American Association for Clinical Chemistry
Better health through laboratory medicine
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

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