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Healthy Pregnancy

Table of Contents

Healthy Pregnancy

Prenatal Care

Image by TheVisualMD

Have a Healthy Pregnancy

Nourishing Baby in the Womb

Image by TheVisualMD

Have a Healthy Pregnancy - Overview

Health care during pregnancy is called prenatal care. Getting prenatal care can help you have a healthy pregnancy and a healthier baby. It also lowers the risk of your baby being born too early, which can lead to health problems for your baby.

Doctors who specialize in women’s health, pregnancy, and childbirth are called obstetricians or gynecologists (often called Ob/Gyn). Some nurse practitioners and midwives can also provide prenatal care. A midwife is a health professional who helps people during pregnancy and childbirth.

Get regular prenatal checkups.

Schedule a visit with your doctor or midwife as soon as you know you're pregnant — or if you think you might be. You'll need many checkups with your doctor or midwife during your pregnancy. Don't miss any of these appointments — they're all important.

Be sure to get all the medical tests that your doctor or midwife recommends so you can find any health problems early. Early treatment can cure many problems and prevent others.

Take steps to have a healthy pregnancy.

To keep you and your baby healthy, it's important that you:

Don’t smoke or drink alcohol
Eat healthy and get enough folic acid
Stay physically active

Source: U.S. Department of Health and Human Services

Additional Materials (4)

4:50

Prenatal (pregnancy) care: How to choose a prenatal caregiver

Howdini/YouTube

1:34

The Importance of Prenatal Care for Your Family

Mi Doctor - Kaiser Permanente/YouTube

5:47

Prenatal Care

UAB Medicine/YouTube

3:35

Why Is Prenatal Care Important? — AMITA Health Medical Group

AMITA Health/YouTube

Topics to Discuss

Pregnant woman speaking with her physician

Image by CDC/ National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)

Have a Healthy Pregnancy - Topics to Discuss

Make the most of each visit with the doctor or midwife.

Talk with your doctor or midwife about:

Your personal and family health history, including any chronic (long-term) health problems or surgeries you've had
When you need to get medical care for issues that can come up — like high blood pressure, dizziness, swelling, pain, bleeding, or contractions
When and where to go for emergency care during your pregnancy
Any prescription and over-the-counter medicines that you take — as well as vitamins, supplements, and herbs
Healthy weight gain during pregnancy

These visits are also a great time to discuss:

Questions you have about pregnancy, childbirth, and breastfeeding
How to get help buying food if you need it — including how to get help from a program called WIC (Women, Infants, and Children)
Anything that’s bothering or worrying you

If you're worried about your health during pregnancy, don't wait to ask for help. Learn more about pregnancy complications and when to call your doctor or midwife.

Make a birth plan.

A birth plan describes what you want to happen during childbirth and after your baby's birth. It can include:

Where you'd like to give birth — for example, at a hospital or birthing center
Who you want with you for support (like your partner, family member, or close friend) before, during, and after childbirth
How you want to manage pain during childbirth
Who you want to help you make important medical decisions during childbirth
Your plan to breastfeed after your baby is born

Talk with your doctor about depression.

Many people experience depression during and after pregnancy. Talk with your doctor about your risk for depression and whether you need counseling to help prevent it.

Source: U.S. Department of Health and Human Services

Additional Materials (4)

1:52

Where can I choose to give birth? | NHS

NHS/YouTube

2:00

Creating a calm birth environment | Advice from moms

BabyCenter/YouTube

2:27

Prenatal Care Appointments

Jesse Reiter/YouTube

2:21

Your First Step to a Healthy Pregnancy | Prenatal Care

EinsteinHealth/YouTube

Weight Gain

Pregnancy and Weight Gain - Timing Matters, Birth Weight, High Birth Weight

Image by TheVisualMD

How Much Weight Should I Gain During Pregnancy?

The amount of weight you should gain during pregnancy depends on your weight before you got pregnant. Your health care provider will advise you on a healthy weight gain based on your current weight, diet, and activity level. Typically, weight gain should be gradual throughout pregnancy, with a total of about 1 to 4 pounds in the first trimester and 2 to 4 pounds each month in the second and third trimesters.

In 2009, the Institute of Medicine released new recommendations for total weight gain during pregnancy, based on pre-pregnancy body mass index (BMI), a measure that combines height and weight. According to these recommendations:

Women in a healthy weight range before getting pregnant should gain between 25 and 35 pounds.
Women who are underweight or overweight before becoming pregnant may need to gain more or less.
- For underweight women with a BMI of less than 18.5, total weight gain should be between 28 and 40 pounds.
- Overweight women (BMI between 25 and 29.9) should gain between 15 and 25 pounds.
- Women with a BMI greater than 30 should gain between 11 and 20 pounds.

More recent guidance from the American College of Obstetricians and Gynecologists largely agrees with these general recommendations, but recognizes that women may vary in how much weight they need to gain to have a healthy infant. Women who are overweight or obese and pregnant should discuss their weight gain needs with their doctor.

It's important for women to discuss with their health care provider how to maintain a healthy weight during pregnancy, as being overweight or obese can affect pregnancy outcomes and the long-term health of the mother and infant. An NICHD study found that women who were obese before pregnancy were more likely to have infants born with congenital malformations such as heart problems and neural tube defects.

Source: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Additional Materials (4)

1:08

Pregnancy weight gain

Baby Care 101/YouTube

2:24

Pregnancy and Weight Gain

Methodist Health System/YouTube

1:54

How Much Weight You Should Gain During Pregnancy?

Consumer Health Digest/YouTube

4:11

Weight Gain and Pregnancy (Q&A)

Howard County General Hospital/YouTube

Medication or Supplements

Pregnancy and Medication - Suppositories

Image by TheVisualMD / HeungSoon

Is It Safe to Take Medications or Supplements During Pregnancy?

Medication use during pregnancy is common. The Centers for Disease Control and Prevention (CDC) reports that nearly all women take at least one medication during pregnancy and, most women, take at least one prescription medication during pregnancy. The CDC also reports that the use of four or more medications anytime in pregnancy has more than doubled since the 1990s.

Certain medications can harm the fetus during pregnancy, however. Talk to your health care provider about the medications you currently take. Tell him or her about prescription and over-the-counter medications, as well as dietary, vitamin, and herbal supplements. Certain types of medications for treating acne, as well as herbal and dietary supplements, can harm the developing fetus. Even ibuprofen or aspirin can cause problems in pregnancy, particularly during the last 3 months.

Many women take medications during pregnancy to treat health problems like diabetes, asthma, heartburn, and morning sickness. Other women take medications to treat conditions they had before they became pregnant. In many cases, health care providers will encourage pregnant women to continue taking their medication. However, in some cases, a safer alternative may be available.

Source: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Additional Materials (4)

0:56

Medication During Pregnancy | FAQ | Baby Talk

BabyTalkShow/YouTube

2:07

Safe Medication During Pregnancy

AllHealthGo/YouTube

3:16

Prescription medicine before and during pregnancy

March of Dimes/YouTube

56:43

Medication Safety in Pregnancy and Breast-feeding

University of California Television (UCTV)/YouTube

Ask About Preeclampsia

Preeclampsia disproportionately impacts pregnant Black women in the U.S.

Image by StoryMD/Pexels

Am I at High Risk for Preeclampsia?

If you’re pregnant or planning to get pregnant, ask your doctor or midwife about your risk for preeclampsia — also called toxemia. If you’re at high risk, the doctor may recommend that you take a low dose of aspirin while you’re pregnant to help prevent preeclampsia.

Preeclampsia is a health problem that some women develop after about 20 weeks of pregnancy. Preeclampsia is usually mild, but it can be dangerous and even deadly for both a pregnant woman and her baby.

Many women who have preeclampsia don’t feel sick. The main sign of preeclampsia is high blood pressure. It’s important to get regular checkups during pregnancy so your doctor or midwife can check your blood pressure.

Am I at high risk for preeclampsia?

Most pregnant women aren’t at high risk for preeclampsia.

You’re at higher risk for preeclampsia if you:

Had preeclampsia in a previous pregnancy
Are carrying more than 1 baby
Have chronic (long-term) high blood pressure
Have type 1 or type 2 diabetes, kidney disease, or certain autoimmune diseases

You may also be at risk if you:

Are pregnant for the first time
Have obesity
Have a family history of preeclampsia
Are African American
Are age 35 or older

Source: U.S. Department of Health and Human Services

Additional Materials (6)

Consultation with you doctor

Bokskapet

1:36

Sharing with your Ob provider about blood pressure

Preeclampsia Foundation/YouTube

2:46

Pre-eclampsia screening – Animated video for parents

PerkinElmer, Inc./YouTube

28:30

Understanding Preeclampsia: Expert Q&A

UChicago Medicine/YouTube

5:01

"Take My Concerns Seriously" - A preeclampsia patient story

Preeclampsia Foundation/YouTube

1:32

What routine prenatal care should I follow?

UCHealth/YouTube

Vaccination

#FightFlu

Image by Centers for Disease Control and Prevention (CDC)

Should Pregnant Women Get the Seasonal Flu Shot?

Yes. Research shows that the seasonal flu shot is safe and effective for pregnant women.

Pregnant women who get the flu are at higher risk for hospitalization and death, compared to non-pregnant women with the flu. That's because a pregnant woman's body experiences changes in the functioning of her immune, respiratory, and cardiovascular systems. When combined with the flu, these changes can sometimes result in serious problems.

Infection during pregnancy also poses risks to the health of the fetus and may lead to preterm birth or birth defects. Simply having the flu does not mean these problems will occur, but it does increase the risk of these and other conditions.

The flu shot or "inactivated flu virus vaccine" can prevent the flu from occurring or can sometimes lessen the symptoms and their severity. When received during pregnancy, the vaccine also protects a newborn from the flu for up to 6 months after birth.

Research supported by NICHD and other has shown that the flu shot is safe and effective for use at any time during pregnancy. There is no evidence that it is harmful to women or their fetuses. There is also no evidence of poor health outcomes among infants whose mothers received the flu shot during pregnancy.

The Centers for Disease Control and Prevention recommends that pregnant women and women who will be pregnant during flu season be vaccinated against seasonal flu. The nasal spray flu vaccine is not recommended for pregnant women.

Source: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Additional Materials (4)

0:59

Flu Vaccine When Pregnant | FAQ | Baby Talk

BabyTalkShow/YouTube

6:26

Flu Vaccine Information for Pregnant Women and Children

Centers for Disease Control and Prevention (CDC)/YouTube

0:44

Dr. Kevin Ault Describes How He Recommends Flu Vaccine to Pregnant Patients

Centers for Disease Control and Prevention (CDC)/YouTube

1:22

Addressing Pregnant Patient Vaccine Concerns with Nurse-Midwife Carol Hayes

Centers for Disease Control and Prevention (CDC)/YouTube

Medical Tests

A woman has her blood pressure taken

Image by U.S. Air Force photo by Staff Sgt. Christopher Gross

Have a Healthy Pregnancy - Medical Tests

Get important medical tests.

During your pregnancy, your doctor or midwife will recommend medical tests that all people need as part of routine prenatal care. You’ll need to get some tests more than once.

These tests give your doctor or midwife important information about you and your baby. The tests will check your blood or urine (pee) for:

Rh factor (a protein some people have in their blood)
Hepatitis B
Urinary tract infection (UTI)
Syphilis
HIV
Signs of past rubella infections (German measles)
Group B strep

If you're younger than age 25 or have certain risk factors, your doctor or midwife may also check for other sexually transmitted diseases (STDs). Learn more about STDs during pregnancy.

Your doctor or midwife will also check your blood pressure regularly during your pregnancy. They may recommend that you check your own blood pressure at home using a monitor you can buy at a drug store. High blood pressure during pregnancy can be a sign of preeclampsia, a health problem that some pregnant people develop. Learn more about preventing preeclampsia.

Talk about your family history.

Share your personal and family health history with your doctor or midwife. This will help you and your doctor or midwife decide whether you need any other tests, like genetic testing. Find out more about genetic testing.

Source: U.S. Department of Health and Human Services

Additional Materials (4)

2:21

How Rh factor affects a pregnancy

Toronto Star/YouTube

2:41

Pregnant or planning for a baby? Get tested now for HIV, hepatitis B and syphilis

World Health Organization Regional Office for the Western Pacific/YouTube

2:01

I'm 24 weeks pregnant and have a slight UTI. What should I do?

IntermountainMoms/YouTube

5:02

HIV and pregnancy | NHS

NHS/YouTube

First Trimester Screen

First Trimester Screen

Also called: First Trimester Maternal Screen Panel, Nuchal Translucency Test with Maternal Blood Test, First Trimester Combined Screening

A first trimester screen measures two pregnancy-related hormones, human chorionic gonadotropin (hCG), and PAPP-A. Then, the results of these two blood tests are compared with the results of a fetal ultrasound and combined into one number that shows your likelihood of having a baby with a genetic abnormality. It's called a first trimester screen because...

First Trimester Screen

Also called: First Trimester Maternal Screen Panel, Nuchal Translucency Test with Maternal Blood Test, First Trimester Combined Screening

A first trimester screen measures two pregnancy-related hormones, human chorionic gonadotropin (hCG), and PAPP-A. Then, the results of these two blood tests are compared with the results of a fetal ultrasound and combined into one number that shows your likelihood of having a baby with a genetic abnormality. It's called a first trimester screen because...

A first trimester screen comprises several tests that are done during the first three months of pregnancy in order to detect how high is your baby's risk of having chromosomal disorders (including Down syndrome and trisomy 18) and other problems such as heart defects.
1. https://www.mayoclinic.org/tests-procedures/first-trimester-screening/about/pac-20394169 [accessed on Jan 24, 2019]
2. http://americanpregnancy.org/prenatal-testing/first-trimester-screen/ [accessed on Jan 24, 2019]
3. https://www.stanfordchildrens.org/en/topic/default?id=first-trimester-screening-90-P08568 [accessed on Jan 24, 2019]
4. https://labtestsonline.org/tests/first-trimester-screening [accessed on Jan 24, 2019]

Pregnancy-Associated Plasma Protein-A Test

Pregnancy-Associated Plasma Protein-A Test

Also called: PAPP-A

The pregnancy-associated plasma protein-A (PAPP-A) is a protein that is normally produced by the placenta during pregnancy. This test measures the levels of this protein, which can be used to help screen for pregnancy complications and chromosomal abnormalities in the fetus.

Pregnancy-Associated Plasma Protein-A Test

Also called: PAPP-A

The pregnancy-associated plasma protein-A (PAPP-A) is a protein that is normally produced by the placenta during pregnancy. This test measures the levels of this protein, which can be used to help screen for pregnancy complications and chromosomal abnormalities in the fetus.

{"label":"Pregnancy-Associated Plasma Protein-A Reference Range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":0.5},"text":"This result means that you have an increased risk of having a pregnancy complication or having a baby with chromosomal abnormalities. ","conditions":["Trisomy 21 (Down syndrome)","Trisomy 18 (Edwards syndrome)","Gestational hypertension","Preeclampsia","Preterm delivery","Fetal growth restriction","Stillbirth"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0.5,"max":2},"text":"Your PAPP-A levels are normal, which means that this result alone is not expected to negatively impact a pregnancy or fetal health. ","conditions":[]}],"value":1.3}[{"abnormal":0},{"normal":0}]
Use the slider below to see how your results affect your health.
0.5
Your result is Normal.
Your PAPP-A levels are normal, which means that this result alone is not expected to negatively impact a pregnancy or fetal health.
Related conditions
The objective of this test along with the other first-trimester screening tests is to identify a pregnant woman’s risk of having a baby with chromosomal abnormalities such as Down syndrome and Edwards syndrome.
The PAPP-A tets can also be used to assess the risk of premature birth, stillbirth, and other pregnancy complications.
Your doctor may recommend this test if:
- You have a history of fetal abnormalities
- Familiar genetic conditions
- To assess the risk of chromosome abnormalities in the fetus
1. Pregnancy-associated plasma protein-A - Embryology [accessed on Nov 14, 2018]
2. Pregnancy-associated plasma protein A (PAPP-A) and preeclampsia. - PubMed - NCBI [accessed on Nov 14, 2018]
3. First Trimester Screening [accessed on Nov 14, 2018]
4. 1STT - Clinical: First Trimester Maternal Screen [accessed on Nov 14, 2018]
5. Variation of Papp-A Level in the First Trimester of Pregnancy and Its Clinical Outcome [accessed on Nov 14, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (34)

Embryo 36 Day Old (Week 7 for Gestational Age) Brain and Cardiovascular System

Computer Generated Image from Micro-MRI, actual size of embryo = 6.0 mm. This image offers a right-sided perspective of the internal organ development of an embryo at the beginning of six weeks. The age is calculated from the day of fertilization. Of the prominent organs displayed are those of the cardiovascular system which continue to develop at a rapid rate during this phase. The heart (seen here as somewhat shadowed red rounded structure in the medial aspect of the embryo) is the first functional organ to develop in the human embryo. The heart begins its existence as two simple tubes that quickly fuse to form a single chamber or heart tube that is busily pumping blood by the 23nd day. At around the 25th day, it exhibits four slightly bulged areas that represent the earliest heart chambers called sinus venosus, atrium, ventricle, bulbous cordis. During the next three weeks of development, the heart tube undergoes dramatic contortions so as to change its structure to become a four-chambered organ capable of acting as a double pump. This image depicts the heart at the 36th day of development. The tubes have undergone the aforementioned changes and the heart is divided into its four definitive chambers. They will assume their adult positions in just one more month. By the fourth week of development, the heart is pumping blood through the rudimentary vascular system. In the eye region (as represented by a red dot surrounded by a green ring) the lens is almost completely closed and are starting to undergo retinal pigmentation. The brain is also undergoing rapid differentiation as the irregularly shaped vesicles continue to form. The prominent uppermost bump in this image represents the future cerebellum. Continual development in the brain will bring about three major components, the forebrain, midbrain, and hindbrain.

Image by TheVisualMD

Embryo 36 Day Old (Week 7 for Gestational Age) External and Internal Anatomy

Computer Generated Image from Micro-MRI, actual size of embryo = 6.0 mm. These images offer several perspectives of the internal and external development of an embryo at the beginning of six weeks. The age is calculated from the day of fertilization. The upper left image depicts a left anterolateral view of the external anatomy of the embryo. The liver region is semi-transparent so as to display the vasculature. The upper right image reveals the a right anterior view of the internal structures of the same embryo. The lower left image illustrates limb development as seen from a superior right view. The lower right image reveals the inner structural development from the same perpective. The cardiovascular system continues to develop at a rapid rate during this phase. The heart is the first functional organ to develop in the human embryo. It begins its existence as two simple tubes that quickly fuse to form a single chamber or heart tube that is busily pumping blood by the 23nd day. At around the 25th day, it exhibits four slightly bulged areas that represent the earliest heart chambers called sinus venosus, atrium, ventricle, bulbous cordis. During the next three weeks of development, the heart tube undergoes dramatic contortions so as to change its structure to become a four-chambered organ capable of acting as a double pump. This upper and lower right hand images depict the heart at the 36th day of development. The tubes have undergone the aforementioned changes and the heart is divided into its four definitive chambers. They will assume their adult positions in just one more month. These two images also offer a clear depiction of the vessels that convey blood to and from the heart and brain. By the fourth week of development, the heart is pumping blood through the rudimentary vascular system. The blood largely bypasses the liver (as seen in the upper left, upper right and lower right images). The umbilical vessels (posterior and anterior to the heart and liver) convey blood between the fetal circulation and the placenta where gas and nutrient exchanges occur with the mothers blood. Once the fetal circulatory system is formed, few vascular changes occur until birth and the umbilical vessels close. In the eye region (as represented by a red dot surrounded by a green ring the two upper and right lower images) the lens is almost completely closed and are starting to undergo retinal pigmentation. The growing nerve endings around the spinal cord are indicated in white in the two right hand images. The brain is also undergoing rapid differentiation as the irregularly shaped vesicles continue to form. The prominent uppermost bump in these images represent the future cerebellum. Continual development in the brain will bring about three major components, the forebrain, midbrain, and hindbrain. During this phase of development the limbs buds become visible as outpocketings from the body walls (as seen in the lower left-hand image). Six week old embryos, the distal portions of the limb buds become flattened to form the handplates and footplates. Fingers and toes will develop when a process called cell death separates the these structures into five distinct parts.

