Submit Search
Upload
Maternal screening in Pregnancy (Double & quadruple marker)
•
Download as PPTX, PDF
•
40 likes
•
15,571 views
Dr Nupur Gupta High Risk Obstetrician
Follow
Screening for aneuploidy
Read less
Read more
Health & Medicine
Slideshow view
Report
Share
Slideshow view
Report
Share
1 of 52
Download now
Recommended
Dual marker test
Dual marker test
medicomicro
Biochemical markers of prenatal diagnosis
Biochemical markers of prenatal diagnosis
International Medicine School - Management and Science University
Fetal therapy
Fetal therapy
magdy abdel
Prenatal diagnosis
Prenatal diagnosis
obgymgmcri
Recurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
Recurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
Dr.Laxmi Agrawal Shrikhande
Maternal serum screening
Maternal serum screening
Dr.M.Prasad Naidu
NIPT, Dr. Sharda Jain, Life Care centre
NIPT, Dr. Sharda Jain, Life Care centre
Lifecare Centre
Triple maternal screen
Triple maternal screen
BALASUBRAMANIAM IYER
Recommended
Dual marker test
Dual marker test
medicomicro
Biochemical markers of prenatal diagnosis
Biochemical markers of prenatal diagnosis
International Medicine School - Management and Science University
Fetal therapy
Fetal therapy
magdy abdel
Prenatal diagnosis
Prenatal diagnosis
obgymgmcri
Recurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
Recurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
Dr.Laxmi Agrawal Shrikhande
Maternal serum screening
Maternal serum screening
Dr.M.Prasad Naidu
NIPT, Dr. Sharda Jain, Life Care centre
NIPT, Dr. Sharda Jain, Life Care centre
Lifecare Centre
Triple maternal screen
Triple maternal screen
BALASUBRAMANIAM IYER
Aneuploidy screening Aneuploidy screening
Aneuploidy screening Aneuploidy screening
Dr Praman Kushwah
Thrombophilia and ٍٍRecurrent Pregnancy Loss
Thrombophilia and ٍٍRecurrent Pregnancy Loss
Marwan Alhalabi
Vulval ca and vulval lymph
Vulval ca and vulval lymph
hemnathsubedii
Multifetal pregnancy (Twins Pregnancy)
Multifetal pregnancy (Twins Pregnancy)
nishma bajracharya
prenatal diagnosis
prenatal diagnosis
ployswift
Gestational trophoblastic neoplasia
Gestational trophoblastic neoplasia
Niranjan Chavan
Fetal growth restriction
Fetal growth restriction
Kirtan Vyas
Manchester repair (Fothergill’s Operation)
Manchester repair (Fothergill’s Operation)
Yapa
Doppler in pregnancy
Doppler in pregnancy
Bharti Gahtori
SCREENING WHAT TESTS WHEN & WHAT NEXT?
SCREENING WHAT TESTS WHEN & WHAT NEXT?
