Antenatal screening (1)

Woman's Health & Midwifery Nursing Department

  • Mansoura University Faculty of Nursing

  • Antenatal screening

  • GROUP : 2B

    • Kholod Mohamed Atallah

    • Khadega Ahmed Ibrahim

General Objectives

  • At the end of this seminar, undergraduate students will be able to acquire knowledge, skills, and attitude about antenatal screening.

Specific Objectives

  • Define antenatal screening tests.

  • Discuss the importance of antenatal screening tests.

  • Discuss tests used to assess fetal well-being.

Definition and Objectives of Antenatal Screening

  • Antenatal Screening: A process to identify pregnant women at high risk for congenital infections and other disabilities.

  • Objectives of Antenatal Screening:

    • Early detection of any problems during pregnancy.

    • Allow parents to make informed decisions about the continuation of pregnancy.

    • Provide a chance for intrauterine therapy for disorders like hemolytic anemia.

    • Continuous monitoring of fetal well-being.

Methods of Assessment for Fetal Well-being

  1. Fetal kick count

  2. Maternal Serum Alpha-fetoprotein Screening

  3. Triple-Marker Screening

  4. Amniocentesis

  5. Chorionic Villus Sampling

  6. Non-Stress Test (NST)

  7. Contraction Stress Test (CST)

  8. Biophysical Profile (BPP)

  9. Ultrasound (US)

Introduction

  • Antenatal screening has become standard in pregnancy follow-up.

  • It helps separate pregnancies into high and low-risk categories, offering further diagnostic options for high-risk cases.

Understanding Key Instruments in Antenatal Screening

1. Fetal Kick Count Test

  • Definition: Monitoring fetal movements by counting kicks over a designated period (usually in a calm environment).

  • Normal Range: At least 10 movements in 12 hours. If less, the healthcare provider should be contacted.

2. Maternal Serum Alpha-fetoprotein (MSAFP) Screening

  • Definition: Detects levels of alpha-fetoprotein (AFP) in maternal serum to identify risks for specific conditions.

  • Indications: Elevated levels may relate to

    • Multiple fetuses

    • Neural tube defects (e.g., spina bifida)

    • Omphalocele and gastroschisis

3. Triple-Marker Screening

  • Combines MSAFP with two other hormones (hCG and estriol) to increase sensitivity for detecting Down syndrome and other chromosomal abnormalities.

4. Amniocentesis

  • A diagnostic procedure to analyze amniotic fluid for biochemical and genetic studies, usually performed between 15-20 weeks of gestation.

  • Requires informed consent and ultrasound guidance to minimize risk.

5. Chorionic Villus Sampling (CVS)

  • Similar to amniocentesis, but performed earlier (10-13 weeks). It carries higher risks if done before 9 weeks.

  • Indications mirror those of amniocentesis.

6. Non-Stress Test (NST)

  • Assesses fetal heart rate in response to movements, usually after 28 weeks gestation.

  • Monitors for reactivity: healthy fetuses will show an increase in heart rate during movement.

7. Contraction Stress Test (CST)

  • Performed late in pregnancy to evaluate fetal heart rate response to contractions, aiming for three contractions in a 10-minute span without abnormal decelerations.

8. Biophysical Profile (BPP)

  • A composite test combining NST with ultrasound to assess fetal well-being.

Conclusion

  • Antenatal screening plays a crucial role in monitoring pregnancy, identifying issues early, providing options for parents, and ensuring fetal health through various tests and assessments.