What Makes a High-Risk Pregnancy?

If you plan to have a baby, or you’re already pregnant, are you aware of the potential risks?

All pregnant women want a safe and risk-free pregnancy, and so long as you are healthy, there is a good chance that everything will go smoothly. Unfortunately, however, there are always some risks, and a high-risk pregnancy can affect the health and welfare of both mother and baby.

Every woman should know what makes a pregnancy high-risk before they get pregnant, and they should also know what to look for while they’re pregnant in order to mitigate problems as quickly as possible.

You should always go through the risks with your OBGYN or Midwife as they will vary from person to person and may not all be listed here. However, here are the more common factors that may put a pregnancy in the high-risk category.

What is a “High Risk Pregnancy?”

Most people think of pregnancy as a fairly routine (if life-changing) process. But there are inherent risks involved with each and every pregnancy. That doesn’t mean every pregnancy is “high risk.” Instead, physicians refer to those pregnancies where risks of complications are elevated as “high risk pregnancies.”

The risk, in this case, is modeled by research and statistics, and represents how likely a specific negative outcome might be. A high risk pregnancy means you have a higher than normal chance for a negative outcome. Such a negative outcome is not a certainty, but it is certainly cause for increased monitoring and active symptom management.

You can also talk to your OBGYN or Midwife about preventative steps you can take to limit your risks. For many women, a high risk pregnancy proceeds smoothly and normally. For others, intervention can make a dangerous situation much more manageable. You can always talk to your OBGYN or Midwife about how your risk factors stack up–and how you can manage possible outcomes.

Pregnancy-Related Health Conditions

There are two specific conditions women develop during a pregnancy that can create a high-risk pregnancy as well as exacerbate other risks: gestational diabetes and preeclampsia. Some women who fall into higher risk categories (such as age) are more prone to these conditions.

Gestational diabetes is a type that develops during pregnancy. It can be managed with a proper treatment plan and diet. However, if not controlled, there is a higher risk for pregnancy and delivery problems.

Preeclampsia is characterized by high blood pressure and can affect various organs in the mother’s body. If you do not get treatment for this condition, it can lead to serious health problems for both mother and baby.

Age Affects Pregnancy Risks

In general, a woman is more prone to a high-risk pregnancy if she is in her teens or over 35.

Women in their teens have a higher potential for various risk factors including preeclampsia, gestational high blood pressure, early labor, and complications related to STIs. After age 35, the possibility for infertility increases as do the potential pregnancy risks.

Research shows older women are more likely to need a cesarean and are more likely to have problems during labor or a long labor. The risk of having a child with genetic disorders also increases as a woman ages.

That being said, it’s essential that women understand that a perfectly healthy pregnancy and delivery is possible after age 35, so long as the mother is healthy.

Multiple Births

Pregnancy with more than one baby is automatically riskier than a single-birth, no matter what other risk factors are present, and this risk multiplies depending on the number of babies. Complications like preeclampsia, early labor, and premature births are common for those carrying multiples.

General (Pre-existing) Health Conditions

Many different health problems can result in higher risk pregnancies. If you are pregnant or considering it, your OBGYN or Midwife should give you a thorough assessment in any case.

Standard tests from your healthcare provider should cover the areas that need to be checked for a high-risk pregnancy, such as high blood pressure, diabetes, and STIs. Still, you need to let them know of any conditions that could potentially affect the baby including addiction (tobacco and alcohol use) or mental health issues.

High blood pressure, polycystic ovary syndrome (PCOS), diabetes, kidney disease, autoimmune diseases (including HIV/AIDS), thyroid disease, and infertility are all conditions to bring to a doctor’s attention.

Being Overweight (Obese) or Underweight

Because obesity puts mothers at risk for more health problems, these health conditions (such as high blood pressure) may be exacerbated during pregnancy. Generally, carrying excess weight will lead to a potentially more difficult pregnancy in many ways. But it’s worth noting that women who are severely underweight may face various complications as well.

