Antenatal Tests by Week: A Global Pregnancy Testing Schedule
A WHO-based antenatal testing schedule by pregnancy week, covering booking blood tests, ultrasound, diabetes screening, GBS, pre-eclampsia checks, and risk-based country-specific tests.
Most uncomplicated pregnancies need a clear testing plan, not every possible test. This WHO-based antenatal testing schedule explains the common checks by week, what each test is for, and when extra tests are added because of symptoms, risk factors, country policy, or abnormal results.
Use this guide as a global starting point. Local pregnancy-care schedules may differ because countries adapt antenatal care to disease prevalence, available services, funding rules, and national clinical protocols. This article is educational information and does not replace care from your doctor, midwife, obstetrician, or local antenatal clinic.
Quick answer: which antenatal tests are usually done?
In an uncomplicated pregnancy, the core early package commonly includes haemoglobin or full blood count, blood group and RhD status, red-cell antibody screening, HIV, syphilis, hepatitis B surface antigen, urine culture, blood pressure, weight/BMI, medication review, and an early ultrasound before 24 weeks. Later pregnancy commonly adds ongoing blood-pressure checks, urine protein assessment when indicated by protocol or symptoms, fetal growth and movement review, gestational diabetes testing around 24–28 weeks, and country-specific tests such as Group B Streptococcus screening where that policy is used.
The safest way to think about antenatal tests is by purpose:
- Confirm and date the pregnancy: pregnancy test and ultrasound when needed.
- Protect the mother: anaemia, blood pressure, urine infection, diabetes, and mental-health screening.
- Protect the baby: blood group/RhD, antibody screen, fetal growth, presentation, and selected genetic screening.
- Prevent infection transmission: HIV, syphilis, hepatitis B, and other infections according to risk and country policy.
WHO antenatal contact schedule
WHO recommends at least eight antenatal contacts for a positive pregnancy experience. The contact model is not just a test timetable; each contact also includes counselling, nutrition, symptom review, mental-health support, birth planning, and risk assessment.
| Contact | Recommended timing | Main testing focus |
|---|---|---|
| 1 | Up to 12 weeks | Booking tests, risk assessment, early ultrasound planning |
| 2 | 20 weeks | Blood pressure, urine/protein assessment if indicated, anatomy scan pathway |
| 3 | 26 weeks | Blood pressure, symptoms, fetal growth review, diabetes testing window |
| 4 | 30 weeks | Blood pressure, fetal growth and movements, follow-up abnormal results |
| 5 | 34 weeks | Blood pressure, anaemia follow-up if required, fetal growth/movement review |
| 6 | 36 weeks | Presentation, fetal wellbeing, country-specific late-pregnancy screening |
| 7 | 38 weeks | Blood pressure, pre-eclampsia symptoms, fetal movement and birth planning |
| 8 | 40 weeks | Blood pressure, fetal wellbeing, post-dates planning if pregnancy continues |
Extra visits and tests are needed for bleeding, pain, fever, severe vomiting, reduced fetal movements, high blood pressure, diabetes, previous pregnancy complications, twin pregnancy, abnormal ultrasound results, or any clinician concern.
Before 12 weeks: booking tests and first assessment
The first antenatal visit should ideally happen before 12 weeks. This visit confirms key baseline information and looks for problems that are safer to identify early.
| Test or assessment | Why it is done | Typical frequency |
|---|---|---|
| Urine or blood hCG pregnancy test | Confirms pregnancy when clinical confirmation is needed | Once initially; repeat only if uncertain or clinically indicated |
| Full blood count or haemoglobin | Checks anaemia and important blood-cell abnormalities | At booking; repeat depends on local protocol and symptoms |
| ABO blood group and RhD status | Identifies maternal blood group and Rh-negative pregnancy | Once if reliable documentation is not already available |
| Red-cell antibody screen | Detects antibodies that may affect the fetus | At booking; repeat based on Rh status, antibodies, and country protocol |
| HIV test | Prevents and manages mother-to-child transmission | At least once, as early as possible; repeat in high-burden settings or continuing risk |
| Syphilis test | Detects infection that needs prompt treatment | At least once, as early as possible; repeat where prevalence or risk is high |
| Hepatitis B surface antigen (HBsAg) | Identifies hepatitis B infection and newborn prevention needs | At least once, as early as possible |
| Midstream urine culture | Finds asymptomatic bacteriuria, which can affect pregnancy outcomes | Once early; repeat after treatment or when symptoms/risk require |
| Blood pressure | Screens for chronic hypertension and pre-eclampsia risk | Every antenatal contact |
| Weight and BMI | Supports nutrition, weight-gain, and risk assessment | Weight at booking and monitored during pregnancy; BMI calculated early |
| Medication and medical-history review | Identifies high-risk pregnancy and medicines that may need review | At booking and updated at later contacts |
WHO has emphasized early testing for HIV, syphilis, and hepatitis B in pregnancy as part of preventing mother-to-child transmission. A positive result should trigger prompt, confidential care—not blame or delay.
