Pregnancy, Initial Screening Profile

CPT: 81001; 85025; 86592; 86762; 86803; 86850; 86900; 86901; 87086; 87340; 87389; 87491; 87591
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Synonyms

  • Obstetric
  • Pregnancy
  • Prenatal
  • Women's Health

Test Includes

CBC with platelet count and differential; ABO grouping and Rh typing; antibody screen (includes ID and titer of all irregular antibodies detected); urinalysis, complete with microscopic examination; urine culture, comprehensive; HBsAg screen; rubella antibodies, IgG; syphilis serology (if RPR positive, Treponema pallidum-specific test is performed); HIV p24 antigen/antibody screen with reflex; HCV antibody with reflex to quantitative real-time PCR; Chlamydia trachomatis and Neisseria gonorrhoeae NAAT


Special Instructions

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

If reflex test is performed, additional charges/CPT code(s) may apply.

Note: Client must clearly label the site/source of each Chlamydia/Gonococcus Nucleic Acid Amplification specimen.

HIV p24 Antigen/Antibody With Reflex to Confirmation [083935] requires a dedicated, unopened, gel-barrier tube or red-top tube sent directly to the testing facility.


Expected Turnaround Time

1 - 4 days


Related Documents


Specimen Requirements


Specimen

Serum and whole blood and urine (UA/Culture) and endocervical swab, vaginal swab, or first-void urine (patient should not have urinated for one hour prior to specimen collection)


Volume

9 mL serum, 8 mL whole blood to fill line on Vacutainer® gray top, 10 mL (red/yellow), one swab (endocervical, vaginal, or urethral), 2 mL of a 20 mL to 30 mL urine collection


Container

Gel-barrier tube and lavender-top (EDTA) tube and gray-top Vacutainer® for urine culture and urinalysis transport (red/yellow) and Gen-Probe® Aptima® swab or Aptima® urine specimen transport


Collection

Serum specimen: Usual blood collection technique.

Urine (urinalysis and culture): A voided specimen is usually suitable. If the specimen is likely to be contaminated, a clean catch midstream specimen is desirable.

Lavender-top (EDTA): Gently invert lavender top tubes 8-10 times immediately to mix specimen with anticoagulant.

Ct/GC: Option 1: Gen-Probe® Aptima® endocervical or vaginal swab.

Endocervical swab: Remove excess mucus from the cervical os and surrounding mucosa using the cleaning swab (white-shaft swab in the package with red printing). Discard this swab. Insert the specimen collection swab (blue-shaft swab in the package with green printing) into the endocervical canal. Gently rotate the swab clockwise for 10 to 30 seconds in the endocervical canal to ensure adequate sampling. Withdraw the swab carefully; avoid contact with the vaginal mucosa. Remove the cap from the swab specimen transport tube and immediately place the specimen collection swab into the transport tube. Carefully break the swab shaft at the scoreline; use care to avoid splashing of the contents. Recap the swab specimen transport tube tightly.

Vaginal Swab:

Care Provider Specimen: Collect vaginal fluid sample using the Gen-Probe® Aptima® vaginal swab kit by contacting the swab to the lower third of the vaginal wall and rotating the swab for 10 to 30 seconds to absorb fluid. Immediately place the swab into the transport tube and carefully break the swab shaft against the side of the tube. Tightly screw on the cap.

Patient Self-Collection: Partially open the package of the Gen-Probe® Aptima® vaginal swab kit. Do not touch the soft tip or lay the swab down. If the soft tip is touched, the swab is laid down, or the swab is dropped, use a new Aptima® swab specimen collection kit. Remove the swab. Carefully insert the swab into the vagina about two inches past the introitus and gently rotate the swab for 10 to 30 seconds, making sure the swab touches the walls of the vagina so that moisture is absorbed by the swab. Withdraw the swab without touching the skin. Immediately place the swab into the transport tube, and carefully break the swab shaft against the side of the tube. Tightly screw on the cap.