Obesity-related risks during pregnancy include high blood pressure, preeclampsia, gestational diabetes, stillbirth, tube defects, depression, and even surgical infection. Early births and miscarriages tend to happen more often in obese individuals as well.

How Can I Prevent a High Risk Pregnancy?

In some cases, there are steps you can take to limit risk factors that may be present. This may help you lower the overall risk associated with your pregnancy. Some of the most potent steps include:
Scheduling a preconception appointment. During this appointment, you’ll be able to discuss your general health and all of your pregnancy concerns with your OBGYN or Midwife. That said, not all conceptions are planned, so preconception appointments aren’t feasible for everyone. Consulting with a healthcare professional as soon as you think you may be pregnant can, in many cases, accomplish similar results.
Adopt a healthy lifestyle. This means eating plenty of fruits and vegetables, limiting your sugar intake, and being sure to get a healthy amount of exercise. Everyone’s body is different, so you can talk to your OBGYN or Midwife about what constitutes a realistically healthy lifestyle for you.
Avoid high-risk substances and chemicals. Smoking tobacco products is generally bad for your health, so you’ll be able to lower your risk of pregnancy complications simply by quitting. Avoiding all risky substances–such as tobacco, alcohol, and illicit drugs–can similarly help you prevent a high risk pregnancy.
Schedule regular prenatal check-ins with your Midwife or OBGYN. Your physician will likely recommend a specific interval for prenatal checks, depending on your overall health and risk factors. You may also be given prenatal vitamins to help bolster your nutrition throughout your pregnancy. This can help manage some possible risk factors that would otherwise contribute to a high risk pregnancy.

In some cases, you won’t be able to avoid a high-risk pregnancy. You may simply have a specific medical history or underlying conditions that you cannot change. And many parents don’t want to wait for a “perfect” health situation before having a child (especially because that perfect situation may never come).

That’s why it’s important to take steps to successfully manage the risks you do experience. To do that, make sure your OBGYN or Midwife is aware of your current health status, your medical history, and any risk factors you may know about. That way, you and your OBGYN or Midwife can both take therapeutic or preventive steps to make your pregnancy as healthy as possible.

Talk to Your OBGYN or Midwife

Whether or not your pregnancy is classified as higher risk, it’s vital that you discuss your situation regularly with your OBGYN or Midwife. Often, with proper treatment plans, risk factors can be mitigated, and a healthy pregnancy is possible.

But it’s important to recognize that, even if you aren’t in a high-risk category, certain health complications can develop during pregnancy. Stay up to date with your OBGYN or Midwife so that you can mitigate risks where possible.

If you have more questions or feel that you might have a high-risk pregnancy, contact us today to schedule an appointment with an OBGYN or Midwife.

Gestational Diabetes

Diabetes occurs when the cells in your body can no longer properly process glucose. As a result, your blood sugar levels can become unregulated, quickly becoming too high or too low. As a result, uncontrolled diabetes can have significant health impacts. For most people, diabetes will develop either early in childhood or due later in adult life; most often, the development of adult-onset diabetes is anything but sudden.

That can change when you’re pregnant.

Gestational diabetes is diagnosed when you develop diabetes during your pregnancy. Your OBGYN or Midwife will want to monitor your gestational diabetes closely, as there can be possible complications for both you and your baby. However, with the right treatment, gestational diabetes can be successfully managed and will usually go away after the delivery of your baby.

What Causes Gestational Diabetes?

Most physicians believe that gestational diabetes is caused, at least in part, because the placenta produces certain hormones during pregnancy that encourage a buildup of glucose in your blood. Usually, the pancreas handles glucose spikes by producing extra insulin. But there are times when your pancreas just can’t keep up, and gestational diabetes is the result.