Ultrasound, fetal anatomy, and genetic screening
WHO recommends one ultrasound before 24 weeks. The main purposes are to estimate gestational age, detect multiple pregnancy, improve detection of fetal abnormalities, and reduce unnecessary induction for a wrongly presumed post-term pregnancy.
| Test | Common timing | Important point |
|---|---|---|
| Early or dating ultrasound | Often first trimester, when available | Helps confirm viability, location, number of fetuses, and gestational age |
| Detailed fetal/anatomy ultrasound | Usually before 24 weeks where available | Looks at fetal anatomy and placental location; follow-up depends on findings |
| Nuchal translucency scan | Approximately 11–13+6 weeks | Used only if the screening pathway is offered and chosen |
| NIPT or cell-free DNA screening | Usually from around 10 weeks | Screening test, not a diagnostic result; abnormal results usually need confirmatory counselling/testing |
| Chorionic villus sampling or amniocentesis | Timing depends on the procedure | Diagnostic tests used when indicated, not routine for everyone |
Genetic and chromosomal screening is highly country-dependent. Eligibility, public funding, counselling requirements, and follow-up pathways vary widely. Patients should be told clearly whether a test is a screening test or a diagnostic test.
20–28 weeks: blood pressure, growth, and diabetes testing
From about 20 weeks onward, antenatal care pays close attention to blood pressure, symptoms of pre-eclampsia, fetal growth, fetal movement education, and diabetes screening.
| Test or assessment | Timing | Frequency |
|---|---|---|
| Blood pressure | Every contact | Every contact |
| Urine protein assessment | Especially from 20 weeks when hypertension or symptoms occur | According to protocol or clinical indication |
| Fundal-height measurement | From approximately 24 weeks | Every contact after 24 weeks in many care models |
| Fetal heart and movement review | When technically appropriate and later after movements are expected | At routine contacts, especially later pregnancy |
| Gestational diabetes testing | Usually 24–28 weeks | Once routinely for most women without known diabetes; repeat/monitor if abnormal |
| Repeat haemoglobin/full blood count | Commonly 24–28 weeks | National protocol or clinical indication |
| RhD/antibody follow-up and anti-D prophylaxis | Around 28 weeks for relevant patients | Rh-negative or antibody-positive pregnancy according to local regimen |
Gestational diabetes testing
For most women without known diabetes, testing is commonly performed at 24–28 weeks using an oral glucose-tolerance pathway. Exact thresholds and screening methods differ between countries. Earlier glucose testing may be needed for previous gestational diabetes, known prediabetes, obesity or strong metabolic risk, a previous large baby, strong family history, symptoms of hyperglycaemia, or abnormal early glucose results.
If diabetes is diagnosed, care usually changes from a single screening test to individualised monitoring, nutrition advice, medication decisions where needed, and fetal-growth surveillance.
28–40 weeks: late-pregnancy checks
The third trimester is focused on pre-eclampsia surveillance, fetal growth and movement, fetal presentation, anaemia follow-up, and birth planning. Not every late-pregnancy test is routine for every low-risk pregnancy.
| Test or assessment | When it is usually considered | Routine for everyone? |
|---|---|---|
| Blood pressure and pre-eclampsia symptom review | Every later contact | Yes, as part of routine care |
| Urine protein | Hypertension, symptoms, or country protocol | Protocol-dependent |
| Fundal height and fetal movements | Every later contact | Common routine assessment |
| Fetal presentation | Late third trimester, especially around 36 weeks | Common routine assessment |
| Repeat full blood count/haemoglobin | Often around 28 weeks and/or 34–36 weeks | Country protocol or clinical indication |
| Repeat HIV, syphilis, or hepatitis testing | High-burden settings, ongoing exposure risk, or national policy | Not universal in every low-burden setting |
| Growth ultrasound or Doppler ultrasound | Growth concern, hypertension, diabetes, reduced movements, or other risk | No, usually indicated by risk or findings |
| Cardiotocography/non-stress test | High-risk pregnancy, reduced movements, or another indication | No, not routine for every uncomplicated pregnancy |
Group B Streptococcus (GBS)
GBS screening policy is country-dependent. Some countries use universal late-pregnancy vaginal–rectal swab screening, commonly around 35–37 weeks. Other countries use risk factors during labour instead of universal screening. A global article should not label GBS screening as an identical WHO requirement everywhere.
