Routine Laboratory test in prenatal care and their purpose

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Routine Laboratory test in prenatal care and their purpose
2011-11-28 11:01:52
Routine Laboratory test prenatal care their purpose

Routine Laboratory test in prenatal care and their purpose
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  1. Blood Type, Rh-factor and presence of irregular antibodies
    determines the risk for matenal-fetal blood incompatibility (erythroblasosis fetalis) or neonatal hyperbilirubinemia. For patients who are Rh negitive and not sensitized the indirect Coombs' test will be repeated between 24 and 28 weeks
  2. CBC with differential, Hgb, and Hct
    detects infection and anemia
  3. Urinalysis
    with microscopic examination of pH, specific gravity, color, sediment, protein, glucose, albumin, RBC's, WBC's, casts, acetone, and human chorionic gonadotropin

    identifies diabetes mellitus, gestational hypertension, renal disease, and infection
  4. One-hour glucose tolerance
    oral ingestion or IV administration of concentrated glucose with venous sample taken 1 hr later [fasting not necessary]

    identifies hematuria; done at initial visit for at-risk patients, and at 24-28 weeks of gestation for all pregnant women (>140 mg/dL requires follow up)
  5. Three hour glucose tolerance
    fasting overnight prior to oral ingestion or IV administration of concentrated glucose with a venous sample taken 1,2,and 3 hours later

    used in patients with elevated 1-hr glucose test as a screening tool for diabetes mellitus.

    A dignosis of gestational diabetes requires two elevated blood-glucose readings
  6. Papanicolaou (PAP) test
    screens for cervical cancer, herpes simplex type 2, and/or hyman papillomavirus
  7. Vaginal/cervical culture
    detects streptococcus B-hemolytic, group B (routinely obtained at 35-37 weeks of gestation), bacterial vaginosis, or sexually transmitted infections (gonorrhea and chlamydia)
  8. Rubella titer
    want this to be positive

    determines immunity to rubella
  9. PPD (tuberculosis screening)
    chest screening after 20 weeks of gestation with positive purified protein derivative

    identifies exposure to tuberculosis
  10. Hepatitis B screen
    identifies carriers of hepatitis B
  11. Venereal disease research laboratory (VDRL)
    Syphilis screening mandated by law
  12. HIV
    recommended however the patient has the right to refuse
  13. Toxoplasmosis, Other infections, rubella, cytomagalovirus and herpes virus (TORCH) screening
    when indicated

    screening for a group of infections capable of crossing the placenta and adversely affecting fetal development
  14. Maternal serum alpha-fetoprotein (MSAFP)
    screening occurs between 15-22 weeks of gestation. Used to rule out Down syndrome (Low Level) and neural tube defects (high level). The provider may decide to use a more reliable indicator and opt for the Quad screening instead of the MSAFP at 16-18 weeks of gestation. This AFP, inhibin-A, a combination analysis of hyman chorionic gonadotropin, and estriol