No one knows why certain people develop gestational diabetes and others don’t. But there are some risk factors which could make you more likely to develop diabetes should you become pregnant. Those risk factors include:

  • Medical history: Your personal and family medical history will have a significant bearing on your diabetes risk. For example, if an immediate family member has diabetes, your risk for developing this gestational variant of the disease is increased.
  • Previous delivery: If you previously gave birth to a child that was considered large for gestational age (LGA) or had macrosomia, you may be at an increased risk for developing diabetes during your next pregnancy.
  • Medical conditions: Some medical conditions, such as polycystic ovary syndrome can also increase your odds of developing diabetes.
  • Race: Cases of gestational diabetes have been reported in higher proportions among individuals who identify as Asian American, American Indian, Black and Latino. These communities seem to experience a higher risk profile for developing this condition.
  • Body weight: Those who are overweight or obese may be at a higher risk for developing diabetes.
  • Age: Women over the age of 35 may have a higher risk of developing diabetes.

The cause and effect relationships between all of these risk factors and the presentation of gestational diabetes is not totally understood. That’s why these are risk factors–and not causes. Just because you exhibit one or more of these risk factors does not mean you will develop diabetes. But when your OBGYN or Midwife know these risk factors are present, they can more closely monitor you during your pregnancy.

What Are the Symptoms of Gestational Diabetes?

In general, gestational diabetes does not have any significant and discernible symptoms. You may be thirsty more often (and, therefore, urinate more often). But when you’re pregnant, these symptoms can be challenging to isolate: are you peeing more often because you’re developing diabetes or because, well, you’re pregnant and your body is changing?

That’s why your OBGYN or Midwife will recommend screening your insulin and blood glucose levels during your pregnancy. Unless there are specific indications or risk factors that suggest gestational diabetes may be present earlier, these screenings usually begin during the second trimester.

Possible Complications From Gestational Diabetes

Uncontrolled gestational diabetes can present complications for both the mother and the baby (before and after birth). The complications that affect the mother include the possibility of requiring a C-section delivery, the possible development of preeclampsia and high blood pressure, as well as a heightened risk of developing diabetes in the future.

In terms of possible complications for the baby, those may include:

  • Stillbirth
  • Preterm delivery
  • Breathing conditions, such as respiratory distress syndrome
  • Excessive weight at birth (this can cause injury to the child during delivery)
  • Higher chances of obesity later in life
  • Higher risk of developing type-2 diabetes later in life
  • Low blood sugar

The good news is that these complications are largely preventable so long as your diabetes is being successfully managed. If you’re diagnosed with gestational diabetes you may be asked to visit a specialist (endocrinologist) to help manage it.

Depending on your situation, you may also be asked to monitor your blood sugar at home. This is usually achieved via daily finger prick.

Treatments for Gestational Diabetes

There are several reliable methods that your OBGYN or Midwife will recommend to manage and treat gestational diabetes. You’ll work with your healthcare providers to find the method that works best for you and your condition. Your Midwife or OBGYN may suggest one of the following treatments:

A Healthy Lifestyle
The first step in controlling your gestational diabetes will likely be to adopt a healthy lifestyle. This generally means:

  • Minimizing the amount of refined sugar you eat. Most OBGYNs and Midwives will recommend that you avoid sweets and candy bars and opt instead for fruits.
  • Eating plenty of whole wheat and whole grains.
  • Exercising daily. You’ll want to talk to your OBGYN or Midwife about exercise levels–typically, anything you were doing before you were pregnant is just fine. If your Midwife or OBGYN gives you the go-ahead, you’ll want to aim for at least 30 minutes of moderate exercise a day. This will lower the amount of glucose in your blood.

Your OBGYN or Midwife will be able to recommend practical and realistic ways for you to safely improve your health choices while you are pregnant.

Monitor Your Blood Sugar
Treating your gestational diabetes may also require monitoring your blood sugar on a daily basis. A healthy diet and exercise can keep your blood sugar from getting too high, but something like vomiting (a common presentation of morning sickness) can cause your blood sugar to drop into an unhealthy range.

