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Advanced Prenatal Package

Pregnancy

84 parameters

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Report in 24Hrs

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Fasting Required

Details

Advanced prenatal package covering first milk, hepatitis B/C, Cardiolopin, HIV, Iron, Liver, Kidney, Lipid, Sugar, Vitamins, Blood Toxicity, Blood

₹3,299₹6,499

49% OFF

Parameters

  • List of Tests
    • First Milk
    • HBsAg
    • Anti Hepatitis C Virus (HCV) - Total
    • Cardiolipin Antibody (ACL) - IgA
    • Cardiolipin Antibody (ACL) - IgG
    • Cardiolipin Antibody (ACL) - IgM
    • HIV I & II
    • Iron Studies
      • Iron
      • TIBC
      • Transferrin Saturation
    • Liver Function Test
      • Albumin
      • Alkaline Phosphatase
      • Bilirubin - Direct
      • Bilirubin - Indirect
      • Bilirubin - Total
      • AST/SGOT
      • ALT/SGPT
      • Total Protein
      • A/G Ratio
      • Gamma GT
      • Globulin
    • Kidney Profile
      • BUN
      • Calcium
      • Creatinine
      • Uric Acid
      • eGFR
      • BUN/Creatinine
      • Urea
    • Lipid Profile
      • Cholestrol/HDL
      • LDL/HDL
      • Non HDL
      • VLDL
      • Total Cholestrol
      • Triglycerides
      • HDL
      • LDL
    • Thyroid Profile
      • Total T3
      • Total T4
      • TSH
    • Hba1c
    • eAG
    • CBC - Complete Hemogram
    • Vitamin Profile
      • 25 - OH Vitamin D
      • Folic Acid
      • Vitamin B12
    • Blood Toxic Element Profile
      • Arsenic
      • Cadmium
      • Chromium
      • Cobalt
      • Lead
      • Mercury
      • Selenium
      • Barium
      • Caesium

Advanced Prenatal Package

  • Why is it done?
    • Comprehensive maternal health assessment to screen for infections, metabolic disorders, and nutritional deficiencies that could affect pregnancy outcomes and fetal development
    • Detection of infectious diseases (HIV, Hepatitis B and C) that require monitoring and management during pregnancy to prevent vertical transmission
    • Identification of antiphospholipid syndrome through cardiolipin antibody testing, which increases thrombotic and pregnancy loss risk
    • Assessment of maternal nutritional status through iron, vitamin D, B12, and folic acid evaluation—critical for fetal development and preventing neural tube defects
    • Evaluation of thyroid function (TSH, T3, T4) to detect hypothyroidism or hyperthyroidism, which can lead to miscarriage, preterm delivery, and developmental issues
    • Screening for gestational diabetes through HbA1c and glucose monitoring to prevent maternal and fetal complications
    • Assessment of liver and kidney function to ensure maternal organs can handle physiological changes of pregnancy
    • Complete blood count evaluation to detect anemia, thrombocytopenia, or leukopenia that could compromise maternal and fetal health
    • Lipid profile assessment to monitor cardiovascular risk and metabolic health during pregnancy
    • Detection of exposure to toxic elements (lead, mercury, arsenic) that can cross the placenta and cause developmental toxicity and birth defects
    • Baseline assessment typically performed during first trimester to establish maternal health status and guide pregnancy management
  • Normal Range
    • First Milk: Negative (antibodies to beta-casein should be absent)
    • HBsAg (Hepatitis B Surface Antigen): Negative or <0.05 mIU/mL
    • Anti-HCV (Hepatitis C Antibody): Negative or <1.0 Signal/Cutoff ratio
    • Cardiolipin Antibody IgA: <1.0 GPL-U/mL (negative)
    • Cardiolipin Antibody IgG: <1.0 GPL-U/mL (negative)
    • Cardiolipin Antibody IgM: <1.0 MPL-U/mL (negative)
    • HIV I & II: Negative (no antibodies detected)
