Contributing to improving the quality of the population.

According to information from the Population Department - Ministry of Health, the nationwide rate of prenatal screening for 4 diseases (Thalasemia, Down syndrome, Patau syndrome, Edwards syndrome) and newborn screening for 5 diseases (congenital hypothyroidism, G6PD deficiency, congenital adrenal hyperplasia, congenital hearing impairment, congenital heart disease) has not yet met the set targets.

Dr. Nguyen Tien Nhut, Specialist Level I - Head of the Obstetrics and Gynecology Department, Lam Dong Hospital II, guides mothers on caring for newborns at the hospital.

Implementing Decision No. 1999/QD-TTg dated December 7, 2020, of the Prime Minister approving the Program to expand screening, diagnosis, and treatment of certain prenatal and neonatal diseases until 2030 (hereinafter referred to as Program 1999), provinces and cities have achieved some results: the rate of pregnant women participating in prenatal screening and newborns participating in neonatal screening has increased year after year. However, the rate of prenatal screening for all four diseases (Thalasemia, Down syndrome, Patau syndrome, Edwards syndrome) and neonatal screening for all five diseases (congenital hypothyroidism, G6PD deficiency, congenital adrenal hyperplasia, congenital hearing impairment, congenital heart disease) has not yet reached the set target.

To obtain comprehensive information on the prenatal and neonatal screening, diagnosis, and treatment network for the management of the 1999 Program, the Population Department of the Ministry of Health has requested the Departments of Health of provinces and centrally-administered cities to cooperate in providing information on the number of health facilities in each district and city capable of providing prenatal screening services for all four congenital diseases and disorders included in the basic service package; including public and private health facilities (if any). Also requested is the number of health facilities in each district and city capable of providing neonatal screening services for all five congenital diseases and disorders included in the basic service package; including public and private health facilities (if any). For provinces and cities that have not yet implemented prenatal screening for all four congenital diseases and newborn screening for all five congenital diseases included in the basic service package as stipulated in Decision No. 3845/QD-BYT dated August 11, 2021, of the Minister of Health, a detailed report is requested: Specifically state the congenital diseases included in the basic service package that have not been screened prenatally or newbornly; the difficulties, obstacles, causes, and proposed solutions and measures to overcome them.

Dr. Nguyen Tien Nhut, Head of the Obstetrics and Gynecology Department at Lam Dong Hospital II, said: "All pregnant women who come for prenatal checkups at the hospital are advised and undergo blood screening from the first three months of pregnancy. Based on the results of peripheral blood cell tests, we filter out pregnant women with the highest risk factors, especially anemia and suspected thalassemia. These pregnant women will be advised to have their husbands (the fathers of the babies) screened. If the husband shows signs of anemia or is suspected of having thalassemia, these couples will be advised to go to a specialized hematology center for more specific screening and diagnosis. At Lam Dong Hospital II, screening for thalassemia faces difficulties such as: pregnant women lacking sufficient knowledge about the disease; and thalassemia diagnosis requires in-depth genetic testing, which the hospital currently cannot perform, only screening pregnant women at risk." "The results were high, and then they advised and guided patients to more specialized centers. Therefore, we propose that the clinic supplement its image-based educational materials to raise awareness among pregnant women; and implement non-invasive prenatal screening, including genetic testing. Lam Dong Hospital II has already provided free newborn screening using heel prick blood samples, screening for 5 metabolic-related diseases."

The purpose of screening is to help couples have healthy children who are capable of developing well both physically and mentally. It avoids the economic burden on families and society of raising children with illnesses or congenital defects that are currently untreatable by modern medicine.

Prenatal screening involves ultrasound examinations of the fetus and blood tests performed on the mother while the fetus is still in the womb to determine if the fetus is normal. The purpose of prenatal screening is to detect early signs of disease in the fetus while it is still in the womb, allowing for timely intervention or the decision to terminate the pregnancy for fetuses with genetic diseases or congenital defects that cannot be treated by medicine.

Newborn screening (after birth) involves ultrasound and blood tests on newborns to determine if they have any diseases or are otherwise healthy. The purpose of newborn screening is to detect early signs of endocrine, metabolic, or genetic disorders in newborns, allowing for timely treatment so that they can develop normally physically and mentally later in life.

Prenatal screening criteria and timing: Pregnant women with any of the following history have a very high risk of giving birth to a child with birth defects or genetic disorders: Miscarriage in previous pregnancies; stillbirth in previous pregnancies; previous birth of a child with birth defects or genetic disorders such as Down syndrome, Edward syndrome, etc.; family history of birth defects or genetic disorders; previous and current exposure to toxic substances (herbicides, pesticides, smoking, radiation, influenza during pregnancy, etc.); older pregnant women (over 35 years old), husbands over 55 years old; husbands exposed to toxic substances (radiation, toxic chemicals). In addition to high-risk pregnant women, those with lower risk should also participate in screening, as low risk does not mean the absence of such diseases. Statistics show that birth defects account for 3% of children.

Timing for prenatal screening tests: Fetal ultrasound, ideally between weeks 11 and 14. If the nuchal translucency of the fetus is greater than 3 mm, further maternal blood biochemistry tests should be performed; if there are any suspected symptoms, chorionic villus biopsy or amniocentesis should be performed for confirmation (at week 16).

Newborn screening schedule: All newborns aged 36-48 hours need two drops of blood taken from their heel for screening. For premature babies, blood samples are taken seven days after birth. The blood samples are collected by hospital medical staff. After collection, the samples are sent to Tu Du Hospital for testing. If the child is found to be ill, the hospital will inform the family of the results and guide them to seek treatment early, within the second week. Children who receive early treatment will develop normally like other children.

Source: https://baolamdong.vn/xa-hoi/202504/gop-phan-nang-cao-chat-luong-dan-so-b806bae/