What tests do I need to take when planning a pregnancy?

Planning a pregnancy in the entire civilized world is quite normal. In recent years, there has also been a tendency in Russia to increase the number of married couples who seek to be thoroughly examined before deciding to conceive a child.

There is common sense in this, because the state of health of the baby, about which all pregnant women are so worried, directly depends on the health state and genetic characteristics of mom and dad.

If the decision is made that the family should be replenished, it's time to start planning a pregnancy. And the first step is to pass all the necessary tests. In this material we will tell you which list of surveys can be considered the most complete, and why certain studies are being carried out.

Where to go?

The husband and wife can pass the necessary tests at the clinic at their place of residence. A woman can also be examined at the antenatal clinic at her place of residence. To do this, she just needs to make an appointment with a gynecologist and tell the doctor about her desire to conceive a child.

A survey in government agencies will not be quick, the couple will have to prepare for the fact that delivery of tests will take quite a long timeMoreover, not all types of research are done free of charge.

You can initially go the other way and go to a paid medical center that specializes in pregnancy planning and management, in the family planning center, which today is in almost every city. There, the examination will take place much faster, but also more expensive.

Therefore, the question of where to undergo research before conception should be decided by the spouses, depending on the level of income of their family and the amount of free time in order to visit all the necessary specialists and pass all the tests that are required. On their basis, it will be possible to judge the state of health of men and women and their ability to conceive and bear a baby.

Sure, perfect health of both spouses in no way guarantees the birth of an absolutely healthy child, but the likelihood of unpleasant "surprises" during pregnancy is significantly reduced. Therefore, to the question of whether it is worth doing a preliminary examination, the answer is obvious - it is.

Basic tests for a woman

The expectant mother should start the examination with a visit to the gynecologist. Desirable, the same one who will subsequently observe her pregnancy right up to the birth. During this visit, the woman is waiting for a gynecological examination on a chair and drawing up her obstetric history.

During the examination, the doctor assesses the structure and size of the uterus, looks for pathologies of the cervix, takes a sample of vaginal secretions for analysis. The swab will be ready in a few days. The survey is best done after menstruation, about 10-13 days of the cycle.

The obstetric history, which the doctor will carefully write down from the woman's words, will include all gynecological diseases that she suffered at a given age, operations (including abortions, ectopic pregnancies, missed pregnancies, previous births).

Special attention is paid by the obstetrician-gynecologist to the duration and frequency of the menstrual cycle, as well as to the peculiarities of menstruation - duration, soreness, abundance, etc. childbirth.

Based on the examination and the patient's individual obstetric history, the doctor gives directions for mandatory tests and consultations with other doctors.

General blood analysis

This is the main study, which is carried out more often than other types of diagnostics. Capillary blood (from a finger) and venous blood are suitable for analysis, if the woman will take the test at the same time as other blood tests. The analysis will show the level of hemoglobin and the quantitative content of blood cells - erythrocytes, leukocytes, platelets, as well as ESR - the rate at which heavy blood cells of erythrocytes are deposited.

In the results of a general blood test, an experienced specialist will be able to see not only the facts of anemia, if any, but also the prerequisites for cancerous tumors, serious inflammatory processes, and hidden infections. The number of monocytes and granulocytes, as well as the leukocyte formula, will tell about the work of the immune system. Total a complete blood count can determine up to 24 parameters.

The analysis does not require special preparation. If he was discharged simultaneously with other blood samples, then it is better to go to the laboratory in the morning, on an empty stomach.

Blood test for group and Rh factor

Even if a woman is 100% sure of her Rh identity, and her blood type is in the passport, such an analysis is considered mandatory. For analysis, blood is taken from a vein, preliminary preparation is not required, since the group and rhesus do not depend on the food eaten the day before, they are unchanged throughout a person's life (the exception is very rare cases of chimerism, when a person's blood has signs of two groups).

The blood group is determined by the content of proteins-agglutinogens in erythrocytes and blood plasma. There are four blood groups in total.

The Rh factor is the presence or absence of a specific protein found in rhesus monkeys in a woman's blood. If there is protein, then Rh is positive; if there is no protein, Rh affiliation is defined as negative.

