Pregnancy screening and testing

Introduction

This section has screening and testing information for pregnant women in the Northern Territory, including:


What to expect at your first doctor visit

Pregnant women in the Northern Territory (NT) should see their doctor or midwife within the first ten weeks of pregnancy.

Your doctor or midwife will:

  • confirm your pregnancy
  • plan your pregnancy care
  • discuss pregnancy care options.

They will also give you advice about:

All tests offered and performed in pregnancy are optional and performed only with your consent.

You will also be offered screening between nine and 13 weeks for a protein produced by the placenta known as PAPP-A. A low PAPP-A is less than 0.37 and should be investigated.

You should ask your doctor or midwife to explain the tests and give you written information.

What to expect on your first doctor/midwife visit 

Your doctor or midwife will work out when your baby is due. They will also:

  • measure your height and weight to calculate your body mass index (BMI)
  • take a medical, surgical, family, mental health and social history
  • ask you about allergies, medication, smoking and alcohol
  • ask you about previous pregnancies and births
  • take your blood pressure
  • check baby position and growth - after 16 weeks of pregnancy
  • listen to the baby's heart beat - after 16 weeks of pregnancy
  • discuss baby feeding preferences - midwives will usually discuss this with you at around 20 weeks
  • check blood, urine and ultrasound tests
  • ask about domestic violence 
  • ask about general health.

What to expect on subsequent doctor/midwife visits

Your doctor or midwife will check to make sure that you and your baby are healthy. They may:

  • take your blood pressure
  • feel your belly to feel the position of the baby
  • measure your belly with a measuring tape
  • listen to the baby's heart beat
  • check blood, urine and ultrasound tests
  • answer you and your partner's questions
  • provide education about good health and parenting
  • discuss breast feeding.

Scheduled pregnancy check ups

This page has suggestions for when pregnant women in the Northern Territory (NT) should schedule medical check ups.

These recommendations should be used as a guide only. You may need more visits than what is recommended below. 

Find out more about birthing services in the Top End or birthing services in Central Australia.

Recommended hospital visits

Alice Springs, Darwin and Katherine

If you live in Alice Springs, Darwin or Katherine, you should visit the hospital where you plan to give birth to your baby when your pregnancy reaches:

  • before 10 weeks to confirm your pregnancy with a midwife or doctor
  • 14 weeks - for Royal Darwin Hospital this is 14 to 17 weeks
  • 16 weeks
  • 20 weeks
  • 24 weeks
  • 28 weeks
  • 32 weeks
  • 36 weeks
  • 41 weeks to discuss inducing the baby if not yet born.

To get an appointment at the hospital you need a referral from a general practitioner (GP). 

Make sure you have your correct address and contact details with your GP, so you can be contacted for your appointment. Leave at least two weeks for the hospital to receive and respond to your referral.

Gove District Hospital

If you live in the Gove district, it is recommended that you visit the hospital when your pregnancy reaches:

  • 20 weeks
  • 24 weeks
  • 36 weeks
  • 41 weeks to discuss inducing the baby if not yet born.

Remote areas

If you live in a remote area, you may only need to travel to the hospital at 37 weeks to await the arrival of your baby. This will depend on you and your baby's health.

You will need to go to hospital between 18 and 20 weeks for an ultrasound. You will also have other health checks done by your community midwife each month.

Find out more about birthing and remote areas.

If you are an Aboriginal woman and live in Canteen Creek, Utopia or Yuendumu, you can access the strong women, strong babies, strong culture program. For more information call (08) 8955 6106

Antenatal schedule of care

Between 14 and 32 weeks you will be seen about once a month. From 32 weeks your visits will be around once a fortnight.

You should see your doctor, midwife or community care clinic staff when your pregnancy reaches each of the following milestones:

  • early to confirm pregnancy
  • 14 to 17 weeks
  • 20 to 22 weeks
  • 24 weeks
  • 28 weeks
  • 32 weeks
  • 34 weeks
  • 37 weeks
  • 39 weeks
  • 40 weeks (due date).

After 40 weeks you will have discussions with your doctor or midwife about inducing the baby if it has not been born.


Tests during pregnancy

The following blood and urine tests are recommended for pregnant women in the Northern Territory (NT). These tests are not compulsory but can help make sure you and your baby are healthy. 

Your doctor or midwife will tell you which tests you should take. You should ask your doctor or midwife to explain the tests and provide written information. 

Blood tests

The following blood tests are recommended for pregnant women:

  • full blood examination for iron levels
  • blood group and antibody screen
  • rubella immunity
  • syphilis
  • HIV
  • hepatitis B
  • hepatitis C - only at risk women
  • pregnancy diabetes and gestational diabetes
  • iron - anaemia.