    • Iron: 60-170 µg/dL (10.7-30.4 µmol/L)
    • TIBC (Total Iron Binding Capacity): 250-425 µg/dL (44.8-76.1 µmol/L)
    • Transferrin Saturation: 20-50%
    • Albumin: 3.5-5.0 g/dL (35-50 g/L)
    • Alkaline Phosphatase: 30-120 IU/L (pregnancy may cause elevation up to 150-200 IU/L)
    • Total Bilirubin: 0.1-1.2 mg/dL (1.7-20.5 µmol/L)
    • Direct Bilirubin: 0.0-0.3 mg/dL (0-5.1 µmol/L)
    • Indirect Bilirubin: 0.1-0.9 mg/dL (1.7-15.4 µmol/L)
    • AST (SGOT): 10-40 IU/L (0.17-0.67 µkat/L)
    • ALT (SGPT): 7-56 IU/L (0.12-0.94 µkat/L)
    • Total Protein: 6.0-8.3 g/dL (60-83 g/L)
    • A/G Ratio (Albumin/Globulin): 1.0-2.5
    • Gamma GT: 0-51 IU/L (0-0.87 µkat/L)
    • Globulin: 2.3-3.5 g/dL (23-35 g/L)
    • BUN (Blood Urea Nitrogen): 7-20 mg/dL (2.5-7.1 mmol/L); pregnancy may lower to 5-15 mg/dL
    • Calcium: 8.5-10.2 mg/dL (2.12-2.55 mmol/L)
    • Creatinine: 0.6-1.2 mg/dL (53-106 µmol/L); pregnancy may lower to 0.4-0.8 mg/dL
    • Uric Acid: 2.6-6.0 mg/dL (155-357 µmol/L); pregnancy may lower to 2.0-4.0 mg/dL
    • eGFR (Estimated Glomerular Filtration Rate): >90 mL/min/1.73m² (may be elevated in pregnancy)
    • BUN/Creatinine Ratio: 10:1 to 20:1
    • Urea: 2.5-7.1 mmol/L (7-20 mg/dL); pregnancy may lower to 5-15 mg/dL
    • Total Cholesterol: <200 mg/dL (<5.18 mmol/L) is optimal; increases in pregnancy are normal
    • HDL Cholesterol: >40 mg/dL (>1.04 mmol/L) for males; >50 mg/dL (>1.30 mmol/L) for females
    • LDL Cholesterol: <100 mg/dL (<2.59 mmol/L) is optimal
    • VLDL: <30 mg/dL (<0.78 mmol/L)
    • Triglycerides: <150 mg/dL (<1.69 mmol/L); may be elevated in pregnancy
    • Cholesterol/HDL Ratio: <5.0 is desirable
    • LDL/HDL Ratio: <3.0 is desirable
    • Non-HDL Cholesterol: <130 mg/dL (<3.37 mmol/L) is optimal
    • TSH (Thyroid Stimulating Hormone): 0.4-4.0 mIU/L (pregnancy: 0.2-3.0 mIU/L first trimester)
    • Total T3: 80-200 ng/dL (1.2-3.1 nmol/L); elevated in pregnancy
    • Total T4: 4.5-12 µg/dL (58-154 nmol/L); elevated in pregnancy due to increased TBG
    • HbA1c: <5.7% (<39 mmol/mol) is normal; 5.7-6.4% indicates prediabetes; ≥6.5% indicates diabetes
    • eAG (Estimated Average Glucose): <100 mg/dL (<5.6 mmol/L) is normal
    • Red Blood Cell Count: 4.0-5.2 million/µL (4.0-5.2 × 10¹²/L); pregnancy: 3.8-5.2 million/µL
    • Hemoglobin: 12.0-16.0 g/dL (120-160 g/L); pregnancy: >11.0 g/dL in first and third trimester; >10.5 g/dL in second trimester
    • Hematocrit: 36-46% (0.36-0.46 L/L); pregnancy: >32% in first and third trimester; >30% in second trimester
    • MCV (Mean Corpuscular Volume): 80-100 fL (80-100 × 10⁻¹⁵ L)
    • MCH (Mean Corpuscular Hemoglobin): 27-33 pg (27-33 × 10⁻¹² g)
    • MCHC (Mean Corpuscular Hemoglobin Concentration): 32-36 g/dL (320-360 g/L)
    • White Blood Cell Count: 4.5-11.0 × 10³/µL (4.5-11.0 × 10⁹/L); pregnancy: 5.0-15.0 × 10³/µL
    • Neutrophils: 50-70% of WBC
    • Lymphocytes: 20-40% of WBC
    • Monocytes: 2-8% of WBC
    • Eosinophils: 1-4% of WBC
    • Basophils: 0-1% of WBC
    • Platelets: 150-400 × 10³/µL (150-400 × 10⁹/L); pregnancy: generally maintained but may slightly decrease
    • RBC Distribution Width: 11.5-14.5%
    • Vitamin D (25-OH): 30-100 ng/mL (75-250 nmol/L) is sufficient; <20 ng/mL is deficient
    • Folic Acid: 5.4-16 ng/mL (12.2-36.3 nmol/L); >5.4 ng/mL is adequate; pregnancy requires higher levels
    • Vitamin B12: 200-900 pg/mL (148-664 pmol/L); values <200 indicate deficiency
    • Lead: <10 µg/dL (<0.48 µmol/L) is safe in pregnancy; >5 µg/dL warrants concern
    • Mercury: <5 ng/mL (<25 nmol/L); higher levels indicate potential exposure
    • Arsenic: <10 ng/L (<0.13 µmol/L) is acceptable; higher levels suggest exposure
    • Cadmium: <1 µg/L (<8.9 nmol/L); accumulates in kidneys and placenta