Rh and the group are of great importance in planning, because immunological conflicts between mother and fetus are not excluded, if a woman has a negative Rh factor, and her baby has a positive one. Less often, but it is also possible, a blood group conflict develops. Different rhesus and groups are not an obstacle to pregnancy and not a ban on conception. This is important information for the doctor who will plan how to manage this pregnancy, what to look out for.

If a woman has a negative Rh, then a similar analysis should be passed to her partner. This will allow predicting the Rh-belonging of the unborn child. If a woman has positive blood, there is no need to study the Rh-belonging of the future dad.

Blood chemistry

It requires venous blood. This laboratory test determines the presence in the blood of certain chemical compounds that can accompany various processes in the body. Its results show how internal organs function, how metabolic processes proceed.

It is this analysis that makes it possible to establish how much sugar is in the blood, and does the woman have diabetes or prerequisites for its appearance. More than a dozen other indicators are also determined - cholesterol, basic proteins, enzymes, metabolic products, ferritin.

This analysis allows you to assess how much the patient's blood is rich in calcium, phosphorus, magnesium, iron, necessary for normal bearing, as well as other substances that are important both for conception and for the subsequent course of pregnancy.

Biochemistry makes it possible to find out if a woman has inflammatory and allergic processes, sources of infections. If they are detected, before conception, you need to be treated and eliminate foci of infection.

The analysis should be taken after preliminary preparation. 2-3 days before delivery, you can not eat fatty foods, a lot of salty and spicy foods. 8 hours before the analysis, you should not eat at all. Ideally, the last time before the examination, eat in the evening, choosing low-fat foods, and in the morning on an empty stomach go to the laboratory or treatment room.

Avoid severe stress, insomnia, physical exertion for several days before the analysis, so as not to get false results. Also, alcohol intake is excluded for several days.

General urine analysis

This study is carried out in order to establish a quantitative balance of the composition of the fluid excreted by the kidneys. Its quantity, color and shade, transparency and smell can tell an experienced laboratory assistant a lot about metabolic processes and the work of the kidneys and excretory system. Kidney health is very important during pregnancy and delivery, so this simple analysis should not be neglected.

As part of the study, salts and impurities in the sediment, the amount of urea, the possible presence of blood cells and other cells, enzymes, and proteins are determined.

For research you need morning urine sample. Before collecting, a woman needs to follow all the rules of hygiene - wash herself, close the entrance to the vagina with a cotton swab to avoid getting into the sample of fluid for examining vaginal secretions, mucus, which can distort the real picture.

It is important to use for the analysis not a glass jar of honey or jam from your own kitchen, but a special container for collecting urine with a lid. You can buy it at any pharmacy.

The urine should be taken to the laboratory no later than two hours after collecting the materialotherwise a natural sediment will fall out in it, which will complicate the assessment of transparency, odor and salt formula. Before the analysis, you should not eat foods that can color the secreted liquid in different colors, for example, beets or fresh carrots.

If a woman is taking any medications or vitamins, in agreement with the doctor, they should be canceled for a while. If this is not possible, and drugs are needed for a course intake, the laboratory assistant must be informed about which drugs and in what dosage are taken. This will provide the most accurate picture of the study.

Urine for bacterial culture

This analysis makes it possible not only to find out if a woman has inflammations and infections, but also to find out what kind of pathogens are caused, in order to know exactly how to deal with a disease of the urinary system.

In the laboratory, specialists "sow" bacteria on a nutrient medium, see which ones begin to multiply after a while, and test which antibiotics can destroy the pathogen.

Urine analysis is collected in compliance with all the rules regarding the collection of a general analysis, with one important caveat. Suitable for bacterial sowing average portion of morning urine... To collect it, the woman first starts urinating into the toilet, then brings a jar and collects from 70 to 100 ml, and finishes urinating back into the toilet. A tightly closed container should be delivered to the laboratory in 1.5-2 hours.

Colposcopy and scraping from the cervix for PCR

Colposcopy is performed as a regular gynecological examination, but using a special device - a colposcope. It allows you to more closely examine the cervix, in particular the structure of its tissues. This is important in order to identify possible pathologies - shortening or lengthening of the neck, as well as erosion and oncological processes, which can greatly complicate the process of carrying a child.

