Archive for the 'TESTS AND PROCEDURES' Category

Sometimes the unforeseen happens. You may only be a month or two pregnant when you begin to feel pain in your abdomen and when you rush to the bathroom, you are bleeding profusely. You are having a miscarriage.

This is not something that any women wants to go through but now it is happening to you. Miscarriages can happen in a few minutes and physicians do not always know what causes them.

You will need to go to the doctor immediately when you start to miscarry. If your physician thinks that it is necessary, they will want to perform a D&C on your uterus.

D&C Surgery

D&C (dilation and curettage) is a surgical procedure that allows your physician to clean out your uterus. They will do this by dilating your cervix and scraping the lining of your uterus.

Having a D&C performed will be necessary if you have very heavy bleeding with your miscarriage. Another reason that your physician may consider a D&C is if your miscarriage does not complete itself naturally.

Your physician will perform a D&C at your request if you do not want to wait for the miscarriage to complete on its own.

In an ideal world every pregnant woman should have a simple thyroid test performed to examine her thyroid function, because the symptoms of thyroid problems are often masked by all the changes that take place in the body during this time.

Consequently, hypothyroidism or hyperthyroidism can result in a miscarriage or brain damage to the fetus growing in the womb.

Up to five women in every thousand will suffer with a thyroid condition but usually goes undiagnosed. A decade ago, Dr. James E. Haddow, lead a study in Maine that examined over twenty five thousand women that were pregnant.

The children of the 62 found to have hypothyroidism were all found to have lower intelligence; they were all aged approximately eight years old.

Currently only women at high risk are tested and this is likely to remain the case. However, certain endocrinologists routinely test pregnant women as a matter of course. The medical world is fairly split over the matter so more research will need to be done in this area.

It appears that therapy involving T4 replacement is very successful, this was highlighted by researchers in Italy. The latter resulted in data noting sharp declines in miscarriage and other factors after at risk women were given a simple thyroid hormone tablet.

One of the most important “maternal blood screening tests” is the quad screen test.

Four specific substances will be tested under this test.

They include: hCG (Human chorionic gonadotrophin), AFP (Alpha fetoprotein), inhibin-A and Estriol.

• hCG is a hormone that is created within the placenta.
• AFP is produced by the fetus.
• Inhibin-A is a protein which is produced by the ovaries and placenta.
• Estriol is an estrogen produced by the placenta and also the fetus.

This test is very similar to the triple screen test. The only difference is, in the quad screen test, the possibility of recognizing the risk of Down syndrome is higher with the evaluation of inhibin-A levels.

How is the quad screen test performed?

This test includes collecting a blood sample from the mother, which lasts for 5-10 minutes. This sample of blood is then tested in the laboratory and the results will be displayed within a few days.

During the test process, you will experience slight discomfort. Instead of this, there are no known dangerous consequences or risks associated with quad screen test.

A new report indicates that although ultrasound has existed for some time now for monitoring babies in pregnant women and no side effects have been noted such as childhood leukemia or other cancers, weight problems or dyslexia, experts still believe that exposure to ultrasound monitoring should be controlled.

If there are no apparent medical reasons for monitoring the baby, the ultrasound exposure should be limited to the essential analysis.

Ultrasound scans during pregnancy are not indispensable; they may at times reassure mothers as to the health of their babies although not all abnormalities can be detected through scans. Sometimes scans can cause doubts, which actually lead to anxiety during pregnancy. [Pregnancy Ultrasound]

Scans can detect abnormalities such as spina bifida or can show slight variations in what are known as markers, which can either be a variation of normal rates or can be a sign of problems such as Down’s syndrome.

These readings are not always precise, and if there is any doubt, mothers must be referred to a Fetal Medicine Specialist, who will perform other tests to determine if the baby’s chromosomes numbers are normal.

This test is available to all pregnant women and also to their partners.

CF carrier screen test is performed to determine whether a person carries the abnormal genetic patterns that cause cystic fibrosis or not.

Cystic fibrosis is an inherited condition. This disease mainly affects digestion and breathing. Mainly this disease is the result of an abnormal gene that makes your body to produce thick mucus in the lungs.

This mucus causes an infection that can be a life threatening condition. The maximum life expectancy for a person with cystic fibrosis is 30 years.

Use of CF carrier screen:

• This prenatal test determines carriers of cystic fibrosis.
• Determines your risk of carrying a child with CF
• Diagnoses cystic fibrosis both prenatal and postnatal
• This test identifies familial transformation in affected individuals.

You need to undergo this test before or in early pregnancy. In order to conduct the test, a blood or saliva sample is taken.

Possibility of getting cystic fibrosis to your child:

The only way to get cystic fibrosis is to have two genes that cause CF. One comes from mother and the other comes from father, which means that both the parents have CF carriers.

Performing chorionic villus sampling (CVS) for prenatal diagnosis may lead to an increased rate of blood vessel malformations called hemangiomas in infants, according to a review in the November Journal of Craniofacial Surgery.

