First-Antenatal-Visit Blood Investigations
At the first antenatal (booking) visit, routine blood tests are recommended to identify anaemia and to establish baseline blood group and immunity, and to screen for key maternal infections. Maternal infection screening is recommended at least once during pregnancy and preferably in the first trimester. [1], [2]
Core Infection Screening Tests
- HIV infection testing is recommended for all pregnant women at the first prenatal visit. [3]
- Syphilis serologic testing is recommended for all pregnant women at the first prenatal visit. [3]
- Hepatitis B testing is recommended with hepatitis B surface antigen (HBsAg) testing at an early prenatal visit (e.g., first trimester) for each pregnancy. [3]
- Hepatitis C testing is recommended for all pregnant women during each pregnancy. [3]
Baseline Hematology and Blood Bank Tests
- Full blood count (FBC) is recommended at the first antenatal (booking) appointment. [1]
- Blood group and rhesus D status are recommended at the first antenatal (booking) appointment. [1]
Immunity Screening Tests
- Rubella immunity is recommended to be assessed using a blood test at the first trimester as part of routine prenatal testing. [4]
Commonly Associated First-Visit Laboratory Additions
- Indirect antiglobulin testing (indirect Coombs) may be performed when indicated by the woman’s baseline blood bank status and policies for antibody screening. [1]
Tests Generally Not Included in “First Visit” Routine Panels
- Gestational diabetes screening is recommended at a later gestational age and is not part of routine blood investigations at the first antenatal visit in standard care pathways. [5]
Documented First-Visit Timing
- HIV, syphilis, and hepatitis B testing are recommended at least once during pregnancy and ideally as early as possible, preferably at the first antenatal care visit/first trimester. [2]
Key Sources
- WHO recommends HIV, syphilis, and hepatitis B testing at least once during pregnancy and as early as possible, ideally at the first ANC visit. [2]
- NICE recommends offering blood tests for full blood count and blood group and rhesus D status at the first antenatal (booking) appointment and includes the national programme for HIV, syphilis, and hepatitis B screening. [1]
- CDC recommends first-visit testing for HIV, syphilis, HBV, and HCV for all pregnant women during each pregnancy. [3]