- Initial Antenatal booking appointment (ideally 6-8weeks of pregnancy)
- Health assessment- Discuss any past pregnancies. Discuss medical and family history. Note any allergies.
- Discuss hospital booking and type of care (Public or private). Ensure individualised model of care is appropriate for individual needs.
- Physical exam; blood pressure, height, weight and BMI
- Discuss any prior blood results. Order relevant blood tests. In the beginning of pregnancy we test for; blood group and antibodies, full blood count, iron levels (it is common for women to develop iron deficiency anaemia in pregnancy); screening for infectious conditions: syphilis, rubella, hepatitis B&C, HIV; varicella (chicken pox), vitamin D and
- Dating scan in rooms
- Offer genetic screening as follows
a) Downs syndrome screening
i) Maternal serum screening (combined screen)
- Blood test at 10-12 weeks.
- Early fetal anatomy ultrasound 12-14weeks.
ii)NIPT/Harmony/NEST/Generation (cell free DNA testing).
- Maternal blood test from 10 weeks onwards.
- Detects >99% fetal trisomy 21 &FFP <0.01%.
b) Antenatal haemoglobinopathy screening
- Multi step process; full blood count, ferritin assay, haemoglobin electrophoresis
- Assessment of clinical risk
- Genetic testing-offered on the basis of combines risk of couple
c) Genetic carrier screening
- should be offered to all women planning a pregnancy or in first trimester.
- Screening for more common genetic conditions that affect children (eg. Cystic fibrosis, spinal muscular atrophy, fragile X syndrome)
- Offered to all mothers irrespective of age or family history
The goal of antenatal screening, whether it be for chromosomal or recessive disorders is to allow the woman and her family to make their own informed choices about the pregnancy and her baby.
You may find the below link to have further useful information on the recommended screening in pregnancy