Exclude diseases of mother and child

Unfortunately, this examination is not paid for by the statutory health insurance, although it does make sense since a proven toxoplasmosis can be treated during the pregnancy. About 20–45% of women in childbearing-age in Germany are immune to toxoplasmosis because they had an infection without having noticed. If an infection with toxoplasmosis takes place during the pregnancy, severe fetal damage (especially brain damage) may result.

Therefore, we recommend checking your immune status early in the pregnancy. If you are not immune, we will advise you to get checked again in the 16.-20. week. Through avoidance of raw meat and especially contact with kittens and young cats, the risk of getting infected can be reduced. In case you get infected during your pregnancy treatment can be carried out in order to prevent damage to your unborn child.

Cytomegaly is a virus infection that gets transmitted through body fluids. Especially endangered are those working at medical institutions, as well as those in close contact with infants and toddlers (for example the change of a diaper constitutes a risk factor).

Similar to the toxoplasmosis infection, chances to be immune without knowing vary between 20 and 30%.

An initial, unrecognized infection during your pregnancy may also lead to an infection of your unborn child. Common consequences for the unborn are infantile brain damage and deafness.

We are able to treat cytomegaly during the pregnancy and prevent the infection of the unborn child.

I do recommend – similar to toxoplasmosis – an initial check up during early pregnancy and further examination in week 16-20, in case you are not immune already.

About 20% of women are aware of their hypothyroidism. Prior to your pregnancy your hypothyroidism should be ideally regulated. In addition you should get a check up every three month.

A pregnancy comes with plenty of hormonal changes and thus may cause a hypothyroidism. Especially an occurrence due to your pregnancy, may have an effect on your child’s development in means of the general growth and the level of intelligence.

We highly advise the intake of iodine to prevent those consequences. To be on the safe side we also recommend the determination of the TSH-level in the first and second trimester of your pregnancy.

According to the official regulations and guidance, an HIV-test should be carried out and is therefore paid for by the statutory health insurance.

An infection with HIV can be treated during the pregnancy. Through special medications and a C-Section before the contractions start, the risk of transferring the infection on to the child can be reduced to 2%.

Furthermore, the progression of the infection can be slowed down through the medications. Because of that and of course also to protect your partner, an early diagnosis does make sense.

If diabetes develops during your pregnancy, maternal as well as fetal diseases may result. This kind of disorder of your blood sugar metabolism, similar to the adult onset diabetes, is in most cases a consequence of genetic predisposition and those hormones that come with a pregnancy. In about 10% of all pregnancies diabetes occurs. The official regulations only recommend an examination of the sugar level in your urine, though it has been concluded that this testing may not be the best method for early recognition.

RISK OF DIABETES DURING THE PREGNANCY

A higher risk of developing diabetes exist for

• Women who are overweight
• Women with a genetic predisposition (family members with diabetes)
• Women who had diabetes in a previous pregnancy
• Women who had a still birth
• Women you gave birth to a child weighing more than 4500g

If diabetes during the pregnancy is not recognized or treated, the risk of urinary tract infections in the mother increases, as well as the risk of gestosis and the necessity of an unwanted C-section based on the fact that the child has grown too big.

THE CONSEQUENCES FOR YOUR CHILD

If the mother is diabetic during the pregnancy, the child will grow too fast although it is relatively immature. That obviously will have complications as a result, such as neonatal hypoglycemia, dyspnea (shortness of breath) and increased incidence of jaundice. Furthermore, damage to the placenta may occur, which may result in an insufficient supply of nutrients.

In the long-term, children that went through diabetes during pregnancy have a higher risk of obesity and diabetes in their lives. Though in most cases the blood sugar level comes back to normal, there is also a higher risk of the re-occurrence of diabetes in the subsequent 10 years for the mother.

THE TEST DECIDES

All pregnant women are supposed to get tested for gestational diabetes, between the 25th and 28th week of pregnancy. Therefore on your routine check-up we will ask you to drink a 50g sugar suspension and take your blood an hour later.

For this test, you are not supposed to be fasting. As a consequence, the test is not as precise as a fasting blood sugar test. It works however, as a good indicator and tells us whether or not you will need further examination.

Therefore I strongly recommend testing the blood sugar level (OGTT) in case you has suspicious results:

In the next days you might come to our office in the early morning fasting (nothing to eat or drink before you come); we will take a blood specimen to find out your fasting blood glucose level is at that time. Then you will drink a very sweet drink; after waiting for one hour another blood test will be taken. If this first test is positive we will do a retest to confirm the result.

If you have a higher risk of diabetes, the test can already be conducted at the beginning of your pregnancy; if there are no abnomalities, the test may take place again within the 25th and 28th week of pregnancy and maybe even once more in between the 32nd and 34th week of pregnancy.

SIMPLE TREATMENT IS POSSIBLE

In case diabetes is diagnosed, there are options to regain a good blood sugar level through a special diet. Only in rare and severe cases is insulin treatment necessary.

The blood-sugar-test is paid for by all health insurances – private and general.

While the 2D screening is paid by the statutory health insurance, 3D screening is an offer that is connected with extra costs.