Blood Test for Pregnancy

There are two ways of finding out you are pregnant one is a urine test and the other is a blood test. You can easily access both of these by contacting your doctor’s surgery or family planning centre. You can also purchase home pregnancy urine test kits from your local chemist or supermarket. Both of these tests are looking specifically for a hormone called hCG – The human chorionic gonadotropin This hormone is produced by the placenta and is present in both urine and blood during your pregnancy. It is measurable after two days of implantation into the uterus. There are two types of blood test for pregnancy which can be done initially for confirmation. Qualitative hCG Pregnancy Blood Test – This gives a yes / no answer as to whether or not hCG is present. It is similar to a urine pregnancy test in as much as it recognizes the presence of hCG. Quantitative hCG Pregnancy Blood Test- This is a more accurate test which calculates the exact amount of hCG in the blood sample this aids in the EDD – estimated due date. Occasionally you can experience a false negative or false positive result this is usually because you may be taking medicines which contain hCG or that you have taken the pregnancy test too early. During your booking visit which is your first appointment your midwife or your doctor will take a detailed medical history and after discussing your estimated dates for your baby’s arrival you will have your first blood sample taken. Click here for Blood Test Procedures. By testing your blood, a lot of information can be gathered about the health of yourself and your baby. The majority of healthcare providers follow similar policies therefore your blood will be tested for:

Another blood test offered from between 14-20 weeks is for Down’s Syndrome. A full blood count will be done again at 28 weeks if diabetes is suspected or you are at risk you may be tested for this too. You will notroutinely be screened for the following unless your medical history indicates otherwise.

Toxoplasmosis and Pregnancy

This is a parasite toxoplasma gondii If this is contracted by the mother during pregnancy it may not affect you too much you may experience flu like symptoms, a sore throat and possibly a slight temperature. The incubation period can be anything form 5- 22 days and you can pass the infection on to your baby. Unfortunately it can cause a significant risk to the development of your baby causing possible eye infections and possibly learning difficulties later in life. If you contract the parasite in the early stages of your pregnancy the risk to the baby are significantly higher and can even be life threatening causing a miscarriage or stillbirth.

How do you get toxoplasmosis?

From cleaning out litter tray of cats faeces – ( ask someone else to do this during your pregnancy)

From contaminated fresh vegetables and fruit

From unpasteurised milk especially goats

From soil in the garden therefore always wear gloves when gardening

From animals which already carry the parasite therefore do not eat

Raw or undercooked meat which includes:

Salami

Parma ham

What you can do to protect yourself from catching toxoplasmosis

Do not eat or drink anything unpasteurised
Wash you hands thoroughly or wear gloves if :-
You have been handling raw meat
Washing vegetables /fruit/ salad
Gardening
Handling / stroking cats

If you believe you have contracted toxoplasmosis you will need to contact your healthcare provider who will take a blood sample.

Treatment for Toxoplasmosis This will include antibiotic treatment for you to reduce the risk of passing it on to your baby and if you are more than 15 weeks pregnant an amniocentesis test and further antibiotics to reduce the seriousness of the infection for the baby.

Cytomegalovirus (CMV) and pregnancy

This is a virus This virus can in a small proportion of unborn baby’s have serious consequences to their health and even be life threatening. The virus is tricky in that you may not even know you are infected, but if you do contract it whilst pregnant you may pass the infection on to your baby. Your baby may develop disabilities such as:-

Visually impaired
Hearing loss
Have learning difficulties
Growth development
Ongoing liver problems

How do you get Cytomegalovirus?This virus is contracted through person to person contact as the virus is transported in the body through fluids like blood saliva, semen, urine breast milk and vaginal fluids. Children under the age of six can carry CMV in their urine and saliva.

What you can do to protect yourself from catching Cytomegalovirus
Practice safe sex during pregnancy
Limit sexual partners
Wash hands frequently especially after exposure to bodily fluids such as after changing a nappy or after cleaning your child’s nose, or picking up a soother.
Do not share cutlery such as spoons and forks with a child under six.
Do not kiss children under six on the mouth

Treatment for Cytomegalovirus Unfortunately there is no cure or vaccination to prevent this virus therefore taking precautions against infection is paramount.

