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Game, Set, Test

04/16/2011

Having a baby is like planning a wedding, there are really fun parts like telling your family and friends and there are not so great parts like checking the costs of venues and having a million vials of blood drawn.

So what tests are there? Well, there are as many as you would like to subject yourself and your baby to, some are optional, some are recommended by your physician, and some are mandatory. I’m providing below a list of tests and doctor appointment that I had and when I did them, this is not a complete list of the tests you may need, though I doubt a complete list could be compiled given the vast number of possibilities.

  • At home pregnancy test. 6 wks 5 days. Mandatory unless you do the next test instead.
  • Lab pregnancy test (requires blood work). 6 wks 6 days. Optional, recommended by my physician.
  • Doctor visit for ultrasound to determine if pregnancy was ectopic. 7 wks. Optional, recommended by my doctor due to my symptoms.
  • First official prenatal doctor appointment with OBGYN, with ultrasound. 9 wks. Mandatory.
  • Blood work to check iron levels and vitamin D levels and a bunch of other stuff. 9 wks. Doctor recommended due to my previous anemia. Being anemic when pregnancy can be harmful to the fetus. (http://www.marchofdimes.com/pregnancy/complications_anemia.html) I’m not sure what all the tests that were performed were, but it involved 8 vials of blood being drawn!
  • Universal genetic testing. 10 wks. Optional and often not covered by insurance. My husband and I elected to do a genetic disorders test on me. My doctor provided a mail away kit for me to send saliva and they tested for literally hundreds of genetic diseases that I could be the carrier of. The cost was less than $400 and I only came back positive for one item which my husband was then able to do a blood test for which was covered by insurance. In our case, the only way the baby could have this disease is if my husband is also a carrier of the genetic disorder. This is the company we used. (https://www.counsyl.com/learn/universal-genetic-test/)
  • First trimester blood work to test for trisomy-21, trisomy-18, spina bifida, and SLOS. 10 wks. Optional, but doctor recommended if you have any close family members with these conditions. Trisomy-21 is better know as down syndrome, while trisomy-18 is known as Edward’s disease and is typically fatal. (http://www.trisomy18.org/site/PageServer?pagename=parents_whatisT18). If you live in California, there is a California Prenatal Screening Program (http://www.cdph.ca.gov/programs/pns/pages/default.aspx) which provides you with a risk assessment for these conditions. These tests as well as those listed below are covered by insurance in most cases.
  • First meeting with geneticist. 11 wks. Optional, but mandatory if you have completed the blood work for trisomy, spina bifida and SLOS noted above. Also a part of the CA Prenatal Screening Program, you meet with a geneticist to review the blood work and receive your risk assessment results. They also perform an nuchal translucency (NT) ultrasound during which they measure the thickness of the fluid on the back of the fetus’ neck. It it desirable for this thickness to be less than 3 mm according to my technician performing the test. A thickness greater than 3 mm can be an indication of down syndrome. A side benefit of having this NT ultrasound performed is it is a higher resolution ultrasound that is capable of being 3D (how cool is that?!?). My husband was impressed by the technology (he’s a computer engineer), I was impressed by the baby’s legs being crossed and how vividly I could see the baby. Example of what this imagery looks like: http://www.advancedwomensimaging.com.au/files/imagecache/page-image-enlarged/img/page/BabyAtTwelveWeeks4D.jpg.
  • Second prenatal appointment with OBGYN with optional ultrasound. 13 wks. Mandatory. The exact number of weeks between your prenatal appointments will be determined by your doctor, my doctor wants to see me every 4 weeks or so. You might want to ask your doctor if they have a doppler so you can listen to your baby’s heart beat!
  • Second trimester blood work to test for trisomy-21, trisomy-18, spina bifida, and SLOS. 15 wks. Optional, but mandatory if you have completed the first trimester blood work for trisomy, spina bifida and SLOS noted above. The second trimester tests are combined with the first trimester tests to better hone in on your baby’s risk levels for these conditions.
  • Second meeting with geneticist. 18 wks. Optional, but mandatory if you have completed the testing for trisomy, spina bifida and SLOS noted above. Discuss your risk levels for the various genetic conditions and determine if you would like to move forward with having more invasive testing done including an amniocentesis during which a technician will take a sample of the amniotic fluid using a long needle. Generally further testing is not recommended by the genetic counselor unless a very high risk level comes back from your blood work and the ultrasounds. Added benefit to this appointment is at 18 weeks they are often able to determine the sex of the baby (if you want to know) based on the ultrasound!

Whew! Long blog post, I know, but I think knowing what lies ahead can be half the battle. I am only taking these appointments to the middle of the second trimester, more to come in a later blog post, but you’re almost halfway there!

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