Antenatal screening

Key Information

Appropriate Tests

National guidelines may vary from country to country.

 

Routine at first antenatal visit, before 20 weeks

Tests recommended: Full blood count, Blood group, Blood group and antibody screen, Rubella Ab status, Hepatitis B serology, Hepatitis C serology, HIV serology (HIV Ab and Ag combination) and Syphilis serology (TPHA or TPPT), Vitamin D.

MCS urine (microscopy and culture)

Other tests to consider: Cervical cytology, screening for haemoglobinopathies, Varicella zoster Ab.

Tests after the first visit: Obstetric ultrasound before 20 weeks gestation, screening for Down syndrome (see link below).

Routine at 26-28 weeks

Full blood count, including Haemoglobin and Platelet count.

Blood group and antibody screen. See also Haemolytic disease of the newborn.

Glucose challenge test. NB: The urine glucose is of no value in the detection of gestational diabetes mellitus.

Repeat Syphilis serology in high risk populations.

Routine at 30-36 weeks

Full blood count. Blood film. Group B streptococcus screening.

If high risk for infection

Genital swab for Chlamydia trachomatis, Neisseria gonorrhoeae, HIV serology (HIV Ab and Ag combination).

If the patient has recurrent genital ulcers, thought to be due to Herpes simplex virus infection, the diagnosis should be confirmed by virus detection. Documentation enables a more informed decision as to the need for Caesarean section if lesions are still present at the onset of labour.

Selective testing for cytomegalovirus (Cytomegalovirus detection) and toxoplasmosis (Toxoplasma Ab) should only be considered for women at substantially increased risk of acquiring such infections, and ideally this testing should be done prior to pregnancy.

Additional tests, if appropriate

Down syndrome antenatal risk test ('triple test'). Alpha-fetoprotein - serum (neural tube defects).

Reference

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Routine Antenatal Assessment in the Absence of Pregnancy Complications. Statement: C-Obs 3 (b), March 2013. https://www.ranzcog.edu.au/college-statements-guidelines.html#obstetrics

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Diagnosis of Gestational Diabetes Mellitus (GDM) and Diabetes Mellitus in Pregnancy. Statement: C-Obs 7,July 2014. https://www.ranzcog.edu.au/college-statements-guidelines.html#obstetrics

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Prenatal Screening for Trisomy 21 (Down Syndrome), Trisomy 18 (Edward Syndrome) and Neural Tube Defects. Statement: C-Obs 4, July 2007. https://www.ranzcog.edu.au/college-statements-guidelines.html#obstetrics

Australian and New Zealand Society for Blood Transfusion. Guidelines for Blood Grouping and Antibody Screening in the Antenatal and Perinatal Period. March 2007. http://www.anzsbt.org.au/publications/documents/Antenatal_Guidelines_Mar07.pdf