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Prenatal Checkups

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Prenatal Checkups

Pregnancy and Prenatal Care

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Prenatal Checkups

Prenatal check-up

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Prenatal Checkups

During pregnancy, regular checkups are very important. This consistent care can help keep you and your baby healthy, spot problems if they occur, and prevent problems during delivery. Typically, routine checkups occur:

Once each month for weeks four through 28
Twice a month for weeks 28 through 36
Weekly for weeks 36 to birth

Women with high-risk pregnancies need to see their doctors more often.

At your first visit your doctor will perform a full physical exam, take your blood for lab tests, and calculate your due date. Your doctor might also do a breast exam, a pelvic exam to check your uterus (womb), and a cervical exam, including a Pap test. During this first visit, your doctor will ask you lots of questions about your lifestyle, relationships, and health habits. It's important to be honest with your doctor.

After the first visit, most prenatal visits will include:

Checking your blood pressure and weight
Checking the baby's heart rate
Measuring your abdomen to check your baby's growth

You also will have some routine tests throughout your pregnancy, such as tests to look for anemia, tests to measure risk of gestational diabetes, and tests to look for harmful infections.

Become a partner with your doctor to manage your care. Keep all of your appointments — every one is important! Ask questions and read to educate yourself about this exciting time.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (13)

Midwife check-up

Pregnancy check-up with a obstetrics technician.

Image by Ricmart 01/Wikimedia

Understanding antenatal care

Video by Medical Aid Films - Films For Life/YouTube

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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

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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

Prenatal Care Appointments

Video by Jesse Reiter/YouTube

What is prenatal care?

Video by Premier Health/YouTube

Prenatal Testing: Nuchal Test (Pregnancy Health Guru)

Video by Healthguru/YouTube

Prenatal Testing - What You Need To Know

Video by Rehealthify/YouTube

Prenatal Screening: Is It Right for You?

Video by Dartmouth-Hitchcock/YouTube

What can I expect during my first prenatal appointment?

Video by Premier Health/YouTube

PREGNANT WOMEN RECEIVING DETAILED INFORMATION ON PRENATAL TESTING LESS LIKELY TO UNDERGO THOSE TESTS

Video by TheJAMAReport/YouTube

Pre-Natal Diagnosis: View from the Womb

Video by Stanford Medicine/YouTube

First Trimester of Pregnancy -- Ultrasound | Parents

Video by Parents/YouTube

Midwife check-up

Ricmart 01/Wikimedia

14:35

Understanding antenatal care

Medical Aid Films - Films For Life/YouTube

4:34

Prenatal Diagnostic Testing

TheVisualMD

4:15

Prenatal Genetic Screening

TheVisualMD

2:27

Prenatal Care Appointments

Jesse Reiter/YouTube

1:17

What is prenatal care?

Premier Health/YouTube

2:42

Prenatal Testing: Nuchal Test (Pregnancy Health Guru)

Healthguru/YouTube

1:45

Prenatal Testing - What You Need To Know

Rehealthify/YouTube

34:24

Prenatal Screening: Is It Right for You?

Dartmouth-Hitchcock/YouTube

0:59

What can I expect during my first prenatal appointment?

Premier Health/YouTube

2:22

PREGNANT WOMEN RECEIVING DETAILED INFORMATION ON PRENATAL TESTING LESS LIKELY TO UNDERGO THOSE TESTS

TheJAMAReport/YouTube

30:46

Pre-Natal Diagnosis: View from the Womb

Stanford Medicine/YouTube

2:22

First Trimester of Pregnancy -- Ultrasound | Parents

Parents/YouTube

Choosing a Prenatal Care Provider

Consultation during Pregnancy

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Choosing a Prenatal Care Provider

You will see your prenatal care provider many times before you have your baby. So you want to be sure that the person you choose has a good reputation, and listens to and respects you. You will want to find out if the doctor or midwife can deliver your baby in the place you want to give birth, such as a specific hospital or birthing center. Your provider also should be willing and able to give you the information and support you need to make an informed choice about whether to breastfeed or bottle-feed.

Health care providers that care for women during pregnancy include:

Obstetricians (OB) are medical doctors who specialize in the care of pregnant women and in delivering babies. OBs also have special training in surgery so they are also able to do a cesarean delivery. Women who have health problems or are at risk for pregnancy complications should see an obstetrician. Women with the highest risk pregnancies might need special care from a maternal-fetal medicine specialist.
Family practice doctors are medical doctors who provide care for the whole family through all stages of life. This includes care during pregnancy and delivery, and following birth. Most family practice doctors cannot perform cesarean deliveries.
A certified nurse-midwife (CNM) and certified professional midwife (CPM) are trained to provide pregnancy and postpartum care. Midwives can be a good option for healthy women at low risk for problems during pregnancy, labor, or delivery. A CNM is educated in both nursing and midwifery. Most CNMs practice in hospitals and birth centers. A CPM is required to have experience delivering babies in home settings because most CPMs practice in homes and birthing centers. All midwives should have a back-up plan with an obstetrician in case of a problem or emergency.

Ask your primary care doctor, friends, and family members for provider recommendations. When making your choice, think about:

Reputation
Personality and bedside manner
The provider's gender and age
Office location and hours
Whether you always will be seen by the same provider during office checkups and delivery
Who covers for the provider when she or he is not available
Where you want to deliver
How the provider handles phone consultations and after-hour calls

What is a doula?

A doula (DOO-luh) is a professional labor coach, who gives physical and emotional support to women during labor and delivery. They offer advice on breathing, relaxation, movement, and positioning. Doulas also give emotional support and comfort to women and their partners during labor and birth. Doulas and midwives often work together during a woman's labor. A recent study showed that continuous doula support during labor was linked to shorter labors and much lower use of:

Pain medicines
Oxytocin (ok-see-TOHS-uhn) (medicine to help labor progress)
Cesarean delivery

Check with your health insurance company to find out if they will cover the cost of a doula. When choosing a doula, find out if she is certified by Doulas of North America (DONA) or another professional group.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

1:43

How to Choose a Doula

Sharp HealthCare/YouTube

The First Visit

Prenatal Blood Test

Image by TheVisualMD

The First Visit

Your first prenatal visit will probably be scheduled sometime after your eighth week of pregnancy. Most health care providers won't schedule a visit any earlier unless you have a medical condition, have had problems with a pregnancy in the past, or have symptoms such as spotting or bleeding, stomach pain, or severe nausea and vomiting.

You've probably heard pregnancy discussed in terms of months and trimesters (units of about 3 months). Your health care provider and health information might use weeks instead. Here's a chart that can help you understand pregnancy stages in terms of trimesters, months, and weeks.

Trimester	Months	Weeks
1	0–3	0–17
2	4–6	18–30
3	7–9	31–42

Because your first visit will be one of your longest, allow plenty of time.

During the visit, you can expect your health care provider to do the following:

Answer your questions. This is a great time to ask questions and share any concerns you may have. Keep a running list for your visit.
Check your urine sample for infection and to confirm your pregnancy.
Check your blood pressure, weight, and height.
Calculate your due date based on your last menstrual cycle and ultrasound exam.
Ask about your health, including previous conditions, surgeries, or pregnancies.
Ask about your family health and genetic history.
Ask about your lifestyle, including whether you smoke, drink, or take drugs, and whether you exercise regularly.
Ask about your stress level.
Perform prenatal blood tests to do the following:
Determine your blood type and Rh (Rhesus) factor. Rh factor refers to a protein found on red blood cells. If the mother is Rh negative (lacks the protein) and the father is Rh positive (has the protein), the pregnancy requires a special level of care.
Do a blood count (e.g., hemoglobin, hematocrit).
Test for hepatitis B, HIV, rubella, and syphilis.
Do a complete physical exam, including a pelvic exam, and cultures for gonorrhea and chlamydia.
Do a Pap test or test for human papillomavirus (HPV) or both to screen for cervical cancer and infection with HPV, which can increase risk for cervical cancer. The timing of these tests depends on the schedule recommended by your health care provider.
Do an ultrasound test, depending on the week of pregnancy.
Offer genetic testing: screening for Down syndrome and other chromosomal problems, cystic fibrosis, other specialized testing depending on history.