    • Chromium: <0.3 µg/L; essential trace element but toxicity is concern at high levels
    • Cobalt: <0.1 µg/L; excessive exposure can affect fetal development
    • Selenium: 80-150 ng/mL (1.0-1.9 µmol/L); antioxidant protection in pregnancy
    • Barium: <0.5 ng/mL; soluble barium salts are better absorbed from GI tract
    • Caesium (Cesium): <0.1 ng/mL; mimics potassium and can affect cellular functions
  • Interpretation
    • First Milk Positive: Indicates protein sensitivity or intolerance; assess for cow's milk protein allergy risk in neonate
    • HBsAg Positive: Indicates active or chronic Hepatitis B infection; requires antiviral therapy, monitoring, and prevention of transmission to infant through vaccination and immunoglobulin
    • Anti-HCV Positive: Indicates Hepatitis C exposure or infection; requires confirmatory testing (HCV RNA), risk stratification, and counseling regarding vertical transmission risk (5% transmission rate)
    • Cardiolipin Antibodies Positive (IgG/IgM): Indicates antiphospholipid syndrome; associated with recurrent thrombosis and pregnancy loss; requires anticoagulation therapy (heparin and aspirin)
    • HIV I & II Positive: Indicates HIV infection; requires immediate treatment initiation with antiretroviral therapy to prevent mother-to-child transmission; maternal viral load goal is <50 copies/mL
    • Iron Low (<60 µg/dL): Indicates iron deficiency; risk for anemia and adverse pregnancy outcomes; requires iron supplementation assessment
    • Iron High (>170 µg/dL): Less common in pregnancy; may indicate hemochromatosis or excessive supplementation; requires investigation
    • TIBC Elevated: Suggests iron deficiency; low transferrin saturation confirms iron-deficient state requiring supplementation
    • Transferrin Saturation Low (<20%): Indicates iron deficiency; combined with low iron and elevated TIBC confirms iron deficiency anemia
    • Albumin Low (<3.5 g/dL): Indicates malnutrition, liver disease, or protein malabsorption; impacts fetal growth and immune function
    • Albumin High (>5.0 g/dL): Rare; suggests dehydration; recheck after hydration
    • Alkaline Phosphatase Elevated (>200 IU/L): In pregnancy, mild elevation is normal from placental source; excessive elevation suggests cholestasis or liver disease
    • Total Bilirubin Elevated: Suggests jaundice, hemolysis, or liver dysfunction; assess for preeclampsia with HELLP syndrome if accompanied by thrombocytopenia and elevated transaminases
    • Direct Bilirubin Elevated: Suggests cholestasis or biliary obstruction; intrahepatic cholestasis of pregnancy (ICP) increases risk of fetal death
    • AST/ALT Elevated (>40 IU/L): Suggests hepatocellular injury; if >1000 IU/L consider viral hepatitis, drug toxicity, or preeclampsia/HELLP syndrome
    • Gamma GT Elevated: Indicates possible cholestasis or liver enzyme induction; assess for intrahepatic cholestasis of pregnancy
    • Total Protein Low (<6.0 g/dL): Suggests malnutrition or protein loss; normal in pregnancy may be 5.5-7.5 g/dL due to hemodilution
    • A/G Ratio Low (<1.0): Indicates relative globulin elevation; assess cause (infection, autoimmune disease, liver disease)
    • Globulin Elevated: Suggests immune activation or chronic infection; assess in context with other parameters
    • BUN Elevated (>20 mg/dL): Suggests dehydration, renal dysfunction, or preeclampsia; lower values in pregnancy are expected due to increased GFR
    • Creatinine Elevated (>1.2 mg/dL): Suggests renal dysfunction; in pregnancy, values >0.8 mg/dL warrant investigation despite being 'normal' in non-pregnant women
    • Calcium Low (<8.5 mg/dL): Hypocalcemia risk; affects fetal bone development and maternal neuromuscular function; requires supplementation
