PRAGNANCY CHECK-UP

Pregnancy feels like the best gift for most couples. Special care should be taken during this time to maintain a healthy pregnancy to full term. Your doctor may recommend a variety of screenings, tests and imaging techniques during your pregnancy. These tests are designed to provide information about your overall health, infections that can cause problems with maintaining the pregnancy, infections that can harm the baby, to determine the health and development of the baby.

Folic acid is needed for the normal development of your baby. Folate enhances the production of red blood cells in your body. This is vital during pregnancy when anemia due to iron deficiency is a common complaint. It can help prevent major birth defects of the baby’s brain and spine. These birth defects are called neural tube defects or NTDs. It lowers the baby’s risk of cleft lip and palate and also reduces the risk of premature birth, miscarriage and low birth weight problems. Expecting mothers need to take folic acid every day to help in the proper development of the baby. Some doctors even suggest to start using folic acid even before they become pregnant to help prevent NTDs. Adequate intake of folic acid daily is known to prevent preeclampsia, heart stroke, heart disease, cancers and Alzheimer’s disease.

Pregnant women are also screened to detect certain infectious diseases that can cause birth defects in the newborn. The TORCH test is the most commonly prescribed test for pregnant women.

The following tests make up the TORCH panel: Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes simplex virus. These infections may be passed from mother to baby through the placenta during pregnancy.

• Toxoplasmosis - Toxoplasmosis is acquired by ingesting the parasite causing it - through infected cats, drinking unpasteurized goat's milk, and, most commonly, by eating contaminated meat. An infection with Toxoplasma gondii can cause eye and central nervous system infections as well as brain and muscle cysts. If acquired during the pregnancy, it may result in a miscarriage or cause birth defects.

• Rubella is the virus that causes German measles. If the mother is infected early in the pregnancy, the baby may develop heart disease, retarded growth, hearing loss, blood disorders, vision problems, or pneumonia. Problems that may develop during childhood include central nervous system disease, immune disorders, or thyroid disease.

• Cytomegalovirus (CMV) is another viral infection that a mother may have acquired. However, it may pass to a baby during the birth process and can also infect newborns through breast milk. Infected infants may have severe problems, such as hearing loss, vision problems, mental retardation, pneumonia, and seizures.

• Herpes simplex is a common viral infection caused by the herpes simplex virus (HSV). The two most common infections with HSV are "cold sores" affecting the lips and genital herpes. The infection is recurrent, which means that once infected, the virus stays in the body and shows signs and symptoms in favorable conditions. HSV is most commonly acquired through oral or genital contact. Newborns who contract the virus usually do so during childbirth when the baby travels through the birth canal of an infected woman. The virus may spread throughout the newborn's body, attacking vital organs. Even if treated, surviving babies may have permanent damage to their central nervous system.

Other Tests During Pregnancy:

First trimester screening: is a combination of fetal ultrasound and maternal blood testing. This screening process can help determine the risk of the fetus having certain birth defects.

Maternal blood tests: The blood tests measure two substances found in the blood of all pregnant women: 

Pregnancy-associated plasma protein screening (PAPP-A) - a protein produced by the placenta in early pregnancy. Abnormal levels are associated with an increased risk for chromosome abnormality.

Human chorionic gonadotropin (hCG) - a hormone produced by the placenta in early pregnancy. Abnormal levels are associated with an increased risk for chromosome abnormality.

Ultrasound test for fetal nuchal translucency (NT): Nuchal translucency screening uses an ultrasound test to examine the area at the back of the fetal neck for increased fluid or thickening.

Second trimester prenatal screening may include several blood tests called Triple or Quadruple Markers. These markers provide information about the risk of having a baby with certain genetic conditions or birth defects.

AFP screening: Also called maternal serum AFP. This blood test measures the level of AFP in your blood during pregnancy. AFP is a protein normally produced by the fetal liver that is present in the amniotic fluid (the fluid surrounding the fetus). It crosses the placenta and enters the mothers blood. Abnormal levels of AFP may indicate defects in the abdominal wall of the fetus, Down’s syndrome or other chromosomal abnormalities, Open neural tube defects, such as spina bifida.

Estriol: This is a hormone produced by the placenta. It can be measured in maternal blood or urine and is used to determine fetal health.

Inhibin: This is a hormone produced by the placenta.

Human chorionic gonadotropin (HCG): This is also a hormone produced by the placenta.

Glucose Testing: Glucose testing is used to measure the level of sugar in your blood.

The initial 1-hour test is a glucose challenge test. If the results are abnormal, a glucose tolerance test is done.

A glucose tolerance test, usually conducted in the 24 to 28 weeks of pregnancy, measures levels of sugar (glucose) in the mother's blood. Abnormal glucose levels may indicate gestational diabetes.

Group B Strep Culture: Group B streptococcus (GBS) is a type of bacteria found in the lower genital tract of about 20% of all women. While a GBS infection does not usually cause problems in women before pregnancy, it can cause serious illness in mothers during pregnancy. GBS may cause chorioamnionitis (a severe infection of the placental tissues) and postpartum infection. Urinary tract infections caused by GBS can lead to preterm labor and birth or pyelonephritis and sepsis. GBS is the most common cause of life-threatening infections in newborns, including pneumonia and meningitis. Newborn babies contract the infection during pregnancy or from the mother’s genital tract during labor and delivery.

Genetic screening: can help diagnose the potential for certain genetic disorders before birth like Cystic fibrosis, Duchenne Muscular Dystrophy, Hemophilia A, Polycystic kidney disease, Sickle cell disease, Tay-Sachs disease and Thalassemia.

You may have ultrasounds performed at different times in your pregnancy to check for fetal growth, estimate your due date and look for any structural abnormalities in the baby. An ultrasound scan is a diagnostic technique that uses high-frequency sound waves to create an image of the internal organs. A screening ultrasound is sometimes done during the course of your pregnancy to check normal fetal growth and verify the due date