Frequently Asked Questions

A wide range of abnormalities affecting the development of a healthy baby can be diagnosed prenatally. These include:

• Chromosomal abnormalities (in which the baby has too many or too few chromosomes, such as Down syndrome)
• Cardiac abnormalities (in which the chambers of the baby’s heart, or the blood vessels connected to the heart, fail to develop normally, such as “hole in the heart”)
• Spine and head abnormalities (in which the bones of the spine or skull fail to develop normally, such as spina bifida)
• Genetic conditions (in which the baby inherits abnormal genes from one or both parents, such as cystic fibrosis)
• Abnormalities of fetal growth or amniotic fluid.

It is important to realise that prenatal tests cannot guarantee that your baby is going to be completely normal. This is because many medical conditions that affect children’s health do not have suitable prenatal tests available yet, such as autism and cerebral palsy. You should discuss your particular concerns directly with your doctor to figure out if special additional tests might be suitable for your particular needs.

Unfortunately, congenital abnormalities affecting babies’ health are common.

About 3% of all babies have some sort of physical or mental abnormality or limitation.

Cardiac abnormalities, such as “hole in the heart”, occur in approximately eight in every 1,000 pregnancies (slightly less than 1%). Fortunately, many of these heart abnormalities are minor and do not require paediatric surgery. Some however are so serious that it may be necessary for your doctor to make special arrangements about where you deliver, and for your baby to undergo urgent heart surgery. If you have previously had a baby with a heart problem, or if someone in your family or your partner’s family have had a baby with a heart problem, your chances of this happening may be significantly higher. In this situation, you should bring this to the attention of your doctor for further specific advice.

Spine and brain abnormalities, such as spina bifida, occur in approximately two in every 1,000 pregnancies. Unfortunately, these problems seem to be more common in Ireland compared to other countries. If you take folic acid supplementation prior to becoming pregnant, and during the first two months of pregnancy, your chances of these problems should be significantly lower. If you have previously had a baby with such a spine problem, or if someone in your family or your partner’s family have had a baby with a spine problem your chances of this happening may be significantly higher. In this situation you should bring this to the attention of your doctor for further specific advice.

Genetic abnormalities, such as cystic fibrosis, can occur even without any family history in your or your partner’s backgrounds. However, in some cases both you and your partner may be carrying an abnormal gene without it affecting either of you. If both of you happen to pass on that abnormal gene to your baby, then your baby may have as high as a one in four chance of having a serious disease. For example, about one in every 20 Irish people carries an abnormal gene for cystic fibrosis. It is difficult to provide you with specific risk information for the many genetic abnormalities without first performing a detailed review of three generations of your and your partner’s family background. This should be arranged through your doctor with a genetic counsellor if there is a specific concern.

The following tests are now easily available in Ireland for any patient who would like reassurance regarding the health of their baby:

• Early Pregnancy Assessment
• Combined Test/First Trimester Screening (FTS)
• Fetal Anatomy Scan
• Chorionic Villus Sampling
• Amniocentesis

Many of these tests need to be performed at very specific times during pregnancy. To figure out how far along you are in your pregnancy, and to find out which of these tests may be available for you, please enter your pregnancy dating information in the box below. If you know the date of the first day of your last menstrual period, enter that date in the correct box below. Alternatively, if you don’t know this date, but you do know your expected due date, enter that date in the correct box below. Information will then appear suggesting how far along in pregnancy you are, and which tests should be scheduled.

Some of these tests may be provided by your local maternity hospital. However, you should realise that most Irish hospitals do not receive special funding from the Department of Health to provide such screening or diagnostic tests on a routine basis. You may therefore need to make special arrangements for these tests yourself, if not provided at your local centre.

It can sometimes be quite difficult to figure out which of the wide range of prenatal tests to choose. It is often easiest to approach this decision in three easy steps:

Step 1 – Should I look for prenatal test results at all?
The first question that all patients and their partners should answer is “Do I want this information at all”? Finding out prenatally whether your baby is healthy or has a problem is a complicated issue and is completely voluntary. It is important to realise that you do not need to undergo any of these tests, irrespective of your age or medical background. Reasons that are commonly quoted by patients to get this information include:

• “I do not want to wait until the end of the pregnancy to find out if my baby is healthy”
• “If I find out early in pregnancy that my baby has a serious medical problem then I can prepare myself and my family by getting as much information as possible”
• “If I find out that my baby has a serious medical problem I can make arrangements to meet with the relevant paediatric specialists in advance and, if necessary, make arrangements to deliver my baby at a special time or in a special location to improve the chances that my baby will do well”
• “If I find out that my baby has such a serious abnormality that the baby will likely not survive, I could avoid having a caesarean section, or avoid delivering far away from my family or my home”
• “If the tests prove that my baby has a serious abnormality, I can have time to figure out what the full implications of this are, and if I want to, I can choose to obtain a pregnancy termination”

A key concept in the areas of fetal medicine and prenatal diagnosis is “non-directive counseling”. This means that you should be able to choose whether or not to have any prenatal tests that you wish, and once you receive results, you should be provided with information on all options available to you, in a non-judgemental manner. Only you, with your partner or family, can make the right decision on what to do with such information.

Step 2: Should I have a screening or a diagnostic test?
CVS (chorionic villus sampling) and amniocentesis are examples of diagnostic tests for conditions like Down syndrome. That means they can tell you for sure whether the baby either has, or does not have, such a condition. Some patients prefer to get very definite, or “black and white” information, like this. However, since these tests involve placing a thin needle into your uterus, there is a small risk that a miscarriage might be triggered. This chance may be about 0.5% to 1%, or about one in 100 to one in 200.

Because of the concern about possibly triggering a miscarriage, some patients prefer to avoid these needle tests, unless absolutely necessary. In this situation, a screening test that gives a more accurate assessment of the chances of a problem with the baby may be suitable. Screening tests do not tell you whether the baby is healthy or whether the baby has a problem. Instead, they tell you what are the “odds” or chances of this happening. If the screening test result suggests that the “odds” of a problem are high, then you can have the definitive diagnostic test at that time.

Step 3: How far along in my pregnancy am I?
Different diagnostic tests and different screening tests are available depending on how far along in pregnancy you are. To figure out how far along you are in your pregnancy, and to find out which of these tests may be available for you, please enter your pregnancy dating information in the box below. If you know the date of the first day of your last menstrual period, enter that date in the Pregnancy Calculator on the left. Alternatively, if you don’t know this date, but you do know your expected due date, enter that date in the Pregnancy Calculator on the left. Information will then appear suggesting how far along in pregnancy you are, and when various tests should be scheduled.

You may need to put on more if underweight pre pregnancy and less if obese pre-pregnancy.

Eat more frequent, smaller meals and avoid foods or odours that trigger nausea or vomiting, decrease stress, more rest, if possible have someone else cook and drink plenty of fluids throughout the day.

Try vitamin B6 tablets, wine gums, ginger ale, pretzels, and peppermint tea.

If it’s a second or third baby you might just need a one day refresher course, otherwise classes can be weekly over a period of 8 weeks starting 8-10 weeks before your due date. Check with Rotunda Physiotherapy Department to book an appointment for these classes, please ring 01 817 1787.

We can also recommend private instructors that are familiar with your hospital and convenient to where you live.

Flying is not harmful; however airlines often won’t let you fly in late pregnancy. Also long distance (longer than 5 hours) carries a risk albeit small of thrombosis (blood clots) in pregnant women. Discuss your plans with your Doctor who may prescribe aspirin or heparin.

If you are flying drink plenty of water, do calf exercises and walk on the flight, wear support stockings. And importantly think about where you are flying to…..could you get medical help if needed, are there any vaccinations needed which may be harmful to a pregnancy. Road traffic accidents tend to be the more common injuries pregnant women sustain during a pregnancy, remember to wear the seatbelt above and below the bump but not over or across it.

Increase the fruit and fibre in your diet, and lots of water, also exercise is important.

If these measures don’t help to alleviate it speak to your doctor who may suggest fybogel or lactulose.

For heartburn try to sleep propped up, drink a glass of milk before bed and avoid eating or drinking a few hours before you go to bed can also help.

For indigestion try eating smaller meals more often, sit up straight when you’re eating as this takes the pressure off your stomach. Discuss with your doctor or midwife as they may also recommend omeperazole (losec), ranitidine (zantac) or Gaviscon.

Yes in the second and third trimesters you may find that your sex drive may change so you may need to talk to your partner about this.

Also you and your partner may have to find different positions that are more comfortable for you both.

If you are worried re reduced fetal movement, any bleeding or unusual loss, pain, spontaneous rupture of membranes, excessive vomiting, or high temperature contact your doctor or midwife.

If bleeding, keep track of it and report it, colour, amount, if associated with pain. Get lots of bed rest, avoid heavy work, avoid sexual intercourse, use pads only not tampons, stay well hydrated and take Panadol if needed.