Expect During Pregnancy

 

Did you know that prenatal screening tests have been shown to detect up to 90% of major chromosomal abnormalities. Bringing a new life into the world is a journey filled with excitement, anticipation, and a multitude of emotions. Amidst the joy, it's crucial for expectant parents to prioritise the health and well-being of both the mother and the baby. Prenatal screening plays a pivotal role in ensuring a smooth and healthy pregnancy. 

In this blog, we’ll discuss the various tests expectant mothers can expect during different stages of pregnancy, shedding light on their importance and how they contribute to informed decision-making.

 

Early Pregnancy: The First Trimester

 

Early pregnancy is vital for establishing a healthy gestation. Prenatal care kicks off with confirming pregnancy, often through a home test. Healthcare providers then start a series of tests to monitor the well-being of both the mother and the developing baby.

 

Confirmation of Pregnancy

 

First, confirming pregnancy is crucial. Home tests, detecting human chorionic gonadotropin (hCG) in urine, are commonly used. Blood tests can verify results and offer more details about the pregnancy.

 

Blood Tests for Basic Health Parameters

 

Early blood tests assess the mother's health and identify potential risks. These include a complete blood count (CBC) for anaemia, blood type, and Rh factor testing, and screening for infectious diseases, Thyroid function, blood sugars, and urine infection.

 

Ultrasound for Dating and Viability

 

An early ultrasound determines the corred-pregnancy location, and fetus's gestational age and confirms viability. This is crucial for estimating the due date and ensuring the pregnancy progresses as expected. Early USG is also vital for establishing the correct diagnosis of twin/multiple gestation.

 

Genetic Screening Options

 

Expectant parents may undergo genetic screening in early prenatal care to gauge the risk of chromosomal abnormalities and genetic disorders.

1. NIPT: NIPT, a non-invasive blood test, examines foetal DNA in the mother's blood, detecting common chromosomal abnormalities like Down syndrome. It's commonly recommended for women at a higher risk based on factors such as maternal age or abnormal first-trimester screening results.
2. Combined Test: The combined test includes a blood test for specific proteins and hormones, coupled with an ultrasound to measure the nuchal translucency thickness, a fluid-filled space at the back of the baby's neck.

 

Second Trimester: Comprehensive Testing

 

In the second trimester of pregnancy, detailed tests gain prominence. This phase concentrates on thoroughly examining the baby's growth and detecting potential abnormalities.

 

Anatomy Ultrasound

 

Typically performed around 18-20 weeks, the anatomy ultrasound is a detailed examination of the baby's organs, limbs, and overall development. This imaging test helps identify any structural abnormalities and ensures that the baby is growing as expected.

 

Maternal Serum Screening

 

Maternal serum screening, using blood tests, gauges levels of specific substances indicating the risk of neural tube defects (like spina bifida) and chromosomal issues. Known as quadruple screen tests, this screening pinpoints higher-risk pregnancies, prompting further diagnostic tests if necessary.

 

Diagnostic Testing

 

Although screening tests give risk assessments, diagnostic tests provide more conclusive answers. Due to their invasiveness and a slight miscarriage risk, these tests are typically suggested based on prior screening results or other risk factors.

1. Amniocentesis: Extracting a small amount of amniotic fluid, containing foetal cells, for analysis of chromosomal abnormalities and genetic disorders. Usually done between 15 and 20 weeks of pregnancy.
2. Chorionic Villus Sampling (CVS): Sampling chorionic villi, small projections in the placenta, to analyse genetic material for chromosomal abnormalities and genetic conditions. Done between 10-14 weeks.

 

Glucose Tolerance Test for Gestational Diabetes

 

Gestational diabetes arises in pregnancy, impacting blood sugar regulation. Between weeks 24 and 28, a glucose tolerance test gauges the risk.

 

Third Trimester: Monitoring and Specialized Tests

 

The third trimester brings the final stretch of pregnancy, and monitoring becomes increasingly important. Specialised tests are introduced to address specific aspects of the baby's and mother's health.

 

Monitoring High-Risk Pregnancies

 

Certain pregnancies are high-risk due to existing health issues or gestational complications. These may require more ultrasounds, tests, and vigilant monitoring for the well-being of both mother and baby.

 

• An ultrasound for baby’s growth is usually done in 3rd trimester.
• The mother is also screened again for anaemia.
• Around 36 weeks - Discussion regarding labor mode of delivery and mother sensitisation for breastfeeding is done.

 

The Emotional Aspect of Prenatal Screening

 

Navigating prenatal screening is not just a medical journey; it also involves a significant emotional component. The uncertainty that accompanies screening results can be a source of stress for expectant parents. Open communication with healthcare providers is crucial during this time.

 

The possibility of receiving abnormal test results can be emotionally challenging. It's important for expectant parents to understand that screening tests provide probabilities and are not definitive diagnoses. Positive results do not necessarily mean a health issue, and further diagnostic testing is often needed for confirmation.

 

Establishing open and honest communication with healthcare providers is key to navigating the emotional aspect of prenatal screening. Providers should take the time to explain the purpose of each test, the potential implications of results, and the available options for further testing or monitoring.

 

Crucial to aiding expectant parents with challenging results are support systems, including counselling and groups where shared experiences offer insights and emotional backing.

 

Informed Decision-Making

 

Providing information empowers expectant parents for decision-making during pregnancy. Knowing the purpose and implications of each test allows informed choices aligning with values and preferences.

 

A crucial aspect of informed decision-making is understanding the difference between screening and diagnostic tests. Screening tests assess the risk of certain conditions, while diagnostic tests provide more definitive answers. Ensuring that expectant parents comprehend the purpose and limitations of each test allows them to make decisions in line with their preferences.

 

Healthcare providers should thoroughly discuss the significance of each test, emphasising the potential benefits and limitations. Clear communication helps parents weigh the importance of the information provided by the tests against the potential risks associated with invasive procedures.

 

Informed consent is a cornerstone of prenatal care. Healthcare providers should ensure that expectant parents fully understand the purpose, risks, and benefits of each test before proceeding. This understanding enables parents to actively participate in decision-making and advocate for their preferences.

 

Conclusion

 

Prenatal screening is pivotal in thorough prenatal care. Tests spanning early confirmation to final gestation weeks monitor both maternal and foetal health. Addressing emotional aspects demands open communication and support. Essentially, informed decisions empower parents-to-be, enabling active participation in prenatal care, fostering a positive pregnancy journey.