    • Calcium High (>10.2 mg/dL): Less common; assess for hyperparathyroidism or granulomatous disease
    • Uric Acid Elevated (>4.0 mg/dL in pregnancy): Indicates possible preeclampsia, especially if combined with hypertension and proteinuria; marker of placental dysfunction
    • eGFR Low (<90 mL/min): Suggests renal impairment; in pregnancy with lower eGFR, careful monitoring of renal function is warranted
    • Total Cholesterol Elevated (>200 mg/dL): Normal and expected in pregnancy; excessive elevation may indicate metabolic risk; reassess postpartum
    • HDL Low: Indicates increased cardiovascular risk; important for long-term maternal health planning
    • LDL Elevated (>130 mg/dL): Associated with increased cardiovascular risk; gestational dyslipidemia in pregnancy requires dietary management
    • Triglycerides Elevated (>200 mg/dL): Common in pregnancy; excessive elevation (>500 mg/dL) increases risk of acute pancreatitis
    • TSH Elevated: Indicates hypothyroidism; requires levothyroxine therapy to prevent intellectual disability and adverse pregnancy outcomes; target TSH varies by trimester
    • TSH Low: Indicates hyperthyroidism (Graves' disease, thyroiditis); requires antithyroid medication; PTU preferred in first trimester
    • Total T3/T4 High: Indicates hyperthyroidism; assess clinical symptoms (tachycardia, anxiety, weight loss) and TSH level
    • Total T3/T4 Low: Indicates hypothyroidism; requires thyroid hormone replacement; assess with TSH for confirmation
    • HbA1c 5.7-6.4%: Indicates prediabetes; requires dietary counseling and monitoring for progression to diabetes
    • HbA1c ≥6.5%: Indicates diabetes mellitus; in pregnancy context, assess for pregestational diabetes versus gestational diabetes (GDM typically diagnosed by glucose tolerance test)
    • Hemoglobin Low (<11 g/dL in pregnancy): Indicates anemia; risk for preterm birth, low birth weight, and maternal complications; determine cause (iron deficiency, B12/folate deficiency, hemolysis)
    • Hemoglobin High (>16 g/dL): Suggests hemoconcentration or polycythemia; recheck after hydration and assess for underlying conditions
    • MCV Low (<80 fL): Indicates microcytic anemia; commonly due to iron deficiency in pregnancy
    • MCV High (>100 fL): Indicates macrocytic anemia; suggests B12 or folate deficiency; assess for pernicious anemia or dietary insufficiency
    • White Blood Cell Count Elevated (>15 × 10³/µL): Normal in pregnancy; if >20 × 10³/µL, assess for infection (UTI, chorioamnionitis) or leukemia
    • Platelets Low (<150 × 10³/µL): Assess for gestational thrombocytopenia (common, benign), or serious conditions (preeclampsia, HELLP syndrome, ITP)
    • Vitamin D Deficient (<20 ng/mL): Increases risk of preeclampsia, gestational diabetes, and preterm birth; requires supplementation with 1000-2000 IU daily
    • Vitamin D Insufficient (20-29 ng/mL): Associated with adverse pregnancy outcomes; supplementation recommended
    • Folic Acid Low (<5.4 ng/mL): Increases risk of neural tube defects and adverse outcomes; requires supplementation with 400-800 µg daily (4 mg in high-risk cases)
    • Vitamin B12 Low (<200 pg/mL): Causes macrocytic anemia; risk for congenital defects and developmental delays; requires supplementation (oral or parenteral)
    • Lead Elevated (>5 µg/dL): Crosses placenta causing fetal neurotoxicity; associated with reduced birth weight, prematurity, and developmental delays; requires environmental investigation
    • Mercury Elevated (>5 ng/mL): Neurotoxin crossing placenta; associated with cerebral palsy, autism spectrum, and cognitive impairment; methylmercury most dangerous
