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Pregnancy exams are important for the obstetrician to monitor the baby's development and health, as well as the woman's health, as it directly interferes with pregnancy. Thus, in all consultations, the doctor assesses the pregnant woman's weight, blood pressure and waist circumference, and indicates the performance of some tests, such as blood, urine, gynecological and ultrasound examinations.
In addition, in some cases, especially when the woman is over 35 years of age, the doctor may indicate the performance of other tests, since pregnancy at this age may have more associated risks. For this reason, follow-up is done more frequently and biopsy of the chorionic villus, amniocentesis and cordocentesis can be performed, for example.
Usually, more tests are performed in the first trimester of pregnancy, as it is essential to monitor the health of the woman in the first weeks of pregnancy. From the second trimester of pregnancy, fewer tests are requested, being more directed at monitoring the baby's development.
Main tests in pregnancy
The tests indicated during pregnancy aim to assess the health of the baby and the pregnant woman and check how the baby is developing. In addition, through the exams requested by the obstetrician, it is possible to identify if there are any changes related to the baby or if there are risks during pregnancy or at the time of delivery. The main exams to be performed during pregnancy are:
1. Complete blood count
The blood count aims to provide information about the woman's blood cells, such as red blood cells and platelets, in addition to the body's defense cells that are also identified in this test, the leukocytes. Thus, from the blood count, the doctor can check if there are infections happening and if there are signs of anemia, for example, and the use of supplements may be indicated.
2. Blood type and Rh factor
This blood test is used to check the mother's blood group and the Rh factor, whether it is positive or negative. If the mother has negative Rh factor and the baby positive Rh factor that she inherited from the father, when the baby's blood comes into contact with the mother's, the mother's immune system will produce antibodies against it, which may cause, in a 2nd pregnancy, hemolytic disease of the newborn. Therefore, it is important that this test is done in the first trimester of pregnancy, because, if necessary, precautionary measures can be taken to avoid an exaggerated immune response.
3. Fasting glucose
Fasting glucose is important to check if there is a risk of developing gestational diabetes, and it is important that it is done in both the first and second trimester of pregnancy, and to monitor the treatment and control of diabetes, for example, if the woman is already has been diagnosed.
In addition, between the 24th and 28th weeks of gestation, the doctor can indicate the performance of the TOTG test, also known as an oral glucose tolerance test or examination of the glycemic curve, which is a more specific test for the diagnosis of gestational diabetes. . Understand how TOTG is done.
4. Tests to identify infections
Some infections by viruses, parasites or bacteria can be transmitted to the baby during delivery or interfere with its development, as in some cases they can cross the placenta. In addition, in the case of women having a chronic infectious disease, such as HIV, for example, it is important that the doctor regularly monitors the virus in the body and adjusts the doses of medication, for example.
Thus, the main infections that should be evaluated in exams during pregnancy are:
- Syphilis, which is caused by the bacteria Treponema pallidum, which can be transmitted to the baby during pregnancy or at delivery, resulting in congenital syphilis, which can be characterized by deafness, blindness or neurological problems in the baby. The exam for syphilis is known as VDRL and must be done in the first and second trimester of pregnancy, in addition to the fact that it is important that the woman performs the treatment correctly to avoid transmission to the baby;
- HIV, which can cause Human Immunodeficiency Syndrome, AIDS, and which can be passed on to the baby during delivery. Therefore, it is important that the woman is diagnosed, the viral load is checked and the treatment is adjusted.
