Pregnancy

Free pregnancy exams week by week

In this article we present a list of free visits and services (fee-free) that can be requested during a physiological pregnancy, i.e. when there are no known pathologies or risks for either the mother or the baby.

In this article, you will find a detailed list of all the visits and tests offered free of charge by the National Health Service (SSN) during a physiological pregnancy , updated according to the new  LEA 2017  published in the Official Gazette n. 65 of 18 March 2017. It is important to underline, however, that these indications are not yet operational throughout the national territory and that, therefore, in some regions , certain exams may still require the payment of a ticket .

The services are divided by quarter and classified according to gestational age (expressed in weeks + days ). If you don’t know this parameter, you can count it using the  pregnancy weeks calculator .

Attention: the gynecologist or midwife will not always prescribe all these tests, but they will evaluate from time to time which ones to request (and which ones to possibly add) based on your medical history and the progress of your pregnancy. As far as prenatal diagnosis investigations are concerned, to identify any genetic or chromosomal abnormalities early, you will be informed about all the possible options available, their degree of reliability and their risks, so that you can make an informed choice .

Tests in pregnancy: when to perform them

Even if pregnancy is not a disease , it is important that expectant mothers undergo some checks , to monitor their health and that of the future child. Consequently, once the pregnancy has been confirmed with a positive test , the first thing to do is make an appointment with the gynecologist or obstetrician , who will perform a first visit and prescribe the first tests to be performed. But be careful: it will not always be possible to see the embryo on ultrasound during this first appointment , because it could be too early.

On the other hand, it should be emphasized that all couples who decide to have a child should, even before trying to become pregnant , request a pre-conception visit from their trusted doctor. In fact , this meeting will make it possible to ascertain that there are no conditions of risk for the health of the mother and the unborn child and to face the pregnancy in a more conscious , healthy and serene way .

Before pregnancy: the importance of preconception tests

During the pre-conception visit, the doctor will carefully evaluate your state of health , he will advise you to start taking a folic acid supplement immediately and to adopt some good habits that will help protect your future child in its early stages of development. when you still don’t have confirmation that you are pregnant.

In addition, he will prescribe some pre-conception tests  (always free ) to evaluate if you are immune to some potentially dangerous diseases for the fetus, such as toxoplasmosis and  rubella . In this regard, it is important to underline that the rubella vaccine allows you to protect yourself from this infection, but it can only be performed before pregnancy and not during.

First trimester of pregnancy

Exams that can be performed free of charge within the 14th week  of pregnancy  (13+6)

