During your pregnancy, you will experience a variety of exams, tests, and procedures. Some of the tests are routine for all pregnant women. Others are optional or may be recommended by your healthcare provider in certain situations or if there are complications.

You should keep all appointments with your healthcare provider so that problems can be detected as soon as possible. If any problems or potential problems are identified, your healthcare provider can plan for your care as necessary. During each visit, you will be asked about any symptoms or problems you may be having, particularly:

• Bleeding
• Contractions
• Leakage of fluid
• Regular movement of your baby once you start feeling your baby moving
• Headaches
• Swelling of your hands or feet
• Medication use

What Will My Healthcare Provider Look for During Prenatal Exams?

Your healthcare provider will look for and ask about signs and symptoms at the various stages of pregnancy including:

• Symptoms of early pregnancy, such as morning sickness, breast enlargement and tenderness, and frequent urination
• An embryo, viewed with ultrasound
• Enlarged uterus
• Enlarged abdomen
• Fetal heartbeat
• Movement of the baby
• Changes in your vagina, cervix, and skin

What Routine Tests and Procedures Can I Expect to Have?

You will probably have the following routine tests and procedures:

• Pelvic exam, to determine the size of your pelvis and uterus
• Pap smear, very early in the pregnancy if you have not had a recent one
• Weight measurement and blood pressure (at each visit)
• Determination of gestational age and due date
• Urine tests to check for protein, sugar, and bacteria
• Assessment of the size and position of the fetus
• Blood tests to check for anemia, diabetes, blood type, Rh factor, rubella antibodies, syphilis, hepatitis, HIV, and other sexually transmitted diseases
• Exam of your lower legs and ankles for swelling

The Centers for Disease Control and Prevention recommends a vaginal/rectal culture for Group B streptococcus (at 35-37 weeks of pregnancy) to prevent infection of the baby during labor and delivery.

Women with certain medical conditions have a higher risk of having problems during pregnancy and may need additional regular prenatal testing like ultrasounds. Examples include women with high blood pressure, diabetes, kidney disease, heart disease, multiple pregnancies (2 or more fetuses), too much or too little amniotic fluid, or post-term pregnancy.

What Additional Tests Might Be Ordered?

Additional tests may be done if your healthcare provider thinks they are medically necessary. It may be done if your baby has a high risk of certain genetic issues or if you have had some complications in your pregnancy. Examples of additional tests include:

• Triple/quadruple blood screen test—This test gives more information about risk of birth defects and includes tests for alpha-fetoprotein, conjugated estradiol, and human chorionic gonadotrophin, as well as Inhibin A in the quadruple screen. If the results are positive, this screening test may be supplemented by an ultrasound or other tests to look for abnormalities.
• Nonstress tests—These tests check changes in the baby’s heart rate as they moves.
• Ultrasound—The ultrasound is used for dating of pregnancy and detecting abnormalities.
• Genetic testing—Preconceptional or prenatal gene carrier screening is recommended for genetic diseases in individuals are at higher risk of these conditions. Examples of people that may need this testing include persons of Eastern European Jewish descent.
• Amniocentesis—This test is used for detecting chromosomal abnormalities and birth defects.
• Chorionic villus sampling (CVS)—CVS is used for detecting chromosomal abnormalities and birth defects.

What Tests Are Given to Women With High Risk Factors?

If you have high risk factors for pregnancy complications, you may have additional tests and procedures. Examples include:

• Amniocentesis to determine fetal lung development
• Blood tests to assess clotting and liver function
• Blood tests to look for genetic and chromosomal abnormalities, and Rh factor
• Biophysical profile—to check fetal health with ultrasound and a non-stress test
• Rh antibody screening—repeated at 28-30 weeks if you are Rh negative
• Stress tests to check your baby's health by monitoring for heart rate during uterine contractions
• Vaginal culture for fetal fibronectin—a screening test for likelihood of premature labor