Image by TheVisualMD

Embryo 44 Day Old (Week 6) Circulatory System

Computer Generated Image from Micro-MRI, actual size of embryo = 13.0 mm - This image presents a left-sided view of the embryo during the seventh week of development. The age is calculated from the day of fertilization. The primary focus is on the circulatory system; the great number of blood vessels and veins throughout the embryo's body. The heart is indicated in bright red and the large structure underneath in deep violet red is the liver. The left lung is marked in orange. The spinal region is indicated in white. The umbilical cord, a transport mechanism for nutrients and wastes between the embryo and mother is visible on the right side of the embyro

Image by TheVisualMD

Human Embryo 18 Day Old (Week 4 for Gestational Age) with Primitive Streak

This image presents a side-view of an embryo during its third week of development. The age is calculated from the day of fertilization. The embryo is attached to the uterine wall and attains a pear-shaped structure. The white line seen on the embryo is the primitive streak, which establishes the longitudinal axis of the embryo and signals the development of the right and left sides of the body. The primitive streak also indicates where the division of the brain will occur.

Image by TheVisualMD

Embryo 56 Day Old (Week 10 Gestational Age, Week 8 Fetal Age) Visible Lung and Liver

Computer Generated Image from Micro-MRI, actual size of embryo = 30 mm - This image presents a left-sided view of the embryo undergoing its eighth week of development. The age is calculated from the day of fertilization. At this point of development, all body parts have been differentiated and all body systems are in place. The right eye is indicated as the pink circle in the facial region. The arms and legs have elongated, and distinctions of fingers and toes can be observed. The heart is indicated in red and the lungs are indicated in white. The liver is the large purplish-red organ below. The pink tube-like protrusion from the embryo is the umbilical cord, which serves as a mechanism of gas exchange, nutrient delivery and waste removal.

Image by TheVisualMD

Embryo 51 Day Old (Week 9 Gestational Age, Week 7 Fetal Age) with Translucent Skin

Computer Generated Image from Micro-MRI, actual size of embryo = 18.0 mm - This image provides a left-sided view of the embryo undergoing its eighth week of development. The age is calculated from the day of fertilization. The image has been manipulated so that the skin appears translucent so that the internal organs can be observed. The embryo still maintains a semblance of a curvature with the head bent downwards, but due to the strengthening neck muscles, the curve has decreased. The brain is highlighted orange. The large red structure in the trunk of the embryo is the liver. The red, tube-like structure protruding outwards from the embryo is the umbilical cord, a which serves as a mechanism for gas exchange, nutrient delivery and waste removal. Outlined in yellow are the arms and legs which have elongated. The hand plates have undergone distinction earlier than foot plates.

Image by TheVisualMD

Somites (developing spinal cord, neural tube), Embryo, with Prominent Yolk Sac

Contained entirely within the nurturing space of the womb, the developing embryo cannot eat or breathe, and therefore must obtain all nutrients from other sources. For the first nine weeks, the early embryo depends on the yolk sac of the embryo for nourishment. Inside the yolk sac, tiny structures called 'blood islands' form. These will become the first blood and the first blood vessels. As pregnancy continues, these important external structures develop into the embryo's link to the mother's system - the umbilical cord and the supporting network known as the placenta. Until birth, the developing embryo is completely dependent on the mother for nutrients and waste disposal through the umbilical cord and the placenta.

Image by TheVisualMD

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20 Week Old Fetus and Placenta

Lateral view of fetus, approximately 20 weeks within the placenta. Womb environment is nondescript and rendered in dark red and black. Camera zooms in. Skin appears translucent showing underlying structures. The shape of the brain is closer to its final one but is still smooth and has no definition yet. Its development is ongoing years after birth.

Video by TheVisualMD

Blastocyst Implanted in the Uterine Wall with coagulation plug

Computer - This image depicts the blastocyst implanted to the uterine wall. The structure of the blastocyst consists of inner cells, called embryoblasts, and of outer cells, called trophoblasts. Early implantation occurs around the sixth day after fertilization. Trophoblasts penetrate into the uterine epithelium wall and by the eleventh and twelfth day, the blastocyst is embedded in the endometrium, which lines the inside wall.

Image by TheVisualMD

Chromosome Arrangement for Blastomere Formation

Computer Generated Image from Micro-MRI, actual size of zygote = 0.1 mm - This image illustrates the alignment and arrangement of chromosomes, highlighted in bright glowing white. A zygote is made up of a total of 46 chromosomes; 23 which are inherited from the mother and 23 from the father. The spindle fibers (indicated in orange) pull apart the chromosomes from the middle during cell division.

Image by TheVisualMD

Embryo 6 Week Old Skeletal System

3D visualization reconstructed from scanned human data of the developing skeletal system of a six week old embryo. During this phase of development, the foreshadowing cartilaginous models of bone begin to ossify and terminal portions of the limb buds become flattened to form the hand plates and footplates, the future hands and feet. Growing outward from the middle of the shaft, the long bones that give the body its adult contours continue to grow until the age of 17 to 21.

Image by TheVisualMD

Circulatory System of a Human Embryo

Computer Generated Image from Micro-MRI of the circulatory system of an embryo. The image has been manipulated so the skin is transparent so as to reveal the circulatory system. One of the first systems to develop in the embryo, the heart can be seen near the center in the image, highlighted in bright red. Blood vessels extend from the heart, carrying blood to supply oxygen and nutrients to other parts of the body. The two gray orb-like structures in the head region indicate the developing eyes.

Image by TheVisualMD

Cardiovascular System of 44 Day Old Embryo

3D visualization based on scanned human data of a 44-day-old embryo. Focus is on the cardiovascular system. Before birth, the cardiovascular system has no use for the lungs. Gases are exchanged via the mother, and blood returning from the body to the right atrium is shunted either to the left atrium through a temporary opening called the foremen ovale, an oval-shaped window, or the thicker-walled right ventricle.

Image by TheVisualMD

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7 week old embryo

Slow zoom out from an extreme close up of the face and than back to a close up of a face of a Carnegie19 stage, about 7 weeks old embryo. Well developed eyes, nasal openings and separated fingers are already present.

Video by TheVisualMD

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Embryo Inside Womb Carnegie Stage 16

Room full of women doing yoga. Slow zoom into one of the woman's torso to reveal the womb and an embryo at Carnegie stage 16, about 40 days developing. The Micro Magnetic Resonance Imaging based visualization reveals upper limb buds that are paddle-shaped and lower limb buds that are flipper-like. The heart is the prominent pink structure at the center of the embryo. Right above the heart is the first and second pharyngeal arches which have overgrown to make the third and forth arches indistinct.

Video by TheVisualMD

This browser does not support the video element.

Embryo at Carnegie Stage 18

Creative take showing a water bottle transitioning into an embryo. When the water bottle is removed from the table, it is replaced with an embryo at Carnegie stage 18, about 44 days. As the camera zooms on the embryo the background fades to black. The eye and external ear auricle are distinct. The heart is represented by the red structure in the centre with the chambers beginning to take shape. The hand and foot plates are more also more distinct.

Video by TheVisualMD

This browser does not support the video element.

Embryo at Carnegie Stage 20

Camera zooms into a computer monitor with an image of an embryo at Carnegie stage 20, about 51 does on it. The image of the embryo transitions to a 3-D SEM-looking embryo. The camera rotates around the embryo to give a 360 view of all sides. At this stage the embryo's fingers are separated and the toes are beginning to separate. the nose is stubby and the eye is pigmented.

Video by TheVisualMD

This browser does not support the video element.

Embryo at Carnegie Stage 14

Environment is within the womb with an embryo at Carnegie stage 14, about 32-day developing. The embryo is encompassed within the amniotic sac and situated beside the fetus is the yolk-sac. Different camera angles rotate around the embryo. Through the amniotic sac, the fetus' heart is represented by the red structure in the centre. The 4 chambers or the heart have developed. The arm and feet plates are visible.

Video by TheVisualMD

Embryo 44 Day Old

Embryo 44 Day Old: A view inside the embryo at 42 days shows that the neural buds along the spinal cord are clearly developed. These tiny buds now are merely one-tenth the width of a human hair and will grow to more than half an inch in some cases. It is noticeable that the hands of the embryo are more defined, rays show up between fingers. The stomach and liver are also visible. At this time, the embryo develops a sense of smell.

Image by TheVisualMD

Brain Development of Human Embryo

The first period of development is call the embryonic period, which begins with fertilization and ends eight weeks later. During this period, the embryo undergoes extraordinary changes in a relatively short time. From Day 28 to Day 50 it grows considerably in size--three to four times the original mass. Early signs are the expansion of spaces within the brain called ventricles, followed by the creation of new nervous tissue. Because of the brain's complexity, development takes place from head to toe.

Image by TheVisualMD

6 Week Old Embryo with Undifferentiated Gonad

Three-dimensional visualization reconstructed from scanned human data. Lateral view of an embryo at 6 weeks, with internal undifferentiated gonad development visible. Structures shown include the eye, 1st, 2nd, and 3rd pharyngeal arches, upper and lower limb buds, and tail, as well as the umbilical cord connecting the embryo to the surrounding chorionic sac. At 6 weeks of development, male and female fetuses look identical both internally and externally. At this stage internal gonad development consists of two undifferentiated ducts: the Mullerian ducts, and the Wolffian ducts. External genital development consists of an indifferent penis, which will either form into a penis and scrotum or clitoris and labia. Differentiation of the gonads begins after the 6th week, while external genital differentiation starts a little later, after the 7th week.

Image by TheVisualMD

Brain of Embryo Cross Section

Early signs are the expansion of spaces within the brain called ventricles, followed by the creation of new nervous tissue. Because of the brain's complexity, development takes place from head to toe.

Image by TheVisualMD

Embryo 56 Day Old Heart and Blood Vessel

Computer Generated Image from Micro-MRI, actual size of embryo = 30.0 mm - This image provides a right-sided perspective of an embryo during its eighth week of development. The age is calculated from the day of fertilization. The skin has been made translucent so that internal organs can be observed. The brain is highlighted in yellow-orange. Red blood vessels branching from the functionally complete, four-chambered heart, indicated in red, extend towards the brain. In the facial region, the red circle indicates the eye. The liver, shown in pale yellow, is situated below the heart.

Image by TheVisualMD

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Cleavage in Developing Embryo

Being shown is the embryonic cleavage or rapid division of a zygote to form a multicellular morula. A morula is an embryo at an early stage of embryonic development, consisting of approximately 12-32 cells (blastomeres) in a sold ball contained within the zona pellucida.

Video by TheVisualMD

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Embryo at Carnegie Stage 19 Cardiovascular System

Lateral view of a woman doing a sit up on the floor. Camera zooms into woman's pelvic area to reveal an embryo at Carnegie stage 19, about 48 days. As the embryo rotates, all of its structures dissolve away to only leave the cardiovascular system. By this stage, the embryo's cardiovascular system is a vast and intricate system needed to fuel its growth.

Video by TheVisualMD

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Embryo at Carnegie Stage 14

Environment is within the womb of an embryo at Carnegie stage 14, about 32 days, developing. The embryo is encompassed within the amniotic sac and situated beside the fetus is the yolk-sac. Different camera angles rotate around the fetus. Through the amniotic, the fetus' heart is represented by the red structure in the centre. The 4 chambers heart can be see beating at the camera rotates from behind. The arm and feet plates are visible.

Video by TheVisualMD

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Embryo at Carnegie Stage 16

Camera view from the underside of an embryo at Carnegie stage 16, about 40 days. View is of the tail and the foot plates.

Video by TheVisualMD

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Embryo at Carnegie Stage 18

Lateral view of a woman doing a sit up on the floor. Camera zooms into woman's pelvic area to reveal an embryo at Carnegie stage 18, about 44 days. As the embryo rotates, all of its structures dissolve away to only leave the cardiovascular system. By this stage, the embryo's cardiovascular system is a vast and intricate system needed to fuel its growth.

Video by TheVisualMD

Embryos at 44 Days (8 for Gestational Age) with Circulatory System

Through rotation and gradual imaging techniques, these human fetal visualizations show the vast amount of blood circulation needed to fuel the extraordinary growth of a 44-day-old fetus. The images at the bottom show only the circulatory system. The blood transports so many substances and does so many jobs it's hard to name them. Chiefly, though, it moves oxygen and food to all parts of the body while taking away waste chemicals. This process necessarily begins in the first week, and by twenty days watertight tubes branch throughout the embryo. The system grows \"ahead\" of the baby, proliferating in all directions like highways on a busy map, stimulating new areas of development. (Understanding how blood vessels are laid down in relation to cellular reproduction has provided some of the most hopeful recent insights against cancer.) After birth this network also serves to provide the baby with central heat, distributing warmth evenly through the body, from busy parts like the heart to cooler areas like still muscles. Please see our Infant Nutrition Health Center.

Image by TheVisualMD

Implantation (human embryo)

Illustration of Implantation of a human embryo

Image by OpenStax College

9-Week Human Embryo from Ectopic Pregnancy

The size (2cm in length) and anatomic features suggest development equivalent to a nine-week pregnancy (or seven weeks post ovulation). In obstetrics, pregnancy is dated from the first day of the last menstrual period, which is about two weeks prior to the ovulation that resulted in the pregnancy

Image by Ed Uthman

Tubal Pregnancy with embryo

This photo of an opened oviduct with an ectopic pregnancy features a spectacularly well preserved 10-millimeter embryo. It is uncommon to see any embryo at all in an ectopic, and for one to be this well preserved (and undisturbed by the prosector's knife) is quite unusual. Even an embryo this tiny shows very distinct anatomic features, including tail, limb buds, heart (which actually protrudes from the chest), eye cups, cornea/lens, brain, and prominent segmentation into somites. The gestational sac is surrounded by myriad chorionic villi resembling elongated party balloons. This embryo is about five weeks old (or seven weeks in the biologically misleading but eminently practical dating system used in obstetrics).

Image by Ed Uthman, MD

Embryo and Fetus Development

Embryo and Fetus Development, placenta and amniotic sac

Image by TheVisualMD

Brain Development of 29 Day Old Embryo

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5

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7

8

Brain development from embryo to adult

The cerebral cortex--the most prominent feature when we think of a human brain--derives from the forebrain. This region is responsible for reason, planning, emotion, and problem solving, and by the end of the second trimester it is the primary visible structure. If you examine the surface of the cerebral cortex, you'll see convoluted folds; the raised surfaces are known as gyri and the \"trenches\" are sulci. These irregular folds provide greater surface area for cell-to-cell communication and interaction, increasing the brain's complexity.

Interactive by TheVisualMD

Embryo 36 Day Old (Week 7 for Gestational Age) Brain and Cardiovascular System

TheVisualMD

Embryo 36 Day Old (Week 7 for Gestational Age) External and Internal Anatomy

TheVisualMD

Embryo 44 Day Old (Week 6) Circulatory System

TheVisualMD

Human Embryo 18 Day Old (Week 4 for Gestational Age) with Primitive Streak

TheVisualMD

Embryo 56 Day Old (Week 10 Gestational Age, Week 8 Fetal Age) Visible Lung and Liver

TheVisualMD

Embryo 51 Day Old (Week 9 Gestational Age, Week 7 Fetal Age) with Translucent Skin

TheVisualMD

Somites (developing spinal cord, neural tube), Embryo, with Prominent Yolk Sac

TheVisualMD

0:22

20 Week Old Fetus and Placenta

TheVisualMD

Blastocyst Implanted in the Uterine Wall with coagulation plug

TheVisualMD

Chromosome Arrangement for Blastomere Formation

TheVisualMD

Embryo 6 Week Old Skeletal System

TheVisualMD

Circulatory System of a Human Embryo

TheVisualMD

Cardiovascular System of 44 Day Old Embryo

TheVisualMD

0:12

7 week old embryo

TheVisualMD

0:31

Embryo Inside Womb Carnegie Stage 16

TheVisualMD

0:41

Embryo at Carnegie Stage 18

TheVisualMD

0:24

Embryo at Carnegie Stage 20

TheVisualMD

0:27

Embryo at Carnegie Stage 14

TheVisualMD

Embryo 44 Day Old

TheVisualMD

Brain Development of Human Embryo

TheVisualMD

6 Week Old Embryo with Undifferentiated Gonad

TheVisualMD

Brain of Embryo Cross Section

TheVisualMD

Embryo 56 Day Old Heart and Blood Vessel

TheVisualMD

0:25

Cleavage in Developing Embryo

TheVisualMD

0:32

Embryo at Carnegie Stage 19 Cardiovascular System

TheVisualMD

0:27

Embryo at Carnegie Stage 14

TheVisualMD

0:11

Embryo at Carnegie Stage 16

TheVisualMD

0:31

Embryo at Carnegie Stage 18

TheVisualMD

Embryos at 44 Days (8 for Gestational Age) with Circulatory System

TheVisualMD

Implantation (human embryo)

OpenStax College

9-Week Human Embryo from Ectopic Pregnancy

Ed Uthman

Tubal Pregnancy with embryo

Ed Uthman, MD

Embryo and Fetus Development

TheVisualMD

Brain development from embryo to adult

TheVisualMD

Nuchal Translucency Scan

Nuchal Translucency Scan

Also called: NT Scan, Nuchal Translucency Screening, NT Screening, Nuchal Translucency Ultrasound Screening

A nuchal translucency scan, or NT scan, is a specialized routine ultrasound performed at the end of the first trimester of pregnancy. The NT scan measures the clear (translucent) space in the tissue at the back of your baby's neck. It is used to help identify chromosomal abnormalities.

Nuchal Translucency Scan

Also called: NT Scan, Nuchal Translucency Screening, NT Screening, Nuchal Translucency Ultrasound Screening

A nuchal translucency scan, or NT scan, is a specialized routine ultrasound performed at the end of the first trimester of pregnancy. The NT scan measures the clear (translucent) space in the tissue at the back of your baby's neck. It is used to help identify chromosomal abnormalities.

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Use the slider below to see how your results affect your health.
mm
2.8
Your result is Normal.
Your baby's NT scan results are normal, which means that this result alone is not expected to negatively impact the fetal health.
Related conditions
The objective of this test along with the other first-trimester screening tests is to identify a pregnant woman’s risk of having a baby with chromosomal abnormalities such as Down syndrome, Edwards syndrome, or Patau syndrome.
Your doctor may recommend this test if:
- You have a history of fetal abnormalities
- Familiar genetic conditions
- To assess the risk of chromosome abnormalities in the fetus
1. First Trimester Screening [accessed on Nov 14, 2018]
2. 1STT - Clinical: First Trimester Maternal Screen [accessed on Nov 14, 2018]
3. Nuchal translucency | Radiology Reference Article | Radiopaedia.org [accessed on Nov 14, 2018]
4. NT Scan: What You’ll Find Out [accessed on Nov 14, 2018]
5. Nuchal Translucency Ultrasound Screening Test In 1st Trimester [accessed on Nov 14, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (7)

Medical ultrasound image. Provided as-is. Please feel free to categorise, add description, crop.

Medical ultrasound image. Provided as-is. Please feel free to categorise, add description, crop.

Image by Nevit Dilmen (talk)

Prenatal Testing: Nuchal Test (Pregnancy Health Guru)

Video by Healthguru/YouTube

Fetal Medicine Foundation - Nuchal translucency

Video by FMFoundation/YouTube

How to perform Nuchal Translucency Scan

Video by ultrasoundlink/YouTube

Nuchal Translucency Patient Information Video

Video by Queensland X-Ray/YouTube

CRL Crown rump length 12 weeks ecografia Dr. Wolfgang Moroder

Ultrasound image of the foetus at 12 weeks of pregnancy in a sagittal scan. Measurements of fetal Crown Rump Lenght (CRL).

Image by This Photo was taken by Wolfgang Moroder. Feel free to use my photos, but please mention me as the author and send me a message. This image is not public domain. Please respect the copyright protection. It may only be used according to the rules mentioned here. This specifically excludes use in social media, if applicable terms of the licenses listed here not appropriate. Please do not upload an updated image here without consultation with the Author. The author would like to make corrections only at his own source. This ensures that the changes are preserved.Please if you think that any changes should be required, please inform the author.Otherwise you can upload a new image with a new name. Please use one of the templates derivative or extract. /Wikimedia

Coronal scan of the fetal esophagus Ecografia a ultrasuoni Dr. Wolfgang Moroder

Ultrasound image of the fetal esophagus at 19 weeks of pregnancy.

Image by This Photo was taken by Wolfgang Moroder. Feel free to use my photos, but please mention me as the author and send me a message. This image is not public domain. Please respect the copyright protection. It may only be used according to the rules mentioned here. This specifically excludes use in social media, if applicable terms of the licenses listed here not appropriate. Please do not upload an updated image here without consultation with the Author. The author would like to make corrections only at his own source. This ensures that the changes are preserved.Please if you think that any changes should be required, please inform the author.Otherwise you can upload a new image with a new name. Please use one of the templates derivative or extract. /Wikimedia

Medical ultrasound image. Provided as-is. Please feel free to categorise, add description, crop.

