Routine Laboratory Tests, Key Points, Prenatal Scheduled visits


Routine Laboratory Tests at return Visits

Blood Rh negative titer, antibody screen

Urinalysis, including microscopic exam and infection screen

Urine protein and glucose

Urine screen for urinary tract infection (UTI)

Maternal serum alpha-feto-protein (MSAFP)f 16-18 weeks gestation)

Toxoplasmosis - if indicated

Tuberculosis - if indicated

Group B Streptococcus - if indicated

Cytomegalovirus (CMV) - if indicated

Oral glucose tolerance testing when there is history of macrosomic, or malformed infant, fetal death; or first degree family history of diabetes

Key Points

  • All pregnant patients should be assessed periodically, to determine medical risk indicators for adverse maternal and infant outcomes.
  • A subset of patients will have a medical history of obstetric risk indicators.
  • Some pregnant patients will experience socio-behavioral-economic events that may be associated with adverse outcomes.
  • Social risk indicators should not be viewed as isolated events, but should be regarded as having a synergistic adverse effect on the pregnancy whether in combination with medical risk indicators or in combination with other social risk indicators.
  • All patients should be periodically assessed for these events and managed according to their unique pattern of risk.
  • All pregnant patients should be assessed for allergic or adverse reactions to latex products. The findings should be communicated to the Labor and Delivery unit prior to admission, where possible, or as soon after admission as practicable.

Prenatal Scheduled visits

[Note: There is limited evidence as to what represents an adequate number of prenatal care visits. More frequent visits may be necessary for high-risk patients.]

First Trimester Second Trimester Third Trimester
1st Visit 8-12 wks. Once 12-16 wks: Once 16-20 wks: Once 20-24 wks: Once 24-28 wks: Once 28-32 wks: Once 32-36 wks: Once 36 + wks: Wkly
Demographic Information
Gynecologic History
Obstetrical History
Menstrual History
Sexual History
Contraceptive History
Family & Genetic History
Infection History
Psychosocial History/ P/D Depression
Nutritional History/Update
Current Pregnancy History
Accurate Pregnancy Dating
Medical/Surgical History
Genetic History
Social History/Lifestyle Behaviors
Environmental Exposures
Pharmacologic History
Employment History
Financial History
Physical Exam
Height
Weight
Blood Pressure
Complete Physical Exam
Fetal Heart Rate
Fundal Height
Fetal Lie
Pelvic Exam
Digital Cervical Exam
Lab Tests & Procedures
Hemoglobin/Hematocrit
Hemoglobinopathies (if indicated)
Hepatitis B Titer
HIV
Rh Factor
Rubella Titer
STD Screening [GC, Chlamydia, VDRL]
Urinalysis or urine Culture
Urine Dipstick (protein & sugar)
Diabetes Screen
Triple Screen
Non-Stress Test (NST)
Group B Strep Culture