Ct/GC: Option 2: Urine Specimen: The patient should not have urinated for at least one hour prior to specimen collection. Direct patient to provide a first-catch urine (approximately 20 to 30 mL of the initial urine stream) into a urine collection cup free of any preservatives. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity; lesser volumes may not adequately rinse organisms into the specimen. Female patients should not cleanse the labial area prior to providing the specimen. Add urine to the Aptima® Combo 2 urine collection device. The final volume must be between the two black lines on the device (about 2 mL).


Storage Instructions

See individual test components.


Stability Requirements

Test Number

Sample Type

Room Temperature

Refrigerated

Frozen

Freeze/thaw Cycles

006510

Serum or plasma

14 days

14 days

14 days

Stable x3

144050

Serum or plasma

Antibody test: 24 hours

PCR test: 24 hours

Antibody test: 6 days

PCR test: 72 hours

Antibody test: 14 days

PCR test: 6 weeks

N/A

N/A

020131

Serum or whole blood

Serum: 2 days

Whole blood: 3 days

Serum: 14 days

Whole blood: 7 days

Serum: 14 days

Whole blood: unstable

Serum: N/A

Whole blood: unstable

083935

Serum

48 hours

14 days

14 days

Stable x5

183194

Swab or urine

Aptima® swab: 60 days

Aptima® urine: 30 days

Aptima® swab: 60 days

Aptima® urine: 30 days

N/A

N/A

005009

Whole blood

1 day

3 days

Unstable

Unstable

003772

Urine

BD transport tube: 72 hours

Urine cup: 2 hours

BD transport tube: 72 hours

Urine cup: 48 hours

N/A

N/A

008851

Urine

Preserved: 72 hours

Unpreserved: 2 hours

Preserved: 72 hours

Unpreserved: 24 hours

N/A

N/A


Causes for Rejection

Grossly hemolyzed and/or contaminated serum and/or plasma specimens; specimen types other than those listed above; specimens received in containers other than those specified above; specimens received outside of the stated stability requirements; specimens without correct labeling


Test Details


Use

Initial screening profile intended for the first prenatal visit to evaluate health status in early pregnancy. This profile aligns with current clinical guidelines and recommendations (see references).


Methodology

See individual test components.


References

AAP Committee on Fetus and Newborn and ACOG Committee on Obstetric Practice. Guidelines for Perinatal Care. Kilpatrick SJ, Papile LA, Macones GA, eds. 8th edition, September 2017.
Centers for Disease Control and Prevention (CDC). Hepatitis B. CDC website: www.cdc.gov/hepatitis/hbv/index.htm. Accessed March 2022.
Centers for Disease Control and Prevention (CDC), The American College of Obstetrics and Gynecologists. Screening and Referral Algorithm for Hepatitis B Virus (HBV) Infection Among Pregnant Women. CDC website: https://www.cdc.gov/hepatitis/hbv/pdfs/prenatalhbsagtesting_508.pdf. Accessed March 2022.
Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018; 67(1):1-31.29939980
U.S. Department of Health and Human Service. 2020. Sexually Transmitted Infections: National Strategic Plan for the United States 2021-2025. Washington, DC. Accessed March 2022 at https://www.hhs.gov/sites/default/files/STI-National-Strategic-Plan-2021-2025.pdf.
U.S. Preventive Services Task Force: Screening for Hepatitis B Virus Infection in Pregnant Women: Recommendation Statement. Am Fam Physician. 2020 Jan 15;101(2):112-114.31939639