Nevit Dilmen (talk)

2:42

Prenatal Testing: Nuchal Test (Pregnancy Health Guru)

Healthguru/YouTube

2:01

Fetal Medicine Foundation - Nuchal translucency

FMFoundation/YouTube

2:24

How to perform Nuchal Translucency Scan

ultrasoundlink/YouTube

7:17

Nuchal Translucency Patient Information Video

Queensland X-Ray/YouTube

CRL Crown rump length 12 weeks ecografia Dr. Wolfgang Moroder

This Photo was taken by Wolfgang Moroder. Feel free to use my photos, but please mention me as the author and send me a message. This image is not public domain. Please respect the copyright protection. It may only be used according to the rules mentioned here. This specifically excludes use in social media, if applicable terms of the licenses listed here not appropriate. Please do not upload an updated image here without consultation with the Author. The author would like to make corrections only at his own source. This ensures that the changes are preserved.Please if you think that any changes should be required, please inform the author.Otherwise you can upload a new image with a new name. Please use one of the templates derivative or extract. /Wikimedia

Coronal scan of the fetal esophagus Ecografia a ultrasuoni Dr. Wolfgang Moroder

This Photo was taken by Wolfgang Moroder. Feel free to use my photos, but please mention me as the author and send me a message. This image is not public domain. Please respect the copyright protection. It may only be used according to the rules mentioned here. This specifically excludes use in social media, if applicable terms of the licenses listed here not appropriate. Please do not upload an updated image here without consultation with the Author. The author would like to make corrections only at his own source. This ensures that the changes are preserved.Please if you think that any changes should be required, please inform the author.Otherwise you can upload a new image with a new name. Please use one of the templates derivative or extract. /Wikimedia

First Trimester Ultrasound

First Trimester Ultrasound

Also called: First Trimester Prenatal Ultrasound, First Trimester Scan, Fetal Ultrasound

A first trimester prenatal ultrasound is a noninvasive, painless, and risk-free imaging test in which an ultrasound machine is used to confirm the pregnancy, find out how far along in the pregnancy you are, and estimate your due date.

First Trimester Ultrasound

Also called: First Trimester Prenatal Ultrasound, First Trimester Scan, Fetal Ultrasound

A first trimester prenatal ultrasound is a noninvasive, painless, and risk-free imaging test in which an ultrasound machine is used to confirm the pregnancy, find out how far along in the pregnancy you are, and estimate your due date.

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Use the slider below to see how your results affect your health.
Your result is Normal.
* Your baby is growing at a normal rate.
* You have the right amount of amniotic fluid.
* No birth defects were found, though not all birth defects will show up on a sonogram.
Related conditions
The first trimester fetal ultrasound is an imaging test that uses an ultrasound machine to:
- Confirm your pregnancy
- Determine the number of embryos
- Make sure the embryo is located in your uterus (womb) instead of another location such as your fallopian tube
- See (and hear) if your baby’s heart is beating as expected
- Find out how long you’ve been pregnant (gestational age)
- Estimate your date of delivery (due date)
- Evaluate your uterus, ovaries, and cervix
Normal
Normal results will vary depending on your gestational age. During the first trimester, the pregnancy goes from no visible embryo to a visible fetus with identifiable organs.
- 0 to 4 weeks: no evidence of pregnancy in the ultrasound.
- 4 to 5 weeks: in some cases, a small structure called the gestational sac can be visualized.
- 5 weeks: the gestational sac can be identified.
- 5.5 to 6 weeks: a tiny embryo, or fetal pole, can be seen and sometimes the heartbeat can be heard. The gestational sac measures roughly 6 mm.
- 6 to 7 weeks: the fetal heartbeat can be found more easily. The gestational sac measures roughly 10 mm and the embryo measures approximately 5 mm as measured by the crown rump length (CRL), which is the length of the embryo fetus from the top of its head to its bottom.
- 7 to 8 weeks: the CRL should be between 11-16 mm.
- 8 to 9 weeks: the CRL should be between 17-23 mm and limb buds appear.
- 9 to 10 weeks: the CRL is between 23-32 mm and fetal movement can be seen.
Abnormal:
Your healthcare provider will inform you about any anomaly in your ultrasound.
The results of this ultrasound are compared to what is expected for your gestational age. If the ultrasound measurements indicate an embryo or heartbeat should be identified, and it is not, the doctor may diagnose a failed early pregnancy (missed miscarriage).
However, due to dating inaccuracies, in most cases a second ultrasound will be performed one or two weeks after the first one to confirm whether the pregnancy I viable or not. This is done because, in early pregnancy, the gestational sac and developing baby change drastically every day, so a few days can make a difference in whether the ultrasound should detect a heartbeat or reach certain measurements.
If the follow-up ultrasound shows that the pregnancy has continued developing, then it is probable that your dates were off and you have fewer weeks than initially thought.
But, if the follow-up ultrasound still shows abnormal development, the doctor can then conclusively diagnose a miscarriage.
1. https://www.healthline.com/health/pregnancy/ultrasound#purpose-anduses [accessed on Sep 12, 2020]
2. https://radiopaedia.org/articles/first-trimester [accessed on Sep 12, 2020]
3. https://www.mayoclinic.org/tests-procedures/fetal-ultrasound/about/pac-20394149#:~:text=The%20first%20fetal%20ultrasound%20is,when%20anatomic%20details%20are%20visible. [accessed on Sep 12, 2020]
4. https://www.verywellfamily.com/understand-early-pregnancy-ultrasound-results-2371367 [accessed on Sep 12, 2020]
5. https://pubs.rsna.org/doi/10.1148/rg.2015150092 [accessed on Sep 12, 2020]
6. https://radiopaedia.org/articles/early-pregnancy?lang=us [accessed on Sep 12, 2020]
7. https://radiopaedia.org/articles/crown-rump-length?lang=us [accessed on Sep 12, 2020]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (1)

5:16

How To: OB Ultrasound - Normal Pregnancy Case Study Video

Sonosite/YouTube

Second Trimester Prenatal Tests

Second Trimester Prenatal Tests

The second-trimester prenatal tests are done to screen for pregnancy-related conditions that could affect the baby. This test also helps detect how high is the baby's risk of having chromosomal disorders and other problems such as heart defects or neural tube defects, such as spina bifida. These tests are normally done between your third and sixth months...

Second Trimester Prenatal Tests

The second-trimester prenatal tests are done to screen for pregnancy-related conditions that could affect the baby. This test also helps detect how high is the baby's risk of having chromosomal disorders and other problems such as heart defects or neural tube defects, such as spina bifida. These tests are normally done between your third and sixth months...

The second trimester prenatal tests comprise blood tests, genetic screening, and fetal ultrasounds that are done between the third and sixth months of pregnancy to screen for possible conditions or abnormalities in your blood that could affect your baby. These tests also help screen for possible chromosomal disorders (such as Down syndrome and trisomy 18) or other problems such as heart defects or neural tube defects in your baby.
These tests can be done either to screen for or to diagnose any particular disorder.
Your doctor may want to order different second-trimester prenatal tests according to your age, clinical findings, family history, and past medical history. These tests can include:
- Triple or quad screen, the triple screen is made up of three blood tests, and the quad screen adds a fourth blood test. These tests are used to assess your baby's risk of having certain chromosomal abnormalities, including Down syndrome, trisomy 18, and neural tube defects (such as spina bifida).
- Glucose Challenge Test (GCT), a blood test that measures how well your body is able to absorb glucose (sugar) from your regular diet. Usually, this test is performed during the weeks 24-28 of pregnancy.
- Advanced fetal ultrasound, which checks for fetal anatomy, growth, and heart rate. It also evaluates the amniotic fluid level and location of the placenta.
- Fetal echocardiogram, which assesses the flow of blood through your baby's heart chambers.
- Amniocentesis, in which a sample of amniotic fluid, the fluid surrounding your unborn baby, is taken. This test checks for many chromosomal and genetic abnormalities, including Down syndrome, Tay-Sachs disease, and sickle-cell disease. It also checks for neural tube defects. An amniocentesis is done between the 15th and 20th weeks of pregnancy and is not a routine test.
- Cordocentesis, in which a blood sample from the umbilical cord is drawn. This test gives the most accurate diagnosis of Down syndrome during pregnancy, but it can't be done until late in pregnancy, between the 18th and 22nd week. A cordocentesis is not a routine test.
- For the blood tests: a sample of your blood is taken in the usual manner, most often from a vein in your arm. The sample is sent to a lab for testing.
- For the advance fetal ultrasound and fetal echocardiogram: if done through the belly (abdominal ultrasound), a gel is applied to the area and a handheld transducer is run across your lower abdomen. If done vaginally (transvaginal ultrasound), a wand-shaped transducer is covered with a sheath and inserted into your vagina.
- For the amniocentesis: a needle is inserted through your abdomen and into the uterus to draw a small amount of amniotic fluid. Ultrasound is used to help guide the needle.
- For the cordocentesis: a needle is inserted through your abdomen and into the uterus to draw a small amount of blood from the baby’s umbilical cord. Ultrasound is used to help guide the needle.
1. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P08956 [accessed on Jan 29, 2019]
2. https://kidshealth.org/en/parents/tests-second-trimester.html [accessed on Jan 29, 2019]
3. https://www.healthline.com/health/pregnancy/second-trimester-checkups-tests#checkup [accessed on Jan 29, 2019]

Maternal Serum Multiple Marker Screen

Maternal Serum Multiple Marker Screen

Also called: Multiple Marker Screening, MMS, Multiple Marker Test, Quad Screen, Triple Screen

A multiple marker test is a blood test for pregnant women. It is used to screen for certain types of birth defects (such as neural tube defects, Down syndrome, and trisomy 18 syndrome).

Maternal Serum Multiple Marker Screen

Also called: Multiple Marker Screening, MMS, Multiple Marker Test, Quad Screen, Triple Screen

A multiple marker test is a blood test for pregnant women. It is used to screen for certain types of birth defects (such as neural tube defects, Down syndrome, and trisomy 18 syndrome).

This blood test provides information about your developing baby. The maternal serum multiple marker test measures at least three markers found in the mother’s blood: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG) and unconjugated estriol. These substances are made by the developing baby and the placenta. The levels of these markers can be analyzed through a simple blood sample. Certain birth defects can sometimes be detected when the levels of these markers are different than expected. Some laboratories will measure additional chemicals to achieve a higher detection rate for these conditions.
Maternal serum multiple marker test is sometimes called triple test, AFP plus, enhanced AFP, AFP3 test or triple screen prenatal risk profile (PRP). When the blood is being tested for four markers, the test may be called the quad screen or AFP4, etc.
The test is a simple blood test on the mother’s blood and poses no threat to the mother or to her baby.
The test is available to any pregnant woman between 15 and 21 weeks of pregnancy (counting from the first day of the last menstrual period). Your provider may especially recommend the test if you:
- Have a family history of birth defects
- Have diabetes
- Have used medicines or drugs during pregnancy that could harm the baby
If you are 35 or older, your healthcare provider will probably suggest you have an amniocentesis or CVS test instead of or in addition to the maternal serum screening.
Maternal serum multiple marker screening is not a diagnostic test, but a screening test. A positive or abnormal result indicates the need for additional testing, such as ultrasound or amniocentesis. An abnormal test does not necessarily mean there is a definite health problem with the pregnancy. Genetic counseling to discuss this test is recommended.
Elevations in AFP may –
- identify a high percentage of neural tube defects including anencephaly;
- detect a miscalculated due date;
- identify twins or a pregnancy with multiples;
- detect an abnormal opening in the abdominal wall;
- predict risk for preterm delivery;
- determine a low birth weight; or
- represent a normal variation.
If the result is negative or normal, it means that it is unlikely that your baby has a birth defect. However, a normal result doesn't guarantee that you will have a normal pregnancy or baby.
1. Alpha-Fetoprotein (AFP) Test: MedlinePlus Medical Test [accessed on Feb 12, 2024]
2. Determining Your Baby's Risk of Birth Defects. Illinois Department of Public Health. [accessed on Feb 12, 2024]
3. Prenatal Test: Multiple Marker Test (for Parents) - Nemours KidsHealth. Mar 7, 2022 [accessed on Feb 12, 2024]
4. Second Trimester Maternal Serum Screening [accessed on Nov 14, 2018]
5. Second Trimester Maternal Serum Screening Programmes [accessed on Nov 14, 2018]
6. Quad Screen Test - American Pregnancy Association [accessed on Nov 14, 2018]
7. Quad screen - Mayo Clinic [accessed on Nov 14, 2018]
8. Quadruple screen test: MedlinePlus Medical Encyclopedia [accessed on Nov 14, 2018]

Additional Materials (4)

4:34

Prenatal Diagnostic Testing

TheVisualMD

Genes and Genetic Defects

TheVisualMD

Mapping Your Future: Screening for Disease Risk

TheVisualMD

Amniocentesis

TheVisualMD

AFP

Alpha-Fetoprotein (AFP) Screening

Also called: AFP Maternal, Maternal Serum AFP, msAFP screen, AFB

An alpha-fetoprotein (AFP) test that measures the amount of AFP in your blood. AFP levels that are too high or too low during pregnancy may indicate a birth defect in the fetus.

Alpha-Fetoprotein (AFP) Screening

Also called: AFP Maternal, Maternal Serum AFP, msAFP screen, AFB

An alpha-fetoprotein (AFP) test that measures the amount of AFP in your blood. AFP levels that are too high or too low during pregnancy may indicate a birth defect in the fetus.

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Use the slider below to see how your results affect your health.
ng/mL
10
150
Your result is Normal.
AFP is a protein made by your fetus' liver. The protein passes through the placenta and into your blood.
Related conditions
An AFP test is a test that is mainly used to measure the level of alpha-fetoprotein (AFP) in the blood of a pregnant person. The test checks the baby's risk for having certain genetic problems and birth defects. An AFP test is usually done between 15 and 20 weeks of pregnancy.
AFP is a protein that a developing baby makes. Normally, some AFP passes from the baby into the pregnant person's blood. Certain conditions can make a baby's body release more or less AFP. During pregnancy, if your AFP blood levels are higher or lower than normal, it may be sign that:
- The baby has a high risk of having a genetic disorder, such as:
  A neural tube defect, which is a serious condition that causes abnormal development of a developing baby's brain and/or spine.
  Down syndrome, a genetic disorder that causes intellectual disabilities and other health problems.
- Your estimated due date is wrong. AFP levels normally rise and fall at set times during pregnancy, so an abnormal AFP may mean that your baby is due earlier or later than estimated. This is the most common reason for abnormal AFP levels.
- You're pregnant with more than one baby. Each baby makes AFP, so your AFP blood levels will be higher with two or more babies.
Other names: AFP Maternal; Maternal Serum AFP; msAFP screen
If you are pregnant, AFP test is routinely offered between the 15th and 20th week of pregnancy. Your provider may especially recommend the test if you:
- Have a family history of birth defects
- Are 35 years or older
- Have diabetes
- Have used medicines or drugs during pregnancy that could harm the baby
The most common cause for abnormal AFP test results during pregnancy is an error estimating your due date. But a result that isn't normal may also be a sign of possible problems:
- Lower than normal AFP levels may mean your baby has a genetic disorder such as Down syndrome, a genetic disorder that causes intellectual disabilities and health problems.
- Higher than normal AFP levels may mean your baby has an increased risk of having a neural tube defect, such as:
  Spina bifida, a condition in which the bones of the spine don't close around part of the spinal cord
  Anencephaly, a condition in which the brain does not develop properly
High AFP levels may also mean that you are having more than one baby. You may also get a false-positive result. That means that your AFP results aren't normal, but your baby is healthy.
If your AFP test results aren't normal, you will likely have more tests to help make a diagnosis.
AFP tests are often part of a group of prenatal tests called multiple marker or triple screen tests. These tests can help diagnose Down syndrome, trisomy 18 (Edwards syndrome), and other genetic disorders. A triple screen test includes tests for:
- Alpha-fetoprotein (AFP)
- Human chorionic gonadotropin (HCG), a hormone produced by the placenta
- Estriol, a form of estrogen made by the baby and the placenta
In some cases, a fourth test is included, called an inhibin A test, which helps diagnose Down syndrome.
If you have a high risk for having a baby with certain birth defects, your provider may also recommend a test called prenatal cell-free DNA (cfDNA) screening. This is blood test can be done as early as the 10th week of pregnancy. It can show if your baby has a higher chance of having Down syndrome or certain other genetic disorders.
1. Alpha-Fetoprotein (AFP) Test: MedlinePlus Medical Test [accessed on Feb 12, 2024]
2. Adigun OO, Bhimji SS. Alpha Fetoprotein (AFP, Maternal Serum Alpha Fetoprotein, MSAFP) [Updated 2017 Oct 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. [accessed on Oct 03, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (10)

3:25

Newborn Screening: A Personal Story

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9:30

Your Newborn's Health Screening

KK Women's and Children's Hospital/YouTube

2:25

Newborn Screening

Mayo Clinic/YouTube

3:57

Maternal Serum Screening (MSS)

Washington State Department of Health/YouTube

4:51

Anterior Total Hip Replacement- Minimally Invasive Hip Replacement

alainelbazmd/YouTube

2:00

Total Hip Replacement

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8:09

3D Medical Animation: MicroHip, Total Hip Joint Replacement Surgery (THR) by Dr. Markus C. Michel

Microhip/YouTube

1:57

Pancreatic Auto Islet Transplantation with Total Pancreatectomy

Johns Hopkins Medicine/YouTube

Hip replacement

BruceBlaus

1:04

Animation of a Total Heart Transplant

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E3

Unconjugated Estriol Test

Also called: uE3

Estriol (E3) is a hormone that belongs to a group of steroids called estrogens. E3 is mainly produced by the placenta in pregnant women, and its levels can be unbalanced when abnormalities in the fetus are present. Unconjugated Estriol (UE3) helps screen for maternal-fetal diseases.

Unconjugated Estriol Test

Also called: uE3

Estriol (E3) is a hormone that belongs to a group of steroids called estrogens. E3 is mainly produced by the placenta in pregnant women, and its levels can be unbalanced when abnormalities in the fetus are present. Unconjugated Estriol (UE3) helps screen for maternal-fetal diseases.

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Use the slider below to see how your results affect your health.
ng/mL
4.2
14.9
Your result is Normal.
Your UE3 results are normal. However, reference ranges can vary depending on the gestational age and the method used for testing by the laboratory. Furthermore, it lacks value as a stand-alone result and must be correlated with the other two or three markers (AFP, hCG, and Inhibin A) of a Triple or Quad screen.
Related conditions
1. Estriol Unconjugated Test - Test Results, Normal Range, Cost And More [accessed on Nov 14, 2018]
2. UE3 - Clinical: Estriol, Unconjugated, Serum [accessed on Nov 14, 2018]
3. Low Maternal Serum Unconjugated Estriol During Prenatal Screening as an Indication of Placental Steroid Sulfatase Deficiency and X-Linked Ichthyosis | American Journal of Clinical Pathology | Oxford Academic [accessed on Nov 14, 2018]
4. Second Trimester Maternal Serum Screening [accessed on Nov 14, 2018]
5. Indication of prenatal diagnosis in pregnancies complicated by undetectable second-trimester maternal serum estriol levels [accessed on Nov 14, 2018]
6. DEFINE_ME [accessed on Nov 14, 2018]
7. Second Trimester Maternal Serum Screening Programmes [accessed on Nov 14, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (7)

This browser does not support the video element.

Prenatal Genetic Screening

Prenatal genetic screening tests can play an important role in the development of a healthy fetus. Ideally, parents will undergo a carrier screening before conception. This allows a couple to find out the chances that they will have a child with a certain genetic diseases. Carrier screenings help determine inherited risks such as cystic fibrosis, fragile-x, and spinal muscular atrophy.

Video by TheVisualMD

Estradiol, Estrone, And Estriol, How Do They Differ?

Video by EmpowHER/YouTube

Estriol (E3)

A hydroxylated metabolite of ESTRADIOL or ESTRONE that has a hydroxyl group at C3, 16-alpha, and 17-beta position. Estriol is a major urinary estrogen. During PREGNANCY, a large amount of estriol is produced by the PLACENTA. Isomers with inversion of the hydroxyl group or groups are called epiestriol.

Estrogen Molecule

Medical visualization of an estrogen molecule. Estrogen, as with all of the other main sex hormones, is a steroid hormone derived from cholesterol. Along with progesterone, estrogen is one of the most important female sex hormones. Estrogen production is primarily located in the developing follicles in the ovaries, called the corpus luteum, and the placenta. Another main site of estrogen production is fatty tissue, making weight a contributing factor to the timing of puberty. Smaller amounts are produced by other tissues such as the the breasts, liver, and adrenal glands. Estrogen is responsible for female secondary sexual characteristics such as breast growth, as well as aspects of menstrual cycle regulation, such as the thickening of the endometrium. As with all sex hormones, the effects of estrogen aren't limited to reproduction; estrogen affects bone growth and is involved with learning and memory. Both men and women have all of the main sex hormones, but in very different amounts. Women have much more estrogen than men, but some research suggests that estrogen may be essential for maintenance of the male libido, or sex drive.

