Mums-to-be missing out on birth defect test

Special ultrasound scan checks for Down's Syndrome and other problems, but many do not know about it or miss it

MANY pregnant women here are missing out on a simple but important procedure to detect birth defects in their unborn babies because they do not go for scans early enough.

Only about 40 per cent of the 2,000 mothers who give birth at the Singapore General Hospital (SGH) each year would ask for a scan, said senior consultant Ann Tan, chief of foetal maternal medicine at SGH.

This is because most women either do not know about the scans or do not come for them at the right time, she said.

She urged all mums-to-be to go for the special ultrasound scan, which costs only about $35, as it enables them to check the health of their foetus.

Called a nuchal translucency, the procedure helps doctors to measure a swelling under the skin at the back of the foetus' neck. If the swelling is thicker than normal, it is a strong indication that the foetus will develop major heart problems, Down's Syndrome or both.

The test is 85-per-cent accurate but must be completed when the foetus is between 11 and 14 weeks old, when the swelling is visible. Those who test positive are offered other tests to confirm the diagnosis.

SOME WOMEN REFUSE TEST

The risk of a baby having Down's Syndrome increases with the mother's age. At 20 years old, the risk is one in 1,500, compared to one in 100 at age 40. All pregnant women who are 35 years old and above are offered screening to find out if their foetus has Down's Syndrome or other complications.

But Dr Tan said that more than one in every 10 such women at SGH choose not to take the tests.

According to the national birth defects registry, 39 babies were born with Down's Syndrome in 1998, while 32 foetuses with the condition were aborted.

About 60 per cent of those with Down's were born to mothers 35 years and older. These are the latest figures available. Associate Professor George Yeo, chief obstetrician and head of the Maternal Fetal Medicine Department at KK Women's and Children's Hospital, said pregnant women at the hospital are given the scan routinely if they come at the appropriate stage of pregnancy. If abnormalities are found, they are counselled by the obstetrician and when needed, the prenatal sub-specialists. But parents must ultimately make their own decision.

Said Prof Yeo: "Whatever they decide, we will facilitate their choice at all stages, giving them the appropriate care and support, whether they want further diagnostic tests, or to abort, or keep an abnormal foetus to term and delivery."

Source: The Straits Times, 14 November 2001