Iowa Maternal Prenatal Screening Program
A test available to all women during pregnancy, the Iowa Maternal Prenatal Screening Program (IMPSP) is designed to identify women with an increased risk to have a baby with Down syndrome, Trisomy 18 or an open neural tube defect. It may also identify women with an increased risk to have a baby with other kinds of birth defects or women at risk to develop a problem later in pregnancy. It is important that you facilitate a conversation with your patient about the meanings behind the tests, as they only predict and do not directly diagnose.
There are two stages to the screening. The first involves an ultrasound and a blood sample in the first trimester, while the second involves a second blood sample between 15 – 20 weeks of pregnancy. It is important to note that if Stage Two is missed, a result may still be calculated using the information from stage one, but is unable to screen for open neural tube defects when analyzed alone. If Stage One is missing, Stage Two can still generate results.
Even though most babies will be healthy, the screening period can be a stressful time, make sure that you are providing your patients with any resources or support that they may need.
Unless your patient specifically prohibits the use in writing, the specimen and information collected may be used for program evaluation or research. If you patient is wary, they can be assured that there are no known risks from being a part of these studies and their identifying information is not published.
Iowa law requires that all maternal prenatal screening testing be conducted by the designated central testing laboratory at the State Hygienic Laboratory at The University of Iowa (SHL). Your hospital or practice should have a process in place to facilitate this transportation. A courier service is available to pick up the specimen as transport to the SHL.
For more information:
If you have questions about the rights of research subjects, please contact the Human Subjects Office at the University of Iowa at (319) 335-6564.
The Maternal Screening Program is administered by the Iowa Department of Public Health. Questions regarding this program may be directed to the state genetics coordinator at 1-800-383-3826.
Folic Acid
Having conversations with your patients about healthy preventative measures both before and during pregnancy is important. Among these recommendations should be a discussion about folic acid. Encouraging them to take a folic acid supplement during their reproductive years, but at least one month before conception and also three months into the pregnancy. Folic acid supplementation is a research- supported preventative measure for neural tube defects. The CDC has information about research demonstrating the benefits of folic acid intake on their website here.
For normal pregnancies, a multivitamin with 400 micrograms is suggested, while for women who have had a previous pregnancy affected by neural tube defects, 4,000 micrograms are suggested.
For more information for you and your patients, consult the following pages: