Have you ever wondered why your healthcare provider is running so many tests? This guide explains what tests may be done during and after pregnancy, when, and why. Preeclampsia, in all of its forms, can mean a lot of testing, both during and after pregnancy. Or what those tests mean? Preeclampsia is a complication of pregnancy that can happen to any woman, in any pregnancy. While preeclampsia most often occurs during a first pregnancy, it can occur in any pregnancy.
Preeclampsia is diagnosed by persistent high blood pressure that develops for the first time after mid-pregnancy or right after delivery. A urine sample is also usually tested at each visit with a dipstick to make sure your kidneys are healthy.
Any excess amount of protein found in a urine sample is known as proteinuria, and may or may not be present in patients who are diagnosed with preeclampsia. Prenatal visits are scheduled closer together near the end of the pregnancy. At 32 weeks in an uncomplicated pregnancy, visits are usually every two weeks; at 36 weeks they become weekly.
Patient with higher risks are seen more frequently. Your healthcare provider should measure your blood pressure at each prenatal appointment.
Pressure can vary in different arms, so ask your caregivers to use the same arm every time. If protein is detected in your urine dipstick screening test, you may be asked to collect all of your urine in a jug for 12 or 24 hours to determine the amount of protein being lost.
Store the jug in the refrigerator or a cooler full of ice in your bathroom. This urine will be tested to see if you are passing more than mg of protein in a day. Any amount of protein in your urine over mg in one day may indicate preeclampsia.
Alternatively, your provider may do a "spot check" to immediately check levels of protein compared to creatinine, also an indicator of kidney health. A protein:creatinine ratio over. Women may have blood drawn and tested for a complete blood count CBC with platelet count and assessment of creatinine, liver enzyme levels, and sometimes uric acid. This blood work provides a baseline that your providers can monitor.
If you experience symptoms of severe preeclampsia, most providers will draw blood again to compare and look for changes in your liver and platelets. In severe forms of preeclampsia such as HELLP syndrome , your red blood cells can be damaged or destroyed to produce a type of anemia. Your liver enzymes the AST and ALT can rise substantially, and your platelets can fall below the normal range most often ,, as determined by the laboratory.
Most providers also routinely weigh you to assess whether your weight gain is within the normal range. Although swelling can be normal in pregnancy, swelling in your face and hands and sudden weight gain three to five pounds or more in a week sometimes precedes signs of preeclampsia.
There are many biomarker tests being developed to predict or diagnose preeclampsia. While none of these have been widely accepted into practice in the U. Another screening test can check a pregnant woman for fetal AFP levels. Mild preeclampsia is diagnosed when a pregnant woman has: 2 , 3. Eclampsia occurs when women with preeclampsia develop seizures. The seizures can happen before or during labor or after the baby is delivered.
HELLP syndrome is diagnosed when laboratory tests show hemolysis burst red blood cells release hemoglobin into the blood plasma , elevated liver enzymes, and low platelets.
There also may or may not be extra protein in the urine. Some women may also be diagnosed with superimposed preeclampsia —a situation in which the woman develops preeclampsia on top of high blood pressure that was present before she got pregnant. Health care providers look for an increase in blood pressure and either protein in the urine, fluid buildup, or both for a diagnosis of superimposed preeclampsia.
In addition to tests that might diagnose preeclampsia or similar problems, health care providers may do other tests to assess the health of the mother and fetus, including:. Despite these clear warning signs, Torres was sent home with orders to buy an over-the-counter home monitor to keep a log of her blood pressure, and to rest in bed. When there were no improvements a week later, her doctor sent her to a hospital where she went into labor the same afternoon.
She had a cesarian section and gave birth to identical twin girls nine weeks early. They spent 38 days in the neonatal intensive care unit, with some breathing assistance at first, before going home.
Some 2 to 8 percent of women will develop preeclampsia during pregnancy, including those with no known risk factors such as a previous history of high blood pressure, obesity, carrying more than one baby, or being either under 18 years old or over Of the 10 million pregnant women around the world who develop preeclampsia every year, about 76, die. And about half a million babies die each year as a result of preeclampsia, including 10, in the United States. There are new screening protocols that can detect preeclampsia early in a pregnancy, when intervention to prevent it is still possible.
But they are complicated and expensive to implement. Hypotheses abound , but the placenta and its blood supply are thought to play a key role. Currently, the only cure for preeclampsia is the delivery of the placenta, explains Inkeri Lokki , a reproductive immunologist of the University of Helsinki.
Lokki studies a preeclampsia marker, called sFlt1 , that regulates growth of new blood vessels. Early on in a normal pregnancy, the spiral arteries—maternal blood vessels that feed the uterus like a twisting garden hose—open up like funnels to bathe the fetus with blood and oxygen.
Throughout the years, researchers have developed about 70 prediction models for preeclampsia. Many of these tests were designed to detect markers of preeclampsia in the first trimester, says genomics researcher Noam Shomron, of Tel Aviv University in Israel. That may have changed this year. SPREE combines maternal risk factors and medical history with testing for four predictors of preeclampsia in the 11th to 13th week of their pregnancies. A similar trial, which included 26, women in the U.
These screening methods use complicated algorithms, sophisticated sonography and other equipment often unavailable to women and doctors in low-income countries. There are doubts, too, as to whether these new screening guidelines would be cost-effective even in rich countries, according to a paper published in Drugs. That is why Shomron and colleagues are planning to develop a cheap, portable blood test to detect preeclampsia in the first trimester based on biomolecular markers.
In August , Shomron and Moshe Hod, a professor of obstetrics and gynecology at Rabin Medical Center in Israel, flew to London to meet with Nicolaides, who had been following a cohort of 10, British women for years, sampling and storing their blood and plasma throughout their pregnancies.
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