A smear for PCR (polymerase chain reaction) allows, in a small amount of a substance, which is taken at the time of scraping from the cervix, to detect the genetic information of infectious agents. Most often, they try to detect the causative agents of sexually transmitted diseases in a smear - chlamydia, ureaplasma, mycoplasma. These infections, like some others detected by PCR, are classified as hidden, after all, for many years a woman may not even be aware of their presence. They have almost no symptoms.

But the harm from such infections is very tangible. During pregnancy, they often cause intrauterine fetal death, missed pregnancy, miscarriage, intrauterine infection, due to which the child is born with serious defects, premature birth.

A smear is taken both from the cervix and from the cervical canal, it is not painful or scary, as many women think. Preparation for the analysis requires refraining from going to the toilet and emptying the bladder three hours before the study.

If necessary, stop taking antibiotics a week before testing. If this is not possible, it is better to postpone the analysis to another time. It is best to do the research in the middle of the menstrual cycle. 3-4 days before visiting a gynecologist, you should not use local vaginal contraceptives (suppositories, cream, vaginal tablets).

Sex, douching should be no later than one and a half days before the smear. After colposcopy, you should wait a few days, and only after that you can go for a PCR smear.

Ultrasound of the pelvic organs and mammary gland

Ultrasound examination is considered one of the most informative in a comprehensive examination. It can be performed in three ways - intravaginally (with a vaginal probe), intrarectally (through the rectum) or transabdominal - through the anterior abdominal wall.

Usually, doctors use a vaginal ultrasound scan when they are planning a pregnancy. It will allow you to assess the uterine cavity, its size, appendages, ovaries, cervix, identify possible pathologies - cyst, fibroids, tumors, multicystosis, etc.

Ultrasound will also be of great help in planning conception after long unsuccessful attempts to become pregnant - using ultrasound waves, ovulation can be tracked with great accuracy - the most favorable moment for conception.

When undergoing an ultrasound by the vaginal method, a woman should come to the doctor's office with an empty bladder. For better visualization with transabdominal ultrasound, it is recommended to fill the bladder after drinking about a liter of liquid. If there is a large accumulation of gas in the intestines, the swollen loops can press on the pelvic organs, and the result will be distorted.

Therefore, it is recommended to give up carbonated drinks, legumes, baked pastries from yeast dough, wine a couple of days before the examination in order to exclude increased gas formation.

On the day of the examination, a few hours before visiting the doctor's office it is advisable to take medications that promote the release of gases, for example, "Espumisan", activated carbon, "Simetikon", "Smectu". The study does not need to be carried out during the period of menstruation, it will be good if the diagnosis is carried out after them. When tracking ovulation, an ultrasound scan may be required 3-5 times a month.

An ultrasound examination of the mammary glands will allow to establish possible pathologies - mastopathy, cysts, lipomas, cancer. No special preparation is required before the procedure, it is only important to know that ultrasound is most reliable on certain days of the menstrual cycle.

It is best to go to a diagnostic doctor in the first half of the cycle, immediately after the completion of the next menstruation. It is during the pre-ovulation period that the ducts of the mammary gland are most clearly visible. therefore The best period is from 5-6 to 12-14 days of the cycle.

Other blood tests

On TORCH infection

Blood on TORCH - infections are taken from a vein. Behind the complex Latin abbreviation are four well-known infections. T - toxoplasmosis, R - rubella, C - cytomegalovirus infection, H - herpes. The letter "O" at the beginning of the abbreviation denotes other infections, which include syphilis, hepatitis B and C, chickenpox.

During the analysis, the presence of antibodies to the causative agents of these infections is determined. If a woman is now sick, the disease is in an acute stage, even if the symptoms have not yet appeared, then IgM antibodies will be found in her blood.

If she has ever been ill, for example, with chickenpox or toxoplasmosis, then her body is already familiar with such pathogens, there is a stable lifelong immunity. It is determined by the detection of IgG antibodies.

