Prenatal care is one of the most widely and often utilized health care services to improve pregnancy outcomes in the U.S. Over 18 million prenatal health care visits happened in 2015 alone. A central part of this is prenatal testing.
What is prenatal testing, and how does it affect outcomes? Keep reading to learn how to promote prenatal health and empower your well-being.
What Is Prenatal Health Care?
Prenatal health care is an umbrella term covering multiple areas of medical treatment, checkups. It tests a person undergoes as soon as they become pregnant or believe they might be pregnant. The initial steps taken during the first 13 weeks, or the first trimester, often includes scheduling the first of multiple prenatal care checkups.
You can schedule these checkups with:
- A trusted family doctor or your general physician
- An OB/GYN (obstetrician or gynecologist) who specializes in reproductive health, pregnancy, prenatal care, and childbirth
- An OB with training in maternal-fetal medicine if you are predisposed to a high-risk pregnancy
- A certified midwife who is an advanced practice registered nurse that specializes in prenatal treatment, pregnancy, childbirth, and postpartum care
Whenever you consider seeing a new healthcare provider, consider your options and your needs. For example, is there anything in your medical history that could put you at risk for complications? Are you looking for someone to discuss prenatal genetic testing with?
Prenatal health care helps you have a pregnancy that is healthy and full-term. Your appointments will likely be more frequent in the first few weeks and near your due date. These checkups will repeat regularly to:
- Monitor fetal development
- Check your vitals
- Conduct tests
- Administer medications or vaccines
Risk Factors for Prenatal Health Issues
Many aspects of life can put a person at high risk for complications during pregnancy or childbirth. Some risk factors for prenatal health issues are environmental, such as exposure to endocrine-disrupting chemicals (EDCs). EDCs cause issues with the body's normal functions and hormone signaling.
EDCs are found in:
- Cigarette smoke
- Air pollution
- Pesticides and herbicides
- BPA
- Phthalates
- Industrial products and waste
Fetuses exposed to EDCs are potentially at risk for poor outcomes or later-onset thyroid dysfunction. Levels of endocrine-disrupting chemicals can be measured in urine and fetal tube blood. However, the actual threat is still unknown.
Several pregnancy-related health issues can lead to complications, miscarriage, or stillbirth. Examples of these conditions include:
- Gestational diabetes mellitus (GDM)
- Hyperthyroidism
- Hypothyroidism
- Poorly managed asthma
- Folate deficiency
- Heart disorders
- Blood disorders
Pre-eclampsia (high blood pressure)Outcomes associated with pregnancy-related health issues are:
- Placental abnormalities
- Premature delivery
- Low birth weight
- Macrosomia
- Facial deformities
- Fetal growth restriction (FGR)
Issues that Can Occur Affecting Prenatal Health
Another pregnancy-related health issue, folate deficiency, which is especially impactful during the first trimester, can lead to neural tube birth defects (NTDs) such as anencephaly or spina bifida. However, if folate deficiency or other pregnancy-related health issues are recognized early enough, you can receive treatment or make changes that lower the risk.
In 1998, the U.S. Food and Drug Administration (FDA) made changes that required manufacturers to fortify foods with 140 mcg folate to lower the risk of NTDs. Such food products include:
- Cornmeal
- Bread
- Flours
- Cereals
- Pasta
- Rice
- Various grain products
A pregnant person may not get enough folate through diet alone and have to rely on prenatal supplements. The change in folate fortification leads to a decrease of neural tube defects by 50 percent in the U.S.
In addition to folate deficiency, a pregnant person is more likely to develop an iron deficiency or anemia. This is because a pregnant body must produce more blood to support the fetus, and the body may not be able to produce enough red blood cells. Iron is necessary for creating more red blood cells and staying healthy.
What Are the Signs and Symptoms of Issues that Can Occur with Prenatal Health Issues?
