🩸 Antenatal Guide — Weeks 8–14
First Trimester Blood Tests
The booking blood tests in early pregnancy form the foundation of your antenatal care. They identify conditions that could affect your pregnancy — many of which are entirely manageable when caught early. Here is exactly what is tested, why each test matters, and what the results mean.
Key Milestones
🌱 Why booking bloods matter
These tests are called "booking" tests because they are done at your first formal antenatal appointment — ideally before 12 weeks. They establish your baseline, identify infectious conditions that need treatment to protect your baby, and flag haematological problems that need correction before labour.
🌱 What happens after abnormal results
Abnormal results do not mean your pregnancy is at risk of failure. Most conditions identified (anaemia, low immunity, infections) are manageable and treated as part of routine antenatal care. You will be counselled about each result and a plan made at the same appointment.
🌱 Results are confidential
All antenatal blood test results — including HIV, Hepatitis B, and syphilis — are confidential and will be discussed only with you. Your result does not appear in any public record without your written consent.
Essential Tests & Scans
Full Blood Count (FBC)
⏱ At booking, weeks 8–12
Screens for anaemia — the most common complication of pregnancy in Nigeria. Haemoglobin below 10.5 g/dL in pregnancy requires treatment (oral iron, or IV iron for severe cases). Also checks platelets (for clotting disorders) and white cells (for unsuspected infection or blood disorders). Sickle cell disease or trait is often first identified via FBC — the MCV (mean cell volume) and blood film provide clues.
Blood Group and Rhesus Factor
⏱ At booking
Determines your ABO blood type (for transfusion planning) and your Rhesus factor (positive or negative). Rhesus-negative mothers (e.g., blood group O-negative) are at risk of Rhesus disease — where maternal antibodies attack a Rhesus-positive baby's red cells. This is entirely preventable with anti-D immunoglobulin injections given at sensitising events (bleeding, trauma, amniocentesis) and at 28 weeks.
HIV Screening (PMTCT)
⏱ At booking and repeat at 36 weeks if high risk
All pregnant women are offered HIV testing as part of prevention of mother-to-child transmission (PMTCT). If positive, ART started in pregnancy reduces transmission risk to less than 1%. A negative test during a window period may need repeat testing.
Hepatitis B (HBsAg)
⏱ At booking
Babies of Hepatitis B positive mothers must receive HBV vaccine and HBIG within 12 hours of birth — this prevents 90%+ of vertical transmission. Without knowing the mother's status, this life-saving intervention cannot be planned. Nigeria has among the highest Hepatitis B carrier rates globally.
Syphilis (VDRL / TPHA)
⏱ At booking
Untreated syphilis in pregnancy causes miscarriage, stillbirth, and congenital syphilis (a devastating syndrome causing bone, skin, and neurological damage in the newborn). Treated with penicillin in pregnancy, transmission is almost entirely preventable. Universal screening is essential — syphilis is more common in Nigerian urban populations than is widely appreciated.
Rubella Immunity Check
⏱ At booking
Rubella (German measles) in the first trimester causes congenital rubella syndrome — cataracts, heart defects, deafness, and intellectual disability. If a pregnant woman is rubella non-immune, she must avoid exposure and be vaccinated after delivery (the vaccine cannot be given in pregnancy). Most women vaccinated in childhood are immune, but immunity can wane.
Urine Culture (Midstream Sample)
⏱ At booking; repeat if symptomatic
Asymptomatic bacteriuria — bacteria in the urine without symptoms — is found in 5–8% of pregnant women and is an independent risk factor for premature labour, kidney infection (pyelonephritis), and low birthweight. Treatment with antibiotics significantly reduces these risks. A midstream urine culture (not just a dipstick) is essential because dipstick alone misses many cases.
Fasting Blood Glucose (for high-risk women)
⏱ At booking if high risk
Women with a family history of Type 2 diabetes, previous GDM, BMI above 30, or previous large baby benefit from early glucose screening rather than waiting until 24–28 weeks. Early-onset gestational diabetes carries higher risks.
Frequently Asked Questions
Can all these tests be done in one blood draw?
Yes — all booking blood tests can be collected in 2–4 blood tubes in a single session at Mascot Healthcare. A urine sample is also collected at the same visit. Results are typically available within 24–48 hours and reviewed at your next antenatal appointment.
Is HIV testing mandatory in pregnancy?
In Nigeria, HIV testing is offered as a standard component of antenatal care (opt-out approach — you are tested unless you explicitly decline). It is strongly encouraged and has saved tens of thousands of babies from HIV infection through the PMTCT programme. You cannot be forced to test, but declining means your baby cannot receive the appropriate prophylaxis if you are HIV positive.
My FBC shows sickle cell trait (AS) — what does this mean for my baby?
Sickle cell trait (AS) in the mother alone does not affect the pregnancy or the mother's health significantly. The risk is if the father is also AS (or SS) — in which case the baby has a 25% chance of sickle cell disease. Your partner should be tested. If both parents are AS, a referral for genetic counselling and discussion of prenatal diagnosis options is appropriate.
I tested syphilis positive — what happens now?
Syphilis in pregnancy is treated with penicillin (benzathine penicillin G injection) — highly effective and safe for the baby. Treatment in the first and second trimester prevents nearly all cases of congenital syphilis. If you are allergic to penicillin, an alternative regimen is used. Your partner must also be tested and treated. Syphilis is curable — a positive result is an opportunity for a simple, effective intervention, not a cause for shame.