Blood tests for assessment of maternal wellbeing
Questions:
Activity 1
Blood tests for assessment of maternal wellbeing
Because of physiological blood changes in pregnancy, haemoglobin levels are reduced in pregnancy. Analyse the cause, treatment and management of low haemoglobin, and reference national and international guidelines. What other diagnostic tests might inform diagnosis?
Activity 2.
From your reading about antenatal screening and watching the antenatal screening video, you will have noted that there are a number of screening options which may be discussed with a woman in the early stages of her pregnancy. Analyse one of the main screening options that the midwife may discuss with a woman and the information that is required in order for her to make an informed decision. Consider both advantages and disadvantages of the screening test. Use a list of bullet points to illustrate the main issues from your analysis.
Activity 3.
Answers:
Activity 1: Factors to Consider Increasing Chances of Conceiving a Healthy Pregnancy
The frequency of sexual intercourse is also a determinant of the ease to conceive. If sexual intercourse takes place 3 to 4 times a week, there will always be presence of live sperms in the fallopian tube (Lum et al, 2017). This increases the chances of fertilization when ovulation occurs. On the other hand, having sexual intercourse once a week lowers the chances of fertilization since ovulation may be missed. Further, emotional factors also take the toll on fertility especially for the female. These factors include stress, overwork, strain, pressure in work. The production of adrenalin during stress inhibits the utilization of the progesterone hormone, which is significant in fertility (Verma et al, 2017). The presence of adrenalin also causes the release of high levels of prolactin by the pituitary gland which is also a cause of infertility. It is therefore, advisable for John and Jane like any other couple to avoid stressful situations in their attempt to have a baby.
Blood tests for assessment of maternal wellbeing
Low Hemoglobin in Pregnancy
Screening for hemoglobin level should be done at first antenatal visit to determine the levels and also the concentration of ferritin (Shinar & Maslovitz, 2017). During pregnancy, low hemoglobin can easily be treated by adding iron and vitamin supplements on a daily routine. However, in severe cases which are usually rare, there may be need for blood transfusion. Screening of hemoglobin and ferritin should be continued in the second and the third trimester visit and treated appropriately.
Serum ferritin of women with known hemoglobinopathy should be checked and if low, they should be given iron supplements. Women whose iron-deficiency has been established should be offered 100-200 mg of iron element daily (Shinar & Maslovitz, 2017). They should be advised on how to correctly administer to optimize absorption. Vitamin C increases the rate of absorption and thus the pregnant women are advised to take foods rich in it. These foods include citrus fruits and juices, oranges, tomatoes, strawberries and kiwis. Preventing low hemoglobin during pregnancy is possible and necessary. One can do this through making changes in the diet. It is recommended that a pregnant woman eat at least 30mg of iron every day. The foods rich in iron include lean, red meats, eggs, leafy green vegetables; spinach, broccoli, beans and lentils and nuts.
Activity 2: Antenatal screening
Main issues from the analysis
To perform the screening there has to be informed consent. The woman should be well informed of the screening test in terms of the procedures, the requirements, the possible outcomes, the next steps depending on the outcome, the advantages and the risks that come with the screening and further diagnosis. This will help the mother to make informed decisions in taking up the screening tests.
Activity 3: Urine Dipstick Test Analysis
Presence of excess proteins in the blood could be a sign of urinary tract infection or kidney damage. If the mother has high blood pressure too during the pregnancy, chances are that it could be preeclampsia (Asadzadeh, 2017). If the blood pressure is normal, the sample could be taken to the laboratory for further analysis. Preeclampsia happens mostly after the 20th week of pregnancy. If it is mild, it could be managed by getting bed rest, reducing salt intake, drinking a lot of water and regularly visiting the doctor (Yeung & Wong, 2009). If serious, one can be admitted for thorough monitoring to reduce the blood pressure or give steroid injections to help quick development of the baby’s lungs.
Ketones can also be found in the urine in the dipstick test. When there are not enough carbohydrates in the body, the body begins to breakdown stored fat in the body to provide energy (Cho, et al, 2014). This maybe accompanied with nausea, weight loss, vomiting. Urine test may indicate the presence of ketones in the urine. If high sugar is found as well, it could be a sign of diabetes. The presence of ketones in the urine is referred to as acetonuria. This leads to dehydration in the body and also metabolic disturbance which can provoke miscarriage or cause premature birth (Asadzadeh, 2017). Treatment of acetonuria depends on the cause to determine its management. Necessary medication and intravenous fluids will be given and healthy eating recommended. Sorbents can also be prescribed to reduce intoxication.
References
Davis, C., Cuckle, H., & Yaron, Y. (2014). Screening for Down syndrome - incidental diagnosis of other aneuploidies. Prenatal Diagnosis, 34(11), 1044-1048.
Friedman, S. (2017). Pregnancy and IBD: Timing Is Everything. Digestive Diseases And Sciences, 62(8), 1847-1849.
Mechery, J., Abidogun, K., Crosfill, F., & Jip, J. (2012). Hyperhemolysis Syndrome Complicating Pregnancy in Homozygous δβ-Thalassemia. Hemoglobin, 36(2), 183-185.
Naik, D. (2017). A Study of Dipstick and Microscopic Analysis of Formed Elements in Urine. Journal Of Medical Science And Clinical Research, 05(04), 20485-20488.
Yeung, K., & Wong, T. (2009). Value of the urine dipstick test for leukocytes in screening for urinary tract infection. Emergency Medicine, 4(2), 73-75.