  • FIRST OBSTETRIC VISIT . Including any cytological sampling (PAP test). Not associated with FIRST GYNECOLOGICAL VISIT.
  • BLOOD CHROME: CYTOMETRIC EXAMINATION AND DIFFERENTIAL WBC COUNT Hb, GR, GB, HCT, PLT, IND. DERIV. Including any microscopic control.
  • Hb – HEMOGLOBINS. Fraction dosage (HbA2, HbF, Abnormal Hb). If not performed as a preconception.
  • BLOOD GROUP AB0 (Agglutinogens and Agglutinins) and Rh (D). If not performed as a preconception.
  • ANTIBODIES TO ERYTHROCYTES [Indirect Coombs test]. To be repeated for all women at 28 weeks.
  • GLUCOSE
  • RUBELLA VIRUS IgG and IgM for suspected acute infection. Included: IgG Avidity Test if IgG positive and IgM positive or equivocal. To be repeated within the 17th week in case of negativity.
  • RUBELLA VIRUS IgG ANTIBODIES for immune status control. To be repeated within the 17th week in case of negativity.
  • TOXOPLASMA IgG and IgM ANTIBODIES . Included IgG Avidity Test if IgG positive and IgM positive or equivocal. Including any IgA and Immunoblotting. To be repeated every 4-6 weeks in case of negativity.
  • TREPONEMA PALLIDUM. Syphilis serology. EIA/CLIA and/or TPHA [TPPA] antibodies plus VDRL [RPR]. Including any titration. Included: possible Immunoblotting.
  • VIRUS ACQUIRED IMMUNODEFICIENCY [HIV 1-2]. COMBINED ANTIBODY AND P24 ANTIGEN TEST. Included: possible Immunoblotting. Not associated with Virus Antibodies Immunoblotting (Confirmatory Assay) NOS. If not performed in the previous three months
  • URINE COMPLETE EXAMINATION . Included: urine sediment.
  • URINE CULTURE [URINE CULTURE] . Search for pathogenic bacteria and yeasts. Including bacterial count. If positive, including identification and antibiogram.
  • CHLAMYDIA TRACHOMATIS IgG and IgM ANTIBODIES. Including IgA if IgM negative.
    In case of recognized risk factors.
  • NEISSERIA GONORRHOEAE IN VARIOUS BIOLOGICAL MATERIALS CULTURAL EXAMINATION. If positive, including identification and possible antibiogram.
    In case of recognized risk factors.
  • HEPATITIS C VIRUS [HCV] ANTIBODIES. Including possible Immunoblotting. Not associated with Virus Antibodies Immunoblotting (Confirmatory Assay) NOS.
    In case of recognized risk factors.
  • HEPATITIS C VIRUS [HCV] GENOMIC TYPING. Including, extraction, reverse transcription, amplification, reverse hybridization, or sequencing. Only in case of HCV positive
  • OBSTETRIC ULTRASOUND  To be performed in the first trimester  to determine the gestational age.
  • HCG FREE FRACTION AND PAPP-A. To be performed only in association with “OBSTETRIC ULTRASOUND FOR THE STUDY OF NUCAL TRANSLUCENCE. Included: combined pre and post test counseling (1st trimester).
  • OBSTETRIC ULTRASOUND FOR THE STUDY OF NUCAL TRANSLUCENCE . Included: combined pre and post test consultation. To be carried out only between 11 weeks + 0 days and 13 weeks + 6 days.
  • EX. CERVICAL-VAGINAL CYTOLOGY [conventional PAP test]  If not performed as part of screening programs.
  • VENOUS BLOOD WITHDRAWAL

Second quarter

Exams can be performed free of charge between the 15th and 19th week of pregnancy (from 14+0 to 18+6).

  • TRI TEST FOR AFP, TOTAL HCG OR FREE FRACTION, E3. PRENATAL RISK DETERMINATIONS FOR CHROMOSOMAL ABNORMALITIES AND NEURAL TUBE DEFECTS (2nd trimester).
  • GLUCOSE Serial dosage after loading (from 2 to 4 determinations). Including Basal Glucose Determination.
    With 75 g of Glucose (OGTT 75 g) and only in the presence of risk factors.
  • RUBELLA VIRUS IgG and IgM for suspected acute infection. Included: IgG Avidity Test if IgG positive and IgM positive or equivocal.
  • TOXOPLASMA IgG and IgM ANTIBODIES . Included IgG Avidity Test if IgG positive and IgM positive or equivocal. Including any IgA and Immunoblotting.
    In case of seronegativity.
  • VENOUS BLOOD WITHDRAWAL

Exams can be performed free of charge between the 20th and 24th week of pregnancy (from 19+0 to 23+6).

Exams can be performed free of charge between the 25th and 28th week of pregnancy (from 24+0 to 27+6).

  • TOXOPLASMA IgG and IgM ANTIBODIES . Included IgG Avidity Test if IgG positive and IgM positive or equivocal. Including any IgA and Immunoblotting.
    In case of seronegativity.
  • GLUCOSE Serial dosage after loading (from 2 to 4 determinations). Including Basal Glucose Determination 90.27.1 (1)
    With 75 g of Glucose (OGTT 75 g) and only in the presence of risk factors.
  • URINE COMPLETE EXAMINATION . Included: urine sediment.
  • URINE CULTURE [URINE CULTURE] . Search for pathogenic bacteria and yeasts. Including bacterial count. If positive, including identification and antibiogram.
    In case of significant bacteriuria or leukocyturia and/or other indications of urinary infection.
  • VENOUS BLOOD WITHDRAWAL

Third quarter

Exams can be performed free of charge from the 29th to the 33rd week of pregnancy (from 28+0 to 32+6).

