The development of medicine has helped to significantly reduce infant mortality, but modern developments may be more - to predict the possibility of serious diseases. For this purpose, screening is used, what it is and when done, it is better to disassemble in more detail.
What is screening?
During pregnancy and immediately after childbirth, a screening test is required to assess the risks to the health of the future mother and infant. Such tests are conducted several times to have dynamic indicators. It is not necessary to doubt whether screening is necessary, what it is and whether the procedure can harm the child, because it is recommended by WHO. This complex of simple measures is harmless, and can save you from serious problems.
Prenatal screening - what is it?
During gestation, it is required to control the process of forming the embryo in time to notice a probable violation. Screening of pregnant women is carried out in each of the three-month stretches, the number and types of tests determine individually. The doctor can send for repeated or additional tests. When the screening is done, what it is, and which mandatory procedures must be prepared, every woman should know. This is especially important for those who are at risk. The following factors are determined here:
- age over 35 years;
- there are children with chromosomal abnormalities;
- more than two consecutive miscarriages;
- reception of harmful medicines in the first 3 months;
- marriage between close relatives;
- prolonged threat of miscarriage;
- irradiation of parents before conception.
Neonatal Screening
This procedure should be carried out in all maternity homes, such a massive assessment allows you to identify congenital and hereditary diseases. Screening newborns gives a chance for a topical treatment. The procedure is carried out in several stages:
- a blood test taken from the baby's heel;
- audiological test;
- repeated research;
- Visiting narrow specialists in case of problems.
Why screening?
The purpose of any survey is to identify the existing diseases or their risks. When the child is pregnant, the second item comes to the fore. This is especially true when a second screening is performed during pregnancy, its results are not always accurate, so alarm signals require recheck by other methods. Completely ignore these studies is not worth it, because even with an internal installation to give birth to any child understanding the situation will help prepare for possible difficulties.
Neonatal screening , carried out in the first days of the baby's life, has more accuracy and helps to identify the presence of the disease. Avoid it is not necessary, many problems with early diagnosis are better manageable. Even with severe diseases, the chances of improving the condition are significantly increased if abnormalities are detected at this age.
Pregnancy examination
Fetal development is required to be monitored continuously, so tests are performed in each trimester:
- Ultrasound and biochemical blood test.
- Ultrasound. Blood can be examined if the first pregnancy screening was ignored. The informativeness of the method is questionable at this stage, therefore, the final conclusions on its basis do not.
- Ultrasound. In detecting developmental abnormalities, Doppler and cardiography may be used additionally.
Biochemical Screening
For the study, venous blood is taken, which is obtained in the morning on an empty stomach. Since they do screening in the first trimester, its result indicates probable problems, and does not become a verdict. The evaluation is made on two markers:
- In-hCG - helps maintain and continue pregnancy.
- RARR-A - is responsible for the immune response of the woman's body, work and formation of the placenta.
Increased content of B-hCG can talk about:
- premature toxicosis;
- Down's syndrome and other chromosomal changes;
- incorrectly delivered term of pregnancy;
- diabetes maternal diabetes;
- multiplicity .
The lower concentration of B-hCG indicates:
- ectopic pregnancy;
- placental insufficiency;
- Edwards syndrome ;
- risk of miscarriage.
The deviation of the PAPP-A indicator shows the probability:
- chromosomal changes;
- spontaneous abortion;
- inhibition of pregnancy;
- monogenic syndromes.
Ultrasound screening
Ultrasound tests are arranged at each stage of gestation, the results of screening allow to see the formation of abnormalities in the formation of the fetus. For correct interpretation of what you see, you need a high qualification for a doctor, so in case of doubt, it is better to check the conclusion with another doctor. In the first trimester, the following points are evaluated:
- The thickness of the collar space - the more it is bigger, the higher the chances of having a pathology.
- The length of the nasal bone may indicate a chromosomal mutation, but must be confirmed by the results of the remaining tests.
In the second trimester, the study is carried out only through the abdominal surface, it is performed for several purposes:
- Evaluation of fetal anatomy for the detection of developmental disorders.
- Correlation of the degree of development and the period of pregnancy.
- Clarifying the presentation of the fetus .
In the third trimester, more attention is paid to possible obstetric complications and fetal growth retardation, because at such a late period seldom manifest defects, the main ones are detected earlier. During the study, the doctor looks at:
- dimensions of the trunk and head (needed to plan the weight of the child);
- genitourinary system;
- brain;
- organs in the abdomen;
- spine;
- jaw, orbit and nasolabial area;
- behavioral reaction;
- the state of the reproductive organs of the mother.
Screening for pregnancy - timing
It is important for the future mother not only to know what this "screening" is, but to represent the time limits of its passage. Tests are very dependent on the duration of pregnancy, if this point is neglected, then it is possible to significantly reduce the effectiveness of the study or obtain false data.
- The first trimester - for the examinations are sent at 11-14 weeks, but experts believe the best time span is 12-13 weeks.
- Second trimester - the optimal term for screening for pregnancy at this stage is 16-20 weeks.
- Third trimester - studies are conducted in 30-34 weeks, the best period is 32-34 weeks.
Diagnosis of the newborn
After heightened medical attention during gestation, women do not always want to understand what a screening test of an infant is. Some rely on their own feelings, forgetting about the possibility of manifestations of diseases later. A simple analysis in the early days of a baby's life can reveal serious problems and give a chance for improvement. The screening of the child is carried out in several stages, giving the parents basic information about his health.
Screening of newborns for hereditary diseases
The first necessarily examination is often called a "heel test", because from here blood is taken for research. If the desired markers are found, additional tests are performed. Screening, the norms of which are periodically enlarged by new diseases, is recommended for all children, if they are not held in the maternity home, parents should apply for it themselves. As a result of the survey, the following hereditary problems can be determined.
- Phenylketonuria - symptoms appear after 6 months, the consequences can be mental disorders. If detected on time, it is possible to prevent development by diet therapy.
- Cystic fibrosis - a violation of the work of breathing and digestion due to a malfunction of the glands of external secretion. Diet and enzymes of the pancreas are used to normalize the condition.
- Galactosemia - does not digest a dairy carbohydrate, which leads to lesions of the liver, nervous system, eyes. In the first months of life often becomes the cause of death, surviving children without treatment remain disabled.
- Adrenogenital syndrome - requires immediate help, without it the risk of death is high.
Audiological screening
To detect hearing disorders in newborns, the method of otoacoustic emission is used, it shows even a slight decrease in the sensitivity of this organ. The resulting screening reveals information about the need for further work with the child. Studies prove that prosthetics at 3-4 degree of hearing loss to 6 months helps to avoid delay in speech and language development of children. If hearing aids are used later, then there will be a backlog. For this reason, the study is recommended for compulsory passage.
Neonatal screening of newborns - dates
High efficiency differs only in screening, the timing of which was met. The blood test is performed on the 4th morning (in preterm infants - at 7) 3 hours after feeding. The results are known no later than 10 days after birth. If problems are found, further tests will be required. A hearing test is done after 4 days of life, earlier errors can occur. If a negative result is found, the test is repeated after 4-6 weeks.