Your Guide to First Trimester Tests

After the news has sunk in, it’s probably time to organise an appointment with your GP. Your local doctor will be able to advise you further on maternity care options (i.e. public or private) as well as discussing any initial concerns and answering any questions you might have. They can also order blood tests, some prenatal screening, as well as discuss general lifestyle changes you might want to start thinking about. 

Whether you decide to continue your pregnancy care with your GP, go to see a midwife in a public hospital or book into a private obstetrician, there are a number of checks and tests which may be offered to monitor the health and well-being of both you and your baby.

First trimester tests: The vital check-ups

First trimester tests offer vital information about the health of both mum and baby, allowing for early detection of possible risks or complications. Below are some checks and tests which your doctor or midwife might order for you:

•    Blood tests: First trimester blood tests can identify a number of things including nutrient deficiencies such as anaemia and vitamin D; whether you have any infectious diseases such as Rubella, HIV, or sexually transmitted infections; provide an estimate of the risk of genetic abnormalities like Down syndrome; confirm your blood group and Rh type which is important to know for when your baby is born; check for immunity to rubella (German measles); and any other conditions that your doctor feels you’re at risk for – all part of a normal pregnancy assessment.

•    Urine tests: These may be conducted to check for infections as well as looking at protein and sugar levels, which may be signs of other medical concerns.

•    Pap smear: If you are due for your pap smear, this can be organised safely by your doctor during your first trimester of pregnancy.

•    Ultrasound: This non-invasive first trimester ultrasound offers images of the baby, giving insights into the baby's size, growth, and overall health. It can also estimate your due date and detect multiple pregnancies and potential abnormalities.

•    Nuchal translucency (NT) scan: This specialised first trimester ultrasound assesses the risk of chromosomal abnormalities by measuring fluid accumulation at the back of the baby's neck.

Preparation for these first trimester screening tests usually involves following specific instructions from your healthcare professional. It's vital to discuss any concerns or queries with your doctor before the tests. Read our checklist for a list of other topics you might want to discuss with your doctor if you haven’t already.

Diving deeper into maternal blood screening

First trimester screening blood tests are non-invasive procedures that measure specific substances in the mother's blood, indicating the risk of certain genetic abnormalities in your growing baby. The test helps identify pregnancies at higher risk but does not offer a definitive diagnosis.

The results are interpreted based on the mother's age, the gestational age, and the specific markers measured in the blood. Remember, the decision to undergo this test is personal and should be discussed with your doctor.

Genetic Counselling and Non-Invasive Prenatal Testing (NIPT)
After the first trimester screening blood test, you may be referred for genetic counselling. This helps in understanding the results and assessing your risk for certain genetic conditions. The counsellor will guide you through additional prenatal tests, like NIPT.

NIPT detects certain genetic conditions by analysing foetal DNA in the mother's blood. This test is particularly sensitive to detecting Down Syndrome, and can also identify other chromosomal differences. It's safe, accurate, and can be performed as early as 10 weeks into pregnancy. However, NIPT is a screening test and cannot provide a definitive diagnosis. In case of a higher risk, further diagnostic testing may be recommended.

Decoding your first trimester ultrasound

The first trimester ultrasound is a critical tool for monitoring foetal development. It helps determine the gestational age of your baby, offers an accurate estimation of the due date, and screens for potential abnormalities.

The combined first trimester screening (CFTS) test brings together ultrasound measurements with a first trimester blood test. The combination of these results is highly accurate in detecting chromosomal abnormalities, such as Down syndrome. It’s important to remember that it provides an indication of the likelihood of certain conditions, not a definitive diagnosis.

12th week visit

One of the most exciting weeks in your pregnancy is number 12! For most, this is the first time you get to ‘see’ your baby via an ultrasound scan!

For some this can be a very emotional milestone, so it helps to have a list of questions pre-prepared for your sonographer. It’s easy to forget things when you’re in front of the monitor!

1. Ask what clothes you need to take off for the scan. If it’s your first time, there’s no harm in asking.

    

2. Ask for a towel or sheet to put over yourself if you don’t feel like you’re covered up enough. You might want to consider your outfit choice on scan day – choose clothes which are easy to take off or can be lifted up to expose your belly.

    

3. Ask what they look for in the 12-week scan if they haven’t already explained this to you.

    

4. Ask if baby is developing normally.

    

5. Ask if you can get a picture or recording before they start scanning. Hospitals and clinics often have different policies about printing scans to keep. Some sonographers may also be able to record the scan session so you can watch it over and over again at home!

    

6. Ask if the foetal heartbeat sounds normal.

    

7. Ask when your next scan is and what you can expect.  

Your doctor will likely discuss the results of the scan in your next visit.    

Note: women who have had fertility assistance (i.e., IVF) may often have an additional scan at week 7. This ultrasound is performed to confirm the number of embryos and your due date and is also the first time you can visualise your babies heart beating! From here on in you’ll be in the hands of your healthcare professional to guide how often you will have check-ups throughout your pregnancy.

Frequently asked questions about first trimester tests

What is the first trimester pregnancy test?

The first trimester pregnancy test is typically a urine or blood test that detects the presence of the hormone hCG (human chorionic gonadotropin). It is used to confirm pregnancy and is often performed around 6-8 weeks after conception.

What tests are done at 12 weeks pregnant?

At 12 weeks pregnant, a common test performed is the nuchal translucency (NT) scan. This ultrasound measures the thickness of the baby's neck and, along with blood tests if necessary, assesses the risk of chromosomal abnormalities such as Down Syndrome. Additionally, routine prenatal blood work may be done to check for overall health and screen for certain conditions.

What are the 4 prenatal tests?

The 4 most common prenatal tests performed during your pregnancy include blood, urine, ultrasound and a pap smear. In addition to these non-invasive tests which are encouraged for all pregnancies, additional diagnostic tests which are more invasive may be performed. Your doctor will assess factors like age, medical history and personal preferences before conducting any of these tests so it’s important to talk openly with your doctor and discuss the benefits, risks and limitations of these tests in order to make an informed decision.

What are the most common prenatal diagnostic tests?

A diagnostic test differs from a screening test in that it can tell for certain whether your baby has a certain condition. Diagnostic tests are not routinely performed, but may be recommended by your doctor if screening tests show your baby is at risk of certain conditions. The most common prenatal diagnostic tests include Chorionic Villus Sampling (CVS) and Amniocentesis. A CVS test, typically performed from 11 weeks, takes a small sample of placental tissue to diagnose genetic conditions such as Down Syndrome or chromosomal abnormalities. An Amniocentesis, typically performed from 15 weeks, involves extracting a small amount of amniotic fluid to diagnose chromosomal abnormalities and genetic conditions.