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

Additional Materials (1)

1:21

When to Schedule Your First Prenatal Visit | Kaiser Permanente

Kaiser Permanente Thrive/YouTube

Prenatal Visit Schedule

Prenatal Care

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

Prenatal Visit Schedule

If your pregnancy is healthy, your health care provider will set up a regular schedule for visits that will probably look about like this:

Before 28 weeks:	Monthly
Weeks 28 to 36:	Every 2 weeks
Week 36 to birth:	Weekly

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

Additional Materials (1)

2:27

Prenatal Care Appointments

Jesse Reiter/YouTube

Prenatal Tests

Fetal Ultrasound

Image by BruceBlaus/Wikimedia

Prenatal Tests

Tests are used during pregnancy to check your and your baby's health. At your fist prenatal visit, your doctor will use tests to check for a number of things, such as:

Your blood type and Rh factor
Anemia
Infections, such as toxoplasmosis and sexually transmitted infections (STIs), including hepatitis B, syphilis, chlamydia, and HIV
Signs that you are immune to rubella (German measles) and chicken pox

Throughout your pregnancy, your doctor or midwife may suggest a number of other tests, too. Some tests are suggested for all women, such as screenings for gestational diabetes, Down syndrome, and HIV. Other tests might be offered based on your:

Age
Personal or family health history
Ethnic background
Results of routine tests

Some tests are screening tests. They detect risks for or signs of possible health problems in you or your baby. Based on screening test results, your doctor might suggest diagnostic tests. Diagnostic tests confirm or rule out health problems in you or your baby.

Common prenatal tests

Test	What it is	How it is done
Amniocentesis (AM-nee-oh-sen-TEE-suhss)	This test can diagnosis certain birth defects, including: Down syndrome Cystic fibrosis Spina bifida It is performed at 14 to 20 weeks. It may be suggested for couples at higher risk for genetic disorders. It also provides DNA for paternity testing.	A thin needle is used to draw out a small amount of amniotic fluid and cells from the sac surrounding the fetus. The sample is sent to a lab for testing.
Biophysical profile (BPP)	This test is used in the third trimester to monitor the overall health of the baby and to help decide if the baby should be delivered early.	BPP involves an ultrasound exam along with a nonstress test. The BPP looks at the baby's breathing, movement, muscle tone, heart rate, and the amount of amniotic fluid.
Chorionic villus (KOR-ee-ON-ihk VIL-uhss) sampling (CVS)	A test done at 10 to 13 weeks to diagnose certain birth defects, including: Chromosomal disorders, including Down syndrome Genetic disorders, such as cystic fibrosis CVS may be suggested for couples at higher risk for genetic disorders. It also provides DNA for paternity testing.	A needle removes a small sample of cells from the placenta to be tested.
First trimester screen	A screening test done at 11 to 14 weeks to detect higher risk of: Chromosomal disorders, including Down syndrome and trisomy 18 Other problems, such as heart defects It also can reveal multiple births. Based on test results, your doctor may suggest other tests to diagnose a disorder.	This test involves both a blood test and an ultrasound exam called nuchal translucency (NOO-kuhl trans-LOO-sent-see) screening. The blood test measures the levels of certain substances in the mother's blood. The ultrasound exam measures the thickness at the back of the baby's neck. This information, combined with the mother's age, help doctors determine risk to the fetus.
Glucose challenge screening	A screening test done at 26 to 28 weeks to determine the mother's risk of gestational diabetes. Based on test results, your doctor may suggest a glucose tolerance test.	First, you consume a special sugary drink from your doctor. A blood sample is taken one hour later to look for high blood sugar levels.
Glucose tolerance test	This test is done at 26 to 28 weeks to diagnose gestational diabetes.	Your doctor will tell you what to eat a few days before the test. Then, you cannot eat or drink anything but sips of water for 14 hours before the test. Your blood is drawn to test your "fasting blood glucose level." Then, you will consume a sugary drink. Your blood will be tested every hour for three hours to see how well your body processes sugar.
Group B streptococcus (STREP-tuh-KOK-uhss) infection	This test is done at 36 to 37 weeks to look for bacteria that can cause pneumonia or serious infection in newborn.	A swab is used to take cells from your vagina and rectum to be tested.
Maternal serum screen (also called quad screen, triple test, triple screen, multiple marker screen, or AFP)	A screening test done at 15 to 20 weeks to detect higher risk of: Chromosomal disorders, including Down syndrome and trisomy 18 Neural tube defects, such as spina bifida Based on test results, your doctor may suggest other tests to diagnose a disorder.	Blood is drawn to measure the levels of certain substances in the mother's blood.
Nonstress test (NST)	This test is performed after 28 weeks to monitor your baby's health. It can show signs of fetal distress, such as your baby not getting enough oxygen.	A belt is placed around the mother's belly to measure the baby's heart rate in response to its own movements.
Ultrasound exam	An ultrasound exam can be performed at any point during the pregnancy. Ultrasound exams are not routine. But it is not uncommon for women to have a standard ultrasound exam between 18 and 20 weeks to look for signs of problems with the baby's organs and body systems and confirm the age of the fetus and proper growth. It also might be able to tell the sex of your baby. Ultrasound exam is also used as part of the first trimester screen and biophysical profile (BPP). Based on exam results, your doctor may suggest other tests or other types of ultrasound to help detect a problem.	Ultrasound uses sound waves to create a "picture" of your baby on a monitor. With a standard ultrasound, a gel is spread on your abdomen. A special tool is moved over your abdomen, which allows your doctor and you to view the baby on a monitor.
Urine test	A urine sample can look for signs of health problems, such as: Urinary tract infection Diabetes Preeclampsia If your doctor suspects a problem, the sample might be sent to a lab for more in-depth testing.	You will collect a small sample of clean, midstream urine in a sterile plastic cup. Testing strips that look for certain substances in your urine are dipped in the sample. The sample also can be looked at under a microscope.

Understanding prenatal tests and test results

If your doctor suggests certain prenatal tests, don't be afraid to ask lots of questions. Learning about the test, why your doctor is suggesting it for you, and what the test results could mean can help you cope with any worries or fears you might have. Keep in mind that screening tests do not diagnose problems. They evaluate risk. So if a screening test comes back abnormal, this doesn't mean there is a problem with your baby. More information is needed. Your doctor can explain what test results mean and possible next steps.

Avoid keepsake ultrasounds

You might think a keepsake ultrasound is a must-have for your scrapbook. But, doctors advise against ultrasound when there is no medical need to do so. Some companies sell "keepsake" ultrasound videos and images. Although ultrasound is considered safe for medical purposes, exposure to ultrasound energy for a keepsake video or image may put a mother and her unborn baby at risk. Don't take that chance.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (2)

3:42

Routine Prenatal Tests

University of California Television (UCTV)/YouTube

1:45

Prenatal Testing - What You Need To Know

Rehealthify/YouTube

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.
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 intellectual disabilities 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 for giving birth too soon (premature birth). In this case, amniocentesis is done later in 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 high risk for having a baby with a health problem. You may have an increased 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 shows 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'd 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 may apply a numbing medicine to your abdomen.
- 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 insert a thin needle into your abdomen and withdraw a small amount of amniotic fluid.
- When the sample is removed, your provider will check your baby's heartbeat with the ultrasound.
The procedure usually takes about 15 minutes. Afterwards, you may be told to avoid any hard exercise or physical activity for the next 24 hours.
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

Biophysical Profile

Biophysical Profile

Also called: BPP

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

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.
6
8
Your result is Normal.
A score of 8 to 10 is reassuring.
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."

Chorionic Villus Sampling

Chorionic Villus Sampling

Also called: CVS, Chorionic Villus Biopsy, Placental Biopsy

Chorionic villus sampling (CVS) is a test for pregnant women that checks cells from the placenta. It is used in the first trimester of pregnancy to diagnose certain chromosome and genetic disorders in an unborn baby.

Chorionic Villus Sampling

Also called: CVS, Chorionic Villus Biopsy, Placental Biopsy

Chorionic villus sampling (CVS) is a test for pregnant women that checks cells from the placenta. It is used in the first trimester of pregnancy to diagnose certain chromosome and genetic disorders in an unborn baby.

