II. Initial Labs: General
- Complete Blood Count
- Urine sample
- Blood Type
- Rubella Antibody
- MMR contraindicated during pregnancy
- Administer postpartum MMR if negative
- Screen prior to pregnancy and immunize if negative
- Syphilis Serology (RPR)
-
Hepatitis B Surface Antigen (HBsAg)
- If at risk, Hepatitis B Vaccine (safe in pregnancy)
-
Hepatitis C Antibody
- ACOG recommends screening as part of Prenatal Labs
- Pelvic Exam Initial Labs
- HIV Test
- Consider Thyroid Stimulating Hormone (TSH) in all women
III. Initial Labs: Specific risk factor directed tests
-
Group B Streptococcus Culture
- Culture both vagina and anus
-
Sickle Cell Anemia or Sickle Cell Trait screen
- Predisposes to Pyelonephritis
- Glucose Challenge Test (50 g Glucola drink)
- Hepatitis C Antibody
- If no maternal history of Varicella infection
- Obtain varicella zoster IgG and if negative
- Avoid Varicella exposure
- If exposed, consider varicella Immunoglobulin
- Offer postpartum Varicella Vaccine
- Wait 3 months after last RhoGAM shot
- Varicella Vaccine is contraindicated in pregnancy
- Screen prior to pregnancy and immunize if negative
- Obtain varicella zoster IgG and if negative
IV. Second Trimester Labs: 16-18 weeks
- See Triple Analyte Screen
- Consider first trimester screening of trisomy 16, 18
- Urine Culture
V. Third Trimester Labs: 26-28 weeks
- Glucose Challenge Test (50 g Glucola drink)
- Hemoglobin
- If Rh Negative mother
- If mother at risk for Sexually Transmitted Disease (e.g. incarceration, multiple sex partners, Illicit Drug use)
- Repeat RPR for Syphilis Testing
- Repeat Gonorrhea Culture or Gonorrhea Antigen
- Repeat Chlamydia Antigen
- Repeat Hepatitis B Surface Antigen (HBsAg)
- Repeat HIV Test
- If high risk for Preterm Labor
- Consider Bacterial Vaginosis screening
- Consider Fetal Fibronectin
VI. Third Trimester Labs: 35-37 weeks
- Group B Streptococcus screening