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ESR Test During Pregnancy: When You Need to Go for Test? And Its Normal Range


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Pregnancy is an extremely delicate situation that requires close monitoring to ensure the optimal health of the baby and the mother. Given that a woman’s body undergoes drastic physiological changes during the entire pregnancy term, it isn’t surprising that getting routine testing is crucial to determine the state of one’s physical well-being.

Among all the tests conducted during pregnancy, the erythrocyte sedimentation rate (ESR) test is one of the most important determinants of one’s health throughout the nine months of gestation.

This article will explore more about the need for an ESR Test during pregnancy and the normal range of the same throughout each trimester.

What is Erythrocyte Sedimentation Rate Test?

ESR test is a non-specific and standard blood test prescribed to determine whether the patient has an active inflammation in the body.

Studies indicate that the levels of ESR drastically increase during pregnancy, and it is quintessential to monitor those levels to keep a check on the pregnant mother’s and the fetus’ health throughout the pregnancy.

Getting an ESR test is also to determine the potential risks of an acute phase response triggered by inflammation due to anemia, inflammatory diseases, etc., during pregnancy.

Unlike normal cases, ESR levels during pregnancy are also influenced by the gestational age and the hemoglobin concentration in the body. Hence, the levels of ESR are significantly higher throughout pregnancy as opposed to the normal range in non-pregnant individuals.

When do you need an Erythrocyte Sedimentation Rate test during pregnancy?

As mentioned before, an ESR blood test is a non-specific test that’s prescribed when a pregnant woman is showcasing signs of inflammation in the body.

Your OB-GYN will most likely prescribe an ESR test if you are experiencing:

  • Headaches
  • Unexplained fever
  • Weight loss
  • Stiffness in the joints
  • Neck pain
  • Shoulder pain
  • Loss of appetite
  • Anemia

These above symptoms are associated with the risks of active inflammation in the body, which can be managed after the test results confirm the suspicion. Since inflammation can lead to many complications during pregnancy, it isn’t surprising that the ESR test is a routine blood test prescribed during each trimester.

However, one thing that you need to understand is that the ESR test is a non-specific test. This means that it tells your doctor that you have inflammation but doesn’t tell why you have one or what’s causing the inflammation in the body.

Once your OB-GYN receives the test reports of the ESR blood test, they will conduct further testing to determine the trigger behind the inflammation. Some of the potential causes include:

  • Arthritis
  • Vasculitis
  • Infection
  • Autoimmune disorders
  • Inflammatory bowel disease, etc.

If you had any of these pre-existing conditions before you got pregnant, your doctor would prescribe an ESR test to monitor the levels throughout your pregnancy term.

How Do you Prepare for an ESR Test during Pregnancy?

Pregnancy itself indicates a potential need for thorough and frequent testing. So, be assured that getting an ESR test won’t be out of the blue but a regular requirement throughout the gestational period.

The ESR test doesn’t require any unique preparation before the test. You don’t need to fast as well. However, your doctor might ask you to stop certain medications before to test to ensure that it doesn’t alter the test results.

Discuss your medications with your doctor and temporarily stop them if your doctor advises you to.

What is the Procedure for an ESR Blood Test during Pregnancy?

The ESR test is a standard blood test that involves a simple blood draw to collect the sample, which is then sent to the laboratory for further testing.

A phlebotomist collects the blood sample by following the steps mentioned:

  • The skin right above the vein in your arm is prepped and disinfected with alcohol.
  • The technician might wrap a rubber above your upper arm to restrict blood flow for a few seconds for an easy blood draw.
  • They will then insert a needle into the vein to draw the blood sample and transfer it to a vial.
  • The puncture site is then cleaned with an alcohol swab, and a bandaid is applied to stop blood flow.

Once the sample is collected, it is sent to the laboratory for further testing. The collected sample is transferred into a thin and long tube, where it remains in a static position for up to an hour. During this period, the professional lab experts will assess the rate at which the red blood cells sink into the bottom of the tube and the amount that sinks.

If there is an active inflammation in your body during your pregnancy, it will lead to the production of certain proteins in the blood, which can cause the red blood cells to clump and sink into the bottom of the tube quickly.

What Tests are Paired with ESR for Confirming a Diagnosis?

Since the ESR test is a non-specific test, determining what’s causing the inflammation is difficult. And, since pregnancy is a very delicate period, paying attention to the smallest change in the body and providing the mother and the child with the correct treatment is necessary.

So, your OB-GYN will prescribe a series of tests besides ESR to confirm their diagnosis further. Some of these additional tests include:

  • Complete blood count
  • C-reactive protein (CRP) test

Once these tests are done, the next thing you need to do is wait for the results to arrive. It typically takes 24-48 hours, depending on the number of tests you are getting and when you send the blood sample for testing.

What is the Normal Range of ESR during Pregnancy?

The ESR normal range for a pregnant and non-pregnant individual varies drastically. Studies have found that ESR levels are significantly higher during pregnancy, and that’s considered normal unless the levels are way out of range.

Following is the normal range of ESR you need to know:

  • Non-pregnant individual – 0 to 20 mm/h
  • First trimester – 4 to 57 mm/h
  • Second trimester – 7 to 47 mm/h
  • Third trimester – 13 to 70 mm/h

If the levels are way within this range in each trimester during pregnancy, it is normal and nothing you should be worrying about. However, if the ESR normal range in females is way out of this range during each trimester, your doctor will prescribe further and immediate testing to assess what’s wrong.

What are the Types of ESR Tests during Pregnancy?

ESR blood test is conducted via the Westergren method and the Wintrobe method. Among these two, the Westergren method is more commonly used in laboratories.

  • During the Westergren method, the collected blood sample is transferred into the Westergren-Katz tube up to the 200 mm mark. The tube is then left undisturbed for about 1 hour at room temperature. Once the time is over, the lab experts measure the distance between the top of the blood sample and the top of the RBC sedimentation.
  • During the Wintrobe method, the same process as the Westergren method is followed. The only difference is in the size of the tube used. Instead of 200 mm, it uses a 100 mm tube for the assessment, making the test reports less sensitive.

Since pregnancy requires a more accurate understanding of the ESR levels, it isn’t surprising that doctors suggest and prefer the Westergren method for determining the ESR range in the individual.


Is ESR high in pregnancy normal?

During pregnancy, there are a lot of changes happening in the body. There is an elevated level of fibrinogen, plasma expansion, and a reduced hemoglobin concentration in the body. Hence, witnessing ESR high range during pregnancy (within the expected range) is considered normal.

How can I reduce my ESR during pregnancy?

If your ESR levels during pregnancy are much higher than the normal or expected range, your doctor will suggest making healthier lifestyle switches. This includes eating a healthier diet, keeping yourself active, etc.

Is ESR 40 high in pregnancy?

Having an ESR level higher than 40 mm/hr is considered a sign of active inflammation or an underlying issue in the body. Your doctor will prescribe further testing to determine what’s causing it.


ESR blood test is a simple procedure that can assess a lot of underlying conditions during pregnancy. Discuss the same with your doctor if you are experiencing any symptoms out of the blue beside the standard pregnancy symptoms. Sometimes, active inflammation could be a sign of anemia, which is associated with many pregnancy risks.


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