Screening for Infection in Pregnancy
Condition InDepth
Screening helps find health problems early so you can get treated. It is given to people who do not have signs, but who may be at high risk.
The Tests
You will get tests as part of your routine care. They can help your doctor know if you are at risk. Tests you may have are:
- Blood test—Your blood is checked for proteins that fight infection.
- Culture—The doctor will gently wipe your genitals to see if group B strep or a sexually transmitted infection (STI) is there. It will be looked at in the office or sent to a lab.
- Ultrasound —A technician will hold a tool over the belly that bounces sound waves off the womb and your growing baby. The sound waves make a picture of the baby on a screen. This helps the doctor check for any problems with the baby that might be a sign of an infection in the mother.
- Urine analysis—This is a test to check for bacteria. Your doctor will use a special paper strip to check for it.
- If you are at high risk you may be screened for certain infections.
The Guidelines
Pregnant women should be screened for STIs on their first doctor visit to look for:
In some cases, your doctor will also screen you for other health problems.
All pregnant women should be screened for Group B streptococcal disease (GBS) at 35-37 weeks. If you have it, you will be given medicine during labor.
Pre-pregnancy Checkup
This health exam can help you avoid infection and raise the chances of having a healthy baby. Your healthcare provider will ask about your health history, past pregnancies, and lifestyle. You can ask questions and talk about any worries you may have, such as whether work or hobbies put you at risk for health problems.
Blood tests measure immunity to certain infections. If you have it, you cannot get the infection again. If you do not have it, you may be able to get a shot to protect yourself. You can be checked for:
- Chickenpox —Women can be vaccinated before pregnancy. Conception should be postponed for three months.
- Hepatitis B —All pregnant women should be screened. Getting immunized and treated right after birth can prevent infection in the baby. High-risk women, such as healthcare workers, should consider vaccination before getting pregnant.
- Rubella —If you are not immune, you can be vaccinated before you get pregnant. Conception should be postponed for three months after the shot.
- Toxoplasmosis —Some healthcare providers screen for immunity to this infection. Unless a woman knows she is immune, she should not eat undercooked or raw meat, or handle cat litter.
- Cytomegalovirus (CMV)—Healthcare and childcare workers may want to be tested before pregnancy. Routine testing for low-risk women is not needed. If you have had CMV, you have little cause to worry during pregnancy.
- Tuberculosis (TB)—If you are from a country that has high rates of TB, you should be screened for this disease.
References
- Apgar BS, Greenberg G, Yen G. Prevention of group B streptococcal disease in the newborn. Am Fam Physician. 2005;71(5):903-910.
- Bacterial vaginosis during pregnancy. American Pregnancy Association website. Available at: http://americanpregnancy.org/pregnancycomplications/bacterialvaginosis-2.html.
- Chickenpox. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T116084/Chickenpox .
- Cytomegalovirus (CMV) and congenital CMV infection. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/cmv/index.html.
- Group B Strep (GBS). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/groupbstrep/index.html.
- Pregnancy and fifth disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parvovirusB19/pregnancy.html.
- Routine prenatal care. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T114252/Routine-prenatal-care .
- Schrag SJ, Arnold KE, Mohle-Boetani JC, et al. Prenatal screening for infectious diseases and opportunities for prevention. Obstet Gynecol. 2003;102(4):753-760.
- STDs during pregnancy. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/pregnancy/default.htm.
- Urinary tract infection during pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/utiduringpreg.html.
Contributors
- Beverly Siegal, MD, FACOG
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