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The pregnancy test is the most important test in females of reproductive age!

Five Important Tests in 1st Trimester Vaginal Bleeding

  • CBC
    • Hemoglobin/Hematocrit
      • Mild anemia in pregnancy is physiologic and normal
    • Thrombocytopenia
  • Type and Screen
    • Required for blood transfusion
    • Determines if patient needs RhoGAM
      • Rho(D) immune globulin
        • Binds fetal Rh antigens from a fetus so that mother doesn’t develop antibodies against future Rh positive children
        • Prevents hemolytic disease of the newborn
        • Give to Rh negative mothers to protect future Rh positive children
  • Quantitative hCG
    • hCG >1500
      • “Cutoff” where definitive pregnancy should be seen on ultrasound
      • If no pregnancy is seen, highly concerning for ectopic pregnancy
    • hCG <1500
      • Ectopic pregnancy still possible
      • Common for healthy early pregnancies to not be visualized below this level
  • Urinalysis (UA)
    • Treat asymptomatic bacteriuria in pregnant patients
      • One of the only times UTI should be treated in asymptomatic patients
      • Theoretical increased risk of miscarriage
  • Pelvic ultrasound
    • Evaluates for ectopic pregnancy
    • Subchorionic hemorrhage
    • Miscarriage

Additional Reading