Second trimester testing: What to expect

second trimester testing Monday, November 26, 2018

In your second trimester of pregnancy, you and baby are likely feeling pretty good! Now you’ll have new things to navigate, including tests at your doctor’s office. Some tests will happen routinely at each visit. Others are optional or depend on your needs during pregnancy. Here’s what you can expect.

Routine tests

  1. Urine test. You’ll pee in a cup so your doctor can monitor for protein, sugar, and signs of infection.

  2. Blood test. A small amount of blood will tell your doctor your blood type and your Rhesus (Rh) factor, which shows if your blood has a certain protein. If you and your baby have different Rh factors, your pregnancy will need special care.
  3. A blood test also checks for:

    • Anemia, or low red blood cell count
    • Hepatitis B, syphilis, and HIV, so you reduce the risk of your baby being born with these conditions
    • Immunity to rubella (German measles) and varicella (chicken pox)
    • Cystic fibrosis or spinal muscular atrophy in the developing fetus
  4. Weight and blood pressure check. Changes in these can be signs of gestational diabetes or preeclampsia, potentially dangerous high blood pressure during pregnancy.

Optional tests

Depending on your health, age, and family history, you might also be offered these tests. Remember you never have to have any test. Ask why a test might be right or wrong for you, says Debra Johnson, MD, managing partner at South Sound Women’s Center.

“Things that patients may want to ask their doctor about testing [include]: What are my risk factors? What is the test for? Is it optional or recommended? What are the next steps if my test is abnormal?” Johnson says.

Doctors may suggest the following extra tests:

  • Multiple marker test. A blood test, done between 15 and 20 weeks’ gestation, that screens for birth defects, such as spina bifida, and chromosomal disorders, such as Down syndrome and trisomy 18, a life-threatening syndrome. You may also have had a first trimester screening for some of these risks. The results of both, called an integrated screening test, can give you the most accurate information.
  • Ultrasound. A safe, painless test using sound waves and a wand over your stomach to show images of the baby’s development, done between 18 and 22 weeks. Women with high-risk pregnancies may get more than one ultrasound this trimester.
  • Glucose screening. A sugary drink and blood test, usually at 24 to 28 weeks, that checks if you are processing carbohydrates normally. If you’re not, that’s a sign of gestational diabetes, or short-term diabetes during pregnancy. It can cause health problems for baby if it’s not treated. It’s also a risk for Type 2 diabetes in mom after pregnancy.
  • Amniocentesis. A test of the amniotic fluid surrounding a fetus that checks for problems including birth defects and genetic disorders, usually between 15 and 20 weeks. A hollow needle is used to remove amniotic fluid from the womb. This is usually done if you have a high risk of having a baby with a birth defect. There is a small risk of miscarriage with this test. There is also a small risk of passing any infection you might have on to your baby.
  • Percutaneous umbilical blood sampling (PUBS). PUBS is also known as cordocentesis, fetal blood sampling, or umbilical vein sampling. This test takes blood from the umbilical cord to detect disorders in the fetus, usually after 18 weeks. It’s done in a similar way to amniocentesis. This test is rare compared to other tests for fetal problems, but can help if those tests are not conclusive. It also has a higher risk for miscarriage than amniocentesis. It also carries a risk for fetal bleeding, bruising of the umbilical cord, infection, or slowing of the baby’s heart.

Rare tests


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Depending on your individual situation, your doctor may recommend additional tests for these risks:

  • Thyroid disease: Hyperthyroidism can make you and your baby sick and it carries an increased risk of miscarriage
  • Toxoplasmosis: A parasite that can cause birth defects; it is carried in cat poop
  • Hepatitis C: A viral infection that can cause liver damage and be passed on to baby
  • Cytomegalovirus (CMV): A common virus among children and adults that can cause lifetime health problems if a baby is born with it
  • Tay-Sachs disease: A rare disorder that destroys brain and spinal cord nerve cells, most common among people with Ashkenazi Jewish ancestry
  • Canavan disease: A progressive, fatal disorder in which the nerves in the brain can’t send signals
  • Fragile X syndrome: A genetic disorder that includes intellectual disability
  • Tuberculosis: A serious disease that affects the lungs and can be harmful or lethal if passed on to baby

Read more about how pregnancy tests and visits are billed through your healthcare plan.

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