Prenatal screening is an important link to minimize the birth of abnormal fetuses by means of economical, simple and minimally invasive test methods to detect high-risk pregnant women with certain congenital defects from the pregnant women groups, and then to carry out prenatal diagnosis (such as screening for genetic diseases, fetal congenital malformations, fetal chromosomal diseases or complications during pregnancy). It is an important approach to effectively solve the health problems caused by birth defects, such as fetus (infant) death, human life injury, child illness and long-term disability, to which every country in the world today pays attention.These tasks should be completed in a timely, standardized, systematic and legal manner through prenatal screening technical services.

The Hospital is the technical guidance center of maternal and child health care in the whole city of Sanya and it is responsible for the supervision of maternal and child health care work in the whole city and the cities and counties around. The Hospital is the earliest hospital carrying out the pregnant woman prenatal screening project in Sanya and it has the conditions and ability to carry out prenatal examination of pregnant women and has obvious unique advantages compared with other general hospitals.

Previously, there was only one prenatal diagnosis center for pregnant women in Hainan, which was an affiliated hospital to Hainan Medical University and specifically responsible for prenatal diagnosis of pregnant women in the province.However, in the process of providing services, due to the occurrence of too many pregnant women from prenatal examination, the workload of the hospital was too large, the patient appointment time was very long, and the needs of the majority of pregnant women could not be met. In addition, the affiliated hospital of Hainan Medical University was located in Haikou, far from Sanya, therefore, it was extremely inconvenient for the pregnant women in Sanya and the cities and counties around.The number of births in Sanya is more than 1,5000 per year, and it is increasing year by year. Therefore, it is necessary to set up a prenatal screening center in Sanya.

The prenatal screening center of the Hospital has been approved by the Municipal Health Bureau and has been officially established. It will be the internal department of Sanya Maternal and Child Health Hospital to undertake the prenatal screening of pregnant women in the whole city. The establishment of the prenatal screening center in the Hospital will help to reduce the incidence of birth defects and further improve the quality of birth population.

Prenatal Screening and Examination Items:

I. Down's Syndrome Screening

Down's syndrome, also known as congenital stupidity, is a chromosomal anomaly.The children with Down syndrome feature mental retardation and developmental retardation, more than 50% of them have congenital malformation.

Common Screening Methods:

1.Determine fetal-related markers in the mother's blood, and assess the risk rate of fetal disease in combination with maternal age, weight, height, gestational age, and history of diabetes.(Screening time: Phase I: 9-13 gestational weeks + 6 weeks; Phase II: 14-20 gestational weeks + 6 weeks)

2.Color ultrasound: the thickness of fetal neck transparent layer (NT) is measured in 11-13 weeks of pregnancy. If the NT value exceeds normal value, the risk rate will increase.

II. Fetal Malformation Screening

Fetal neural tube malformation (including anencephaly and spinal fracture), congenital heart disease,  celoschisis, lagocheilus and other fetal malformations, which can be screened during pregnancy through 3D/4D color ultrasound.(Screening time: in 22-26 weeks of middle gestation and 28-32 weeks of later gestation)

III. Mediterranean Anemia Screening

Mediterranean anemia is a hereditary blood disease.There is no obvious difference between mild Mediterranean anemia patients and normal people.However, if both the husband and the wife are the patients of the same type Mediterranean anemia, their children may be the patients of severe Mediterranean anemia.a. A patient with severe Mediterranean thalassemia will die after birth.B. A patient with Mediterranean thalassemia depends on blood transfusion to support life or dies early.

Screening and diagnosis of Mediterranean thalassemia: Through blood routine, erythrocyte fragility, hemoglobin electrophoresis screening to the husband and the wife, it is possible to detect the suspected Mediterranean thalassemia, and then Mediterranean thalassemia gene test can be conducted to determine whether it is Mediterranean thalassemia.

IV. Non-invasive Prenatal Screening

A non-invasive DNA prenatal screening technique is performed from 12 to 24 weeks of gestation by pumping 5 ml maternal blood directly, and the free fetal DNA in the maternal plasma can be used to determine the risk rate of fetal aneuploidy.At present, this technique can be used to detect 21 trisomy syndrome (Down syndrome), trisomy 18 syndrome (Edward syndrome) and 13 trisomy syndrome (Patau's syndrome).It is the screening closest to prenatal diagnosis.This technique can greatly reduce the psychological burden of pregnant women without worrying about the abortion and other injuries caused by puncture.The result can be obtained two weeks after material selection, faster than amniotic fluid puncture, more accurate than prenatal serum screening.

V. Gestational Diabetes Screening

Diabetes that occurs or is first found after pregnancy is called gestational diabetes mellitus (GDM).A woman with GDM is prone to abortion, macrosomia, hydramnios, premature delivery, fetal malformation, maternal infection, and dystocia, etc.