Some Essential Tests during Pregnancy
There are essential tests which are carried out in the laboratory which reveal about the health of both the mother and the baby inside her womb, as also prepare the treating physician about some complications the delivery might present before him (or her).
These are done to ascertain the pregnant lady’s blood group, her hemoglobin count, her power to resist the viral infections, as also to know whether or not she is suffering from some serious venereal disease like syphilis etc.
- Hemoglobin: As we all know hemoglobin count has great importance. Hence it is essential to keep tabs on the amount of hemoglobin in the blood of the expectant mother throughout the period of pregnancy. An active substance in the red blood corpuscles (erythrocytes) hemoglobin performs the important function of carrying oxygen to all the cells of the body. The amount of hemoglobin in the blood, therefore, determines the capacity of blood to absorb oxygen, and a low proportion of hemoglobin is indicative of anemia. It is not possible for a baby to develop normally in the womb of an anemic woman-i. e. with low hemoglobin count. A timely diagnosis of anemia in the initial stages of pregnancy would make it possible to restore the correct concentration of hemoglobin in the blood of the expectant mother by the relatively simple expedient of giving her tablets containing organic iron. The hemoglobin count of the pregnant woman should not be allowed to fall below 70%.
- Resisting Viral Infections: Viral infections of various kinds have been surfacing quite alarmingly. The best way to check them is by increasing the resistance of the pregnant woman through proper medication. Any failure to do so might prove hazardous even to the baby. the virus of Rubella (German measles) is especially notorious in this case because it might greatly disturb the growth of the baby and leave some potential disorders. In case the mother contracts this disease in the first three months of pregnancy the effects-malformation, deafness, blindness, heart disease etc. on the baby can be serious enough to make termination of the pregnancy mandatory. Hence it is advisable beforehand to ascertain whether the pregnant woman has a natural immunity to this disease or not. Make sure whether the vaccine has been administered to her or not. In no case, the woman should contemplate conception unless she is either naturally immune or has been immunized against this disease. It is not a difficult treatment as the doctor can easily know whether the woman has been immunized against the disease or not by testing her blood. In case not, then she can be immunized by administering the required vaccine. However, she should care to ensure that she does not conceive for at least three months after she has been immunized.
- Rhesus Blood Group: As we know the blood of every human being is either Rhesus positive (Rh +) or Rhesus negative (Rh -). The Rhesus group of a woman should be ascertained in the very beginning of the first pregnancy if you even earlier. Also to be checked whether the blood contains antibodies to Rhesus positive blood cells or not. These antibodies are a potential source of disturbance in the baby’s growth and even its eventual birth.
- Syphilis: The pregnant woman should not have this serious infectious disease at all. Whether she had it or not can be easily determined by the first blood test. Necessary treatment to control infection is undertaken immediately on detection of the disease, so as to safeguard the baby against this serious affliction.
- Hypertension: The medical term for high blood pressure. Some women develop high blood pressure during pregnancy. If the condition persists continuously for two months or so, it becomes necessary to keep watch on developments. In case of hypertension persists for even longer periods, the mother-to-be must seek admission to a hospital for intensive treatment. Many a time high blood pressure is only caused by unnecessary worries. The pregnant lady, owing to her misconceptions feels unduly concerned for her condition and the expected travails of delivery. The moment a competent doctor dispells her worries she becomes free of this infection.
- Test for Detecting the Pressure of Alpha-Fetoprotein: This test in medical parlance is called Spina Bifida Test. This is carried out only after the fetus has been developing for 16 weeks in the womb. A positive result in this test would indicate the possibility of Spina bids. It means that the spine of the child is not fully developed and so has failed to protect the spinal cord, a part of the cord remaining exposed on the surface of the skin. If such a possibility is indicated, a test known as amniocentesis is recommended in order to assess the situation properly. Additionally, an ultrasound scan (sonography) is also used to determine whether the spinal cord of the baby is developing normally or not.
- The Ultra Sound Scan: Nowadays this test is becoming extremely popular but for the wrong reasons. It is a very good test to reveal various pieces of information about the internal state of the mother and her baby. This is a very sophisticated diagnostic tool. Details of the uterus and the developing baby, including any defects and malformations, can be examined on a television-like screen. But the main cause of this scan-test’s popularity is predetermining the sex of the child. The test is not harmful either to the mother or to the baby in any way.