NARENDRA MALHOTRA
Gynecologic Tumor Markers
Gynecologic Tumor Markers
waleed shehadat
Recurrent pregnancy loss panel discussion
Recurrent pregnancy loss panel discussion
Niranjan Chavan
Carbohydrate metabolism in pregnancy
Carbohydrate metabolism in pregnancy
saisucheethra
Antenatal Screening in Pregnancy ADBHUT MATRUTVA
Antenatal Screening in Pregnancy ADBHUT MATRUTVA
NARENDRA MALHOTRA
Rh negative pregnancy
Rh negative pregnancy
obgymgmcri
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)
Sujoy Dasgupta
Fetal therapy
Fetal therapy
rajasthan govt
antenatal fetal surveillance
antenatal fetal surveillance
Bharati vidyapeeth university
Presentation on Preimplantation Genetic Diagnosis (PGD)
Presentation on Preimplantation Genetic Diagnosis (PGD)
Dr.Laxmi Agrawal Shrikhande
screening for down syndrome
screening for down syndrome
Sadaf Khan
High risk pregnancy
High risk pregnancy
Dr Nupur Gupta High Risk Obstetrician
Sridhar prenatal diagnosis
Sridhar prenatal diagnosis
Sridhar Mulaka
More Related Content
What's hot
Aneuploidy screening Aneuploidy screening
Aneuploidy screening Aneuploidy screening
Dr Praman Kushwah
Thrombophilia and ٍٍRecurrent Pregnancy Loss
Thrombophilia and ٍٍRecurrent Pregnancy Loss
Marwan Alhalabi
Vulval ca and vulval lymph
Vulval ca and vulval lymph
hemnathsubedii
Multifetal pregnancy (Twins Pregnancy)
Multifetal pregnancy (Twins Pregnancy)
nishma bajracharya
prenatal diagnosis
prenatal diagnosis
ployswift
Gestational trophoblastic neoplasia
Gestational trophoblastic neoplasia
Niranjan Chavan
Fetal growth restriction
Fetal growth restriction
Kirtan Vyas
Manchester repair (Fothergill’s Operation)
Manchester repair (Fothergill’s Operation)
Yapa
Doppler in pregnancy
Doppler in pregnancy
Bharti Gahtori
SCREENING WHAT TESTS WHEN & WHAT NEXT?
SCREENING WHAT TESTS WHEN & WHAT NEXT?
NARENDRA MALHOTRA
Gynecologic Tumor Markers
Gynecologic Tumor Markers
waleed shehadat
Recurrent pregnancy loss panel discussion
Recurrent pregnancy loss panel discussion
Niranjan Chavan
Carbohydrate metabolism in pregnancy
Carbohydrate metabolism in pregnancy
saisucheethra
Antenatal Screening in Pregnancy ADBHUT MATRUTVA
Antenatal Screening in Pregnancy ADBHUT MATRUTVA
NARENDRA MALHOTRA
Rh negative pregnancy
Rh negative pregnancy
obgymgmcri
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)
Sujoy Dasgupta
Fetal therapy
Fetal therapy
rajasthan govt
antenatal fetal surveillance
antenatal fetal surveillance
Bharati vidyapeeth university
Presentation on Preimplantation Genetic Diagnosis (PGD)
Presentation on Preimplantation Genetic Diagnosis (PGD)
Dr.Laxmi Agrawal Shrikhande
screening for down syndrome
screening for down syndrome
Sadaf Khan
What's hot
(20)
Aneuploidy screening Aneuploidy screening
Aneuploidy screening Aneuploidy screening
Thrombophilia and ٍٍRecurrent Pregnancy Loss
Thrombophilia and ٍٍRecurrent Pregnancy Loss
Vulval ca and vulval lymph
Vulval ca and vulval lymph
Multifetal pregnancy (Twins Pregnancy)
Multifetal pregnancy (Twins Pregnancy)
prenatal diagnosis
prenatal diagnosis
Gestational trophoblastic neoplasia
Gestational trophoblastic neoplasia
Fetal growth restriction
Fetal growth restriction
Manchester repair (Fothergill’s Operation)
Manchester repair (Fothergill’s Operation)
Doppler in pregnancy
Doppler in pregnancy
SCREENING WHAT TESTS WHEN & WHAT NEXT?
SCREENING WHAT TESTS WHEN & WHAT NEXT?
