آزمایشها و غربالگریهای دوران بارداری؛ راهنمای کامل و علمی برای مادران
آزمایشها و غربالگریهای دوران بارداری یکی از مهمترین بخشهای مراقبت قبل از تولد هستند که به مادران کمک میکنند سلامت خود و جنین را ارزیابی کنند. این آزمایشها شامل غربالگریهای سهماهه اول، دوم و سوم و تستهای تشخیصی در موارد خاص میشوند و هدف اصلی آنها شناسایی مشکلات ژنتیکی، کروموزومی و سلامت جنین است.
آگاهی از انواع آزمایشها، زمان مناسب انجام آنها و تفاوت بین غربالگری و تست تشخیصی، به مادران امکان میدهد تصمیمهای آگاهانه بگیرند و اضطراب ناشی از بارداری کاهش یابد. علاوه بر این، انجام آزمایشها و غربالگریهای دوران بارداری به تشخیص زودهنگام شرایطی مانند سندرم داون و سایر ناهنجاریهای ژنتیکی کمک میکند و مسیر مراقبتهای پزشکی را مشخص میسازد.
در این راهنما، تمامی آزمایشها و غربالگریهای دوران بارداری بهصورت مرحلهای و بر اساس سهماهههای بارداری معرفی شدهاند. تمرکز بر ارائه اطلاعات دقیق، علمی و قابل فهم برای مادران است تا بتوانند با اطمینان و آرامش از این مسیر عبور کنند و سلامت خود و جنین را تضمین کنند. To get complete information about pregnancy, the article Table of Contents
Tests and screenings during pregnancy play a key role in monitoring maternal and fetal health. These examinations help in the early identification of genetic problems, structural abnormalities and medical conditions of the mother and enable accurate planning of medical care. Paying attention to performing these tests at the right time will reduce the risks to the fetus and the mother and will ensure the health of both.
What is the main goal of pregnancy screenings?
The goal of pregnancy screenings is early identification of fetuses. who may be subject to genetic or chromosomal abnormalities. By measuring risk factors and providing a relative result, these tests help the doctor and mother to perform more accurate diagnostic tests if needed. The important thing is that screening does not give a definitive result, but it determines the level of risk.
Difference between diagnostic test and screening test
Screening test: Estimates the risk of a problem and is done on all mothers. Samples are usually maternal blood or ultrasound and are not invasive.
Diagnostic testing: to confirm or Abnormalities are used and include amniocentesis or CVS. These tests are highly accurate, but they are invasive and have a risk of miscarriage.
Division of pregnancy tests and screenings by trimester
Pregnancy tests and screenings are usually grouped according to trimesters of pregnancy so that care can be staged and targeted. Each trimester includes a series of tests and ultrasounds, the purpose of which is to monitor the health of the mother, the development of the fetus, and the early detection of abnormalities. data-end="377">First trimester (weeks 1 to 13): including blood tests, combined screening, NT ultrasound and, if needed, non-invasive fetal DNA screening (NIPT) to detect the risk of Down syndrome and chromosomal abnormalities.
The second trimester (weeks 14 to 27): including a quadruple test, ultrasound anomaly scan and fetal neural tube defect screening.
Third trimester (week 28) until delivery): including gestational diabetes test, anemia and iron check, streptococcal group B test and fetal growth and health ultrasound.
Division by trimester allows mothers and doctors to plan care steps, perform tests on time and provide accurate information for Have medical decisions at their disposal. This approach optimizes preventive and diagnostic care and increases the health of the mother and fetus.
Tests and screenings of the first trimester of pregnancy
The first trimester of pregnancy is one of the most important periods for Evaluation of maternal and fetal health. During this period, tests and screenings help to identify genetic and chromosomal abnormalities early and determine the path of further care. data-start="372" data-end="427">The level of hormones, blood factors and some genetic markers. These tests help to determine the risk of chromosomal abnormalities and maternal medical problems in the early stages and take preventive measures.
Combined Test
Combined screening includes Maternal blood test and NT ultrasound and helps to diagnose the risk of Down syndrome, trisomy 18 and other chromosomal abnormalities. This test does not give a definitive result, but shows the possibility of danger and if needed, more accurate diagnostic tests are suggested.
NT ultrasound and its role in diagnosing abnormalities
Ultrasound NT (Nuchal Translucency) measures the thickness of the back of the fetal neck. Increasing NT thickness can be a sign of the risk of chromosomal and cardiac abnormalities and together with blood tests, it is used in the first trimester screening.
Non-invasive fetal DNA screening (NIPT)
NIPT is an advanced blood test that examines fetal DNA from maternal blood. This test evaluates the risk of Down syndrome, trisomy 18 and trisomy 13 with high accuracy and is non-invasive and safe.
Who are candidates for NIPT?
Mothers over 35 years old
Result of combined high-risk screening
History of chromosomal abnormality in the family
Parental request for more assurance
Do NIPT For these people, it can provide higher assurance and reduce the need for invasive tests.
Tests and screenings for the second trimester of pregnancy
Second trimester of pregnancy (week 14 to 27) is a vital step for monitoring fetal health and identifying structural and genetic abnormalities. During this period, tests and ultrasounds help to diagnose problems early and plan follow-up care.
Quadruple Test
The quadruple test includes the examination of four maternal blood markers: AFP, hCG, Estriol and Inhibin-A. This test estimates the risk of Down syndrome and fetal neural tube defects and helps the doctor to perform additional diagnostic tests if needed.