Image by TheVisualMD

Estrogens: Pregnancy

Estrone (E1) and estradiol (E2) are the two main estrogens in non-pregnant females, while estriol (E3), produced by the woman's placenta and liver of the fetus, is the main hormone of pregnancy.

Image by TheVisualMD

Embryo and Fetus Development, placenta and amniotic sac.

Embryo and Fetus Development, placenta and amniotic sac. Unconjugated estriol (uE3), a hormone produced by the placenta and the baby

Image by TheVisualMD

Estrogen Molecules

Estrogens are a group of steroids that function as the main female sex hormones. More than 20 forms exist, but the most common forms of estrogens tested are estrone (E1), estradiol (E2), and estriol (E3). Total estrogens are most commonly measured in blood or urine. E1 and E2 are the two main estrogens in non-pregnant females, while E3 is the main pregnancy hormone (Progesterone is another major female hormone that also plays key roles in pregnancy and menstruation). High levels of estrogen may accompany early onset of puberty, tumors of the ovary, hyperthyroidism and cirrhosis (and in males, breast enlargement or tumors of the testes). Low levels of estrogen may be due to hypopituitarism, genetic disorders, pregnancy complications, post menopause or extreme exercise.

Image by TheVisualMD

4:15

Prenatal Genetic Screening

TheVisualMD

3:34

Estradiol, Estrone, And Estriol, How Do They Differ?

EmpowHER/YouTube

Estriol (E3)

Estrogen Molecule

TheVisualMD

Estrogens: Pregnancy

TheVisualMD

Embryo and Fetus Development, placenta and amniotic sac.

TheVisualMD

Estrogen Molecules

TheVisualMD

Amniocentesis

Amniocentesis

Also called: Amnio, Amniotic Fluid Test, AFT, Amniotic Fluid Analysis

Amniocentesis is a test done during pregnancy, usually between weeks 15 and 20. It uses a sample of amniotic fluid to diagnose certain genetic disorders, birth defects, and other health problems in an unborn baby.

Amniocentesis

Also called: Amnio, Amniotic Fluid Test, AFT, Amniotic Fluid Analysis

Amniocentesis is a test done during pregnancy, usually between weeks 15 and 20. It uses a sample of amniotic fluid to diagnose certain genetic disorders, birth defects, and other health problems in an unborn baby.

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Use the slider below to see how your results affect your health.
Your result is Normal.
Normal results are reported as "normal" or "negative." This means that it's very unlikely that your baby has the disorder that was tested, but it does not guarantee your baby will not have any health problems.
Related conditions
{"label":"Chromosome Analysis reference range","description":"The test determines fetal karyotype (collection of chromosomes). It looks at the size, shape, and number of your unborn baby's chromosomes. Chromosomes are parts of cells that contain genes. If the number or structure of your baby's chromosomes is not normal, it can indicate a genetic abnormality.","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal or negative result means that there were 46 chromosomes in the sample without any unusual changes in their structure. Normal karyotypes for females contain two X chromosomes and are denoted 46,XX; males have both an X and a Y chromosome denoted 46,XY.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An abnormal or positive result means that unusual changes in the number or structure of chromosomes were found. Abnormal results can mean many things about your baby's health depending on the chromosome changes that were found. Talk with your provider to learn what your results mean.","conditions":["Chromosome abnormalities","Sex chromosome abnormalities","45,X\/46,XY mosaicism","47,XYY syndrome","48,XXXY syndrome","48,XXYY syndrome","49,XXXXY syndrome","Down syndrome (47,XX,+21 or 47,XY,+21)","Edwards syndrome (47,XX,+18 or 47,XY,+18)","Klinefelter syndrome (47,XXY)","Patau syndrome (47,XX,+13 or 47,XY,+13)","Turner syndrome (45,X)"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
A normal or negative result means that there were 46 chromosomes in the sample without any unusual changes in their structure. Normal karyotypes for females contain two X chromosomes and are denoted 46,XX; males have both an X and a Y chromosome denoted 46,XY.
Related conditions
Amniocentesis is used to diagnose certain health problems in an unborn baby. It is commonly used to find:
- Genetic and chromosomal disorders, including:
  Down syndrome, a disorder that causes delays in physical and mental development and other health problems.
  Cystic fibrosis, a disease of the mucus and sweat glands that causes thick sticky mucus, which can lead to problems with breathing and digestion.
  Sickle cell disease, a group of red blood cell disorders that can cause anemia and other health problems.
  Tay-Sachs disease, a disease that destroys nerve cells, causes mental and physical problems, and often death in early childhood (uncommon).
- Neural tube defects, severe birth defects of the baby's brain and/or spine, such as spina bifida and anencephaly.
The test may also be used to:
- Check your baby's lung development if you have a risk of giving birth too soon (premature birth). In this case, amniocentesis is done later in your pregnancy.
- Diagnose an infection or certain other illnesses in the baby.
Having amniocentesis is your choice. You may want this test if you have a higher risk of having a baby with a health problem. You may have a higher risk if:
- You are age 35 or older; the risk of having a baby with a genetic disorder increases with age
- You had a prenatal screening test that showed your baby might have a problem
- You or your partner have a family history of a genetic disorder or neural tube defect
- You or your partner had genetic testing that showed you carry a genetic disorder
- You or your partner have a child with a genetic disorder or birth defect
Amniocentesis isn't right for everyone. Before you decide to get tested, think about how you might feel and what you might do after learning the results.
The test is usually done between 15 and 20 weeks of pregnancy. It is sometimes done later in pregnancy to check the baby's lung development or diagnose certain infections or illnesses, such as anemia in the unborn baby caused by Rh incompatibility.
During the procedure:
- You'll lie on your back on an exam table.
- Your provider will apply a gel to your belly.
- Your provider will move an ultrasound wand-like device, called a transducer, on your belly. Ultrasound uses sound waves to show the position of your baby and placenta so your provider can see where to take a sample of amniotic fluid.
- Your provider will clean your belly.
- Your provider will insert a thin needle into your belly, withdraw a small amount of amniotic fluid, and then remove the needle.
- When the sample is removed, your provider will check your baby's heartbeat with the ultrasound.
- The sample is sent to a lab for testing. Results may take from a few days to a few weeks.
The procedure usually takes about 15 minutes. Afterward, you may be told not to exercise or have sex for a day or two.
Amniotic fluid may be tested for many different disorders. Your test results will depend on which tests your provider ordered.
- Normal results are reported as "normal" or "negative." This means that it's very unlikely that your baby has the disorder that was tested, but it does not guarantee your baby will not have any health problems.
- Results that are not normal are reported as "abnormal" or "positive." This means that your baby very likely has the disorder that was tested.
Your provider will explain your test results. Amniocentesis is very accurate, but in certain cases, your provider may order more tests to learn about your baby's health.
It may help to speak to a genetic counselor before testing and/or after you get your results. A genetic counselor is a specially trained professional in genetics and genetic testing who can help you understand what your results mean.
1. Amniocentesis (amniotic fluid test): MedlinePlus Medical Test [accessed on Jan 20, 2024]
2. Amniocentesis: MedlinePlus Medical Encyclopedia [accessed on Jan 17, 2019]
3. Diagnosis of Birth Defects | CDC [accessed on Jan 17, 2019]
4. Amniocentesis. Test in pregnancy, amniocentesis information. | Patient [accessed on Jan 17, 2019]
5. Amniocentesis - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 17, 2019]
6. Amniotic Fluid Analysis [accessed on Jan 17, 2019]
7. Amniocentesis - InsideRadiology [accessed on Jan 17, 2019]
8. Amniocentesis - NHS [accessed on Jan 17, 2019]
9. Amniocentesis - American Pregnancy Association [accessed on Jan 17, 2019]
10. Amniocentesis Procedure [accessed on Jan 17, 2019]
11. Amniocentesis | March of Dimes [accessed on Jan 17, 2019]

Additional Materials (10)

Amniocentesis

TheVisualMD

Amniocentesis Being Performed on Human Pregnancy

TheVisualMD

3:15

Amniocentesis

Obstetrics & Gynecology Associates/YouTube

2:01

Amniocentesis: Pre-Baby Care (Pregnancy Health Guru)

Healthguru/YouTube

4:57

Amniocentesis | Parents

Parents/YouTube

4:34

Prenatal Diagnostic Testing

TheVisualMD

4:38

Genetic Testing During Pregnancy

University of California Television (UCTV)/YouTube

0:49

Amniocentesis.flv

PortalMedicoModerno/YouTube

1:56

Amnio vs. Genetic Blood Testing

Lee Health/YouTube

3:44

Amniocentesis

Washington State Department of Health/YouTube

Glucose Challenge Test

Glucose Challenge Test

Also called: GCT, Gestational Diabetes Screen

The glucose challenge test comprises a series of steps which involve drinking a load of glucose (sugar) to see how the body reacts to it. This test is commonly used to diagnose gestational diabetes in pregnant women without a preexisting diabetes diagnosis.

Glucose Challenge Test

Also called: GCT, Gestational Diabetes Screen

The glucose challenge test comprises a series of steps which involve drinking a load of glucose (sugar) to see how the body reacts to it. This test is commonly used to diagnose gestational diabetes in pregnant women without a preexisting diabetes diagnosis.

A glucose challenge test measures how well your body is able to absorb glucose (sugar) from your regular diet.
In pregnant women GDM diagnosis can be accomplished with either of two strategies:
One-step strategy:
After drinking a syrupy solution containing 75 grams of glucose, your blood glucose levels will be measured at 1 and 2 hours. You must be fasting prior to this test.
The one-step glucose challenge reference ranges and are as follows:
- Fasting blood glucose: normal values are considered to be less than 92 mg/dL (5.1 mmol/L).
- 1 hour after oral glucose intake: normal values are less than 180 mg/dL (10.0 mmol/L).
- 2 hours after oral glucose intake: normal values are less than 153 mg/dL (8.5 mmol/L).
When any of these values are exceeded in pregnant women, the diagnosis of gestational diabetes is made.
Two-step strategy:
Step 1
After drinking a syrupy solution containing 50 grams of glucose, your blood glucose levels will be measured after 1 hour. You don’t need to be fasting prior to this test.
If your blood glucose levels exceed 130 mg/dL (7.2 mmol/L), the second step must be performed.
Step 2
After drinking a syrupy solution containing 100 grams of glucose, your blood glucose levels will be measured at 1, 2, and 3 hours. You must be fasting prior to this test.
- Fasting blood glucose: normal values are considered to be less than 95 mg/dL (5.3 mmol/L).
- 1 hour after oral glucose intake: normal values are less than 180 mg/dL (10.0 mmol/L).
- 2 hours after oral glucose intake: normal values are less than 155 mg/dL (8.6 mmol/L).
- 3 hours after oral glucose intake: normal values are less than 140 mg/dL (7.8 mmol/L).
When at least one (in some cases two) of these values are exceeded in pregnant women, the diagnosis of gestational diabetes is made.
1. https://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf [accessed on Oct 22, 2018]
2. 102277: Gestational Diabetes Screen (ACOG Recommendations) | LabCorp [accessed on Oct 02, 2018]
3. Glucose challenge test - Mayo Clinic [accessed on Oct 22, 2018]
4. 50 Grams Oral Glucose Challenge Test: Is It an Effective Screening Test for Gestational Diabetes Mellitus? [accessed on Oct 22, 2018]

Additional Materials (3)

Baby Development in the Womb

TheVisualMD

1:47

Glucose Challenge Test during Pregnancy | 1mg Lab Test

Tata 1mg/YouTube

1:13

I get a glucose test at my 26 week checkup. What can I eat, and when should I stop eating?

IntermountainMoms/YouTube

Fetal Echocardiogram

Fetal Echocardiogram

Also called: Fetal echo, Fetal echocardiography

A fetal echocardiogram (also called a fetal echo) uses sound waves to check the heart of your unborn baby. It is used to evaluate the position, size, structure, function and rhythm of your baby's heart.

Fetal Echocardiogram

Also called: Fetal echo, Fetal echocardiography

A fetal echocardiogram (also called a fetal echo) uses sound waves to check the heart of your unborn baby. It is used to evaluate the position, size, structure, function and rhythm of your baby's heart.

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Use the slider below to see how your results affect your health.
Your result is Normal.
Your baby's heart structure, rhythm, and blood flow seems to be within normal parameters.
Related conditions
You should have this test if any of the following risk factors are present:
- If you or the baby’s father has a congenital heart defect
- If you’ve been exposed to certain dangerous chemicals
- If you have or have had particular diseases (including type I diabetes, lupus, and rubella)
- If you’ve abused drugs or alcohol during pregnancy
- If you’ve taken certain medications
1. https://www.heart.org/en/health-topics/congenital-heart-defects/symptoms--diagnosis-of-congenital-heart-defects/fetal-echocardiogram-test [accessed on Sep 19, 2019]
2. https://www.healthline.com/health/fetal-echocardiography [accessed on Sep 19, 2019]
3. https://www.nationwidechildrens.org/specialties/heart-center-cardiology/services-we-offer/programs/echocardiography/fetal-echo [accessed on Sep 19, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (7)

Fetal Circulation

OpenStax College

Sensitive content

This media may include sensitive content

Photo of a photo

U.S. Air Force photo by Senior Airman Collette Brooks

Vascular remodelling in the embryo

OpenStax College

Ultrasound Transducer

Drickey at English Wikipedia

4:14

What is Echocardiography?

Mayo Clinic/YouTube

25:46

Chapter- 23 of 24 Truncus arteriosus

Echocardiography in Congenital Heart Disease/YouTube

Head-3D

Cordocentesis Test

Cordocentesis Test

Also called: Percutaneous Umbilical Blood Cord Sampling, PUBS, Umbilical Vein Sampling, Fetal Blood Sampling

Cordocentesis, also known as percutaneous umbilical blood sampling, is a diagnostic prenatal test in which a sample of the baby's blood is collected from the umbilical cord for testing. It is used primarily to detect and treat blood conditions.

Cordocentesis Test

Also called: Percutaneous Umbilical Blood Cord Sampling, PUBS, Umbilical Vein Sampling, Fetal Blood Sampling

Cordocentesis, also known as percutaneous umbilical blood sampling, is a diagnostic prenatal test in which a sample of the baby's blood is collected from the umbilical cord for testing. It is used primarily to detect and treat blood conditions.

{"label":"Cordocentesis Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal result means that no chromosomal abnormalities, blood disorders, or infection were detected in your developing baby.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An abnormal result may indicate a chromosomal abnormality, blood disorder, or infection. Talk to your doctor to know what this result means in your baby's specific case.","conditions":["Down syndrome","Edwards syndrome","Patau syndrome","Blood disorders","Fetal anemia","Infection"]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that no chromosomal abnormalities, blood disorders, or infection were detected in your developing baby.
Related conditions
1. https://medlineplus.gov/lab-tests/down-syndrome-tests/ [accessed on Sep 18, 2019]
2. https://www.mayoclinic.org/tests-procedures/percutaneous-umbilical-blood-sampling/about/pac-20393638 [accessed on Sep 18, 2019]
3. https://www.nichd.nih.gov/health/topics/down/conditioninfo/diagnosis [accessed on Sep 18, 2019]
4. https://www.ncbi.nlm.nih.gov/pubmed/27014852 [accessed on Sep 18, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (7)

Cordiocentesis Being Performed on Human Pregnancy with Placenta towards Front

Cordiocentesis Being Performed on Human Pregnancy with Placenta towards Front

Image by TheVisualMD

3D Visualization of Fetus and Placenta

The placenta is an indispensable but temporary organ that physiologically joins the mother and the developing fetus. This remarkable, shared structure is the centerpiece of the complex dance that takes place between the needs of the mother’s body and the demands of the growing fetus. The placenta’s role is to facilitate the constant exchange of nutrients and wastes, including gases, as well as hormones and key immune factors.

Image by TheVisualMD

Nurture & Protect

As the fetus grows, there is a strict separation of maternal and fetal blood supplies. This is the work of the placenta, which allows maternal and fetal capillaries to intertwine closely enough to allow the exchange of gas, nutrient, and messenger molecules, but keeps them separate enough to prevent the triggering of an immune response. The fetus would be seen as an unwelcome invader by the mom`s immune system. The placenta serves as a traffic cop, making sure that nutrients are delivered to the fetus and wastes removed, but doing its best to keep harmful substances out. Certain pathogens such as the measles virus, and poisons such as heavy metals, drugs, and alcohol do seep through to the fetus, and can impair normal growth and development. In many cases, the timing of the exposure plays a key role in the degree of impact.

Image by TheVisualMD

The Knot close up

Image by andrechinn

Percutaneous umbilical cord blood sampling

Fetus in utero, between fifth and sixth months.

Image by Henry Gray / Gray's Anatomy

Fetal Circulation

Fetal Circulation

Image by OpenStax College

Fetal Circulation

The fetal circulatory system includes three shunts to divert blood from undeveloped and partially functioning organs, as well as blood supply to and from the placenta.

Image by OpenStax College

Cordiocentesis Being Performed on Human Pregnancy with Placenta towards Front

TheVisualMD

3D Visualization of Fetus and Placenta

TheVisualMD

Nurture & Protect

TheVisualMD

The Knot close up

andrechinn

Percutaneous umbilical cord blood sampling

Henry Gray / Gray's Anatomy

Fetal Circulation

OpenStax College

Fetal Circulation

OpenStax College

Second Trimester Ultrasound Scan

Second Trimester Ultrasound Scan

Also called: Fetal Anomaly Scan, Anatomy Scan, TIFFA, Targeted Imaging For Fetal Anomalies, Anatomical Scan, Second trimester anatomy scan

A second trimester anatomy scan is a non-invasive, painless, and risk-free imaging test in which an ultrasound machine is used to assess whether your baby’s growth and development is going as expected for their gestational age.

Second Trimester Ultrasound Scan

Also called: Fetal Anomaly Scan, Anatomy Scan, TIFFA, Targeted Imaging For Fetal Anomalies, Anatomical Scan, Second trimester anatomy scan

A second trimester anatomy scan is a non-invasive, painless, and risk-free imaging test in which an ultrasound machine is used to assess whether your baby’s growth and development is going as expected for their gestational age.

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Use the slider below to see how your results affect your health.
Your result is Normal.
Your baby’s development and growth is going as expected, and your placenta is in a normal position. Normal values differ widely depending on your pregnancy week
Related conditions
Your healthcare practitioner will take several measurements of your baby’s body, such as:
- Biparietal diameter (BPD): measures across your baby’s head.
- Head circumference (HC): measures around your baby’s head.
- Abdominal circumference (AC): measures around your baby’s abdomen (belly).
- Femur length (FL): the femur bone (the only bone in your baby’s thigh) is measured. This parameter can be used to calculate your baby’s length.
Those four measurements, taken together, help estimate your baby's weight and gestational age (how far along the pregnancy is).
The healthcare practitioner will also assess all your baby’s major organs and structures, including:
- Heart
- Brain
- Stomach
- Kidneys
- Bladder
- Sex organs
- Spine
- Limbs
This scan will also look for soft markers, which are features that, in some cases, are related to an increased risk of certain conditions in the fetus, such as Down syndrome or trisomy 18. Some examples of soft markers are an increased nuchal fold (excessive thickness of the fold of skin located at the back of the baby’s neck) and ventriculomegaly (some fluid-filled structures in the brain are too large), among others.
The second trimester anatomy scan can also provide information about your baby's movement, heart rate, breathing, position inside the womb, and their estimated weight and size.
Your placenta's location and the amount of amniotic fluid in your uterus (womb) will also be evaluated.
1. https://radiopaedia.org/articles/second-trimester-ultrasound-scan#:~:text=The%20following%20measurements%20are%20routinely,abdominal%20circumference%20(AC) [accessed on Sep 12, 2020]
2. https://www.healthline.com/health/baby/anatomy-ultrasound#1 [accessed on Sep 12, 2020]
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029995/ [accessed on Sep 12, 2020]
4. https://prenatalscreeningontario.ca/en/pso/about-prenatal-screening/detailed-anatomy-ultrasound.aspx [accessed on Sep 12, 2020]
5. https://www.nhs.uk/conditions/pregnancy-and-baby/20-week-scan/ [accessed on Sep 12, 2020]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Third Trimester Prenatal Tests

Third Trimester Prenatal Tests

Third-trimester prenatal tests help assess the overall fetus well-being and also screens for Group B strep, a type of bacterium that can be normally found in the vagina and rectum of pregnant women, and which can be harmful to the baby if he or she gets infected during birth.