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Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that no signs of chromosomal or genetic defects were detected in your developing baby.
Related conditions
CVS testing is used to diagnose chromosome problems or other genetic diseases in an unborn baby. These include:
- Down syndrome, a disorder that causes intellectual disabilities, certain physical features, and various health problems.
- Cystic fibrosis, a disease that causes mucus buildup in the lungs and other organs, making it hard to breathe.
- Sickle cell disease, a disorder of the red blood cells. It can cause pain, infections, organ damage, and strokes.
- Tay-Sachs disease, a disorder that causes fatty proteins to build up in the brain. It affects sight, hearing, and mental development. Most children with Tay-Sachs die by the age of 5.
CVS testing is very accurate and can be done early in pregnancy, between the 10th and 13th week. But it can only diagnose certain genetic diseases. A CVS test does not diagnose or screen for birth defects such as neural tube defects, conditions that cause abnormal development of a developing baby's brain and/or spine. Different tests, including an alpha-fetoprotein (AFP) blood test, are used to screen for or diagnose these and other birth defects.
You may need CVS testing if you are at higher risk for having a baby with a chromosome disorder. Risk factors include:
- Age. Women age 35 and older have a higher risk of having a baby with Down syndrome or another genetic disorder.
- Family history of a genetic disorder
- Having another child with a genetic disorder
You may also need CVS testing if you had abnormal results on a prenatal screening test.
There are two types of CVS tests:
- Transabdominal The sample is taken through the abdomen.
- Transcervical. The sample is taken through the cervix. The cervix is the lower, narrow end of the uterus that opens into the vagina.
Your provider will use an ultrasound to check your baby's position and guide the procedure (transabdominal or transcervical). Ultrasound is an imaging test that uses sound waves to create pictures.
During a transabdominal CVS, your provider will:
- Clean your abdomen with an antiseptic.
- Apply a numbing medicine to your abdomen.
- Insert a long, thin needle through your abdomen and uterus and into the placenta. You may feel a cramping or stinging sensation as the needle enters the uterus.
- Use the needle to withdraw a sample of tissue from the placenta.
- Remove the needle.
During a transcervical CVS, your provider will:
- Clean your vagina and cervix with an antiseptic
- Use an instrument called a speculum to gently spread apart the sides of your vagina.
- Insert a thin tube through your vagina and cervix and up to the placenta. You may feel a slight twinge or cramping as this is done.
- Use the tube to gently suck in a sample of tissue from the placenta.
- Remove the tube.
CVS is generally considered to be a safe procedure, but it does have some risks. These include:
- Miscarriage, which happens in about one in every hundred procedures
- Infection
- Bleeding
- Rh sensitization. This is a condition in which your body makes antibodies (proteins made by the immune system) that attack your baby's red blood cells. If diagnosed during pregnancy, it is easily treatable.
- Limb defects in the baby (this is very rare)
1. http://americanpregnancy.org/prenatal-testing/chorionic-villus-sampling/ [accessed on Jan 26, 2019]
2. https://medlineplus.gov/ency/article/003406.htm [accessed on Sep 18, 2019]
3. https://medlineplus.gov/lab-tests/down-syndrome-tests/ [accessed on Sep 18, 2019]
4. https://www.cdc.gov/ncbddd/birthdefects/diagnosis.html [accessed on Sep 18, 2019]
5. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/chorionic-villus-sampling-cvs [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 (14)

Chorionic Villus Sampling

Video by manny1976/YouTube

Chorionic Villus Sampling (CVS)

Video by Washington State Department of Health/YouTube

Prenatal screening, fetal testing, and other tests during pregnancy

Video by MedLecturesMadeEasy/YouTube

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

Diagnostic Testing in Pregnancy

Video by Michigan Medicine/YouTube

Prenatal Testing - What You Need To Know

Video by Rehealthify/YouTube

Amniocentesis: Pre-Baby Care (Pregnancy Health Guru)

Video by Healthguru/YouTube

Chorionic Villus Sampling (CVS) Mnemonic

Video by Medicosis Perfectionalis/YouTube

First Trimester of Pregnancy -- CVS Prenatal Test | Parents

Video by Parents/YouTube

Genetic Testing During Pregnancy

Video by University of California Television (UCTV)/YouTube

Prenatal Screening Options: Chorionic Villus Sampling (CVS)

Video by UNC Center for Maternal and Infant Health/YouTube

Embryo 26 Day Old (Week 5 for Gestational Age) Suspended in Chorionic Cavity

Computer Generated Image from Micro-MRI, actual size of embryo = 4.0 mm - This image presents a right-sided view of the embryo during its fourth week of embryonic development. The age is calculated from the day of fertilization. At the beginning of the 4th week, the heart begins to beat and the embryonic circulation sets in. At the end of 4 weeks over 30 somites are present . Somites are paired blocks of cells which in the later stages of development give rise to connective tissue, bone, muscle and the spine. The embryo is suspended in the protective chorionic cavity by the body stalk (the amniotic cavity and yolk sac have been removed to demonstrate the C-shaped curvature of the embryo). The red spot in the head region indicates the developing eye.

Image by TheVisualMD

Chorionic villi

Chorionic villus

Image by BruceBlaus

Chorionic villi

Schematic view of the placenta and chorion.

Image by Swils6

4:42

Chorionic Villus Sampling

manny1976/YouTube

4:16

Chorionic Villus Sampling (CVS)

Washington State Department of Health/YouTube

18:42

Prenatal screening, fetal testing, and other tests during pregnancy

MedLecturesMadeEasy/YouTube

4:34

Prenatal Diagnostic Testing

TheVisualMD

2:10

Diagnostic Testing in Pregnancy

Michigan Medicine/YouTube

1:45

Prenatal Testing - What You Need To Know

Rehealthify/YouTube

2:01

Amniocentesis: Pre-Baby Care (Pregnancy Health Guru)

Healthguru/YouTube

2:13

Chorionic Villus Sampling (CVS) Mnemonic

Medicosis Perfectionalis/YouTube

2:44

First Trimester of Pregnancy -- CVS Prenatal Test | Parents

Parents/YouTube

4:38

Genetic Testing During Pregnancy

University of California Television (UCTV)/YouTube

5:18

Prenatal Screening Options: Chorionic Villus Sampling (CVS)

UNC Center for Maternal and Infant Health/YouTube

Embryo 26 Day Old (Week 5 for Gestational Age) Suspended in Chorionic Cavity

TheVisualMD

Chorionic villi

BruceBlaus

Chorionic villi

Swils6

Ultrasound

Ultrasound

Also called: Sonogram

An ultrasound is an imaging test that uses sound waves to create pictures of structures inside the body. It's often used during pregnancy to check the health of an unborn baby. It's also used to diagnose certain medical conditions.

Ultrasound

Also called: Sonogram

An ultrasound is an imaging test that uses sound waves to create pictures of structures inside the body. It's often used during pregnancy to check the health of an unborn baby. It's also used to diagnose certain medical conditions.

An ultrasound is an imaging test that uses sound waves to create a picture (also known as a sonogram) of organs, tissues, and other structures inside the body. Unlike x-rays, ultrasounds don’t use any radiation. An ultrasound can also show parts of the body in motion, such as a heart beating or blood flowing through blood vessels.
There are two main categories of ultrasounds: pregnancy ultrasound and diagnostic ultrasound.
- Pregnancy ultrasound is used to look at an unborn baby. The test can provide information about a baby’s growth, development, and overall health.
- Diagnostic ultrasound is used to view and provide information about other internal parts of the body. These include the heart, blood vessels, liver, bladder, kidneys, and female reproductive organs.
An ultrasound can be used in different ways, depending on the type of ultrasound and which part of the body is being checked.
A pregnancy ultrasound is done to get information about the health of an unborn baby. It may be used to:
- Confirm that you are pregnant.
- Check the size and position of the unborn baby.
- Check to see you are pregnant with more than one baby.
- Estimate how long you have been pregnant. This is known as gestational age.
- Check for signs of Down syndrome, which include thickening in the back of the baby's neck.
- Check for birth defects in the brain, spinal cord, heart, or other parts of the body.
- Check the amount of amniotic fluid. Amniotic fluid is a clear liquid that surrounds an unborn baby during pregnancy. It protects the baby from outside injury and cold. It also helps promote lung development and bone growth.
Diagnostic ultrasound may be used to:
- Find out if blood is flowing at a normal rate and level.
- See if there is a problem with the structure of your heart.
- Look for blockages in the gallbladder.
- Check the thyroid gland for cancer or non-cancerous growths.
- Check for abnormalities in the abdomen and kidneys.
- Help guide a biopsy procedure. A biopsy is a procedure that removes a small sample of tissue for testing.
In women, diagnostic ultrasound may be used to:
- Look at a breast lump to see if it might be cancer. (The test may also be used to check for breast cancer in men, though this type of cancer is far more common in women.)
- Help find the cause of pelvic pain.
- Help find the cause of abnormal menstrual bleeding.
- Help diagnose infertility or monitor infertility treatments.
In men, diagnostic ultrasound may be used to help diagnose disorders of the prostate gland.
A ultrasound usually includes the following steps:
- You will lie on a table, exposing the area that’s being viewed.
- A health care provider will spread a special gel on the skin over that area.
- The provider will move a wand-like device, called a transducer, over the area.
- The device sends sound waves into your body. The waves are so high pitched that you can’t hear them.
- The waves are recorded and turned into images on a monitor.
- You may be able to view the images as they are being made. This often happens during a pregnancy ultrasound, allowing you to look at your unborn baby.
- After the test is over, the provider will wipe the gel off your body.
- The test takes about 30 to 60 minutes to complete.
In some cases, a pregnancy ultrasound may be done by inserting the transducer into the vagina. This is most often done early in pregnancy.
If your pregnancy ultrasound results were normal, it doesn’t guarantee you’ll have a healthy baby. No test can do that. But normal results may mean:
- 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 an ultrasound.
If your pregnancy ultrasound results were not normal, it may mean:
- The baby is not growing at a normal rate.
- You have too much or too little amniotic fluid.
- The baby is growing outside the uterus. This is called an ectopic pregnancy. A baby can’t survive an ectopic pregnancy, and the condition can be life threatening for the mother.
- There is a problem with the baby’s position in the uterus. This could make delivery more difficult.
- Your baby has a birth defect.
If your pregnancy ultrasound results were not normal, it doesn’t always mean your baby has a serious health problem. Your provider may suggest more tests to help confirm a diagnosis.
If you had diagnostic ultrasound, the meaning of your results will depend on which part of the body was being looked at.
If you have questions about your results, talk to your health care provider.

