Pregnancy Screening & Testing
| First prenatal visit | Blood type & Rh Factor Rubella IgG and IgM — positive IgG only = immune CBC HBsAg VDRL (syphilis) — can use EIA Ab then RPR. Re-screen @ delivery HIV antibody STI (chlamydia, gonorrhea) — with NAAT Varicella IgG — (+) means immune Safe vaccines = Tdap, flu, HBV Unsafe vaccines = HPV, MMR, Varicella, live attenuated influenza Diclectin® (pyridoxine/doxylamine) for nausea/vomiting |
| Second prenatal visit | PAP smear if not done in last 3 years |
| Week 11 | Dating ultrasound @ 8-12 weeks Week 11-14: Beta-hCG, PAPP-A, nuchal translucency Week 15-20: MSAFP, Beta-hCG, estrogen, inhibin A Chorionic villus sampling (week 10), amniocentesis (week 15) |
| Week 20 | Ultrasound anatomy scan offered |
| Week 24-28 | Tdap @ 27-32 weeks |
| Week 35-37 | GBS swab |
| Week 38-39 | “Stretch & Sweep” — sweeping membranes to reduce incidence of late term pregnancy (low evidence, conditional recommendation) |
| Week 39 (full term) | induce @ 39 weeks if GDM or older mom (≥40 years) |
| Late term | induce when ≥41 weeks |
| C-section indications | >4500g baby in GDM mom >5000g baby in any mom |
| IOL (induction of labor) | oxytocin or misoprostol GBS+ ROM GBS- ROM — can do IOL or expectant management for 24h but no digital exams until active labor |
