Prenatal testing

All pregnant women in the Netherlands are regularly checked and monitored by a midwife or doctor. This mainly concerns control of normal development. However, a number of prenatal tests can be performed to check the fetus for abnormalities. This may be necessary due to the medical history of the mother and her family, previous pregnancies, age and general physical condition of the mother. During the first visit to the midwife or doctor, a number of routine tests will be carried out, such as the blood test and the ultrasound scan. The medical history will be reviewed and appropriate lifestyle tips may be given based on this. Blood pressure is also always measured, this will be a recurring measurement throughout the pregnancy. You usually need
to visit the midwife or doctor once every 4 weeks until the first 28 weeks , every 2 weeks until the 36th week and every week at the end of the pregnancy.

Blood test

During a blood test, a few drops of blood are taken from you, after which the blood is tested for, among other things, blood group , hemoglobin level , syphilis, diabetes, hepatitis and the Rhesus factor . The blood can have two types of rhesus factors: positive + or negative -. If the mother has + and the unborn child has -, anti-D immunoglobulin will be administered during pregnancy around 28 weeks of pregnancy and immediately after birth. This is to prevent the mother’s body from producing antibodies against her unborn baby and the child from developing Rhesus disease .

Urine examination

In some cases, a urine test is also done. This involves checking for ketones (these reduce the efficiency of oxygen transport), proteins (checking for eclampsia and infection) and sugar .

Ultrasound scan

An ultrasound scan can take place from 16 to 18 weeks of pregnancy. During an ultrasound scan, high-frequency sound waves bounce off the baby and create an electronic image of the baby on a screen. An ultrasound can be used to determine the exact date of conception , the number of fruits and certain abnormalities of the placenta. An ultrasound is a painless affair and does not give any chance of a miscarriage .

Special prenatal tests

In addition to the general prenatal tests, there are a number of prenatal tests that can be performed. However, these special prenatal tests are usually not entirely without risk . You should therefore carefully consider whether the benefits outweigh the possible risks.

Vaginal ultrasound scan

A vaginal ultrasound scan is a variation on the regular ultrasound scan. The big difference is that this test can be done around 5-6 weeks of pregnancy. Using a probe, an image of the unborn baby is created. This test gives immediate results , but does expose the baby to extremely high sound waves.

Chorionic villus sampling

Chorionic villus sampling can be used to detect any chromosomal and genetic abnormalities in the unborn baby. To perform this test, some tissue around the placenta is scraped away between 8 and 12 weeks of pregnancy, which is then examined. This test gives very reliable results within 48 hours, but increases the chance of miscarriage to 1 in 100.

Nuchal translucency measurement

The nuchal translucency measurement is an external prenatal test that does not increase the risk of miscarriage. The ultrasound measures the thickness of the nuchal fold of the unborn child. This, in combination with a blood test, can determine 80 to 90% whether the child has Down syndrome or not. This test can be performed from approximately 12 weeks of pregnancy.

AFP

AFP stands for alpha fetoprotein . This is a blood test, a check of protein levels and neurological defects (such as spina bifida) and takes place between the 15th and 18th week of pregnancy. However, the reliability of this test is only about 50%, because abnormal levels of AFP also occur in women with healthy babies.

Amniocentesis

During an amniocentesis, the woman is given a local anesthetic and some amniotic fluid is collected through the abdominal wall . This test checks for various conditions, including Down syndrome. Amniocentesis can be performed between weeks 16 and 18 of pregnancy and is very reliable. The gender is also known during amniocentesis. However, the risk of miscarriage is greatly increased by amniocentesis.

To test or not to test?

Prenatal tests never provide certainty, they provide a chance. And a baby with a 1 in 200 chance of Down syndrome may still have the condition or not. Currently, an average of 2 to 3% of babies are born with a physical or mental disability. With the help of prenatal tests, this reduces to 2 to 2.5%. There are still many conditions for which there is no prenatal test yet.

read more

  • Prenatal examination: the combination test
  • Prenatal examination: the term ultrasound
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