Types OF Pre-Natal Test For Pregnancy After Age 35.

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 women who are pregnant and over 35 are more likely to have certain problems during pregnancy.  It is especially important you get early and regular pre-natal care to ensure early diagnosis and proper medications.

THE CONSULTATION:  The first visit to your practitioner affords him/her the opportunity to discuss your medical and obstetrical history, he/she asks about the various aspects of your physical health as well as your lifestyle that may affect the pregnancy.

(a)       Last menstrual date:  The practitioner seeks to know about the start date of your last menstrual period as to enable him to determine the due date, but most women sometimes could not remember same with the date of conception.  The accuracy of using  the date of your last menstrual period holds in few women i.e. those with regular menstrual circle, while in majority of others an ultrasound is performed transvaginally to show whether  the festus is any longer or smaller than the date of your last menstrual period would suggest, not withstanding other method of computing due dates.

            Ultrasound may also be used later in pregnancy to see how the baby is doing, determine the location of the placenta and the amount of amniotic fluid around the baby.

(b)       Lifestyle of the expectant mother is also considered, the practitioner asks about her occupation to find out if whether her job is active or sedentary. – if she spends more time or hours standing or lifting heavy objects or whether she works at nights or shift work.  Her general life style is also a factor to consider – for example smoking, heavy alcohol use and exercise pattern, gynecological obstetrical history.

The practitioner seeks to know about the patients past history as to help manage her obstetrical and gynecological history including any prior pregnancies and experiences with fibroid tumors, vaginal infections and other gynecological problems.

INFERTILITY TREAMENT PRIOR TO PREGNANCY

The practitioner will like to know if the pregnancy is conceived with infertility treatments, which will bring up many points to be addressed, since impact of infertility treatment on pregnancy outcomes is related to higher incidence of multi-fetal pregnancies – twins and more, and increase in certain birth defects in children born after IVF (Intracytoplasmic sperm injection).

MEDICAL RELATED PROBLEMS

Any medical problem the patient may have had including surgeries need to be disclosed realizing that certain medical problems will affect pregnancy.  The practitioner will also need to know any allergies (if not all) to medications,

FAMILY MEDICAL HISTORY – the family medical history- that of the woman, the baby’s father are important, this will enable the practitioner to identify pregnancy related conditions that can recur from generations to generations like having twins.

The other reason is to identify serious hereditary problems within the two families that the baby may inherit the risk of inheritable diseases overlap from one ethnic or geographical group to another; genes get passed from around among the various populations whenever parents are from different ethnic groups.

ETHNIC ROOTS – Ethnic backgrounds of parent are important because some genetic disorders occur more frequently in one ethnicity than others.  For example it has been established that the Jewish people of Eastern European descent, are ten times more likely than others to carry the rare gene for Tay-Sachs, a disease of the nervous system that is usually fatal in early childhood.

Another ethnically selective medical condition is sickle cell anemia, a blood disorder that’s especially prevalent among people within African or Hispanic ancestors.  This condition is recessive and so both members of a couple need to be carriers for the baby to be at risk of inheriting the disease. 

For the baby to be at risk of having tay-sach and sickle-cell anemia both parents have to carry the gene thus reinforcing the statement                                               /fact that inheritable diseases overlap from one ethnic or geographical group to another, hence the need for people to know very much about their ethnic background or family medical history.

Considering the physical Exam/standard tests.  At pre-natal visit, the practitioner examines the patients head, neck, breasts, lungs, abdomen and extremities.  The practitioner   evaluates/performs an internal examination.

Blood Tests: At your first prenatal visit, your practitioner draws your blood for standard test, to check for general health as well as to make sure that she is immune to certain infections.

  Quad Maker screen:  A blood test in which substances in the blood sample are measured to screen for problems in the development of the fetus brain, spinal cord and other neutral tissues of the central nervous system (neural tube) Neural tube defects occur in 1 or 2 out of every 1000 births.  The Quad make screen can detect approximately 76 – 80% of open neutral tube defects, and also genetic disorders such as Down syndrome.

The positive result obtained from this test is not definitive of a birth defects; usually the next step is to offer the mother an amniocentesis to evaluate the baby’s chromosomes as well as an ultra sound to evaluate the baby’s body for any birth defects.  This test is carried out early in pregnancy between the 15th and 20th weeks of pregnancy.

Trimester screen – Test done between 10-14 weeks from blood sample done in conjunction with ultra-sound to measure the thickness of the back of the fetus neck.  It tests for chromosomal abnormalities like Down syndrome.

Amniocentesis:  is a procedure in which a small amount of amniotic fluid is removed from the sac surrounding the fetus and tested for birth defects, while it cannot detect all birth defects, it can detect sickle cell disease, Tay – Sachs disease, Down syndrome if the parents have a significant genetic risk.

 Chronic Villas {CVS}-Sampling is a test which is offered to women who have certain risk factors as a way to detect birth defects during pregnancy.

A small sample of cells called (ch orionic villa) is taken from the placenta where it attaches to the wall of the uterus, they are tiny parts of a placenta that are formed from the fertilized egg. Note-not all the tests or procedures are performed in all pregnancies but only a specific problem is present and usually done in centers that specialize in fetal medicine.

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