Daily monitoring of your glucose levels via a finger prick and a blood glucose meter can help ensure that your blood sugar stays in a safe and healthy zone.

If your gestational diabetes cannot be managed by a combination of lifestyle changes and blood sugar monitoring, you may be prescribed medication in the form of insulin injections. Roughly 10-20% of women with gestational diabetes will need to take insulin to manage their symptoms at some point during their pregnancy. Your Midwife or OBGYN will be able to address any concerns you might have about insulin injections and discuss the best way to control your blood sugar levels for the duration of your pregnancy.

Monitoring After Delivery

In the vast majority of cases, effective management and treatment can minimize the possible complications from gestational diabetes. And for most women, the condition will effectively disappear once you deliver your baby.

However, your OBGYN or Midwife will want to continue monitoring your diabetes symptoms after you deliver your baby to make sure this is the case. In most cases, this means checking your bloodwork six to twelve weeks after delivery to ensure your blood sugar levels and insulin production have returned to normal.

Controlling Gestational Diabetes

No one knows why some women will develop gestational diabetes and others don’t. What’s important, however, is not necessarily why you develop this condition–but, rather, that you are able to successfully manage this condition.

When your condition is fully managed and under control, you’ll have less reason to worry about possible complications. You’ll be able to look forward to a normal and healthy delivery!

If you have questions about gestational diabetes or how to stay healthy during your pregnancy, contact our Wilmette or Glenview offices to schedule an appointment today!

To Bank or Not to Bank Your Baby’s Cord Blood

Your baby’s umbilical cord is filled with healthy, amazing stem cells. These stem cells have a wide breadth of medical applications, especially when it comes to treating certain blood disorders and genetic conditions. 

In the past, umbilical cords had been discarded after a baby’s birth. But now, modern science has offered parents a new option: banking their baby’s cord blood. Cord blood that has been banked is preserved, stored, and able to be used for medical purposes in the future.

Because banking cord blood is a relatively novel option, parents will often have questions about what happens to these stem cells, how they’re stored, and what they might be used for in the future.

What is Cord Blood Banking?

A baby’s umbilical cord is filled with a special kind of cell, called stem cells. These stem cells are powerful on a genetic level, and they can be used to treat a wide variety of ailments, including some types of cancers, blood conditions (such as anemia), and even some disorders of the immune system. Cord blood banking is the process of saving and storing these cells before the umbilical cord is discarded. 

What Are Stem Cells?

Your baby’s cord blood is so potent and valuable because it’s filled with something called stem cells. You can think of stem cells as the body’s raw material, almost like blank slates. Stem cells are used to help your body create red blood cells, white blood cells, and so on. In other words, stem cells can divide into many other types of cells. And that’s why they’re so valuable. 

Under the right laboratory conditions, stem cells can be used to create medical treatments. Historically, such cells for treatment were gathered from the bone marrow; but bone marrow stem cell donation can be quite painful. Cord blood allows physicians to gather more donor material in a way that does not involve any pain or discomfort.

Conditions that Can Benefit from Cord Stem Cells

The following conditions are often successfully treated with donor stem cells from banked cord blood.

  • Leukemia, a cancer of the blood cells (particularly the blood immune system).
  • Myelodysplastic Syndromes (often called pre-Leukemia)
  • Lymphoma, a cancer of the blood cells and lymph nodes.
  • Blood anemias
  • Sickle Cell Disease
  • Inherited Immune System Disorders

This list is not exclusive. In fact, there are a wide variety of ailments that can have successful stem cell-based therapies and others that are currently being researched. 

How Cord Blood is Banked

The banking process itself is generally quite simple and occurs after delivery. Once it is removed from the baby, both ends of the umbilical cord are clamped, and then a physician will use a syringe to collect the desired fluid (generally at least 40mL or so). This collected fluid will then be sent back to the blood bank of your choosing (and there are several choices to make about which type of blood bank is right for you). 