    • Arsenic Elevated (>10 ng/L): Teratogen associated with fetal growth restriction and congenital abnormalities; requires source investigation and remediation
    • Cadmium Elevated (>1 µg/L): Accumulates in placenta reducing calcium transport; associated with hypertension and fetal growth restriction
    • Chromium Elevated: Potential developmental toxin; requires investigation of occupational or environmental sources
    • Cobalt Elevated: Potential teratogen affecting fetal development; investigate sources including supplements and occupational exposure
    • Selenium Low (<80 ng/mL): Reduces antioxidant protection; may increase preeclampsia and adverse outcomes; supplementation may be beneficial
    • Barium Elevated: Rare but toxic at high levels; assess gastrointestinal sources or occupational exposure
    • Caesium Elevated: Accumulates similar to potassium; can disrupt cellular ion transport; radioisotope contamination concern in certain regions
  • Associated Organs
    • First Milk: Gastrointestinal tract immune system; breast tissue; potential allergic reactions in neonate affecting GI and systemic health
    • HBsAg: Liver; blood; placenta for transmission; hepatitis B causes chronic hepatitis, cirrhosis, and hepatocellular carcinoma
    • Anti-HCV: Liver; blood; placenta; Hepatitis C causes chronic infection with progressive liver fibrosis and cirrhosis
    • Cardiolipin Antibodies: Vascular endothelium; placenta; blood coagulation system; causes thrombosis and pregnancy complications
    • HIV: Immune system (CD4+ T cells); blood; lymph nodes; placenta; causes AIDS and opportunistic infections
    • Iron Studies: Blood (hemoglobin synthesis); bone marrow; liver (storage); gastrointestinal tract (absorption); oxygen transport to fetus depends on adequate iron
    • Liver Function Tests: Liver (detoxification, protein synthesis, metabolic processing); blood; affects drug metabolism and fetal metabolism
    • Kidney Profile: Kidneys (glomerular filtration, electrolyte balance); blood; affects fluid balance critical in pregnancy; preeclampsia damages kidneys
    • Lipid Profile: Liver (synthesis); blood vessels (atherosclerosis risk); heart; metabolic health affects gestational diabetes and cardiovascular complications
    • Thyroid Profile: Thyroid gland; hypothalamic-pituitary-thyroid axis; brain (neurodevelopment); metabolism; growth; affects fetal neurological development if abnormal
    • HbA1c/eAG: Pancreas (insulin production); blood glucose regulation; affects placental metabolism and fetal growth; gestational diabetes affects newborn hypoglycemia risk
    • CBC: Bone marrow (hematopoiesis); blood; immune function; oxygenation capacity; anemia affects placental insufficiency
    • Vitamin D: Bones (calcium homeostasis); placenta; immune system; intestines (calcium absorption); fetal skeletal development depends on adequate maternal vitamin D
    • Folic Acid: Bone marrow (DNA synthesis); neurological system (neural tube formation); rapidly dividing cells; deficiency causes neural tube defects
    • Vitamin B12: Bone marrow (hematopoiesis); neurological system; gastrointestinal tract absorption; deficiency causes macrocytic anemia and neurological damage
    • Lead: Central nervous system (neurotoxicity); bones (replaces calcium); blood; placenta; crosses placenta damaging fetal brain development
    • Mercury: Central nervous system (neurotoxin); kidneys; liver; placenta; methylmercury crosses placenta affecting fetal brain development
    • Arsenic: Skin; GI tract; blood; placenta; teratogen affecting multiple organ systems and fetal development
    • Cadmium: Kidneys; liver; bone; placenta; accumulates over time affecting renal function and placental calcium transport
    • Chromium: Immune system; metabolism; kidneys; liver; essential element but toxicity at high doses
