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Pregnancy / PrenatalTier 2 · Mid-Specialty

Antenatal Profile-B

Also known as: Antenatal Panel B · Pregnancy Booking Test · First Trimester Antenatal Workup · ANC Profile B · Pregnancy Initial Screen

Sample: Serum Reference price: ₹990Code: ZNT-ANTENATALPROFILEB

What this test measures

The Antenatal Profile-B is a packaged battery of tests obstetricians order at the first booking visit (usually 6–12 weeks) and again in the third trimester. The exact panel varies by lab but typically includes: Complete Blood Count (CBC), Blood Group + Rh typing, Fasting blood sugar, HbA1c, Thyroid (TSH ± Free T4), Urine routine + culture, HIV, HBsAg, VDRL/RPR (syphilis), and Rubella IgG.

Each component answers a different clinical question. CBC screens for anaemia (very common in Indian pregnancies). Blood group identifies Rh-negative mothers who need anti-D prophylaxis. Sugars and thyroid pick up gestational diabetes and hypothyroidism — both treatable but harmful if missed. Urine catches asymptomatic bacteriuria. The infection serologies prevent vertical (mother-to-baby) transmission.

Why it matters

India still has unacceptably high maternal and neonatal mortality, and most of it is preventable. Anaemia complicates more than 50% of Indian pregnancies and is the single biggest contributor to maternal death. Gestational diabetes affects roughly 1 in 7 pregnancies in urban India. Untreated maternal hypothyroidism reduces foetal IQ. Hepatitis B and HIV transmission to the baby can be reduced to <2% with timely identification and prophylaxis. Syphilis is rising again in Indian cities and is fully treatable if caught.

Doing all of this in one packaged profile is the difference between a 90% complete antenatal record and a sketchy one. FOGSI and ICMR both recommend this comprehensive booking workup at the first visit so issues are surfaced when there is still time to intervene safely.

How to prepare

Fast for 8–10 hours (water allowed) — needed for the fasting blood sugar component. Collect a clean mid-stream urine sample. Bring any previous pregnancy reports, blood-group cards, and a list of current medications/supplements. Inform the phlebotomist if you have had a recent transfusion or anti-D injection.

Markers & reference ranges

Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.

MarkerNormal rangeIf lowIf high
Haemoglobin (CBC) (g/dL)[1]Pregnancy ≥ 11.0Anaemia in pregnancy: 10–10.9 mild, 7–9.9 moderate, <7 severe. Iron deficiency is most common in India; check ferritin and start oral iron + folic acid. Severe anaemia in 2nd/3rd trimester may need IV iron or transfusion.Rare; can reflect dehydration or, very uncommonly, polycythaemia. Recheck with normal hydration.
Blood Group & Rh[1]Any ABO group; Rh-positive or Rh-negativeRh-negative mothers carrying an Rh-positive baby need anti-D immunoglobulin at 28 weeks and within 72 hours of delivery to prevent haemolytic disease of the newborn in future pregnancies.
Fasting Blood Sugar (mg/dL)[1]< 92 in pregnancyHypoglycaemia uncommon unless on insulin. Symptomatic hypoglycaemia <60 mg/dL needs review.≥ 92 mg/dL meets IADPSG criterion for gestational diabetes. India follows DIPSI (single-step 75g OGTT, ≥140 mg/dL at 2h = GDM) in some centres. Confirm with OGTT and start medical nutrition therapy ± insulin.
TSH (µIU/mL)[1]1st trimester 0.1–2.5 · 2nd 0.2–3.0 · 3rd 0.3–3.0Suppressed TSH in pregnancy — consider gestational transient hyperthyroidism (often hCG-driven, self-limiting), Graves disease, or over-replacement in known hypothyroidism.Elevated TSH suggests subclinical or overt hypothyroidism. Untreated maternal hypothyroidism is linked to miscarriage, preterm birth, and lower offspring IQ. Initiate / adjust levothyroxine.
HBsAg[1]Non-reactiveMaternal Hepatitis B infection. The baby needs HBIG + Hepatitis B vaccine within 12 hours of birth to reduce vertical transmission risk from ~90% to <5%. Mother needs viral load and hepatology referral.
VDRL / RPRNon-reactiveReactive test suggests syphilis. Confirm with treponemal test (TPHA). Treated promptly with benzathine penicillin to prevent congenital syphilis (stillbirth, neonatal death, bone/CNS abnormalities).
Rubella IgGPositive (immune) preferredNon-immune. Avoid exposure to anyone with rash illness; receive MMR vaccine post-partum (live vaccine — not given during pregnancy).Positive IgG indicates past infection or vaccination. Baby is protected.

Antenatal booking visit — what each result triggers

FindingAction
Haemoglobin < 11 g/dLIron studies + oral iron / IV iron
Rh-negative motherAnti-D at 28 weeks + post-delivery
FBS ≥ 92 mg/dL or OGTT positiveDiet + glucose monitoring ± insulin
TSH > 2.5 (1st trimester)Levothyroxine titration
HBsAg reactiveViral load; newborn HBIG + vaccine at birth
VDRL reactiveTPHA confirm + benzathine penicillin
Rubella IgG negativeMMR vaccination post-partum
HIV reactiveConfirm + ART; planned delivery, infant prophylaxis

Frequently asked questions

When should I do the Antenatal Profile-B?

At the first antenatal visit, ideally between 6 and 12 weeks. Some components (CBC, urine, sugars) are repeated again at 24–28 weeks and again before delivery.

Do I need to fast for this profile?

Yes — for the fasting blood sugar component, fast for 8–10 hours. Water is allowed. Skipping fasting will invalidate the FBS result.

My HBsAg is positive — does my baby need extra care?

Yes. The baby should receive Hepatitis B immunoglobulin (HBIG) and the first dose of Hepatitis B vaccine within 12 hours of birth, and complete the vaccine schedule. With this, vertical transmission risk drops from ~90% to under 5%.

I am Rh-negative — what does that mean for my pregnancy?

If your partner / baby is Rh-positive, your body can develop antibodies that harm future Rh-positive babies. To prevent this, you will receive anti-D injection at 28 weeks and another within 72 hours of delivery. This is routine, safe, and very effective.

What if my Rubella IgG is negative?

It means you are not immune. Avoid contact with anyone who has a rash illness during pregnancy. The MMR vaccine is a live vaccine and cannot be given during pregnancy — you will receive it before discharge after delivery.

Is HIV testing mandatory in pregnancy?

HIV testing is recommended for every pregnant woman in India, with opt-out consent. Early detection allows antiretroviral therapy that can reduce mother-to-baby transmission from ~25% to under 1%. The result is confidential.

How long does the full panel take?

Reports for most components are available within 24 hours. Urine culture takes 48–72 hours. Your obstetrician will review the complete panel at the second visit.

My TSH is 3.5 — is that okay during pregnancy?

No — pregnancy targets are stricter (TSH below 2.5 in the first trimester). A TSH of 3.5 suggests subclinical hypothyroidism and typically warrants a low-dose levothyroxine to protect foetal brain development.

Related Pregnancy / Prenatal tests

Tests commonly ordered alongside Antenatal Profile-B, or that help interpret an unexpected result.

Sources & references

  1. ACOG — Routine Tests During Pregnancy · accessed 2026-05-30T00:00:00.000Z
  2. WHO Recommendations on Antenatal Care · accessed 2026-05-30T00:00:00.000Z
  3. RCOG Green-top Guidelines · accessed 2026-05-30T00:00:00.000Z
  4. FOGSI Good Clinical Practice Recommendations · accessed 2026-05-30T00:00:00.000Z

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