Gynecologic Tumor Markers
Gynecologic Tumor Markers
Recurrent pregnancy loss panel discussion
Recurrent pregnancy loss panel discussion
Carbohydrate metabolism in pregnancy
Carbohydrate metabolism in pregnancy
Antenatal Screening in Pregnancy ADBHUT MATRUTVA
Antenatal Screening in Pregnancy ADBHUT MATRUTVA
Rh negative pregnancy
Rh negative pregnancy
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)
Fetal therapy
Fetal therapy
antenatal fetal surveillance
antenatal fetal surveillance
Presentation on Preimplantation Genetic Diagnosis (PGD)
Presentation on Preimplantation Genetic Diagnosis (PGD)
screening for down syndrome
screening for down syndrome
Similar to Maternal screening in Pregnancy (Double & quadruple marker)
High risk pregnancy
High risk pregnancy
Dr Nupur Gupta High Risk Obstetrician
Sridhar prenatal diagnosis
Sridhar prenatal diagnosis
Sridhar Mulaka
Obstetric emergencies
Obstetric emergencies
Dr Nupur Gupta High Risk Obstetrician
Gene screen technology
Gene screen technology
Miriya Johnson
Be Breast Aware 2020
Be Breast Aware 2020
Dr Nupur Gupta High Risk Obstetrician
Genetic counselling 7 march13-Dr.Gourav
Genetic counselling 7 march13-Dr.Gourav
Gourav Thakre
Top excellent facts to make pregnacy condition to delivered a healthy baby
Top excellent facts to make pregnacy condition to delivered a healthy baby
Root India Healthcare
sex selection
sex selection
Princess Alen Aguilar-Cabunoc
High-risk approach with screening and assessment
High-risk approach with screening and assessment
Anamika Ramawat
Ultrasonography Scans in Pregnancy
Ultrasonography Scans in Pregnancy
DrNisheethOza
UNIT 3 GENETICS.pptx
UNIT 3 GENETICS.pptx
AyanaRajendran2
Fertility Options: IVF Overview
Fertility Options: IVF Overview
Mark Perloe
Every fetus at risk
Every fetus at risk
NARENDRA MALHOTRA
prenatal genet.pptx
prenatal genet.pptx
krts131j
Cervical Cancer Awareness
Cervical Cancer Awareness
dharshinee-shri
diagnosis teaching on power point.pptx
diagnosis teaching on power point.pptx
KaranSingh321255
Cervical Cancer Awarness!!!!
Cervical Cancer Awarness!!!!
dharsubaby
Ivf necessary element in gynaecology
Ivf necessary element in gynaecology
drhemantzaveri
SCREENING OF HIGH RISK PREGNANCY NEWER MODALITIES OF_110313.pptx
SCREENING OF HIGH RISK PREGNANCY NEWER MODALITIES OF_110313.pptx
RDiJ1
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...
Lifecare Centre
Similar to Maternal screening in Pregnancy (Double & quadruple marker)
(20)
High risk pregnancy
High risk pregnancy
Sridhar prenatal diagnosis
Sridhar prenatal diagnosis
Obstetric emergencies
Obstetric emergencies
Gene screen technology
Gene screen technology
Be Breast Aware 2020
Be Breast Aware 2020
Genetic counselling 7 march13-Dr.Gourav
Genetic counselling 7 march13-Dr.Gourav
Top excellent facts to make pregnacy condition to delivered a healthy baby
Top excellent facts to make pregnacy condition to delivered a healthy baby
sex selection
sex selection
High-risk approach with screening and assessment
High-risk approach with screening and assessment
Ultrasonography Scans in Pregnancy
Ultrasonography Scans in Pregnancy
UNIT 3 GENETICS.pptx
UNIT 3 GENETICS.pptx
Fertility Options: IVF Overview
Fertility Options: IVF Overview
Every fetus at risk
Every fetus at risk
prenatal genet.pptx
prenatal genet.pptx
Cervical Cancer Awareness
Cervical Cancer Awareness
diagnosis teaching on power point.pptx
diagnosis teaching on power point.pptx
Cervical Cancer Awarness!!!!
Cervical Cancer Awarness!!!!
Ivf necessary element in gynaecology
Ivf necessary element in gynaecology
SCREENING OF HIGH RISK PREGNANCY NEWER MODALITIES OF_110313.pptx
SCREENING OF HIGH RISK PREGNANCY NEWER MODALITIES OF_110313.pptx
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...
