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Your Pregnancy After 35 : Tests for You and Your Baby (part 10) - Tests for the Woman Expecting Multiples

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Pelvic Exam

Your healthcare provider will usually perform a pelvic examination at the first or second prenatal visit and again in late pregnancy. In early pregnancy, it helps evaluate the size of the uterus and determine how far along you are in pregnancy. In late pregnancy, it reveals many things:

the presentation of the baby—whether the baby is head first or breech

the dilatation of the cervix—how much the cervix has opened (if at all)

effacement—how much the cervix has thinned

station—how low the baby is in your birth canal

shape and size of your birth canal or pelvic bones

After a pelvic exam late in pregnancy, your healthcare provider may tell you some numbers, such as “2 and 50%.” This means your cervix has dilated 2 centimeters and is 50% thinned out.

Information collected during the exam is helpful if you go to the hospital thinking you’re in labor. At the hospital, you’ll be checked again. Knowing the measurements from your last pelvic exam can help medical personnel determine if you are in labor.

A pelvic exam does not tell your healthcare provider when you’ll go into labor. Labor can start at any time, regardless of the condition of your cervix.

Tests for the Woman Expecting Multiples

We know the chance of a multiple birth increases as a woman gets older. If you are carrying more than one baby, the number of tests you receive, and when you receive them, will be different. Some researchers recommend if you are at least 32 years old and your healthcare provider determines you’re carrying more than one baby, you should have chromosome testing, such as amniocentesis or chorionic villus sampling. Research indicates there is a slightly higher chance of an abnormality when a woman is carrying two or more babies.

Kay did most of the talking at her prenatal visits. I mainly listened to this bubbly, excited first-time mom-to-be. I don’t think her husband, Bob, said a word. They both came for her 18-week visit, when we were doing an ultrasound. Kay had been a little unsure about her last period, and her uterus seemed larger than expected, so we hoped her ultrasound would help us determine if we had the right due date. The ultrasound told us a lot—her due date was right, but she was carrying twins! Kay was in shock; all she could do was gasp. Bob was ecstatic—he whooped with joy. They left with Kay shaking her head and Bob grinning from ear to ear. At her next visit, Kay and I talked about twins and twin pregnancies.

In many cases, screening tests are the first indication a woman is carrying more than one baby. Sometimes these tests give an “abnormal” result. An abnormal test result does not necessarily indicate the babies have a problem; it alerts the healthcare provider to perform follow-up tests.

Often with a multiple pregnancy, blood tests are repeated around week 28 to check for gestational diabetes. Tests can also reveal if the mother-to-be is anemic, which is more common in women carrying multiples.

You may have more tests if other problems develop. If there’s an indication of preterm labor or pre-eclampsia, you may have amniocentesis to check lung maturity in the babies. Premature lung disease is a serious complication for multiples who are delivered too early.

Ultrasound at the mall can be hazardous to you and baby because untrained technicians doing the test on you may not use equipment correctly.

Tests to Avoid during Pregnancy

There is no known safe amount of radiation from X-ray tests for a developing fetus. X-ray exposure may harm the baby. Don’t have any X-rays during pregnancy unless it’s an emergency. The medical need for an X-ray must always be weighed against its risk to your pregnancy. Discuss the procedure with your pregnancy healthcare provider before any X-ray is taken during pregnancy. This warning also applies to dental X-rays.

Computerized tomographic scans, also called CT scans or CAT scans, are a specialized X-ray. The test involves the use of X-ray with computer analysis. Many researchers believe the amount of radiation received from a CT scan is far lower than from a regular X-ray. However, it is probably wise to avoid even this amount of exposure, if possible.

If you’re over 35, you may have had a baseline mammogram, or breast X-ray, which is usually repeated every 2 years after the age of 40. If you had a mammogram before pregnancy, you’re ahead of the game. If not, don’t have one until after baby is born. Unless you have a good reason for undergoing the test, such as a breast lump, don’t expose your developing baby to this type of radiation.

With radiation exams, risk to the fetus appears to be the greatest between 8 and 15 weeks of gestation (between the fetal age of 6 weeks and 13 weeks). Some physicians believe the only safe amount of radiation exposure for a fetus is no exposure.

Magnetic resonance imaging (MRI) is a widely used diagnostic tool. No harmful effects have been reported from its use in pregnancy, but pregnant women are advised to avoid MRI during the first trimester of pregnancy.

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