Additional Materials (21)

Pregnancy week by week: 25 to 29 - Pancitas.com

Video by Little Bellies Ultrasound & Pregnancy Spa/YouTube

How an Ultrasound Works

Video by preciouspeeks/YouTube

What is 4D ultrasound scan?

Video by ultrasoundlink/YouTube

9 Months In The Womb: A Remarkable Look At Fetal Development Through Ultrasound By PregnancyChat.com

Video by PregnancyChat/YouTube

Pregnancy week by week: 30 to 34 - Pancitas.com

Video by Little Bellies Ultrasound & Pregnancy Spa/YouTube

How Pregnancy Tests Work (Pregnancy Health Guru)

Video by Healthguru/YouTube

Pregnancy week by week: 35 to 40 - Pancitas.com

Video by Little Bellies Ultrasound & Pregnancy Spa/YouTube

Pregnancy week by week: 10 to 14 - Pancitas.com

Video by Little Bellies Ultrasound & Pregnancy Spa/YouTube

The Facts on Miscarriages (Getting Pregnant #6)

Video by Healthguru/YouTube

Pregnancy week by week: 15 to 19 - Pancitas.com

Video by Little Bellies Ultrasound & Pregnancy Spa/YouTube

Pregnancy week by week: 20 to 24 - Pancitas.com

Video by Little Bellies Ultrasound & Pregnancy Spa/YouTube

How to use ultrasound in pregnancy

Video by Medical Aid Films - Films For Life/YouTube

Is Your Baby a Boy or a Girl? (Pregnancy Health Guru)

Video by Healthguru/YouTube

This browser does not support the video element.

Embryo at Carnegie Stage 23 Inside Womb

Video footage of a doctor and a woman discussing an image of a sonogram. Camera zooms down a hallway and into the woman's belly. Cut to womb environment showing a developing embryo at about Carnegie stage 23. Skin is translucent and shows some underlying structures. Camera zooms in to the face and there is subtle movement of the mouth.

Video by TheVisualMD

Obstetric ultrasonography

Medical ultrasound examination of a pregnant woman.

Image by Scott

Twins

Monoamniotic twins at 15 weeks : Abdominal ultrasonography of monoamniotic twins at a gestational age of 15 weeks. A coronal plane is shown of the twin at left, and a sagittal plane of parts of the upper thorax and head is shown of the twin at right.

Image by Haggstrom, Mikael. Medical gallery of Mikael Haggstrom 2014

Fetal Ultrasound

Ultrasound image (sonogram) of a fetus in the womb.

Image by BruceBlaus/Wikimedia

Colorized Ultrasound of Possible Breast Tumor

Colorized ultrasound of possible breast tumor (center, with irregular edges). Ultrasound alone isn't used for screening because it can't produce an accurate picture of the entire breast. However, mammograms and ultrasound together catch more tumors than mammograms alone. Ultrasound is very good at telling if a lump is solid, and possibly cancerous, or a harmless cyst. It is particularly useful for women with dense breast tissue.

Image by TheVisualMD

Obstetric ultrasonography

3D Ultrasound of Fetus at 20 weeks

Image by Staecker

What unique challenges do pregnant women with disabilities face?

Sonogram Projected on belly

Sensitive content

This media may include sensitive content

Photo of a photo

Annalisa McCormick, spouse of Airman 1st Class Kristopher McCormick, a 35th Civil Engineer Squadron pavement and equipment journeyman, takes a photo of her baby during an ultra sound appointment at Misawa Air Base, Japan, April 10, 2019. An ultrasound, also called a sonogram, monitors fetal development and screens for any potential medical concerns. (U.S. Air Force photo by Senior Airman Collette Brooks)

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

2:20

Pregnancy week by week: 25 to 29 - Pancitas.com

Little Bellies Ultrasound & Pregnancy Spa/YouTube

0:54

How an Ultrasound Works

preciouspeeks/YouTube

2:47

What is 4D ultrasound scan?

ultrasoundlink/YouTube

4:37

9 Months In The Womb: A Remarkable Look At Fetal Development Through Ultrasound By PregnancyChat.com

PregnancyChat/YouTube

2:21

Pregnancy week by week: 30 to 34 - Pancitas.com

Little Bellies Ultrasound & Pregnancy Spa/YouTube

2:42

How Pregnancy Tests Work (Pregnancy Health Guru)

Healthguru/YouTube

2:48

Pregnancy week by week: 35 to 40 - Pancitas.com

Little Bellies Ultrasound & Pregnancy Spa/YouTube

2:37

Pregnancy week by week: 10 to 14 - Pancitas.com

Little Bellies Ultrasound & Pregnancy Spa/YouTube

3:41

The Facts on Miscarriages (Getting Pregnant #6)

Healthguru/YouTube

3:18

Pregnancy week by week: 15 to 19 - Pancitas.com

Little Bellies Ultrasound & Pregnancy Spa/YouTube

2:31

Pregnancy week by week: 20 to 24 - Pancitas.com

Little Bellies Ultrasound & Pregnancy Spa/YouTube

12:31

How to use ultrasound in pregnancy

Medical Aid Films - Films For Life/YouTube

1:29

Is Your Baby a Boy or a Girl? (Pregnancy Health Guru)

Healthguru/YouTube

0:38

Embryo at Carnegie Stage 23 Inside Womb

TheVisualMD

Obstetric ultrasonography

Scott

Twins

Haggstrom, Mikael. Medical gallery of Mikael Haggstrom 2014

Fetal Ultrasound

BruceBlaus/Wikimedia

Colorized Ultrasound of Possible Breast Tumor

TheVisualMD

Obstetric ultrasonography

Staecker

What unique challenges do pregnant women with disabilities face?

Sensitive content

This media may include sensitive content

Photo of a photo

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

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.

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Use the slider below to see how your results affect your health.
mg/dL
65
92
Your result is Normal.
Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.
Related conditions
{"label":"Two-Step Glucose Challenge Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":30,"max":65},"text":"Your blood sugar (glucose) levels are low. Talk to your OB\/GYN to know what this means in your specific case. ","conditions":["Hypoglycemia"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":65,"max":130},"text":"Normal reference ranges can slightly vary depending on the laboratory and the method used for testing. ","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":130,"max":300},"text":"Your blood sugar (glucose) levels are high and you must undergone the second step of this test. Talk to your OB\/GYN to know what this means in your specific case. ","conditions":["Gestational Diabetes Mellitus"]}],"value":97.5}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
mg/dL
65
130
Your result is Normal.
Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.
Related conditions
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

Glucose Tolerance Test

Glucose Tolerance Test

Also called: Oral Glucose Tolerance Test, OGTT

The oral glucose tolerance test consists of a series of steps that involve drinking a load of 75 grams of glucose (sugar). This test is commonly used to diagnose type 1 and type 2 diabetes as well as gestational diabetes.

Glucose Tolerance Test

Also called: Oral Glucose Tolerance Test, OGTT

The oral glucose tolerance test consists of a series of steps that involve drinking a load of 75 grams of glucose (sugar). This test is commonly used to diagnose type 1 and type 2 diabetes as well as gestational diabetes.