More from Dr Nupur Gupta High Risk Obstetrician
Lets Talk Menopausal Health in Women.pptx
Lets Talk Menopausal Health in Women.pptx
Dr Nupur Gupta High Risk Obstetrician
Nutrition in pregnancy & lactation.pptx
Nutrition in pregnancy & lactation.pptx
Dr Nupur Gupta High Risk Obstetrician
Diet during & after pregnancy.pptx
Diet during & after pregnancy.pptx
Dr Nupur Gupta High Risk Obstetrician
Vitamin D & Women Health
Vitamin D & Women Health
Dr Nupur Gupta High Risk Obstetrician
Menstrual pain or Period Pain or Menstrual Carmps: Home Remedies
Menstrual pain or Period Pain or Menstrual Carmps: Home Remedies
Dr Nupur Gupta High Risk Obstetrician
Emotional Changes during Pregnancy: Mood swings in Mommy Brain
Emotional Changes during Pregnancy: Mood swings in Mommy Brain
Dr Nupur Gupta High Risk Obstetrician
Labour epidural myths
Labour epidural myths
Dr Nupur Gupta High Risk Obstetrician
Getting Pregnant at 35: What to Expect?
Getting Pregnant at 35: What to Expect?
Dr Nupur Gupta High Risk Obstetrician
Polycystic Ovaries (PCOS) & Fertility
Polycystic Ovaries (PCOS) & Fertility
Dr Nupur Gupta High Risk Obstetrician
Dental Health in Pregnancy: Problems & Solutions
Dental Health in Pregnancy: Problems & Solutions
Dr Nupur Gupta High Risk Obstetrician
Unwanted hair (hirsutism) and polycystic ovaries
Unwanted hair (hirsutism) and polycystic ovaries
Dr Nupur Gupta High Risk Obstetrician
Poweream health wellness
Poweream health wellness
Dr Nupur Gupta High Risk Obstetrician
HPV vaccination against Cervical Cancer
HPV vaccination against Cervical Cancer
Dr Nupur Gupta High Risk Obstetrician
Better Health For Women 30s 40s 50s
Better Health For Women 30s 40s 50s
Dr Nupur Gupta High Risk Obstetrician
Vitamin D and Women's Health [autosaved]
Vitamin D and Women's Health [autosaved]
Dr Nupur Gupta High Risk Obstetrician
Women Healthy Living in 30s & 50s: Health Goals
Women Healthy Living in 30s & 50s: Health Goals
Dr Nupur Gupta High Risk Obstetrician
Mirena: An emerging tool in managing abnormal uterine bleeding
Mirena: An emerging tool in managing abnormal uterine bleeding
Dr Nupur Gupta High Risk Obstetrician
Boostrix: An Update on Tdap Vaccine in Pregnancy
Boostrix: An Update on Tdap Vaccine in Pregnancy
Dr Nupur Gupta High Risk Obstetrician
Cervical cancer Awareness 3.3.19 Cann Win
Cervical cancer Awareness 3.3.19 Cann Win
Dr Nupur Gupta High Risk Obstetrician
International Women's day 7.3.19
International Women's day 7.3.19
Dr Nupur Gupta High Risk Obstetrician
More from Dr Nupur Gupta High Risk Obstetrician
(20)
Lets Talk Menopausal Health in Women.pptx
Lets Talk Menopausal Health in Women.pptx
Nutrition in pregnancy & lactation.pptx
Nutrition in pregnancy & lactation.pptx
Diet during & after pregnancy.pptx
Diet during & after pregnancy.pptx
Vitamin D & Women Health
Vitamin D & Women Health
Menstrual pain or Period Pain or Menstrual Carmps: Home Remedies
Menstrual pain or Period Pain or Menstrual Carmps: Home Remedies
Emotional Changes during Pregnancy: Mood swings in Mommy Brain
Emotional Changes during Pregnancy: Mood swings in Mommy Brain
Labour epidural myths
Labour epidural myths
Getting Pregnant at 35: What to Expect?
