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PRENATAL LABORATORY TESTS

URINE TESTS

One of the first laboratory tests to obtain [ preferably before beginning the physical examination] is the clean catch midstream urine specimen = which will be tested for

Glucose [ to assess for diabetes] Protein [ to assess for PIH] Nitrites and Leukocytes [ to assess for infection]

BLOOD TESTS Initial prenatal blood tests include: CBC [Complete Blood Count] Blood type RH Status

Rubella titer Serologic test for syphilis Hepatitis B Surface Antigen

Name of Test Blood Type, Rh Factor, and Antibody Screen Hematocrit

Time of Test in Pregnancy Initial OB visit & 8 weeks for Rh negative females Initial OB visit & 36 weeks

Normal Value A, B, AB, O, Rh+ or - ; no irregular antibodies

Abnormal Values Irregular antibodies found

Special Teachings If not her first pregnancy, inquire about previous Rh immune globulin if Rh - , RhoGAM administration Eat iron-rich foods Report any bleeding

33 to 44%

Outside range

Initial OB Hemoglobin visit & 36 weeks RBC Initial OB visit Initial OB visit

11 to 14g/dl

Outside range

Effects of pregnancy on iron needs

100 to 400g/dl 3

Outside range Outside range Outside range Positive Confirmed by further testing:

Red cell indices will also be examined to R/O hemoglobinopathies Report signs of infxn Report abnormal bleeding of gums, Bruising Specific informed consent Obtained prior to testing. Advise of dramatic decrease of vertical

WBC

Platelets

3 6 to 16 X1O/mm 130,000 to Initial OB visit 300,000/ml

HIV

Offered @ Initial visit

Negative

Western Blot

Hepatitis B

Initial OB visit

Negative

Positive

[mother to child] transmission with medication] Inform client of sexual transmissibility. Explain importance of prophylaxis for infant. Educate client about infxn. Empathetic listening if positive. Stress importance of compliance And partner treatment.

Gonorrhea

Initial OB visit

Negative

Positive

Rubella Titer
[ German Measles]

Initial OB visit

Immune

Recommend maternal Nonimmun immunization after e birth. Stress the avoidance of pregnancy for 3 mos. after immunization. Avoid

First trimester exposure to infxn due to risk of congenital rubella syndrome Urinalysis Initial OB visit Negative Presence of protein, glucose, ketones, RBCs, WBCs Refrain from Epithelial intercourse or cell douching 2 to 3 days abnormalitie prior to test [for s accuracy]. Or neoplasm Discuss individualized schedule of testing. Client can decide whether gender of child should be Abnormal revealed; some ultra sound studies require vaginal probe; nuchal

ou

Papanicola Smear

Initial OB visit

Negative

Ultrasound

Optional, frequently at 15 to 20 weeks dependent

Normal

on rationale

translucency test % 11 weeks is ti screen for chromosomal abnormalities