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Testing During Pregnancy and Why It’s So Important

A couple of decades ago when prenatal testing facilities were sparse and almost non-existent, birth was a mysterious process that could come as a surprise at any moment. Although human population continued to grow, many lives could have been saved or made better had prenatal care existed back then. Today, prenatal care has a massive role in mother-child wellness that is being practiced in almost every part of the world.

Statistics have shown that women who receive prenatal care have a higher chance of delivering a healthy baby successfully. When a woman gets pregnant, it’s important to establish an obstetrician that can help guide her throughout the pregnancy period.

Every country has its own testing recommendations during pregnancy. Generally, testing in pregnancy is categorized according to the trimester. These tests include scans, blood tests and the more invasive procedures; however, invasive testing is only done when absolutely indicated.

1st Trimester Testing

The first trimester is the most critical developmental period for the baby. This is when most the baby’s organs are developing optimally. In fact, most of the critical organogenesis period occurs in the week 4 to week 8 of pregnancy. This is the time when some women may not even know they are pregnant, which is why proper pregnancy planning is advised so that you can always be prepared.

An ultrasound is usually one of the earliest tests your doctor will order for you. An ultrasound scan will help diagnose the viability and health of the pregnancy, along with any potential abnormalities that can be picked up in the first trimester. Down’s Syndrome or Trisomy 21 can often be picked up through a special ultrasound scan performed in the first trimester. This scan measures the nuchal translucency or the thickness of the baby’s back that, if increased, can point to Down’s Syndrome.

Down’s Syndrome can also be screened through certain blood tests. Although not highly specific, these blood tests, along with an ultrasound scan, can serve as important clues for the diagnosis. Blood tests for Down’s Syndrome in the first trimester include the measurement of plasma protein-A and beta-HCG.

Your doctor may also get some routine blood tests done in the first trimester as well. You may be asked to screen for viral infections that can be passed down to the baby through vertical transmission. Examples of such infection include HIV, rubella, hepatitis B, cytomegalovirus, toxoplasmosis, syphilis etc.

Other blood tests that may be ordered include blood group testing that establishes your blood type and Rh factor. Women who are Rh negative are given anti-Rh injections once during the pregnancy at 28 weeks, and once after delivery (if the baby turns out to be Rh+ve) to prevent an antibody-antigen reaction in the baby.

Although most invasive testing is done later in the pregnancy, chorionic villous sampling is a notable exception. This test can be done to diagnose genetic defects such as Down’s syndrome. Because this is an invasive test with a slight risk of miscarriage, it is performed only when absolutely indicated.

2nd Trimester Screening

By the second trimester, most of the baby’s organs have completed their critical development stage. This is when growth continues, and structures become more visible on ultrasound scans. A second trimester ultrasound scan helps determine proper fetal anatomy and looks for any structural abnormalities. The baby’s gender can also be revealed in this scan.

In the later weeks of the second trimester, women are advised to undergo blood pressure and blood glucose screening. Pregnancy-induced hypertensive disorders and gestational diabetes usually present by the end of the second and the beginning of the third trimester.

Further blood testing called the quadruple screening test can also be performed in the second trimester to determine the risk of Down’s syndrome. This test measures alpha fetoprotein (AFP) in addition to the three other tests done in the first trimester.

Amniocentesis is an invasive test that is done after 15 weeks. This optional test is used to diagnose genetic abnormalities but is only indicated if previous non-invasive screening tests showed abnormal results. Because of the increased risk of a miscarriage, amniocentesis is completely optional and advised only when necessary.

3rd Trimester Screening

By the time the third trimester rolls around, the baby is well developed and may be able to survive if delivered by 7 months. However, 3rd trimester screening is still absolutely crucial to determine fetal health and choose the best mode of delivery. An ultrasound scan is used to determine the position of the baby; a breech presentation may be planned for a C-section. Other indications for C-section that can be determined through 3rd trimester scans include placenta previa and morbidly adherent placentae.

Another important test that is done by 35 weeks of pregnancy is a group B strep screen. This bacterium is notorious for causing infections in pregnancy that can be passed on to the baby. If left untreated, a group B streptococcus infection may result in meningitis or pneumonia in the newborn. In severe cases, sepsis can occur.

Screening for group B strep infection is simple and requires a vaginal swab culture taken around 35 weeks of pregnancy. If diagnosed with an infection, women are put on pregnancy-safe antibiotics (usually penicillin) to treat the infection before the baby is delivered.

Why Should Every Woman Opt For Prenatal Care?

Prenatal care has helped reduce maternal and fetal mortality and morbidity across the globe. Testing for common pregnancy-related problems and managing them in a timely manner can help save your baby’s life and yours as well. Women who receive appropriate prenatal care also have options to abort the pregnancy if a major genetic defect is found in the scans.

It’s true that certain invasive prenatal tests have their share of risks. That’s why it’s good to know your screening options and choose what you’re comfortable with.

In any case, it’s important that you talk to your doctor about your prenatal screening options when you find out you’re pregnant. You should also discuss any and all concerns that you may have regarding your prenatal health with your physician for a healthy pregnancy.

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