Conditions affecting your health or the health of the fetus may not always show symptoms, but experienced doctors can typically see the signs. Signs and symptoms of potential issues include:
- Bleeding, itching, or vaginal leakage
- Severe pain in stomach or back
- Blurry vision
- Recurrent or intense headaches
- Rash
- Excessive vomiting or nausea
- Fever above 101F
- Painful urination
- Swelling on one side of the body
Signs of dangerous conditions like ectopic pregnancy, when the fertilized egg develops outside of the uterus, may become apparent a few weeks in. The first symptoms are vaginal bleeding or spotting, pain in the pelvis, cramps, nausea, and pain in your neck or shoulder. It can be confirmed with a pelvic exam and an ultrasound.
Additionally, lab tests can check hCG levels. In the first trimester, hCG blood levels should double every few days. Abnormal hCG results could point to an ectopic pregnancy.
In later trimesters, your doctor may monitor fetal movement. Fetal movement count or kick count tests start around 20 weeks in. Your doctor will ask for you to feel for how often the fetus kicks.
You will keep track of the amount of time it takes to feel ten kicks or movements. Ten movements within one hour are typical.
The Lab Tests to Screen, Diagnose, and Monitor Prenatal Health Issues
Prenatal tests are regular procedures done to check on the health of you and the fetus and to detect congenital anomalies. Some tests are often repeated several times throughout the pregnancy. Here are some examples of routine prenatal tests:
Blood pressure: Regular blood pressure monitoring is essential for preventing or treating pre-eclampsia and the damage it causes.
Urinalysis: This test checks your urine for infections, proteins, and glucose levels.
hCG Total: hCG stands for human chorionic gonadotropin, a hormone that becomes detectable in the blood in the very early stages of pregnancy. Initial hCG testing checks for any amount of hCG to confirm pregnancy. Subsequent screenings track levels and totals to help track development and detect potential complications or signs of a miscarriage.
Complete Blood Count: A CBC is a specific blood test that assesses the body's three primary blood cell types: white blood cells, red blood cells, and platelets. CBC panels are run as early as possible, ideally before conception, to look for signs of anemia, infection, or blood clotting issues.
Blood Typing (ABO Group and Rh Type) Tests: You will have routine checks for infections, organ function, and hormone levels. Additionally, you may be tested to find out your blood type: A, B, AB, or O and your Rh factor—a compound present on the red blood cells of some people. You are either Rh-positive or Rh-negative.
Understanding this is crucial because if you are Rh-negative with an Rh-positive fetus, both of you are at risk for hemolytic disease. To help prevent dangerous or fatal consequences, the drug RhoGAM is given to suppress the immune response that leads to hemolytic shock.
Other routine tests include tracking your weight. These screenings often happen once (and usually during your first trimester):
Genetic Carrier Screening Tests: This test looks at samples of your saliva or blood for genetic markers indicating you are a carrier of genetic conditions that can affect your fetus. Carriers are unaffected but pass on the faulty genes. This is conducted before or in the first trimester.
Noninvasive Prenatal Testing: This test finds traces of fetal DNA in your blood. The fetal DNA is tested for genetic conditions like trisomy 13, trisomy 18, and trisomy 21 (Down syndrome). The results are typically accurate but not indisputable.
Measles, Mumps, and Rubella: These are highly infectious diseases that pose a serious risk to fetal health and development. Immunity testing is best done before becoming pregnant. Otherwise, this will be a part of your first prenatal checkup.
TSH: Thyroid-stimulating hormone level testing occurs in the first trimester. Your prenatal healthcare provider will advise you on whether you need regular screenings. Those with hypothyroidism receive tests monthly until their 3rd trimester.
Varicella-Zoster Virus: VZV is responsible for chickenpox and shingles infections. While chickenpox infections usually infect children who become immune, the virus can re-emerge as shingles later in life. Testing for VZV antibodies early on is necessary as the germ can cross the placenta and cause fetal defects or sickness.
