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Pregnancy Examinations

Pregnancy is a special time in every woman’s life, full of joy, anticipation, but also questions and uncertainty. One of the key aspects of taking care of your health and that of your developing baby is to perform regular prenatal tests. This comprehensive guide will help you understand what tests are necessary during pregnancy, when to do them, and what to expect from them. Our goal is to provide you with reliable knowledge so that you can consciously and calmly go through this extraordinary period.

The Magic of Expectation and the Role of Prenatal Testing

Waiting for a baby is real magic, but also a time of great responsibility. Modern medicine offers a wide range of prenatal tests to monitor the proper development of the fetus and the health of the future mother. Regular visits to the doctor and conscientious performance of the recommended tests are the foundation of a safe pregnancy and a healthy start for your baby.

Why are pregnancy tests so crucial?

• Monitoring the baby’s development should include regular ultrasound examinations during pregnancy. The tests allow for the assessment of the normal growth and development of fetal organs at every stage of pregnancy.
• Early detection of abnormalities: Some tests allow for early diagnosis of possible birth defects or genetic diseases, which gives you time to take appropriate steps, including possible treatment while still in the womb or to prepare for specialist care after childbirth.
• Taking care of the mother’s health is crucial in the context of the pregnancy examination calendar. The tests monitor the health of the pregnant woman, allowing for early detection and treatment of potential complications, such as gestational diabetes, hypertension or infections.
• Peace and security: Knowledge about the proper course of pregnancy and the health of the child gives future parents great psychological comfort.

Types of prenatal tests:

Pregnancy tests can be divided into several categories:

• Screening: They are aimed at selecting a group of women with an increased risk of specific problems (e.g. genetic defects of the fetus, gestational diabetes). They are non-invasive and safe. An abnormal result does not indicate a disease, but only indicates the need for further diagnostics.
• Diagnostic tests during pregnancy: They are performed to confirm or exclude the initial diagnosis made on the basis of screening tests. They can be invasive (e.g. amniocentesis) and involve a low risk of complications.
• Mandatory examinations: Defined by the standards of perinatal care, financed by the National Health Fund.
• Recommended tests: Additional tests that may be indicated in specific situations (e.g. maternal age, family history, abnormal previous test results).

This article is your comprehensive guide to the world of prenatal testing. Step by step, we will discuss the tests recommended in each trimester of pregnancy, explain their purpose and course.

Preparing for Pregnancy: The Foundation for a Healthy Start

Although this article focuses on tests during pregnancy, it is worth emphasizing the importance of properly preparing the body even before conception. Conscious pregnancy planning and preconception tests can significantly increase the chance of a healthy pregnancy and the birth of a healthy child.

Preconception tests – why is it worth it?

The preconception period is the perfect time to take care of your health and identify possible risk factors, including tests that should be performed during pregnancy. Performing certain tests before pregnancy allows you to:

• Detection and treatment of existing diseases that could negatively affect the course of pregnancy or the health of the child (e.g. thyroid disease, diabetes, anaemia, infections).
• Checking immunity to infectious diseases dangerous to the foetus (e.g. rubella, toxoplasmosis, cytomegalovirus) and possibly supplementing vaccinations.
• Starting folic acid supplementation, which is crucial for the proper development of the baby’s nervous system during pregnancy.
• Introducing healthy eating habits and lifestyle.

Consultation with a gynaecologist before a planned pregnancy:

A visit to a gynaecologist at the stage of planning pregnancy is a great opportunity to:

• Conducting a detailed interview about your health condition, medical history, medications taken, previous pregnancies.
• Gynecological examination and cytology.
• Ordering appropriate laboratory tests (complete blood count, urine test, glucose level, tests for infections, blood group determination).
• Get advice on supplementation, diet and lifestyle.

Folic acid supplementation and its importance:

Folic acid (vitamin B9) plays an extremely important role in preventing neural tube defects in the fetus (such as spina bifida or anencephaly). It is recommended that every woman planning pregnancy start supplementation with folic acid at a dose of 0.4 mg per day at least 3 months before conception and continue it at least until the end of the first trimester of pregnancy. In some cases (e.g. earlier birth of a child with a neural tube defect, taking certain medications), your doctor may recommend a higher dose.