Hepatitis C and Pregnancy

This is a virus Hepatitis C is a virus that is transported around the body in the blood and can cause serious damage to the liver. Lots people who have it have no symptoms and may have had it for years. Some people eventually develop mild liver disease whilst other go on the have cirrhosis of the liver. The risk of transmitting the virus to the unborn child is approximately 5% according to stats from The Hepatitis C Trust. How do you get Hepatitis C Hepatitis C is contracted by having direct contact with an infected person’s blood. This can have happened whilst you were abroad and required either dental or medical treatment or were contaminated with an unsterile needle. You may have needed a blood transfusion whilst abroad or had one here in UK prior to 1991 where blood donors were not checked for the virus. You may have had unprotected sex Shared needles during the injection of drugs

What you can do to protect yourself from catching Hepatitis C

This virus is more prevalent in south Asia therefore if you do require any medical or dental treatment whilst abroad you will need to take precautions to make sure everything that is being used is properly sterilised. Do not share toothbrushes or razors Do not share needles if you are an intravenous drug user Do not have unprotected sex

Treatment for Hepatitis C

Unfortunately there is no vaccination against Hep C however there is plenty of treatment which can help with your recovery which you will need to discuss with your healthcare provider. Breast feeding can be an issue where there is the potential to pass the virus on to your child, as cracked nipples can bleed raising the risks.

Sickle cell and pregnancy

Thalassaemia major and Pregnancy

These are both genetic blood disorders which can be inherited (passed on to your unborn child) If you or your partner or both of you carry the gene for either of these conditions there is a higher chance that your child will have the disorder. If both parents are carriers (have the sickle cell trait) the chance is 1:4 if only one parent has it, it is unlikely but probable that they too will be a carrier. Anyone can be a carrier although it is more prevalent in people from African and Asian decent. If you suffer from Sickle Cell it means you may well have problems with anaemia, pain and repeated infections. If you suffer from Thalassaemia it means you will have severe anaemia and have to endure monthly blood transfusions If you and your partner think there is a possibility that you may have either of these traits it is an idea to discuss it with your health care provider prior to the pregnancy for genetic counseling and advice.

Spina Bifida and Pregnancy

Spina Bifida is a condition where the spine has not formed correctly it does not enclose the spinal cord which means that there are problems with the development of the brain, spinal cord and the covering layers (meninges).

How do you get Spina Bifida The reasons for Spina Bifida are not apparent as yet although research seems to agree that a lack of Folic acid in the mother’s diet is a contributing factor. This is why prior to becoming pregnant it is advised that folic acid supplements are taken. 400 micrograms of folic acid daily is the recommended amount. There are three types of Spina Bifida: Occulta – This is the mildest form which doesn’t cause symptoms or disability Meningocele – Some people suffer no ill effects from this protrusion of the meninges others have problems with partial paralysis with bowel and urinary disorders. Myelomeningocele – this is the most severe and can result in the partial or total paralysis of the parts of the body below the exposed spinal opening. This leaves the spinal sac opening to infection, as well as bowel and bladder incontinence Spina bifida is usually picked up either prenatally or prior to the birth with a blood test called MSAFP – maternal serum alpha –fetoprotein this test is undertaken during the second trimester of pregnancy. If abnormally high levels of the alpha –fetoprotein are registered an amniocentesis test and ultrasound will be the next investigations to follow.

Treatment for Spina Bifida

Once you have Spina bifida there is no cure or surgical repair that will restore lost nerve pathways. Treatment is relative to the degree of severity of the condition with physiotherapy and walking aids or wheelchairs being used appropriately.

Down’s Syndrome and Pregnancy

This is a congenital (something you are born with) condition and is caused by an extra piece of chromosome 21 is copied in all the cells in the affected persons body. It is something that happens almost immediately after conception as soon as the fertilised egg cell division begins.

