The Test of Motherhood

Some tests come with life’s experiences. But the one we focus on here could even come in a kit. Gynaecologist Dr Duru Shah lists pre-natal tests for all the mommies-to-be. Read; get the tests done and yes … Happy motherhood!

Investigations or check ups are done in the beginning of pregnancy to make sure that you are medically fit to carry your pregnancy. They are also done to determine if there is any problem that could harm your baby or adversely affect your health. For instance if you are a diabetic and your blood sugar levels are high and uncontrolled in the first three months of your pregnancy, this could give rise to problems in your baby. The chances of having an abnormal baby in such cases is eight times higher than when the blood sugar is well under control.

THE FIRST TRIMESTER

The following are routinely done test:

• Pregnancy tests to confirm a pregnancy. Done either by urine examination or a blood test.

• Urine analysis. A routine test to rule out infection and other problems.

• Rh type and blood group. If you are Rh -ve discuss further details of its effect on pregnancy and its management with your doctor.

• Routine blood tests for anemia, diabetes, thyroid disorders, and infections.

• HIV and HbSAg for hepatitis B. This is important as the line of management for such high risk pregnancies is different.

• Ultrasound screening. This test is performed at the sonologist’s clinic or sometimes in the clinic of your obstetrician. The test is not invasive and does not cause any problems in the baby even if repeated frequently throughout the pregnancy. It tells us how the baby is growing, even detects some abnormalities and gives a lot of details on the overall foetal well being.

In addition there are some special tests:

• Chronic villus sampling (CVS) (nine and 12 weeks) – a screening test for genetic defects done.

• Amniocentesis (15-18 weeks) – a very accurate diagnostic test for genetic disorders and chromosomal problems.

• Percutaneous Umbilical Blood Sampling (PUBS) (20-24 weeks) – guided by ultrasound, a test on fetal blood cells for blood, genetic disorders, Rh incompatibility and other infections.

THE SECOND TRIMESTER

• Alpha Feto Protein (AFP) test:

This test is to be taken between the 15th­-20th weeks. A higher reading indicates the possibility of a neural tube defect or spine bifida (a defect in the spine of your baby). A low AFP could indicate a Downs syndrome (a condition in which a baby is born with mental deficiency).

• Triple marker:

When AFP is combined with Estriol and B-hCG (human chorionic gonadotropic) we get a more accurate prediction of Downs than AFP alone.

• Ultrasound:

 Go for an ultrasound between 18-20 weeks to look for any physical deformity in the baby, its overall growth and also the position of the placenta.

THE THIRD TRIMESTER

• Ultrasound/Biophysical profile:

I usually suggest a repeat ultrasound around 32 weeks to get more information on the baby’s well being and to check if your baby is moving and breathing adequately.

• Non Stress Test (NST):

A foetal monitor determines whether the foetal heart rate increases as the foetus move (which is good sign). For this test you will be asked to lie down on a bed next to the NST machine. A belt with a sensor will be put on your abdomen to record foetal heart beats. This recording is printed on a special paper which fairly resembles an ECG strip. A baby in good health shows an increase of heart beat with every movement. You will be given a button to press every time your baby moves.

(THIS IS AN EXTRACT FROM GYNAECOLOGIST DR DURU SHAH’S BOOK ‘FETAL ATTRACTION’)