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
144053 Pregnancy, Initial Screen 000000
144053 Pregnancy, Initial Screen 005025 WBC x10E3/uL 6690-2
144053 Pregnancy, Initial Screen 005033 RBC x10E6/uL 789-8
144053 Pregnancy, Initial Screen 005041 Hemoglobin g/dL 718-7
144053 Pregnancy, Initial Screen 005058 Hematocrit % 4544-3
144053 Pregnancy, Initial Screen 006015 Antibody Screen 890-4
144053 Pregnancy, Initial Screen 006056 ABO Grouping 883-9
144053 Pregnancy, Initial Screen 006064 Rh Factor 10331-7
144053 Pregnancy, Initial Screen 006072 RPR 20507-0
144053 Pregnancy, Initial Screen 006204 Rubella Antibodies, IgG index 5334-8
144053 Pregnancy, Initial Screen 006510 HBsAg Screen 5196-1
144053 Pregnancy, Initial Screen 008851 Urine Culture,Prenatal, w/GBS 630-4
144053 Pregnancy, Initial Screen 012237 Microscopic Examination 12235-8
144053 Pregnancy, Initial Screen 013045 Urine-Color 5778-6
144053 Pregnancy, Initial Screen 013052 Appearance 5767-9
144053 Pregnancy, Initial Screen 013060 Specific Gravity 5811-5
144053 Pregnancy, Initial Screen 013078 pH 5803-2
144053 Pregnancy, Initial Screen 013086 Glucose 25428-4
144053 Pregnancy, Initial Screen 013094 Protein 20454-5
144053 Pregnancy, Initial Screen 013102 Occult Blood 5794-3
144053 Pregnancy, Initial Screen 013104 Bilirubin 5770-3
144053 Pregnancy, Initial Screen 013105 Urobilinogen,Semi-Qn mg/dL 20405-7
144053 Pregnancy, Initial Screen 013106 Nitrite, Urine 5802-4
144053 Pregnancy, Initial Screen 013110 Ketones 2514-8
144053 Pregnancy, Initial Screen 013185 WBC Esterase 5799-2
144053 Pregnancy, Initial Screen 015065 MCV fL 787-2
144053 Pregnancy, Initial Screen 015073 MCH pg 785-6
144053 Pregnancy, Initial Screen 015081 MCHC g/dL 786-4
144053 Pregnancy, Initial Screen 015107 Neutrophils % 770-8
144053 Pregnancy, Initial Screen 015108 Immature Granulocytes % 71695-1
144053 Pregnancy, Initial Screen 015123 Lymphs % 736-9
144053 Pregnancy, Initial Screen 015131 Monocytes % 5905-5
144053 Pregnancy, Initial Screen 015149 Eos % 713-8
144053 Pregnancy, Initial Screen 015156 Basos % 706-2
144053 Pregnancy, Initial Screen 015172 Platelets x10E3/uL 777-3
144053 Pregnancy, Initial Screen 015180 Hematology Comments: 18314-5
144053 Pregnancy, Initial Screen 015909 Neutrophils (Absolute) x10E3/uL 751-8
144053 Pregnancy, Initial Screen 015911 Immature Grans (Abs) x10E3/uL 53115-2
144053 Pregnancy, Initial Screen 015917 Lymphs (Absolute) x10E3/uL 731-0
144053 Pregnancy, Initial Screen 015925 Monocytes(Absolute) x10E3/uL 742-7
144053 Pregnancy, Initial Screen 015933 Eos (Absolute) x10E3/uL 711-2
144053 Pregnancy, Initial Screen 015941 Baso (Absolute) x10E3/uL 704-7
144053 Pregnancy, Initial Screen 015945 NRBC % 58413-6
144053 Pregnancy, Initial Screen 019054 PDF 11502-2
144053 Pregnancy, Initial Screen 083936 HIV Ab/p24 Ag Screen 56888-1
144053 Pregnancy, Initial Screen 105007 RDW % 788-0
144053 Pregnancy, Initial Screen 115398 Immature Cells N/A
144053 Pregnancy, Initial Screen 144035 HCV Ab 40726-2
144053 Pregnancy, Initial Screen 188078 Chlamydia trachomatis, NAA 43304-5
144053 Pregnancy, Initial Screen 188086 Neisseria gonorrhoeae, NAA 43305-2
144053 Pregnancy, Initial Screen 333336 Microscopic Examination 12235-8
144053 Pregnancy, Initial Screen 000000 SOURCE OF SPECIMEN

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