Lifestyle and fertility and health of future pregnancy:

A healthy lifestyle has a huge impact on fertility and the course of pregnancy. Before the planned conception, it is worth to:

• Give up smoking and alcohol.
• Limit caffeine intake.
• Take care of a balanced diet rich in vegetables, fruits, whole grain cereal products, lean protein and healthy fats.
• Maintain a healthy body weight.
• Engage in moderate-intensity physical activity regularly.
• Take care of the right amount of sleep and reduce stress.

Remember that healthy habits developed before pregnancy will pay off not only with easier conception, but also with a healthier pregnancy and better well-being, which is important during pregnancy.

I Trimester – Calendar of examinations in pregnancy

The first trimester is a time of dynamic embryo development and formation of all the most important organs. It is also a period when a number of fundamental tests are performed to confirm pregnancy, assess the mother’s health and early detection of possible abnormalities in the fetus.

First Visit to the Gynaecologist (usually between 6 and 10 weeks of pregnancy)

The first visit after confirming pregnancy (e.g. with a urine pregnancy test) is extremely important. This is the moment when the doctor:

• Confirms pregnancy: Usually by vaginal ultrasound.
• She sets up a pregnancy card: A document in which all information about the course of pregnancy, test results, measurements will be recorded.
• Conducts a detailed medical history: The questions will concern the date of the last menstrual period (in order to determine the approximate date of delivery), general health, past illnesses, surgeries, medications taken, allergies, working conditions, addictions, obstetric history (previous pregnancies, births, miscarriages), diseases occurring in the family (especially genetic).
• Performs gynaecological examination: Assessment of the reproductive organ.
• It measures blood pressure and body weight.
• He orders a package of first, mandatory laboratory tests.
• It gives the first recommendations: Concerning diet, supplementation (continuation of folic acid, possibly other vitamins), lifestyle, avoiding harmful factors.

Basic Laboratory Tests (ordered at the first visit)

These are blood and urine tests that provide key information about the health of the future mother.

• Blood count: One of the basic tests assessing the number and quality of red blood cells (erythrocytes), white blood cells (leukocytes) and platelets (thrombocytes). It allows you to detect, m.in. anaemia, which is common in pregnancy, inflammation or coagulation problems.
• General urinalysis: It allows for the assessment of kidney function and the detection of possible urinary tract infections, which may be asymptomatic during pregnancy and, if left untreated, lead to serious complications (e.g. premature birth). This test will be repeated regularly throughout the pregnancy.
• Determination of blood type and Rh factor: An extremely important test to determine the mother’s blood type (A, B, AB, 0) and the presence or absence of the Rh factor. If the mother has Rh-negative (Rh-) blood and the child’s father has Rh-positive (Rh+), there is a risk of serological conflict, which should be monitored during pregnancy.
• Immune antibodies (anti-RhD in Rh-negative women): In women with Rh-negative blood type, the presence of anti-RhD antibodies is tested. If they are absent and there is a risk of conflict, anti-D immunoglobulin is administered at the right time during pregnancy and after childbirth to prevent the production of these antibodies. This test is repeated in the following trimesters.
• Fasting glucose: Preliminary assessment of carbohydrate metabolism and the risk of gestational diabetes. A full test for gestational diabetes (glucose tolerance test) is usually performed in the second trimester.
• Tests for infectious diseases:
  • Syphilis (VDRL/WR): Screening for syphilis, a sexually transmitted disease that can be very dangerous for the fetus.
  • HIV: assessment for pre-pregnancy Igg antibodies. Testing for HIV infection. Early detection and appropriate treatment significantly reduce the risk of transmitting the virus to the child.
  • HCV (hepatitis C): Hepatitis C test
  • Rubella (IgG and IgM antibodies) – tests should be performed during pregnancy. Assessment of immunity to rubella and performing a test for the presence of pre-pregnancy igg antibodies. Having recovered from the disease or vaccination gives immunity (IgG antibodies present). Active infection (present IgM) during pregnancy is very dangerous for the fetus. If a woman does not have immunity, she should avoid contact with sick people.
  • Toxoplasmosis (IgG and IgM antibodies): Assessment of the risk of infection with toxoplasmosis, a parasitic disease transmitted, m.in, during pregnancy. through contact with cat feces or raw meat. A fresh infection in pregnancy (present IgM, low or no IgG) is dangerous for the fetus, so it is important to monitor blood during pregnancy. This test is often repeated in subsequent trimesters in seronegative women (without antibodies).
  • Cytomegalovirus (CMV) (IgG and IgM antibodies): Testing for cytomegalovirus, a common viral infection. Primary CMV infection in pregnancy can lead to serious defects in the baby. Although it is not mandatory by all standards, it is increasingly recommended.