    • Cobalt: Blood (erythropoiesis); cardiovascular system; teratogenic at excessive levels
    • Selenium: Thyroid gland (selenoproteins); immune system; antioxidant protection throughout tissues; deficiency impairs immunity and increases oxidative stress
    • Barium: GI tract (diagnostic use); bones; accumulates slowly; generally low toxicity but replaces potassium in cardiac tissue at high levels
    • Caesium: Blood; bone; cellular potassium metabolism; mimics potassium affecting cardiac function and neurological systems
  • Follow-up Tests
    • First Milk Positive: IgE serum testing for milk protein allergy; pediatric allergy consultation; plan for infant feeding strategy and monitoring
    • HBsAg Positive: HBeAg/HBeAb testing; HBV DNA quantitation (viral load); liver function tests; hepatitis B vaccination status; infant vaccination immediately after birth plus HBIG; repeat testing in third trimester
    • Anti-HCV Positive: HCV RNA testing (confirmatory); HCV genotype; liver function tests; hepatitis C viral load assessment; assess need for direct-acting antivirals; pediatric follow-up at 18-24 months
    • Cardiolipin Antibodies Positive: Repeat testing at 6-12 weeks for confirmation; lupus anticoagulant testing; anti-beta2-glycoprotein antibodies; thrombophilia panel; rheumatology consultation; anticoagulation therapy (low-molecular-weight heparin and aspirin) initiation
    • HIV I & II Positive: HIV RNA (viral load); CD4 count; antiretroviral therapy resistance testing; baseline liver and kidney function; initiate antiretroviral therapy immediately; monitor viral load monthly until undetectable; infant antiretroviral prophylaxis planning
    • Iron Low: Serum ferritin; iron supplementation (ferrous sulfate 325 mg daily or equivalent); repeat iron studies in 4-6 weeks; dietary iron assessment; evaluate for ongoing blood loss
    • Iron High: Hemoglobin electrophoresis; ferritin level; assess for hereditary hemochromatosis; phlebotomy may be considered; screen partner for hemochromatosis gene mutations
    • Albumin Low: Liver function panel; prealbumin; 24-hour urine protein; nutritional assessment; evaluate for liver disease or nephrotic syndrome; dietary protein counseling
    • Alkaline Phosphatase Elevated: GGT and 5'-nucleotidase to distinguish source; liver ultrasound if significantly elevated; transaminases (AST/ALT); total/direct bilirubin; assess for cholestasis
    • Total Bilirubin Elevated: Direct vs. indirect fractionation; reticulocyte count; indirect hyperbilirubinemia suggests hemolysis; direct suggests cholestasis; liver ultrasound; Coombs test if hemolysis suspected
    • Direct Bilirubin Elevated: Liver ultrasound; pruritus assessment (intrahepatic cholestasis of pregnancy); fetal monitoring (NST); ursodeoxycholic acid therapy consideration; early delivery planning if severe
    • AST/ALT Elevated: Repeat testing; viral hepatitis serology (HAV, HBV, HCV, EBV, CMV); ultrasound liver; LDH and bilirubin levels; assess for HELLP syndrome if hypertension/proteinuria present
    • BUN Elevated: Serum creatinine; repeat after hydration; assess for preeclampsia if hypertension; evaluate kidney disease; urine dipstick for proteinuria
    • Creatinine Elevated: Baseline renal assessment; 24-hour urine for creatinine clearance and protein; ultrasound kidneys if significantly elevated; nephrology referral if concerning; monitor quarterly
    • Calcium Low: Ionized calcium; phosphate and magnesium levels; vitamin D 25-OH; PTH level; assess for hypoparathyroidism; calcium supplementation (1000 mg daily); vitamin D optimization
    • Uric Acid Elevated (>4.0 mg/dL): Blood pressure monitoring; 24-hour urine protein; repeat uric acid at follow-up; preeclampsia screening; fetal monitoring; assess for eclampsia risk
