Which of the following investigations is NOT routinely performed at the first antenatal visit in India?

Question

Accepted Answer

B. Amniocentesis for chromosomal analysis. ## Routine First Antenatal Visit Investigations

**Key Point:** Amniocentesis is **NOT** a routine first-visit investigation. It is an **invasive diagnostic procedure** reserved for specific indications (advanced maternal age, abnormal screening, fetal anomaly, etc.) and is performed only after informed consent and risk counseling, typically in the second or third trimester.

### Investigations at First Antenatal Visit (8–12 weeks)

| Investigation | Purpose | Timing |
| --- | --- | --- |
| Blood group & Rh typing + IAT | Identify Rh-negative mothers; detect alloimmunization | First visit |
| Hemoglobin & PBF | Screen for anemia; assess RBC morphology | First visit |
| Urine routine & culture | Detect bacteriuria, proteinuria, glycosuria | First visit |
| Blood glucose (fasting/random) | Baseline glucose; screen for overt diabetes | First visit |
| VDRL/RPR | Syphilis screening | First visit |
| HIV, HBsAg, HCV serology | Infectious disease screening | First visit |
| Pap smear (if due) | Cervical cancer screening | First visit |
| Transvaginal ultrasound | Confirm viability, dating, rule out ectopic | First visit |

**High-Yield:** Amniocentesis is a **second/third-trimester invasive test** with a small risk of miscarriage (~0.1–0.3%); it is never routine and requires specific indication and counseling.

### When Amniocentesis IS Indicated

- Advanced maternal age (≥35 years)
- Abnormal first-trimester combined screening (high risk)
- Abnormal quad screen or integrated screen
- Fetal anomaly on ultrasound
- Previous child with chromosomal disorder
- Carrier status for single-gene disorder

**Clinical Pearl:** Non-invasive prenatal testing (NIPT) and sequential/integrated screening have reduced the need for invasive testing in many centers, but when indicated, amniocentesis is performed at 15–18 weeks gestation.

Answer

A. Urine routine examination and culture

Answer

C. Hemoglobin estimation and peripheral blood smear

Answer

D. Blood group and Rh typing with indirect Coombs test

Which of the following investigations is NOT routinely performed at the first antenatal visit in India?

Explanation

Routine First Antenatal Visit Investigations

Investigations at First Antenatal Visit (8–12 weeks)

When Amniocentesis IS Indicated

Practice similar questions

Join our NEET PG community

Investigation	Purpose	Timing
Blood group & Rh typing + IAT	Identify Rh-negative mothers; detect alloimmunization	First visit
Hemoglobin & PBF	Screen for anemia; assess RBC morphology	First visit
Urine routine & culture	Detect bacteriuria, proteinuria, glycosuria	First visit
Blood glucose (fasting/random)	Baseline glucose; screen for overt diabetes	First visit
VDRL/RPR	Syphilis screening	First visit
HIV, HBsAg, HCV serology	Infectious disease screening	First visit
Pap smear (if due)	Cervical cancer screening	First visit
Transvaginal ultrasound	Confirm viability, dating, rule out ectopic	First visit