First ultrasound examination (usually between 6 and 10 weeks of pregnancy)

The first ultrasound examination, most often performed with a vaginal (transvaginal) probe, is aimed at:

• Confirmation of intrauterine pregnancy: Exclusion of ectopic pregnancy.
• Assessment of gestational age: Based on the measurement of the embryo’s parietal-sit length (CRL). This allows you to precisely determine the date of delivery.
• Determination of the number of embryos: Whether it is a single, twin or multiple pregnancy.
• Fetal Heart Function Visualization (FHR): Confirmation of pregnancy viability.
• Assessment of the mother’s reproductive organ: Detection of possible uterine fibroids or ovarian cysts during an ultrasound examination during pregnancy is important.

This examination provides a lot of emotions and is often the first “meeting” between parents and their child.

Genetic Screening (between 11 and 13 weeks + 6 days of pregnancy)

These are non-invasive tests that allow to estimate the risk of the most common genetic defects in the fetus, such as Down syndrome (trisomy 21), Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13). They consist of an ultrasound examination and biochemical tests from the mother’s blood.

• Genetic ultrasound of the first trimester (so-called reference ultrasound): This is a very detailed ultrasound examination, performed by a certified doctor, which includes:
  • Nuchal Translucency (NT) assessment: Measurement of a small reservoir of fluid at the nape of the fetus. An increased NT value may indicate an increased risk of genetic defects, but also heart defects.
  • Assessment of the presence of nasal bone (NB – Nasal Bone): The absence or underdevelopment of the nasal bone is more often observed in fetuses with Down syndrome.
  • Evaluation of other ultrasound markers (optional): Such as blood flow through the tricuspid valve (TR), blood flow in the ductus venosus (DV). Abnormalities in these flows can also increase the risk of defects.
  • Early assessment of fetal anatomy and pregnancy ultrasound: The doctor assesses the structure of the skull, brain, spine, limbs, abdominal organs, and bladder.
  • Accurate measurement of the parietal-sit length (CRL): To accurately determine gestational age.
• PAPP-A test (dual test): A maternal blood test that determines the concentration of two substances:
  • PAPP-A proteins (pregnancy plasma protein A): Produced by bearing.
  • Free subunit of beta-hCG (free chorionic gonadotropin): A hormone produced by the trophoblast. Abnormal concentrations of these proteins (e.g., low PAPP-A and high beta-hCG in the case of Down syndrome) may indicate an increased risk of genetic defects.

The results of the genetic ultrasound and the PAPP-A test are then entered into a special computer program which, also taking into account the mother’s age, calculates the individual risk of the fetus developing trisomy 21, 18 and 13. The result is given as a ratio, e.g. 1:1000 (which means that out of 1000 women with the same results, statistically one will give birth to a child with a given defect).

Important: First trimester screening tests do not give a definitive diagnosis, but only estimate the risk. If the risk is elevated, your doctor may recommend further diagnostics, such as non-invasive prenatal tests (NIPT) or invasive tests (amniocentesis, chorionic villus sampling).

Non-Invasive Maternal Blood Prenatal Tests (NIPT)

NIPT (Non-Invasive Prenatal Testing), such as the NIPT test, Harmony, Sanco, Panorama, are modern screening tests with very high sensitivity (above 99% for Down syndrome). They involve the analysis of free fetal DNA (cffDNA), which circulates in the mother’s blood, coming from placental cells.

