13.5: Summary
13.1 Prenatal Testing during the First Trimester
Many prenatal tests are recommended during the first trimester of pregnancy. Nurses are responsible for obtaining a comprehensive obstetric and menstrual history and educating pregnant persons on the routine, screening, and diagnostic tests available and the reasons they are performed and recommended. The nurse may also assist with some of the procedures and can help prepare the pregnant person by explaining what to expect during the procedure. It is important for nurses to educate the pregnant person on the screenings recommended and inform them that the screenings predict the risk of the fetus having a genetic, structural, or neural tube defect. Additional diagnostic testing is needed if the screenings come back abnormal.
Nurses also use therapeutic communication with pregnant persons and their support persons. It is important for the nurse to support the pregnant person in any decisions they make concerning their pregnancy. Part of this support includes referrals to specialists in maternal-fetal medicine, genetics, and infectious disease.
13.2 Prenatal Testing during the Second Trimester
Prenatal testing in the second trimester includes screening and diagnostic tests. Some of the testing is performed after an abnormal first trimester screening result. Some of the prenatal testing allows for interventions to take place during the procedure. Before the second trimester screening or diagnostic testing, the nurse will collect any important information that may be helpful to the health-care provider when interpreting results, such as gravida, para, living children, gestation in weeks, and any maternal health problems.
The nurse reinforces education about the risks and benefits of prenatal testing, the test results, and recommendations made by the health-care provider. The nurse has a very important role in educating the pregnant person on the screenings and procedures that are recommended, answering any questions, preparing the pregnant person for what to expect during the procedures, and educating the pregnant person on what the results mean and any additional recommendations. The nurse should provide the pregnant person and their partner with clear explanations of what the tests assess, the purpose of the tests, and the frequency of any tests recommended. It will be important for the pregnant person to know how long the test will take and what happens during the test to help reduce any anxiety. The pregnant person may need additional support depending on the results of the test performed, and additional testing or referrals may be appropriate. Abnormal results can often cause anxiety in the pregnant person.
13.3 Prenatal Testing during the Third Trimester
Routine prenatal screening is usually complete prior to the third trimester. However, additional screenings and tests may be recommended. If results from routine screening performed in the second trimester are inconclusive or positive, additional testing may be needed in the third trimester. Additionally, if any complications occur in the third trimester, additional fetal surveillance may be needed to check on the well-being of the fetus.
The nurse has an important role in educating and supporting the pregnant person on all the recommended screening and diagnostic tests performed in the third trimester. These nursing actions assist the pregnant person in their decisions on what prenatal testing is right for them and their fetus.