Tests in pregnancy

Across the nine months of pregnancy, you and your baby will be monitored with various tests to ensure your safety and the healthy development of your baby.

Ultrasound imaging is a diagnostic procedure that uses high-frequency sound waves to produce images of the internal structures of your body. It is performed during pregnancy to determine the health of your pelvic organs and monitor the development of your baby in the womb. It helps to monitor the progress of pregnancy, determine your baby’s age, growth, heartbeat and position, detect problems and identify multiple pregnancies.

The procedure is performed as an outpatient procedure on a full bladder. While you lie on your back, a gel is applied to your abdomen and pelvic area. A device called a transducer is gently glided over the gelled area. The transducer emits and receives sound waves as they bounce off the internal organs. The sound waves are converted into images that can be viewed on a monitor. The procedure is painless and involves no risks to you or your baby.

Down syndrome is a chromosomal disorder associated with intellectual disability and certain physical abnormalities. Screening tests help determine your chance of having a baby with Down syndrome, and are performed during the first and second trimesters of pregnancy.

The first trimester screening test (performed in your 9th to 13th week) includes a blood test and ultrasound exam. The second trimester screening test (performed between 15 and 20 weeks) include blood tests. The ultrasound measures the thickness of a fluid pocket behind your baby’s neck, and the blood tests detect the levels of a protein and pregnancy hormones. The tests of the first and second trimester screenings are usually combined to confirm if your baby has Down syndrome, a congenital disorder due to a chromosome defect, causing intellectual impairment and physical abnormalities. Positive screening tests are usually followed by other diagnostic tests for further information.

Gestational diabetes refers to diabetes during pregnancy, a condition in which the levels of sugar in your blood are higher than normal. It usually develops in the second trimester, and most often, your blood sugar levels return to normal soon after delivery. High blood sugar levels can affect you as well as the development and growth of your baby.

If you have a high risk of developing gestational diabetes i.e., if you have a family history of diabetes or you are obese, you will usually be screened at your first prenatal visit, otherwise, else during your second trimester. The initial glucose challenge test will involve the measurement of your blood glucose levels one hour after drinking a glucose solution. If your levels are high, a follow-up glucose tolerance test will be performed where you will be asked to fast overnight and drink a glucose solution. Your glucose levels, before and every hour for three hours after drinking the solution, will be measured to confirm a diagnosis of gestational diabetes.

Based on these results, your doctor will suggest ways to control your pregnancy-induced diabetes with dietary changes, regular exercising, insulin administration and frequent monitoring.
Pregnancy Complicated by High BP and gestational diabetes_ver final.

Insulin is a hormone produced by the pancreatic gland to maintain normal levels of glucose in the blood. High levels of blood glucose in gestational diabetics can lead to complications such as preeclampsia, preterm delivery, a large-sized baby, caesarean section, or a newborn with low blood sugar, breathing difficulties and jaundice. It can usually be controlled by simple lifestyle changes, but some may require insulin hormone injections to lower blood glucose levels.

• Your doctor will instruct you on how to draw and administer insulin. Here is a step by step process.
• Always store insulin in the refrigerator until opened.
• Insulin may be kept at room temperature once you’ve opened it for use, as long as you keep it away from direct sunlight and other sources of heat.
• Wash your hands well and attach the needle to the syringe.
• Prime the needle with insulin
• Fill the syringe with the prescribed amount of units of insulin.
• Hold the needle pointing up and remove all air bubbles by tapping the sides.
• Push the syringe up slowly until a drop of insulin exits out the needle.
• You may have to repeat the priming process until the insulin flows out of the needle.
• After priming you can insert the needle into the selected site once the site has been cleaned. The recommended sites for injection during pregnancy are the abdomen and thighs.
• Depress the plunger to release the medicine and remove the needle.
• Dispose all used needles into approved sharps containers that you can purchase from retail pharmacies.
• In order to avoid unpleasant problems, avoid injecting yourself at the same place each time and instead follow a regular pattern of rotation. Consult your doctor immediately if you notice change of colour, lumpiness, depressions or burns at the injection site.
• The administration of insulin hormone poses no harm to your baby as the injected insulin works the same as the insulin produced by your body.
• Pregnancy Complicated by High BP and gestational diabetes_ver final.

In the Caucasian population 1 in 25 people are carriers. If two carriers are trying to conceive they have a 1 in 4 chance of having a child with Cystic Fibrosis. Modern medicine has dramatically improved the life expectancy for children born with CF. However many still suffer from severe respiratory infections from childhood requiring hospital admissions, regular antibiotics and chest physiotherapy and have problems with malnutrition and pancreatic disorders. The genetic deletion causes a thickening of secretions in the lung and digestive symptoms.

Cystic Fibrosis Victoria
Tel: 03 9686 1811
Website: https://cfcc.org.au/

FX is caused by an increase in the length of the FMR1 gene. 1 in 150 people are carriers of the FX gene. The FX carrier test will tell women whether they carry the low risk gene or the increased risk gene. Women who carry the increased risk gene may have a child with FX, regardless of their male partner/donors status. A male baby born with FXS is at increased risk of cognitive impairment, behavioural issues, disorders of the nervous system, autism and epilepsy. Females may have premature ovarian failure and find it difficult to conceive. Unfortunately there is no cure for FX.

Fragile X Association of Australia Inc
Tel: 1300 394 636
Website: https://www.fragilex.org.au/

SMA is a condition that affects nerves in the spinal cord and causes muscles to get weak. This not only affectsthe muscles for movement but also the respiratory muscles. There are several types of SMA with Type 1 being the most severe. Like Cystic Fibrosis both the female and male partner/donor need to be carriers for a child to be effected. Should two carriers meet they have a 1 in 4 (25%) chance of having a child born with SMA. In the general population 1 in 70 people are carriers of SMA.

Spinal Muscular Atrophy Association of Australia Inc.
Tel: 03 9545 3633
Website: https://smaaustralia.org.au/

An amniocentesis is when we take a small sample of fluid from the womb. This is done by inserting a needle into the mothers abdomen to take a sample.

The test is offered as there may be a suspected chromosomal or genetic condition that has shown up on an ultrasound and further testing may be required.

Red blood cell alloimmunisation is important to diagnose in pregnancy because it can lead to a serious complication called haemolytic disease of the newborn.