Tests added by country policy, symptoms, or risk group
WHO provides a global framework, but national programmes may add tests because local disease patterns are different. The following tests may be routine in one country, risk-based in another, and uncommon in a third.
Infection tests that may be added
- Hepatitis C testing based on national universal policy or maternal risk factors.
- Chlamydia and gonorrhoea testing for symptoms, exposure risk, young age, or national policy.
- Tuberculosis assessment or testing in high-burden settings, exposure, symptoms, or immunosuppression.
- Malaria testing in endemic areas or after relevant travel/exposure.
- Toxoplasmosis, rubella immunity, varicella immunity, Chagas disease, or Zika testing where local programmes or exposure risks apply.
Maternal-condition tests that may be added
- Thyroid function when there is thyroid history, symptoms, goitre, medication use, or local protocol.
- Kidney function, liver function, urine protein-to-creatinine ratio, or 24-hour urine protein for hypertension, kidney disease, diabetes, pre-eclampsia concern, or severe symptoms.
- Ferritin, vitamin B12, folate, or iron studies for anaemia, diet risk, malabsorption, or abnormal blood count.
- Haemoglobin electrophoresis, sickle-cell testing, or thalassaemia testing according to ancestry, family history, anaemia pattern, or country screening programme.
- Bile acids for itching that raises concern for intrahepatic cholestasis of pregnancy.
Symptoms that should trigger urgent assessment
Seek urgent local care for heavy bleeding, severe abdominal pain, fainting, severe headache, visual symptoms, chest pain, breathlessness, seizures, fever with feeling very unwell, reduced fetal movements, leaking fluid before labour, severe swelling with high blood pressure symptoms, or any symptom your clinician told you to treat as urgent.
Simple antenatal testing timeline
| Pregnancy stage | Common tests and checks |
|---|---|
| Before 12 weeks | Pregnancy confirmation if needed; full blood count/haemoglobin; ABO/RhD; antibody screen; HIV; syphilis; HBsAg; urine culture; blood pressure; weight/BMI; medication and risk assessment; early ultrasound planning. |
| 11–14 weeks | Dating/viability ultrasound if not already completed; nuchal translucency or chromosomal screening where chosen and available; NIPT from around 10 weeks where available. |
| 18–24 weeks | Fetal anatomy ultrasound, placental location, fetal number and structural assessment, blood-pressure and pre-eclampsia surveillance. |
| 24–28 weeks | Gestational diabetes testing, repeat haemoglobin/full blood count according to local protocol, fundal-height monitoring, Rh-negative management and antibody follow-up. |
| 28–34 weeks | Blood pressure, pre-eclampsia symptom review, fundal height, fetal movement review, repeat infection tests only if national policy or risk requires, growth scan only if indicated. |
| 35–37 weeks | GBS screening in screening-based countries, fetal presentation, repeat blood count or other tests according to country protocol. |
| 38–40 weeks | Blood pressure, proteinuria/symptom assessment, fetal growth, movements, heart rate and presentation, additional fetal surveillance only when overdue, symptomatic, or high-risk. |
Questions to ask at your antenatal visit
- Which tests are routine in my country or clinic, and which are optional?
- Do I need any extra tests because of my history, medicines, age, symptoms, previous pregnancy, or family background?
- Which results need urgent contact, and which can wait for the next appointment?
- Is this a screening test or a diagnostic test?
- Who will explain abnormal results, and how quickly?
- Do I need a repeat test later in pregnancy?
Keep a copy of your results and bring them to each appointment. If you move between countries or clinics during pregnancy, ask the new care team which tests are accepted as documented and which need repeating.
Bottom line
A strong antenatal testing plan starts early, repeats only what needs repeating, and adds country-specific or risk-based tests when they genuinely change care. The WHO framework supports at least eight antenatal contacts, early infection testing, one ultrasound before 24 weeks, ongoing blood-pressure surveillance, and flexible adaptation to local health systems.
This article is for educational purposes only. It does not replace professional medical advice, diagnosis, treatment, or emergency care. Always consult your healthcare professional for a testing plan that matches your pregnancy, country, and clinical risk.
Medical references
- WHO recommendations on antenatal care for a positive pregnancy experience — World Health Organization, 2016
- WHO: New guidelines on antenatal care for a positive pregnancy experience — World Health Organization, 2016
- WHO antenatal care adaptation toolkit — World Health Organization
- WHO prequalifies first triple diagnostic test for HIV, hepatitis B and syphilis — World Health Organization, 2025
- WHO HIV testing services decision logic: retesting during pregnancy — World Health Organization
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