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Understanding Screening Blood Work Offered in Pregnancy

Congratulations! You're pregnant! After attending our personal class to review what to expect, you may still have questions related to screening blood work. I will explain each of these below so that you have all the information you can to make the best decision for you and your growing baby! Keep in mind, these tests are for screening purposes, not diagnostic testing. If you have an abnormal result, you may need to go for additional diagnostic testing.
 
1st Trimester Screen/PAPP-A (Pregnancy Associated Plasma Protein A):
This test combines 3 part; the PAPP-A, HCG, and the nuchal transluceny. The PAPP-A is a protein produced by the placenta. HCG is the hormone produced during pregnancy by the placenta. Lastely, the nuchal translucency is when the fluid collection at the nape of the neck is measured between the spine and the skin. A mathematical calculation is then done combining these 3 results to give a numeric risk of a chromosomal defect. This formulates a ratio that is compared to an established cut-off. If the ratio is higher than the cut-off, the baby may have an increased risk of chromosome abnormality and may need additional testing. This test is most commonly offered between 12 and 14 weeks. When you have your nuchal ultrasound done, this blood test has to be done within 24 hours at a quest location. This screening test will detect approximately 85% of women carrying a fetus with Down Syndrome and up to 75% of women carrying a fetus with Edwards Syndrome. Approximately 5-10% of women may have a false positive result.
 

NIPT:
This stands for noninvasive prenatal testing. This is normally recommended in those that are over the age of 35 or have a personal or family history of genetic mutations. However, anyone can have this blood test done. The NIPT looks for increased risks of Down Syndrome, Trisomy 18, Trisomy 13, and determines the gender. This test can be performed as early as 10 weeks gestation. However, it's more accurate if you wait until closer to 12 to 13 weeks gestation. There are several different companies that do this testing. This test can be expensive, so we have you check with your insurance so you know what to expect for the cost. You may know this test better as a Qnatal or a Panorama.
 

AFP:
This stands for Alpha-fetoprotein. This test measures high and low levels. The results are combined with both mother's age and her ethnicity. High levels may indicate the baby has a neural tube defect such as spina bifida or anencephaly. Spina bidifa is when the spine doesn't fully close and anencephaly is when the skull does not fully form.
 
The most common chromosome abnormalities we screen for are Trisomy 21 (Down Syndrome), Trisomy 18 (Edwards Syndrome), and Trisomy 13 (Patau Syndrome).
 
If you have any other questions about testing please contact the office. We'll be happy to discuss this more in person with you!
 
Author
Kearsten Howe-Ball PA-C

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