Perinatal Testing Options

The following are standards of care in the field of obstetrics; they are not all required tests by any means. The practice at Beautiful One Midwifery is to obtain the initial routine prenatal blood test described below, which includes HIV testing unless you decline. Please discuss the testing in which you are interested with your midwife. We will give you information regarding the various tests and provide the testing you desire. When a test or procedure is required by California law (such as eye treatment of the newborn), you may sign a refusal form if you wish. If you have further questions, please ask.

 

1st Trimester

  1. Routine Prenatal Blood Testing:

    • Antibody Screen

    • Blood type (A,B,O) and Rh factor (positive or negative)

    • Complete Blood Count (CBC) – includes the following:

      • WBC (to check for infection or abnormalities)

      • RBC (red blood cells)

      • HGB (Hemoglobin – the oxygen-carrying pigment in RBCs; detects anemia)

      • HCT (Hematocrit – determines proportion of RBCs to plasma; detects anemia)

      • HCV (Mean Corpuscular Volume – indicates average size of red blood cell)

      • MCH (Mean Corpuscular Hemoglobin – indicates average amount of Hgb per cell)

      • MCHC (Mean corpuscular Hemoglobin Concentration- amount of Hgb per cell relative to cell size)

      • PLATELETS (determines ability of clotting)

    • Hepatitis B Screen

    • Hepatitis C Screen

    • HIV Screen

    • Rubella Screen

    • Syphilis Serology (RPR)

  2. Hemoglobin A1C (indicates average blood glucose regualtion from the past 3 months)

  3. Chlamydia and Gonorrhea Culture (to rule out STI’s)

  4. Pap Smear as indicated– ACOG-recommended to screen for cancer and HPV infection

  5. 1st Trimester Ultrasound – early U/S provides most accurate EDD, referral as requested

  6. CVS (Chorionic Villi Sampling – screens for fetal abnormalities in early pregnancy), referral as requested

  7. Cystic Fibrosis Carrier Screen, as requested

  8. Ethnic origin or other genetic screening, as requested 

 

Between 10 and 14 weeks, as requested

  1. Serum Integrated Screening (1st draw between 10 – 13wks+6 days (2nd draw between 15 -20 wks)

  2. Full Integrated Screening (same as above plus nuchal translucency U/S between 11+2 and 14+2 wks)

  3. Ultrasound for nuchal translucency (per client choice w/o integrated screening)

 

2nd Trimester – Between 15 and 22 weeks

  1. Quad Marker Screen – (single draw between 15 – 20 weeks), as requested

  2. Second blood draw if integrated screening was selected (see tests between 10 – 14 weeks), as requested

  3. Ultrasound between 18 and 22 weeks – this is considered the optimal time for visualizing organ development and other anatomical landmarks and is advised.

 

 

Between 26 – 28 weeks

  1. Blood Glucose Screening (screens for gestational diabetes – GTT follows if initial BG is high)

  2. Repeat CBC – see above

  3. Repeat Antibody Screen in Rh negative women

  4. 28-week Rhogam (injection given to Rh negative women with Rh positive mates)

 

 

3rd Trimester Between 35 – 37 weeks

  1. Group Beta Strep Culture (vaginal/rectal cultures which screen for asymptomatic infection that can be dangerous to the newborn)

  2. Repeat Chlamydia and Gonorrhea Cultures, if indicated

  3. Repeat CBC in anemic women

 

Other Tests, Treatments, or Consultations available

  1. Urinalysis as indicated

  2. Amniocentesis (screens for fetal chromosomal and other abnormalities)

  3. Genetic counseling as desired or indicated

  4. Physician consultation for a disease or condition likely to significantly affect the course of pregnancy and birth

 

Newborn

  1. Eye prophylactics (offered to reduce the risk of newborn infection or blindness)

  2. Vitamin K (given by injection to aid clotting in the event of Hemorrhagic Disease in the newborn- Oral protocol can be provided by parents but not considered standard of care by the CDC)

  3. Cord blood collection (to determine baby’s blood type; routinely done for Rh negative moms)

  4. Cord Blood Stem Cell Collection for banking (must be planned in advance with a cord blood bank)

  5. Glucose test (may be given to babies whose mothers had blood sugar imbalances or who are less than 2500 grams or larger than 4000 grams or as appropriate)

  6. Newborn Screening Test (for more info: www.dhs.ca.gov/gdb) – tests for the following:

  • Metabolic Disorders

  • PKU (inability to digest a certain amino acid, phenylalanine, found in proteins; can lead to brain damage

which is preventable through diet regulation; occurs in 1 in 10,000 babies)

  • Galactosemia (absence of a certain enzyme that digests milk sugar; can also lead to brain damage which

is preventable through diet regulation; occurs in 1 in 60,000 babies)

  • Maple Syrup Urine Disease (MSUD) – (rare fat- and protein-metabolizing problem in babies)

  • MCADD – (inability to convert fat into energy)

  • Biotinidase Deficiency – (inability to recycle Vitamin B from diet)

  • Endocrine Diseases (abnormalities in hormone production)

    • Congenital Adrenal Hyperplasia (CAH)

    • Primary Congenital Hypothyroidism

  • Hemoglobin Disorders (RBC abnormalities)

  • Sickle Cell Anemia and other sickle cell diseases

  • Hemoglobin H Disease

  • Cystic Fibrosis – Disease that affects many body organs and can cause poor nutrition absorption

  • Severe Combined Immunodeficiency (SCID)

  • Other Genetic Diseases

 

  1. Newborn Hearing Screening Test – See your pediatrician or ask for a referral for testing

  2. Vaccines – Ask your pediatrician for current schedule.

 

Mother Postpartum

  1. Postpartum Rhogam in Rh negative mother who’s baby is Rh positive (within 72 hours of birth)

  2. CBC (if significant blood loss or anemia is suspected)

  3. Pap smear – recommended at 6 weeks postpartum to screen for cancer or infection

We are located in North County San Diego, CA

904 W San Marcos Blvd

San Marcos, 92078

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T (760) 410-6499 

F (760) 452-4988

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