Tests and Scans to Confirm Pregnancy, Types and Costs

Discovering that you are pregnant is one of the most exciting time in every woman’s life but are you certain about your pregnancy? Even though the pregnancy symptoms are obvious, you can only be sure once a medical test confirms it. Remember that there are a host of other causes of nausea, vomiting, fatigue and bloating which may women use as a marker of whether they are pregnant or not. Pregnancy tests can be done at home, in a lab or at your doctor’s office. As soon as you suspect that you are pregnant, it is important to have a test or scan and confirm it before taking any further steps.

Types of Pregnancy Tests

Broadly pregnancy tests can be divided between biochemical tests and imaging studies. Biochemical tests detect the presence of beta-HCG (human chorionic gonadotropic), a hormone that is produced mainly during pregnancy. Imaging studies most commonly involves an ultrasound scan where sound waves are used to create an image of the uterus and its contents. While biochemical tests may confirm pregnancy, it cannot immediately differentiate between a viable pregnancy or a miscarriage. Therefore imaging studies are preferred as it can more conclusively identify any problems at the outset.

Urine Pregnancy Test

The pregnancy hormone, HCG, increases steadily after conception. Urine tests are accurate but there is many factors that need to be taken into consideration. The home pregnancy test which most women use as the first confirmation of pregnancy works by detecting the presence of HCG in the urine. This is best done in the morning when the urine HCG levels are at its highest.

Although manufacturers claim that these home pregnancy tests are over 90% accurate, it largely depends on when you take the test. Ideally you should take the test at least a week after missing a period. Taking the test any earlier may give false-negative results as the HCG levels are too low to be detected by the tester application.

Newer tests that have been developed are more accurate in the early stages but a single negative test result is not reliable in the first few weeks of pregnancy. Sometimes a period can be late or even missed so it is best to wait at least one week after the expected date of the period to do the home pregnancy test or test again.


Urine pregnancy tests can be easily purchased over-the-counter at any pharmacy. There are a wide range of options with prices starting from R40 upwards.

Blood Pregnancy Test

The blood pregnancy test also depends on the detecting HCG but in this case in the bloodstream. There are two type of HCG blood tests. One is used to confirm pregnancy and the other to monitor the progression of pregnancy.

  1. Qualitative HCG confirms the presence of HCG in the bloodstream. It is highly sensitive and much more accurate than a urine test in the early stages of pregnancy.
  2. Quantitative HCG confirms the level of HCG in the bloodstream. Based on these levels the laboratory will also provide an estimate of gestational age (how far along you are in your pregnancy) but this is not an accurate measure.

Qualitative and quantitative HCG blood tests are not routinely done unless it is in the very early stages of pregnancy where the foetus and yolk sac are not visible on ultrasound. A quantitative HCG blood test is helpful for confirming miscarriage in the very early stages. Normally the HCG levels rise exponentially every few days but with a miscarriage, these levels may rise slightly and then gradually dip.

Both qualitative and quantitative HCG blood tests can be done at any pathology laboratory. A doctor’s referral is not necessary but medical aids will not pay for these tests unless it has been requested by a doctor. Nevertheless any person can request the test and the qualitative test results may be available within 20 to 30 minutes while the quantitative test results takes over 3 hours.


Cash prices for both these tests range between R300 to R450. Duration for the availability of results and the cost may vary from among laboratories in South Africa.

Pregnancy Ultrasound Scan

An ultrasound scan is the method that most doctors prefer for confirming a viable pregnancy. Sound waves are used to create images of the uterus by placing a handheld probe over the abdomen. In the early stages of pregnancy, there are two options – an abdominal or a transvaginal ultrasound.

  1. The abdominal ultrasound is done by running the probe over the abdomen.
  2. A transvaginal ultrasound involves inserting a probe into the vagina and is usually a more accurate way of visualising the embryo and yolk sac in the very early stages of pregnancy.

Not only can the ultrasound confirm a viable pregnancy but it can also provide an indication of the gestational age and estimate the due date.

Antenatal scans should be continued at regular intervals throughout pregnancy. It is not only for confirming pregnancy and occasionally assessing the progression of pregnancy. There are more high-tech scans such as the 4D scan and similar ultrasounds used by foetal specialists which may not be necessary immediately. Pregnancy ultrasound scans can be done by your family doctor (GP) if he/she has the equipment but ideally pregnant women should be seeing a gynaecologist.


Most gynaecologists charge a single cash fee for consultations and in-house investigations like an ultrasound which can be anywhere between R600 to R800 upwards.