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Testing, testing

by Dr Howard Lee

Along with the regular pregnancy testing you have to endure, there is another more invasive set to collect. Dr Lee guides you through the maze

In all pregnancies there is a basic set of 'invasive' investigations that usually occur at set stages of gestation and are designed to ensure the continuing good health of the baby and mother.

A major fear for any parent-to-be is the possibility of congenital abnormality in their forthcoming baby. Following the initial 'booking in' appointment or from a prior knowledge of the medical or obstetric history, certain situations may be found that need further investigation and observation.

Antenatal services aim to diagnose congenital abnormalities as early as possible. If an abnormality is detected early enough, the couple may be offered the choice of a termination.

At the moment, screening for congenital abnormalities is mostly concerned with the detection of malformations of the central nervous system (like Spina Bifida) and abnormalities of chromosomal origin (like Down's Syndrome).

The special tests

Amniocentesis
This test is usually carried out at 16-18 weeks to detect abnormalities in the foetus. However, it is now possible to get a good sample of amniotic fluid safely at 12-13 weeks and, in some specialist centres it may be performed as early as 10 weeks.

This test is usually offered to older women (usually in their late 30s) as this age group have a higher risk of having a Down's Syndrome baby.

Amniocentesis is also offered if there is a family history of genetic abnormalities, or a positive result from certain of the screening tests done in early pregnancy.

In this test a needle is inserted through the wall of the abdomen and womb, under ultrasound guidance, to obtain a sample of the amniotic fluid (in which the baby is floating). Cells from the foetus are floating in the amniotic fluid and these are needed for testing.

The results are usually available after a few weeks. There is a small chance of miscarriage (less than one per cent) following this test.



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