SCREENING

Maternal Screening

Maternal Screening

Introduction

Prevention in pregnancy focuses on activities that reduce the risk of a baby being born with a birth defect, thereby decreasing the morbidity and mortality. Prevention in pregnancy can occur through universal prevention programs which are targeted to the general population. For instance, both men and women can be provided information on how to reduce the risks of birth defects. An example is education regarding the teratogenic effects of drugs such as isotretinoin. Another example of universal prevention includes offering all women tests to screen for birth defects, for example, ultrasound screening for physical birth defect. The aim and objective of this paper is to talk about the phenomenon of screening. The paper discusses various types of screening, the conditions in which the screening is applicable and advantages and disadvantages of the screening process.

Screening

Screening is a strategy that can be used to detect a disease or problem in individuals within population. Screening tests are administered to individuals who are usually asymptomatic. The objective of screening is early identification, leading to earlier interventions and management to reduce the morbidity and mortality associated with the disease or problem. The UK National Screening Committee defines screening as: “A public health service in which members of a defined population, who do not necessarily perceive they are at risk of, or are already affected by a disease or its complications, are asked a question or offered a test, to identify those individuals who are more likely to be helped than harmed by further tests or treatment to reduce the risk of a disease or its complication (Clarren, 2001).”

WHO Criteria

According to the World Health Organization, to successfully implement a screening program the following conditions should be met (Haberman, 2000):

Interventions should be acceptable to the population

Screening programs should be a continuing process

The test should be acceptable to the population

There should be facilities for assessment, diagnosis and rehabilitation

The cost of screening should not be disproportionate to the cost of caring for the affected individuals

There must be an accepted and effective treatment for the condition

The natural history of the disease should be understood and the population at risk should be identifiable

The disease or condition that is being screened for should be important medically, socially, or economically

A suitable test should exist

The condition should be recognizable at an early stage

Criteria for screening

Half of all pregnancies are unplanned and many adults are not immediately aware of health and lifestyle factors that may influence the outcome of pregnancy. It is therefore important to screen during pregnancy for known reproductive risks. A report on pre-conceptional health identifies eight areas of screening: reproductive awareness, environmental toxins and teratogens, nutrition and folic acid, genetics, substance use, medical conditions and medications, infectious diseases and vaccination, and psychosocial concerns. Other methodologies of screening currently employed during pregnancy include ultrasound and glucose tolerance tests. In addition, screens are employed after the delivery of the baby including thyroid testing and genetic testing for rare conditions (Zollinger, 2007).

Application of Screening during Pregnancy

Yes screening process can be ...