• What do they consist of? CffDNA is isolated from the mother’s blood sample and analyzed for the presence of additional chromosome copies (aneuploidy).
• When are they recommended?
  • Maternal age over 35 years.
  • Abnormal first or second trimester screening result.
  • Earlier birth of a child with a genetic defect.
  • Presence of specific chromosomal translocations in the parents.
  • Parents are very concerned about the child’s health, even with normal results of other screening tests (at the patient’s request, the test is fully paid).
• What defects do they detect? Mainly the most common trisomies (21, 18, 13), sex chromosome aneuploidies (e.g. Turner syndrome, Klinefelter syndrome). Some tests offer a broader panel of disorders studied, including microdeletions, and the presence of pre-pregnancy igg antibodies. Most NIPT tests also determine the sex of the baby with high accuracy.
• Sensitivity and specificity: These tests are of very high sensitivity and specificity, especially for Down syndrome. However, these are still screening tests.
• When does the NIPT result need to be confirmed? If a result indicating a high risk of a genetic defect is obtained, it is recommended to confirm it by an invasive diagnostic test (e.g. amniocentesis), as there is a small risk of a false positive result (e.g. due to placental mosaicism).

NIPT tests, as non-invasive prenatal tests, are usually available from the 10th week of pregnancy. They are safe for mother and child, because they only require blood from the pregnant woman.

Second Trimester of Pregnancy (14th – 27th week + 6 days): Growth Time and Detailed Assessment

The second trimester is the most pleasant period of pregnancy for many women. The discomfort of the first trimester usually subsides and the abdomen begins to be visible. It is also a time of important tests that focus on a detailed assessment of the anatomy of the fetus and monitoring the health of the mother.

Laboratory tests (continuation)

As in the first trimester, basic laboratory tests are performed regularly:

• Blood count: Control for anemia, which can worsen as pregnancy progresses. Usually ordered between the 15th and 20th week.
• General urinalysis: Regular check-up for urinary tract infections. Ordered at each follow-up visit.
• Immune antibodies in Rh-negative (anti-RhD) women: If the first test in the first trimester showed a lack of antibodies, the test is repeated. In Rh-negative women whose partner is Rh-positive or whose blood type is unknown, and who have not developed anti-D antibodies, anti-D immunoglobulin is given prophylactically between 28 and 30 weeks of pregnancy.

Glucose Tolerance Test (OGTT) – Diagnosis of Gestational Diabetes (between 24 and 28 weeks of pregnancy)

This is a crucial screening test for gestational diabetes – a glucose tolerance disorder that first appears in pregnancy. Untreated gestational diabetes can lead to complications both in the mother (e.g. hypertension, preeclampsia, infections) and in the baby (e.g. excessive birth weight – macrosomia, hypoglycemia after childbirth, increased risk of obesity and type 2 diabetes in the future).

• The course of the test (the so-called 3-point sugar curve):
  1. The first blood sample on an empty stomach (after a minimum of 8 hours of fasting) to determine glucose levels.
  2. Drinking a solution containing 75g of glucose dissolved in water (within 5 minutes).
  3. The second blood sample is taken 1 hour after drinking glucose.
  4. The third blood sample is taken 2 hours after drinking glucose.
• Preparation for the test:
  • For 3 days before the test, you should follow a normal diet, without restricting carbohydrates.
  • You should come to the test on an empty stomach (last meal at least 8-12 hours earlier, you can drink water).
  • On the day of the test, you should not take your morning medication (unless your doctor tells you otherwise).
  • During the test (2 hours), you should stay in the clinic, at rest, do not eat, drink (except for the recommended blood glucose) and do not smoke.
• Interpretation of results: Gestational diabetes is diagnosed when at least one of the following glucose values is exceeded:
  • Fasting: ≥ 92 mg/dL (5.1 mmol/L)
  • After 1 hour: ≥ 180 mg/dL (10.0 mmol/L)
  • After 2 hours: ≥ 153 mg/dL (8.5 mmol/L)
• Further procedure: If gestational diabetes is diagnosed, the woman is referred to a diabetes clinic. Treatment consists mainly of a proper diet, regular physical activity and self-control of glycemia. In some cases, insulin may need to be introduced.

Mid-Term Ultrasound (Anomaly Scan) (between 18 and 22 weeks of pregnancy, optimally 20 weeks)

It is one of the most important and detailed ultrasound examinations throughout pregnancy, including the assessment of the occurrence of defects. Its main purpose is to accurately assess the anatomy of the fetus for possible birth defects.

