When women are pregnant, they go through a range of different screening tests. These are done to monitor the progress of the unborn child and to make sure there are no problems that could put the health of the baby or mother at risk. Often, if something is picked up on, treatment can be offered to prevent further problems. Most of the times, the screening tests come back completely clear. Only if they don’t will further screening tests or treatment be offered.
General history screening is done verbally. The doctor or midwife will discuss any hereditary conditions you or your partner (or parents) may have that could affect the child. A good example is diabetes or a history of pre-eclampsia.
A number of standard physical tests will also be performed. These are:
• Height and weight. Weight in particular will be monitored throughout pregnancy, as this can be a good indicator of pregnancy diabetes.
• The baby’s growth, done through ultrasounds and feeling the woman’s belly. There are no known side effects to ultrasounds.
• Blood pressure, which monitors the risk of pre-eclampsia.
• Positioning the baby, usually done by hand. There are no side effects to this, although manipulation may be required if the baby is presenting in the wrong direction. Although harmless, this can be very painful.
In the past, women would be put through vaginal examinations, but these are generally not necessary anymore, unless some problem is suspected.
At every checkup, a pregnant woman’s urine will also be tested. This is done to determine:
• Levels of protein (too high may mean pre-eclampsia).
• Levels of glucose (too high may mean diabetes).
• The presence of germs.
At regular interval, a number of blood tests will also be taken. These are checked in a laboratory for:
• Anemia, a lack of iron.
• Finding out a woman’s blood group (if she is rhesus negative, she will need anti-D injections in order to support further pregnancies).
• Rubella status, to make sure a woman already has antibodies. If not, women will be advised to stay away from children and they will be urged to be immunized after their pregnancy.
• Disorders of hemoglobin, such as sickle cell.
• Various infections (including sexually transmitted diseases like HIV, Hep B and Syphilis)
Usually, the full blood test is done only once, but another one will be offered at 28 weeks to check for anemia once again.
Ultrasound scans are usually offered twice during pregnancy. The first is the dating scan, which is done when a woman believes she is around 12 weeks pregnant. This will determine the baby’s due date. A second one is offered at around 20 weeks, which will determine whether the baby is still growing properly or whether there is any fetal anomaly. If there is, further interventions will be required.
Down’s Syndrome Screening
The most controversial of all tests is the one that screens for Down’s Syndrome. When a baby has a copy of chromosome 21, they will have Down’s Syndrome. A range of different tests are offered to check whether a woman is carrying a Down baby or not. Not all women will be offered these, although they are recommend for older mothers (if they are over the age of 30), because the risk of Down is greatly increased.
One test is to simply have a blood test, others use ultrasounds and others still take a sample of amniotic fluid. This is the most controversial of all, because it increases the risk of miscarriage. Usually, this test is only offered if blood tests or ultrasounds already indicate the possibility of Down’s being present. If a baby does have Down’s Syndrome, women will be offered the possibility of aborting their child. Many women choose not to have the tests done, because they would not abort their child anyway, which means the risk of miscarriage is not a risk they are willing to take.
In the 1950s and before, newborn were often treated with radiation, particularly if they were too big. The process, known as irradiation, caused a huge degree of problems in children, with radiation being a carcinogenic. The biggest effect seemed to be on their thyroids, although most did not have any permanent effects. Interestingly, a lot of women still associate irradiation with pregnancy tests, even though radiation treatment is no longer offered and was never part of screening.
What do you think?