First prenatal visit exams and tests

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

Medical history

Your medical history helps your doctor 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.
• Diseases that are passed down through your family (genetic disorders). You may want to have a screening test if you or your partner has a family history of genetic disorders or if certain genetic disorders are more common among people of your racial or ethnic background. Some screenings for genetic disorders include:¹
  • Sickle cell disease, which is most common in people of African descent.
  • Tay-sachs disease, which is most common in people with an Ashkenazi Jewish, Cajun, or French Canadian background.
  • Cystic fibrosis, which is most common in people with a Caucasian, European, or Ashkenazi Jewish background.

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 doctors routinely test for the sexually transmitted diseases gonorrhea and chlamydia. If test results show that you have an STD, your doctor will discuss treatment with you.

Citations

1. American Academy of Pediatrics, American College of Obstetricians and Gynecologists (2007). Antepartum care. In Guidelines for Perinatal Care, 6th ed., pp. 83–137. Elk Grove Village, IL: American Academy of Pediatrics.