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Imaging
A dating scan at 12 weeks.
Imaging is another important way to monitor a pregnancy. The mother and fetus are also
usually imaged in the first trimester of pregnancy. This is done to predict problems with
the mother; confirm that a pregnancy is present inside the uterus; estimate the gestational
age; determine the number of fetuses and placentae; evaluate for an ectopic pregnancy
and first trimester bleeding; and assess for early signs of anomalies.

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Induction is a method of artificially or prematurely stimulating labour in a woman.
Reasons to induce can include pre-eclampsia, placental malfunction, intrauterine growth
retardation, and other various general medical conditions, such as renal disease. Induction
may occur any time after 34 weeks of gestation if the risk to the fetus or mother is greater
than the risk of delivering a premature fetus regardless of lung maturity.

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Third trimester
* Hematocrit (if low, mother will receive iron supplementation)
* Glucose loading test (GLT) - screens for gestational diabetes; if > 140 mg/dL, a glucose
tolerance test (GTT) is administered; a fasting glucose > 105 mg/dL suggests gestational
diabetes.
Most doctors do a sugar load in a drink form of 50 grams of glucose in cola, lime or
orange and draw blood an hour later (plus or minus 5 minutes) ; the standard modified
criteria have been lowered to 135 since the late 1980s

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Examination
Gynaecology is typically considered a consultant specialty. In some countries, women
must first see a general practitioner (GP; also known as a family practitioner (FP)) prior
to seeing a gynaecologist. If their condition requires training, knowledge, surgical
technique, or equipment unavailable to the GP, the patient is then referred to a
gynaecologist. In the United States, however, law and many health insurance plans
allow/force gynaecologists to provide primary care in addition to aspects of their own
specialty. With this option available, some women opt to see a gynaecological surgeon
for non-gynaecological problems without another physician's referral.
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Other tools used for assessment include:
* Fetal karyotype can be used for the screening of genetic diseases. This can be obtained
via amniocentesis or chorionic villus sampling (CVS)
* Fetal hematocrit for the assessment of fetal anemia, Rh isoimmunization, or hydrops
can be determined by percutaneous umbilical blood sampling (PUBS) which is done by
placing a needle through the abdomen into the uterus and taking a portion of the
umbilical cord.
* Fetal lung maturity is associated with how much surfactant the fetus is producing.
Reduced production of surfactant indicates decreased lung maturity and is a high risk
factor for infant respiratory distress syndrome. Typically a lecithin:sphingomyelin ratio
greater than 1.5 is associated with increased lung maturity.
* Nonstress test (NST) for fetal heart rate
* Oxytocin challenge test

First trimester
* Complete blood count (CBC)
* Blood type
* General antibody screen (indirect Coombs test) for HDN
*Rh D negative antenatal patients should receive RhoGam at 28 weeks to prevent Rh
disease.
* Rapid plasma reagent (RPR) which screens for syphilis
* Rubella antibody screen
* Hepatitis B surface antigen
* Gonorrhea and Chlamydia culture
* PPD for tuberculosis
* Pap smear
* Urinalysis and culture
* HIV screen
* Group B Streptococcus screen – will receive IV penicillin or ampicillin (it is much
cheaper and has a wider coverage)if positive (if mother is allergic, alternative therapies
include IV clindamycin or IV vancomycin)

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