BIOCHEMICAL TEST

INTRODUCTION
Prenatal diagnosis or prenatal screening
testing for diseases or conditions in a fetus
embryo before it is born.
Congenital anomalies account for 20 to 25%
perinatal deaths.
Diagnostic prenatal testing can be by invasive
non-invasive methods.

is
or
of
or

USE
Managing the remaining weeks of the pregnancy
Determining the outcome of the pregnancy
Planning for possible complications with the
birth process
Planning for problems that may occur in the
newborn infant
Deciding whether to continue the pregnancy
Finding
conditions that may affect future
pregnancies

PURPOSES OF PRENATAL
DIAGNOSIS
To enables timely medical or surgical treatment
of a condition before or after birth.
To give the parents the
chance to abort a fetus with the diagnosed
condition.
To give parents the chance to
"prepare" psychologically, socially, financially, and
medically for a baby with a health problem or
disability, or for the likelihood of a stillbirth.

INDICATION
Women over the age of 35
Women who have previously had premature
babies or babies with a birth defect, especially
heart or genetic problems
Women who have high blood pressure, diabetes,
asthma, or epilepsy
Women who have family histories or ethnic
backgrounds prone to genetic disorders, or whose
partners have these
Women who are pregnant with multiples (twins
or more)
Women who have previously had miscarriages

MATERNAL SERUM ALPHA-FETOPROTEIN (MSAFP)

INTRODUCTION
Alpha-fetoprotein (AFP) is a protein that is
normally produced by the fetus' liver.
AFP is present in the fluid around the fetus
(amniotic fluid).
This test is performed between weeks 15 and 20
of a pregnancy.


PROCEDURE

The AFP test involves taking a blood sample.

Blood is drawn from a vein (venipuncture),
usually from the inside of the elbow or the back of
the hand.

RISKS
Excessive bleeding.
Fainting or feeling lightheaded.
Hematoma (blood accumulating under the skin).
Infection (a slight risk any time the skin is
broken).
Multiple punctures to locate veins.

RESULT

Normal AFP levels for non-pregnant women are

less than 300 nanograms per milliliter.
Greater-than-normal levels of AFP in men and
non-pregnant women may indicate:
Cancer in testes, ovaries, stomach, or pancreas
Cirrhosis of the liver
Liver cancer
Malignant teratoma

During pregnancy, increased levels of AFP may

indicate:
Fetal defects
Spina bifida
Anencephaly
Omphalocele
Tetralogy of Fallot
Duodenal atresia
Turner's syndrome

Wrong gestational age

Open nural tube defect
Multiple pregnancy
Intrauterine fetal death
Renal abnormalities
Anterior abdominal wall defects

TRIPLE TEST

INTRODUCTION
Also Known As, Multiple Marker Screening.
The triple screen test is performed between the
15th and 20th week of pregnancy although results
obtained in the 16th -18th week are said to be the
most accurate.

The triple screen test is a maternal blood

screening test that looks for three specific
substances:
AFP
hCG and
Estriol

The triple test measures,

AFP:- alpha-fetoprotein is a protein that is

produced by the fetus.
hCG:- human chorionic gonadotropin is a hormone
produced within the placenta
Estriol:- estriol is an estrogen produced by both the
fetus and the placenta

INDICATIONS
Have a family history of birth defects
Age 35 years or older
Used possible harmful medications or drugs
during pregnancy
Have diabetes and use insulin
Had a viral infection during pregnancy
Have been exposed to high levels of radiation

Low levels of AFP may indicate increased risk for,

Trisomy 18
Down Syndrome

High levels of AFP may indicate increased risk

for,
Open Nural Tube Defect
IUGR
Still Birth
Premature
Multiple Gestation

PROCEDURE
Triple test is a screening test and not a
diagnostic test.
The triple screen test involves drawing blood
from the mother which takes about 5 to 10
minutes.
The blood sample is then sent to the laboratory
for testing.
The results usually take a few days to receive.

