First Trimester Screening : Treatment, Procedure, Cost And Side Effects

First Trimester Screening is a combination of fetal ultrasound and maternal blood testing methods so as to rule out any birth defects in the fetus. This test is performed during the first trimester of pregnancy and thus gets its name as First Trimester Screening. This screening is a safe process and is used for determining the risk of the fetus having a certain birth defect. This is an early prenatal test that offers information about certain chromosomal defects which may affect the birth of a baby and can cause birth defects. First-trimester screening is a combination of ultrasound along with a blood test. This is totally a legal affair and no government has banned this anywhere.

This is a very important test in the context of the child. The fetus wile development can come under many mutations and defects in chromosomes can cause chromosomal diseases like Down Syndrome etc. With the help of tests like First Trimester Screening the in depth fetus analysis can help in analysing the development of the fetus and thus can be used to gauge your risk of carrying a baby with Down syndrome or trisomy 18. If the outcome of the results from the tests are moderate or high, one might choose to follow first trimester screening with another test like chorionic villus sampling, amniocentesis that's more definitive in nature. Down syndrome is a disease which causes lifelong impairments in mental and social development, as well as various physical concerns in the child. Trisomy 18 disease causes more severe delays and is often fatal by age 1. Thus, if through this test these disease can be ruled out then it would be a boon to the parents. At the time of the first trimester of pregnancy women are advised to have this test done as this will reduce the risk of miscarriage by any means.

This test requires an ultrasound for fetal nuchal translucency (NT) and two maternal serum (blood) tests which shall examine Pregnancy-associated plasma protein-A (PAPP-A) and Human chorionic gonadotropin (hCG). The abnormal levels of these protein and hormone indicates abnormal chromosomal development.

The First Trimester Screening test is done in two main stages:

1. Ultra sound: A special ultrasound, called a nuchal translucency screening, measures the baby nasal bones as well as the fluid at the back of baby's neck. The ultrasound examines the area at the back of the fetal neck for increased fluid or thickening. A high volume of fluid can be a sign of problems. The ultra sound done is usually a transvaginal ultrasound (a small ultrasound transducer is inserted through the vagina).
2. Blood test of the mother: A blood test checks the level of two things, pregnancy-associated plasma protein-A (PAPP) and human chorionic gonadotropin. The abnormal levels of the protein and the hormone is an indication of chromosomal defect.

These two tests are necessary for the first-trimester screening. The combination of both tests will result in the information about the baby in the womb. Most women who have an abnormal first-trimester screening go on to have healthy babies. This test is not a compulsion for a pregnant woman. It's totally up to the woman that if she wants to get this test done or not. First trimester screening results are represented in the form of positive or negative along with a probability, such as a 1 in 250 risk of carrying a baby with Down syndrome. This test has the ability to correctly identifies about 85 % of women who are carrying a baby with Down syndrome. The first-trimester screening is performed between the 11th and 13th week of pregnancy. Because the test is performed so early, it is often used to determine whether a mother should consider undergoing an early (first trimester) diagnostic test, such as chorionic villus sampling, or second-trimester amniocentesis. There is a 5% false positive rate for the test. Parents should be aware of the possibility of receiving abnormal results and then finding, after future testing, the baby is normal.

All pregnant ladies are eligible for the treatment. In case any pregnant women has a history of some genetic disorder or any disease can opt for this treatment. Some women who are above the age of 36 and are having conceived very lately can also undergo this screening test.

No one is deemed ineligible for the treatment. Any pregnant lady can go for it. There are some women’s who may feel anxiety or may undergo stress if they are unable to cope up with the outcome of the result. In such cases the patient consent is must and such patients should avoid the screening.

This test is very simple and except for the discomfort of drawing blood, there are no known risks or side effects associated with the first-trimester screening. The first-trimester screening test is not harmful to both the woman and the child. It is just an easy process which involves certain technicalities to be performed. A technician will take a quick blood sample from the mother's fingertip or arm. This is just like the normal injecting process for removal of the blood sample. It doesn't need any special injection or anything. The nuchal translucency screening is a normal ultrasound. This is not something very big and this does not have any side effect.

The test can be considered as the early test for the baby. This is an optional test which can be performed if needed or desired. In case the results of the First Trimester screening are not good then the doctor may advise for further investigations like: Prenatal cell-free DNA (cfDNA) screening, Chorionic villus sampling (CVS), Amniocentesis etc. But if the results of the First Trimester screening are free from risk then the patient can resume her daily activities without any stress. There shall be no health complications caused by this test.

It takes a few days for the result of the first screening test to come. If the result is normal, the baby has a low risk of birth defects. If the result is abnormal, the doctor may suggest further tests to rule out problems. These could include ultrasounds or invasive procedures, like CVS or amniocentesis. Try not to worry if the results are abnormal. Remember, this test can't diagnose birth defects. It only shows if the baby has a greater risk than average. There are many cases in which many babies took birth in a healthy condition even if the result was for very high risk. Sometimes the test results are combined with a second screening trimester screening test. In that case, one may not get the results until the second-trimester screening. Or one may get the result and combine it with the second screening result thereafter.

Since this is an examination procedure the patient need no specific recovery time. The tests are done and that’s it, the patient is free to go.

The first-trimester screening test in India costs around rupees 1700 to 50000 rupees. This is the cost of the full package test for a pregnant woman. This is a nominal charge for the test. Many can afford this as this is for the new child.

The results of the first-trimester screening test are not permanent. It can be a false result too. The result of this test is not 100% true. Even if the test result reads risk apparently it is found in many cases that the child delivered may have no risk or no birth defects. So never take this as a serious consideration and try doing other tests for a better and a best overall presumption. There are many other tests that can show up the condition of a baby inside the womb. Mothers are requested not to take this as the supreme test and consider other tests too for an overall view of the scenario. There are tests called triple screen, quad screen, MSAFP and sequential screening which can be taken as an alternative to this first-trimester screening test. If the first-trimester screening test is not available for certain reasons, one is always free to opt for these above-mentioned test. They are very much similar to the first screening test and they too don't have any major side-effect and can be done as a legal affair.

Some of the availble options which one can think of along with the First trimester screening or as an alternative are other diagonistic test that can help in knowing the chromosomal defects. With new technological advancement in medical science new kinds of tests are being developed so as to early diagnose any birth defect before the child birth. First trimester screening is one such available option. Apart from this test there are other tests which can help the parents to rule out any child defects and thus can be considered as an alternative test.

1. Prenatal cell-free DNA (cfDNA) screening: This is a blood test which examines fetal DNA so as to determine whether the baby is at risk of Down syndrome.
2. Chorionic villus sampling (CVS): where a tissue from the placenta is used for test so as to diagnose chromosomal conditions, such as Down syndrome.
3. Amniocentesis: where Amniocentesis a sample of amniotic fluid is removed from the uterus for testing and is used to diagnose both chromosomal conditions, such as Down syndrome, and neural tube defects, such as spina bifida.