Types of Cord Blood Banking

There are three common ways to bank cord blood. These include:

  • Public cord blood banking: This service is free. Your physician will collect your baby’s cord blood and that cord blood is then sent to a bank where anybody with a medical need can access donor material. So, you aren’t saving your baby’s cord blood for yourself–you’re making it available to anyone that might need it. In many cases, public cord banks may be full, which means that they are not taking donations at the current time. If cord banks are full, you can talk to your OBGYN about what your options might be. 
  • Private cord blood banking: A private blood cord bank is designed to keep your baby’s umbilical cord blood reserved for you and your family. No one else can access that cord blood without your permission. Private cord blood facilities charge fees for processing and storing this blood. 
  • Direct donation banks: These are kind of a combination of both approaches: you have access to the blood you donated, but so does everyone else. The terms and conditions at direct donation banks will likely change from facility to facility. As with public cord banks, these may be full or no longer taking donations. As a result, your options may vary depending on which banks are currently receiving donations.

Patients should plan on bringing their own cord blood collection kits to the hospital at the time of their labor, as most hospitals no longer have them in supply. Additionally, patients will usually be responsible for arranging the transportation of collected cord blood. 

How Do You Choose the Right Banking Option?

Each option provides parents with different costs and benefits. In some ways, it can feel as though parents are asked to weigh the possible future benefits to their children against the benefits of others–as well as the possible costs involved. It’s understandable, then, that parentings thinking about banking cord blood would have questions. 

The Case Against Banking Cord Blood as “Biological Insurance”

Many parents might initially feel that having access to their baby’s own stem cells will provide a kind of insurance against future illness (in fact, that’s often how private cord banks are marketed). 

But the reality is that this rarely happens. That’s because many of the diseases and conditions that stem cells are used to treat are genetic. If your baby is genetically healthy, they won’t need stem-cell based treatment. However, if your child develops a condition such as anemia or leukemia, their stem cells will still not be useful, as the same genetic markers that caused the condition will be present. What would be needed is an infusion of healthy, compatible stem cells.

For this reason, there have been only 400 transfusions from the donor’s own stem cells in the last 20 years (compared to 60,000 transfusions from other donors). There are some rare instances in which saving your own baby’s stem cells as a future insurance policy may make sense, but most physicians regard the chances of this occurring are so remote that the possible benefits do not justify the costs.

Should You Bank Your Baby’s Cord Blood?

The stem cells in banked cord blood can be a significant source of help to others. These stem cells can help treat conditions such as anemia, leukemia, and more. In the future, they may even be able to help treat conditions such as spinal cord injuries or Alzheimer’s disease. This means that banked cord blood can be an absolutely essential resource for those with serious diseases who are seeking treatment.

Right now, the American Association of Pediatrics and other physician associations do not recommend private cord banking, except in cases where a sibling has already been diagnosed with a condition that may benefit from cord blood (such as immune deficiencies, lymphoma, or leukemia, to name a few). Even then, a sibling is only likely to be a donor match in 25% of cases. The majority of treatments will be required to find a donor outside of siblings for successful treatment.

But medical professionals make no such warnings about public cord banking (though most such associations do not make any recommendations in terms of cord blood banking). Banking cord blood can significantly help others, and there are no healthcare risks to the mother or the infant–but it can sometimes feel like a personal decision.

The Decision is Up to You

If cord blood banking is something that you’d like to know more about, you can discuss all your options with your OBGYN. Contact us to schedule an appointment at either our Glenview or Wilmette offices to get all your questions answered!

IUDs – What You Need to Know

If you’ve been doing your research, you are probably already aware of the different forms of birth control. From the pill to the patch and the good (or not-so-good) condom options, they may all seem like they are less-than-ideal.