Other blood tests may be considered, including:

  • vitamin D
  • cytomegalovirus
  • thyroid disease
  • toxoplasmosis
  • iron studies - if you are anaemic
  • varicella. 

If you are blood group negative, you may also be offered an Anti-D injection at 28 weeks, again at 34 weeks and possibly after the birth of your baby. This will depend on your baby's blood type.

Urine tests

The following urine tests are recommended:

  • midstream urine - looking for infection
  • protein late in pregnancy
  • glucose in urine - for detection of diabetes.

Vaginal swabs

The following vaginal swabs may be needed:

  • group B streptococcal - low vaginal and rectal swab
  • infection swab - if you have signs of a vaginal infection
  • broken waters or ruptured membranes - high vaginal swab
  • sexually transmitted diseases - first trimester and again at 36 weeks.

Ultrasounds and pregnancy

This page has information about ultrasounds and pregnant women in the Northern Territory (NT). 

It is recommended that you have an ultrasound at 18 to 20 weeks. You can also have one early in your pregnancy if you are wanting to have genetic testing done or to confirm dates. Your doctor or midwife will tell you if you need another ultrasound later in your pregnancy. 

Your doctor or midwife can organise and discuss all ultrasounds that are recommended in pregnancy. 

Ultrasound in early pregnancy

An ultrasound between 11 and 14 weeks of your pregnancy can tell you:

  • your baby's date of birth 
  • if you have a multiple pregnancy
  • if the pregnancy is viable/in the uterus. 

A nuchal translucency ultrasound between 11 and 13 weeks (and up to six days) can be used to check if your baby has abnormalities.

If you wish to screen for Down syndrome and neural tube defects this scan can be used in conjunction with a blood test.

Ultrasound at 19 to 20 weeks

This ultrasound looks for concerns like:

  • position of the placenta and cord
  • amount of fluid around baby
  • structure of baby heart, lungs, sex.

You can also screen for neural tube defects as part of this ultrasound. This gives a clear view of your baby's spine at this gestation.

Ultrasound later in pregnancy

Your doctor or midwife may recommend more ultrasounds to check for:

  • concerns about baby's growth or weight
  • fluid around baby
  • concern with the position of the placenta from the 18-20 week scan - to recheck
  • concern with baby from previous scan
  • reduced movements later in pregnancy.

Genetic screening

For most parents, pregnancy ends with the birth of a normal healthy baby. In a small amount of pregnancies the baby develops with a serious problem.

If you have a history of any abnormalities in your family, a history of recurrent miscarriages or that you are a known carrier of a genetic condition, you should consider genetic counselling to find out your chances of having an affected baby.

Neural tube defects, Down syndrome and trisomy 18 are serious abnormalities that occur early in the development of a baby. It is not known why they happen.

Screening tests involve blood tests from the mother and ultrasounds to work out if your baby is at an increased risk of one of the following conditions:

  • Down syndrome
  • neural tube defects including spina bifida and anencephaly
  • trisomy 18.

If the screening is positive or the markers are high, you may receive a diagnostic test such as chorionic villus sampling or an amniocentesis. The risk of miscarriage is around 1% for both of these procedures.

Genetic screening tests are not compulsory. Before deciding if you want these tests, you should understand what the abnormalities are, what the tests can tell you and what the results can mean for you and your family.

Your doctor will give you information about genetic screening tests and pregnancy, but it is your decision to have the tests.

Genetic screening blood tests include:

Blood tests and ultrasounds are conducted in the Northern Territory (NT) by the South Australian Maternal Antenatal Screening program.

Your general practitioner (GP) can give you a referral for these tests and tell you about any costs and how long it takes to get your results.

If you do decide to have tests, a high risk screen will likely be followed up with an amniocentesis to confirm any issues.

Amniocentesis

Amniocentesis tests your pregnancy for chromosomal abnormalities like Down syndrome. It involves taking a small sample of the fluid surrounding your baby through a needle in your abdomen. The needle does not touch your baby.

For more information, read the amniocentesis fact sheet on the Royal Women's Hospital website.

Chorionic villus sampling

Chorionic villus sampling tests your pregnancy for genetic abnormalities. It involves taking a sample of the developing placenta transvaginally.

For more information, read the chorionic villus sampling fact sheet on the Royal Women's Hospital website.

More information

To find out more about genetic tests and genetic counselling in the NT, contact the NT Clinical Genetics Service:

Royal Darwin Hospital
PO Box 41326
Casuarina NT 0811

Phone: 08 8944 8731
Fax: 08 8922 8463 
genetichealth.ths@nt.gov.au

For Aboriginal women

For more information about genetic screening in pregnancy for Aboriginal women, go to the Menzies School of Health Research website.

This information was developed in consultation with Yolngu women in Galiwin'ku.