Prenatal Testing Video Transcript

My name is Charles Hageman, I go by Chuck to most of my friends. I am a board certified obstetrician/gynecologist.

Initial Evaluation

When a lady seeks out prenatal care, she trusts us to provide the best pre-natal care that we can provide. That involves listening to her story, gathering a history, doing a physical exam and to a certain degree ordering particular tests. The tests are reflection of her health and the baby’s health.

Prenatal Panel

The prenatal panel includes your blood type, your blood count, and your status on if you’re immune to rubella (measles) or not. There are several infectious tests we check: syphilis, gonorrhea, Chlamydia, HIV is optional. We’re trying to get a good medical background on the start of this pregnancy.

First Appointment

From the first appointment we want to know some real basic information: are you pregnant; how many babies are there and where is the baby located. That’s where the ultrasound can help. We like to smile and say you have one baby, it’s in the uterus and there’s the heart beat. That’s great information. That starts the prenatal care out on the right note. When we talk about tests, I break them up into three categories: the standard prenatal tests, the panel; 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 such as Down’s syndrome or something worse. It’s an option, so ladies want these tests, some women don’t.

Ultrasounds

Ultrasounds or sonograms have been around for 40 to 50 years now. It’s a great test. Prior to the routine use of ultrasounds in pregnancy, up to 50 percent of twins went undiagnosed until the lady was in labor. That’s a pretty exciting and scary moment at that time when the obstetrician says, “Oh I have something else to tell you. . . . have you thought of a second name.” I can’t imagine practicing obstetrics without ultrasounds. It’s a wonderful test. There’s no risk to the mother or the baby and they give us a world of information.

Reviewing Test with Mom

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.