13.) Lab Tests Required For Normal Pregnancy And For Pregnancy At Risk

Question 1

What is the purpose of a Full Blood Count (FBC) in pregnancy?

Answer 1

• To monitor for physiological anemia, which is common in pregnancy.
• To identify the common causes of anemia such as iron deficiency (microcytic hypochromic anemia) or folate/B12 deficiency (macrocytic anemia).

Question 2

What is physiological anemia in pregnancy?

Answer 2

• It refers to a decrease in hemoglobin levels, but the lower limit for ‘normal’ hemoglobin in pregnancy is 10.5 g/dL.
• The most common cause is iron deficiency.

Question 3

How is iron deficiency anemia assessed in pregnancy?

Answer 3

• By measuring ferritin and total iron-binding capacity (TIBC).

Low ferritin
High TIBC
High transferrin

Question 4

What tests are used to assess macrocytic anemia in pregnancy?

Answer 4

• Serum folate and red blood cell folate levels.
• Serum B12 levels.

Question 5

What is the purpose of the blood grouping and antibody screen in pregnancy?

Answer 5

• To identify rhesus-negative women who are at risk of isoimmunization.
• To detect abnormal antibodies such as Kell and Duff.

Question 6

Why is rubella screening important in pregnancy?

Answer 6

• To detect immunity to rubella.
• Around 2% of women may not be immune to rubella, and these women are advised to receive post-partum rubella vaccination.

It can cause hearing/eyesight loss , heart defects

Question 7

What is the purpose of syphilis, hepatitis B&C, and HIV screening in pregnancy?

Answer 7

• To screen for infections that could affect the pregnancy and the baby.
• Early detection allows for appropriate treatment to reduce transmission risks.

Question 8

When is hemoglobin electrophoresis recommended in pregnancy?

Answer 8

• In women of minority ethnic or racial origins where there is a high incidence of hemoglobinopathies, such as sickle cell disease or thalassemia.

Question 9

What miscellaneous blood tests might be indicated during pregnancy?

Answer 9

• Thyroid function tests (TFTs) in women with a history of thyroid disease.
• HbA1c to assess long-term control of diabetes.
• Baseline urea and creatinine levels in chronic hypertensives with renal complications.

Question 10

What is the screening process for gestational diabetes?

Answer 10

• Targeted screening based on known risk factors.

Question 11

What are the risk factors for gestational diabetes?

Answer 11

1. Previous gestational diabetes (GDM).
2. Family history of diabetes (first-degree relative with diabetes).
3. Previous macrosomic baby (birth weight >4,000 grams).
4. Previous unexplained stillbirth.
5. Obesity (BMI >30).
6. Glycosuria (glucose in urine on more than one occasion).
7. Polyhydramnios (excess amniotic fluid).
8. Large-for-gestational-age fetus in current pregnancy.

Question 12

Why is it important to screen for gestational diabetes in pregnancy?

Answer 12

• Gestational diabetes can lead to complications for both the mother and the baby, such as macrosomia, pre-eclampsia, and an increased risk of developing type 2 diabetes later in life.
• Early detection allows for better management of the condition to reduce risks.

Question 13

What tests are included in routine blood tests for normal pregnancy?

Answer 13

1. Full Blood Count (FBC).
2. Blood grouping and antibody screen.
3. Rubella screen.
4. Syphilis screen.
5. Hepatitis B&C screen.
6. HIV screen.

Question 14

What is the role of baseline urea and creatinine tests in pregnancy?

Answer 14

• These tests are used to assess kidney function, particularly in women with chronic hypertension, to monitor for renal complications.

Question 15

What does the term ‘miscellaneous tests’ refer to in pregnancy blood work?

Answer 15

• A variety of tests that may be indicated based on individual risk factors or history, such as thyroid function tests, HbA1c, and renal function tests.