Women's Diagnostic Imaging & Prenatal Testing
The Women’s Center provides a broad range of diagnostic studies for women, now all located on the 4th floor. All participating physicians and technologists have specialized training in the services they provide.
Expert Prenatal Testing
Having a baby is an exciting and challenging experience. Mills-Peninsula has for many years offered comprehensive prenatal testing services, including amniocentesis, ultrasound and genetic counseling. Today the medical experts and latest technology are all located conveniently on the Women’s Center 4th floor.
The goal is to identify certain genetic disorders and birth defects in a developing fetus using the most advanced technology and procedures. Our program is fully accredited by the American Institute of Ultrasound in Medicine and the California Genetics Disease Branch. A genetic counselor will provide you personalized care.
Who should have a screening test?
You may benefit from genetic counseling and prenatal testing if:
- You are pregnant and under age 35 but would like more accurate screening for Down syndrome
- You are pregnant and will be 35 years or older on your due date
- You are pregnant with an abnormal screening test result (for example, a positive expanded AFP blood test or integrated screening result)
- You have had an ultrasound of your fetus showing a possible birth defect
- You have already had a child or other close relative with a birth defect or genetic disease
- You and your partner are carriers of a recessively inherited disease such as Tay-Sachs, sickle cell anemia, cystic fibrosis, or thalassemia
- You are a carrier of an X-linked disease such as Fragile X, hemophilia, or muscular dystrophy
- You and your partner are closely related (such as first cousins)
- You have been exposed to medications, X-rays or other agents during
your pregnancy that may be harmful to the developing fetus
Specially trained genetic counselors provide information and support to individuals and families, addressing concerns about birth defects or inherited diseases before or during pregnancy. They also discuss family and personal health history to determine the chance that fetal disorders might occur and present appropriate options for prenatal testing.
What are screening tests and what types are available?
Screening tests help identify women who are at increased risk of having babies with certain chromosomal abnormalities such as Down syndrome, selected inherited diseases such as cystic fibrosis, or physical birth defects such as spina bifida. The tests pose no risk to the pregnancy and identify many, but not all, women who are carrying fetuses affected with
the conditions that are being screened.
First Trimester Screen
Also known as the combined screen, the test offers the earliest screening for Down syndrome in a pregnancy. Between 11 and 14 weeks of pregnancy, a specialized ultrasound called the Nuchal Translucency (NT) is performed and a woman’s blood is drawn. The NT ultrasound is performed exclusively by doctors and sonographers who have special certification to perform this test. It involves measuring a small pocket of fluid at the back of the baby’s neck. Results from this test are available in about one week. This test screens for Down syndrome and trisomy 18 (a rare genetic disorder of chromosomes). This test does not screen for spina bifida.
Integrated Screen
Integrated screen is a screening test that offers the highest detection rate for Down syndrome and is done in two stages. The first stage is performed between 11 and 14 weeks of pregnancy, which includes the specialized NT ultrasound and a blood draw for the mother. The second phase is an additional blood draw performed between 15 and 20 weeks of pregnancy. The results are available one week after the second blood draw. The integrated screening also offers the highest detection rate for trisomy 18 and screens for spina bifida.
These screening tests are alternatives to the Expanded AFP (XAFP) blood test that is widely available from obstetricians. Information booklets about the XAFP test are available at your obstetrician’s office.
Ultrasound
An ultrasound examination uses high frequency sound waves to create a visual image of fetal structures. The ultrasound allows evaluation of the anatomy of the baby, number of fetuses present, fetal growth, due date confirmation, determination of placental positions and other
information about the pregnancy that can be useful to you and your doctor.
Targeted Ultrasound Examination
In pregnancies at increased risk for specific genetic conditions or physical abnormalities, ultrasound may be used to examine a specific organ system or part of the body in an attempt to detect problems before birth.
Carrier Screening
Individuals may have an increased chance of being a carrier of some genetic diseases based on their ethnic background and family history. For example, cystic fibrosis is more common in Caucasians. A genetic counselor will discuss what carrier screening options may be appropriate for you.
What Are Diagnostic Tests and What Types Are Available?
Diagnostic tests identify chromosome abnormalities such as Down syndrome. We can test for other genetic diseases including cystic fibrosis and thalassemia, if the fetus is determined to be at risk. Because cells are tested directly from the fetus or placenta, the results are diagnostic (greater than 99 percent accurate for chromosome results). However, because it is necessary to enter the womb to obtain the cells, there is a small risk of miscarriage due to the procedure. At our center, the risk of miscarriage due to either amniocentesis or CVS is less than 1 in 200.
Chorionic Villus Sampling (CVS)
CVS is a procedure in which a small amount of tissue (chorionic villi) is obtained from the placenta between 10 and 13 weeks of pregnancy. The tissue is then analyzed for chromosome studies and, if indicated, specific genetic diseases. CVS provides the earliest diagnostic test results for Down syndrome and other chromosome problems. (CVS cannot screen for spina bifida). Approximately one percent of CVS results will be unclear or indeterminate. Most fetuses screened are normal, but additional testing, such as amniocentesis, may be indicated.
Amniocentesis
Amniocentesis is traditionally performed between 16 and 20 weeks of pregnancy. During the procedure, a thin needle is inserted through the mother’s abdomen into the amniotic fluid surrounding the fetus. A small amount of fluid is removed and analyzed for chromosome abnormalities, spina bifida and, if indicated, specified genetic diseases.
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Diagnostic Imaging
Osteoporosis testing
All women 65 and older should be tested for osteoporosis, or low bone mass, which places people at greater risk for fractures. There usually are no osteoporosis symptoms until a bone breaks, making screening so important.
Heel screening
This initial bone density screening, particularly appropriate for women younger than 65, makes a preliminary measurement of bone density using ultrasound on the heel to determine if further diagnostic testing is indicated. No physician referral is required.
Full bone density screening
A painless, low-dose X-ray to determine calcium content of bones in the spine and hip. Physician referral is required.
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Women’s Ultrasound
Pelvic ultrasound
Produces pictures of the pelvic area. Often performed to evaluate the bladder, ovaries, uterus, cervix and fallopian tubes; to monitor development of a fetus during pregnancy; or to identify kidney stones, tumors or disorders in the urinary bladder.
Hysterosonogram
An ultrasound exam often used to check for uterine abnormalities in women who experience infertility or multiple miscarriages. It also is valuable in evaluating unexplained vaginal bleeding caused by abnormalities such as polyps and fibroids.
Abdomen, gallbladder or abdominal, aorta ultrasound
Provides an image of the organs and other structures of the upper abdomen. Useful in diagnosing conditions including abdominal pains, inflamed appendix, stones in the gallbladder or kidney, or an aneurysm in the aorta. Also helpful in guiding procedures such as needle biopsies and in assessment of damage caused by illness.
Renal, bladder ultrasound
Performed to detect problems with the kidneys, bladder and related blood vessels.
Thyroid ultrasound
Typically used to diagnose a lump in the thyroid or a thyroid that is not functioning properly.
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Children
Pediatric ultrasound
Provides pictures of the internal organs and blood vessels inside a child’s abdomen. Helpful for evaluating organs such as the bladder, appendix, liver, and kidneys; diagnosing appendicitis; or determining the source of abdominal pain, such as stones and abscesses.
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