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Use the slider below to see how your results affect your health.
mg/dL
140
200
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
Your doctor may want to order this test to diagnose prediabetes, type 1 diabetes, and type 2 diabetes in the following situations:
- If you have symptoms of diabetes, such as polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hungriness).
- For all people older than 45-years-old, despite not having any symptoms.
- If you are younger than 45-years-old and don’t have any symptoms of diabetes but are overweight or obese and have one or more risk factors, which includes:
  Having a close relative with diabetes.
  Hypertension (high blood pressure).
  History of cardiovascular diseases, such as stroke.
  High triglyceride levels.
  Low levels of HDL cholesterol, also known as “good cholesterol.”
  Physical inactivity
  Polycystic ovary syndrome in women.
- To diagnose gestational diabetes (onset of diabetes during pregnancy).
Two-hour oral glucose tolerance test (OGTT) reference ranges are:
- Less than 140 mg/dL (or 7.8 mmol/L): normal.
- From 140 to 199 mg/dL (or from 7.8 to 11.1 mmol/L): prediabetes. This means that your blood glucose levels (glycemia) is too high to be considered normal but still doesn’t met the criteria for diabetes.
- Greater or equal than 200 mg/dL (or 11.1 mmol/L) on more than one testing occasion: diabetes.
Usually, when the first two-hour OGTT result is greater or equal than 200 mg/dL, and in the absence of symptoms of hyperglycemia (high blood sugar), a second test must be performed to confirm the diabetes diagnosis.
1. LabCorp: Glucose Tolerance Test (GTT), Two-hour (Oral WHO Protocol) [accessed on Sep 01, 2018]
2. https://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf [accessed on Oct 17, 2018]
3. Glucose Tolerance Test: Purpose, Procedure, and Risks [accessed on Oct 17, 2018]
4. Glucose tolerance test - Mayo Clinic [accessed on Oct 17, 2018]
5. RACGP - Oral glucose tolerance testing [accessed on Oct 17, 2018]
6. Glucose tolerance test - non-pregnant: MedlinePlus Medical Encyclopedia [accessed on Oct 17, 2018]
7. Glucose Tests [accessed on Oct 17, 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 (16)

Oral Glucose Tolerance Test

The glucose tolerance test is a lab test to check how your body breaks down sugar. The most common glucose tolerance test is the oral glucose tolerance test (OGTT).

Image by TheVisualMD

Insulin and Glucose Vessel Dispersion

Our bodies and brains run on glucose. Our ability to use glucose as a source of energy depends on the hormone insulin, produced by the pancreas. Levels of insulin and glucose in the blood must be maintained in careful balance. Chronic conditions of too much or too little glucose in the bloodstream can damage the heart, kidneys, eyes, nerves, and blood vessels.

Image by TheVisualMD

Random glucose (pink) in a capillary

This image depicts a healthy capillary. Capillaries, the smallest blood vessels in your body, are where nutrients are transferred from blood to cells, and waste from cells to blood. The body's cells depend on sugar in the blood, which is derived from carbohydrates, for food and energy. Allowing for the innumerable differences among individuals, the threshold for a normal blood-sugar (glucose, pink) level in healthy people is 100 mg/dL; that is, 100 milligrams of glucose per deciliter of blood. Lower-than-normal levels characterize hypoglycemia and higher than normal levels characterize hyperglycemia. Without insulin (yellow), glucose is not able to enter cells to be used as fuel. Because of this, healthy insulin levels are a key factor in keeping blood glucose levels normal.

Image by TheVisualMD

Testing and Diagnosing Diabetes

Several tests are used to diagnose prediabetes and diabetes. In June 2009, the ADA, the European Association for the Study of Diabetes, and the International Diabetes Federation made a joint recommendation that type 2 diabetes testing include the glycated hemoglobin (A1C) test. This test measures average blood glucose level during the past 2-3 months by measuring the percentage of glucose attached to hemoglobin, the oxygen-carrying protein pigment in red blood cells.

Image by TheVisualMD

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Glucose tolerance test

Oral Glucose Tolerance Test : The glucose tolerance test is a lab test to check how your body breaks down sugar. The most common glucose tolerance test is the oral glucose tolerance test (OGTT).

Video by TheVisualMD

This browser does not support the video element.

Blood Glucose and Baselining Your Health

Our bodies and brains run on glucose, a simple sugar produced by the digestion of carbohydrates. The body's ability to use glucose depends on the hormone insulin, which is produced by the pancreas. Blood sugar levels naturally rise after meals, but insulin from a healthy pancreas keeps these levels within a narrow range. In diabetes, however, this balance is disrupted because either the body loses its ability to respond to insulin or the pancreas loses its ability to produce insulin. Too much or too little glucose in the bloodstream can damage blood vessels in the kidneys and eyes, as well as nerve cells; acute disruptions of the insulin/glucose balance can be life threatening. Blood and urine tests can determine whether someone is diabetic or pre-diabetic. Diabetes is looming as a major public health concern; an estimated 25 million people in the U.S. have diabetes, with more than a quarter of them undiagnosed.

Video by TheVisualMD

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Fasting Plasma Glucose

The fasting plasma glucose (FPG) test, also known as the fasting blood sugar test, measures blood sugar levels and is used to diagnose diabetes.

Video by TheVisualMD

This browser does not support the video element.

Type 1 Diabetes Diagnosis & Treatment

Type 1 diabetes can be diagnosed with blood tests that measure how much sugar is in your blood. They include: hemoglobin A1C, fasting blood glucose, and oral glucose tolerance. Type 1 diabetes is usually diagnosed in childhood or adolescence. About 5% of adults with diabetes have type 1 diabetes. Early diagnosis is crucial for early treatment. Type 1 diabetics need to take insulin, either through a pump or injections. Regular exercise as well as a diet low in refined carbohydrates will also help control blood sugar levels. By maintaining appropriate blood sugar levels, type 1 diabetics can lead normal lives free of serious complications.

Video by TheVisualMD

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What Is Type 2 Diabetes?

Go deep inside your body to see how type 2 diabetes happens, what it does to your body-and what you can do about it. Diabetes expert Dr. David Katz of the Yale Prevention Research Center talks about the frightening future of diabetes: in just a few decades, one third of all Americans may have diabetes. See the pancreas, where insulin is produced. Real imaging data reveals the body's inner anatomy slice by slice, from brain to base of spine. Dr. Cynthia Geyer of Canyon Ranch talks about how insulin resistance develops. View its results, as visceral abdominal fat builds up and chokes the vital organs. Discover the symptoms of type 2 diabetes and find out if you should be tested. See the complications of diabetes, including cardiovascular disease, hypertension, vision damage, kidney disease, and gangrene. The good news? Diabetes is a highly manageable disease. Dr. Mark Liponis of Canyon Ranch talks about controlling your risk for type 2 diabetes and, by managing it, reversing its symptoms and literally slowing the aging process.

Video by TheVisualMD

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Exercise & Diabetes

The body is powered by glucose, commonly called blood sugar, which it converts to fuel. In diabetics, the system of signaling the cells to take up glucose from the blood is impaired, disrupting this vital chain of events. Researchers have found that exercise helps diabetics' insulin sensitivity, meaning that their bodies are better able to gather up this glucose for energy. In fact, those who exercise at least 5 days a week and improve their diet improved their health more than diabetics who took medication only.

Video by TheVisualMD

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Managing Diabetes

The first step in managing type 2 diabetes is accepting the fact that you have diabetes. Diabetics need to take an active role in managing their condition. Regular doctor visits are a must to check on blood pressure and cholesterol levels and to monitor eye health. Dr. Michael Stein of Brown University talks about stabilizing kidney function. Blood sugar levels need to be monitored using self-testing kits. According to Dr. Osama Hamdy of the Joslin Diabetes Center, the best treatments for type 2 diabetes are diet and exercise, not medications. Cynthia Geyer of Canyon Ranch explains how exercise enables tissues to take up glucose independent of insulin receptors. Eating small sensible meals helps to keep blood sugar levels and weight under control. Losing 7% of body weight can increase insulin sensitivity by 50%--that's equivalent to two diabetes medications at maximum dose. Dr. Mark Liponis of Canyon Ranch tells us the good news about diabetes: we have the ability to improve diabetes, and that isn't true of many conditions.

Video by TheVisualMD

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Blood glucose monitoring

Self Test Blood Glucose Level : Unlike many other diseases, type 2 diabetes is treatable, and its symptoms can be reduced or even eliminated. The key is monitoring your blood sugar level by self-testing. When you keep your glucose level down, you can prevent serious health consequences and health care costs: For every 1% reduction in HbA1C levels, there is a 30% reduction in complications such as eye disease and nerve damage, and a 16% drop in complications such as heart disease.

