Lab and Diagnostic Tests During Pregnancy (1st Visit)
A standard panel of laboratory tests should be obtained for every pregnant
woman during the first prenatal visit. This panel can be augmented if a woman is
at risk for any particular specific condition. This panel may include a CBC, blood
typing and Rh factor, infectious disease screening, urinalysis and a pap smear.
PLAY PICMONIC
Diagnosis
Complete Blood Count (CBC)
Blood Cell Count-dracula
A complete blood count (CBC) is performed, which checks hemoglobin, hematocrit, as well as red and white blood cell counts for the early detection
of any systemic abnormalities. This also creates a baseline so that the patient can be monitored throughout the pregnancy.
Blood Typing and Rh
Blood-cell Typing and Recess-playground
A mother's blood type and the presence or absence of Rhesus (Rh) factor need to be determined at the initial visit. If a mother is Rh negative and her
fetus is Rh positive, the mother can develop antibodies against the Rh factor on the fetal blood cells. If a mother becomes pregnant a second time
with an Rh positive fetus, maternal anti-Rh antibodies will recognise the Rh positive fetal RBCs as invasive cells causing an immune reaction, resulting
in a potentially fatal condition called hemolytic disease of the newborn. If indicated, Rh negative women without alloantibodies can receive anti (D)-
immune globulin, which helps prevent development of anti-Rh antibodies against fetal RBCs, and thereby helping prevent hemolytic disease of the
newborn in subsequent pregnancies.
Rubella
Red-bell
Rubella is an RNA virus that can cause one of the congenital TORCH infections. Also known as German measles or three-day measles, rubella is tested
for during the first prenatal visit due to its potential for serious neonatal disease.
HIV
Band-AIDS
The CDC recommends that all pregnant women in the United States should be counseled about HIV early in their pregnancy and receive voluntary
HIV testing to protect the child’s health. This is because women who test positive for HIV and begin treatment early in their pregnancy reduce the risk
of mother- to- child HIV transmission to 2% or less.
Hepatitis B
Happy-tie-liver Bee
Hepatitis B surface antigen (HBsAg) screening is recommended for all pregnant women to prevent perinatal transmission. Presence of HBsAg
indicates high risk for vertical transmission of HBV from the mother to the fetus. Congenital infection with Hepatitis B increased the risk of premature
delivery, intrauterine growth restriction (IUGR) and increase the risk of neonatal death if acute disease develops. Hepatitis B is an enveloped DNA virus
with a double stranded partial circular genome.
Tuberculosis Skin Mantoux Test (PPD)
TB-tv with Mantis-toe Test-tubes
A PPD test is a screening test to determine previous exposure to TB. The test is positive if induration is present, not erythema. Screening for
tuberculosis (TB) is not routinely done during pregnancy, but is indicated in women who are immunocompromised, and those who have had close
contact with individuals with active TB infection. Screening is performed with an intradermal skin test using purified protein derivative (PPD). If the
PPD is negative, no further follow-up for TB is necessary. If the PPD is positive, a chest x-ray is indicated. A positive chest x-ray will necessitate a
sputum culture. If the chest x-ray is negative, isoniazid (INH) and vitamin B6 is given for the duration of the pregnancy.
Sexually Transmitted Infections
Sex-symbols on Infectious-bacteria
Sexually transmitted infections, such as gonorrhea, chlamydia, and syphilis are common sexually transmitted diseases caused by bacterial infections,
which are tested for during the first prenatal visit. In a pregnant woman, these diseases can lead to a miscarriage or infect the baby before or during
delivery.
Chlamydia
Chlamydia-clam
Screening is recommended in all women less than 25 years old and at increased risk of infection (multiple sex partners, etc). Chlamydia is an STI
caused by the bacteria Chlamydia trachomatis. Infants who pass through the vaginal canal of women with Chlamydia trachomatis infections can
develop neonatal conjunctivitis, as well as neonatal pneumonia, which classically presents with a staccato cough. Erythromycin is the treatment of
choice for neonatal chlamydial infections.
Neisseria gonorrhoeae
Knives Gunner-ship
Screening is recommended in all women less than 25 years old and at increased risk of infection (multiple sex partners, etc).
Neisseria gonorrhoeae is a gram-negative diplococci that causes the sexually transmitted infection gonorrhea. N. gonorrhoeae can cause neonatal
conjunctivitis when the infant is exposed to the organism in the vaginal canal. This can lead to corneal scarring and perforation, which can result in
blindness. Treatment for neonatal conjunctivitis is erythromycin and silver nitrate eye drops.
Syphilis
Syphilis-Sisyphus
Syphilis is another STD tested for during the first prenatal visit. Untreated syphilis during pregnancy is associated with stillbirth, neonatal death, bone
deformities, and neurologic impairment, and is easily targeted with antibiotics.
Pap Smears
Papa Smearf
Cervical or Papanicolaou (PAP) smears are completed to identify possible cervical dysplasia. Smears are also a detection tool for sexually transmitted
infections (STI) and inflammation or malformations of the cervix.
Urinalysis
Urinal with Urinalysis-cup
Urine is screened for ketones, glucose, protein, bacteria and casts. Screening establishes a baseline, and also allows for detection of metabolic
abnormalities, renal impairment or gestational diabetes. Urine culture is also suggested for assessment of asymptomatic bacteriuria.
Sickle Cell Screening (If Indicated)
Sickle Anemone and Screen-door
Screening for sickle cell disease and other hemoglobinopathies is based on a comprehensive personal and family medical history, with a focus on
anemia and other hematological disorders.
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