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Routine Tests During Pregnancy

Routine, run-of-the-mill tests are the ones your doctor will conduct almost every time you visit him or her for a checkup. These include an evaluation of weight, blood pressure, urine, and blood.

Weight

For this "test" you will probably want to put down your pocketbook and take off your shoes, rings, earrings, barrettes, clothing, and maybe even your makeup. Although you're expected to gain weight during pregnancy, you should try to keep the total gain between 25 and 35 pounds. And so the climbing numbers on the scale will be closely watched by your health-care provider.

Hey Mom!

Fortunately, the weight you gain during pregnancy is not all from your baby. (Imagine delivering a 35-pound baby!) Only 6 to 8 pounds are from the baby; the other 14 to 27 pounds are from the placenta, uterus, amniotic fluid, breasts, blood, fat, tissue, and fluids. Of course, women who are carrying twins (or more) gain much more weight.

Although nobody can say exactly how much weight you will put on each month, a general guideline says you should gain a total of about three or four pounds

in the first three months; one pound a week for the next five months; and, finally, one or two pounds (if you gain any at all) in the ninth month of pregnancy.

Your health-care provider will be watching carefully for a sudden weight gain, which, combined with excessive swelling, could mean trouble. She will also take note if you aren't gaining enough weight, which could be dangerous for the developing fetus.

Blood Pressure

Blood pressure is tested every month. The test is no big deal, but it is very important. A health-care provider will wrap a Velcro sleeve around your upper arm. She will then check the blood pressure at the bend of your inner elbow with her stethoscope (the instrument medical people always wear around their necks to make them look official). The first reading will be used as a base to compare with all the others every month. A sudden rise in blood pressure is a warning for a problem such as preeclampsia--a high-tech word for high blood pressure during pregnancy.

Urine Tests

How good is your aim? By the end of your pregnancy you will probably be very good at peeing into a little cup because you get to practice this skill at every medical visit. Urine is tested for three things: (1) infection; (2) protein, which can be a sign of high blood pressure; and (3) sugar, which can be a sign of diabetes.

Blood Tests

If your health-care provider doesn't already know the details about your blood, he or she will draw some blood early in the pregnancy. The blood will be taken from a vein on the inside bend of your elbow. This blood will tell a lot about…

Baby Talk!

Glucose screening is a test given between Weeks 24 and 28 of pregnancy to check for gestational diabetes.

Gestational diabetes is a high blood sugar condition that some women get during pregnancy. It is different from other forms of diabetes because it usually goes away after the baby is born.

Glucose Screening

Most expectant moms are given a glucose-screening test between Weeks 24 and 28 of the pregnancy to check for gestational diabetes.

You are at risk for developing gestational diabetes if you fit into any of these categories:

The test for gestational diabetes is not painful. It is long, however. To take the glucose screening test you will drink a sugar solution (which tastes like a thick, flat cola—I'm not saying it's delicious, but it's not all that awful either). An hour later, a blood sample will be taken and the blood sugar level will be checked. If the reading is abnormal (which occurs about 20 percent of the time) you'll go home and come back at a later date for a diagnostic exam, called a three-hour glucose tolerance test, to verify the results. If you get a high sugar reading on the first test, don't get too worried. Approximately 85 percent of those with a positive result on this screening test show normal blood sugar levels in the glucose tolerance test.

If you have gestational diabetes, it's good to find out early. Your doctor can then help you create a diet and exercise program that will keep the problem in check and safeguard the health of your baby. He may also prescribe insulin if necessary. Finding out that you have diabetes is certainly upsetting, but it's not cause for great alarm. Most women who develop diabetes during pregnancy go on to have normal, healthy babies. Be aware, however, that although gestational diabetes will probably disappear after the birth of the baby, some women ultimately develop full-fledged diabetes within the next 20 years. This is something you'll have to watch out for at yearly follow—up tests.

Baby Talk!

Alpha-fetoprotein (AFP) is a screening test given between Weeks 16 and 18 that identifies a potential risk of birth defects.

Hey Mom!

Like all prenatal tests, the AFP test is an optional test—which means you don't have to take it. Your physician may strongly recommend it, but the final decision is yours alone.

Baby Talk!

Down's syndrome is a condition in which a child has an excess number of chromosomes. These babies have a distinct appearance and may have several birth defects--most commonly abnormalities of the heart and some degree of mental retardation that ranges from minimal to severe.

Alpha-Fetoprotein Screening Test

Alpha-fetoprotein (AFP) is a type of protein produced only by a fetus—you do not produce it on your own. Sometime between Weeks 16 and 18, your doctor will take a blood sample from you to check the level of this protein, which can give an indication of the risk of certain birth defects. A high level of AFP might mean trouble; a low level might mean another kind of trouble.

High levels of AFP indicate the possibility of various things: It could mean twins, or that you have been pregnant longer than you thought. It could also mean that the baby has a neural tube defect, such as spina bifida (a deformity of the spinal column) or anencephaly (the absence of all or part of the brain).

Low levels of AFP mean you might be earlier in your pregnancy than you thought, or it can mean that the baby has a birth defect called Down's syndrome.

The AFP test is just like any other blood test and it is not risky at all—it will not hurt or harm you or your baby. The real risk associated with this test is the same one you'll find with all screening tests—the results are not absolute and can cause a lot of needless worry. If your test results are low, for example, there is a very, very slim (some say minute) chance that your baby may have Down's syndrome. To find out for sure, you will need to have further diagnostic testing done, such as amniocentesis. This test is a bit risky and has been known to cause miscarriages in a percentage of cases. A low or high result on an AFP test can put the fear of birth defects in your heart. The risks involved in taking the diagnostic tests add to the fear of miscarriage, as well. If the results come back either too high or too low, deciding what to do next is the most difficult part of the AFP test. The decision is ultimately what to do with a defective fetus. Do you abort it or do you want to know early on what the challenges are that you'll be facing at birth? There are other choices, such as adoption for Down's syndrome infants. Parents need to think, before they take an AFP, what they'll do with the results. You may be advised to take the screening test again, seek a second opinion, and/or meet with a genetic counselor. Whatever your choice, you must always keep in mind that most women who get abnormal screening test results give birth to normal babies.

Excerpted from The Complete Idiot's Guide to Pregnancy and Childbirth © 2004 by Michele Isaac Gliksman, M.D. and Theresa Foy DiGeronimo. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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