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Home › Articles › Pregnancy › First Trimester Pregnancy Screenings

First Trimester Pregnancy Screenings

Choosing or Refusing First Trimester Screenings

By Katherine Bontrager

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"CVS and early amniocentesis done before 15 weeks are somewhat controversial," Dr. Williams says. "The safer of the two tests is the CVS, though both are invasive tests. At this moment all diagnostic tests are invasive, and if a patient wants to know whether her fetus is affected with an abnormality, she must have an invasive test."

"CVS is the most acceptable diagnostic procedure in the first trimester," Dr. Williams says. "It is very critical that a woman who wants CVS seek out a physician with extensive experience with the procedure, because, as with many things, safety and success are very much dependent on the skill of the operator. If you have an unskilled person, there is an increased risk for miscarriage or complications. But in the hands of experienced professionals, it is just as safe as an amniocentesis in the second trimester."

Testing for Ethnic-based Disorders
Ethnic background plays a huge role in genetic makeup, and for this reason, additional testing may be advisable for certain couples to uncover their chances of passing on additional ethnic-based disorders.

"Individuals of Ashkenazi Jewish ancestry are at increased risk for eight different disorders; Italian/Mediterranean/Asian/African American individuals are at increased risk for a group of anemias," Weinblatt says. "Determining which tests would be right for you can occur during a genetic counseling session."

Mushlin had the nuchal translucency test and the bloodwork, which took about five days. Although she says she wasn't too stressed about the results because she is younger and at a lesser chance for such abnormalities, it was nonetheless a relief when the tests were completed and indicated everything was normal. Mushlin is now the proud mother of a healthy, happy baby girl, and is thankful for the peace of mind the first trimester testing provided.

Pregnancy Screening Recommendations

Dr. Adelaide G. Nardone, an OB/GYN and medical adviser for the Vagisil Women's Health Center, has composed a list of tests that all women should have completed during their first trimester. She has also included special considerations for older women or women of certain ethnic backgrounds.

The following laboratory tests should be performed on all pregnant women:

  • Blood count (CBC)
  • Urinalysis
  • Urine culture (to detect bacteria)
  • Blood type and antibody screen
  • Rubella titer
  • Syphilis screen
  • Cervical cytology (Pap)
  • Hepatitis B virus surface antigen
  • Human immunodeficiency virus antibody test (HIV)
  • High-risk populations should have STD testing (GC/Chlamydia) and TB screening

Couples at high risk for certain genetic disorders based on racial and ethnic backgrounds should be offered screening for these disorders. For example European Caucasians and Ashkenazi Jewish patients should be offered cystic fibrosis (CF) testing. African Americans should be offered sickle cell hemoglobin testing. Mediterraneans and Asians should be offered testing for hemoglobinopathies.

A first trimester ultrasound is not mandatory. There are certain indications, however, whereby one may be ordered and they include: bleeding, size discrepancy, pain and a history of twins.

Since women 35 and older are at increased risk for chromosomal abnormalities, the most common of which is Down syndrome, these women can be offered a special first trimester screening for such abnormalities. These risks increase dramatically with age. For example:

  • The incidence of Down syndrome at age 35 is one in 270.
  • The incidence of Down syndrome at age 40 is one in 78.
  • The incidence of Down syndrome at age 45 is one in 22.

Regardless of a woman's age it is important that she share any important history (medical, social, sexual, etc.) with her health care provider so that the appropriate prenatal testing can be implemented in each trimester.


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