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Pregnancy: First Prenatal Visit

Topic Overview

Your first prenatal visit is likely to be more extensive than later prenatal checks. Your doctor will take your medical history and do a complete physical exam.

Medical history

Your medical history helps your doctor plan the best possible care for your pregnancy and childbirth. It includes:

  • Your menstrual history, including your age when menstruation started, whether your cycles are regular, and the date of your last menstrual period.
  • Your reproductive history. This includes:
    • Any previous pregnancies, abortions, miscarriages, or stillbirths.
    • Problems with previous pregnancies.
    • Any problems with reproductive organs.
  • Family health conditions, such as heart disease or genetic defects.
  • Your general health, including vaccinations, surgeries, and serious illnesses you have had.
  • Tobacco or other substance use.

Physical exam

Your complete physical exam will include:

  • Weight and blood pressure measurement.
  • A pelvic examination to confirm the pregnancy.
  • A Pap smear (if not done recently).

Urine tests

A urine test can check for:

Blood tests

Blood testing may include:

  • Blood typing (A, B, or O, and Rh factor). If you are Rh-negative and the father is Rh-positive, your fetus may have Rh-positive blood, which can lead to problems with Rh sensitization. For more information, see the topic Rh Sensitization During Pregnancy.
  • Complete blood count (CBC), which checks hemoglobin and hematocrit to make sure you don't have iron deficiency anemia.
  • Checking for immunity to German measles (rubella).
  • Checking for the sexually transmitted infection syphilis. This blood test is called a venereal disease research laboratory (VDRL) test. The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend that all pregnant women be screened for syphilis early in pregnancy.1, 2
  • Testing for the human immunodeficiency virus (HIV). Early detection and treatment lowers the chance that the baby will get HIV from the mother. The U.S. Preventive Services Task Force and U.S. Centers for Disease Control and Prevention recommend that all pregnant women be screened for HIV infection to help prevent fetal infection.3, 4

You may also be screened for:

  • Hepatitis B. If you have a hepatitis B infection, your baby will receive the hepatitis vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth.
  • Diseases that are passed down through families (genetic disorders). Screening tests for genetic disorders include those for:
  • Sexually transmitted infections (STIs). STIs during pregnancy have been linked to miscarriage, premature birth, low birth weight, and stillbirth. Many doctors routinely test for the sexually transmitted infections gonorrhea and chlamydia. If test results show that you have an STI, your doctor will discuss treatment with you.
  • Thyroid disease. Many women have thyroid tests done if they have a personal or family history of thyroid problems.

Related Information

References

Citations

  1. Centers for Disease Control and Prevention (2010). Syphilis section of Sexually transmitted diseases treatment guidelines, 2010. MMWR, 59(RR-12): 26–39. Also available online: http://www.cdc.gov/std/treatment/2010/default.htm.
  2. U.S. Preventive Services Task Force (2009). Screening for syphilis infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement. Annals of Internal Medicine, 150(10): 705–709.
  3. American Academy of Pediatrics, American College of Obstetricians and Gynecologists (2007). Human immunodeficiency virus section of Perinatal infections. In Guidelines for Perinatal Care, 6th ed., pp. 316–320. Elk Grove Village, IL: American Academy of Pediatrics.
  4. U.S. Preventive Services Task Force (2013). Screening for HIV: U.S. Preventive Services Task Force recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspshivi.htm.

Other Works Consulted

  • American Academy of Pediatrics, American College of Obstetricians and Gynecologists (2007). Antepartum care. In Guidelines for Perinatal Care, 6th ed., pp. 83–137. Elk Grove Village, IL: American Academy of Pediatrics.
  • U.S. Preventive Services Task Force (2004). Screening for Rh (D) incompatibility. Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdrhi.htm
  • U.S. Preventive Services Task Force (2006). Screening and supplementation for iron deficiency anemia. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsiron.htm.
  • U.S. Preventive Services Task Force (2008). Screening for asymptomatic bacteriuria in adults: U.S. Preventive Services Task Force reaffirmation recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbact.htm.
  • U.S. Preventive Services Task Force (2009). Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. Preventive Services Task Force reaffirmation recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspstbac2.htm.
  • U.S. Preventive Services Task Force (2009). Screening for hepatitis B virus infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement. Annals of Internal Medicine, 150(12): 869–874.

Credits

By Healthwise Staff
Sarah Marshall, MD - Family Medicine
Kirtly Jones, MD - Obstetrics and Gynecology
Last Revised October 7, 2013

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