Dr. Lewis B. Holmes of Massachusetts General Hospital for Children, Boston, reviews past research on the possible link between CVS and the development of hemangiomas, limb defects, and certain other malformations.

According to Dr. Holmes, the findings suggest but do not prove some possible ways in which CVS might lead to “vascular disruption defects or hemangiomas.”

Chorionic villus sampling is a frequently performed prenatal test in which a small sample of the placenta is obtained early during pregnancy to look for evidence of genetic diseases. The procedure is generally considered safe.

However, in the past decade, several published reports have suggested “occasional fetal effects” in infants undergoing CVS, including an increased rate of hemangiomas.

Hemangiomas are common blood vessel malformations, caused by abnormal growth of the cells lining the blood vessels (endothelial cells). They range from small birthmarks to large malformations causing serious deformity.

Read more at Medical News Today

Also known as fetal blood sampling or Percutaneous Umbilical Cord Blood Sampling (PUBS), cordocentesis is a diagnostic test mainly used to examine the blood of the fetus for detecting fetal abnormalities.

This prenatal testing is used to diagnose in utero complications along with Down syndrome and heart defects.

How is the test performed?

Advanced imaging ultrasound is used to find the area where the baby’s umbilical cord joins the placenta.

During the procedure, a thin needle is passed through the abdomen and uterine walls to the umbilical cord to get a blood sample. The only difference between this test procedure and amniocentesis test is that blood is retrieved from the fetus.

When is the test performed?

Usually, the test is done when the required information is inconclusive or cannot be obtained from amniocentesis, ultrasound or CVs. Usually, the right time to undergo this test is after the gestational period of 17 weeks, i.e. after the complete development of the umbilical cord.

How is cordocentesis useful?

The test is used to detect chromosomal abnormalities such as Down syndrome and other blood disorders like fetal hemolytic disease. It also helps diagnose the following abnormalities:

• Fetal anemia;

Pregnant women worried about their babies’ genetic health face a tough decision: get prenatal gene testing and risk of miscarriage [causes of  early miscarriage] or skip the tests and miss the chance to learn of genetic defects before birth.

But a new prenatal test could make this dilemma obsolete. The new method, developed by scientists at Stanford University, the Howard Hughes Medical Institute and Lucile Packard Children’s Hospital, requires only a maternal blood sample to spot chromosomal disorders such as Down syndrome.

“Right now, people are risking their pregnancies to get this information,” said Yair Blumenfeld, MD, a postdoctoral medical fellow in obstetrics and gynecology and co-author of a paper describing the technique.

Current prenatal gene tests, such as amniocentesis and chorionic villus sampling, require inserting a needle in the uterus and carry a miscarriage risk of around half a percent.

“Non-invasive testing will be much safer than current approaches,” said Stephen Quake, PhD, professor of bioengineering and the study’s senior author.

The new technique takes advantage of fragments of fetal DNA in the woman’s blood. Safety may not be the only gain. Quake hopes the test will spot genetic problems much earlier in gestation than the other methods.

Testing for genetic defects early in pregnancy through chorionic villus sampling, or CVS, does not appear to raise the risk of fetal loss.

CVS involves using a needle to collect samples of the embryonic structure that goes on the form the placenta.

The process can be performed as early as 10 weeks into pregnancy, and provides cells of fetal origin that can be examined for chromosomal abnormalities.

There has been concern that the procedure might cause miscarriage [causes of early miscarriage], but in the current study the fetal loss rate following chorionic villus sampling was no different than the rate among pregnant women who did not undergo an invasive procedure.

“With the recent recommendations for screening for chromosomal abnormalities…demand for prenatal diagnosis are expected to increase,” the researchers write in the medical journal Obstetrics & Gynecology.

“Providing reliable information on the fetal loss rate and potential risk factors for fetal loss is important during counseling before undergoing an invasive procedure.”

Read more at Reuters

Usually done within the second trimester of pregnancy i.e. between 15-18 weeks of pregnancy, multiple marker screening is a non-invasive blood test which can detect whether your baby is at an increased risk of certain problems.

Ideally, this test is done in conjunction with first-trimester screening tests. This combination is known as integrated or sequential screening.

Similar to other screening tests, multiple marker test will give you an estimation of your baby’s complications, but not a diagnosis.

The test also helps you to decide whether you need an invasive diagnostic test such as amniocentesis.

The markers measured by this test include: alpha-fetoprotein (AFP), a protein produced by the baby’s liver, and also two hormones generated by the placenta called as human chronic gonadotropin (hCG) and unconjugated estriol (uE3).

There are other multiple marker tests:  quad screen, which measures the above three substances and a fourth marker called inhibin A.

Who needs to undergo this test?

Multiple marker screening is advised for all pregnant women, whether or not they have low or high risk complications associated with pregnancy. These are the high risk factors: