During your pregnancy your providers main concern is the health of you and your baby. Thanks to modern technology, providers have advanced tests they can use to carefully monitor your health and the progress of your baby. These tests can help identify many problems while the baby is still in the womb. Some issues can even be treated before the baby is born. Fortunately for Wyoming residents, Memorial Hospital of Sweetwater County has access to state of the art prenatal testing and an excellent team of technicians that can identify risks early.
As a Certified Nurse Midwife practicing at Memorial Hospital of Sweetwater County in Wyoming, I follow the guidelines and regulations of our outstanding hospital and it's Board of Trustees in accordance with the American College of Nurse Midwives (ACNM). Generally speaking, the same standard of care, testing and examination will apply statewide in the County hospital environment throughout the State of Wyoming.
Your may experience slight differences in testing timelines, testing procedures and examination techniques, materials you will receive and even specific equipment used. However, the exceptional care you receive as a patient will always be consistent with the high standards we adhere to.
Categories of prenatal tests include:
Routine Screening: Basic tests done to check for any condition that may cause a health problem for you or your baby.
Fetal Monitoring: Special monitors that are used to check the well-being of the baby by monitoring his/her heartbeat; usually done later in pregnancy.
Genetic Screening: Special testing to see if you or your baby are likely to have certain genetic conditions.
Ultrasound (Sonography): Special imaging that is used to visualize your uterus and the fetus during pregnancy.
Routine Screening
Initial Prenatal Testing
At the first prenatal visit and examination, blood will be drawn to check your health status. It will screen for many potential risks that can affect your pregnancy. At the examination, a complete physical will be done to check your health status at the beginning of the pregnancy, including a pap test on the your cervix if needed as well as testing for any potential infections that can affect your or your baby's health.
Glucose Challenge Screening
Glucose challenge screening (usually performed between 24-28 weeks) is a blood test to see if you have gestational diabetes brought on by pregnancy. Before the test, you drink a sugary solution, then your blood is drawn and tested at certain times to see how well your body uses the sugar. If your body does not process the sugar normally and you have a high amount of sugar in your blood, you’ll be treated for gestational diabetes.
Group B streptococcus (GBS) Screening
Group B Streptococcus is a type of bacteria that every person has the their intestinal tract and can also be found in the birth canal of one in every three pregnant women. It usually doesn’t cause any disease or symptoms but could infect the baby during a vaginal birth possibly leading to with serious consequences. Between 36-37 weeks testing is done by performing a gentle swab of the vagina and rectum. If the test is positive for GBS in the vagina, antibiotics will be given during labor to help protect baby from potential infection.
Rh Immunoglobulin
At the first prenatal visit your blood type will be tested. If the Rh of your blood type is negative (for example, A Negative or O Negative type of blood), an antibody screen is performed and this will be retested again at 24-28 weeks. You then will receive an Rh immunoglobulin injection to stop any Rh problems in this and any future pregnancies.
Monitoring Tests
Fetal Movement Test (Kick Count)
You will usually feel that first “flutter” of life (called quickening) between 16-20 weeks. You may feel the baby move a lot during the 2nd trimester, then settle down as you get closer to your due date. How much the baby moves can be affected by the baby's position, your blood sugar level, working and eating habits, sound, light , and physical input to the uterus. Each baby has its own rhythm of movement and each pregnant person can recognize their own baby's movement.Babies also have sleep-awake cycles that lasts between 20 minutes and 2 hours. This affects how frequently you feel your baby move.
The term "Kick Count" refers to your baby's random movements in your womb. The American College of Obstetricians and Gynecologists (ACOG) recommends that you time how long it takes to feel 10 kicks, twists, turns, swishes or rolls. A healthy baby should have at least 10 movements in less than 2 hours. Most babies will do this in less than 30 minutes. If you do not feel 10 kicks in a 2-hour period, contact me or your healthcare provider.
Non-Stress Test (NST)
This is a test using a special fetal monitor to check your baby's well-being. It is used to look at your baby's heartbeat while they are resting and while they are moving. If the heart rate goes up when the baby kicks or moves, they are doing well. This result is called “reactive”. If the results are “non-reactive” more testing may be needed to check your baby's health in the womb.
Contraction Stress Test (CST)
This test is performed using the special fetal monitor that shows how the baby's heart rate reacts to uterine contractions. A small number of contractions are stimulated in two ways:
1) You receive a small amount of medication given through an IV line that creates contractions
2) You stimulate your nipples using touch/massage to stimulate your own natural release oxytocin (the hormone in your body that causes contractions).
The reaction or "stress" created by the contractions can show if the baby is getting enough blood and oxygen and can help determine the health of your baby in your womb.
Biophysical Profile
This testing combines results from an Ultrasound Exam that checks for fetal movements, breathing motions, muscle tone, and amount of amniotic fluid, with the Non-Stress Test described above.
The total score of this test (results are scored from 0 to 10) helps your healthcare provider evaluate the baby's well-being and decide how to manage your pregnancy. This is a more detailed study than the non-stress or contraction stress tests.
Ultrasound (Sonography)
Ultrasound or sometimes called sonography testing is a simple, non-invasive test that uses sound waves to create a video image of your baby inside your uterus. The image is created using an instrument called a probe that is placed either on your tummy or in your vagina. While your provider is doing the test, you may be able to watch your baby on a special screen.
Ultraounds may be used for screening, monitoring or special diagnosis. Your doctor or midwife may perform and ultrasound at any time during your pregnancy. Some of the most common reasons to have an ultrasound include:
To confirm your due date and if you are carrying more than one baby
To make sure the baby is growing and developing properly
To locate the placenta and check the volume of amniotic fluid
To detect a problem or monitor the condition of your baby
This is not an inclusive list as every woman and her pregnancy is unique. Some women require additional testing based on their health and how their individual pregnancy proceeds. As a Nurse-Midwife I believe that I and each pregnant woman are a team, and together we determine the most appropriate testing and monitoring for her and her baby's health. My responsibility as a CNM is to provide the safest and healthiest pregnancy for you and will do my best to guide you through the pregnancy. If you have any questions please feel free to contact me at Memorial Hospital of Sweetwater County.
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