Atrisk women should receive additional tests

1. Gonorrhea, tuberculosis and red cell indices to screen for thalassemia (eg, MCV <80), hemoglobin electrophoresis to detect hemoglobin-opathies (eg, sickle cell, thalassemias)

2. Hexosaminidase A for Tay Sachs screening (serum test in nonpregnant and leukocyte assay in pregnant individuals), DNA analysis for Canavan's disease, cystic fibrosis carrier testing, serum phenylalanine level, toxoplasmosis screen, and Hepatitis C antibodies.

3. Testing for sexually transmitted diseases (eg, HIV, syphilis, hepatitis B surface antigen, chlamydia, gonorrhea) should be repeated in the third trimester in any woman at high risk for acquiring these infections; all women under age 25 years should be retested for Chlamydia trachomatis late in pregnancy.

D. CBC, AB blood typing and Rh factor, antibody screen, rubella, VDRL/RPR, hepatitis B surface Ag.

E. Pap smear, urine pregnancy test, urinalysis and urine culture. Cervical culture for gonorrhea and chlamydia.

F. Tuberculosis skin testing, HIV counseling/testing.

G. Hemoglobin electrophoresis is indicated in risks groups, such as sickle hemoglobin in African patients, B-thalassemia in Mediterranean patients, and alpha-thalassemia in Asian patients. Tay-Sachs carrier testing is indicated in Jewish patients.

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