  • BLOOD CHROME: CYTOMETRIC EXAMINATION AND DIFFERENTIAL WBC COUNT Hb, GR, GB, HCT, PLT, IND. DERIV. Including any microscopic control.
  • ANTIBODIES TO ERYTHROCYTES [Indirect Coombs test].
  • TOXOPLASMA IgG and IgM ANTIBODIES . Included IgG Avidity Test if IgG positive and IgM positive or equivocal. Including any IgA and Immunoblotting.
    In case of seronegativity.
  • OBSTETRIC ULTRASOUND
    Only in case of fetal and/or adnexal or maternal pathology.
  • VENOUS BLOOD WITHDRAWAL

Exams that can be performed free of charge from the 34th to the 38th week of pregnancy (from 33+0 to 37+6)

  • BLOOD CHROME: CYTOMETRIC EXAMINATION AND DIFFERENTIAL WBC COUNT Hb, GR, GB, HCT, PLT, IND. DERIV. Including any microscopic control.
  • TOXOPLASMA IgG and IgM ANTIBODIES . Included IgG Avidity Test if IgG positive and IgM positive or equivocal. Including any IgA and Immunoblotting.
    In case of seronegativity.
  •  HBV VIRUS [HBV] REFLEX. HBsAg ANTIGEN + HBsAg ANTIBODY + HBcAg ANTIBODY]. Including ANTIBODIES to HBcAg IgM if HBsAg and anti HBcAg positive. Included HBeAg ANTIGEN if HBsAg positive. Included ANTIBODIES to HBeAg if HBeAg negative.
  • TREPONEMA PALLIDUM. Syphilis serology. EIA/CLIA and/or TPHA [TPPA] antibodies plus VDRL [RPR] including titration if applicable. Including possible Immunoblotting.
  • VIRUS ACQUIRED IMMUNODEFICIENCY [HIV 1-2].COMBINED TEST ANTIBODIES AND P24 ANTIGEN including possible Immunoblotting. Not associated with Virus Antibodies Immunoblotting (Confirmatory Assay) NOS.
  • URINE COMPLETE EXAMINATION . Included: urine sediment.
  • URINE CULTURE [URINE CULTURE] . Search for pathogenic bacteria and yeasts. Including bacterial count. If positive, including identification and antibiogram.
    In case of significant bacteriuria or leukocyturia and/or other indications of urinary infection.
  • BETA-HEMOLYTIC STREPTOCOCCUS GROUP B.  Recommended at 36-37 weeks .
  • VENOUS BLOOD WITHDRAWAL

Exams can be performed free of charge from the 42nd week of pregnancy (from 41+0).

  • OBSTETRIC ULTRASOUND for quantitative evaluation of the amniotic fluid
  • EXTERNAL CARDIOTOCOGRAPHY

Attention: the main international scientific societies of gynecology generally recommend bringing these checks up to the 40th week (or even earlier, depending on the progress of the pregnancy).

Checks and tests during pregnancy: how to obtain exemption?

For services to be exempt, they must be requested by the general practitioner or by the gynecologist or midwife at a public health facility (such as a hospital or family advisory board).

The prescription must bear a specific  exemption code , made up of the letter M followed by the number of the week of gestation (for example M14 for the 14th week, while for pre-conception exams the code will be M00 ).

For expectant mothers who have not performed their first check-up within the 14th week of pregnancy , specialist services in the first trimester will also be exempt , when appropriate, provided that the M99 code is entered on the prescription .

Warnings

To be carried out free of charge, the exams must be performed in accredited public or private health facilities , where there may be long waiting lists . So be careful to schedule the checks in advance and to book the services in time!

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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