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The results of the blood test are then combined with the NT ultrasound measurements, maternal age, and gestational age of the fetus to yield a risk score for Down syndrome, trisomy 18, and trisomy 13. First Trimester Combined Test has a sensitivity (i.e. detection rate for abnormalities) of 82–87% and a false-positive rate of around 5%. [73] [74]
[13] [14] Blood typing would also detect maternal blood, as the I antigen only occurs in adults. [12] The Kleihauer–Betke test can detect very small amounts of maternal blood before the third trimester of pregnancy by monitoring hemoglobin elution in acid because adult and fetal hemoglobin elute differently in acid. [12]
Noninvasive prenatal testing (NIPT) is a method used to determine the risk for the fetus being born with certain chromosomal abnormalities, such as trisomy 21, trisomy 18 and trisomy 13. [1] [2] [3] This testing analyzes small DNA fragments that circulate in the blood of a pregnant woman. [4]
Blood and urine tests can detect pregnancy by 11 and 14 days, respectively, after fertilization. [77] [78] Blood pregnancy tests are more sensitive than urine tests (giving fewer false negatives). [79] Home pregnancy tests are urine tests, and normally detect a pregnancy 12 to 15 days after fertilization. [80]
Routine tests in the first trimester of pregnancy generally include: Complete blood count; Blood type. Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. Indirect Coombs test (AGT) to assess risk of hemolytic disease of the newborn [5] Rapid plasma reagin test to screen for syphilis; Rubella antibody screen [6]
There is a multilevel urine pregnancy test (MLPT) that measures hCG levels semiquantitatively. The hCG levels are measured at <25, 25 to 99, 100 to 499, 500 to 1999, 2000 to 9999, and >10,000 mIU/mL. This test has utility for determining the success of medication abortion. [13] [14] Single intrauterine pregnancy, first trimester.
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Obstetric causes of first trimester bleeding include the following: Early pregnancy loss is a term often used interchangeably with spontaneous abortion and miscarriage and refers to pregnancy loss during the first trimester. [7] It is the most common cause of early pregnancy bleeding and is associated only with heavy (versus light) bleeding. [8]
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