Routine Tests During Pregnancy

Glucose and Alpha-Fetoprotein screening test

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:

  • You have had gestational diabetes during an earlier pregnancy.
  • You have previously delivered a very large baby.
  • You are greatly overweight (approximately 20 percent over ideal body weight).
  • You are over 35.
  • You have high blood pressure.
  • You have a parent or sibling who is a diabetic.

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:

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.

To order this book visit Amazon's website or call 1-800-253-6476.

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