Expectant Parents
You are pregnant and it’s great news! Having a positive pregnancy test changes a woman’s life. The months ahead are like a roller coaster of exciting emotions. Let’s not forget the appointments. It is really something that our parents can’t prepare us for or we ourselves can never really prepare for, and that is true for even the most prepared of women. 
So why is pregnancy such as big event! Well it’s down to the chemistry of pregnancy. Biologically, physiologically and psychologically our bodies change. 
Pregnancy is divided into thirds. The first third is also known as the first trimester, up to 13 weeks. The second trimester is from 14 to 26 weeks and the third trimester starts at 27 weeks up to 40 weeks. 
During the first trimester the fetus is developing its early structures. The placenta produces hormones that work to provide nutrition and a good blood flow to the growing fetus. Some of the hormones have an effect on the mum-to-be resulting in the common early complaints of pregnancy such as nausea and vomiting, heart burn, change in sense of smell or taste and sore and tender breasts. 
When a mum-to-be has a missed period the important thing to do aside from taking a pregnancy test is to contact the GP or midwife. Most women will be around 4 to 5 weeks when they take a positive pregnancy test. This early contact with the midwife or GP leads the way to the Antenatal Booking appointment which takes place at around 8 to 10 weeks. Enter now into the journey of antenatal screening and appointments! 

Why is pregnancy screening important? 

Pregnancy screening is a choice. Pregnant women are offered screening tests to allow early identification of potential problems that could affect the health of the mum-to-be or developing fetus during the pregnancy. The antenatal period not only assesses the health of mum-to-be to be and fetus but prepares the mum-to-be for birth. Lots of advice is given and lots of questions may be asked from healthcare providers. The advice will range from medical advice to health and lifestyle advice. 

Antenatal Booking bloods explained 

Most mum-to-be’s will have their medical history taken by the midwife. This is to pick up any concerns that might indicate a consultant needs to be involved in her care. Then a series of blood tests are taken. 
Iron stores are checked with a test called a full blood count. Low iron stores (anaemia) can lead to tiredness in pregnancy and this is something that can be managed when detected early. 
The type of blood each person has is classified into different groups. In pregnancy, mums-to-be will have their blood group checked. This information is important if a mum-to-be has episodes of bleeding. Rarely a mum-to-be may have some factors on her red blood cells that can cross her placenta (afterbirth) and attach to the fetal red blood cells causing anaemia in the fetus before birth. This is very rare but knowing about any risk of this allows specialist care with the fetal medicine doctors. The full blood count and blood group is checked again at around 28 weeks. 
Other tests will assess blood conditions that may be inherited such as sickle cell and thalassemia. A mum-to-be’s urine may also be checked for urine infection. Women are offered testing for infections such as Hepatitis B, HIV, Syphilis and German Measles (rubella). These are uncommon and knowing about them allows careful care during pregnancy and planning for birth. For example, with rubella, if a woman has never been vaccinated or is not immune she can be vaccinated after the birth of the baby. 

What tests look for chromosomal abnormalities? 

One main part of the antenatal screening tests is to assess the risk of chromosomal abnormalities. The cells in our bodies contain genetic material (DNA) that determine how we are made up. The DNA is stored in structures called chromosomes. We have 46 chromosomes (that’s 23 pairs). If an error occurs this can lead to a problem with the chromosomes. 
Down syndrome is due to an extra copy of chromosome 21 and is associated with some physical and learning disabilities. Edwards syndrome is due to an extra copy of chromosome 18. Patau syndrome is due to an extra copy of chromosome 13. Edwards syndrome and Patau’s syndrome are associated with severe medical problems and affected babies may not survive pregnancy or die soon after birth. 
Mums-to-be are offered testing for Downs syndrome, Edwards Syndrome and Patau syndrome because they are the most commonly seen abnormalities. This is done with the combined test (this is the nuchal scan in addition to biochemical markers measured in blood) https://www.asterbabyscan.com/pregnancy-scans-services/ 
For one reason or another if a mum-to-be has missed the combined test she may be offered the Quad test, which only assesses the risk of Downs syndrome. It is done after 14 weeks up to 20 weeks. It’s detection rate or pick up rate is lower than the combined test. 
Non-invasive prenatal testing is another test that provides a risk for the three most common chromosome disorders, Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), and Patau syndrome (trisomy 13). https://www.asterbabyscan.com/pregnancy-scans-services/harmony-test/ 
Additional blood tests will usually be performed according to medical history or clinical need. 

Pregnancy ultrasound scans explained 

Pregnancy ultrasound scans are part of the screening process. Mums to be are offered these starting with a dating scan at around 10 weeks, a nuchal scan at around11-14 weeks and anomaly scan (mid-pregnancy scan). These look at the appropriate development of the baby for the stage of pregnancy and assess the developing structures. In the majority of mums-to-be there will be no concerns, however where a concern is noted, the mum-to-be will be referred to a Fetal Medicine Specialist. 
The anomaly scan also indicates the position of the placenta, the growth of the fetus and the amniotic fluid around the fetus. 
From this stage scans may be performed depending on clinical need or hospital policy which may vary from hospital to hospital. Private scans are available should a mum-to-be want more reassurance. 
Antenatal classes are also useful as they provide birth preparation and general education about pregnancy, birth and the postnatal time. The mum-to-be will also see her midwife for checks of blood pressure, urine and clinical assessment of growth and direct any concerns to the doctors. 
To come and visit our Aster Baby Scan Clinic, just contact us on our Contact us Page and schedule your appointment. 
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