Maternal-Fetal Testing

Background

Prenatal care is a medical specialty that has benefited greatly from the explosion of technology and scientific discovery that occurred in the 20th Century , as witnessed by declining infant mortality rates in both developing and industrialized nations, and lower rates of maternal death as well.

In the traditional model of pregnancy care, obstetricians treat the expectant mother while pediatricians look after the newborn infant and the growing child. According to some experts, this arrangement leaves a gap in the care of the developing fetus. Today, however, the medical community is recognizing the importance of monitoring the “maternal fetal unit” and predicting the consequences of maternal condition on neonatal outcomes.

Why is Maternal-fetal Testing Important?

  • Preterm birth—i.e., delivery before 37 weeks of gestation—drains $5 billion from the U.S. health care system each year, with a cost of approximately $5,000 for every case of false preterm labor. One hospital administrator described the costs of preterm birth at his facility as “tremendous”—over $300,000 for each baby born at 24 weeks gestation; over $200,000 for each baby born at 25 weeks; and over $175,000 for each baby born at 26 weeks.
  • Premature babies have lower survival rates than full-term babies and face long-term problems such as chronic lung disease, brain hemorrhage, and blindness, with much of the cost of prematurity expended in treating these sequelae.
  • In 2001, the U.S. spent ~$2 billion to care for adverse pregnancy outcomes related to tobacco use.
  • Diagnosis of premature labor allows obstetricians to initiate any number of interventions to head off premature delivery, including bed rest, hydration, nutritional interventions, counseling, or therapy with tocolytic agents.

Guidelines for Maternal-Fetal Testing

NACB Laboratory Medicine Practice Guidelines: Maternal-Fetal Risk Assessment and Reference Values in Pregnancy

Articles from the Association for Diagnostics & Laboratory Medicine (formerly AACC) Resources

Expert Access Live Online

  • Prenatal Screening for Down Syndrome: New Developments for Biochemical and Ultrasound Markers - Nathalie LePage, PhD

Publications from the Association for Diagnostics & Laboratory Medicine (ADLM)

  • Congenital and Perinatal Infections: A Concise Guide to Diagnosis - Edited by Cecelia Hutto
  • Handbook of Clinical Laboratory Testing During Pregnancy - Edited by Ann M. Gronowski, PhD
  • Maternal Fetal Risk Assessment and Reference Values in Pregnancy - Edited by John E. Sherwin, PhD

Additional Websites