Most of these diseases are dangerous for pregnant women in the acute stage. If a woman has already been ill, and now only antibodies are found in her, indicating the presence of immunity, but this does not pose any danger for the future planned child. Moreover, the mother will definitely pass on these protective antibodies to the baby.

If the absence of antibodies of all types to a particular infection is found, this indicates that the woman has not previously had it, and the risks of getting sick already during pregnancy are higher.

Rubella, toxoplasmosis, cytomegalovirus can cause the death of a child in utero, the birth of a child with developmental defects (deafness, blindness, problems with the formation of internal organs, etc.), not caused by genetic factors.

If no antibodies to infections are detected, you need to consult with an infectious disease specialist before becoming pregnant. He will give advice on how to protect yourself from these dangerous ailments.

For HIV status

It is necessary to pass such an analysis in order to identify the immunodeficiency virus in women. If done early on, antiretroviral treatment will work well. Despite the fact that HIV is considered incurable, such a woman will be able to bear and give birth to a completely healthy normal child.

Pregnancy with HIV infection will require special management, taking certain medications that will protect the child from contracting the infection, special tactics during childbirth.

Therefore, a positive HIV status is not yet a sentence stating that a woman cannot have offspring. The incubation period of the disease is long, and therefore it is recommended to do the analysis several times - six months, three months before conception, immediately after pregnancy and several times during the period of bearing a child.

For syphilis

Even if a woman is sure that she could not become infected with syphilis, because she remains faithful to her sexual partner, the analysis will still have to be done. If only for the reason that this sexually transmitted disease is transmitted not only sexually, but also by household, contact.

Antibodies to syphilis are determined by various methods and methods, it is not worth going into particular. It is important to remember that, as in the case of HIV, it is necessary to test for syphilis several times, given the long incubation period.

Blood is usually taken at the same time as sampling for HIV; laboratory research technology allows the collection of a woman's venous blood material at a time for two analyzes in one tube.

For hepatitis B and C

Infectious hepatitis may not manifest itself in any way for a long time, and a woman can be sure that she just had the usual flu.

For pregnant women, viral hepatitis is extremely dangerous, they can lead to termination of pregnancy at any time, impaired liver function, and serious blood disorders. Therefore, at the time of planning pregnancy it is very important to know for sure whether a woman has had such hepatitis, whether she has them now.

A blood test is taken from a vein. Requirements for it are similar to those for biochemical research. A woman should not eat fatty foods, drink alcohol and antibiotics 3-4 days before donating blood, should not be nervous and subject herself to heavy physical exertion. You should come to the laboratory on an empty stomach.

Comprehensive coagulation study

This is a whole complex of tests that allows you to identify the ability of blood to clot. Too "liquid" blood, in which the clotting time increases, threatens to result in severe bleeding and total blood loss during childbirth, as well as profuse internal bleeding during the period of gestation.

Too "thick" blood with a large number of platelets is dangerous for thrombophilia, thrombosis. In addition, the baby during pregnancy will receive less nutrients due to the violation of the uteroplacental blood flow.

A comprehensive blood test is called coagulograms. The blood coagulation time, prothrombin level, platelet count, fibrinogen are mandatory. Each indicator in combination with other indicators will give the most complete picture of how hemostasis proceeds - how blood clots are formed to prevent bleeding and how they subsequently dissolve so that the vessels become clean.

When a woman deviates from the norms it is recommended to visit a hematologist - a specialist in blood diseases, to undergo preliminary treatment, and only then to start conceiving a child.

The fact is that most of the problems with hemostasis are perfectly solved by medicines, which are contraindicated during pregnancy. Therefore, it is better to undergo treatment before the onset of an “interesting situation”.

Medical consultations

Among the doctors that a woman will visit before conceiving a child, there are such specialists:

dentist;
ENT;
optometrist;
cardiologist;
allergist;
therapist.

These doctors must pass their verdict on the state of health of a woman who will have to carry a baby and give birth for nine months. So, some diseases of the organs of vision are a contraindication for natural childbirth, and constant sources of infection in the mouth or in the ear-throat-nose system can greatly complicate the course of pregnancy itself.

The health of the heart and blood vessels is of great importance. In addition, a woman at the time of conception must know exactly her “non-pregnant” weight, blood pressure level and the presence of all chronic diseases.