Getting Pregnant at 35: What to Expect?
Polycystic Ovaries (PCOS) & Fertility
Polycystic Ovaries (PCOS) & Fertility
Dental Health in Pregnancy: Problems & Solutions
Dental Health in Pregnancy: Problems & Solutions
Unwanted hair (hirsutism) and polycystic ovaries
Unwanted hair (hirsutism) and polycystic ovaries
Poweream health wellness
Poweream health wellness
HPV vaccination against Cervical Cancer
HPV vaccination against Cervical Cancer
Better Health For Women 30s 40s 50s
Better Health For Women 30s 40s 50s
Vitamin D and Women's Health [autosaved]
Vitamin D and Women's Health [autosaved]
Women Healthy Living in 30s & 50s: Health Goals
Women Healthy Living in 30s & 50s: Health Goals
Mirena: An emerging tool in managing abnormal uterine bleeding
Mirena: An emerging tool in managing abnormal uterine bleeding
Boostrix: An Update on Tdap Vaccine in Pregnancy
Boostrix: An Update on Tdap Vaccine in Pregnancy
Cervical cancer Awareness 3.3.19 Cann Win
Cervical cancer Awareness 3.3.19 Cann Win
International Women's day 7.3.19
International Women's day 7.3.19
Recently uploaded
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
GENUINE ESCORT AGENCY
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
GENUINE ESCORT AGENCY
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
parulsinha
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Call Girls Delhi
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
TANUJA PANDEY
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
GENUINE ESCORT AGENCY
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
Call Girls In Delhi Whatsup 9873940964 Enjoy Unlimited Pleasure
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
perfect solution
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
parulsinha
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
chennailover
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
khalifaescort01
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
hotbabesbook
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Ishani Gupta
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Anamika Rawat
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
aartirawatdelhi
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Dipal Arora
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
BhumiSaxena1
Recently uploaded
(20)
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Maternal screening in Pregnancy (Double & quadruple marker)
1.
1Copyright © 2014
Well Woman Clinic. All rights reserved. Maternal Serum Screening: Advancements Dr Nupur Gupta Department of Obstetrics & Gynecology
2.
2Copyright © 2014
Well Woman Clinic. All rights reserved.
3.
3Copyright © 2014
Well Woman Clinic. All rights reserved. What is a screening test? These tests DO NOT diagnose a problem; they only signal that further testing should be done. As diagnostic tests tend to be more expensive and have a degree of risk; screening tests are quick and easy to do. Screening tests have a greater chance of being wrong; there are “false-positive” (test indicates the baby has the condition when the baby really does not) and “false-negatives” (baby has the condition but the test indicates they do not).
4.
4Copyright © 2014
Well Woman Clinic. All rights reserved. Most babies are born healthy About 4 in 100 will be born with a birth defect Type of tests: SCREENING & DIAGNOSTIC Genetic Counseling Introduction to Prenatal Screening
5.
5Copyright © 2014
Well Woman Clinic. All rights reserved. What is Maternal Serum Screening? Measurement of proteins produced by fetus or placenta Results are calculated relative to population standards (MoMs) Screening tests do not look only at results from the blood test They compare a number of different factors (including age, ethnicity, results from blood tests, etc...) and then estimate what are a person’s chances of having an abnormality
6.
6Copyright © 2014
Well Woman Clinic. All rights reserved. It is a prenatal screening test Offered in first (9 to 13+6 weeks) and second trimester (14 to 22 weeks) It gives an estimate of the risk but doesn’t give a definitive diagnosis What is this test?
7.
7Copyright © 2014
Well Woman Clinic. All rights reserved. 7 What is Fetal Aneuploidy? Aneuploidy is having one or more extra or missing chromosomes, leading to an unbalanced chromosome number in a cell
8.
