Mommy To Be Guide: First Trimester Office Visits

Welcome Visit: Your first visit will begin with our nurse supervisor. She will review your history and introduce you to our practice as a Millennium Mommy to Be.

The First Medical Visit:

  • The Clinician will review your history and address any issues or concerns that you may have.
  • A brief physical exam will be performed.
  • You may have a Pap Smear and Genital cultures performed.
  • If there is uncertainty about your last menstrual period or how far along you are in your pregnancy, a transvaginal (internal) ultrasound may be performed.
  • Your approximate due date will be assigned.
  • Blood will be drawn and you’ll be asked to provide a urine specimen for routine prenatal lab tests.

Follow up visits: In the first trimester, follow up medical visits are generally scheduled at 4­6 week intervals, but may be more frequent depending on the circumstances. At each visit you’ll be asked about any troubling symptoms and the baby’s heartbeat will be examined. You will also be asked to provide a urine specimen at each visit to check for abnormalities.

Genetic screening and diagnostic tests

In the first and early second trimester, you will be offered genetic tests. You will have the opportunity to ask questions about these tests to help decide which tests, if any, are right for you and your pregnancy. These tests are not required and it is your personal choice to decide if you want any of this testing. Below are the options available in the first trimester:

Cell­free Fetal DNA (Harmony or Panorama Test)

  • Requires a sample of maternal blood drawn after 10 weeks of pregnancy.
  • Fragments of fetal DNA in the blood are isolated to identify pregnancies 
at increased risk for Down syndrome (trisomy 21) and two other chromosome conditions called trisomy 18 and trisomy 13. It may also test for fetal sex and differences in the number of sex chromosomes.
  • Results take 8-­10 days.
  • False positive results are rare (about 1/1000).

Nuchal Translucency with serum markers

  • An ultrasound is performed at 11­-14 weeks of pregnancy to measure a 
pocket of fluid behind the fetal neck. This is performed at the Antenatal Testing Center (ATC): 703­-776­-6654 or by Dr. Reyes of Virginia Hospital Center: 703-­558­-6077.
  • Maternal blood is drawn at 9­-14 weeks and again at 15­-22 weeks to measure the level of certain proteins.
  • This information is combined to estimate the risk of Down syndrome (trisomy 21), trisomy 18 and abnormal formation of the spinal cord and abdomen. About 80% of effected pregnancies will be identified.
  • Results take about 5­7 days.
  • False positive results occur in about 1/20 cases.

Chorionic Villus Sampling

  • A small sample of placenta cells is collected through the cervix at 10-­13 
weeks of pregnancy. These are grown in the laboratory and the chromosomes are studied. This testing is performed by a specialist, Dr. Reyes at the Virginia Hospital Center or by your own designated Perinatologist.
  • CVS is >99% accurate for the detection of chromosome conditions.
  • It has a risk of miscarriage of less than 1/100 (1%).
  • CVS cannot detect neural tube defects like spina bifida.
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