    • eGFR Low: 24-hour creatinine clearance; repeat baseline testing; ultrasound for kidney disease; renal consultation for declining function; monitoring every 1-2 months
    • Total Cholesterol Elevated: Reassess postpartum; dietary modification counseling; if extremely high (>300 mg/dL), assess for familial hypercholesterolemia; statin avoidance in pregnancy preferred
    • HDL Low: Lifestyle modification; dietary fat composition assessment; exercise recommendations; postpartum follow-up lipid panel; assess cardiovascular risk factors
    • LDL Elevated (>130 mg/dL): Dietary modification; reduce saturated fat intake; increase fiber; postpartum statin consideration if familial hypercholesterolemia; repeat postpartum
    • Triglycerides Elevated: Fasting repeat testing; diet assessment (refined carbohydrates, alcohol); weight management; if >500 mg/dL assess for hypertriglyceridemia and pancreatitis risk; postpartum follow-up
    • TSH Elevated: Free T4 level; thyroid peroxidase antibodies (TPO); levothyroxine initiation (50 mcg daily); TSH monitoring every 6-8 weeks with dose adjustments; repeat testing each trimester
    • TSH Low: Free T4; thyroid antibodies (TSI); PTU or propylthiouracil initiation for hyperthyroidism; beta-blocker for symptoms; TSH monitoring every 2-4 weeks; endocrinology referral
    • HbA1c 5.7-6.4%: Fasting glucose; 2-hour glucose tolerance test; dietary counseling; exercise recommendation; monthly glucose monitoring; repeat HbA1c in 3 months
    • HbA1c ≥6.5%: Fasting glucose; glucose tolerance test; endocrinology referral; insulin therapy if pregestational diabetes confirmed; close glucose monitoring (target 70-130 mg/dL fasting); monthly HbA1c
    • Hemoglobin Low: Iron studies; B12 and folate levels; reticulocyte count; peripheral smear; assess for iron deficiency vs. B12/folate deficiency; target Hgb >11 g/dL; recheck in 4-6 weeks after supplementation
    • MCV Low: Iron studies; serum iron, TIBC, ferritin; peripheral smear; assess for iron deficiency; iron supplementation; dietary assessment; recheck in 6-8 weeks
    • MCV High: Vitamin B12; folic acid levels; methylmalonic acid and homocysteine if B12 low; peripheral smear; assess for pernicious anemia; B12 supplementation (oral or IM)
    • WBC Elevated: Differential count; review medications; assess for infection (urinalysis, urine culture); CRP/ESR; if >20 × 10³/µL consider infection or hematologic malignancy
    • Platelets Low (<150 × 10³/µL): Repeat count (may be platelet clumping artifact); blood smear; assess for gestational thrombocytopenia vs. ITP vs. preeclampsia; coagulation studies if <100; monitoring every 2-4 weeks
    • Vitamin D Deficient: High-dose vitamin D supplementation (2000-4000 IU daily or 50,000 IU weekly × 6-8 weeks); dietary vitamin D sources; sun exposure; repeat 25-OH vitamin D at 6-8 weeks; target >30 ng/mL
    • Vitamin D Insufficient: Supplementation 1000-2000 IU daily; dietary optimization; repeat testing at 4-6 weeks; target >30 ng/mL; check postpartum
    • Folic Acid Low: Prenatal vitamin with 400-800 µg folic acid minimum; 4 mg folic acid daily if history of neural tube defects; dietary folate increase (leafy greens, legumes); repeat folate in 4-6 weeks
    • Vitamin B12 Low: Serum methylmalonic acid and homocysteine; assess for intrinsic factor antibodies (pernicious anemia); B12 supplementation (oral 1000 µg daily or IM 1000 µg monthly); dietary sources; repeat in 4-6 weeks
    • Lead Elevated: Environmental assessment for sources (paint, dust, water, occupational); chelation therapy not recommended in pregnancy; repeat testing; neonatal lead screening at birth