8Copyright © 2014
Well Woman Clinic. All rights reserved. FIRST TRIMESTER SCREEN TRIPLE SCREEN QUADRUPLE SCREEN PENTA SCREEN INTEGRATED SCREENING SEQUENTIAL SCREENING SINGLE SCREENING TESTS COMBINED FIRST & SECOND TRIMESTER SCREENING TYPES OF SCREENING
9.
9Copyright © 2014
Well Woman Clinic. All rights reserved. To detect the risk of having a baby with chromosomal abnormality Risk of developing early onset preeclampsia Why maternal serum screen?
10.
10Copyright © 2014
Well Woman Clinic. All rights reserved. Why Maternal Serum Screen ? Provides a non-invasive method to identify pregnancies at risk for birth defects rather than performing Chorionic Villous Sampling (CVS) or Amniocentesis in every case Fewer invasive procedures will be required to identify an aneuploid fetus in patients who have screening Individual patient risk is affected by parental age, medical/pregnancy history, family history of hereditary disease, mental retardation, or birth defects
11.
11Copyright © 2014
Well Woman Clinic. All rights reserved. All women; choice depends upon Desire for information before delivery Prior obstetric history Family history Number of foetuses Availability of reliable NT measurement Cost of screening Options for pregnancy care or termination for an abnormal diagnostic test result Who should be offered screening for aneuploidy?
12.
12Copyright © 2014
Well Woman Clinic. All rights reserved. 12
13.
13Copyright © 2014
Well Woman Clinic. All rights reserved. Down’s syndrome Edward’s syndrome Patau syndrome Down’s syndrome Edward’s syndrome Neural tube defects First Trimester Second Trimester What conditions do these tests look for?
14.
14Copyright © 2014
Well Woman Clinic. All rights reserved. Down Syndrome - Trisomy 21 Most common chromosomal abnormality 1/800 births Congenital and genetic, rarely inherited Over 350,000 affected patients in US
15.
15Copyright © 2014
Well Woman Clinic. All rights reserved. Down Syndrome - Trisomy 21 JLH Down first described it in 1866 “Observations on an ethnic classification of idiots” – Average life expectancy 30 years – Characteristic phenotype – Learning disability (IQ 20-60) – Developmental delay – Delayed puberty / Early menopause Major Causes of Morbidity & Mortality – > 50% visual or hearing impairment – 30-50% minor to severe heart defects – 10-20% intestinal malformations Others: leukemia-thyroid disease-presenile dementia….
16.
16Copyright © 2014
Well Woman Clinic. All rights reserved. All Live Births Maternal Age 35 y 87% live births are to women < 35 y #LiveBirths
17.
17Copyright © 2014
Well Woman Clinic. All rights reserved. Down Syndrome Births 35 y Maternal Age #DSCases 55% DS cases occur in women < 35y
18.
18Copyright © 2014
Well Woman Clinic. All rights reserved. Edwards syndrome – Trisomy 18 John H. Edwards, first described in 1960 Most common trisomy after Down Syndrome More common in girls The rate of occurrence for Edwards Syndrome is 1:3000 conceptions and 1:6000 live births 50% of those diagnosed prenatally with the condition will not survive the prenatal period
19.
19Copyright © 2014
Well Woman Clinic. All rights reserved. PATAU SYNDROME 1 in 10,000 births It is a chromosomal condition associated with severe intellectual disability and physical abnormalities in many parts of the body They have heart defects, brain or spinal cord abnormalities, microphthalmia, extra fingers or toes, cleft lip with or without cleft palate and weak muscle tone (hypotonia) Infants usually die within first few days or weeks of life Ony 5 to 10% survive past one year
20.
20Copyright © 2014
Well Woman Clinic. All rights reserved. Neural Tube Defects - NTD 1/1000 live births Are birth defects of the brain & spinal cord The two most common are spina bifida & anencephaly 75% affected fetuses miscarry or are stillborn 95% have no family history Maternal risk factors: Diabetes, anticonvulsants, obesity, low folic acid status
21.