Third Trimester Prenatal Tests

Third-trimester prenatal tests help assess the overall fetus well-being and also screens for Group B strep, a type of bacterium that can be normally found in the vagina and rectum of pregnant women, and which can be harmful to the baby if he or she gets infected during birth.

Third trimester prenatal tests comprise several tests that are performed during late pregnancy to monitor the fetus's health, oxygen supply, and lung maturity. It also screens for the presence of Streptococcus agalactiae, a type of bacteria that can be found in the intestines or lower genital tract of most adults, and which can pose a serious threat to unborn babies.
Your doctor may want to order one or more third-trimester prenatal tests according to your age, clinical findings, family history, and past medical history. These tests can include:
- Nonstress test (NST), during this test, two belts are placed around your belly to see if the baby's heart rate goes faster while resting or moving. This can help determine if the baby is getting enough oxygen.
- Biophysical profile (BPP), which is a combination of the nonstress test and a special ultrasound exam. It is done to monitor for fetal well-being.
- Contraction Stress Test (CST), which is used to monitor your baby’s heart rate after you have been induced to have mild contractions. This test is done to assess how well your baby will react to the stress of contractions during actual labor.
- Late amniocentesis, in which a sample of amniotic fluid, the fluid that surrounds your unborn baby, is taken. It is usually done between weeks 32 and 39 of pregnancy. This test checks for fetal well-being and fetal lung maturity if a baby is expected to arrive early.
- Group B Strep (GBS) screening test, in which a sample of cells and secretions from your vagina and rectum is taken. This is done to screen for Streptococcus agalactiae, a type of bacteria that can cause complications during pregnancy and, rarely, serious illness in newborns.
- For the nonstress test: two belts are attached to your waist: one to monitor the fetal heart rate and another to measure your spontaneous uterine contractions. This test lasts for 20-40 minutes.
- For the biophysical profile: this comprises a nonstress test and an ultrasound. During the ultrasound part of the exam, a gel is applied to the abdominal area and a handheld transducer is run across your lower abdomen.
- For the contraction stress test: two belts are attached to your waist: one to monitor the fetal heart rate and another to measure your uterine contractions. Then, your doctor will induce you to have mild contractions.
- For the late amniocentesis: a needle is inserted through your abdomen and into the uterus to draw a small amount of amniotic fluid. Ultrasound is used to help guide the needle.
- For the Group B Strep screening test: sterile cotton-tipped swabs are used to collect samples of cells and secretions from your vagina and rectum. In some cases, you might be instructed on how to collect the samples yourself.
1. https://www.webmd.com/baby/guide/third-trimester-tests [accessed on Jan 29, 2019]
2. https://www.webmd.com/baby/prenatal-tests-3rd-trimester [accessed on Jan 29, 2019]
3. https://kidshealth.org/en/parents/tests-third-trimester.html [accessed on Jan 29, 2019]
4. https://www.brennerchildrens.org/KidsHealth/Parents/Doctors-and-Hospitals/Medical-Tests-and-Exams/Prenatal-Tests-Third-Trimester.htm?__t=778 [accessed on Jan 29, 2019]

Nonstress Test

Nonstress Test

Also called: NST, Non-Stress Test, Fetal Nonstress Test, Nonstress Test

A nonstress test measures fetal heart rate as a baby moves in a mother's uterus. In most healthy babies, the heart rate increases during movement. If your nonstress test results are not normal, you may need more testing or treatment or to have delivery induced.

Nonstress Test

Also called: NST, Non-Stress Test, Fetal Nonstress Test, Nonstress Test

A nonstress test measures fetal heart rate as a baby moves in a mother's uterus. In most healthy babies, the heart rate increases during movement. If your nonstress test results are not normal, you may need more testing or treatment or to have delivery induced.

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Use the slider below to see how your results affect your health.
Your result is Reactive.
A reassuring or reactive NST means the fetus’ heart rate accelerates (increases) when it moves or when you have a contraction. This is a normal result.
Related conditions
Not all pregnant people need a nonstress test. But you may need this test if:
- Your baby doesn't seem to be moving as much as usual.
- Your pregnancy is overdue (at 42 weeks or beyond).
- You have a chronic medical condition that makes your pregnancy high risk, such as high blood pressure, diabetes, heart disease, or a clotting disorder.
- You had complications in a previous pregnancy.
- Your blood is Rh negative, and your baby's is Rh-positive, which is called Rh incompatibility. This condition can cause your immune system to attack your baby's red blood cells.
- You are having more than one baby (twins, triplets, or more).
The test may be done in your provider's office or a hospital's prenatal area. It generally includes the following steps:
- You will lie on a reclining chair or exam table.
- Your provider will spread a special gel on the skin over your abdomen (belly).
- Your provider will attach two belt-like devices around your abdomen. One will measure your baby's heartbeat. The other will record your contractions.
- Your provider will move the device over your abdomen until the baby's heartbeat is found.
- The baby's heart rate will be recorded on a monitor, while your contractions are recorded on paper.
- You may be asked to press a button on the device each time you feel your baby move. This allows your provider to record the heart rate during movement.
- The test usually lasts about 20 minutes to 30 minutes.
- If your baby isn't active or moving during that period, they may be asleep. To wake up the baby, your provider may place a small buzzer or other noisemaker over your abdomen. This won't harm the baby but it may help a sleepy baby become more active. Your baby may also wake up if you have a snack or sugary drink.
- Your provider will remove the belts. They will likely review the results with you soon after the test.
The procedure is very safe. It's called a "nonstress" test because no stress, or risk, is placed on the baby during the test.
Nonstress test results are given as one of the following:
- Reactive or Reassuring. This means your baby's heart rate increased two or more times during the testing period.
- Nonreactive. This means your baby's heartbeat didn't increase when moving or the baby wasn't moving much.
A nonreactive result doesn't always mean your baby has a health problem. Your baby may have been asleep and not easily awoken. Nonreactive results may also be caused by certain medicines taken during pregnancy. But if the result was nonreactive, your provider will probably take more tests to find out if there is cause for concern. If your baby is found to be at risk, you may need treatment or monitoring, or to have labor induced if it is late enough in your pregnancy.
If you have questions about your results, talk to your provider.
Additional noninvasive tests to check your developing baby's heart rate and health can include:
- Biophysical profile. This test combines a nonstress test with an ultrasound. An ultrasound imaging test uses sound waves to create a picture. The ultrasound checks your baby's breathing, muscle tone, and amniotic fluid level.
- Contraction stress test. This test checks how your baby's heart reacts when your uterus contracts. To make your uterus contract, you may be asked to rub your nipples through your clothing or may be given a medicine called oxytocin, which can cause contractions.
These tests pose no known risks to you or your baby.
1. Nonstress Test: MedlinePlus Medical Test [accessed on Sep 29, 2024]
2. Monitoring your baby before labor: MedlinePlus Medical Encyclopedia [accessed on Jan 10, 2019]
3. Nonstress test - Mayo Clinic [accessed on Jan 17, 2019]
4. Nonstress Test (NST) [accessed on Jan 17, 2019]
5. Nonstress and Contraction Stress Testing | GLOWM [accessed on Jan 17, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (8)

Non Stress Test - Fetal Heart Beat

Ultrasound with heartbeat at 13 weeks

Image by Marcel Berteler

Circulatory System of a Human Fetus

Circulation operates differently in the fetus. While a fetus is developing in the womb, the lungs never expand and never collect or contain any air. Oxygenated blood comes directly from the mother through the placenta and umbilical cord. In addition, the path of blood through the fetal heart is different from that of an adult. In the fetus, much of the blood that enters the right side of the heart flows directly into the left side of the heart through a valve called the foramen ovale and back out into the body. The remaining blood that flows into the major vessel to the lungs - the pulmonary artery - is still redirected away from the non-functioning lungs. It moves directly from the pulmonary artery through a pathway called the ductus arteriosis into the major vessel to the rest of the body - the aorta. Although the vessels are in place and the four-chambered heart works, until birth, blood circulating through the fetus bypasses the pulmonary circulation entirely.

Image by TheVisualMD

Fetal Heart Rate Tone Monitoring Decelerations | Early, Late, Variable NCLEX OB Maternity Nursing

Video by RegisteredNurseRN/YouTube

Fetal Heart Monitoring & OB Nursing

Video by Simple Nursing/YouTube

Prostate Cancer

Imaging and Radiation in Prostate Cancer: Radiation treatment is one of the major treatment options for prostate cancer. University of Chicago's radiation oncologist Dr. Stanley Liauw explains the crucial role imaging plays in the planning and execution of radiation treatment for prostate cancer.

Image by TheVisualMD

Cancers Associated with Overweight and Obesity

People who are obese may have an increased risk of several types of cancer, including cancers of the breast (in women who have been through menopause), colon, rectum, endometrium (lining of the uterus), esophagus, kidney, pancreas, and gallbladder.

Image by National Cancer Institute (NCI)

Alcohol causes 7 types of cancer

Drinking less alcohol could prevent 12,800 cancer cases per year in the UK. Based on a Cancer Research UK graphic published in 2014: http://www.cancerresearchuk.org/cancer-info/healthyliving/alcohol/alcohol-and-cancer Original sources: cruk.org, 2014 (data from 2011); Parkin et al, BJC, 2011;

Image by Cancer Research UK/Wikimedia

National Trends in Cancer Death Rates

Among men between 2012 and 2016, death rates for non-melanoma skin cancer had the highest increase. Melanoma had the highest decrease. For women, death rates for corpus and uterus cancer had the highest increase, and melanoma had the highest decrease.

Image by National Cancer Institute (NCI)

Non Stress Test - Fetal Heart Beat

Marcel Berteler

Circulatory System of a Human Fetus

TheVisualMD

10:44

Fetal Heart Rate Tone Monitoring Decelerations | Early, Late, Variable NCLEX OB Maternity Nursing

RegisteredNurseRN/YouTube

7:00

Fetal Heart Monitoring & OB Nursing

Simple Nursing/YouTube

Prostate Cancer

TheVisualMD

Cancers Associated with Overweight and Obesity

National Cancer Institute (NCI)

Alcohol causes 7 types of cancer

Cancer Research UK/Wikimedia

National Trends in Cancer Death Rates

National Cancer Institute (NCI)

Biophysical Profile

Biophysical Profile

Also called: BPP, BPP Score

A biophysical profile (BPP) is a prenatal ultrasound evaluation of fetal well-being, often combined with a nonstress test. Biophysical profile testing is usually performed in the last trimester of pregnancy.

Biophysical Profile

Also called: BPP, BPP Score

A biophysical profile (BPP) is a prenatal ultrasound evaluation of fetal well-being, often combined with a nonstress test. Biophysical profile testing is usually performed in the last trimester of pregnancy.

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Use the slider below to see how your results affect your health.
score
6
8
Your result is Normal.
A score between 8 and 10 is considered normal.
Related conditions

Each BPP component is assigned a score of 2 or 0. The numbers are then tallied for a final score from 0 to 10. A score of 8-10 is normal, 6 is borderline, and a score below 6 is of concern.
BPP Component	Normal (2 Points)	Abnormal (0 Points)
Breathing	1 breathing episode in 30 min	No breathing episodes in 30 min
Movement	>2 movements in 30 min	2 movements in 30 min
Muscle Tone	>1 active extension/flexion of limb/hand	Slow extension/flexion of limb/hand
Heart Rate	>2 episodes of rate acceleration in 20 min	>1 episode unreactive rate acceleration
Amniotic Fluid	1 or more pockets of fluid	Absent or inadequate pockets of fluid

1. Monitoring your baby before labor: MedlinePlus Medical Encyclopedia [accessed on Jan 10, 2019]
2. [accessed on Jan 17, 2019]
3. Biophysical Profile - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 10, 2019]
4. Biophysical Profile (BPP) [accessed on Jan 10, 2019]
5. Biophysical profile - Mayo Clinic [accessed on Jan 17, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Strep B Test

Strep B Test

Also called: GBS Testing, Group B Streptococcus Test, Group B Strep

Strep B is a type of bacteria that is usually harmless in adults but can be very serious in newborns. A group B strep test is most often used to check for bacteria in pregnant people.

Strep B Test

Also called: GBS Testing, Group B Streptococcus Test, Group B Strep

Strep B is a type of bacteria that is usually harmless in adults but can be very serious in newborns. A group B strep test is most often used to check for bacteria in pregnant people.

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Use the slider below to see how your results affect your health.
Your result is Negative.
streptococcus was not found in your sample.
Related conditions
Strep B, also known as group B strep (GBS), is a type of bacteria commonly found in the digestive tract, urinary tract, and genital area. Many healthy people have GBS bacteria in their bodies.
Most of the time, GBS bacteria are not harmful and do not make people feel sick or have any symptoms. But in rare cases, these bacteria cause certain infections, known as GBS disease. This is more likely in people who are age 65 and older, have certain chronic health problems, or have a condition that weakens their immune system. And sometimes GBS infections can be very serious, or even life-threatening, in newborns.
In most cases, it is not known how people spread GBS bacteria to others. However, it is known that pregnant people can pass the bacteria to their babies during a vaginal delivery. GBS is usually found in the vagina and rectum, so. the baby can be exposed to the GBS bacteria during labor. It is rare, but it can cause serious illness in the baby.
There are two types of GBS infections in babies. The types are based on the age of the infant when signs and symptoms begin to show:
- In early-onset GBS disease, the signs and symptoms start during the first six days of life
- In late-onset GBS disease, the signs and symptoms start during between 7 to 89 days of life. The source of late-onset GBS infection is unknown.
In newborns, GBS can cause:
- Bacteremia (infection in the bloodstream)
- Pneumonia (inflammation of the lung)
- Meningitis (inflammation of the thin tissue that surrounds the brain and spinal cord)
- Other serious illnesses
GBS bacteria are a leading cause of meningitis and bloodstream infections in a newborn's first three months of life.
In pregnant people, GBS can cause:
- Bacteremia
- Chorioamnionitis (infection of the placenta and amniotic fluid)
- Endometritis (infection of the membrane lining the uterus)
- Urinary tract infections
In older adults and people with chronic health conditions, GBS bacteria can cause:
- Bacteremia
- Urinary tract infection
- Pneumonia
- Bone and joint infections
- Endocarditis (infection of the heart valves)
- Meningitis
- Skin or soft-tissue infections
A group B strep test checks for GBS bacteria. If the test shows that a pregnant person has GBS, taking antibiotics during labor can protect the baby from infection.
Other names: group B streptococcus, group B beta-hemolytic streptococcus, Streptococcus agalactiae, beta-hemolytic strep culture
You may need a strep B test if you are pregnant. The American College of Obstetricians and Gynecologists recommends GBS testing for all pregnant people. Testing is usually done between 36 and 38 weeks of pregnancy. If you go into labor earlier than 36 weeks, you may be tested at that time.
Symptoms depend on the part of the body that is infected. Symptoms of GBS disease are different in newborns compared to people of other ages who get GBS disease. Most newborns who get sick in the first week of life (early onset) have symptoms on the day of birth. In contrast, babies who develop disease later (late onset) can appear healthy at birth and during their first week of life.
A baby may need a group B strep test if he or she has symptoms of infection. These include:
- High fever
- Trouble with feeding
- Trouble breathing
- Lack of energy (hard to wake up)
- Irritability
- Blue-ish skin color
- Unstable blood pressure (a pattern where the blood pressure suddenly spikes and then falls back to normal)
- Kidney problems
Pregnant people usually do not feel sick or have any symptoms. In adults, symptoms depend on the infection caused by GBS.
Symptoms of bacteremia include:
- Fever
- Chills
- Low alertness
Symptoms of pneumonia include:
- Fever
- Chills
- Cough
- Rapid breathing or trouble breathing
- Chest pain
Skin and soft tissue infections often appear as a bump or infected area on the skin that may be:
- Red
- Swollen or painful
- Warm to the touch
- Full of pus or other drainage
- Fever, in some cases
Bone and joint infections often appear as pain in the infected area and might also include:
- Fever
- Chills
- Swelling
- Stiffness or being unable to move the affected joint(s)
If you are pregnant, your health care provider may order a swab test or a urine test.
For a swab test, you will lie on your back on an exam table. Your provider will use a small cotton swab to take a sample of cells and fluids from your vagina and rectum.
For a urine test, a health care professional may give you a cleansing wipe, a small container, and instructions for how to use the "clean catch" method to collect your urine sample. It's important to follow these instructions so that germs from your skin don't get into the sample:
- Wash your hands with soap and water and dry them.
- Open the container without touching the inside.
- Clean your genital area with the cleansing wipe:
- For a penis, wipe the entire head (end) of the penis. If you have a foreskin, pull it back first.
- For a vagina, separate the labia (the folds of skin around the vagina) and wipe the inner sides from front to back.
- Urinate into the toilet for a few seconds and then stop the flow. Start urinating again, this time into the container. Don't let the container touch your body.
- Collect at least an ounce or two of urine into the container. The container should have markings to show how much urine is needed.
- Finish urinating into the toilet.
- Put the cap on the container and return it as instructed.
If your baby needs testing, a provider may do a blood test or a lumbar puncture (spinal tap).
For a blood test, a health care professional will use a small needle to take a blood sample from your baby's heel. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. Your baby may feel a little sting when the needle goes in or out.
A lumbar puncture, also known as a spinal tap, is a test that collects and looks at spinal fluid, the clear liquid that surrounds the brain and spinal cord. During the procedure:
- A nurse or other provider will hold your baby in a curled-up position.
- A provider will clean your baby's back and inject an anesthetic into the skin, so your baby won't feel pain during the procedure. The provider may put a numbing cream on your baby's back before this injection.
- The provider may also give your baby a sedative and/or pain reliever to help him or her better tolerate the procedure.
- Once the area on the back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in the lower spine. Vertebrae are the small backbones that make up the spine.
- The provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
The provider may also order a chest X-ray to help determine if someone has GBS disease.
1. Strep B Test: MedlinePlus Medical Test [accessed on Mar 24, 2024]
2. GBS | Prevention in Newborns | Group B Strep | CDC [accessed on Nov 19, 2018]
3. Group B strep test - Mayo Clinic [accessed on Nov 19, 2018]
4. Group B Streptococcus screening – Pregnancy Info [accessed on Nov 19, 2018]
5. Group B Strep Infection: GBS - American Pregnancy Association [accessed on Nov 19, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (34)

Real Questions | Pregnancy and Strep | UCLA OB/GYN

Video by UCLA Health/YouTube

Study Reveals New Mechanism Fueling Group B Strep Infection

Video by Seattle Children's/YouTube

What is a Group B Strep Test?

Video by University of California Television (UCTV)/YouTube

Chronic Health Conditions: Prescription Medicines and Pregnancy

Video by March of Dimes/YouTube

Streptococcus pyogenes

Magnified 100x, this 1977 photograph depicted a Petri dish filled with trypticase soy agar medium, containing 5% defibrinated sheep's blood. After having been inoculated by streaking the surface with Group A Streptococcus pyogenes (GAS) bacteria, the dish was incubated in a carbon dioxide enriched atmosphere at 35oC for 24 hours. The characteristic color changes, including a light colored halo surrounding each colony, indicated that these bacteria were beta-hemolytic in nature.

Image by CDC/ Richard R. Facklam, Ph.D.

Strep Throat - Causes and Spread

A throat infected with group A streptococcus.

Image by James Heilman, MD

Streptococcus Pyogenes (Group A Strep)

A colorized scanning electron microscope image of Group A Streptococcus (pink) during phagocytic interaction with a human neutrophil (green).

Image by NIAID

Strep throat

This image depicts an intraoral view of a patient, who had presented to a clinical setting exhibiting redness and edema of the oropharynx, and petechiae, or small red spots, on the soft palate. A diagnosis of strep throat had been made, caused by group A Streptococcus bacteria. These bacteria are spread through direct contact with mucus from the nose or throat, of persons who are infected, or through contact with infected wounds, or sores on the skin.

Image by CDC/ Heinz F. Eichenwald, MD

Strep throat

A culture positive case of strep throat with typical tonsillar exudate in an 8 year old.

Image by James Heilman, MD

This is an example of beta-hemolytic group B Streptococcus (GBS) growing in StrepB carrot broth.

This is an example of beta-hemolytic group B Streptococcus (GBS) growing in StrepB carrot broth. This media is a pigmented enrichment broth and the tube on the right shows a positive color change, indicating the presence of beta-hemolytic group B strep. Selective enrichment broths that incorporate chromogenic pigments for the detection of GBS using color detection can be used as an alternative to enrichment in Lim or TransVag broth. If no color is detected in the broth then the broth should be subcultured to an appropriate agar plate and further tested, or the broth can be tested directly to determine if GBS is present.

