When we talk about tests, I break them up into three categories: the standard prenatal tests, optional tests, and finally, indicative tests. Back to the standard tests, a prenatal panel on the first appointment. The second trimester we frequently do a glucose test called the glucose challenge test. It’s done at 24 weeks. It’s the test to see if you’re going to develop diabetes during pregnancy. It’s very important to know that not just during the pregnancy but your health following the pregnancy. During the third trimester we’ll do a Q-tip test from the vaginal area called a group E beta strep test to see if you’re a natural carrier for that bacteria. If you are then that indicates you’ll need antibiotics while you are in labor. This is just a quick overview of the standard tests. We do have optional tests, many of which come in the first trimester. One of them is a test called nuchal translucency. It’s a relatively new test that’s performed by a perinatologist who’s an additionally-trained high risk obstetrician. It’s a very specific sonogram where they are checking the thickness of the back of the baby’s neck. If the baby’s neck appears to be abnormally thickened, which means they fail the nuchal translucency test, especially if it appears the baby may be missing a nasal bone, that would correlate very highly with a genetic malformation. If you’re African American, do you need a Sickle Cell trait; do you know your status in that regard. Similar to Sickle Cell, if you’re Greek or from one of the other Mediterranean countries, there is another blood test that we check for, a condition called Thalassemia. If you’re of Jewish decent, or a very specific type of location from Europe, we offer to see if there is any recognition of Tay Sachs disease. There’s a large number of specific disease processes that are unique to different ethnic groups. It’s up to the physician to recognize that. What I like to do with every patient in the prenatal appointment is I review the labs with them. I’ll say ‘your blood type is such-and-such, your blood count is good, you passed your glucose test, the baby seems to be growing well, and the heart beat is strong.’ So, it’s just not tests that we do and look at the results and keep to ourselves. This is information we share with the patient to reassure her that she’s doing the right thing, the baby’s doing the right thing . . .growing well, and our plan remains on track . . . full nine months, vaginal birth, everybody’s happy.
