The “Normal” Pregnancy
What to expect when there's no complications
Bloodwork and Other Laboratory Tests
Routine blood work will check for anemia, immunity to Rubella (German measles), blood type, and diseases such as syphilis, hepatitis, thyroid function, and exposure to HIV, the virus that causes AIDS. Routine cultures will be for chlamydia, gonorrhea, and perhaps group B strep, although the strep culture is usually done later around 28 weeks.
You should have a Pap smear, because no prenatal care is adequate without a recent one (less than one year old by your due date).
If you’re not rubella immune, then you should ask for an immunization after you have your baby so you don’t have to worry about this ever again.
Life with cats, normal or otherwise, should prompt a test for immunity to toxoplasmosis.
The CBC (Complete Blood Count) will check you for anemia, which is important because many pregnant women get anemic during their pregnancies. If you were anemic to begin with, this would be handy to know so that you can be evaluated for the weird things like Pernicious Anemia (Vitamin B12 deficiency), Thallassemias (congenital anemias in women of Mediterranean extraction), and Sickle Cell Anemia (if you’re African-American). Within the CBC are measurements of red blood cell size and concentration, and if you’re just the common iron deficiency anemia type, your doctor will throw a lot of iron at you.
If you don’t know your blood type, your prenatal blood work will include this important information. The different types of A, B, AB, and O-type blood are important when it comes to needing a transfusion, should you need one. But initially it’s important to know if you’re Rh-Negative. This is not important for this baby, but for your next one. Also, you may have a peculiar flavor of blood that may contain antibodies that may prove hostile to your baby. Forewarned is forearmed on this one, and a baby in jeopardy from hostile antibodies making their way from your blood stream into the baby’s is one of the most convincing arguments for prenatal care. Such a problem may even impact you in that you’re not going to be the most hospitable host for even well-matched blood, complicating matters beyond the usual matching A to A, B to B, and so on, if you were to need blood.
The initial blood work will also screen for infectious diseases. With all of the publicity over AIDS, many people don’t realize that hepatitis is much more common as a sexually transmitted disease (STD). It can sit unnoticed, only to flare up unpredictably and possibly create serious danger. Also, if you’re a silent carrier for it, the pediatrician needs to know so that he can take precautions to protect your newborn after delivery. Syphilis is making a big comeback, and missing this diagnosis is a real tragedy because it’s so easy to treat.
HIV, the virus responsible for AIDS, has been an official part of prenatal screening since 1985. Although still considered a fatal disease, on the obstetrical side of things we’ve made great progress in preventing it’s transmission to the fetus, so it’s a must-have on any initial prenatal screening.
Unless you were born under a red sun or you and your husband were both virgins when you met each other, either of you may have a little souvenir from love lives past. Absolute fidelity and undisputed monogamy are not protection from the past. Don’t be insulted when your doctor checks you for gonorrhea, chlamydia, syphilis, and other things. Even a condition without symptoms can cause problems for your newborn.
Vaginal (cervical) cultures for Chlamydia (an STD which often has no symptoms) and gonorrhea (which almost always does) can save your future fertility as well as protect the baby from the infection and possibly premature labor. Group B beta-hemolytic strep, which can be a normal inhabitant of your vagina, as it is in 10 percent of women, but can cause serious infection in your baby during delivery. It is best screened for in the third trimester, although many doctors do it instead, or additionally, in an initial culture.
Abnormal functioning of the thyroid gland can cause problems with the development of your baby, so that might be investigated, although most people with thyroid problems know they have them already. If you don’t think you’ve ever had chicken pox (and you’re probably wrong), testing for immunity to this is just as important as the Rubella concern.
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