PLANNING TO HAVE A BABY? One should-do before trying to conceive is to go for a pre-pregnancy health screening as they are multiple benefits that come with it. Firstly, it helps to ensure that the health of a couple is in optimal condition before pregnancy. Any medical issues that might affect pregnancy can be addressed early. There are no risks involved in the screening and it is recommended that couples go for it three to six months before trying to conceive. This will allow time for the treatment of any medical or gynaecological conditions found. It will also allow time to complete various important vaccinations against Rubella, Hepatitis B as well as cervical cancer.
The screening usually includes a medical consultation, examination, ultrasound scan, cervical Pap smear and blood tests.
The medical consultation helps identify any personal or family history of illnesses. This would help to exclude any hereditary or genetic conditions. Some birth defects are inherited and can be passed on to the baby. A carrier is a person who shows no signs of a particular disorder but could pass the gene on to his or her children. Carrier testing is done to see if a couple carries a gene for certain inherited disorders and to check for a number of genetic disorders, such as cystic fibrosis, sickle cell anemia, Tay–Sachs disease, and thalassemia. Here’s how the test works: A sample of a person’s blood is sent for genetic testing. If the test result shows the mother is a carrier, then the baby’s father is tested. If the test result shows that both parents are carriers, a genetic counsellor will provide more information about the risk of having a baby with the disorder.
After this, an examination, ultrasound scan and cervical Pap smear are then performed. These would help to determine if there are any medical or gynaecological conditions such as cysts or fibroids. There are also several routine blood tests that one needs to go for. They include:
Maternal full blood count: This test screens for anaemia, sickle cell disease and thalassaemia. If necessary, testing of the father is undertaken so that the probability of the fetus being affected can be assessed. In cases where the fetus has a high chance of inheriting a genetic condition, assisted reproductive techniques such as in-vitro fertilisation with pre-implantation genetic diagnosis of the embryo may be performed. Alternatively, chorionic villus sampling at around 14 weeks pregnancy may be performed to determine if the baby has inherited the condition.
Maternal blood group and Rhesus D antigen status: This screens for haemolytic disease of the newborn. All pregnant women who are Rhesus negative and are non- sensitised, that is, they have not been exposed to Rhesus antigens, are offered routine antenatal anti-D prophylaxis during pregnancy at 28 and 34 weeks gestation.
Screening for hepatitis B, HIV and syphilis: If a woman found to be positive for any of these infections, effective pre-natal as well as post-natal intervention can be offered to decrease the risk of mother-to-child-transmission.
Screening for rubella (German measles) immunity: If a woman is found to be non- immune, it will be recommended that she gets vaccinated against rubella to prevent the risk of contracting rubella in pregnancy. Congenital rubella is associated with birth defects in the child including deafness and blindness.
The screening also provides a good opportunity to discuss diet and lifestyle issues, as well as ways to increase fertility and the chances of conceiving a healthy baby. Studies have shown that the developing fetus is affected very early on by the mother’s diet and nutrition and so it is important to observe a healthy diet and lifestyle even before pregnancy. It is recommended that all couples go for a pre-pregnancy health screening before trying for a child.