Maybe you’ve even tried the pill or other options, but don’t love the idea of having to remember to take something every day or even every month.

Have you ever thought about getting an Intrauterine Device (IUD) for birth control? There are many IUD choices on the market, some of which are newer, and you may not know about.

Read on for more information about what IUDs are, how they work, how they differ, and how you can make the best decision for yourself concerning IUDs as the ideal birth control option.

What Exactly is an IUD?

IUDs are small devices that are permanently placed in the uterus to prevent unwanted pregnancies. Unlike most other options, IUDs are both long-term and reversible.

And as far as birth control effectiveness goes, they are also believed to be at least 99% effective, if not more. Unlike condoms, they are not prone to breakage, leaks, or other types of human mistakes that can affect their overall efficacy.

They are also not “forgettable”, that is, they are permanent and working all the time, so you can’t forget to insert them or take them, as you could a diaphragm or pill, respectively. You can have one inserted and forget about it for years.

It’s important to note that IUDs do not protect against STDs.

How Safe Are IUDs?

IUDs got a bad rep back in the day when they were first introduced, and there were some complications. But since then they’ve come a long way.

Strict screening also comes along with wearing an IUD so that on the very small chance of infection, your gynecologist can treat it right away.

Some people might wonder if the copper in IUDs like ParaGard could cause problems in the body, but there shouldn’t be much to worry about as there is no evidence that there’s enough copper for it to be toxic. Of course if you’ve had a bad reaction or known allergy to copper in the past, you should be sure to disclose that information to your provider when discussing IUD options.

Side effects like pain, cramping, spotting, and irregular periods, as well as regular periods, do happen with some IUD users. These should only occur in the first several months.

There is a risk of expulsion, that is, the IUD may come out of the vagina. While there is only a small chance of this (though it may be more likely for younger women), most experts conclude that IUDs are a safe and effective birth control method and that the risks of unwanted or dangerous pregnancies associated with other methods far outweigh the very low risks associated with the IUD.

Getting an IUD Inserted

If you’re wondering what getting an IUD feels like, here’s a bit of an overview. Some women will feel more discomfort than others, of course. In addition, sometimes you may be offered medicine to help open the cervix and numb the pain.

With a speculum, a gynecologist will put the IUD in through the cervix and into the uterus. It only takes a few minutes on average and can be done at any time. Some women feel pain or cramping as it’s being inserted, and if this is the case, pain medication can be prescribed.

There’s a small chance that you will feel dizzy or have more severe cramps after the time of insertion, and for this reason, your gynecologist will recommend that someone pick you up after the surgery.

Most of the time there is no recovery time, but you may have cramps so treat it like a period and schedule some rest just in case.

The Different Types of IUDs

There are a few different types of IUDs. Some IUDs are hormone-free, and some secrete low doses of progesterone to prevent pregnancy. All of them essentially “kill” sperm on the way to the uterus, making pregnancy impossible.

ParaGard is a copper, non-hormonal option and is the most effective–it can even serve as emergency contraception if you get it five days after unprotected sex, and in this case, you can also opt to keep it in.

The other four are hormonal and use progestin (like progesterone) for pregnancy prevention. If size is an issue, newer models are coming out with smaller sizes than earlier models, so ask your doctor if you think a smaller option may be a better fit.

How Do IUDs Work?

Most IUDs will typically work in one of two ways.

  1. Hormone-based IUDs will effectively thicken mucus n the cervix. This makes it difficult for sperm to reach the egg and begin the fertilization process. Additionally, the hormones will thin the lining of the uterus while also partially suppresses ovulation. These two processes, together, help ensure fertilization does not occur. Mirena, Liletta and Kyleena are examples of a hormone-based IUD.
  2. Copper-based IUDs will instead produce an inflammatory response in the local area of the body. This inflammation creates an environment that is inhospitable to sperm cells. Because the sperm cannot survive, fertilization and pregnancy is prevented. ParaGard is an example of a copper-based IUD.

Both hormone and copper based IUDs work to prevent fertilization from occurring at any point.

However, if fertilization does occur while an IUD is in place, there is a high chance for the development of an ectopic pregnancy, so you should talk to your OBGYN if you think you might be pregnant or have taken a positive pregnancy test.

What Are The Benefits of IUDs?

IUDs are a popular contraceptive option for a wide variety of reasons. Some of the most significant reasons include:

  • Long term birth control: You don’t need to think about taking a pill every day or interrupting sex due to the need for contraception. What’s more, most IUDs can remain in place for anywhere between 5-10 years (depending on the type).
  • Regulation of severe periods: Many women who have heavy periods end up using IUDs to help manage their discomfort and symptoms (for somewhere around 20% of women, IUDs will eliminate their period altogether).
  • You can remove an IUD at any time: Your OBGYN can remove your IUD at any time (you may want local anesthesia depending on your comfort level). Once your IUD is removed, your normal fertility will usually return within a few days.
  • You can also use your IUD while breastfeeding: Most physicians recommend waiting 6-8 weeks after you deliver your baby to insert a new IUD, however.
  • IUDs are contraceptives that do not require partner participation: This means you remain in control of your reproductive choices. For many women, this is a significant and much appreciated benefit.
  • IUDs do not use estrogen: IUDs are often a safe and effective option when other options are not able to be used because they do not use estrogen. Estrogen methods of birth control can be contraindicated in individuals with hypertension, smokers, history of bleeding disorders and other medical conditions.

To learn more about IUDs and other contraceptive options, contact us today at our Wilmette or Glenview locations to schedule an appointment with a gynecologist.

Prenatal Testing in the First Trimester: What and Why?

Prenatal testing will go on throughout your pregnancy. Most tests are routine and not uncomfortable, and they will give your obstetrician a lot of valuable information regarding your health and the health of your baby. The intention of most of these prenatal tests is to confirm that everything is just fine, but they also aim to identify any complications that may be developing. The first trimester of pregnancy is a time of important development for your baby. Your OBGYN will want to make sure that everything is moving along exactly as it should.

Initial Bloodwork

The first round of prenatal bloodwork will check to make sure you are in good health, and it will look for conditions that could affect your pregnancy. Your blood type will be checked, and your OBGYN will make sure you don’t have anemia. Your obstetrician will also check your Rh factor, a protein in the blood cells. If you are Rh-negative and your fetus is Rh-positive, this can lead to incompatibility problems, which your doctor will want to prevent.

This initial bloodwork will also check for conditions such as syphilis, Hepatitis B, and HIV and will check your immunity for German measles.

Urine Test

You will have a urine test at your first prenatal visit and probably at every subsequent visit as well. In early pregnancy, your urine can be tested for the hCG level, which will confirm you are pregnant. Your OBGYN will also look for signs of kidney infection, glucose or albumin to identify possible problems with gestational diabetes or high blood pressure. Your urine will continue to be monitored for abnormalities throughout your pregnancy.

Do You Want Genetic Testing?

As the first trimester approaches its completion, your obstetrician may ask you if you want genetic testing. These tests are not 100% accurate but may give information on whether your baby is at risk for certain congenital conditions.

You may prefer to decline this and just let the pregnancy run its course rather than going through the stress of trying to detect possible problems. If you do decide to go through with genetic testing, you should discuss all the options and possible complications with your doctor.

Non-Invasive Tests

Some genetic tests are non-invasive and work like a specialized ultrasound. One or more of these tests may be offered to you, particularly if you are over 35. Non-invasive tests don’t pose any risk to you or the fetus. They screen for chromosomal abnormalities such as spina bifida and Down syndrome. If abnormalities are detected, further testing may be recommended, because screening tests don’t actually diagnose. An abnormal result on a screening test sometimes proves to be false.