AMNIOCENTESIS

PROCEDURE
Inform mother about a procedure.
Emptying the bladder.
Proper position is given.
A local anesthesia can be given to the mother.
A needle is usually inserted through the mothers
abdominal wall, then through the wall of the
uterus and finally in to the amniotic sac.
With the aid of ultrasound guidance.
Aspirate approximately ,20 ml.

AFTER CARE

Doctors recommend client to rest and avoid

physical
strain
(such
as
lifting)
after
amniocentesis.
Test results are generally available in two to
three weeks.

COMPLICATION

CORDOCENTESIS

INTRODUCTION
Percutaneous
umbilical
cord
blood
sampling(PUBS), also calledcordocentesis.
This test carries a significant risk of complication
and is typically reserved forpregnancies
determined to be at high risk forgenetic defect.

It is performed at 18 weeks' gestation.

PROCEDURE
This procedure can also be used to check if baby
has anemia.
If baby has severe anemia, health care provider
can immediately give baby a blood transfusion.
Guided by ultrasound, doctor pinpoints the spot
where the umbilical cord meets the placenta.
He then inserts a needle through abdomen and
uterus and into the umbilical cord and withdraws
a small amount of fetal blood.
There are two routes for retrieving fetal blood.

CORDOCENTESIS DETECTS ,
Chromosome abnormalities
Blood disorders
Malformations of the fetus
Fetal infection (i.e.toxoplasmosisor rubella)

Fetal platelet count in the mother

Fetal anemia

RISK
Blood loss from the puncture site
Infection
Drop in fetal heart rate
Premature rupture of membrane
Fever
Chills
Leaking of amniotic fluid

CHORIONIC VILLUS SAMPLING

INTRODUCTION
Chorionic villus sampling(CVS), sometimes
misspelled chorionicvilloussampling.
CVS usually takes place at 1012 weeks'
gestation.
This procedure is mostly associated with testing
for Down syndrome.

INDICATION
Abnormal first trimester screen results
Increasedabnormalultrasoundfindings

Family history of achromosomal abnormalityor

othergenetic disorder

Parents are known carriers for agenetic disorder

Advanced maternal age (maternal age above 35).

PROCEDURE
Patient may be asked to drink a glass of fluid
about an hour before the test.
Be sure to tell your doctor if you are allergic to
any medicines.
Transabdominal
(through the belly) chorionic
villus sampling or transcervical (through the
cervix) chorionic villus sampling can be done.

The choice may depend on where the fetus and

placenta are in the uterus.


THROUGH THE BELLY (TRANSABDOMINAL)

Client will lie on your back on an examination

table.
Gel or oil will be rubbed on your belly to use with
the ultrasound unit.
Doctor then puts a long thin needle through your
belly and uterus to the placenta and collects a
sample of the chorionic villus cells.
After the sample is collected, your doctor may
listen to babys heart rate and check your
blood pressure,pulse, and breathing.

THROUGH THE CERVIX (TRANSCERVICAL)

Client will be asked to take off clothes below the
waist and drape covering around your waist.
Client will then lie on back on an examination
table.
Doctor will put an instrument with curved sides
(speculum) into vagina.
The cervix will be cleaned with a special soap.
An ultrasound will be used to help doctor guide
the catheter through cervix to the placenta.
When the catheter is correctly placed, a sample of
chorionic villus cells will be collected.

AFTER THE PROCEDURE

It is normal to have mild cramping, leakage of a
small
amountamniotic fluid,
and
vaginal
spotting for the first day or two after the
procedure.
Moderate or severe belly pain or cramping.
More leakage of amniotic fluid from your vagina.
More vaginal bleeding than spotting or bright red
bleeding.
Chills or a fever.
Dizziness.

Redness or swelling at the needle site.

RESULT
Normal:
No abnormalities are found in the genetic material
of the chorionic villus cells.

Abnormal:
Abnormalities are found in the genetic material of
the chorionic villus cells.