21Copyright © 2014
Well Woman Clinic. All rights reserved. To obtain a complete report… Patient’s date of birth (not chronological age) Specimen collection date Gestational age (Ultrasound report) Weight at the time of sample collection Race Insulin-dependent diabetes status prior to the pregnancy Whether this is a repeat sample Number of fetuses History of NTD
22.
22Copyright © 2014
Well Woman Clinic. All rights reserved. MORE conditions ………
23.
23Copyright © 2014
Well Woman Clinic. All rights reserved. Blood tests Ultrasound SCREENING TESTS (Noninvasive)
24.
24Copyright © 2014
Well Woman Clinic. All rights reserved. 24 Role of Ultrasound: Soft markers First trimester increased NT: congenital heart & abdominal wall defects, diaphragmatic hernia Second trimester scan detects only 50 to 60% of Down’s syndrome fetuses Third trimester followup: isolated renal pelvis dilatation, echogenic bowel, or shortened humerus or femur
25.
25Copyright © 2014
Well Woman Clinic. All rights reserved. When there is a family history of a particular condition Screening tests show an increased risk of a particular condition Fetal anomaly scan is abnormal A woman more than 37 years who does not choose to have screening Diagnostic Tests: Amniocentensis/ Chorionic villous sampling
26.
26Copyright © 2014
Well Woman Clinic. All rights reserved.
27.
27Copyright © 2014
Well Woman Clinic. All rights reserved. ACOG Recommendations (2007) All pregnancies have baseline risk of major malformations and congenital disorders: approx 3% of newborns have congenital malformation Ideally, all women should be offered aneuploidy screening before 20 weeks of gestation, regardless of age The goal is to offer screening tests with high detection rates and low false-positive rates
28.
28Copyright © 2014
Well Woman Clinic. All rights reserved. PAPP A, Free Beta HCG Nuchal Translucency Maternal age, weight & gestation First Trimester (11 to 13+6 weeks)
29.
29Copyright © 2014
Well Woman Clinic. All rights reserved. It is the collection of fluid under the skin at the back of baby's neck. The amount of fluid is measured during a nuchal translucency (NT) ultrasound scan What is Nuchal Translucency (NT)?
30.
30Copyright © 2014
Well Woman Clinic. All rights reserved. Gestational age: 11 to 13+6weeks Fetal CRL: 45 to 84 mm When should NT be measured?
31.
31Copyright © 2014
Well Woman Clinic. All rights reserved. First trimester Combined (PAPP-A + Free beta HCG + NT) First trimester Triple Combined (PAPP-A + Free beta HCG + NT + AFP) First Trimester Quad Combined (PAPP-A + Free beta HCG + NT + PlGF +AFP) Triple marker (Free beta HCG + AFP + uE3) Quadruple marker (Free beta HCG + AFP + uE3 + Inhibin A) First Trimester Second Trimester Different models for Prenatal Screening
32.
32Copyright © 2014
Well Woman Clinic. All rights reserved. Protein produced in the baby’s liver during the second trimester of pregnancy. The levels of AFP generally increase in the pregnancy & in Open Neural Tube Defects, such as spina bifida, levels are very high AFP levels tend to be lower than average in babies who have Down syndrome or trisomy 18. Maternal Serum Alpha Fetoprotein (MSAFP)
33.
33Copyright © 2014
Well Woman Clinic. All rights reserved. It is produced by the placenta and crosses into mom’s blood stream Its levels rise about mid-pregnancy and then begin to decline Babies with Down syndrome tend to have higher than average levels of hCG Babies with trisomy 18 tend to have lower than average levels of hCG hCG or Human Chorionic Gonadotropin
34.
34Copyright © 2014
Well Woman Clinic. All rights reserved. It is made by both the baby’s liver and the placenta Levels of this protein rise throughout the pregnancy Babies with Down syndrome or trisomy 18 tend to have lower levels of uE3 UE3 or Unconjugated Estriol
35.