- Rubella, which is a disease caused by viruses of the family Rubivirus and that when acquired during pregnancy it can result in malformations of the baby, deafness, changes in the eyes or microcephaly, it is important that tests are carried out to identify the virus during pregnancy;
- Cytomegalovirus, like rubella, cytomegalovirus infection can have consequences for the baby's development, which can happen when the woman has not started the treatment and the virus is able to pass to the baby through the placenta or during delivery. For this reason, it is important that an examination be done to identify cytomegalovirus infection during pregnancy;
- Toxoplasmosis is an infectious disease caused by a parasite that can pose serious risks to the baby when the infection happens in the last trimester of pregnancy and, therefore, it is important that the woman be careful to avoid the infection, as well as perform the exam for start treatment and prevent complications. Learn more about toxoplasmosis in pregnancy;
- Hepatitis B and C, which are infectious diseases caused by viruses that can also be transmitted to the baby, which can cause premature birth or low birth weight baby.
These tests should be done in the first trimester and repeated in the second and / or third trimester of pregnancy, according to the guidance of the obstetrician. In addition, in the third trimester of gestation, between the 35th and the 37th week of pregnancy, it is important that the woman is tested for group B streptococcus, the Streptococcus agalactiae, that a bacterium that is part of the woman's vaginal microbiota, however depending on its quantity can pose a risk to the baby at the time of delivery. See how the test is done to identify group B streptococcus.
5. Examination of urine and urine culture
Urinalysis, also known as EAS, is important to identify urinary tract infection, which is frequent during pregnancy. In addition to the EAS, the doctor also indicates that urine culture is performed, especially if the woman reports symptoms of infection, as from this examination it is possible to identify which microorganism is responsible for the infection and, thus, it is possible for the doctor to indicate the best treatment.
6. Ultrasound
The performance of ultrasound is very important during pregnancy, as it allows the doctor and the woman to monitor the baby's development. Thus, ultrasound can be performed to identify the presence of the embryo, the time of pregnancy and help determine the date of delivery, the baby's heartbeat, position, development and growth of the baby.
The recommendation is that the ultrasound be performed in all trimesters of pregnancy, according to the guidance of the obstetrician. In addition to conventional ultrasound, a morphological ultrasound examination can also be performed, which allows you to see the baby's face and identify diseases. Find out how the morphological ultrasound exam is done.
7. Gynecological exams
In addition to the tests normally indicated by the doctor, gynecological tests may also be recommended in order to assess the intimate region. It may also be recommended to perform the preventive exam, also known as Pap smear, which aims to check the presence of changes in the cervix that may be indicative of cancer, for example. Thus, the performance of these exams is important to prevent complications for women.
Exams for high-risk pregnancies
If the doctor finds that it is a high-risk pregnancy, he may indicate that more tests are carried out in order to assess the level of risk and, thus, indicate measures that can reduce the risk of pregnancy and possible complications for the mother and for the baby. High-risk pregnancies are more common among women over 35 years of age, with a greater likelihood of miscarriage or complications.
This is because because the eggs can undergo some changes that increase the risk of the baby suffering from some genetic syndrome, such as Down Syndrome. However, not all women who became pregnant after 35 years of age have complications during pregnancy, childbirth or postpartum, the risk being greater among women who are obese, diabetic or who smoke.
Some of the tests that can be indicated by the doctor are:
- Fetal biochemical profile, which serves to help in the diagnosis of genetic diseases in the baby;
- Biopsy of the chorionic villus and / or fetal karyotype, which serves to diagnose genetic diseases;
- Fetal echocardiogram and electrocardiogram, which assesses the functioning of the baby's heart and is usually indicated when a cardiac abnormality has been detected in the baby through previous tests;
- MAPA, which is indicated for hypertensive women, to check the risk of pre-eclampsia;
- Amniocentesis, which serves to detect genetic diseases, such as Down syndrome and infections, such as toxoplasmosis, rubella, cytomegalovirus. It must be performed between the 15th and 18th week of pregnancy;
- Cordocentesis, also known as a fetal blood sample, serves to detect any chromosomal deficiency in the baby or suspected rubella contamination and late toxoplasmosis in pregnancy;
Performing these tests is important because it helps to diagnose important changes that can be treated so that they do not affect the development of the fetus. However, despite all the tests, there are diseases and syndromes that are only discovered after the baby is born.