Prenatal Collections

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Course Objectives
  1. Identify the different routines and special lab collections done for prenatal patients.
  2. Discuss the importance of timing and frequency of prenatal blood collections.
  3. Identify various challenges associated with handling prenatal blood draws and explore effective methods for preventing errors.
  4. Analyze potential prenatal blood draw scenarios in the phlebotomy setting.

Course Content
Course Creator: Kirsten Hermens, NCMA-P
Total CE Hours: 1 Credit Hour 
Pace Course #: 586-2314-25

Key Terms:
CLIA
CVS
Gestational Age
HCG
mL/dL
OSHA

Outline:
  • Introduction
    • Purpose of prenatal collections
    •  Learning objectives
  • Key Terms & Abbreviations
  • Prenatal Testing Overview
    • Blood Tests
    •  Genetic Carrier Screening
    •  Glucose Tolerance Test (GTT)
      • 1-hour and 3-hour protocols
      •  Interpretation of results & impact of vomiting
    •  Other Tests (Non-Blood) 
      •  Ultrasound
      •  Amniocentesis
      •  CVS
      •  NIPT
      •  Fetal Monitoring
      •  Group B Strep Culture
      •  Urinalysis
  •  Timing & Frequency of Collections
    • First Trimester (8–12 wks)
      •  CBC
      •  Rh
      •  Antibody screen
      •  Infection testing
    •  Second Trimester (14–28 wks)
      • Quad screen
      •  Detailed ultrasound
      •  GTT
    •  Third Trimester (36–38 wks) 
      •  GBS screening
      •  Repeat testing for specimen errors or new clinical needs
  • V. Special Testing
    • Amniocentesis
      • Procedure
      •  Timing
      •  Risks
      •  Aftercare
    •  Chorionic Villus Sampling (CVS)
      • Procedure
      •  Risks
      •  Follow-up testing
    •  NIPT
      • Screening role
      •  Accuracy
      •  Limitations
    • Comparisons
      • NIPT vs. Amnio vs. CVS
    •  High-Risk Pregnancy Testing
      • Preeclampsia labs 
      • Thyroid panels
      •  STI monitoring
  • Phlebotomy Techniques in Prenatal Care
    • Site Selection & Vein Fragility
    •  Patient Positioning
      • Semi-reclined, avoid supine late in pregnancy
    •  Fainting Prevention & Response
    •  Order of Draw Review
    •  Special Considerations
      • Edema
      •  Difficult veins
      •  Hydration
  • Safety & Accuracy
    • Patient identification protocols 
      • OSHA
      • CLIA compliance
    • Common collection errors
      • Labeling
      •  Timing
      •  Tube selection
    •  Preventing repeat specimens: double-check orders, label immediately
  • Legal & Ethical Considerations
    • Informed consent for prenatal testing
    •  Patient autonomy in decision-making
    •  Cultural sensitivity in test discussions
  •  Phlebotomist’s Role Beyond the Needle
    • Empathy & Patient Support 
    • Advocacy
      • Ensuring patients’ rights, clarity, and comfort
    • Stress Communication 
      • Using calm, clear explanations
  • Case Scenarios
  • Conclusion

 
References: 
  1. Routine tests during pregnancy. (n.d.-b). ACOG. https://www.acog.org/womens-health/faqs/routine-tests-during-pregnancy
  2. Common tests during pregnancy. (2024b, June 20). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/common-tests-during-pregnancy
  3. Professional, C. C. M. (2025b, July 22). Glucose Tolerance Test (GTT). Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/glucose-tolerance-test
  4. Glucose tolerance test - Mayo Clinic. (n.d.). https://www.mayoclinic.org/tests-procedures/glucose-tolerance-test/about/pac-20394296
  5. Murray, H. (2005). Diagnosis and treatment of ectopic pregnancy. Canadian Medical Association Journal, 173(8), 905–912. https://doi.org/10.1503/cmaj.050222
  6. Prenatal diagnostic testing for genetic disorders. (n.d.). ACOG. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2016/05/prenatal-diagnostic-testing-for-genetic-disorders
  7. Amniocentesis. (2025, January 13). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/amniocentesis
  8. Professional, C. C. M. (2025, March 19). Chorionic villus sampling for prenatal diagnosis. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/4028-chorionic-villus-sampling-for-prenatal-diagnosis
  9. Professional, C. C. M. (2025b, March 19). NIPT test. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/21050-nipt-test
  10. Group B strep and pregnancy. (n.d.). ACOG. https://www.acog.org/womens-health/faqs/group-b-strep-and-pregnancy
  11. Preeclampsia - Diagnosis & treatment - Mayo Clinic. (2022, April 15). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/preeclampsia/diagnosis-treatment/drc-20355751
  12. Soldin, O. P. (2006). Thyroid function testing in pregnancy and thyroid disease. Therapeutic Drug Monitoring, 28(1), 8–11. https://doi.org/10.1097/01.ftd.0000194498.32398.7b
  13. STIs and pregnancy. (2025, February 12). Sexually Transmitted Infections (STIs). https://www.cdc.gov/sti/about/about-stis-and-pregnancy.html
  14. Prenatal care: Second-trimester visits. (n.d.). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044581
  15. Quad Screen Test. (2024, August 17). American Pregnancy Association. https://americanpregnancy.org/prenatal-testing/quad-screen
  16. Order of blood draw tubes and additives. (2025, April 2). CLSI. https://clsi.org/resources/insights/order-of-blood-draw-tubes-and-additives/

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