First prenatal visit exams and tests

Your first prenatal visit is likely to be more extensive than later prenatal checks. Your health professional will take your medical history and perform a complete physical examination.

Medical history

Your medical history helps your health professional plan the best possible care for your pregnancy and childbirth. It includes:

• Your menstrual history, including your age when menstruation started, whether your cycles are regular, and the date of your last menstrual period.
• Your reproductive history. This includes:
  • Any previous pregnancies, abortions, miscarriages, or stillbirths.
  • Problems with previous pregnancies.
  • Any problems with reproductive organs.
• Family health conditions, such as heart disease or genetic defects.
• All serious illnesses, vaccinations, and surgeries you have had.

Physical exam

Your complete physical exam will include:

• Weight and blood pressure measurement.
• A pelvic examination to confirm the pregnancy.
• A Pap smear (if not done recently).
• Urine testing for:
  • Sugar, a sign of gestational diabetes.
  • Protein, a sign of preeclampsia.
  • Bacteria, a sign of urinary tract infection (UTI), which can be present without symptoms. UTI is common during pregnancy and, if untreated, may lead to kidney infection.
• Blood testing, including:
  • Blood typing, (A, B, or O, and Rh factor). If you are Rh-negative and the father is Rh-positive, your fetus may have Rh-positive blood, which can lead to problems with Rh sensitization. For more information, see the topic Rh Sensitization During Pregnancy.
  • Complete blood count (CBC), which includes hemoglobin and hematocrit to make sure you don't have iron deficiency anemia.
  • Immunity to German measles (rubella).
  • The sexually transmitted disease syphilis. This blood test is called a venereal disease research laboratory (VDRL) test. The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend that all pregnant women be screened for syphilis early in pregnancy.

Your blood may also be screened for:

• Hepatitis B. If you have a hepatitis B infection, your baby will receive the hepatitis vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth.
• The human immunodeficiency virus (HIV). This is done only with your consent or request.
• The abnormal gene that causes cystic fibrosis (CF). If you have this gene, your partner is also tested. According to the laws of genetics, if you both have the gene, you have a 1-in-4 chance of conceiving a fetus with the disease. Using chorionic villus sampling during the first trimester, you can learn whether your fetus has cystic fibrosis. The American College of Obstetricians and Gynecologists recommends that all women be screened for the CF gene before pregnancy or early in pregnancy; however, this is not yet a common practice.

HIV. Some states require that testing for HIV, which causes acquired immunodeficiency syndrome (AIDS), be offered to all pregnant women. This is because early detection and treatment lowers the chance that the baby will get HIV from the mother. The United States Preventive Services Task Force and United States Centers for Disease Control and Prevention recommend that all pregnant women be screened for HIV infection to help prevent fetal infection.

If you have HIV and you are pregnant, treatment can help prevent your fetus from getting it from you.

Sexually transmitted diseases (STDs) during pregnancy have been linked to miscarriage, premature birth, low birth weight, and stillbirth. Many health professionals routinely test for the sexually transmitted diseases gonorrhea and chlamydia. If test results show that you have an STD, your health professional will discuss treatment with you.