Measure height weight (BMI) at first visit

Urinalysis

Performed at every visit

• Dipstick - Protein levels (pre eclampsia)
• MSU - For diagnosis of asymptomatic bacterial infections

Blood tests

Done in one of the first visits (before 10 weeks)

• FBC - Anaemia
• Blood group and Rhesus status - If mother is negative and baby is positive, mother will be offered anti-D injections later in pregnancy
• Haemoglobinopathies - Sickle cell(women at higher risk), thalassaemia (all women)
• Infection screen -
  • HIV (risk of passing on to baby can be reduced with prophylaxis and C-section)
  • HBV (baby can be immunised at birth)
  • Syphillis (Abx prophylaxis for baby)
• OGTT at 24-28 weeks for diabetes if previous gestational diabetes or other risk factors

Down’s syndrome screening

• Combined test (1st line) - performed between 11-14 weeks gestation, combined results from:
  • USS (Nuchal translucency>6cm)
  • maternal blood tests - Beta-HCG: Higher result indicated a greater risk. Pregnancy associated plasma protein-A (PAPPA): lower result indicates greater risk
• Triple test - At 14-20 weeks gestation. Involved maternal bloods only:
  • Beta-HCG – a higher result indicates greater risk
  • Alpha-fetoprotein (AFP) – a lower result indicates a greater risk
  • Serum oestriol (female sex hormone) – a lower result indicates a greater risk
• Quadruple test - At 14-20 weeks gestation
  • Same as triple test. Also includes testing for inhibin-A. Higher = greater risk
• trisomy 18 (Edward syndrome) and 13 (Patau syndrome) give similar results but the hCG tends to lower

These tests provide a risk score, higher then 1 in 150 - Women is offered non-invasive testing or aminocentesis or chorionic villus sampling (Invasive testing)