Monitoring and blood tests during pregnancy

During the period when she is carrying a child, a woman's body undergoes significant changes, including the restructuring of hematological indicators under the influence of hormonal factors. To monitor the health of the future mother and the fetus, obstetricians and gynecologists regularly prescribe a general blood test during pregnancy, the results of which are compared to established norms. This test is performed three times during the gestation period.

Blood Test During Pregnancy

The first test should be done at the beginning of the pregnancy, during the first trimester. It includes all mandatory serologies (toxoplasmosis, rubella, hepatitis, HIV…) as well as a blood type if it is not known. A complete blood count is also typically performed to evaluate potential anemia and a fasting glucose test to screen for potential diabetes. The doctor directs the future mother to biochemical and general blood tests (CBC), including the determination of platelet count and hematocrit. The CBC is repeated at 29 weeks. If there are medical indications, this analysis can be scheduled at any stage of the pregnancy.

Main Elements of the Blood Analysis

• Red blood cells (erythrocytes) contain hemoglobin, responsible for transporting oxygen throughout the body. An increased concentration of red blood cells may indicate dehydration caused by digestive disorders, vomiting, or excessive sweating in hot weather. Conversely, a decrease in the number of red blood cells signals the presence of anemia, iron, and folic acid deficiency.
• Reticulocytes are young forms of red blood cells. Their sudden increase in a pregnant woman who is not undergoing treatment for iron deficiency anemia may indicate diseases such as malaria or hemolytic anemia.
• Hemoglobin is one of the key indicators in blood tests. During pregnancy, slight fluctuations in its levels are possible depending on the trimester. However, a significant decrease in hemoglobin can lead to the development of fetal hypoxia and increase the risk of premature birth.
• Hematocrit reflects the ratio of red blood cells to total blood volume. Monitoring this indicator is important as it allows for the assessment of the severity of anemia and any deviations from the norm.
• Platelets play a key role in the blood coagulation process. A low platelet count may indicate a high risk of blood loss during childbirth, while a high count indicates the possible development of thrombosis.
• White blood cells have a protective function and participate in fighting viral and infectious diseases. If the white blood cell count in a pregnant woman's blood exceeds the norm, it may indicate the presence of an infection. Conversely, a low count indicates a deficiency in vitamins, trace elements, and weakened immunity. White blood cells are divided into basophils, eosinophils, neutrophils, and monocytes, each of these groups fulfilling specific functions.
• The erythrocyte sedimentation rate (ESR) is determined by the protein composition of the blood plasma and changes during pregnancy. However, an excessively high erythrocyte sedimentation rate may be a sign of inflammation or infectious disease in the mother.

Blood Tests Before IVF

To prepare for in vitro fertilization (IVF), women are prescribed a series of blood tests, including:

• Complete blood count (CBC);
• Biochemical blood analysis;
• Blood type and Rh factor analysis;
• Blood coagulation test: prothrombin time (PT) and activated partial thromboplastin time (aPTT);
• Hormonal profile (FSH, LH, estradiol, progesterone, prolactin, testosterone, AMH, TSH, T3, T4);
• Tests for infectious disease screening (HIV, syphilis, hepatitis B and C, TORCH infections);
• Rubella antibody screening;
• Glucose tolerance test (if indicated);
• Coagulation tests (D-dimer, fibrinogen, ACTH);
• Antibodies against chlamydia, mycoplasma, ureaplasma (if indicated).

Sample Collection

For a general blood test in pregnant women, the sample is taken from the finger. The analysis should be performed in the morning on an empty stomach. The day before the analysis, it is advisable to avoid physical exertion, stress, hypothermia, and overheating, as these factors can affect the accuracy of the laboratory study results.