HEALTHNET

What is a pre-marital check-up?

Different people may have different priorities, and doctors may do this differently depending on the needs of the couple.

(Posted on 8 February 2007)

Q1. I am getting married next month. What is a pre-marital check-up?

A1. Different people may have different priorities, and doctors may do this differently depending on the needs of the couple.

Usually doctors would start with a personal medical history in private. They would pay particular attention to hereditary illness, and problems that might jeopardize parenting abilities, such as learning disorders and psychiatric problems. Be prepared that they may also bring up sensitive issues such as sexual experiences, previous pregnancies, and history of venereal diseases.

Physical examination would include measurements such as height, weight, and blood pressure and a routine examination of various systems, with emphasis given to secondary sexual characteristics and the genitalia. Conditions such as tight foreskin may need to be taken care of.

Blood tests usually include a full blood count, blood grouping, testing for hepatitis B. For those with sexual experience it may be a good time to be tested for HIV and other sexually transmitted diseases. Syphilis is one of the most common that can affect the fetus. Women would be tested for antibodies against rubella (German measles). Antibodies against microorganisms that may behave in a similar way to infect the fetus may also be included in the battery if so desired. A chest radiograph is sometimes taken as a routine, since tuberculosis is still quite common in Hong Kong.

Q2. How good would the tests be able to detect potentially inherited diseases?

A2. Most congenital abnormalities are accidents of nature. Few could be picked up by pre-marital check-ups.

Thalassemia, a severe type of anemia, is one of the few genetic diseases that are preventable with pre-marital blood tests. The field of molecular genetics is moving fast however, and the list of genetic diseases that can be diagnosed may become longer in a couple of years.

The aim of a pre-marital health check is not to prevent genetic diseases. Getting married is an important milestone in life. It would be a convenient time to review how best to look after your body and your responsibility towards the health of your new family. It is time to discuss your plans for either contraception or potential pregnancies. Your health care provider can help you decide which type of birth control is best for you, as well as the best plan for your future fertility.

If you plan for a honeymoon, you should also take the opportunity to discuss any special precautions that you may need to take. Discuss with your health care provider if you want to delay the onset of menstruation.

Q3. How would a pre-marital checkup differ from a prenatal maternity check-up for the female?

A3. Whereas the aim of a pre-marital check-up is to safeguard the health of the new family, the purpose of a prenatal check-up is to ensure the wellbeing of the pregnant woman and safe delivery of the baby. The list of laboratory tests recommended can vary, but the following are likely to be included in the first visit:

Complete blood count (CBC)
Blood type (blood transfusion may be needed in an emergency)
Screens for syphilis
Rubella antibody screen
Hepatitis B screen
Pap smear
Urinalysis and culture
HIV screen
Screen for Group B Streptococcus (a bacteria that can cause premature births and fatal infection in newborns)

More tests may be required in later part of the pregnancy to detect problems such as diabetes. Screening blood tests for Down's Syndrome and prenatal ultrasound studies are now recommended to most pregnant women.

In each prenatal visit, the parents would be given nutritional advice, counseling, general information and reassurance that all is well. Opportunity would also be given to discuss the sort of birth parents would like. There is a lot to be learnt on being a new parent. Antenatal care is part of the process where doctors and midwives would help you prepare physically and emotionally to welcome your baby.

Source: Quality HealthCare