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. Pregnancy tests provide information about a woman’s body, its condition and possible health problems.
Tests during pregnancy are ordered by the doctor or midwife supervising the pregnancy, whose care the pregnant woman uses under the National Health Fund. All results are entered in the pregnancy card.
Pregnancy tests – what tests are mandatory?
According to the standards of perinatal care, every pregnant woman must undergo a series of non-invasive tests. The following tests are spread over 9 months: the first one should be performed by the 10th week of pregnancy, and the last one after the 40th week if delivery has not occurred by then.
Tests at the beginning of pregnancy are performed up to the 10th week during the first visit to the gynecologist during pregnancy. The doctor will conduct an interview, examine the patient gynecologically, take a sample for a cytological test, measure blood pressure, weigh her, and provide recommendations for a healthy lifestyle. He or she will also order mandatory tests, the results of which the pregnant woman should bring to the next visit. These will include urine tests and blood sampling to determine blood type, a complete blood count, a sugar level test, TSH (thyroid hormone) testing, tests for syphilis (VDRL), HIV and HCV, toxoplasmosis and rubella. If your doctor has an ultrasound machine in his/her office, he/she can confirm pregnancy with a photo of the gestational sac – this first test during pregnancy is not mandatory.
During the second visit between the 11th and 14th week of pregnancy, the doctor will review the results, examine the patient, and 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.
The visit between weeks 15 and 20, in addition to measuring weight and blood pressure, will bring referrals for another blood count and 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 the test will make it possible to eventually find out the baby’s gender.
Between weeks 21 and 26, in addition to a traditional gynecological examination and blood pressure and weight measurements, a woman must also undergo laboratory tests for toxoplasmosis and perform a so-called sugar curve, i.e. an assessment of blood glucose levels after drinking 75 g of glucose on an empty stomach, 1 and 2 hours after its administration. This test should be performed between 24 and 26 weeks of pregnancy. This is also the time to test for anti-D antibodies in Rh (–) women, i.e. tests to prevent serological conflict. During the visit, the doctor will also assess the fetal heart function.
Between weeks 27 and 32, a blood count, a general urine test, and a third-trimester ultrasound scan are performed to assess whether the baby is developing and growing properly for its ageand whether it has any congenital defects.
During a visit between weeks 33 and 37, the doctor will measure blood pressure and body weight, and will assess fetal movements, among other things. At this stage of pregnancy, it is important to assess the baby’s heart function and to take a sample for vaginal and rectal culture for B-hemolytic streptococci (35–37 weeks of pregnancy). Other referrals for tests during pregnancy include a complete blood count, urinalysis, HBs antigen (HBV), HIV, VDRL and HCV tests.
The last visit should take 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 delivery documentation. If delivery does not occur on time, after the 40th week it is necessary to perform CTG and ultrasound examinations – these should be repeated until the end of pregnancy.
Prenatal tests after the age of 35
The National Health Fund also offers prenatal tests, i.e. more precise blood tests, e.g. the PAPP-A test, which detects the risk of genetic defects in the fetus, including Down syndrome, Patau syndrome and Edwards syndrome. These tests should be performed in the first and second trimester of pregnancy. The tests are free of charge for women with risk factors, i.e. after the age of 35, when the risk of defects increases, for women 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 tests, such as amniocentesis (collection and assessment of amniotic fluid) or cordocentesis, which involves taking blood from the umbilical vein.
