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Pregnancy: These checkups are useful

2019-10-18T08:44:38.012Z


Blood test for Downsyndrom, ultrasound, HIV test: There are numerous investigations for expectant mothers, some pay the health insurance. But which are really necessary? The overview.



When women learn that they are pregnant, they often face a marathon of inquiry: ultrasound, tests for gestational diabetes, diagnostic tests and many other potential tests often overwhelm expectant mothers - or even scare them.

In addition, some of the investigations are taken over by the health insurance, some not and sometimes only sometimes. An overview:

What do the statutory health insurance companies pay?

The maternity guidelines in Germany determine what legally insured pregnant women are entitled to. "The primary goal of medical prenatal care is the early detection of high-risk pregnancies and high-risk births," it states.

These include, for example, an HIV test , a test for gestational diabetes, a chlamydia test, a test for rubella antibodies or even examinations to determine maternal and child blood group intolerances .

In addition, three ultrasound examinations are planned at the gynecologist:

  • between the 8th and 12th week of pregnancy,
  • between the 18th and 22nd week and
  • between the 28th and 32nd week.

The examinations enable measurements of the body, and physicians can assess the heart activity of the fetus. In the study around the 20th week pregnant women can choose between two variants: a basic ultrasound and an extended ultrasound, which collects more data. Gynecologists must be specially trained for the second version.

What do the cash registers only pay under certain circumstances?

In addition, there are even more detailed ultrasound examinations: the so-called Feindiagnostik between the 18th and 22 Week is performed by a prenatal physician - a gynecologist with special training. During the examination, he looks more closely at the child's body, brain and organ systems.

"Certain severe malformations, such as some heart defects, do not necessarily have to be detected during extended ultrasound, but are found with great certainty during fine diagnosis," says Annegret Geipel, Head of the Department of Prenatal Medicine at the University Hospital Bonn.

"If such disorders are detected early, you can, for example, plan the birth in a perinatal center, where specialists take care of the newborn," says Geipel. Anyone who is not referred due to abnormalities, must pay the fine diagnostics itself: 200 to 300 euros cost of the investigation.

The blood test for trisomies will in future also be a cash benefit. In September, the Federal Joint Committee (G-BA) decided that funds would have to pay for the test for pregnant women under tight conditions from autumn 2020 onwards. For self-payers, the so-called non-invasive prenatal test (NIPT) costs about 300 euros.

PregnancyWhat you need to know about blood tests for Down syndrome

The blood test results in a probability that a child with a certain disability is born. These include trisomy 21, 18 and 13 as well as a maldistribution of the sex chromosomes X and Y.

"The NIPT is not a diagnostic procedure, but only a risk analysis," says Karl Oliver Kagan, expert of the German Society for Gynecology and Obstetrics (DGGG) and head of the Department of Prenatal Medicine at the University Hospital Tübingen. Especially for the trisomies the test is very reliable.

After the decision, disabled associations expressed criticism, however. There is concern that children with Down syndrome may be perceived as avoidable in the future and that parents will be pressured to opt for an abortion.

Chromosome disorders can only be clearly diagnosed by amniocentesis and chorionic villus sampling . For a thin instrument is guided through the abdominal wall of the pregnant woman, which is associated with a - albeit small - risk of miscarriage. The funds finance the punctures only for certain existing risks. They are possible after the 16th or 12th week - the NIPT, however, from the 10th week.

Prenatal physician Kagan recommends that women who want to use the NIPT should always combine the test with good ultrasound diagnostics. Thus, malformations that occur independently of chromosome disorders can also be detected.

Which tests do pregnant women have to pay for themselves?

In addition to malformations, infectious diseases can endanger the unborn, such as toxoplasmosis and cytomegalovirus . Whether or not a woman is immune to her at the beginning of pregnancy can be determined by her blood.

Those who are not immune can have their own blood repeatedly examined for new infections during pregnancy - and take medication in case of illness. The costs for immunity test and controls are around 15 to 20 euros each.

Self-pay customers may also perform a vaginal smear on B streptococci for about 20 euros. If the bacteria are found in pregnant women, they can receive an antibiotic via a drip during birth. This prevents the transfer to the child. "I consider this study to be very important and I always recommend it to my patients," says Dieter Grab, President of the German Society for Prenatal and Obstetric Medicine (DGPGM).

More expenses on request

The professional association of gynecologists points out that almost all health insurance companies take over many of the medical self-payer benefits - on request. Many health insurance companies also offer patients a fixed budget, which they can use for preventive medical examinations.

Source: spiegel

All life articles on 2019-10-18

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