Amniocentesis or CVS

Amniocentesis and chorionic villus sampling (CVS) are examples of tests that are more invasive. They take samples of the amniotic fluid or placenta to more accurately diagnose genetic abnormalities or genetic defects such as sickle cell anemia, cystic fibrosis, muscular dystrophy or Down syndrome. CVS is performed during the first trimester and amniocentesis would be done during the second trimester. A genetic counselor may be able to help you decide if you want to go through with one of these tests.


Early in pregnancy an ultrasound can be useful to confirm viability and get accurate dating. If you are unclear when your last period was, an ultrasound can be performed as early as 6-7weeks of pregnancy to estimate your due date. Or your obstetrician may wait until the second trimester to do this non-invasive diagnostic test. You will most likely have an additional ultrasound in each of your second and third trimesters to monitor fetal development and screen for any potential problems.

When Should You Schedule Your First Test?

Some prenatal labs will be drawn on your first pregnancy-related visit to your OBGYN. Urine samples will also be taken each visit thereafter in order to measure things like your protein and glucose levels. 

In general, you’ll want to schedule a visit with your OBGYN as soon as you think you might be pregnant, and these initial screenings are a big reason why. The data gathered will provide both a useful baseline and an early indicator for your baby’s health. You and your OBGYN will then discuss a schedule for further testing. Usually, the first trimester testing schedule looks something like this:

  • Initial Visit: Blood and urine screenings Often we perform ultrasound with the initial visit to validate dating or establish viability/dating.
  • Between weeks 6-12: First Trimester Ultrasound
  • Between Weeks 10-12: CVS and other genetic screenings (as noted, these genetic tests are considered optional).Often a second ultrasound performed her for assessing nuchal translucency which is also a part of genetics so you could just leave as is. 

Based on your individual needs, there may be other screenings or diagnostics your OBGYN will want to incorporate into your schedule. You’ll talk to your OBGYN about the value and benefit of each of these screenings and then decide on an appropriate and timely course of action. The goal of prenatal testing is to monitor the health of your baby and provide you with peace of mind that everything is progressing normally.

What Happens if You Miss Your First Trimester Testing?

If you do not have access to prenatal testing during your first trimester, it’s important to talk to your OBGYN about what your options may be. Some first trimester tests may simply be moved to “as early as possible” in the schedule order. For example, blood tests and ultrasounds are common throughout your pregnancy. 

Other tests and screenings may also be combined for your convenience, but you’ll want to talk to your OBGYN about specifics for your situation.

First trimester prenatal tests are very important, but you shouldn’t panic if unavoidable circumstances have caused you to miss them. The goal is simply to get your testing back on track as quickly as possible.

Are There Risks to Screenings?

Ultrasounds, blood work, and urine screenings pose absolutely no risk to you or to your fetus. They are completely routine. You also don’t need to do anything special to prepare: you can eat and drink normally (unless instructed to do otherwise by your OBGYN). As mentioned earlier, one risk to genetic screening is that it could be a false positive screen that leads to further testing and sometimes more invasive diagnostic procedures. Ultimately this could cause more stress and worry.

The Importance of Prenatal Testing

First trimester prenatal testing is designed to provide information to parents as early in the pregnancy as possible. Screenings can detect problems early and, often, therapies can be deployed to help ensure a healthy and productive pregnancy. The goal of your OBGYN will be to monitor your health and the health of your growing baby.

The point of optional genetic screenings, on the other hand, is to provide parents with time: If the tests reveal nothing to worry about, you’ll have more time to enjoy your pregnancy without some specific anxieties hanging over your head. 

On the other hand, if genetic screenings reveal a cause for concern, you will have more time to consider your options and plan accordingly. For example, you may wish to schedule further screenings, depending on the results of your first trimester screenings.

All your testing options should be discussed with your OBGYN so that you understand what tests are being run and why.

If you’d like to see a gynecologist at NSAGO, please contact us at our Wilmette or Glenview locations.