This scan, also called sonography can reveal the following information without any ambiguity :
(i) Has conception occurred?
(ii) Is the baby developing normally?
(iii) Is the conception uterine or ectopic (i.e. at a site other than the uterus? In other words is the baby developing in the uterus, or outside the uterus (a dangerous situation)?
(iv) Is there only one child, or more than one child developing in the uterus?
(v) What is the approximate period for which the child has been developing?
(vi) Is the child in the normal position for delivery, or is it in the breech (head-down) position or transverse position. Moreover, if it is not in the normal position, what is the reason?
(vii) Is the baby a boy or girl ?
(viii) Is the baby suffering from any defect of development. [This question assumes greater importance in cases where there have been cases of malformed babies in the nearest blood relatives of the parents, or if the mother has been taking medicines which are known to cause malformation in the baby ?]
(ix) If there is vaginal bleeding, it becomes important to know the position of the placenta-whether the placenta is in a position which precludes normal delivery etc.
(x) The position of the umbilical cord, any defects in the cord, and whether it is entwined around the baby can be established.
(xi) This test can also reveal the condition of the uterus, any defects it may have, the state of development of the baby (whether too small or underdeveloped etc.)
(xii) A tumor in the uterus or cervix can be detected.
(xiii) Benign or malignant (cancer) tumors in the abdomen or in the ovaries can be detected and their exact location ascertained.
(xiv) If the woman has not been able to conceive, the process of ovulation can be studied in detail, and appropriate measures are taken.
(xv) It can be ascertained whether contraceptive devices like copper T or the silver ring are in the correct position, or whether they have become displaced.
- Urine Tests: These are mainly carried out to determine the amounts of sugar and proteins in the urine. The urine passed out immediately on leaving the bed in the morning before taking anything is to be taken for these tests since it is more concentrated and reflects the proportions of this substance in the blood with better accuracy. However, the proportions of sugar in the urine if a pregnant woman keeps on changing. If these changes are very rapid or if the proportion of sugar is found to be constantly high, then there are chances that the pregnant woman may be having diabetes. This detection calls for special care that the baby in the womb doesn’t develop any deficiency or defect of any kind.
A positive test for proteins in the urine in the primary stages is indicative of some kind of infection in the urinary system. A positive test in the second stage indicates a condition called toxemia. This condition shows that some positive substances and wastes present in the blood of the expectant mother may have infiltered into the developing body of the baby. This condition is quite amenable to treatment and the doctor should take special care for this complication. However, there is nothing to worry as with due precaution the preventive treatment may remove the toxicity of the blood.
- The Uterus Tests: These tests are conducted generally in the case of women conceiving at an advanced age One test is termed Amniocentesis. It is to detect Down’s syndrome (mangolism), genetically linked disorders etc. In the Uterus, the baby floats in a fluid known as the amniotic fluid. Some of this fluid is withdrawn by means of an injection syringe, and the cells in it are tested. The test can be, usually carried out only after 16 weeks from the last menstrual period, since by this time the limbs of the baby get formed. In the ultrasound scan, which is necessary preliminary to amniocentesis (again, in the cases of women of advanced age becoming pregnant), the doctor can discern all the limbs of the baby, and even its movements-such as sucking the thumb. The sex of the baby can, therefore, be ascertained at this age during the ultrasonic scan or sonography. By amniocentesis too the sex of the baby can be determined. The other test in this category is the ultrasound scan which has already been discussed.
This can also be used to ascertain the sex of the baby. This test has resulted out of the quest of all scientists and doctors to ensure perfect health of the baby before delivery. Accordingly, they have evolved numerous testing procedures, so that congenital defects can be detected and eliminated before birth as far as possible. If the defects are serious and incurable abortion is invariably recommended. A chorionic biopsy is one such testing procedure which is of quite a recent origin. The rest can be performed in the 10th or 12th weeks of pregnancy. In this test, a thin tube or hollow needle is introduced into the uterus, and a few of the cells of the baby which have been discarded and are floating in the amniotic fluid are extracted. These cells are then cultured in vitro by special methods and are subjected to various tests. Nowadays this test is recommended by all the doctors as it enlightens them much about the baby’s health prior to delivery.