Image by CDC / American Society for Microbiology

Streptococcus pyogenes

This illustration depicts a photomicrograph of a specimen revealing numbers of chain linked Streptococcus pyogenes bacteria.

Image by CDC

Instructions for the collection of a genital swab for the detection of GBS from CDC

Instructions for the collection of a genital swab for the detection of GBS

Image by Centers for Disease Control

Streptococcus pyogenes

This 1977 image depicted two Petri dishes, each filled with trypticase soy agar medium, containing 5% defibrinated sheep's blood. The plate on the left had been stabbed and streaked with an inoculum containing Streptococcus mitis, alpha-hemolytic bacteria, a member of the Viridans group, while the right plate was stabbed with an inoculum containing Group A Streptococcus pyogenes (GAS), a typical beta-hemolytic bacteria. The inoculation was performed using a wire loop, which had been dipped into a primary culture medium. The BAPs were incubated in a carbon dioxide enriched atmosphere at 35oC for 24-hours. Additional Information:All culture organisms were Gram-positive cocci bacteria. The alpha-hemolytic organisms in the left plate grew colonies that were surrounded by a hazy, indistinct zone of partial red blood cell (RBC) hemolysis, and the beta-hemolytic bacteria on the right grew colonies surrounded by a clear, colorless zone of complete RBC destruction. Using the "stabbing" method of inoculation makes the qualitative interpretation of the hemolytic reaction much easier, for the results of colonial interactivity with the blood agar medium is much more pronounced, and therefore, easier to discern.

Image by CDC/ Richard R. Facklam, Ph.D.

Streptococcus agalactiae (Group B Streptococcus) colonies on Granada agar. Anaerobic incubation

Image by 43trevenque/Wikimedia

What Is Group B Strep (GBS)? | Pregnancy

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Group B Strep in pregnancy

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Streptococcus pyogenes

CDC/ Richard R. Facklam, Ph.D.

Strep Throat - Causes and Spread

James Heilman, MD

Streptococcus Pyogenes (Group A Strep)

NIAID

Strep throat

CDC/ Heinz F. Eichenwald, MD

Strep throat

James Heilman, MD

This is an example of beta-hemolytic group B Streptococcus (GBS) growing in StrepB carrot broth.

CDC / American Society for Microbiology

Streptococcus pyogenes

CDC

Instructions for the collection of a genital swab for the detection of GBS from CDC

Centers for Disease Control

Streptococcus pyogenes

CDC/ Richard R. Facklam, Ph.D.

Streptococcus agalactiae (Group B Streptococcus) colonies on Granada agar. Anaerobic incubation

43trevenque/Wikimedia

1:44

What Is Group B Strep (GBS)? | Pregnancy

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What should a pregnant woman know about group B strep?

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Two Signs of Strep

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When strep triggers OCD and tics - Leah's story

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Strep Throat in Kids

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How dangerous are strep infections?

Moleculera Labs/YouTube

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Mayo Clinic Minute: Is your child’s sore throat actually strep throat?

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Group A Strep Infections and Associated Rhinitis

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Invasive Strep A cases on the rise

CBC News/YouTube

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Group B Strep in Pregnancy

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1:14

Strep Throat

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6:07

Group B Strep in pregnancy

Bernadette Bos/YouTube

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Group B Strep Infection in Adults

Otolaryngologist,ORL,ENT-Medical Office,Artz Praxis/YouTube

7:39

Strep throat (streptococcal pharyngitis)- pathophysciology, signs and symptoms, diagnosis, treatment

Armando Hasudungan/YouTube

2:12

Strep Throat and Scarlet Fever

Larry Mellick/YouTube

5:08

Strep Throat Causes Loss of Limbs?

The Doctors/YouTube

2:42

Strep Throat - Akron Children's Hospital video

AkronChildrens/YouTube

0:44

Strep Throat – The Basics

WebMD/YouTube

1:22

Strep Throat Turning into Scarlet Fever

WAAY-TV 31 News/YouTube

16:21

Group B Strep in Pregnancy - CRASH! Medical Review Series

Paul Bolin, M.D./YouTube

Contraction Stress Test

Contraction Stress Test

Also called: CST, Contraction Stress Test

A contraction stress test (CST) is used to monitor your baby’s heart rate after you have been induced to have mild contractions. This test is done during the last trimester of pregnancy to assess how well your baby will withstand actual labor.

Contraction Stress Test

Also called: CST, Contraction Stress Test

A contraction stress test (CST) is used to monitor your baby’s heart rate after you have been induced to have mild contractions. This test is done during the last trimester of pregnancy to assess how well your baby will withstand actual labor.

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Use the slider below to see how your results affect your health.
Your result is Negative.
A negative CST is normal. It means that your baby’s heart rate responds well (do not decelerate or stays slower) after the contraction. This result indicates adequate fetal oxygenation and normal placental function.
Related conditions
Your doctor may want to order this test when results from a nonstress test (NST) or biophysical profile are abnormal. This is done to:
- Find out if your baby’s heart rate will stay within a safe range during labor, when contractions reduce the oxygen levels to the placenta.
- Check to see if your placenta is healthy enough to withstand labor.
A contraction stress test is done when you are 34 or more weeks pregnant.
This test should not be done in the following situations:
- Preterm rupture of membranes (you have already broken your water)
- You have bleeding, especially if due to a condition known as placenta previa
- You’ve had a previous cesarean section with a midline (vertical) incision
- Known hypersensitivity to oxytocin
- Multiple pregnancy (you are pregnant with more than one baby)
- You’ve had a previous uterine surgery, because strong contractions may cause a uterine rupture
- You are obese or have marked uterine overdistention
Negative
A negative result is normal. It means that your baby’s heart rate responds well (do not decelerate or stays slower) after the contraction.
This result is associated with well-being of the fetus for up to 1 week after the test.
Equivocal
- Suspicious: in this case, there is at least one late deceleration (the baby’s heart rate stays slower after the contraction), but it is not repetitive enough to meet criteria for a positive test.
- Hyperstimulation: this means that one or more late deceleration is present with or following excessive uterine activity.
- Unsatisfactory: an adequate number and length of contractions cannot be achieved, or the quality of tracing is too poor for accurate interpretation.
Positive
A positive result is abnormal. It means that on more than half of the contractions your baby's heart rate gets slower (decelerates) and stays that way after the contraction (late decelerations).
This indicates that your baby might have problems during normal labor. Therefore, your doctor may want to admit you to the hospital for an early delivery.
1. Monitoring your baby before labor: MedlinePlus Medical Encyclopedia [accessed on Jan 10, 2019]
2. Contraction Stress Test | Michigan Medicine [accessed on Jan 10, 2019]
3. Contraction stress test | BabyCenter [accessed on Jan 10, 2019]
4. What is a contraction stress test? | Parents [accessed on Jan 10, 2019]
5. Nonstress and Contraction Stress Testing | GLOWM [accessed on Jan 10, 2019]
6. Prenatal Test: Contraction Stress Test (for Parents) [accessed on Jan 17, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Fetal Fibronectin Test

Fetal Fibronectin Test

Also called: fFN

Fetal fibronectin (fFN) is a test used to assess a pregnant woman's risk of preterm delivery. It is usually done between weeks 22 and 35 of pregnancy in women who are having symptoms of premature labor.

Fetal Fibronectin Test

Also called: fFN

Fetal fibronectin (fFN) is a test used to assess a pregnant woman's risk of preterm delivery. It is usually done between weeks 22 and 35 of pregnancy in women who are having symptoms of premature labor.

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Use the slider below to see how your results affect your health.
Your result is Negative.
A negative test result means that there is no presence of fetal fibronectin in the vaginal fluid, indicating that the pregnant woman hasn’t started labor yet. It is also highly predictive that the delivery won’t happen within the next two weeks.
Related conditions
If you are between 22 and 35 weeks of pregnancy and you are experiencing symptoms of preterm labor, this test will help to determine the likeliness of going into premature labor.
Your doctor may recommend this test if you have:
- Uterine contractions
- Changes in your vaginal discharge
- Abdominal pain and discomfort
- Cramping
- Dilation of the cervix
- Pelvic pressure
- Backache
1. Fetal Fibronectin (fFN) Test [accessed on Oct 02, 2018]
2. fFN [accessed on Dec 06, 2018]
3. Fetal Fibronectin - Health Encyclopedia - University of Rochester Medical Center [accessed on Dec 06, 2018]
4. Fetal fibronectin testing for reducing the risk of preterm birth | Cochrane [accessed on Dec 06, 2018]
5. Fetal Fibronectin (38226) [accessed on Dec 06, 2018]
6. Fetal fibronectin test - Mayo Clinic [accessed on Dec 06, 2018]
7. http://www.nichd.nih.gov/health/topics/preterm/conditioninfo/diagnosed [accessed on Nov 10, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Diabetes Testing

Gestational Diabetes

Image by TheVisualMD

Have a Healthy Pregnancy - Diabetes Testing

Get tested for gestational diabetes.

All pregnant people need to get tested for gestational diabetes between 24 and 28 weeks of pregnancy. Gestational diabetes is a type of diabetes that some people develop during pregnancy.

Pregnant people at high risk for type 2 diabetes may need to get tested earlier than people at normal risk. Find out about your risk for type 2 diabetes.

What do I need to know about gestational diabetes?

Gestational diabetes can lead to health problems for moms and babies — both during and after pregnancy. It’s important to get tested so that you and your doctor or midwife can take steps to protect you and your baby.

You're at higher risk for gestational diabetes if you:

Are overweight or have obesity
Have a family history of diabetes
Are over age 25
Are African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander
Had gestational diabetes during an earlier pregnancy
Have had a baby weighing over 9 pounds
Have polycystic ovary syndrome (PCOS)

You can reduce your risk for gestational diabetes by eating healthy and staying active during pregnancy.

Learn more about gestational diabetes
Ask your doctor about getting tested for gestational diabetes

Source: U.S. Department of Health and Human Services

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How Does Gestational Diabetes Affect Mother and Baby?

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Get Prenatal Care

Prenatal Care

Image by Nick Youngson CC BY-SA 3.0 Alpha Stock Images

Have a Healthy Pregnancy - Get Prenatal Care

There are lots of things you can do today to help you have a healthy pregnancy and a healthy baby.

Get regular prenatal care.

Plan on getting a prenatal checkup at least once a month for the first 6 months (through week 28) — and more often during the last 3 months of your pregnancy (after week 28). Learn more about prenatal care.

Get important vaccines.

All pregnant people need whooping cough and flu vaccines (shots). Talk to your doctor or midwife about getting other vaccines to help protect you and your baby. Learn more about vaccines for adults.

Take charge of your health care.

Speak up and ask questions when you're with your doctor or midwife. When you play an active role in your health care, you help make sure that you and your growing family will get good care. Find out how to take charge of your health care.

Keep track of your baby’s movement.

Sometime between 16 and 28 weeks of pregnancy, you'll probably start to feel your baby move. Keep track of how often your baby moves. If you think your baby is moving less than usual, call your doctor or midwife.

Source: U.S. Department of Health and Human Services

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Importance of Prenatal Care

Prenatal Care

Image by TheVisualMD

What Is Prenatal Care and Why Is It Important?

Having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy. This care can begin even before pregnancy with a pre-pregnancy care visit to a health care provider.

Pre-Pregnancy Care

A pre-pregnancy care visit can help women take steps toward a healthy pregnancy before they even get pregnant.
Women can help to promote a healthy pregnancy and birth of a healthy baby by taking the following steps before they become pregnant:

Develop a plan for their reproductive life.
Increase their daily intake of folic acid (one of the B vitamins) to at least 400 micrograms.
Make sure their immunizations are up to date.
Control diabetes and other medical conditions.
Avoid smoking, drinking alcohol, and using drugs.
Attain a healthy weight.
Learn about their family health history and that of their partner.
Seek help for depression, anxiety, or other mental health issues.

Prenatal Care

Women who suspect they may be pregnant should schedule a visit to their health care provider to begin prenatal care. Prenatal visits to a health care provider usually include a physical exam, weight checks, and providing a urine sample. Depending on the stage of the pregnancy, health care providers may also do blood tests and imaging tests, such as ultrasound exams. These visits also include discussions about the mother's health, the fetus's health, and any questions about the pregnancy.

Pre-Pregnancy and prenatal care can help prevent complications and inform women about important steps they can take to protect their infant and ensure a healthy pregnancy. With regular prenatal care women can:

Reduce the risk of pregnancy complications. Following a healthy, safe diet; getting regular exercise as advised by a health care provider; and avoiding exposure to potentially harmful substances such as lead and radiation can help reduce the risk for problems during pregnancy and promote fetal health and development. Controlling existing conditions, such as high blood pressure and diabetes, is important to prevent serious complications and their effects.
Reduce the fetus's and infant's risk for complications. Tobacco smoke and alcohol use during pregnancy have been shown to increase the risk for Sudden Infant Death Syndrome. Alcohol use also increases the risk for fetal alcohol spectrum disorders, which can cause a variety of problems such as abnormal facial features, having a small head, poor coordination, poor memory, intellectual disability, and problems with the heart, kidneys, or bones. According to one recent study supported by the NIH, these and other long-term problems can occur even with low levels of prenatal alcohol exposure.

In addition, taking 400 micrograms of folic acid daily reduces the risk for neural tube defects by 70%. Most prenatal vitamins contain the recommended 400 micrograms of folic acid as well as other vitamins that pregnant women and their developing fetus need. Folic acid has been added to foods like cereals, breads, pasta, and other grain-based foods. Although a related form (called folate) is present in orange juice and leafy, green vegetables (such as kale and spinach), folate is not absorbed as well as folic acid.
Help ensure the medications women take are safe. Women should not take certain medications, including some acne treatments and dietary and herbal supplements, during pregnancy because they can harm the fetus.

Source: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Additional Materials (18)

This browser does not support the video element.

Prenatal Diagnostic Testing

If a pregnant woman has an abnormal genetic screening test result, a doctor may suggest a prenatal diagnostic test be done to determine with more certainly whether or not a fetus has a particular disorder. There are two main diagnostic testing procedures, chorionic villus sampling (CVS) and amniocentesis. Both of these tests involve collecting a sample from inside the womb, which is then examined to detect diseases such as Down Syndrome, Edwards Syndrome, neural tube defects, cystic fibrosis, fragile-x, and spinal muscular atrophy. Prenatal diagnostic tests provide valuable information on the health of the fetus and can help alleviate the stress of expectant parents.

Video by TheVisualMD

Week 19 Fetal Development and Pregnancy

The fetus is surrounded by amniotic fluid—a salty interior ocean.

Image by TheVisualMD

Prenatal Blood Test

Prenatal Blood Test

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Pregnancy and Prenatal Care

Pregnancy and Prenatal Care

Image by culturarte86

Prenatal check-up

Prenatal check-up

Image by PublicDomainPictures

Prenatal Genetic Screening

Prenatal genetic screening tests can play an important role in the development of a healthy fetus. Ideally, parents will undergo a carrier screening before conception. This allows a couple to find out the chances that they will have a child with a certain genetic diseases. Carrier screenings help determine inherited risks such as cystic fibrosis, fragile-x, and spinal muscular atrophy.

Image by TheVisualMD

Prenatal Testing: What to Expect During a First Prenatal Visit

An ultrasound is a simple test during pregnancy that will give your healthcare provider a detailed look at your baby's progress. Learn helpful tips for what to expect and how to stay healthy while pregnant.

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Amniocentesis

Amniocentesis is a prenatal test that gathers information about a fetus` health from a sample of amniotic fluid. Amniotic fluid is the fluid that surrounds the fetus in the uterus. It contains cells from the fetus that naturally slough off during development. If a woman is at high risk for a genetic disease, a doctor may recommend an "amnio" to determine whether a fetus has certain genetic disorders, such as cystic fibrosis, among other diseases.

Image by TheVisualMD

Prenatal Cell-Free DNA Screening (cfDNA Screening)

Noninvasive Prenatal Testing - Prenatal Cell-Free DNA Screening (cfDNA Screening)

Image by TheVisualMD

What will the doctor do at my first prenatal appointment?

Video by IntermountainMoms/YouTube

Your First Step to a Healthy Pregnancy | Prenatal Care

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The Importance of Prenatal Care for Your Family

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Why Is Prenatal Care Important? — AMITA Health Medical Group

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Prenatal Care

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Prenatal Testing - What You Need To Know

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Prenatal Testing: Nuchal Test (Pregnancy Health Guru)

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What is prenatal care?

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Prenatal Care Appointments

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4:34

Prenatal Diagnostic Testing

TheVisualMD

Week 19 Fetal Development and Pregnancy

TheVisualMD

Prenatal Blood Test

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Pregnancy and Prenatal Care

culturarte86

Prenatal check-up

PublicDomainPictures

Prenatal Genetic Screening

TheVisualMD

Prenatal Testing: What to Expect During a First Prenatal Visit

TheVisualMD

Amniocentesis

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Prenatal Cell-Free DNA Screening (cfDNA Screening)

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What will the doctor do at my first prenatal appointment?

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Your First Step to a Healthy Pregnancy | Prenatal Care

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The Importance of Prenatal Care for Your Family

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3:35

Why Is Prenatal Care Important? — AMITA Health Medical Group

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5:47

Prenatal Care

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1:45

Prenatal Testing - What You Need To Know

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2:42

Prenatal Testing: Nuchal Test (Pregnancy Health Guru)

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1:17

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2:27

Prenatal Care Appointments

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Don't Smoke, Drink Alcohol, or Use Drugs

Stop Smoking before, during, after your Pregnancy

Image by TheVisualMD / Alexas _ Fotos

Have a Healthy Pregnancy - Don't Smoke, Drink Alcohol, or Use Drugs

Don’t smoke, drink alcohol, or use drugs.

One of the best ways to protect you and your baby is to stop smoking, drinking alcohol, and using drugs before you become pregnant — or as soon as possible during your pregnancy.

There's no safe amount to drink or smoke while you're pregnant. Both can harm your baby’s health. Talk with your doctor or midwife about ways to help you quit.

Quitting all forms of tobacco products, including e-cigarettes (vapes), is best for you and your baby. Secondhand smoke (smoke from other people’s cigarettes) can also put you and your baby at risk for health problems. Stay away from cigarette smoke during your pregnancy.

Using drugs during pregnancy — including opioid pain medicines and marijuana — can also put your baby’s health at risk. If you’re pregnant and using drugs, talk with your doctor right away.

Source: U.S. Department of Health and Human Services

Additional Materials (4)

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Smoking | FAQ | Baby Talk

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How Much Alcohol Can A Pregnant Woman Drink?

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0:32

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Quit Smoking for Two

Dangers of Smoking and Fetal Development

Image by TheVisualMD

Quit Smoking for Two

Quitting at any stage of your pregnancy is the best thing that you can do for you and your baby. Being prepared can help you succeed.

Maybe you’re thinking about quitting because you’re trying to get pregnant, or you have a baby on the way. No matter where you are in your pregnancy, it’s never too late to quit smoking. Deciding to quit is the first step to becoming smokefree. Being prepared can keep you moving forward.

Plan to Quit for Good

Many women quit smoking or try to do so while they’re pregnant. Some plan to start smoking again after their baby is born. Quitting smoking during and after your pregnancy can help ensure your baby has the best possible start in life. Keep your baby and yourself safe from the harms of cigarettes and make your pregnancy the start of your smokefree life. To help you prepare and boost your chances of success, build a quit plan today.

Talk to Your Doctor

If you’re pregnant, or are trying to become pregnant, talk to your doctor about quitting. You can begin by being open about your challenges, especially if you haven’t been able to quit in the past. Ask your doctor or pharmacist about local support groups, in-person or telephone counseling, and digital health resources such as smartphone apps or online quitting programs.

Pregnant women are encouraged to try quitting without medications. More research is needed about the medications’ safety and effectiveness for pregnant women. But, if you have not been successful in quitting, ask your doctor if medication is right for you and your baby.

Talk to your doctor before taking any of the following:

Over-the-counter medications
Prescription medications (for example: Chantix, Wellbutrin)
“Herbal products” from health stores

Know What to Do When It Gets Tough

Triggers, cravings, and withdrawal are some of the biggest challenges smokers face when quitting.

Know what makes you want to smoke and learn ways to avoid these triggers so you can stay smokefree.
Make a list of things you can do when you’re having a craving. It can set you up for smokefree success.
Withdrawal symptoms usually last for a few days or weeks. Be prepared to deal by building healthy coping skills, exploring quit methods, or creating an exercise plan.

Practice

It takes most people several tries before they quit for good. Even if you haven’t completely stopped yet, know that every cigarette you don’t smoke is helping you and your baby be healthier. Try a Practice Quit text messaging program and practice quitting for one, three, or five days. You can repeat the program as often as you want to. If you’re ready to quit for a longer time, sign up for SmokefreeMOM.

