Midwifery Care – Routine Prenatal Visits

Ultrasound for fetal anatomy
A screening test for physical abnormalities in the developing baby. Like all screening tests, ultrasound cannot detect every potential problem that could occur with a developing baby. However, most major physical abnormalities can be found during this exam. Fortunately, most ultrasound results reveal a normally developing baby.

Diabetes screen
Changes in carbohydrate metabolism during pregnancy can lead to the development of diabetes during pregnancy (gestational diabetes). Because there is no certain way to predict who will develop gestational diabetes, it is recommended that all women be screened for this disorder. Low-risk women will be screened between 24–28 weeks; women with increased risk will be tested earlier in pregnancy.

The standard screening test is called a glucose challenge test (GCT). You will be given a drink that contains 50 grams of glucose. A blood test will be performed one hour later to measure the amount of glucose (sugar) in your blood. An elevated glucose level could be indicative of gestational diabetes. In this case, a 3-hour glucose tolerance test (3-hr GTT) will be performed to determine if you have developed gestational diabetes.

Hemoglobin/Hematocrit (H/H)
A blood test (either by blood draw or finger-stick sample), measures the amount of oxygen saturation and hemoglobin on the blood cells. Decreased levels of these are indicative of iron-deficiency anemia.

Group B Strep (GBS)
A vaginal/rectal swab is sent to the lab to check for the overgrowth of the Group B strep bacteria. Group B Strep is normally found in our intestines as part of the normal gastrointestinal flora. Women who are found to be GBS-positive are said to be colonized with the bacteria. This simply means the bacteria is present in the woman’s body in amounts significant enough to yield a positive test result. For some women, the amount is large enough to show up in the urine during pregnancy. There are no symptoms of being colonized with GBS, and it usually does not lead to infection. However, because babies’ immune systems are immature, they are more prone to developing a severe infection if exposed to the bacteria during birth. For this reason, it is recommended that any woman who is GBS-positive receive intravenous (IV) antibiotics during labor to decrease the risk of transmission from mother to baby.