Medical screenings for a succesful pregnancy

Pregnancy is a time of excitement, anticipation and joy for most expecting couples.

One of my greatest joys as an obstetrician is to deliver a healthy baby to a healthy mother.

Fortunately, this is usually the case, and one way to help ensure this outcome is with prenatal testing. As with all screening tests, the idea is to test individuals without any evidence of disease and identify those that may benefit from treatment for both them and their unborn child.

Pregnancy is a special case as it involves two individuals who may be affected in very different ways by asymptomatic conditions.

No specific treatment may be necessary for the mother, but steps can be taken to minimize risk for the baby.

We look for infectious diseases that may be silent, the mother’s blood type, the possibility of diabetes arising during pregnancy, a specific bacteria that may be present in or near the birth canal that could infect the newborn infant, and occasional chromosomal abnormalities affecting the unborn infant.

This article will cover infectious diseases and the next will describe the rest.

Infections that are commonly screened for include hepatitis B and C, syphilis, HIV, rubella, bacteria in the urine, and group B strep. These are either simple blood tests or cultures.

While there are effective treatments for both hepatitis B and C, these are not commonly used during pregnancy. Knowledge of the virus that causes these conditions can allow for better management during labor and delivery, minimizing the risk of transmission to the baby. Furthermore, if an individual tests positive, they can be treated effectively following the pregnancy.

But unlike with hepatitis, if a women tests positive for HIV, she can and should be treated during pregnancy. How effectively she is treated during pregnancy affects the chances she will pass the virus to her child.

Rubella, commonly called German measles, is well known to cause birth defects in unborn children. Most women are immune as a result of vaccination, but occasionally the vaccine doesn’t confer long-lasting immunity. If a mother is found not to be immune to rubella it is recommended that she receive the vaccine following delivery to protect against this in future pregnancies.

Unfortunately, there is no treatment for rubella during pregnancy. If there is any doubt, it is best to determine immune status prior to becoming pregnant.

Sometimes bacteria present in the urinary tract fails to trigger symptoms.

Kidney infections can result if left undetected and untreated. Kidney infections during pregnancy can be very dangerous, contributing greatly to the risk of sepsis, preterm labor and delivery. As such, a urine culture is done to identify and treat those individuals.

Finally, between 36 and 38 weeks gestation, a culture is done to look for specific bacteria called group B strep. Many people have group B strep bacteria living in their colons, but it causes adults no problems. Newborn infants, however, are susceptible to infections, which can be serious. If the bacterium is found in or near the birth canal, antibiotics can be administered during labor to prevent such infections from developing.

These are the most common prenatal tests performed but there are others. As always, the best recommendation is to discuss your individual risks and needs with your obstetrics provider.

Brian Bell is a board-certified OB/GYN and chief of staff at Cabinet Peaks Medical Center