Testing before, during pregnancy

Dear Dr Mitchell,

What kind of blood/medical/genetic testing services are available in Jamaica if I wanted to get tested before becoming pregnant? I would like children, but would like to know that they are healthy and protected.

It is important when you are planning to become pregnant that you get yourself in the best possible state of health to reduce the risk of complications during the pregnancy and delivery of your baby.

It is preferred if you exercise regularly and diet to achieve your ideal weight for height as this will reduce the risk of diabetes mellitus and hypertension in pregnancy. Obese pregnant women are also at increased risk of developing a clot in the legs and the lungs and this can be fatal or associated with severe consequences. Diabetes mellitus, especially if it is undetected or poorly controlled, can be associated with birth defects, increased risk of a pregnancy loss, or premature labour. It is extremely important for women planning to become pregnant to be screened for this condition and for it to be tightly controlled to reduce the risks of a bad outcome on the foetus.

Hypertension should also be appropriately managed and a switch to safe drugs done so that any adverse effects on the foetus in the first few weeks of pregnancy when the foetus is being formed is minimised. It is usual for both partners to do a screening for sickle cell disease to determine the risk of passing this on to their offspring. This is part of the routine blood test done in early pregnancy. Screening for sexually transmitted diseases such as herpes simplex 2, syphilis and human immunodeficiency virus should also be done. These infections can be treated to reduce the risk of passing them onto the foetus and newborn.

Genetic testing can also be done and is readily available at Carigen at the University of the West Indies, Mona campus. This not usually done routinely before pregnancy but can be done if you have had an abnormal foetus in a past pregnancy or if you have had a history of recurrent pregnancy losses. In women who are 35 years and older it is usually recommended in early pregnancy to detect chromosomal abnormalities such as Down Syndrome and other abnormalities. A detailed ultrasound done at 20 weeks of pregnancy can also detect abnormalities in the various organs and is a part of the routine screening in all pregnant women.

It is important to take daily folic acid supplementation and eat a balanced diet with lots of fruits and vegetables to reduce the risk of birth defects in the brain and spinal cord of the foetus.

Consult your gynaecologist who will do a complete physical examination and advise you further about these tests.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com ; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.