Prenatal Care

What is prenatal care and why is it important?

‏Prenatal care is medical attention given to the expectant mother and her developing baby in preparation for birth. It involves the mother caring for herself by following her doctors’ advice, practicing good nutrition, getting plenty of rest, exercising sensibly, and avoiding stress and cigarette smoke, as well as specialist attention to help the expectant mother go through this experience with ease, comfort and confidence. Such attention includes certain laboratory tests that can help an expecting mother, and her physician, check and monitor her health and the health of the baby and assess any potential risks, treat any maternal or fetal complications, and monitor the growth and development of the baby throughout the different stages of pregnancy.

‏While all pregnant women should have these tests performed, women over 30 who smoke or drink alcohol, have chronic medical conditions, a family history of mental retardation or birth defects, recurrent miscarriages, pre-term deliveries or still birth, are at higher risk.

‏Laboratory tests recommended before conception:

‏Before deciding to get pregnant, a woman should check her health and fitness to make sure she can cope with the physical demands of pregnancy. Following are three recommended tests:

Rh factor Typing: In Blood group typing, the positive (+) or negative (-) sign refers to the presence or absence of the Rh factor, respectively. Usually, mother-fetus Rh factor incompatibility has no negative effect on the expecting mother or her baby. However, if the mother is Rh negative and is carrying an Rh Positive fetus she could develop antibodies against the baby’s Rh factor shortly after delivery that could harm future pregnancies. Knowing the mother’s Rh type allows the physician to take action in due time to prevent that from happening.

Hemoglobin Level: Anemia (low red blood cell count or low hemoglobin) is common during pregnancy. Checking the hemoglobin level before & during pregnancy is important to avoid developing anemia.

TORCH (Toxoplasma, Rubella, Cytomegalovirus, Herpes) Screen:

‏The TORCH screen is important to rule out infections that could cause serious fetal damage. Contracting Toxoplasmosis and Rubellosis (Germa measles) during the first three months of pregnancy could cause abnormalities, still birth or abortion. Cytomegalovirus infection can cause mental retardation, learning disabilities or vision loss, while contracting Herpes Simplex Virus can cause genital herpetic ulcers that could lead to blindness of the baby as it passes through the birth canal.

‏N.B. The TORCH Screen may be performed in later stages of pregnancy.

Laboratory tests recommended during the First Trimester:

‏Congenital (genetic) abnormalities such as Down’s syndrome (Trisomy 21), Patau syndrome (Trisomy 13), Edwards’ syndrome (Trisomy 18) and Neural Tube Defect have serious consequences that affect the quality of life of a baby born with these conditions as well as his/her parents. However, early assessment of the risk of having a child with these abnormalities can be tested between weeks 11 and 13 of pregnancy through the Nuchal Translucency (NT) Ultrasound Screen. The laboratory test is a combination of two tests; Pregnancy associated plasma protein-A (PAPP-A) & Free Beta Human Chorionic Gonadotropin (FβHCG), in addition to Ultrasound Scan and computer program based calculations. Parameters such as age, weight, race and exact gestational period are needed to complete the risk calculation.

‏The inclusion of PAPP-A and FβHCG for risk assessment with the ultrasound scan increases the rate of detecting fetal abnormalities to 90% while decreasing the rate of  false positive detection to only 5%. If high risk is indicated, more specific tests (Amniocentesis or Chorionic Villus Sampling for genetic studies) can be performed to confirm or rule out the condition.

Laboratory tests recommended during the Second Trimester:

‏The suggested test is called a “Prenatal Interpretive Screen”, and is usually performed between weeks 14 and 21 of gestation. This test is made up of a Dual (Alpha Feto-Protein (AFP) & Beta Human Chorionic

Gonadotropin (βHCG)), Triple (AFP, βHCG & Free Estriol (FE3)). The result of these tests as well as the age, weight, exact gestational period and race of the mother are processed with the help of computer software and the risk of having a child affected with the previously mentioned conditions is calculated. If high risk is indicated, more specific tests (Amniocentesis or Chorionic Villus Sampling for genetic studies) should be performed with the consultation of the physician to confirm or rule out the condition. The accuracy of screening increases as the number of test parameters increases.

Other tests useful throughout pregnancy:

‏A pregnant woman should perform a Urine Analysis regularly to test for Urinary Tract Infections and for the presence of Albumin (Protein) in her urine. Since some women develop Gestational Diabetes during pregnancy, it is recommended to check Blood Sugar Levels regularly as well, especially during the Third Trimester.

* If preeclampsia is suspected (high risk pregnancies or in women with history of PE) ask about the new sFlt-1/PIGF ratio test at any of MedLabs Laboratories from week 22 of gestation.

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