Video by TheVisualMD

Oral Glucose Tolerance Test Infomercial

Video by Dokie PH/YouTube

Diagnosis of Type 2 Diabetes

Video by Animated Diabetes Patient/YouTube

A Critical Balance

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Diabetes in the US

Interactive by TheVisualMD

Healthy Capillary Blood Vessel

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Healthy Capillary Blood Vessel and and Damaged Capillary Blood Vessel Caused by High Levels of Blood Glucose

1) Healthy Capillary Blood Vessel - This image depicts a healthy capillary. Capillaries are the smallest blood vessels in your body. They can be so thin in diameter that blood cells have to bend in order to pass through. Capillaries are where the transfer of nutrients from the blood to cells, and the transfer of waste from cells to blood, takes place. In a healthy body, the blood vessels are smooth and elastic. 2) Cross-Section of Healthy Capillary Blood Vessel with Normal Glucose and Insulin Levels - This image depicts a healthy capillary. The body's cells depend on sugar in the blood, which is derived from carbohydrates, for food and energy. Allowing for the innumerable differences among individuals, the threshold for a normal blood sugar (glucose, pink) level in healthy people is 100 mg/dL; that is, 100 milligrams of glucose per deciliter of blood. Lower-than-normal levels characterize hypoglycemia and higher-than-normal levels characterize hyperglycemia. Without insulin (yellow), glucose is not able to enter cells to be used as fuel. Because of this, healthy insulin levels are a key factor in keeping blood glucose levels normal. 3) Cross-Section of Damaged Capillary Blood Vessel with Very High Glucose and Insulin Levels - This image depicts an unhealthy, damaged capillary with very high levels of insulin and glucose. Higher than normal levels of blood glucose lead to hyperglycemia. Hyperglycemia is the hallmark of prediabetes (between 100 and 125 mg/dL) and diabetes (126 mg/dL and higher). It is caused by either too little insulin being released by the pancreas or the body's inability to use insulin properly. Hyperglycemia leads to microangiopathy, marked by endothelial cell apoptosis (programmed cell death), accumulation of AGEs (advanced glycation end products), and thickening of the basement membrane, which can lead to the development of lesions, vasoconstriction, and altered vessel function

Interactive by TheVisualMD

Oral Glucose Tolerance Test

TheVisualMD

Insulin and Glucose Vessel Dispersion

TheVisualMD

Random glucose (pink) in a capillary

TheVisualMD

Testing and Diagnosing Diabetes

TheVisualMD

0:27

Glucose tolerance test

TheVisualMD

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Blood Glucose and Baselining Your Health

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Fasting Plasma Glucose

TheVisualMD

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Type 1 Diabetes Diagnosis & Treatment

TheVisualMD

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What Is Type 2 Diabetes?

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Exercise & Diabetes

TheVisualMD

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Managing Diabetes

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Blood glucose monitoring

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Oral Glucose Tolerance Test Infomercial

Dokie PH/YouTube

4:31

Diagnosis of Type 2 Diabetes

Animated Diabetes Patient/YouTube

Diabetes in the US

TheVisualMD

Healthy Capillary Blood Vessel and and Damaged Capillary Blood Vessel Caused by High Levels of Blood Glucose

TheVisualMD

Group B Strep Test

Group B Strep Test

Also called: Group B strep, GBS, Prenatal group B strep (GBS) screening, Group B streptococcus, Group B beta-hemolytic streptococcus, Streptococcus agalactiae, Beta-hemolytic strep culture

Strep B is a type of bacteria that is usually harmless in adults but can be deadly in newborns. A group B strep test is most often used to check for the bacteria in pregnant women. Antibiotics can prevent a mother from infecting her unborn baby.

Group B Strep Test

Also called: Group B strep, GBS, Prenatal group B strep (GBS) screening, Group B streptococcus, Group B beta-hemolytic streptococcus, Streptococcus agalactiae, Beta-hemolytic strep culture

Strep B is a type of bacteria that is usually harmless in adults but can be deadly in newborns. A group B strep test is most often used to check for the bacteria in pregnant women. Antibiotics can prevent a mother from infecting her unborn baby.

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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
You may need a strep B test if you are pregnant. The American College of Obstetricians and Gynecologists recommends GBS testing for all pregnant women. Testing is usually done in the 36th or 37th week of pregnancy. If you go into labor earlier than 36 weeks, you may be tested at that time.
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)
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 health care provider will use a small cotton swab to take a sample of cells and fluids from your vagina and rectum.
For a urine test, you will most likely be told to use the "clean catch method" to ensure your sample is sterile. It includes the following steps.
- Wash your hands.
- Clean your genital area with a cleansing pad given to you by your provider. To clean, open your labia and wipe from front to back.
- Start to urinate into the toilet.
- Move the collection container under your urine stream.
- Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
- Finish urinating into the toilet.
- Return the sample container as instructed by your health care provider.
If your baby needs testing, a provider may do a blood test or a 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 spinal tap, also known as a lumbar puncture, 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 health care provider will hold your baby in a curled-up position.
- A health care 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.
1. GBS | Prevention in Newborns | Group B Strep | CDC [accessed on Nov 19, 2018]
2. Group B strep test - Mayo Clinic [accessed on Nov 19, 2018]
3. Group B Streptococcus screening – Pregnancy Info [accessed on Nov 19, 2018]
4. Group B Strep Infection: GBS - American Pregnancy Association [accessed on Nov 19, 2018]
5. https://labtestsonline.org/tests/prenatal-group-b-strep-gbs-screening [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 (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

Video by Howcast/YouTube

What should a pregnant woman know about group B strep?

Video by IntermountainMoms/YouTube

Two Signs of Strep

Video by Lee Health/YouTube

When strep triggers OCD and tics - Leah's story

Video by Moleculera Labs/YouTube

Strep Throat in Kids

Video by Children's Health/YouTube

How dangerous are strep infections?

Video by Moleculera Labs/YouTube

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

Video by Mayo Clinic/YouTube

Group A Strep Infections and Associated Rhinitis

Video by Larry Mellick/YouTube

Invasive Strep A cases on the rise

Video by CBC News/YouTube

Group B Strep in Pregnancy

Video by CNN/YouTube

Strep Throat

Video by Best Docs Network/YouTube

Group B Strep in pregnancy

Video by Bernadette Bos/YouTube

Group B Strep Infection in Adults

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

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

Video by Armando Hasudungan/YouTube

Strep Throat and Scarlet Fever

Video by Larry Mellick/YouTube

Strep Throat Causes Loss of Limbs?

Video by The Doctors/YouTube

Strep Throat - Akron Children's Hospital video

Video by AkronChildrens/YouTube

Strep Throat – The Basics

Video by WebMD/YouTube

Strep Throat Turning into Scarlet Fever

Video by WAAY-TV 31 News/YouTube

Group B Strep in Pregnancy - CRASH! Medical Review Series

Video by Paul Bolin, M.D./YouTube

1:09

Real Questions | Pregnancy and Strep | UCLA OB/GYN

UCLA Health/YouTube

4:35

Study Reveals New Mechanism Fueling Group B Strep Infection

Seattle Children's/YouTube

2:29

What is a Group B Strep Test?

University of California Television (UCTV)/YouTube

1:26

Chronic Health Conditions: Prescription Medicines and Pregnancy

March of Dimes/YouTube

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

Howcast/YouTube

1:39

What should a pregnant woman know about group B strep?

IntermountainMoms/YouTube

1:52

Two Signs of Strep

Lee Health/YouTube

4:04

When strep triggers OCD and tics - Leah's story

Moleculera Labs/YouTube

2:08

Strep Throat in Kids

Children's Health/YouTube

1:54

How dangerous are strep infections?

