Blood tests during pregnancy

We offer many blood tests but these are mostly taken at the same time and so require only one needle.

Anaemia

We offer two tests for anaemia: one at your booking appointment and another at 28 weeks. Anaemia is often caused by a lack of iron and can make you feel tired. If you develop anaemia while you are pregnant, it is usually because you do not have enough iron to meet your baby’s need for it in addition to your own; we may also recommend further blood tests. If your iron levels are low, simply changing your diet to include more iron rich foods may be all that is needed. Occasionally iron supplements are recommended.

Blood group, rhesus D status and antibodies

Early in your pregnancy (usually at booking) you will be offered tests to find out your blood group (A, AB, B or O) and your rhesus D (RhD) status. It is important to know your blood group in case you need a blood transfusion. It is also important to discover whether you are Rhesus positive or Rhesus negative. Women who are rhesus negative will be offered an anti-D injection at 28 weeks of pregnancy to prevent future babies developing problems. If you are rhesus negative your midwife will discuss this with you in more detail. For more information and guidance about anti-D please use this link to visit the National Institute for Health and Clinical Excellence (NICE) website.

Early in your pregnancy, and again at 28 weeks, you will be offered tests to check for red-cell antibodies. Most women do not have antibodies but if we do detect some you will be referred to a consultant. In some cases we offer referral to our fetal medicine unit for more investigation and advice on managing the rest of your pregnancy.

Sickle cell and Thalassaemia

Inherited blood conditions, such as thalassaemia and sickle cell disease, mainly affect people whose family origin is African, Caribbean, Middle Eastern, Asian or Mediterranean, but these conditions are also found in the North European population. At your first appointment, your midwife will ask some questions about you and your baby’s father’s family origins to find out whether you are at risk of being a carrier or having a baby with an inherited blood condition. If you are a carrier of an inherited blood condition, we would discuss this with you and arrange for your baby’s father to be offered advice, support and screening without delay. Medway has a Pegasus trained midwife to facilitate this pathway of care swiftly. She can be contacted on 01634 830000 ext 5160.

Gestational diabetes(GDM)

About one to two percent of women develop diabetes during pregnancy nationally. At Medway our rate is 4%. We offer a blood test to screen for this condition if indicated. We offer screening to women of certain family origins, those with a BMI of 30 or more, women who have previously had babies over the 97th centile or greater than 4.5 kg, women with  a past history of GDM and women who develop glycosuria, polyhydramnios or who measure large for dates.  Your midwife will discuss this with you in more detail. If you have any further questions or concerns please contact the GDM screening midwife on 01634 830000 ext 5160

Testing for infections

We routinely offer screening tests to check for certain infections. These infections are not common, but they can cause problems if they are not detected and treated. We recommend that these tests are taken early in pregnancy – usually at booking.

Hepatitis B virus

Hepatitis B virus is a potentially serious infection that can affect the liver. Many people have no symptoms. It can be passed from a mother to her baby (through blood or body fluids), but may be prevented if the baby is vaccinated at birth. The infection can be detected in the mother’s blood and a test is offered at booking. A multidiscipline team including a Hepatologist, microbiologist, obstetrician and specialist midwife/nurse will be involved in the care pathway.

HIV

HIV usually causes no symptoms at first but can lead to AIDS. HIV can be passed from a mother to her baby, but this risk can be greatly reduced if the mother is diagnosed before the birth. The infection can be detected through a blood test. If you are pregnant and are diagnosed with HIV, you will be offered specialist care. A multidiscipline team including a Sexual health consultant, microbiologist, obstetrician, neonatologist and specialist midwife/nurse and pharmacist will be involved in the care pathway. Other places to gain information include the World Health Organisation and British HIV Association.

Syphilis

Syphilis is rare in the UK. It is a sexually transmitted infection that can also be passed from a mother to her unborn baby. Mothers and babies can be successfully treated if it is detected and treated early. A person with syphilis may show no symptoms for many years. A positive test result does not always mean you have syphilis. If you test positive you will need further investigation. A multidiscipline team including a Sexual health consultant, microbiologist, obstetrician and specialist midwife/nurse will be involved in the care pathway.

Hepatitis C

Screening is offered to women with high risk factors such as drug users or sex workers. A multidiscipline team including a Sexual health consultant, microbiologist, obstetrician and specialist midwife/nurse will be involved in the care pathway.

Useful information

More information can be found in the publication 'Screening Tests For You And Your Baby’, which is available to download in leaflet format from the UK National Screening Committee and is available in 12 different languages as well as an easy to read version and an audio downloadable version for those with sight loss

You can also visit the NHS Choices website for further information about antenatal checks and tests.