• What does the doctor assess during a mid-term ultrasound?
  • Head and brain: The shape of the skull, the structure of the brain (ventricles, cerebellum, sickle brain).
  • Face: Profile, eye sockets, nose, lips (exclusion of cleft lip and palate).
  • Neck: Exclusion, e.g. thyroid goiter.
  • Thorax: Lungs, diaphragm.
  • Heart: Location, size, structure of four heart cavities, main blood vessels (the so-called fetal echocardiographic examination). Heart defects are one of the most common congenital defects.
  • Abdominal cavity: stomach, intestines, kidneys, bladder, abdominal wall (exclusion of e.g. umbilical hernia during pregnancy).
  • Spine: Continuity assessment, cleft exclusion.
  • Limb: The presence and structure of long bones of arms and legs, hands, feet, fingers.
  • Sex of the baby: If the parents wish it and the position of the child allows it, the doctor can determine the sex.
  • Placenta: Location (whether it is not superior), structure, thickness.
  • Umbilical cord: Number of vessels (normally two arteries and one vein).
  • Amniotic fluid volume: An AFI (Amniotic Fluid Index) or MVP (Maximum Vertical Pocket) rating.
  • Cervix: Length measurement, especially important in women at risk of preterm birth.
  • Fetal biometrics: Measurements of the head (BPD, HC), abdomen (AC) and femur (FL) to assess fetal growth and estimate its weight.
• What if irregularities are detected? If a defect in the foetus is suspected or found, the doctor refers the patient for further, more specialised tests (e.g. foetal heart echo, genetic consultation, foetal magnetic resonance imaging) or to a reference centre dealing with the diagnosis and treatment of foetal defects. Early detection of some defects allows treatment to be planned in the prenatal period or immediately after birth, which significantly improves the child’s prognosis.

A mid-term ultrasound is a test reimbursed by the National Health Fund.

Diagnostic (Invasive) Testing – Indications and Risks

Invasive testing involves taking the genetic material of the fetus (fetal cells) in order to accurately analyze its chromosomes (karyotype) or specific genes. They are recommended only in specific situations where there is an increased risk of a genetic defect, as they are associated with a small (0.5-1%) risk of complications, including miscarriage. The decision to perform an invasive test is always made individually, after consultation with a doctor and geneticist.

• When are they necessary (most common indications)?
  • Abnormal first or second trimester screening result (e.g., high risk of trisomy on PAPP-A or NIPT test).
  • The mother’s age over 35 years (although age itself is increasingly rarely the only indication if the screening results are normal).
  • Birth of a previous child with a genetic defect or metabolic disease.
  • The presence of genetic diseases in the family or the carriage of a chromosomal translocation in one of the parents.
  • Finding fetal malformations in an ultrasound.
• Types of invasive tests:
  • Amniocentesis (usually performed after the 15th week of pregnancy):
    • What does it involve? Under ultrasound guidance, the doctor punctures the abdominal wall and uterus with a thin needle, collecting a small amount of amniotic fluid, which contains fetal cells (amniocytes).
    • What information does it provide? It allows for an accurate assessment of the fetal karyotype (number and structure of chromosomes), as well as for molecular tests for specific genetic diseases. The karyotype test result is usually available after 2-3 weeks (the time needed for cell culture). It is possible to obtain a faster initial result (e.g. by FISH) for the most common aneuploidies within a few days.
    • Risk of complications: The main risk is miscarriage (approx. 0.5-1%), less often intrauterine infection, amniotic fluid leakage.
  • Chorionic Villus Sampling (CVS) (performed between 11 and 14 weeks of pregnancy):
    • What does it involve? Under ultrasound guidance, a fragment of the chorionic villus (part of the future placenta) is taken, which has the same genetic origin as the fetus. It can be performed transabdominally or transvaginally.
    • Advantages: Possibility of obtaining a diagnosis earlier than in the case of amniocentesis.
    • Risk: Slightly higher risk of miscarriage than with amniocentesis (approx. 1-2%) during pregnancy. There is also a small risk of so-called placental mosaicism, which may make it difficult to interpret the result and require additional verification (e.g. amniocentesis).
  • Cordocentesis (usually performed after the 18th week of pregnancy):
    • What does it involve? Under ultrasound guidance, a blood sample is taken directly from the umbilical vein of the fetus.
    • Indicate: It is performed less frequently, mainly in situations requiring rapid karyotype assessment (e.g. in the case of late detected ultrasound defects), diagnosis of foetal anaemia, serological conflict, intrauterine infections, as well as for therapeutic purposes (e.g. intrafoetal transfusions).
    • Risk: Higher than in amniocentesis and CVS (approx. 1-3%).