35Copyright © 2014
Well Woman Clinic. All rights reserved. It comes from the placenta Levels of this protein in mom’s blood remain relatively constant through the 15th-18th week of pregnancy Babies with Down syndrome tend to have higher than average levels of inhibin-A and Babies with trisomy 18 tend to have lower than average levels of inhibin-A Inhibin-A or dimeric inhibin-A
36.
36Copyright © 2014
Well Woman Clinic. All rights reserved. Huang et al 2014 Prenat Diag
37.
37Copyright © 2014
Well Woman Clinic. All rights reserved. First Tri Quad is better than 2nd Tri Triple
38.
38Copyright © 2014
Well Woman Clinic. All rights reserved. Started in the 1970’s when it was found that fetal neural tube defects were associated with increase in maternal MSAFP Such measurements were offered to pregnant woman for screening purposes It was also noted that MSAFP tended to be low in fetal down’s syndrome. With a cut off of 2.0 multiples of median[MOM] 85% of NTD’s would be screened in & with a threshold of 0.5 MOM approx 33% of DS fetus would be screened Second trimester biochemical screening
39.
39Copyright © 2014
Well Woman Clinic. All rights reserved. Quad Screen: Analytes 15 20 Gestational Age (weeks) AFP UE3 HCG Screening Window DIA
40.
40Copyright © 2014
Well Woman Clinic. All rights reserved. Triple Vs Quad Screen 79 72 68 70 72 74 76 78 80 Higher Detection Rates Fewer Invasive Procedures Triple Quad Triple Quad Source: Adapted from Wald, et. al. NEJM, 341:7, 461-467 Source: Adapted from Palomaki, et. al. Clin Chem. 2004; 50:1804-1808. Down Syndrome Sensitivity in 2nd Trimester 9.9 14.6 0 2 4 6 8 10 12 14 16 % of Women Requiring Amnio or CVS for a DR of 85% Quad has higher detection rates & fewer invasive procedures
41.
41Copyright © 2014
Well Woman Clinic. All rights reserved. Adding markers improved sensitivity….
42.
42Copyright © 2014
Well Woman Clinic. All rights reserved. Free beta HCG improved senstivity…
43.
43Copyright © 2014
Well Woman Clinic. All rights reserved. Free beta HCG showed better results…..
44.
44Copyright © 2014
Well Woman Clinic. All rights reserved. If Positive Screening Test Offer diagnostic testing (Invasive CVS or amniocentensis) NIPT (cell free DNA) Advanced Level II scan Genetic counseling should be offered if increased NT or cystic hygroma Fetal Echo at 24 weeks Women with negative screening should not be offered a repeat screening test
45.
45Copyright © 2014
Well Woman Clinic. All rights reserved. 45 Preeclampsia Screening
46.
46Copyright © 2014
Well Woman Clinic. All rights reserved. Prevalence of Preeclampsia
47.
47Copyright © 2014
Well Woman Clinic. All rights reserved. Long-term effects of Preeclampsia
48.
48Copyright © 2014
Well Woman Clinic. All rights reserved. PlGF is the most discriminating biochemical marker for preeclampsia in first trimester
49.
49Copyright © 2014
Well Woman Clinic. All rights reserved. Biomarker screening & preeclampsia risk Poon et al 2014 Prenat Diag
50.
50Copyright © 2014
Well Woman Clinic. All rights reserved. Dissociation Enhanced Lanthanide Fluorescence Immunoassay Fetal Medicine Foundation (FMF) Algorithm supports DELFIA platform
51.
51Copyright © 2014
Well Woman Clinic. All rights reserved. 51 Conclusion Future is Prenatal Testing In First Trimester Prevention of morbidity
52.
52Copyright © 2014
Well Woman Clinic. All rights reserved. 52 THANK YOU
Download now