Moleculera Labs/YouTube

1:01

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

Mayo Clinic/YouTube

2:53

Group A Strep Infections and Associated Rhinitis

Larry Mellick/YouTube

6:19

Invasive Strep A cases on the rise

CBC News/YouTube

2:09

Group B Strep in Pregnancy

CNN/YouTube

1:14

Strep Throat

Best Docs Network/YouTube

6:07

Group B Strep in pregnancy

Bernadette Bos/YouTube

4:10

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

Nonstress Test

Nonstress Test

Also called: NST, Non-Stress Test, Fetal 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

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 Normal/Reactive.
If the baby's heart rate goes up from time to time, the test results will most likely be normal.
Related conditions
Not all pregnant women need a nonstress test. But you may need this test if:
- Your baby doesn't seem to be moving as much as usual.
- You are overdue.
- You have a chronic medical condition such as high blood pressure, diabetes, heart disease, or a clotting disorder.
- You had complications in a previous pregnancy.
- Your blood is Rh negative, a rare but potentially serious condition that causes your body to make antibodies to your baby's blood.
- You are having more than one baby (twins, triplets, or more).
The test may be done in your provider's office or in a special prenatal area of a hospital. It generally includes the following steps:
- You will lie on a reclining chair or exam table.
- A health care provider will spread a special gel on the skin over your abdomen.
- 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.
- If your baby isn't active or moving during that time period, he or she 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. He or she 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 the baby's heart rate increased two or more times during the testing period.
- Nonreactive. This means the 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. The baby may simply 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 delivery induced if it is late enough in your pregnancy.
If you have questions about your results, talk to your health care provider.
Additional noninvasive tests for an unborn baby's heart rate include:
- Biophysical profile. This test combines a nonstress test with an ultrasound. An ultrasound is an imaging test that 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 for 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. Monitoring your baby before labor: MedlinePlus Medical Encyclopedia [accessed on Jan 10, 2019]
2. Nonstress test - Mayo Clinic [accessed on Jan 17, 2019]
3. Nonstress Test (NST) [accessed on Jan 17, 2019]
4. 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)

Glucose in Urine Test

Glucose in Urine Test

Also called: Urine sugar test, Urine glucose test, Glucosuria test, Glucose urine dipstick

A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.

Glucose in Urine Test

Also called: Urine sugar test, Urine glucose test, Glucosuria test, Glucose urine dipstick

A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.

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Use the slider below to see how your results affect your health.
mg/dL
15
Your result is Negative.
Glucose is not usually found in urine. If it is, further testing is needed.
Related conditions
You may get a glucose in urine test as part of your regular checkup or if you have symptoms of diabetes and cannot take a blood glucose test. Symptoms of diabetes include:
- Increased thirst
- More frequent urination
- Blurred vision
- Fatigue
You may also need a urinalysis, which includes a glucose in urine test, if you are pregnant. If high levels of glucose in urine are found, it may indicate gestational diabetes. Gestational diabetes is form of diabetes that happens only during pregnancy. Blood glucose testing can be used to confirm a diagnosis of gestational diabetes. Most pregnant women are tested for gestational diabetes with a blood glucose test, between their 24th and 28th weeks of pregnancy.
If your urine glucose test is part of a urinalysis, you will need to provide a sample of your urine. During your office visit, you will receive a container in which to collect the urine and special instructions to ensure the sample is sterile. These instructions are often referred to as the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
Your health care provider may ask you to monitor your urine glucose at home with a test kit. He or she will provide you with either a kit or a recommendation of which kit to buy. Your urine glucose test kit will include instructions on how to perform the test and a package of strips for testing. Be sure to follow the kit instructions carefully, and talk to your health care provider if you have any questions.
Glucose is not normally found in urine. If results show glucose, it may be a sign of:
- Diabetes
- Pregnancy. As many half of all pregnant women have some glucose in their urine during pregnancy. Too much glucose may indicate gestational diabetes.
- A kidney disorder
A urine glucose test is only a screening test. If glucose is found in your urine, your provider will order a blood glucose test to help make a diagnosis.
1. https://medlineplus.gov/lab-tests/glucose-in-urine-test/ [accessed on Sep 15, 2019]
2. https://medlineplus.gov/ency/article/003581.htm [accessed on Sep 15, 2019]
3. https://www.labcorp.com/test-menu/26061/glucose-quantitative-urine [accessed on Sep 15, 2019]
4. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=glucose_urine [accessed on Sep 15, 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 (6)

Abdomen Revealing Pancreas and Kidney

Sugar is one of the nutrients your body uses for energy. It is the product of the body's breakdown of complex carbohydrates and is circulated in the blood to all your cells. Although blood sugar levels change depending on whether you just ate or exercised, in general, your body keeps the sugar levels within a narrow range. Not enough sugar - hypoglycemia - and you can get hungry, shaky, sweaty, tired, and even faint. Too much sugar - hyperglycemia - is a cardiovascular risk factor leading to arteriosclerosis (hardening of the arteries). To control blood sugar levels, your body depends on a hormone called insulin.

Image by TheVisualMD

Diabetes Symptoms

(left to right) Fatigue: dehydration, lack of ability to utilize glucose for energy and other factors cause fatigue; weight loss: because it can't use glucose for energy, the body breaks down muscle instead; constant hunger: diabetes prevents glucose from entering cells, leading to constant hunger due to cell starvation; increased thirst: too much urination leaves tissues dehydrated and causes increased thirst; frequent urination: fluids are drawn from tissues and the kidneys constantly filter out glucose, leading to frequent urination.

Image by TheVisualMD

Male Figure with Urinary System

Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.

Image by TheVisualMD

Kidney Glomeruli, Compromised Filtration

Our kidneys are remarkable filters. Each day, they filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Proteins are also normally filtered out of the blood and recycled in the body by the kidneys. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

Image by TheVisualMD

Diseased and Aging Kidney Tissue Comparisons

As a person ages, the number of nephrons, the kidneys' vital filters, decreases, as does the overall amount of tissue in the kidneys. A healthy aging kidney will not function like a 20-year-old kidney, but it can still do its job. The difference between an aging kidney in a healthy body and a kidney damaged by hypertension or diabetes can be as stark as the difference between someone who is a picture of health and someone who is debilitated by illness.

Image by TheVisualMD

Glomerulonephritis

Our kidneys filter about 200 quarts of blood each day to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. Glomerulonephritis is the inflammation of these tiny filters and can be caused by diabetes and chronic high blood pressure or, in acute cases, infection. When kidney function declines, waste products normally filtered out and excreted into the urine begin instead to accumulate in the blood.

Image by TheVisualMD

Abdomen Revealing Pancreas and Kidney

TheVisualMD

Diabetes Symptoms

TheVisualMD

Male Figure with Urinary System

TheVisualMD

Kidney Glomeruli, Compromised Filtration

TheVisualMD

Diseased and Aging Kidney Tissue Comparisons

TheVisualMD

Glomerulonephritis

TheVisualMD

Monitor Your Baby's Activity

Human Fetus With Smooth Skin, 29 Weeks Gestational age, 28 Weeks Fetal age

Image by TheVisualMD

Monitor Your Baby's Activity

After 28 weeks, keep track of your baby's movement. This will help you to notice if your baby is moving less than normal, which could be a sign that your baby is in distress and needs a doctor's care. An easy way to do this is the "count-to-10" approach. Count your baby's movements in the evening — the time of day when the fetus tends to be most active. Lie down if you have trouble feeling your baby move. Most women count 10 movements within about 20 minutes. But it is rare for a woman to count less than 10 movements within two hours at times when the baby is active. Count your baby's movements every day so you know what is normal for you. Call your doctor if you count less than 10 movements within two hours or if you notice your baby is moving less than normal. If your baby is not moving at all, call your doctor right away.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (12)

Pregnancy week by week: 25 to 29 - Pancitas.com

Video by Little Bellies Ultrasound & Pregnancy Spa/YouTube

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Third Trimester Fetus

Close up shot of fetus's face in the third trimester. Environment is foggy and has a lot of particle matter floating around the fetus. Camera zooms out from the face to reveal more of the hands and shoulders. Fetus is approximately between 15- 20 weeks.

Video by TheVisualMD

28 Weeks Pregnant - What to Expect Your 28th Week of Pregnancy

Video by What To Expect/YouTube

"28 Weeks Pregnant" by PregnancyChat.com @PregChat

Video by PregnancyChat/YouTube

28 Weeks Pregnant: What You Need To Know - Channel Mum

Video by Channel Mum/YouTube

This browser does not support the video element.

6 Month Old Fetus

Fetus is shown in utero. Camera zooms around fetus and then zooms out. Skin is slightly translucent. Environment is pinkish and foggy. Fetus is approximately 6 months.

Video by TheVisualMD

This browser does not support the video element.

8 Week Old Fetus Cardiovascular System

Camera is zoomed out above the womb containing an 8 week old fetus. Environment is a pinkish fog and the womb is rendered in the translucent glass-style. Camera pans and zooms toward a lateral view of the fetus. Then around to its front. The skin fades out and the developing circulatory, nervous system and eyes are revealed.

Video by TheVisualMD

This browser does not support the video element.