How do you get Down’s Syndrome? This is a genetic defect which has occurred because when the sperm carrying 23 chromosomes and the egg holding 23 chromosomes come together the fertilized foetus should have 46 chromosomes however in 95% of all Down’s this occurs but an extra copy of chromosome21 occurs as well. It is not anyone’s fault and not a result of doing anything wrong during pregnancy. Age is relevant when considering your chances of having a Down’s syndrome baby but it can happen to anyone. This form of down’s is known as Trisomy 21, Mosaic Trisomy 21 – where some cells have 47 chromosomes and other 46 A rare form called Translocation Trisomy21. – There are 46 chromosomes but an extra copy of chromosome 21 is attached.

Treatment for Down’s Syndrome also known as Trisomy 21 Down’s syndrome is a condition which varies greatly in severity and the discussions you will have should be held with councillors and specialist doctors who have all the facts. The decision of whether to proceed or not with the pregnancy is a choice only you and you partner can make when you have been fully informed of all the facts.No -one is able to predict what the child’s requirements health wise will be, but help will be. The NHS have produced a booklet you may like to read called “Testing for Down’s syndrome in Pregnancy” When you have the blood test explained you will find you have ample support from your doctor and midwife whatever your decision.

What is the Quadruple test?

This is a screening blood sample test which is taken between 15-22 weeks of your pregnancy. The test is done to determine which ladies are at a greater risk of having a baby with either Downs’s syndrome or spina bifida. These tests do not confirm categorically either way of a definitive diagnosis. The combination of calculations, your age, scan size, and blood tests will lead to further tests, amniocentesis and measurements. The blood is tested for which are all serum markers AFP - alpha –fetoprotein if this is significantly raised it could indicate Spina bifida Beta hCG – Human chorionic gonadotropin will be raised if there is a problem Inhibin-A – This is a glycoprotein which is significantly raised in cases of Down’s syndrome Unconjugated Oestriol – This is an indicator if levels have dropped of Downs syndrome

Blood type and Pregnancy (ABO)

This is performed early in your pregnancy to check two details To determine your Blood Group To determine your Rhesus Status There are two proteins in your blood which are called antigens these define your blood grouping and Rhesus status. You will be classed as either:- A – B – AB – O – This is the most common Then your rhesus status will be added you will be either positive or negative which is shortened to RhD Pos / RhD + or RhD Neg / RhD – According to statistics on the NHS Give Blood website 85% of the UK population are RhD Positive and the remaining 15% are RhD Negative It is important to find out which blood group you are as if you do require a blood transfusion for any reason you will need the correct match. If you do not have the same blood transfused your body may react to the “invading” blood cells and attack it with antibodies (infection-fighting chemicals). This can be life threatening. People with group O blood are known as the “universal donor” group O can make both Anti A and Anti B if given these antigens.

Rhesus Disease This is a disease which can affect your unborn child which is why it is important to know your Blood type and Rhesus status. The condition occurs when the mother is RhD Negative, the baby is RhD Positive and the mother has been previously exposed and become sensitive to RhD Positive blood; either via a blood transfusion or a previous RhD Positive pregnancy. When you are exposed for the first time to Rhd Positive Blood and you are RHd Negative you become sensitised this is called sensitisation. The occurrence of this now has been dramatically reduced by 90% due to the introduction of anti-D immunoglobulin in 1977.By giving this to ladies it prevents the development of the antibodies that attack the baby’s blood. If somehow this has unfortunately been missed and your baby develops Rhesus disease your baby may suffer from jaundice and anaemia which will require specialist treatment in neonatal unit. If untreated the learning development can be affected as well as hearing and visual impairment of the baby.

Anaemia and pregnancy This blood test will be done to assess the amount of iron you have in your blood. Iron Is required for both you, for energy as they carry and store the oxygen around the body as well as the baby’s development. During pregnancy the demands are obviously higher therefore you will need to ensure you are increasing your intake People who need to be more careful about iron intake include: Vegetarians / vegans Ladies carrying multiple births – twins/ triplets Those already anaemic If you are suffering from haemorrhoids (piles)

Symptoms of Iron deficiency Anaemia include Feeling very tired Looking pale Breathless Dizziness Palpitations – where you are aware of your heart beating

Treatment for Anaemia Occasionally you will have depleted stock levels therefore you may need to take supplements and or improve your diet. Iron tablets do have the rather unpleasant side effect of causing either constipation or diarrhoea therefore you will have to take plenty of fibre in your diet.