Basic tests for men

Despite the fact that the woman has to bear the fetus, and quite reasonable high requirements are imposed on her body, some analyzes at the planning stage must also be passed to the man, because he is directly involved in conception, giving exactly half of the genetic information to the child with his sperm, including , and about existing diseases. If there are no problems with conception, the couple is not in a multi-year planning, then the list of studies for a man is small:

general blood analysis;
general urine analysis;
blood per group and Rh factor (if a woman has a negative Rh factor);
blood test for TORCH infection;
blood test for genital infections;
tests for HIV, hepatitis and syphilis.

Additional examinations

To clarify some situations related to the state of health of the spouses, additional tests are sometimes prescribed. They are especially relevant if the spouses cannot get pregnant for a long time without contraception, or there were miscarriages, ectopic and non-developing pregnancies in the early stages.

Hormonal blood tests in women

Blood from a vein for the study of hormonal levels is taken on an empty stomach, before this, a woman should stop taking any hormonal drugs, including contraceptives, in advance, and also limit nervous stress, excessive physical exertion (if a woman is involved in professional sports, for example). Before taking the test, you must not take alcohol and smoke.

A woman is determined concentration of hormones important for conception and gestation, including female reproductive hormones:

progesterone;
estradiol;
FSH - follicle-stimulating hormone;
LH - luteinizing hormone;
prolactin;
thyroid hormones - TSH, thyroxine (T4), triiodothyronine (T3).

An analysis of hormones when planning pregnancy and without suspicion of infertility can be prescribed to women who have already turned 35 years old, whose menstrual cycle is not regular, often "failures", as well as women with obesity, profuse acne, excessive male hair growth. type, etc.

Unfortunately, most antenatal clinics do not provide hormone tests free of charge. Therefore, most of the hormones from this list are determined only for a fee in the laboratories of private clinics and family planning centers.

Blood test for hormones is given on a certain day of the cycle. So, FSH is taken on the 3-5th day of the cycle, LH - on the 3-8 or 21-23 days, prolactin on the 3-5 or 19-21 days, estradiol - on the 4-8 days, progesterone - on the 6-8 days after ovulation.

Blood for hormones in men

A man is given a referral for a hormonal blood test if he has a suspicion of male infertility. Like a woman, the blood of the stronger sex is determined by:

FSH;
LH;
prolactin;
estradiol.

Additionally, future dads measure the concentration of testosterone - the male sex hormone.

Spermogram in men

Analysis of the ejaculate allows you to establish the mobility of spermatozoa, their quantity, quality, viability. It is on these characteristics of male sex cells that the likelihood of quick and high-quality fertilization depends.

Before handing over material to a man you should refrain from sexual intercourse for 2-3 days. You can collect sperm both in the laboratory by masturbation, and at home, with your wife, through the usual sexual intercourse. The condom is dispensed in a laboratory and does not contain lubricants or other substances that can affect sperm cells. In a maximum of an hour, the material must be delivered to the laboratory for research in a special thermal container.

A week before the analysis, a man should not take alcohol, drugs, go to a bathhouse, a sauna, sunbathe in the sun for a long time, or overheat.

Genetic screening

Before conception, it is worth visiting a geneticist for couples who already have children born with pathologies, as well as for men and women who have love with chromosomal pathologies in their relatives, for example, Down's disease.

It also makes sense to determine the karyotype of the spouses if they are going to conceive a child after the age of 36, if they have previously had unsuccessful pregnancies - miscarriages, non-developing pregnancies. The reason for this sad outcome is often extra or missing chromosomes in the baby's genetic makeup.

If a couple cannot get pregnant for a long time, despite the fact that all their tests are good, hormones are normal, there are no diseases or infections, then a geneticist can check the compatibility of the spouses.

A compatibility test is a blood sampling from a vein from expectant mothers and fathers. Results are usually available in 2-3 weeks. Even if the analysis shows that there is no compatibility, it should not be a tragedy. Special courses of immunocytotherapy will allow to overcome the natural barrier, in which the woman's body does not perceive the fetus, if compatible, as pregnancy, but as a tumor.