Before each invasive examination, the patient is informed in detail about its purpose, course, possible benefits and risks.

Third Trimester of Pregnancy (28 weeks to delivery): Preparation for the Meeting

The third trimester is a time of intensive growth of the baby and preparations for childbirth. Follow-up visits are becoming more frequent, and research is focusing on monitoring fetal well-being and maternal health in the final stages of pregnancy.

Regular check-ups

The frequency of visits to the doctor in charge of the pregnancy increases:

• Until the 32nd week of pregnancy: every 3-4 weeks.
• From 32 to 36 weeks of pregnancy: every 2 weeks, an ultrasound examination is recommended.
• From the 37th week of pregnancy until delivery: every week.

During each visit, the doctor:

• It measures blood pressure.
• It controls body weight.
• It assesses the presence of swelling.
• He examines the height of the uterine fundus.
• It auscultates the fetal heart rate.
• He asks about the feeling of fetal movements (a very important indicator of the baby’s well-being).
• Analyzes the results of the ordered tests.

Laboratory tests

• Blood count: Check-up, usually ordered between 33 and 37 weeks.
• General urinalysis: At every visit.
• Immune antibodies in RhD-negative women: Again, if there has been no intragestational prophylaxis with anti-D immunoglobulin or if there are indications.
• Tests for infectious diseases (repeated, if indicated):
  • HIV: Recommended re-examination in the third trimester.
  • HCV: If you are pregnant and there are risk factors.
  • Syphilis (VDRL) – tests should be performed during pregnancy. If there are risk factors.

Culture for GBS (Streptococcus agalactiae) (between 35 and 37 weeks of gestation)

This is a very important screening test for group B streptococcal (GBS) carriers.

• Group B streptococci – why are they dangerous for a newborn? GBS is a bacterium that can colonize the genital tract and gastrointestinal tract in about 10-30% of healthy women without giving any symptoms. However, during childbirth, they can be transferred to the newborn, causing severe infections such as pneumonia, sepsis (sepsis) or meningitis.
• Swab collection: The doctor or midwife takes a swab with a special swab from the vagina (from the lower part of the vagina) and from the anus at the same time. The examination is painless.
• Procedure in the event of a positive result: If the culture result is positive (GBS is found), the woman is given a prophylactic antibiotic intravenously during labor (usually penicillin or ampicillin, the first dose at least 4 hours before the birth of the baby). Such perinatal antibiotic prophylaxis is very effective in preventing early GBS infection in newborns.

Third Trimester ultrasound examination (usually between 28 and 32 weeks, sometimes later, e.g. 36-37 weeks)

This is another important ultrasound examination, the main purpose of which is:

• Fetal growth assessment (biometrics): Remeasurement of the head (BPD, HC), abdomen (AC) and femur (FL) to estimate the current fetal weight and compare it with the norms for a given gestational age. This allows you to detect possible growth disorders such as hypotrophy (too low weight) or macrosomia (too much weight).
• Assessment of fetal welfare:
  • Amniotic fluid volume: An important indicator of fetal placental and kidney function.
  • Fetal movements: Physical activity of the child.
  • Vascular flow assessment (Doppler examination): Blood flow in the umbilical artery, the middle artery of the fetal brain, sometimes in other vessels. Abnormal flows may indicate foetal hypoxia or placental insufficiency.
• Position of the fetus: Determining whether the baby is in a cephalic (correct), pelvic or transverse position. This is crucial for planning how to give birth.
• Placenta Location and Evaluation: It is particularly important to exclude placenta previa, which may be an indication for caesarean section.
• Assessment of certain markers of preparation for labour.