Anomaly Scan ultrasound
Anomaly scan ultrasound is performed around 18 to 22 weeks and checks the structure of the fetal body, heart, brain and spinal cord. This ultrasound is one of the most important structural screening tools and helps to detect physical abnormalities.
Fetal Neural Tube Defect Screening
This screening is performed by Measurement of maternal blood AFP level will be An increase in the level of AFP can indicate a neural tube defect such as spina bifida, and if the result is positive, additional tests and genetic counseling are recommended. data-start="1163" data-end="1216">Indicates the possibility of abnormality risk and is not certain.
Low risk: Usually no further action is required.
High risk: Diagnostic tests such as amniocentesis or genetic counseling are recommended
The accurate interpretation of the results helps the doctor and the mother to make informed decisions for the continuation of the pregnancy and the necessary care.
Experiments and Screenings of the third trimester of pregnancy
The third trimester of pregnancy (28 weeks to delivery) is a key stage for monitoring the health of the mother and fetus and preparing for delivery. During this period, tests and ultrasounds help diagnose maternal medical problems and the proper development of the fetus.
Gestational Diabetes Mellitus (GDM)
The GDM test is usually performed between weeks 24 and 28 and checks the mother's blood sugar. Early diagnosis of gestational diabetes helps to control sugar and prevent problems such as high fetal weight and premature birth.
Checking anemia and mother's iron status
Anemia in the third trimester can cause fatigue, weakness and reducing oxygen supply to the fetus. A blood test to check hemoglobin and iron levels will identify deficiencies and enable appropriate complementary therapy.
Group B Streptococcus (GBS) test
GBS is a bacteria that can be transferred to the fetus during delivery. The test is usually done between 35 and 37 weeks, and if it is positive, prenatal antibiotics are recommended to reduce the risk of infection in the baby.
Fetal growth and health ultrasound
This ultrasound It helps to check weight, growth, condition of placenta and amniotic fluid. Its purpose is to ensure the normal development of the fetus and identify possible problems before delivery.
invasive diagnostic tests in pregnancy
In some cases, early screening tests may require diagnostic confirmation. Invasive diagnostic tests allow the doctor to examine the chromosomal and genetic abnormalities of the fetus with high precision. If needed and diagnosed by the doctor, these tests are also part of tests and screenings during pregnancy.
What is amniocentesis and when is it done?
Amniocentesis is a diagnostic test. In this test, the fluid around the fetus called amniotic fluid is taken. Liquid IM is used to examine chromosomes and genes. This test is usually performed between 15 to 20 weeks of pregnancy and is recommended to confirm the results of high-risk screening.
Sampling of placental villi (CVS)
CVS or placental villus sampling is a diagnostic test performed in the first trimester (weeks 10-13). In this method a sample of the placenta is taken to check the chromosomal and genetic abnormalities of the fetus and it allows early diagnosis.
Risks and benefits of invasive tests
Advantages: High accuracy in diagnosing genetic and chromosomal abnormalities, the possibility of planning medical care
Risks: Minimally invasive, less than 1% chance of miscarriage, infection and temporary discomfort
These tests recommended only in cases where there is a high risk of abnormality are and always done together with genetic counseling.
Interpretation of test results and medical decision-making
After performing prenatal tests and screenings, Correct interpretation of the results and Informed medical decision making is very important. This step helps mothers to take the necessary measures to preserve their health and the fetus in time.
What does a positive or high-risk result mean?
A positive or high-risk result means that the possibility of an abnormality in the fetus. It is higher than normal, but it does not mean that the disease is certain. In such cases, more accurate diagnostic tests such as amniocentesis or CVS are recommended to confirm the condition.
Importance of genetic counseling in pregnancy
Genetic counseling helps mothers to Understand the results of the tests and the risks correctly and make informed decisions about the continuation of the pregnancy and subsequent care. This consultation helps to reduce anxiety and provide scientific and practical guidance.
The doctor's role in managing the screening results
The doctor, by reviewing the test results, necessary recommendations for additional tests, care plan and It offers preventive treatments. Medical decisions are made based on risk level and health status of mother and fetus to provide the best care.
Frequently Asked Questions
Why are tests and screenings during pregnancy important?
The difference between a screening test and What is a diagnostic?
Are the results always definitive?
Conclusion
Tests and screenings during pregnancy are a vital part of prenatal care that guarantee the health of mother and fetus. Performing tests at the right time and interpreting the results correctly will help in early detection of abnormalities and informed medical decisions.
Key recommendations for mothers:
Regular care follow-up: Perform tests and ultrasounds according to the trimesters of pregnancy.
Medical consultation and genetics: In case of high-risk or positive results, be sure to consult a doctor and genetic counselor.
Awareness of the difference between screening and diagnosis: Know that most tests show the possibility of risk and a definitive diagnosis It is not.
Nutrition and healthy lifestyle: Necessary supplements, proper nutrition and light activities improve the health of mother and fetus.
Active Q&A: Ask your doctor questions to reduce anxiety and provide more accurate care.
By following these tips, mothers can with confidence and spend the rest of the pregnancy and maintain the health of the fetus and themselves.
Dr. Zahra Sabekrou - surgeon and obstetrics and gynecology specialist
source
ACOG Practice Bulletin No.226 – Screening for Fetal Chromosomal Abnormalities
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