LABORATORY & DIAGNOSTIC TESTING

FOR PREGNANT

JOANNE MARIE S. GARCIA, RN, MAN

LABORATORY & DIAGNOSTIC TESTING

1. Complete Blood Count (CBC)

- series of blood tests that provide information
on the hematologic system as well as other body
systems
Procedure: obtain 5-7 ml of blood
2. Blood group & Rh typing
Purpose: To determine the client’s blood group
& Rh status to identify a fetus at risk for
developing erythroblastosis fetalis or
hyperbilirubinemia in the neonatal period

Procedure: collect 7-10 ml of venous blood in a

nonadditive tube; avoid hemolysis
3. TORCH
- Group of infections caused by viruses &
protozoa that cause serious fetal problems when
contracted by the mother during pregnancy
- Toxoplasmosis, Other infections (usually
Hepatitis), Rubella, Cytomegalovirus, Herpes
Simplex Virus
TOXOPLASMOSIS
 Cause: Infection with the protozoan parasite
toxoplasma gondii
 Transmission: undercooked meat
poor hand washing after
handling cat litter
- fetal infection occur after conception via
placenta
 Procedure: collect 5ml of venous blood
 Fetal / Neonatal effects
- miscarriage in early pregnancy
- neonates, CNS lesions can result in
hydrocephally, microcephally, chronic retinitis, &
seizures
OTHER INFECTIONS (HEPATITIS)
 Cause: infection with HAV or HBV
 Transmission: HAV – droplets
HAB – via placenta; infant is exposed
to blood and genital secretions during labor &
delivery
 Procedure: collect 5-7 ml of venous blood
 Fetal/Neonatal effects: Preterm birth, hepatitis
infection, intrauterine fetal death
RUBELLA
 Cause: infection with the rubella virus
 Transmission: droplet
 Procedure: collect 3-5 ml of venous blood in a
serum separator tube, a vacuum tube
 Fetal/neonatal effects:
- Miscarriage
- Congenital anomalies
- death
CYTOMEGALOVIRUS
 Cause: exposure to cytomegalovirus
 Transmission: respiratory droplet, semen,
cervical & vaginal secretions, breast milk,
placental tissue, urine, feces
 Procedure: collect a swab specimen from urine,
sputum, or mouth for a viral culture, 3-7 days.
 Fetal/neonatal effects: fetal death, hemolytic
anemia & jaundice, hydrocephaly or
microcephaly, deafness, pneumonitis
HERPES SIMPLEX VIRUS
 Cause: exposure to herpes virus
 Transmission: infant is usually infected during
exposure to a lesion in the birth canal
 Procedure: the client is placed in the lithotomy
position and the cervix is visualized; a cotton
tipped swab is used to obtain a specimen from the
endocervical canal
 Fetal/Neonatal effects: Miscarriage, Preterm
labor, still birth
- Transplacental is rare – MR, Microcephaly
4. Sexually Transmitted Infections
- Syphilis – caused by Treponema Pallidum;
transmitted through kissing, biting, oral-genital
sex, fetus-via placenta
Fetal/neonatal effects: CNS damage
hearing loss
death
- Gonorrhea – caused by Neisseria Gonorrhea;
neonates can acquire infection by exposure to the
bacteria in the birth canal
Fetal/neonatal effects:
- preterm birth
- neonatal sepsis
- ophthalmia neonatorum, which
can cause blindness
5. Urinalysis
- the pH may be decreased with poor glucose
matabolism and ketone acids in the urine
- specific gravity may be increased with
dehydration
- glucose reabsorption is impaired
LABORATORY & DIAGNOSTIC DURING FOLLOW-UP VISITS

1. Hemoglobin – assessed monthly to monitor for

iron-deficiency anemia
2. Clean-catch urine specimen – collected at each
visit to assess for glucose, protein, nitrates, &
leukocytes which can indicate DM, PIH,
Infection
3. Glucose Tolerance Test (GTT) – used to screen for
gestational diabetes
Procedure: 50 g oral glucose load is administered;
the venous plasma glucose is assessed 1 hour after
the glucose load
Findings: a level greater than 140mg/dl is
considered abnormal
- if abnormal – should be assessed with 3 hour 100
gm OGTT, use to diagnose gestational diabetes
4. Alpha-fetoprotein (AFP) – levels peak in the
maternal serum at around 16 weeks; screening
tests for Down’s syndrome and neural tube defects.
5. Nonstress Test – assessment of fetal well-being
that analyzes the response of the fetal heart to fetal
movement
6. Amniocentesis - assesses fetal well-being and
maturity
ULTRASOUND
 Uses high frequency sound waves
 Hand held transducer is placed directly to the
mother's abdomen, and reflected waves are
recorded on screen image.
 Can give valuable information about pregnancy
and fetus
CLINICAL USES OF ULTRASOUND
 Identify Pregnancy
 Determine Fetal age
 Observe amniotic fluid abnormalities
 Detect fetal anomalies
 Identify placental abnormalities
 Determine fetal position
 Examine fetal HR, and RR
ACTIVITY
 https://nursinglecture.com/partograph/
 https://www.open.edu/openlearncreate/mod/ouco
ntent/view.php?id=272&printable=1