Every pregnant woman in Poland has the right to free tests during pregnancy. They are mandatory (even if the pregnancy is going well) – thanks to them, the doctor can monitor the pregnancy and the development of the fetus. The list of examinations during pregnancy is established in the regulation on standards of perinatal care.
Tests that need to be performed during pregnancy are ordered by the doctor or midwife supervising the pregnancy and are reimbursed by the National Health Fund. All results are entered into the pregnancy card and constitute essential documentation of the course of the pregnancy.
Pregnancy tests – what does care for a pregnant woman look like?
The standards of perinatal care include a schedule of tests that should be performed during pregnancy. They are prescribed during visits to the gynecologist – every pregnant woman should have about 10 such visits during the 9 months. The first one should take place by the 10th week of pregnancy, and the last one in the 38th-39th week of pregnancy (or after the 40th if delivery has not occurred by then).
During each visit, the doctor examines the patient gynecologically, but also measures blood pressure, measures body weight, gives tips on a healthy lifestyle and orders a series of diagnostic tests. Every month there will be a blood and urine test, and 4 times during the pregnancy she will order an ultrasound scan. From time to time, according to the schedule, he will refer her for other genetic, laboratory, or prenatal tests. During pregnancy, it is also necessary to perform cytology and culture.
Pregnancy checkup calendar
- Tests in the first trimester of pregnancy
The specialist orders the first tests during the first visit, which should take place by the 10th week of pregnancy. After conducting an interview and performing basic tests, the doctor will take a sample for a cytological test. The doctor will also write referrals for tests, the results of which the pregnant woman should bring to the next visit. These are the following tests: urine analysis and blood collection to determine blood type and Rh factor, complete blood count, blood sugar level test, TSH test (thyroid hormone in pregnancy), tests for syphilis (VDRL), HIV and HCV, tests for toxoplasmosis and rubella. You can also ask for confirmation of the presence of a gestational sac – this test can be performed if your doctor has a pregnancy ultrasound machine in his/her office, but it is not mandatory.
During the second visit, between the 11th and 14th week of pregnancy, the doctor will order a pregnancy ultrasound, a so-called genetic test. This is a standard test that allows for the anatomical assessment of the fetus, exclusion of defects and determination of the gestational age based on the size of the baby.
- Tests in the second trimester of pregnancy
Recommended tests between weeks 15 and 20 include a blood count and a urine test. The future mother will also receive a referral for a pregnancy ultrasound, which should be performed between weeks 18 and 22. These are the so-called mid-term studies. The aim of the examination is to assess the structure of the fetus, its internal organs, including the heart and kidneys, and the weight, appearance and position of the placenta. Taking a test will sometimes make it possible to find out the baby’s gender.
Between weeks 21 and 26, your doctor will measure your blood pressure and weight as usual, and will assess your fetal heart rate. The doctor will also order laboratory tests for toxoplasmosis and a so-called glucose curve, which is an assessment of blood glucose levels after drinking 75 g of glucose on an empty stomach, 1 and 2 hours after its administration (to be done between weeks 24 and 26). This is also the time to test for anti-D antibodies in Rh (–) women, i.e. tests to prevent serological conflict.
- Tests in the third trimester of pregnancy
Necessary tests between weeks 27 and 32 include a blood count, a general urine test and a third trimester ultrasound, which allows us to assess whether the baby is developing and growing properly for its age and whether it shows any congenital defects.
During the visit between weeks 33 and 37 of pregnancy, the mother-to-be will have a vaginal and rectal culture sample taken for B-hemolytic streptococci (weeks 35–37 of pregnancy). The doctor will also assess the fetus’s movements and heart activity. At this stage of pregnancy, a complete blood count, urine test, HBs antigen (HBV) test, HIV, VDRL and HCV test should be performed.
The last visit takes place at 38-39 weeks. The obstetrician will write a referral for urine and blood tests, the results of which should be included in the hospital documentation. If delivery does not occur on time, after the 40th week it is necessary to perform CTG and ultrasound tests – they should be repeated until the end of pregnancy.
Prenatal tests reimbursed
The National Health Fund also offers non-invasive prenatal tests, i.e. more accurate blood tests, e.g. the PAPP-A test, which detects the risk of Down syndrome, Patau syndrome and Edwards syndrome. Prenatal testing for genetic and congenital defects in the first and second trimester of pregnancy is free of charge for women with risk factors, i.e. pregnant women after the age of 35 (when the risk of defects increases), those who have previously given birth to a child with a genetic disease or congenital defect, and those who had abnormal ultrasound results in the first trimester.
If problems are detected, pregnant women are also advised to undergo invasive prenatal tests, e.g. amniocentesis or cordocentesis.