Explore Quit Smoking Tools

There are many ways to quit smoking – you don’t have to quit cold turkey. Below are free, no-judgment resources that will help you quit.

Try SmokefreeMOM. This text message program gives 24/7 support to pregnant women. Enter your child’s due date to receive customized messages that match where you are in your pregnancy. Then, choose your goal of the program: to quit smoking or receive messages on smoking and health. You have the option to receive support even if you’re not yet ready to quit permanently. Sign up online or text MOM to 222888 to join now.
Join the Smokefree Women Facebook page. Women who have quit, or are trying to quit, offer one another advice and inspiration.
Make your phone your quit buddy. Download quitSTART or QuitGuide, Smokefree’s free smartphone apps. Track your cravings by time and location to help you see patterns so you can stay in control. They also have ways to see your progress and fun distractions to keep you from having a slip.
Speak with a quit smoking counselor. Call 1-800-QUIT-NOW, or log on to LiveHelp, an online chat service. A trained specialist will give you support and quit smoking information.

Tip: It might take some time to find the quit method that works best for you. If one isn’t working, try something new. Each time you try is a step closer to a smokefree life.

What About E-Cigarettes?

E-cigarettes should not be used during pregnancy. This is because e-cigarettes usually contain nicotine, which can hurt pregnant women and their babies. Nicotine is addictive and can damage a developing baby’s brain and lungs. E-cigarettes may also contain other substances that are harmful to a developing baby, like heavy metals, flavorings, and cancer-causing chemicals.

There is little evidence that e-cigarettes help people quit. Quitting all forms of tobacco products, including e-cigarettes, is best for you and your baby. Talk to your health care provider about proven, safe, and effective quit methods.

Ask for Support

Tell your friends, family, and loved ones that you’re planning to quit smoking for good – for you and the baby. When pregnant women and new mothers get positive support from their loved ones, they’re more likely to successfully quit.

Explain to them how they can help. Maybe you just need someone to listen. Or maybe you want someone to celebrate with you. Ask them to try to be there for you as much as possible.
Tell them you may go through mood changes and irritability because of withdrawal. Ask them to be patient and supportive even if you’re in a bad mood.
Have no smoking rules in your house and car and ask smokers to follow them. Many people say that it’s hard to stay smokefree around people who smoke.

Tip: It’s OK to take a temporary break from people who don’t support your quit. Remember your reasons for quitting and surround yourself with people who will provide positive support and encouragement.

Source: U.S. Department of Health and Human Services

Additional Materials (1)

1:49

Discover What Can Happen When You Smoke While Pregnant

Sanford Health/YouTube

Fetal Alcohol Exposure

Fetal alcohol syndrome

Image by NIH/National Institute on Alcohol Abuse and Alcoholism

Fetal Alcohol Exposure

Fetal alcohol exposure occurs when a woman drinks while pregnant. Alcohol can disrupt fetal development at any stage during a pregnancy—including at the earliest stages before a woman even knows she is pregnant.

Research shows that binge drinking and regular heavy drinking put a fetus at the greatest risk for severe problems. (The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration [BAC] to 0.08 percent—or 0.08 grams of alcohol per deciliter—or higher. For a typical adult female, this pattern of alcohol consumption corresponds to consuming 4 or more drinks in about 2 hours. [NIAAA. (2007, November). Defining binge drinking. What Colleges Need to Know Now. Available at: https://www.collegedrinkingprevention.gov/media/1College_Bulletin-508_3….]) However, even lesser amounts can cause damage.In fact, there is no known safe level of alcohol consumption during pregnancy.

Alcohol passes easily from a mother’s bloodstream into her developing baby’s blood. Alcohol present in a developing baby’s bloodstream can interfere with the development of the brain and other critical organs, structures, and physiological systems.

Prenatal alcohol exposure is a leading preventable cause of birth defects and neurodevelopmental abnormalities in the United States. It can cause a range of developmental, cognitive, and behavioral problems, which can appear at any time during childhood and last a lifetime.

The most profound effects of prenatal alcohol exposure are brain damage and the resulting impairments in behavioral and cognitive functioning.

Fetal Alcohol Spectrum Disorders

Scientists define a broad range of effects and symptoms caused by prenatal alcohol exposure under the umbrella term Fetal Alcohol Spectrum Disorders (FASD).

The medical disorders collectively labeled FASD include the Institute of Medicine of the National Academies (IOM) diagnostic categories:

Fetal Alcohol Syndrome (FAS)
Partial FAS (pFAS)
Alcohol-Related Neurodevelopmental Disorder (ARND)
Alcohol-Related Birth Defects (ARBD)

In addition to the IOM medical diagnoses, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) includes the psychiatric diagnosis, Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE). People who meet criteria for an FASD diagnosis according to the IOM may also meet criteria for ND-PAE.

The essential features common to the IOM medical diagnoses and the DSM–5 psychiatric diagnosis are prenatal alcohol exposure and central nervous system (CNS) involvement.

Evidence of CNS involvement can be structural (e.g., small brain size, alterations in specific brain regions) or functional (e.g., cognitive and behavioral deficits, motor and coordination problems). Advanced imaging studies have revealed differences in brain structure and activity that are consistent with data from neuropsychological testing, including deficits in sensory processing, cognition, and behavior in persons with FASD compared to people without FASD.

FASD-Related Problems

Each individual with FASD experiences a unique combination of day-to-day challenges that may include medical, behavioral, educational, and social problems. People with FASD may have difficulty in the following areas:

Learning and remembering
Understanding and following directions
Shifting attention
Controlling emotions and impulsivity
Communicating and socializing
Performing daily life skills, including feeding, bathing, counting money, telling time, and minding personal safety

FASD-related brain damage makes it difficult to address routine life situations. It causes people to make bad decisions, repeat the same mistakes, trust the wrong people, and have difficulty understanding the consequences of their actions.

FASD cases are seriously under-diagnosed. FASD can be difficult for practitioners to distinguish from other developmental disorders since these disorders share certain learning and behavioral problems.

In addition, people with FASD are more likely to suffer from the following mental health disorders:

Attention Deficit Hyperactivity Disorder (ADHD)
Depression and anxiety
Problems with hyperactivity, conduct, and impulse control
Increased incidence of alcohol and other substance use disorders

Key Statistics for the United States—Maternal Drinking

About 20 to 30 percent of women have reported drinking at some point during pregnancy—most typically during the first trimester.
More than 8 percent of women have reported binge drinking at some time during pregnancy—most typically during the first trimester.
Almost 10 percent of pregnant women reported drinking alcohol in the previous month.
Almost 5 percent of pregnant women reported binge drinking in the previous month (4 or more drinks per occasion).

Relevant Clinical Diagnoses

IOM Diagnoses

Fetal Alcohol Syndrome (FAS)

Fetal Alcohol Syndrome (FAS) was the first form of FASD discovered and is the most well-known. Heavy alcohol use during the first trimester of pregnancy can disrupt normal development of the face and the brain. In fact, exposure at any point during gestation may affect brain development. An FAS diagnosis requires:

Evidence of prenatal alcohol exposure
Evidence of central nervous system (CNS) abnormalities (structural or functional)
A specific pattern of three facial abnormalities: narrow eye openings, a smooth area between the lip and the nose (vs. the normal ridge), and a thin upper lip
Growth deficits either prenatally, after birth, or both

Partial FAS (pFAS)

Partial FAS (pFAS) involves prenatal alcohol exposure, and includes some, but not all, of the characteristics of full FAS.

Alcohol-Related Neurodevelopmental Disorder (ARND)

A diagnosis of Alcohol-Related Neurodevelopmental Disorder (ARND) requires evidence of both prenatal alcohol exposure and CNS abnormalities, which may be structural or functional. Functional abnormalities may involve a complex pattern of cognitive or behavioral problems that are not consistent with developmental level, and that cannot be explained by factors other than prenatal alcohol exposure (e.g., family background, environment, and other toxicities). Facial abnormalities and growth retardation need not be present.

Alcohol-Related Birth Defects (ARBD)

This disorder includes medical conditions linked to prenatal alcohol exposure such as: heart, kidney, and bone problems and other malformations; difficulty seeing and hearing; and reduced immune function. Alcohol-Related Birth Defects (ARBD) is rarely seen alone but rather as a secondary disorder accompanying other FASD conditions (e.g., FAS and ARBD).

DSM–5 Diagnosis

Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)

Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE) is a new psychiatric diagnosis in the DSM–5. It requires evidence of both prenatal alcohol exposure and CNS involvement, as indicated by impairments in the following three areas: cognition, self-regulation, and adaptive functioning. This new diagnosis for use by mental health professionals will improve understanding of the multifaceted behavioral deficits seen in some people exposed to alcohol prenatally, and facilitate improved diagnosis and treatment of these individuals.

Risk Factors

The severity of alcohol’s effects on a fetus primarily depends on the following:

Quantity—how much a pregnant woman drinks per occasion
Frequency—how often a pregnant woman drinks
Timing—in what stage of pregnancy a woman drinks and if she drinks heavily just as the fetus develops a particular feature or brain region

Other factors can also play a role in how prenatal alcohol exposure affects children. These include:

Maternal Characteristics

Research demonstrates that children may be more affected by prenatal alcohol exposure if their mothers:

Have poor nutrition
Have had multiple pregnancies and births
Have lower-than-average weight, height, and body mass index (BMI)
Smoke
Are older
Are a member of a family of heavy drinkers

Environmental Factors

Research demonstrates that children can be more affected by prenatal alcohol exposure if their mothers experience adverse-living conditions and high levels of stress. These may include: social isolation, living in circumstances where alcohol misuse is common and accepted, and living in a community where resources for prenatal care are limited.

Genetics

The extent of FASD symptoms may depend on the mother’s genetic makeup, her child’s genetic makeup, and changes in gene activity caused by prenatal alcohol exposure.

Interventions

Researchers and clinicians have developed effective learning and behavioral interventions to help people with FASD. For example, school-based interventions can help children with FASD learn more easily. School-based interventions may include specialized teaching strategies that provide a consistent routine and allow children to practice new skills over and over again. Other promising interventions include:

Family support groups and classes to help parents better care for a child with FASD.
Nutritional supplements for pregnant women and postnatal supplements for their children.
Behavioral interventions for affected children, including training in social skills, problem solving, and personal safety.

Source: National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Additional Materials (4)

Fetal Alcohol Exposure

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

11:04

Khan Academy - What is Fetal Alcohol Syndrome?

Emma Giles/YouTube

3:36

Diagnosing FASD

FASD Hub Australia/YouTube

3:55

Taking Steps to Prevent Birth Defects (WEWS)

AkronChildrens/YouTube

Substance Use

Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome

Image by National Institute on Drug Abuse (NIDA)

Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome

Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome Use of opiates during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). A new study to determine the extent, context, and costs of NAS found that incidence of NAS is rising in the United States. There was a five-fold increase in the proportion of babies born with NAS from 2000 to 2012, when an estimated 21,732 infants were born with NAS -equivalent to one baby suffering from opiate withdrawal born every 25 minutes. Newborns with NAS were more likely than other babies to also have low birthweight and respiratory complications. The number of delivering mothers using or dependent on opiates rose nearly five-fold from 2000 to 2009, to an estimated 23,009. In 2012, newborns with NAS stayed in the hospital an average of 16.9 days (compared to 2.1. days for other newborns), costing hospitals an estimated $1.5 billion; the majority of these charges (81%) were paid by state Medicaid programs, reflecting the greater tendency of opiate-abusing mothers to be from lower-income communities. The rising frequency (and costs) of drug withdrawal in newborns points to the need for measures to reduce antenatal exposure to opiates.Top Graph: Every 25 minutes, 1 baby is born suffering from opiate withdrawal.Bottom Left Graph: Average length or cost of hospital stay graph. Newborns with NAS stayed in the hospital for an average of 16.9 days compared to 2.1 days for those without NAS. The hospital costs for newborns with NAS were $66,700 on average compared to $3,500 for those without NAS.Bottom Right Graph: NAS and maternal opiate use on the rise graph.The rate of babies born with NAS per 1,000 hospital births was 1.2 in 2000, 1.5 in 2003, 1.96 in 2006, 3.39 in 2009 and 5.8 in 2012. The rate of maternal opiate use per 1,000 hospital births was 1.19 in 2000, 1.26 in 2003, 2.52 in 2006, and 5.63 in 2009.References: Patrick et. Al., JAMA 2012, Patrick et. Al., Journal of Perinatology 2015

Image by National Institute on Drug Abuse (NIDA)

Substance Use While Pregnant and Breastfeeding

Research shows that use of tobacco, alcohol, or illicit drugs or misuse of prescription drugs by pregnant women can have severe health consequences for infants. This is because many substances pass easily through the placenta, so substances that a pregnant woman takes also reach the fetus. Recent research shows that smoking tobacco or marijuana, taking prescription pain relievers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth. Estimates suggest that about 5 percent of pregnant women use one or more addictive substances.

Regular use of some drugs can cause neonatal abstinence syndrome (NAS), in which the baby goes through withdrawal upon birth. Most research in this area has focused on the effects of opioids (prescription pain relievers or heroin). However, data has shown that use of alcohol, barbiturates, benzodiazepines, and caffeine during pregnancy may also cause the infant to show withdrawal symptoms at birth. The type and severity of an infant's withdrawal symptoms depend on the drug(s) used, how long and how often the birth mother used, how her body breaks the drug down, and whether the infant was born full term or prematurely.

Symptoms of drug withdrawal in a newborn can develop immediately or up to 14 days after birth and can include:

blotchy skin coloring
diarrhea
excessive or high-pitched crying
abnormal sucking reflex
fever
hyperactive reflexes
increased muscle tone
irritability
poor feeding
rapid breathing
seizures
sleep problems
slow weight gain
stuffy nose and sneezing
sweating
trembling
vomiting

Effects of using some drugs could be long-term and possibly fatal to the baby:

birth defects
low birth weight
premature birth
small head circumference
sudden infant death syndrome (SIDS)

Risks of Stillbirth from Substance Use in Pregnancy

Tobacco use—1.8 to 2.8 times greater risk of stillbirth, with the highest risk found among the heaviest smokers
Marijuana use—2.3 times greater risk of stillbirth
Evidence of any stimulant, marijuana, or prescription pain reliever use—2.2 times greater risk of stillbirth
Passive exposure to tobacco—2.1 times greater risk of stillbirth

Source: Tobacco, drug use in pregnancy, 2013

Risks of Sudden Infant Death (SIDS)

Children born to mothers who both drank and smoked beyond the first trimester of pregnancy have a twelvefold increased risk for sudden infant death syndrome (SIDS) compared to those unexposed or only exposed in the first trimester of pregnancy.

Source: National Institute on Drug Abuse (NIDA)

Additional Materials (20)

Newborn baby

Image by The White House

Neonatal Abstinence Syndrome - Low Birthweight

Prematurity can accompany withdrawal

Image by Aneta Meszko, Marcin Meszko

Treating Neonatal Abstinence Syndrome

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Neonatal Abstinence Syndrome

Video by Lee Health/YouTube

Fighting Neonatal Abstinence Syndrome (NAS) - East Tennessee Children's Hospital NICU

Video by East Tennessee Children's Hospital/YouTube

Medical Minute: Neonatal Abstinence Syndrome with Dr. Barnette

Video by Saint Francis Healthcare System/YouTube

Neonatal Abstinence Syndrome | Cincinnati Children's

Video by Cincinnati Children's/YouTube

Primary Prevention and Public Health Strategies to Prevent Neonatal Abstinence Syndrome

Video by Centers for Disease Control and Prevention (CDC)/YouTube

Neonatal Abstinence Syndrome

Video by Centers for Disease Control and Prevention (CDC)/YouTube

Neonatal Abstinence Syndrome: Using Infant Massage as a Calming Technique

Video by Atrium Health/YouTube

Opioid Use in Pregnancy and Neonatal Opioid Withdrawal

Video by Children's Healthcare Canada/YouTube

Drugs and Pregnancy

Video by Lee Health/YouTube

Beyond Addiction | The Center For Addiction and Pregnancy

Video by Johns Hopkins Medicine/YouTube

Prescription medicine before and during pregnancy

Video by March of Dimes/YouTube

Opioid Use During Pregnancy

Video by NICHDVideos/YouTube

Jaye’s Story: A Reason for Hope

Video by Dartmouth-Hitchcock/YouTube

Standard of care for pregnant women with an opioid use disorder

Video by National Institute on Drug Abuse (NIDA/NIH)/YouTube

New Life, New Hope: Helping Moms and Babies in the midst of the Opioid Crisis

Video by Dartmouth-Hitchcock/YouTube

Born on Opioids | What It's Like

Video by Today's Parent/YouTube

Born Addicted NAS

Video by Lee Health/YouTube

Newborn baby

The White House

Neonatal Abstinence Syndrome - Low Birthweight

Aneta Meszko, Marcin Meszko

1:44

Treating Neonatal Abstinence Syndrome

NEJMvideo/YouTube

1:58

Neonatal Abstinence Syndrome

Lee Health/YouTube

3:42

Fighting Neonatal Abstinence Syndrome (NAS) - East Tennessee Children's Hospital NICU

East Tennessee Children's Hospital/YouTube

1:02

Medical Minute: Neonatal Abstinence Syndrome with Dr. Barnette

Saint Francis Healthcare System/YouTube

3:33

Neonatal Abstinence Syndrome | Cincinnati Children's

Cincinnati Children's/YouTube

1:00:59

Primary Prevention and Public Health Strategies to Prevent Neonatal Abstinence Syndrome

Centers for Disease Control and Prevention (CDC)/YouTube

1:22:16

Neonatal Abstinence Syndrome

Centers for Disease Control and Prevention (CDC)/YouTube

2:36

Neonatal Abstinence Syndrome: Using Infant Massage as a Calming Technique

Atrium Health/YouTube

1:06:58

Opioid Use in Pregnancy and Neonatal Opioid Withdrawal

Children's Healthcare Canada/YouTube

1:48

Drugs and Pregnancy

Lee Health/YouTube

3:45

Beyond Addiction | The Center For Addiction and Pregnancy

Johns Hopkins Medicine/YouTube

3:16

Prescription medicine before and during pregnancy

March of Dimes/YouTube

2:51

Opioid Use During Pregnancy

NICHDVideos/YouTube

5:18

Jaye’s Story: A Reason for Hope

Dartmouth-Hitchcock/YouTube

1:53

Standard of care for pregnant women with an opioid use disorder

National Institute on Drug Abuse (NIDA/NIH)/YouTube

10:27

New Life, New Hope: Helping Moms and Babies in the midst of the Opioid Crisis

Dartmouth-Hitchcock/YouTube

20:26

Born on Opioids | What It's Like

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2:00

Born Addicted NAS

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Eat Healthy and Stay Active

Healthy Eating

Image by StoryMD

Have a Healthy Pregnancy - Eat Healthy and Stay Active

Get the nutrients you need.

Making healthy food choices and taking supplements as needed can help you gain weight in a healthy way, feel good while you're pregnant, and have a healthy baby.

Check out these tips on healthy eating during pregnancy
Ask your doctor or midwife if you need to take a daily prenatal supplement during pregnancy
Take a daily supplement with 400 to 800 micrograms (mcg) of folic acid — folic acid is a vitamin that can prevent birth defects

Gain weight in a healthy way.

Gaining a certain amount of weight during pregnancy is important for both you and your baby. Learn how much weight is healthy for you to gain during pregnancy.

Even if you're overweight, you still need to gain some weight for your baby to grow. Ask your doctor or midwife how much weight is healthy for you to gain.

Stay active.

Being physically active can help you have a healthier pregnancy. Aim for at least 150 minutes a week of moderate-intensity aerobic activity — like walking, dancing, or swimming.

If you haven’t been active before, start slow and do what you can! Even a 5-minute walk has real health benefits, and you can add more activity over time.

Source: U.S. Department of Health and Human Services

Additional Materials (4)

1:13

What to Eat During Pregnancy: Decoding Pregnancy Cravings | Parents

Parents/YouTube

6:25

Pregnancy Fitness and Food: You Don’t Need to Eat for Two | Kaiser Permanente

Kaiser Permanente Thrive/YouTube

45:56

Are You Really Eating for Two? Food and Nutrition During Pregnancy

St. Louis Children's Hospital/YouTube

1:14

Pregnancy Weight Gain

WebMD/YouTube

Tips for Healthy Weight

Nutrition For a New Life

Image by TheVisualMD

Health Tips for Pregnant Women: Healthy Weight

Why is gaining a healthy amount of weight during pregnancy important?

