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Friday, February 23, 2024

The importance of early pregnancy screenings

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Promoting healthy pregnancy and safe motherhood is a priority for the maternal and foetal specialists at Tygerberg Hospital who manage complicated high-risk pregnancies and provide appropriate care and treatment to mothers and their newborns.


August is Women’s Month, and the hospital stresses the importance of early antenatal care attendance to ensure healthcare workers can detect and manage medical conditions which impact negatively on pregnancy outcome.


This is why it is very important for pregnant women to attend antenatal care as early as the first weeks of their pregnancy.


Tygerberg Hospital showcases excellence in maternal-foetal medicine, also known as perinatology.


This subdiscipline of obstetrics and gynaecology focuses on managing health concerns of both the mother and foetus prior to, during and shortly after pregnancy. These specialists can only be found at a tertiary hospital such as Tygerberg.


In 2022, the Maternal Foetal Medicine Unit at the hospital performed 6 927 pregnancy ultrasounds. They screen pregnancies to identify foetuses at risk of certain problems (e.g. Down Syndrome), diagnose conditions in the foetus (e.g. abnormal structure of the foetus), and perform surveillance in which they serially monitor certain high-risk pregnancies for complications (e.g. multiple pregnancies) and intervention (treatment of the mother and/or foetus for a problem identified during the pregnancy).


Dr Samantha Budhram, subspecialist at Tygerberg Hospital’s Department of Obstetrics and Gynaecology and senior lecturer at the Faculty of Medicine and Health Sciences, Stellenbosch University, says, “Most of our work involves using ultrasound machines to examine the foetus. It is very important for pregnant women to book early for antenatal care (preferably in the first three months of pregnancy) so that we can provide the best possible care and outcome for the pregnancy.”


One such journey with a happy ending for everyone started early this year when 27-year-old, Mrs Wilna-Mari van Antwerpen from Swellendam booked at her antenatal clinic at eight weeks of pregnancy.


She was very anxious due to having lost a previous baby with the same condition and was therefore immediately referred to Tygerberg Hospital where staff were able to detect that her foetus was severely anaemic.


They started transfusing the foetus with blood from 16 weeks of pregnancy and her baby needed another 8 blood transfusions for the remainder of the pregnancy.


She delivered a healthy baby boy on 16 July 2023. Wilna-Mari said: ‘I’m so grateful and happy for the Tygerberg Hospital staff for the lifesaving treatment my baby has received. I believe that because of them my baby boy is alive and thriving today.’


If you are pregnant and have certain risk factors for having a baby with Down Syndrome (e.g. maternal age >37 years old) Tygerberg Hospital can offer you a special ultrasound examination (nuchal translucency scan) in the first three months of pregnancy to look for signs of this condition.


All pregnant women are offered a detailed scan examining the structure of the foetus at about five months of the pregnancy. Some women may then need counselling by the genetics team and further testing depending on the findings of the ultrasound examination.


This testing in the first three months of pregnancy is called chorionic villous sampling (a needle passed through the mum’s tummy and into the womb, while being guided by ultrasound, and little pieces of the placenta are sent to the laboratory for examination).


After the first four months of pregnancy, the procedure for testing is called amniocentesis. In this procedure, staff pass a needle through the mother’s tummy into the womb, guided by ultrasound, but they now take a sample of the fluid (amniotic fluid) that surrounds the baby for further testing.


Apart from testing for Down Syndrome, they can test for many other genetic conditions and infections depending on the findings of the ultrasound examination or history of the patient. The earlier in pregnancy a foetal diagnosis is reached (and before 24 weeks) is extremely important for the management of the pregnancy.


If you are pregnant with twins, early in the pregnancy (the first three to four months) staff can tell you if they are identical twins or not and this is very important information to plan how often you need to attend the antenatal clinic, the level of care you need and how often the staff use ultrasound to follow the growth of your babies and look for complications.


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Twins (and other multiple pregnancies) are at high risk of both maternal and foetal complications (such as foetal abnormalities, insufficient foetal growth and preterm labour) and they take care of many of these high-risk pregnancies.


There are conditions in which the foetus can become anaemic (have weak blood) and if not treated, the foetus may become very sick and even die. The hospital can care for these at-risk pregnancies and detect early if the baby has become anaemic.


Many times, staff can transfuse the foetus with blood while they are still inside the womb to help them along in the pregnancy. This can be lifesaving if detected in time like in the case of Baby van Antwerpen.


Dr Budhram concluded, “Booking at your antenatal clinic early in pregnancy is essential to improve your chances of having a safe and successful pregnancy.“


Supplied by: Western Cape Department of Health and Wellness

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