Important Tests During Pregnancy

What blood tests, urine tests, and investigations are done during pregnancy and why?

18/08/2026

Blood Pressure Monitoring

Blood pressure is checked at every ANC visit because hypertensive disorders of pregnancy — including preeclampsia — are among the leading causes of maternal death in Rwanda and globally. A sustained reading of 140/90 mmHg or higher after 20 weeks, especially combined with protein in the urine, indicates preeclampsia.

Preeclampsia can progress rapidly to eclampsia (seizures), organ failure, and death if not treated. It can only be detected through blood pressure monitoring and urine testing at ANC visits. There are no reliable symptoms in the early stages — which is why regular ANC attendance is life-saving.

Haemoglobin — Testing for Anaemia

A haemoglobin test measures the amount of red blood cells in your blood. Anaemia in pregnancy is defined as a haemoglobin level below 11 g/dL. It is estimated that up to 40% of pregnant women in sub-Saharan Africa have anaemia, most commonly due to iron deficiency.

Severe anaemia significantly increases the risk of maternal death from haemorrhage during or after delivery. Treatment includes increasing the dose of iron supplements and, in severe cases, a blood transfusion. Testing at the first visit and again at week 28–32 allows providers to monitor your response to treatment.

HIV and Syphilis Testing

Rwanda has one of Africa's most successful Prevention of Mother-to-Child Transmission (PMTCT) programmes. All pregnant women are offered an HIV test at their first ANC visit. If you test positive, you will immediately begin antiretroviral therapy (ART), reducing the risk of transmitting HIV to your baby to less than 1%. ART is free at all public health facilities.

A syphilis test (RPR) is also done routinely. Untreated syphilis can cause stillbirth, premature birth, and severe disability in the newborn. Treatment is a single injection of benzathine penicillin — simple, effective, and free. This is one of the most powerful examples of how a routine ANC test saves lives.

Urine Tests

A urine test at each ANC visit checks for protein (a warning sign of preeclampsia), glucose (a screen for gestational diabetes), and signs of urinary tract infection (UTI). UTIs are common in pregnancy and must be treated promptly — an untreated UTI can ascend to the kidneys and cause preterm labour.

Glucose in the urine may indicate gestational diabetes, which is associated with large babies, difficult delivery, and long-term risk of type 2 diabetes. Confirmation requires a blood glucose test. Management includes dietary modification, blood sugar monitoring, and sometimes insulin therapy.

Malaria Prevention (IPTp-SP)

In malaria-endemic areas of Rwanda, intermittent preventive treatment with Sulfadoxine-Pyrimethamine (IPTp-SP) is given at each ANC visit from 13 weeks onward, with a minimum of three doses recommended. Malaria in pregnancy is associated with severe anaemia, low birth weight, and preterm birth.

IPTp-SP is provided free at public health facilities. Sleeping under an insecticide-treated bed net every night provides additional protection. Both interventions together are among the most effective tools for protecting mothers and babies in malaria-affected areas of Rwanda.

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