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Pregnancy Guide Update – Prenatal Testing – Some risks reduced

Triple Screen is now Quad Screen:  Commonly used prenatal blood tests now check for a fourth substance in the blood, increasing sensitivity (ability to identify) to Down’s syndrome.  Rather than add another acronym to the list, I will remove the references to HCG and UE, substances detected along with AFP in the triple screen.  The alphabet soup does not improve understanding or increase ability to use the information to enhance health.

Amniocentesis: Beginnings Pregnancy Guide 2007 edition states:
For every 100 women who have this test, 1 might have a miscarriage. p10

March of Dimes now reports the risk of miscarriage with amniocenteses is reduced to “1 in 300 to 1 in 500.” Therefore, the Pregnancy Guide statement will be edited to read as follows: 
For every 300 women who have this test, 1 might have a miscarriage. P10 2011

CVS:  Beginnings Pregnancy Guide 2007 edition states:
CVS (Chorionic Villus Sampling) is a test for problems in the cells that form the baby.  For every 100 women who have the test, 1 to 3 might have a miscarriage. P 11

According to the March of Dimes, when an experienced provider conducts the test, risk is “1 in 200 or less”. Therefore, the Pregnancy Guide statement will be edited to read as follows:                  
For every 200 women who have the test, 1 might have a miscarriage. p11 2011

HIV/AIDS Testing:  Encourage testing for all women.  With treatment, transmission to baby is now rare. No change is required in the information on AIDS. All women should be offered HIV testing. Several sources suggest it is common practice for providers to offer the test only those they judge to be at risk. This means it is important for home visitors to discuss testing with moms and prepare them to request the test when appropriate. With antiretroviral drugs and careful management of labor, transmission from mother to baby in the US is now a sentinel event with fewer than 100 infected babies out of about 4 million births per year. 

To aid mothers’ decision-making Beginnings Pregnancy Guide will continue to offers these guidelines, adding text in italic:
Take the AIDS test if there is any chance that:
·  You have had sex with more than one partner in the last 10 years,
·  Your partner(s) had sex with other partners, including men,
·  You or your partner (s) shared needles with other people to inject anything,
·  You or your partner had sex while high on drugs. p 11

Paintsil E & Andiman WA. (2009). Update on successes and challenges regarding mother-to-child transmission f HIV. Current Opinions in Pediatrics 21 (1): 94-101. Review.  44 references  
MedlinePlus, Prenatal Testing. Multiple resources, including  March of Dimes articles and information for parents in Spanish http://www.nlm.nih.gov/medlineplus/prenataltesting.html 
Lab Tests Online. (November 2010). Triple Screen or Quad Screen. Labtestsonline.org/understanding /analytes/triple_screen/multiprint.html      A good peer-reviewed plain language explanation of the test.  8 current references American Pregnancy Association, Maternal Serum Alpha-Fetoprotein Screening (MSAFP). (undated). http://www.americanpregnancy.org/prenataltesting/afp.html A good plain language explanation of the test and its results.  2 slightly dated references  
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