First trimester blood test
In the first trimester of pregnancy you will be advised to have bloodwork done. Your midwife will either draw the blood herself at your first appointment or give you a form to take to our SHO laboratory to have the blood test. Your blood will only be tested with your consent. It is best to have the results before the 13th week of the pregnancy so that there is ample time for action if needed. This bloodwork is free of charge.
If you also want the NIPT done both blood samples can be drawn at our laboratory in one go.
Your blood will be tested for:
- Level of iron
- Blood type: O, A, B or AB
- Rhesus D and Rhesus c blood type
- Antibodies to foreign blood types (irregular antibodies)
- Syphilis
- Hepatitis B
- HIV
- Level of glucose, only on personal indication
Level of Iron
A low iron level could indicate anemia. Your iron level will also be checked later in pregnancy. Weariness and dizziness can be signs of anemia. This condition is quite common during pregnancy and can be treated by diet and/or medication.
Blood type
Your ABO blood type is only relevant in the rare case of severe bleeding during or after the delivery for which a blood transfusion is necessary. To be on the safe side the blood type of all pregnant women is tested. The possible blood types are O, A, B or AB. The blood type is in your genetics, just like your eye colour. During pregnancy we test for two specific other blood type factors: the Rhesus D and the Rhesus c factor for which you can be either positive or negative.
Blood type Rhesus-D-factor
During pregnancy there is a tiny chance of transfusion of fetal bloodcells into the mothers bloodstream. At the birth, especially of the placenta, this chance is much higher. If blood of a Rhesus D positive baby reaches the bloodstream of a Rhesus D negative mother this mothers immune system can produce antibodies against Rhesus D positive blood. These antibodies can travel through the placenta and umbilical cord into a babies bloodstream were they can break down the red blood cells. This could cause anemia in the baby in this, or a future, pregnancy. That is why the Rhesus D blood type will be checked.
The Rhesus D blood type can be either positive ( in 84% of people) in which case no further action is required, or negative (in 16% of people). If your blood type is Rhesus D negative your blood will be drawn again in week 27 of your pregnancy. It will be checked for antibodies and the Rhesus D blood type of your baby will be determined. This is possible because small amounts of the babies DNA material are present in your blood during pregnancy. If the baby has a Rhesus D positive blood type you will receive an injection with antibodies in week 30 to prevent your immune system from producing antibodies in the case of a transfusion. The baby will not be affected by these antibodies. After the delivery you will receive another injection of antibodies because the chance of a transfusion is greater during and immediatly after the birth. This injection will prevent you from producing antibodies that could harm a baby in a future pregnancy. There are also some other obstetric situations in which you will be given an injection of antibodies against Rhesus D positive blood. In the case that your baby also has a Rhesus D negative blood type no further action is required.
Rhesus c blood type
About 18% of all women have a Rhesus c negative blood type. In the rare case of a transfusion from baby (with a Rhesus c positive blood type) to mother the mothers immune system could produce antibodies against Rhesus c positive blood. These antibodies could then cause anemia in the baby. Pregnant women with a Rhesus c negative blood type will be tested for antibodies in week 27 of the pregnancy. If antibodies are detected further testing and monitoring of the babies condition will be performed. More information on this will be given to you by your midwife.
Other antibodies to foreign blood types
In rare cases women have produced antibodies against a foreign blood type during a previous pregnancy or after a blood transfusion. These antibodies could harm the babies health by breaking down its blood cells. If such antibodies are found in your blood there will be further testing to see which type of antibodies they are and what risk they pose. Your midwife will inform you about this.
For more information on, so called, irregular antibodies visit www.rivm.nl or www.nvog.nl to download the information booklet ‘bloedgroep, rhesusfactor en irregulaire antistoffen’
Syphilis
Syphilis, also named lues, is a sexually transmitted disease. You can be infected with Syphilis without noticing anything. To prevent infection of the baby during pregnancy it is important to determine whether you have the disease as early as possible. Syphilis can be treated by a gynaecologist with antibiotics so that the baby will not be affected. Because Syphilis can be a chronic disease the fact that you carry it will have consequences for your social life. It is important to take precautions so that you will not infect your partner and/or other family members. The GGD will be involved to help you with this change in your life. The result could also have consequences for insurance or mortgage contracts.
Hepatitis B
Hepatitis B is an infection of the liver caused by the Hepatits B virus. It is mostly transferred as a sexually transmitted disease but can also be transferred through blood to blood contact. You can be infected with this virus without noticing any symptoms. This infection can heal spontaneously but a percentage of people will carry the virus for life. This last group will stay infectious to others. When you carry the Hepatitis B virus this will have no consequences for your baby during the pregnancy. But during or after the delivery there is a chance that the baby will get infected. Therefore the baby will receive an injection with Hepatitis B immunoglobulin within two hours of birth to protect it against the virus. After that it is important that the babies immune system produces antibodies against the virus to protect it from future infection. Vaccinations will be given to the baby within the first 48 hours and at the age of 2, 3, 4 and 11 months. For more information on Hepatitis B and pregnancy visit www.rivm.nl.
If you carry the Hepatitis B virus this will have consequences for your social life. It is important to take precautions so that you will not infect your partner and/or other family members. The GGD will be involved to help you with this change in your life. The result could also have consequences for insurance or mortgage contracts.
HIV/Aids
Hiv is the virus that can cause Aids. This virus is mostly transferred as a sexually transmitted disease but can also be transferred through blood to blood contact. HIV can be transferred to the baby during pregnancy, delivery or breastfeeding. The chance of infecting the baby can be greatly reduced by treatment with anti viral medication during pregnancy. That is why it is useful to have HIV tested early in the pregnancy. When the test is positive for HIV you carry the virus for life. In that case you will be transferred to a specialised HIV centre for optimal medical assistence during your pregnancy.
If you carry HIV this will have consequences for your social life. It is important to take precautions so that you will not infect your partner and/or other family members. The GGD will be involved to help you with this change in your life. The result could also have consequences for insurance or mortgage contracts.
For more information on HIV/Aids visit www.soaaids.nl or www.hivnet.org