    • Mercury Elevated: Source identification and elimination (fish consumption, occupational exposure); repeat testing; counseling regarding fish consumption; neonatal follow-up
    • Arsenic Elevated: Water source testing; environmental remediation; dietary modifications; toxicology consultation; repeat testing; neonatal monitoring
    • Cadmium Elevated: Occupational exposure assessment; smoking cessation (major source); dietary modification; kidney function monitoring; repeat testing; neonatal assessment
    • Chromium Elevated: Occupational health consultation; workplace exposure control; repeat testing; kidney function monitoring; dietary assessment
    • Cobalt Elevated: Source investigation (supplements, occupational); discontinue potential sources; occupational health referral; repeat testing; toxicology consultation
    • Selenium Low: Supplementation 200 µg daily; dietary selenium sources (Brazil nuts, fish); repeat in 4-6 weeks; assess thyroid function (selenium important for thyroid health)
    • Barium Elevated: Source investigation (diagnostic contrast exposure); repeat testing; GI tract assessment if needed; monitoring for complications
    • Caesium Elevated: Potassium supplementation if deficient; environmental source investigation; cardiac monitoring; repeat testing; toxicology consultation; assess for contamination exposure
  • Fasting Required?
    • Yes, fasting is required for optimal results of the Advanced Prenatal Package, specifically for 8-12 hours before blood collection
    • Fasting Duration: 8-12 hours (ideal fasting time is 10 hours); blood should be drawn in the morning between 7:00-9:00 AM after overnight fasting
    • Water Intake: Plain water (unflavored, unsweetened) is permitted and actually recommended during fasting to maintain hydration, especially important in pregnancy
    • Medications to Avoid: Consult physician before fasting regarding essential medications (e.g., prenatal vitamins, thyroid medication, antihypertensive medications); most can be taken with water unless specifically directed otherwise
    • Supplements to Discontinue: Iron supplements should be discontinued 24 hours before testing for accurate iron studies; resume after blood draw
    • Dietary Restrictions: No food, beverages other than water, coffee (black), or tea (without milk/sugar) permitted for 8-12 hours before testing
    • Alcohol Avoidance: No alcohol consumption for at least 24 hours before testing and throughout pregnancy
    • Physical Activity: Avoid strenuous exercise for 24 hours before testing as it may affect some test results (lipid profile, liver enzymes)
    • Stress Reduction: Minimize emotional and physical stress before testing as stress hormones can affect glucose and lipid measurements
    • Sleep Quality: Ensure adequate sleep (7-8 hours) the night before testing for accurate results
    • Timing Consistency: Menstrual cycle phase may affect some hormonal values; if possible, schedule testing during consistent cycle phases for baseline establishment
    • Position During Draw: Remain seated for 5 minutes before blood draw to minimize hemolysis and ensure accurate results
    • Documentation Requirements: Bring identification and insurance card; provide accurate medical history including current medications and supplements; disclose recent immunizations or illness
    • Nausea Management: If pregnancy nausea is severe, inform phlebotomist; avoid fasting if severe morning sickness present and consult healthcare provider for rescheduling
    • Specimen Processing: Blood samples typically require 24-48 hours for complete testing; some components (lipid profile, glucose) take 2-3 days

How our test process works!

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