Sometimes, in justified cases (e.g. suspected macrosomia, pregnancy after the due date), an additional ultrasound is performed closer to the due date.

Cardiotocography (CTG) (from approx. 38 weeks of pregnancy or earlier if indicated)

CTG is a test that involves simultaneous monitoring of fetal heart function (cardiography) and uterine contractions (tocography).

• Purpose: Assessment of the well-being of the fetus, especially its response to possible uterine contractions and detection of symptoms of hypoxia.
• The course of the pregnancy examination calendar: Two belts with sensors are placed on the woman’s abdomen: one records the fetal heart rate, the other the uterine muscle tone. The examination usually takes 20-30 minutes, the woman lies on her side or in a semi-sitting position, and then another examination is performed.
• When is it performed?
  • Routinely in the final stages of pregnancy (usually from the date of delivery, i.e. from the 40th week, or a little earlier, e.g. from the 38th week, depending on the practice of a given center).
  • Earlier, if there are indications, e.g. reduced sensation of fetal movements, hypertension in the mother, diabetes, pregnancy after the due date, suspected fetal growth disorders.
  • It is the basic tool for monitoring the fetus during childbirth.

A correct CTG recording indicates that the child is in good condition. Abnormalities in the recording may be an indication for more frequent monitoring, additional tests or hastening labor.

Anaesthesiology consultation

If a woman plans to give birth with an epidural or if there are indications for a caesarean section, a consultation with an anesthesiologist is recommended. The doctor will conduct an interview, assess the patient’s health, explain the anesthesia procedure, possible benefits and risks.

Additional and Specialist Tests

In addition to the standard test panel, in some situations the doctor may order additional tests or specialist consultations.

• Thyroid tests (TSH, FT3, FT4, anti-TPO, anti-TG antibodies):
  • Recommended for women with a history of thyroid disease (hypothyroidism, hyperthyroidism, Hashimoto’s).
  • TSH testing is increasingly recommended in all pregnant women at the beginning of pregnancy, as the proper function of the mother’s thyroid gland is crucial for the development of the fetal brain. Untreated thyroid disorders in pregnancy can lead to complications and defects.
• Genetic testing in parents (e.g. karyotype testing):
  • Indicated in the case of recurrent miscarriages, birth of a child with a genetic defect, occurrence of genetic diseases in the family.
• Specialist consultations:
  • Geneticist: In the case of abnormal screening results, fetal defects in ultrasound, burdened family history.
  • Cardiologist: If the mother has heart disease or if a fetal ultrasound shows a heart defect.
  • Endocrinologist: In the case of thyroid disease, diabetes or other hormonal disorders.
  • Haematologist: With coagulation problems, severe anemia.
  • Other specialists depending on individual needs.

The emotional dimension of prenatal testing

It should not be forgotten that the period of pregnancy and related tests is a time of intense emotions. Waiting for the results, especially genetic screening tests or mid-term ultrasound, can be associated with a lot of stress and anxiety.

• Coping with stress: It is important to have the support of loved ones, your partner. Talking to your attending physician, midwife or psychologist can help dispel doubts and reduce anxiety. Relaxation techniques, self-care, and rest are also helpful.
• Difficult information: In a situation where the test results indicate health problems in the child or mother, it is always a difficult experience. It is crucial to obtain reliable information from specialists, discuss the available treatment options, and prognosis.
• Psychological support: Don’t hesitate to seek professional psychological support if you feel that your emotions are overwhelming you. Many hospitals and clinics offer psychological help for pregnant and postpartum women.

Remember that most pregnancies are normal and the tests are designed to provide you and your baby with the best possible care.

The Road to Safe Motherhood

Regular check-ups during pregnancy, as recommended by your attending physician, is the foundation of safe motherhood and a healthy start for your baby. Each pregnancy is different, which is why the test plan is always tailored individually to the patient’s needs.

Cooperation with the doctor, asking questions, expressing your fears and needs is the key to consciously experiencing pregnancy. Remember that the purpose of all these tests is to take care of your health. Take care of yourself, follow the recommendations, enjoy this special waiting time, and if in doubt – always ask specialists. We wish you a peaceful and healthy pregnancy!