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Pre-Marital Screening

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Pre-Marital Screening

What is pre-marital screening? For couples considering marriage, pre-marital screening helps to identify potential health risks for both themselves and also their offsprings. Couples are tested for infectious, blood-transmitted and genetic diseases, the latter being especially important in consanguineous marriages (marrying a blood relative), since these couples run the risk of having children with genetic birth defects such as Down’s syndrome etc. 

Importance of pre-marital screening:

Even if you or your partner have never experienced any health problems in the past, you may be a silent carrier of an infectious or hereditary disease, which, if expressed, could affect your children once you choose to conceive. The importance of pre-marital testing is to:

  • Asses your general health status.
  • Check for hereditary conditions that may affect future offspring e.g. Thalassaemia (blood disorder that affects haemoglobin).
  • Check if either of you could be a carrier of a genetic disorder.
  • Detect infectious diseases e.g. HIV and Hepatitis B infection.
  • Screen for any potential infertility issues.

A routine blood test can reveal such conditions so that necessary precautions or treatments can be initiated.

Why is pre-marital screening required? Nowadays premarital testing is considered an important issue as a result of the increasing number of children affected with genetic or blood transmitted diseases. Hereditary blood diseases, especially sickle cell disease and Thalassemia,are particularly prevalent in the Arab World and cause great suffering in children.

In Jordan, the Ministry of Health made premarital testing mandatory in 2004. Couples need a Ministry of Health clinicto certify the results of their premarital screening, whichis then submitted to the court to proceed with the wedding.

Premarital screening is mainly aimed at reducing the number of children with inherited diseases. It is particularly beneficial for couples ina consanguineous marriageor if either or both parties have a family history of a serious genetic condition.

What tests make up a pre-marital screen?

The standard tests that are required as part of pre-marital screening include:

  1. Complete Blood Count & blood film.
  2. Blood group.
  3. HB electrophoresis (for Thalassemia trait).
  4. Hepatitis B surface Antigen.
  5. Rubella IgG (females only) - confirms the presence of adequate immunity against the rubella virus.

Further optional tests that many couples choose to add as an extra precaution include:

  1. HIV.
  2. Syphilis.
  3. Chlamydia.
  4. Seminal fluid analysis.
  5. Fertility hormones.

The case for Jordan and the Arab World: Available evidence suggests that congenital and genetic disorders are responsible for a major proportion of infant mortality, morbidity and handicap in Arab countries.

Certain disorders are common throughout the Arab world such as haemoglobinopathies, G6PD deficiency, different congenital malformations caused by recessive genes and several metabolic disorders

Latest statistics suggest that about 4% of the Jordanian population are carriers of the Thalassemia gene (a carrier may exhibit no symptoms at all or just mild anaemia, however if two carriers marry, the chance of conceiving a child with the full disease is significant. Children born with Thalassemia Majorcannot survive without regular blood transfusions.).

Carriers can be detected using routine blood tests. When screening is performed as recommended, over 96% of couples carrying a haemoglobin disorder can be detected and informed of their risk and options before they have children. 

Contributed by MedLabs

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