German measles – Rubella and pregnancy The majority of the UK population have been immunised against Rubella during school days however it is emerging that the effects may not be as long term as initially indicated. Therefore if you are planning a pregnancy it may be prudent to be tested for immunity. The rubella virus is transmitted via droplets from person to person If you are already pregnant you will not be able to have the vaccination due to the live virus infecting your baby.

Symptoms of German measles – Rubella The symptoms are usually quite mild and include A temperature Sore throat and headache Aching joints Swollen glands around the neck Pink or red itchy spots which often begins on the face Rubella in pregnancy can cause congenital Rubella syndrome which can have sever effects of the physical and mental development of a child born with this. Multiple organ disorders can also have a dramatic effect on the quality of life for the child and family.

Treatment for German measles – Rubella Early vaccination and checking immunity can be a positive prevention method. The controversial MMR has now gathered momentum which had initially be responsible for a dramatic reduction in the childhood immunisation Program in UK.

HIV and pregnancy If you are HIV Positive it is possible to transmit the virus to your child during or after your pregnancy. However there is a tremendous amount of support available as well as medications to help keep you and your baby in the best of health during and after the pregnancy. The blood test in the UK is on an opt out basis which means everyone automatically has one unless they specifically say they don’t want it. This needs to be discussed with your healthcare professionals if you have any doubts. If you are hoping to become pregnant, it may be prudent if you believe there is even a slight chance you may be HIV positive to be tested prior to embarking on a pregnancy. You may need to have a follow up test for the HIV antibody as it can take between 6-12 weeks for the antibodies to develop. The ELISA test will be used initially with a confirmation test called the Western blot to make a definitive diagnosis.

Symptoms of HIV There are no definitive signs and symptoms of HIV as most people initially remain healthy; some suffer a brief flu- like illness with swollen glands. However, that can be indicative of a number of illnesses the only way to find out if you have the HIV virus it to be tested. Be warned there are a certain amount of tests on the internet which can be purchased anonymously which are unreliable and can be wildly inaccurate.

Treatment for HIV It is essential for the health of both you and your unborn baby that antiviral treatment can be started as soon as HIV is confirmed. According to statistics from Avert the international AIDS charity this can reduce the chance of the baby being infected from 25% to 2% Syphilis and pregnancy Syphilis is a bacteria and is a sexually transmitted disease (STD) Fortunately in the UK it is rare to see many cases of syphilis as the complications presented in pregnancy can result in still-births and spontaneous miscarriages. Babies who are born with syphilis will require immediate treatment to prevent a host of unpleasant symptoms taking place. Symptoms of Syphilis Syphilis is spread during the first two stages of the disease process. Between10-90 day after infection a chancre which is a painless sore appears, the sore will heal but during this time you will be highly infectious. If not treated at this stage in three to six weeks time you will experience a rash of red/brown spots on the palms of the hands and soles of the feet, sores will appear in cavities like the throat or cervix. Swollen glands, a temperature, fatigue and hair loss along with muscle weakness will all take their toll. You will continue at this stage to be infectious. It is a progressive illness which has periods of remission and reoccurrence, if you remain untreated it is possible to die from the disease but that is unlikely in UK.

Treatment for Syphilis The good news is that it is curable! Antibiotic treatment will be prescribed by your doctor. Research Sources Brighton & Sussex Pathology B.N.F – British National Formulary Bmj.com – British medical journal N.i.c.e. – National Institute for Health and Clinical Excellence Journal of clinical pathology Review article – MATERNAL SERUM MARKERS FOR DOWN’S SYNDROME PREGNANCIES Chew, C Anandakumar, S S Ratnam SMJ 1995

Blood Test Results Explained