human Immunodeficiency Virus (HIV): HIV virus causes AIDS (Acquired Immunodeficiency Syndrome) and can be passed to and infect the baby during pregnancy.

● Tests to check Syphilis and other common sexually transmitted diseases: In a pregnant woman, these diseases can lead to a miscarriage or infect the baby before or during delivery. Hence it is very important to test for sexually transmitted diseases.

● Hepatitis B and Hepatitis C screening: It is important to detect active hepatitis B infections in pregnant women because newborns are especially vulnerable to developing chronic infection. Hepatitis C can also be passed from a mother to her baby in rare cases.

● Calcium, Serum Test - This blood test is done to determine the calcium level in the body. Calcium is essential for the growth of the baby’s bones and teeth. It also helps in the development of the baby’s musculoskeletal, nervous, and circulatory systems. Calcium deficiency has numerous implications in women and may cause a spectrum of diseases.

● Chorionic Villus Sampling: This diagnostic procedure may be recommended to women above the age of 35 years and who have a family history of some specific pregnancy-related diseases. CVS has the ability to diagnose a broad range of genetic defects, including Down Syndrome, muscular dysentery, sickle cell anemia, hemophilia, and cystic fibrosis.