8 Month Old Fetus with Developing Body System

Animation of an 8-month fetus in utero. The environment is textured and tinted a dark red to similiate being in the womb. The initial camera shot is of the posterior of the fetus. The skin of the fetus is translucent and vaguely shows the skeletal system beneath. The camera zooms in and begins to rotate to the front of the fetus. As this occurs, the different systems of the body are highlighted. First the nervous system is highlighted with the developing brain and spinal cord, followed by the digestive system, then a glmpse of the sketetal and muscular system and finally the skin becomes opaque.

Video by TheVisualMD

This browser does not support the video element.

8 Month Old Fetus in Utero

8-month fetus in utero. The environment is fluid-fill suggested by the floating particles. The cameara view is a lateral view of the upper body the fetus. The camera zooms in to focus on the head of the fetus.

Video by TheVisualMD

This browser does not support the video element.

Hand of 6 Month Old Fetus

Close up of 6 month old fetus. Camera is focused on the hands and then pans up to the face. The perspective is mostly superior. The environment is liquid with a lot floating particles.

Video by TheVisualMD

Normal Fetal Movement and Growth | Kaiser Permanente

Video by Kaiser Permanente Thrive/YouTube

This browser does not support the video element.

Fetus in Fetal Position

Camera is showing close-up view of a fetus. From the perspective, the fetus is in classic fetal position, and face, torso, and right arm and thigh are seen. The environment is liquid with a lot floating particles.

Video by TheVisualMD

2:20

Pregnancy week by week: 25 to 29 - Pancitas.com

Little Bellies Ultrasound & Pregnancy Spa/YouTube

0:29

Third Trimester Fetus

TheVisualMD

2:47

28 Weeks Pregnant - What to Expect Your 28th Week of Pregnancy

What To Expect/YouTube

7:30

"28 Weeks Pregnant" by PregnancyChat.com @PregChat

PregnancyChat/YouTube

8:09

28 Weeks Pregnant: What You Need To Know - Channel Mum

Channel Mum/YouTube

0:18

6 Month Old Fetus

TheVisualMD

0:20

8 Week Old Fetus Cardiovascular System

TheVisualMD

0:09

8 Month Old Fetus with Developing Body System

TheVisualMD

0:11

8 Month Old Fetus in Utero

TheVisualMD

0:22

Hand of 6 Month Old Fetus

TheVisualMD

1:54

Normal Fetal Movement and Growth | Kaiser Permanente

Kaiser Permanente Thrive/YouTube

0:12

Fetus in Fetal Position

TheVisualMD

High-Risk Pregnancy

Sensitive content

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Chorionic Villus Sampling (CVS)

Image by TheVisualMD

High-Risk Pregnancy

Pregnancies with a greater chance of complications are called "high-risk." But this doesn't mean there will be problems. The following factors may increase the risk of problems during pregnancy:

Very young age or older than 35
Overweight or underweight
Problems in previous pregnancy
Health conditions you have before you become pregnant, such as high blood pressure, diabetes, autoimmune disorders, cancer, and HIV
Pregnancy with twins or other multiples

Health problems also may develop during a pregnancy that make it high-risk, such as gestational diabetes or preeclampsia. See Pregnancy complications to learn more.

Women with high-risk pregnancies need prenatal care more often and sometimes from a specially trained doctor. A maternal-fetal medicine specialist is a medical doctor that cares for high-risk pregnancies.

If your pregnancy is considered high risk, you might worry about your unborn baby's health and have trouble enjoying your pregnancy. Share your concerns with your doctor. Your doctor can explain your risks and the chances of a real problem. Also, be sure to follow your doctor's advice. For example, if your doctor tells you to take it easy, then ask your partner, family members, and friends to help you out in the months ahead. You will feel better knowing that you are doing all you can to care for your unborn baby.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (9)

2:02

What is a High Risk Pregnancy? | Kaiser Permanente

Kaiser Permanente Thrive/YouTube

1:02

High Risk Pregnancy with Twins

Sharp HealthCare/YouTube

5:00

High Risk Pregnancy Indicators and Diagnosis (Q&A)

Howard County General Hospital/YouTube

5:46

What is a High-Risk Pregnancy?

Mills-Peninsula Health Services/YouTube

1:02:43

What Does it Really Mean if Your Pregnancy is High Risk?

St. Louis Children's Hospital/YouTube

1:25

What factors can put a mother into a high risk pregnancy category?

AMITA Health/YouTube

1:44

Preventing Flu During Pregnancy Could Reduce Autism Risk - Mayo Clinic

Mayo Clinic/YouTube

2:18

High Risk Pregnancy: High BMI

Swedish/YouTube

Sex Chromosome Problems Discovered Through Prenatal Diagnosis: Klinefelter Syndrome

Washington State Department of Health

Places to Deliver Your Baby

Childbirth edited

Image by Gilberto Santa Rosa/Wikimedia

Places to Deliver Your Baby

Many women have strong views about where and how they'd like to deliver their babies. In general, women can choose to deliver at a hospital, birth center, or at home. You will need to contact your health insurance provider to find out what options are available. Also, find out if the doctor or midwife you are considering can deliver your baby in the place you want to give birth.

Hospitals are a good choice for women with health problems, pregnancy complications, or those who are at risk for problems during labor and delivery. Hospitals offer the most advanced medical equipment and highly trained doctors for pregnant women and their babies. In a hospital, doctors can do a cesarean delivery if you or your baby is in danger during labor. Women can get epidurals or many other pain relief options. Also, more and more hospitals now offer on-site birth centers, which aim to offer a style of care similar to standalone birth centers.
Questions to ask when choosing a hospital:
- Is it close to your home?
- Is a doctor who can give pain relief, such as an epidural, at the hospital 24-hours a day?
- Do you like the feel of the labor and delivery rooms?
- Are private rooms available?
- How many support people can you invite into the room with you?
- Does it have a neonatal intensive care unit (NICU) in case of serious problems with the baby?
- Can the baby stay in the room with you?
- Does the hospital have the staff and set-up to support successful breastfeeding?
- Does it have an on-site birth center?
Birth or birthing centers give women a "homey" environment in which to labor and give birth. They try to make labor and delivery a natural and personal process by doing away with most high-tech equipment and routine procedures. So, you will not automatically be hooked up to an IV. Likewise, you won't have an electronic fetal monitor around your belly the whole time. Instead, the midwife or nurse will check in on your baby from time to time with a handheld machine. Once the baby is born, all exams and care will occur in your room. Usually certified nurse-midwives, not obstetricians, deliver babies at birth centers. Healthy women who are at low risk for problems during pregnancy, labor, and delivery may choose to deliver at a birth center.
Women can not receive epidurals at a birth center, although some pain medicines may be available. If a cesarean delivery becomes necessary, women must be moved to a hospital for the procedure. After delivery, babies with problems can receive basic emergency care while being moved to a hospital.
Many birthing centers have showers or tubs in their rooms for laboring women. They also tend to have comforts of home like large beds and rocking chairs. In general, birth centers allow more people in the delivery room than do hospitals.
Birth centers can be inside of hospitals, a part of a hospital or completely separate facilities. If you want to deliver at a birth center, make sure it meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers. Accredited birth centers must have doctors who can work at a nearby hospital in case of problems with the mom or baby. Also, make sure the birth center has the staff and set-up to support successful breastfeeding.
Homebirth is an option for healthy pregnant women with no risk factors for complications during pregnancy, labor or delivery. It is also important women have a strong after-care support system at home. Some certified nurse midwives and doctors will deliver babies at home. Many health insurance companies do not cover the cost of care for homebirths. So check with your plan if you'd like to deliver at home.
Homebirths are common in many countries in Europe. But in the United States, planned homebirths are not supported by the American Congress of Obstetricians and Gynecologists (ACOG). ACOG states that hospitals are the safest place to deliver a baby. In case of an emergency, says ACOG, a hospital's equipment and highly trained doctors can provide the best care for a woman and her baby.
If you are thinking about a homebirth, you need to weigh the pros and cons. The main advantage is that you will be able to experience labor and delivery in the privacy and comfort of your own home. Since there will be no routine medical procedures, you will have control of your experience.
The main disadvantage of a homebirth is that in case of a problem, you and the baby will not have immediate hospital/medical care. It will have to wait until you are transferred to the hospital. Plus, women who deliver at home have no options for pain relief.
To ensure your safety and that of your baby, you must have a highly trained and experienced midwife along with a fail-safe back-up plan. You will need fast, reliable transportation to a hospital. If you live far away from a hospital, homebirth may not be the best choice. Your midwife must be experienced and have the necessary skills and supplies to start emergency care for you and your baby if need be. Your midwife should also have access to a doctor 24 hours a day.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

0:31

Where to Deliver Your Baby

InHealth: A Washington Hospital Channel/YouTube

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