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Two Bear Midwifery Service, LLC
“E mbracing Families, Promoting Wellness”
Lab Work in Pregnancy
INITIAL PRENATAL LAB WORK- Required by Alaska State Law for CDMs
OB Panel includes: CBC, Blood type, Rh factor, and antibody screening, Rubella
immunity, Hepatitis B Screening and Syphilis Screening
Complete Blood Count A complete blood count (CBC) gives important information about the
kinds and numbers of cells in the blood, especially red blood cells, white blood cells, and platelets. A
CBC test usually includes:
• White blood cell (WBC, leukocyte) count. White blood cells protect the body against
infection. If an infection develops, white blood cells attack and destroy the bacteria, virus, or
other organism causing it. White blood cells are bigger than red blood cells but fewer in number.
When a person has a bacterial infection, the number of white cells rises very quickly.
• Red blood cell (RBC) count. Red blood cells carry oxygen from the lungs to the rest of the
body. They also carry carbon dioxide back to the lungs so it can be exhaled. If the RBC count is
low (anemia), the body may not be getting the oxygen it needs. If the count is too high (a
condition called polycythemia), there is a chance that the red blood cells will clump together and
block tiny blood vessels (capillaries). This also makes it hard for your red blood cells to carry
oxygen.
• Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space
(volume) red blood cells take up in the blood. The value is given as a percentage of red blood
cells in a volume of blood. For example, a hematocrit of 38 means that 38% of the blood’s
volume is made of red blood cells. Hematocrit and hemoglobin values are the two major tests
that show if anemia or polycythemia is present.
• Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen
and gives the blood cell its red color. The hemoglobin test measures the amount of hemoglobin
in blood and is a good measure of the blood’s ability to carry oxygen throughout the body.
• Platelet (thrombocyte) count. Platelets (thrombocytes) are the smallest type of blood cell.
They are important in blood clotting
Blood Type It is important to know your blood type in pregnancy. Blood type is based on particular
molecules that sit on the surface of red blood cells. People either have A antigens (type A blood), B
antigens (type B), both (type AB) or neither (type O) on their red blood cells. When it comes to Rh
factor, some people have the antigen (Rh-positive) and some people don’t (Rh-negative.) In other
words, your blood type identifies which antigens you have from each group. We will also order an
antibody screen and discuss options for prevention of Rh sensitization if you are Rh-negative.
Rubella (German measles) immunity This test, called a rubella titer, checks the level of
antibodies to the rubella virus in your blood to see whether you’re immune. Most women are immune to
rubella, either because they’ve been vaccinated or had the disease as a child.
Hepatitis B testing Some women with this liver disease have no symptoms and can unknowingly
pass it to their baby during labor or after birth. This test will reveal whether you’re a hepatitis B carrier.
Syphilis screening This sexually transmitted infection (STI) is relatively rare today, but all women
should be tested because if you have syphilis and don’t treat it, both you and your baby could develop
serious problems. In the unlikely event that you test positive, you’ll be given antibiotics to treat the
infection.
Urinalysis and Urine Culture A urinalysis is used to assess bladder or kidney infections, diabetes,
dehydration and preeclampsia by screening for high levels of sugars, proteins, ketones and bacteria. A
urinalysis will be done at your initial visit and as indicated during your pregnancy. We will do a Urine
Culture with your initial bloodwork to make sure you do not have an asymptomatic urinary tract
infection (more common in pregnancy) nor Group B Strep bacteria in your urine.
Standard of Care Pregnancy Lab Work (not required by Alaska Law)
HIV testing- The Centers for Disease Control and Prevention and the Alaska Departments of Health
recommend that all pregnant women be tested for the human immunodeficiency virus (HIV), the virus that
causes AIDS.
STI Screening- Alaska Departments of Health recommends screening for Gonorrhea and Chlamydia,
sexually transmitted bacterial infections (STIs).
Prenatal Genetic Screening- See handout- “Guide to Prenatal Testing”
Toxoplasmosis- Toxoplasmosis is an infection that has few symptoms for an adult, but can cause serious
illness for a fetus. Many adults have been exposed to the parasite that causes the disease, and have developed
immunity to it. But if you are not immune, and get your first bout of toxoplasmosis while pregnant, your child
could be affected. “Toxo” can be gotten from raw meat, and from cat and kitten feces. So, if you have cats and
handle their litter box, you might want to consider this blood test to make sure you are immune to toxo.
Vitamin D Levels- See Handout
Thyroid Levels- See Handout
Hepatitis C Screening- Recommended when there are risk factors present in health history.
Gestational Diabetes Screening (at 28 Weeks)- See Handout
Group B Strep Screening (at 36 Weeks)- See Handout