Gaining an appropriate amount of weight during pregnancy helps your baby grow to a healthy size. But gaining too much or too little weight may lead to serious health problems for you and your baby.

According to experts, gaining too much weight during pregnancy raises your chances for developing gestational diabetes (diabetes during pregnancy) and high blood pressure during pregnancy. It also increases your risk for type 2 diabetes and high blood pressure later in life. If you’re overweight or have obesity when you get pregnant, your chances for health problems may be even higher. You could also be more likely to have a cesarean section (C-section).

Gaining a healthy amount of weight helps you have an easier pregnancy and delivery. It may also help make it easier for you to get back to your normal weight after delivery. Research shows that recommended amounts of weight gain during pregnancy can also lower the chances that you or your child will have obesity and weight-related problems later in life.

How much weight should I gain during my pregnancy?

How much weight you should gain depends on your body mass index (BMI) before pregnancy. BMI is a measure of your weight in relation to your height. You can use a formula to calculate your BMI online.

The general weight-gain advice below is for women having only one baby.

If you’re	You should gain about
Underweight (BMI less than 18.5)	28 to 40 pounds
Normal weight (BMI of 18.5 to 24.9)	25 to 35 pounds
Overweight (BMI of 25 to 29.9)	15 to 25 pounds
Obese (BMI of 30+)	11 to 20 pounds

It’s important to gain weight very slowly. The old myth that you’re “eating for two” is not true. During the first 3 months, your baby is only the size of a walnut and doesn’t need many extra calories. The following rate of weight gain is advised

1 to 4 pounds total in the first 3 months
2 to 4 pounds each month from 4 months until delivery

Talk to your health care professional about how much weight gain is appropriate for you. Work with him or her to set goals for your weight gain. Take into account your age, weight, and health. Track your weight at home or when you visit your health care professional.

Don’t try to lose weight if you’re pregnant. Your baby needs to be exposed to healthy foods and low-calorie beverages (particularly water) to grow properly. Some women may lose a small amount of weight at the start of pregnancy. Speak to your health care professional if this happens to you.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (4)

A Fitter Fetus

TheVisualMD

3:32

Weight gain and pregnancy

March of Dimes/YouTube

4:11

Weight Gain and Pregnancy (Q&A)

Howard County General Hospital/YouTube

2:54

How Much Weight Should You Gain in Pregnancy? | Kaiser Permanente

Kaiser Permanente Thrive/YouTube

Tips for Healthy Eating

Nutrition For a New Life

Image by TheVisualMD

Health Tips for Pregnant Women: Healthy Eating

How much should I eat and drink?

Consuming healthy foods and low-calorie beverages, particularly water, and the appropriate number of calories may help you and your baby gain the proper amount of weight.

How much food and how many calories you need depends on things such as your weight before pregnancy, your age, and how quickly you gain weight. If you’re at a healthy weight, the Centers for Disease Control and Prevention (CDC) says you need no extra calories in your first trimester, about 340 extra calories a day in your second trimester, and about 450 extra calories a day in your third trimester. You also may not need extra calories during the final weeks of pregnancy.

Check with your health care professional about your weight gain. If you’re not gaining the weight you need, he or she may advise you to take in more calories. If you’re gaining too much weight, you may need to cut down on calories. Each woman’s needs are different. Your needs also depend on whether you were underweight, overweight, or had obesity before you became pregnant, or if you’re having more than one baby.

What kinds of foods and beverages should I consume?

A healthy eating plan for pregnancy includes nutrient-rich foods and beverages. The 2015–2020 Dietary Guidelines for Americans recommend these foods and beverages each day

fruits and vegetables (provide vitamins and fiber)
whole grains, such as oatmeal, whole-grain bread, and brown rice (provide fiber, B vitamins, and other needed nutrients)
fat-free or low-fat milk and milk products or nondairy soy, almond, rice, or other drinks with added calcium and vitamin D
protein from healthy sources, such as beans and peas, eggs, lean meats, seafood that is low in mercury (up to 12 ounces per week), and unsalted nuts and seeds, if you can tolerate them and aren’t allergic to them.

A healthy eating plan also limits salt, solid fats (such as butter, lard, and shortening), and sugar-sweetened drinks and foods.

Fruit, colorful vegetables, beans, fish, and low-fat dairy are rich sources of nutrients needed during pregnancy.

Does your eating plan measure up? How can you improve your habits? Try consuming fruit like berries or a banana with hot or cold cereal for breakfast; a salad with beans or tofu or other non-meat protein for lunch; and a lean serving of meat, chicken, turkey, or fish and steamed vegetables for dinner. Think about new, healthful foods and beverages you can try. Write down your ideas and share them with your health care professional.

For more about healthy eating, see the MyPlate Daily Checklist. It can help you make an eating plan for each trimester (3 months) of your pregnancy.

A meal of steamed veggies and grilled chicken breast contains nutrients without too many calories.

What if I’m a vegetarian?

A vegetarian eating plan during pregnancy can be healthy. Consider the quality of your eating plan and talk to your health care professional to make sure you’re getting enough calcium, iron, protein, vitamin B12, vitamin D, and other needed nutrients. Your health care professional may also tell you to take vitamins and minerals that will help you meet your needs.

Do I have any special nutrition needs now that I’m pregnant?

Yes. During pregnancy, you need more vitamins and minerals such as folate, iron, and calcium.

Getting the appropriate amount of folate is very important. Folate, a B vitamin also known as folic acid, may help prevent birth defects. Before pregnancy, you need 400 mcg per day from supplements or fortified foods, in addition to the folate you get naturally from foods and beverages. During pregnancy, you need 600 mcg. While breastfeeding, you need 500 mcg of folate per day. Foods high in folate include orange juice, strawberries, spinach, broccoli, beans, fortified breads, and fortified low-sugar breakfast cereals. These foods may even provide 100% of the daily value of folic acid per serving.

Most health care professionals tell women who are pregnant to take a prenatal vitamin every day and consume healthy foods, snacks, and beverages. Ask your doctor about what you should take.

What other new habits may help my weight gain?

Pregnancy can create some new food, beverage, and eating concerns. Meet the needs of your body and be more comfortable with these tips. Check with your health care professional with any concerns.

Eat breakfast every day. If you feel sick to your stomach in the morning, try dry whole-wheat toast or whole-grain crackers when you first wake up. Eat them even before you get out of bed. Eat the rest of your breakfast (fruit, oatmeal, hot or cold cereal, or other foods) later in the morning.
Eat high-fiber foods. Eating high-fiber foods, drinking water, and getting daily physical activity may help prevent constipation. Try to eat whole-grain cereals, brown rice, vegetables, fruits, and beans.
If you have heartburn, eat small meals spread throughout the day. Try to eat slowly and avoid spicy and fatty foods (such as hot peppers or fried chicken). Have drinks between meals instead of with meals. Don’t lie down soon after eating.

High-fiber foods like beans help prevent constipation during pregnancy.

What foods and drinks should I avoid?

Certain foods and drinks can harm your baby if you have them while you’re pregnant. Here’s a list of items you should avoid.

Alcohol. Do not drink alcohol, such as wine, beer, or hard liquor.
Caffeine. Enjoy decaf coffee or tea, drinks not sweetened with sugar, or water with a dash of juice. Avoid diet drinks, and limit drinks with caffeine to less than 200 mg per day—the amount in about 12 ounces of coffee.
Fish that may have high levels of mercury (a substance that can build up in fish and harm an unborn baby). Limit white (albacore) tuna to 6 ounces per week. Do not eat king mackerel, marlin, orange roughy, shark, swordfish, or tilefish. To get the helpful nutrients in fish and shellfish, you may eat up to 12 ounces of seafood per week, choosing from many safe seafood choices (PDF, 387.44 KB), such as cod, salmon, and shrimp.
Foods that may cause illness in you or your baby (from viruses, parasites, or bacteria such as Listeria or E. coli). Avoid soft cheeses made from unpasteurized or raw milk; raw cookie dough; undercooked meats, eggs, and seafood; and deli salads. Take care in choosing and preparing lunch meats, egg dishes, and meat spreads. See more food safety guidelines during pregnancy.
Anything that is not food. Some pregnant women may crave something that is not food, such as laundry starch, clay, ashes, or paint chips. This may mean that you’re not getting the right amount of a nutrient. Talk to your health care professional if you crave something that isn’t food. He or she can help you get the right amount of nutrients.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (4)

0:31

Food to avoid during pregnancy - Stanford Children's Health

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1:37

Most common pregnancy food cravings

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1:21

What to Eat During Pregnancy: How To Avoid Listeria | Parents

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1:58

Foods To Avoid During Pregnancy | FAQ | Baby Talk

BabyTalkShow/YouTube

Tips for Physical Activity

Pregnant Woman Yoga

Image by 7089643/Pixabay

Health Tips for Pregnant Women: Physical Activity

Should I be physically active during my pregnancy?

Almost all women can and should be physically active during pregnancy. According to current physical activity guidelines, regular physical activity may

help you and your baby gain the appropriate amounts of weight
reduce backaches, leg cramps, and bloating
reduce your risk for gestational diabetes (diabetes during pregnancy)
reduce your risk for postpartum depression

There's also some evidence that physical activity may reduce the risk of problems during pregnancy such as preeclampsia (high blood pressure during pregnancy), reduce the length of labor and postpartum recovery, and reduce the risk of having a cesarean section (or C-section).

If you were physically active before you became pregnant, you may not need to change your exercise habits. Talk with your health care professional about how to change your workouts during pregnancy.

Being physically active can be hard if you don’t have childcare for your other children, haven’t exercised before, or don’t know what to do. Keep reading for tips about how you can work around these hurdles and be physically active.

How much and what type of physical activity do I need?

According to current guidelines, most women need the same amount of physical activity as they did before becoming pregnant. Aim for at least 150 minutes a week of moderate-intensity aerobic activity. Aerobic activities—also called endurance or cardio activities—use large muscle groups (back, chest, and legs) to increase your heart rate and breathing. Brisk walking is a form of aerobic activity.

How can you tell if you’re doing moderate-intensity aerobic activity? Take the “talk test” to find out. If you’re breathing hard but can still have a conversation easily—but you can’t sing—that’s moderate intensity.

If you can only say a few words before pausing for a breath, that’s called vigorous-intensity activity. If you were in the habit of doing vigorous-intensity aerobic activity or were physically active before your pregnancy, then it’s likely okay for you to continue these activities during your pregnancy.

You can talk to your health care professional about whether to or how to adjust your physical activity while you’re pregnant. If you have health issues such as obesity, high blood pressure, diabetes, or anemia (too few healthy red blood cells), ask your health care professional about a level of activity that’s safe for you and your unborn baby.

How can I stay active while pregnant?

Even if you haven’t been active before, you can be active during your pregnancy. Here are some tips.

Go for a walk where you live, in a local park, or in a shopping mall with a family member or friend. If you already have children, take them with you and make it a family outing.
Get up and move around at least once an hour if you sit most of the day. When watching TV or sitting at your computer, get up and move around. Even a simple activity like walking in place can help.
Make a plan to be active while pregnant. List the activities you’d like to do, such as walking or taking a prenatal yoga class. Think of the days and times you could do each activity on your list, such as first thing in the morning, during your lunch break from work, after dinner, or on Saturday afternoon. Look at your calendar or phone or other device to find the days and times that work best and commit to those plans.

How can I stay safe while being active?

For your health and safety, and for your baby’s, you should not do certain physical activities while pregnant. Some of these are listed below. Talk to your health care professional about other physical activities you should not do.

Safety do’s and don’ts

Follow these safety tips while being active.

Do…	Don’t…
Choose moderate activities that aren’t likely to hurt you, such as walking or water or chair aerobics.	Don’t engage in sports where you could fall or injure your abdomen, such as soccer or basketball.
Drink fluids before, during, and after being physically active. Don’t overdo it.	Avoid brisk exercise outside during very hot weather.
Wear comfortable clothing that fits well and supports and protects your breasts.	Don’t use steam rooms, hot tubs, and saunas.
Stop exercising if you feel dizzy, short of breath, tired, or sick to your stomach.	Avoid exercises that call for you to lie flat on your back after week 12 in your pregnancy.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

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Prevent Infections

Infections in Pregnancy

Image by StoryMD/CDC

Have a Healthy Pregnancy - Prevent Infections

Take steps to prevent infections.

Follow these tips to prevent infections and help keep your baby safe:

Wash your hands often with soap and water
Make safe food choices and prepare food safely
If you have a cat, learn how to protect yourself from toxoplasmosis (a disease spread by dirty cat litter)
Get vaccines to protect you from whooping cough and the flu
Avoid traveling to an area with Zika virus — and if you have to travel to an area with Zika, learn how to protect yourself from Zika virus

Source: U.S. Department of Health and Human Services

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10 Tips for Preventing Infections

Hand Washing

Image by renateko

10 Tips for Preventing Infections Before and During Pregnancy

Some infections before and during pregnancy can hurt both you and your developing fetus. They can cause serious illness, birth defects, and lifelong disabilities, such as hearing loss or learning problems. Here are 10 tips to help prevent infections before and during pregnancy:

Protect yourself from Zika virus.
Zika virus can be passed from a pregnant woman to her fetus during pregnancy or to her baby around the time of birth. Zika virus infection during pregnancy can cause microcephaly (a birth defect where a baby’s head and brain are smaller than babies of the same age and sex) and other severe brain defects.
- If you are pregnant, do not travel to areas with Zika.
  - If you must travel to an area with Zika, talk to your doctor or other healthcare provider first and strictly follow steps to prevent mosquito bites during the trip.
  - If you have a partner who lives in or has traveled to an area with Zika, use condoms from start to finish, every time you have sex (vaginal, anal, or oral) to protect against infection or do not have sex during the pregnancy.
- If you are trying to become pregnant
  - Talk with your healthcare provider before traveling to areas with Zika and strictly follow steps to prevent mosquito bites during the trip.

Wash your hands with soap and water after the following:
- Using the bathroom
- Touching raw meat, raw eggs, or unwashed vegetables
- Preparing food and eating
- Gardening or touching dirt or soil
- Handling pets
- Being around people who are sick
- Getting saliva (spit) on your hands
- Caring for and playing with children
- Changing diapers
Reduce contact with saliva and urine from babies and young children
A common virus called cytomegalovirus (CMV) can cause problems for some babies, including microcephaly and hearing loss. A woman who is infected with CMV can pass the virus to her developing baby during pregnancy. Women may be able to lessen their risk of getting CMV by reducing contact with saliva and urine from babies and young children. Some ways to do this are by not sharing food and utensils with babies and young children, and washing hands after changing diapers. These actions can’t eliminate your risk of getting CMV, but may lessen your chances of getting it.
Avoid unpasteurized (raw) milk and foods made from it.
Do not eat soft cheeses, such as feta, brie, and queso fresco, unless they have labels that say they are pasteurized. Unpasteurized products can contain harmful bacteria.
Do not touch or change dirty cat litter.
Have someone else do it. If you must change the cat litter yourself, be sure to wear gloves and wash your hands afterwards. Dirty cat litter might contain a harmful parasite.
Stay away from wild or pet rodents and their droppings.
Have a pest control professional get rid of pests in or around your home. If you have a pet rodent, like a hamster or guinea pig, have someone else care for it until after your baby arrives. Some rodents might carry a harmful virus.
Get tested for sexually transmitted diseases (STDs), such as HIV and hepatitis B, and protect yourself from them.
Some people that have HIV, hepatitis B, or an STD do not feel sick. Knowing if you have one of these diseases is important. If you do, talk to your healthcare provider about reducing the chance that your baby will become sick.
Talk to your healthcare provider about vaccinations (shots).
Some vaccinations are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting very sick or having life-long health problems.
Avoid people who have an infection.
If you have not yet had or did not have the vaccine before pregnancy, stay away from people who you know have infections, such as chickenpox or rubella.
Ask your doctor about group B strep.
About 1 in 4 women carry this type of bacteria, but do not feel sick. An easy swab test near the end of pregnancy will show if you have this type of bacteria. If you do have group B strep, talk to your healthcare provider about how to protect your baby during labor.

These tips can help you prevent infections that could harm you and your developing baby. You will not always know if you have an infection and sometimes you will not feel sick. If you think you might have an infection or think you are at risk, see your healthcare provider. Be sure to talk with your healthcare provider to learn more about safe food preparation, wearing insect repellent when outside, taking medicine, and other important topics.

Source: Centers for Disease Control and Prevention (CDC)

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Get Support and Plan Ahead

Maternal Age

Image by CDC; Photo credit: James Gathany

Have a Healthy Pregnancy - Get Support and Plan Ahead

Ask for help if you need it.

Being pregnant may be tiring or stressful at times. Extra support from loved ones can help. For example, family members or friends can:

Provide emotional support so you feel less stressed
Visit the doctor or midwife with you
Go with you to a breastfeeding or birthing class
Change the litter box if you have a cat
Help prepare for the baby’s arrival by setting up furniture

Think about what you need, and don’t be afraid to ask for help.

Plan ahead for the first year with your new baby.

Having a new baby is exciting, but it can be stressful. Take steps to help you prepare for your new baby:

Create a safe sleeping area for your baby, without soft objects in the crib.
Talk with your doctor or midwife about newborn screening tests.
Learn how to breastfeed your baby.
Know the signs and symptoms of postpartum depression. About 1 in 8 women experience depression after they have a baby. Talk to your doctor or midwife if you have any questions or concerns.
Make sure to keep up with postpartum visits to your doctor or midwife.
Talk to friends and family about helping out after the baby arrives. If you don't want visitors, people can support you in other ways, like dropping off food.

Source: U.S. Department of Health and Human Services

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Before You Get Pregnant

It’s folly not to take folate or folic acid when pregnant

Image by StoryMD

Have a Healthy Pregnancy - Before You Get Pregnant

Not pregnant yet? Plan ahead.

Planning ahead can help you have a healthier pregnancy. For example:

Take a daily supplement with 400 to 800 micrograms (mcg) of folic acid. Taking folic acid before and during early pregnancy can help prevent certain birth defects. Most multivitamins have 400 mcg of folic acid — check the label to be sure.
Stop drinking alcohol when you start trying to get pregnant.
If you smoke, quit smoking when you start trying to get pregnant.

Read about more things you can do to plan ahead.

Schedule an appointment with a doctor or midwife.

Get your blood pressure checked. If you have high blood pressure, ask your doctor how you can control it before and during your pregnancy.
If you have a chronic (long-term) health condition, like diabetes, ask your doctor how you can control it before and during your pregnancy.
Ask about getting vaccines before you get pregnant.
Talk with your doctor about your family health history, including any medical conditions you have that could affect a pregnancy.
Talk with your doctor about your risk for depression during pregnancy and whether you need counseling to help prevent it. Learn about depression during and after pregnancy.
Talk with your doctor about any medicines you’re taking — both prescription drugs and over-the-counter medicines. Some medicines may not be safe to take while you’re pregnant.
If you take opioid pain medicine, talk with your doctor about how to protect yourself and your baby. Learn more about opioids and pregnancy.

Source: U.S. Department of Health and Human Services

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Get Enough Folic Acid

Pregnancy and Nutrition Rich in Vegetables and Fruit

Image by TheVisualMD

Get Enough Folic Acid

Everyone who can get pregnant or is planning to get pregnant needs to take a daily supplement with 400 to 800 micrograms (mcg) of folic acid. It’s important to take a folic acid supplement in addition to following a healthy eating routine.

Why is folic acid important?

Folic acid is a type of folate added to supplements and foods. Folate is a vitamin that’s especially important if you’re pregnant or may become pregnant. It can help prevent serious problems with your baby’s brain and spine.

Getting enough folic acid is important even when you aren’t planning to get pregnant. It’s most important to take folic acid at least 1 month before you get pregnant and through the first 3 months of pregnancy.

Talk with your doctor about folic acid.

Vitamins

How can I get enough folic acid?

You can take a multivitamin or a supplement pill that has only folic acid. You can find vitamins and folic acid pills at most pharmacies and grocery stores.

Be sure to check the label and choose a pill with 400 to 800 mcg of folic acid. This label shows a supplement with 400 mcg folic acid.

Make it easy to remember.

Take it at the same time every day — for example, take it when you brush your teeth in the morning or when you eat breakfast
Leave the vitamin bottle somewhere you’ll notice it every day, like on the kitchen counter

Eat Healthy

In addition to taking a folic acid supplement, it’s important to follow a healthy eating routine.

Make sure to include foods with folate in your eating routine. Many healthy foods have folate, including:

Spinach and other leafy greens
Asparagus
Oranges and orange juice
Beans and peas

Folic acid is also added to foods like many cereals, breads, pastas, and other foods made with grains. Check the labels and choose foods with folic acid.

Source: U.S. Department of Health and Human Services

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