Prenatal screening uses hematological parameters to detect possible illnesses and infections in the future mother, which may endanger her or her pregnancy, as well as the health of the child to be born.
BASIC APPEARANCES – INDICATIONS – IMPORTANCE
Prenatal screening is aimed at all pregnant women, as there are a number of asymptomatic conditions that can present serious complications in pregnancy and in the fetus – newborn infant.
The selection of analytes is designed for the investigation – detection :
- Hemodynamic assessment offuture mother (general health assessment, traceability of trace elements)
- Possible diabetes (affects fetal development)
- Possible Sicle Cell Anemia (Marriage Compatibility Assessment in Thalassemia – Avoidance)
- Possible thyroid disorder (affects pregnancy outcome – fetal development)
- Immunity to parasites ( an infection during pregnancy may affect pregnancy outcome – fetal development)
- Possible sexually transmitted deseases (in hepatitis B/C -HIV measures mast be taken to prevent transmission to the fetus)
- Possible gynecological infections (to prevent taking medicines during pregnancy)
LABORATORY HEMATOLOGICAL TESTING
- Comple Blood Count: Check for hematocrit, white blood cells and platelets. The future mother is monitored for anemia, systemic infections, inflammation, and coagulation factor adequacy.
- Hemoglobin electrophoresis : control heterozygous for β-thalassemia (Mediterranean anemia). In case of a positive result, further control of the future father is absolutely necessary.
- Blood and rhesus group : performed to determine if the mother will need special treatment during pregnancy to protect phetus from mothers immune system rejection . In the case of a negative rhesus, we are conducting the indirect Coombs test additionally.
- Blood sugar (glu), glycosylated hemoglobin (HbA1c) : ensure the absence of diabetes, for the smooth and safe rate of development of the fetus. Possible high blood sugar and diabetes are associated with particularly large embryos and increased risk in pregnancy – delivery. Because diabetes can occur during pregnancy, doctors also recommend the sugar dynamic test from the sixth month of pregnancy, to ensure the absence of transient – pseudo – diabetes of pregnancy.
- TSH (thyroid hormone), anti – TPO (anti – thyroid antibodies), anti – TG (anti – thyroglobulin antibodies) : Assess regulation of thyroid function, which determines overall body metabolism and affects the course of pregnancy. Auto-antibodies testing also detects possible autoimmune thyroiditis, which during pregnancy may threaten its safety.
- Toxoplasma Antibodies (Toxo IgG / IgM) : Detection of possible old infection and immunization against toxoplasm (the toxoplasm is mainly transmitted by stools of infected cats, infected uncooked meats, infected vegetables that have not been washed well and kitchen utensils from uncooked meats and contaminated water). In the absence of antibodies immunization (IgG negative result), it is necessary to recheck this test during pregnancy.
- Antibodies to rubella (Rubella IgG / IgM) : Detection of possible old infection and immunization against rubella virus. Red is a mild, contagious, erosive disease that affects mainly children who have not been vaccinated. In the absence of antibodies – immunization (IgG negative result), it is necessary to recheck this test during pregnancy.
- Antibodies against cytomegalovirus (CMV IgG / IgM) : Detection of possible old infection and immunization against CMV, an herpesvirus that is transmitted primarily through the blood.In the absence of antibodie – IMMUNIZATION (IgG negative resulat), re-testing during pregnancy is necessary.
- VDRL : In recent years with population movement, there has been an increase in cases of sexually transmitted syphilis. This test checks whether there is a bacterial infection, as to give proper therapy to the mother in time.
- Hepatitis B, C and AIDS (HBsAg, anti-HCV, anti-HIV I / II): Screening tests for these viruses are necessary. In cases of infected mothers, appropriate measures can protect the infant born and protect the mother in a timely and effective manner.
- HSV II: Herpes viruses extremely prevalent in the general population (1 out of 4 people). Testing for HSV in the mother is important, as appropriate treatment in the last trimester of pregnancy generally prevents the transmission of HSV to the child at birth. Newborns with HSV infection may have serious complications of their health in future.
- Listeria: It is mainly transported from soft cheeses (bri and camembert and cheeses containing blue substances such as Blue Danish & Stylon), raw uncooked meat, poultry and fish, after surviving in refrigerator temperatures. Although Listeria infection is not very widespread, it is advisable to test for a possible infection for the safety of pregnancy.
- Vaginal cultures, urine test: To make sure that appropriate treatments are given early and to avoid any complications due to infections during pregnancy time, the medicines choices for treatment during pregnancy, is limitted.
Optinal Screening Tests
Additional prenatal testing is recommended, especially in cases with families with corresponding incidents, in:
- Cystic fibrosis, second in frequency severe genital disease after thalassemia
- Preschool deafness
- Muscular dystrophy syndrome
- Spinal muscular atrophy
In the case of pregnancy in relatively aged mothers – high risk pregnancies or with a history of miscarriages, addition gene screening tests may be required :
- Thrombophilia gene screening
- Karyotype / molecular karyotype
- Trisomy Control – Fragile X – non invasive Nifty Test
Medical Tests performed with analytical systems and reagents
by SIEMENS-USA & BECMAN COULTER-USA
Recomendations -preparation for morning blood sampling :
- Should have a mandatory meal previous night.
- Last meal should be up to 11-12 hours before blood collection.
- In the morning should not have any lunch. Coffe without sugar and water are free.
For urine collection:
- First urination sample is preferable
- Prior urination, a local wash with plenty of water, no soap.
- Results are given within 2 days.
- Optional tests may require even 15 working days