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Prenatal Testing

A Dad's Eye View

By Dr. Aneema Van Groenou

After the first couple of months of pregnancy, an abdominal ultrasound can visualize the fetus. This means that the doctor or ultrasound technician will put gel on the mother's belly and glide the probe on top of the skin to visualize the fetus. This is completely painless, and you can usually watch the images on the monitor and ask the ultrasonographer to identify what you are looking at. Most machines will also be able to print you a photo or two to jump-start your baby album!

Later in the first trimester, the ultrasound can also determine if you're going to be having twins, triplets – or more. Every pregnant woman should also have a formal ultrasound done by a trained prenatal ultrasound technician or obstetrician to look for birth defects. Having an ultrasound in the emergency department does not count for this important prenatal test.

The alfa-fetoprotein (AFP or MSAFP) test is a maternal blood test done in the second trimester that checks for a protein normally secreted by the fetal liver. The levels of this protein alert the obstetrician to the possibility of a chromosomal abnormality, such as Down syndrome or the presence of twins. Abnormal AFP levels may also indicate developmental problems in the fetus, such as neural tube defects like spina bifida or defects in the abdominal wall of the fetus.

An abnormal AFP may also simply mean that your due date has been miscalculated. Therefore, an abnormal AFP indicates the need for further testing. AFP testing is often done in concert with testing for other markers, such as hCG, estriol and inhibin, three hormones produced by the placenta.

This is called multiple marker screening (sometimes called the "triple screen"), but abnormal results do not necesarily mean your pregnancy has a problem. This is why these are considered screening tests – typically other tests, such as an amniocentesis or an ultrasound have to be done to diagnose a problem, if one exists.

Want to see more?

• Picture Day! A Guide to Ultrasounds
• Prenatal Screening: The Pros and Cons of Enhanced AFP
• Coping With Morning Sickness: How to Help Your Partner
• Putting Yourself in Her Shoes: Sympathy-Building Exercises for the Dad-to-be
• What Not to Do in the Delivery Room
• Talk about it!

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