Some screening tests are conducted later in pregnancy. These occur during the second or third trimester:
Chorionic Villus Sampling: Chorionic villus sampling (CVS) takes a sample of placenta tissue to test for genetic disorders. It is invasive, and potential side effects include cramping, bleeding, infection, preterm labor, and in rare cases, limb defects. This may happen late into the first trimester or early into the second.
Amniocentesis: Similar to a CVS, amniocentesis tests amniotic fluid for lung development and infections. This screening tool can specifically uncover possible genetic conditions like chromosomal disorders, Tay-Sachs disease, muscular dystrophy, and cystic fibrosis. It is commonly run in the second or third trimester.
Sexually Transmitted Infections (STIs)
STIs, such as HIV, gonorrhea, chlamydia, syphilis, hepatitis B and C, have pronounced consequences on pregnancy. Silent infections may lay dormant for years without symptoms. Proceeding with pregnancy with an untreated STI sharply increases the risk of miscarriage, stillbirth, early delivery, SIDS, brain damage, meningitis, and cirrhosis.
While you may deny routine testing of STIs in some areas of the country, screening is strongly recommended, at least during the first trimester. Subsequent tests are advisable for those at a higher risk.
Gestational Diabetes Mellitus
There are two common laboratory tests for gestational diabetes mellitus (GDM). The first test is run in the early weeks of pregnancy:
Hemoglobin A1c: By checking hemoglobin A1c levels in the first trimester, it is potentially easier to predict GDM before it happens. Those with A1c levels in the "prediabetic" range will need regular blood glucose checks and monitoring.
As you hit milestones in your pregnancy and make it past the second trimester, your chance of developing GDM rises. The placenta secretes necessary hormones that have an adverse effect in some, impacting how your body uses insulin.
Blood Glucose: The first type of blood glucose test takes place over the span of an hour. You will ingest a drink high in glucose and have your blood glucose levels checked in one hour. By comparing these results to prior levels, a doctor gauges your risk of GDM.
A glucose challenge test followed by a two-hour glucose tolerance are methods for screening pregnant people and diagnosing GDM. This type of diabetes increases the risk of complications like premature birth, birth injury, respiratory distress syndrome, jaundice, and the need for a cesarean section. You are at a higher risk for GDM if:
- You are older than 25
- You have had GDM before
- You have PCOS, hormonal imbalances, high blood pressure, or heart disease
- You are prediabetic
- You have a BMI of 25 or higher
- You have a family history of diabetes
Your prenatal care provider can help identify what tests are right for you.
Frequently Asked Questions About Prenatal Health and Lab Testing for Prenatal Health
Prenatal lab testing helps parents-to-be understand whether their fetus is at risk for birth defects or genetic conditions. Here are some frequently asked questions about prenatal testing and their answers.
Why Do People Get Prenatal Tests?
Your prenatal healthcare provider may recommend screening or diagnostic tests during different trimesters to monitor your health and the development of the fetus. The types of tests may depend on your age, health, medical history, and other factors.
How Do I Get a Prenatal Test?
Ulta Lab Tests offers over 1,000 lab tests and a variety of wellness panels. You can order our tests online, have your blood drawn at a participating patient service center, and review your results online.
What Do I Do with the Results?
Regardless of whether your test results come back within normal ranges or contain abnormalities, we strongly urge you to see your doctor. In the case of prenatal care, you need to work with a specialist to understand the next best steps. Using your test results, a physician can provide you with an official diagnosis.
Prenatal Testing with Ulta Lab Tests
Several factors, many of which are out of your control, impact your health and the health of your fetus. Help yourself with prenatal testing and by working with a trusted medical professional.
Ulta Lab Tests offers tests that are accurate and reliable. You will get secure, confidential results without insurance or a referral at affordable prices when you order your testing with Ulta Lab Tests. You can order your comprehensive obstetric and prenatal lab tests and receive your results online within 24 to 48 hours for most tests.
Take control of your health with Ulta Lab Tests today!
