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Early detection tests in Germany: Prenatal care

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In Germany, there are a lot of child healthcare tests covered by the insurance companies. Which prenatal care examinations are recommended and when? 

What does the health insurance in Germany pay? What kind of provision makes sense, but has to be paid for privately? Below are the most important prenatal care examinations that you need to be aware of if you are expecting a child.

prenatal care in germany

Prenatal Care: 1-3 Month of pregnancy

Who / When:  

Women in the 1st-3rd Month of pregnancy

Examination:

Ultrasound is used to check the child’s position and heart activity, and determine its age (basic examinations). In addition, there are various laboratory tests, such as determining the hemoglobin value, tests for syphilis, syphilis, chlamydia, HIV and rubella antibodies as well as the determination of blood group, rhesus factor and antibody search test. A

ll of these are fundamental examinations for pregnant women, the results of which are then documented in the maternity record. Optionally, a toxoplasmosis test, test for cytomegalovirus (CMV) and first trimester screening or aneuploidy test can be done.

Is it sensible?

All basic examinations are recommended to ensure a healthy development of the child. Toxoplasmosis or CMV tests seem useful in suspected cases, as an infection can cause serious harm to the child. 

First-trimester screening or aneuploidy tests are intended to detect chromosomal disorders, especially trisomy 21 (Down’s syndrome), at an early stage – the tests, however, have gaps: For further clarification, further examinations are necessary, such as an amniotic fluid puncture, which is associated with a certain risk. We recommend an individual consultation with a gynecologist beforehand.

What are the costs?

The health insurance companies cover all costs for the basic basic and laboratory tests. Toxoplasmosis and CMV tests can be covered by health insurances if there is justified suspicion, otherwise it is IGel benefits of around 15 euros each. The costs for a first trimester screening or an aneuploidy test have to be paid by yourself and are between 150 and 250 euros.

prenatal care in germany

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Prenatal Care: 4th-6th Month of pregnancy

Who / When:  

Women in the 4th-6th Month of pregnancy

Examination

A second basic ultrasound checks the child’s development for abnormalities. The child is measured, the action of the heart is observed, and the amount of amniotic fluid and placental position are assessed. The child’s organs can also be systematically morphologically examined in the “extended basic ultrasound”. In addition, a triple test to detect Down syndrome or neural tube defects and a 3D / 4D ultrasound to detect organic anomalies can be done.

Is it sensible?

Examination of the amount of amniotic fluid and placental position are useful in order to be able to assess whether, for example, the kidneys or the gastrointestinal tract of the child are functioning properly. 

The extended basic ultrasound is also recommended, as it allows malformations to be detected more quickly, so that doctors can treat the child early in the womb or immediately after birth – for example in the case of heart defects that occur relatively frequently.

The triple test is not very accurate and can give false positive results that can be psychologically stressful. For further clarification, examinations such as an amniotic fluid puncture are necessary, which is associated with a certain risk. We recommend an individual consultation with a gynecologist beforehand. 3D / 4D ultrasound is primarily recommended if there is a justified suspicion of organic anomalies.

What are the costs?

The costs for basic or extended ultrasound are covered by the health insurance companies. Some health insurances subsidize or pay for the triple test, otherwise it costs between 50 and 100 euros. Statutory health insurance companies usually only pay for 3D / 4D ultrasound screening if there is a medical reason for it. If parents-to-be only want souvenir photos, they have to pay themselves – depending on the price (including film, CD, etc.) between 45 and 150 euros.

prenatal care in germany

Prenatal Care: 7th-9th Month of pregnancy

Who / When:

Women in the 7th-9th Month of pregnancy

Examination:

In addition to the third basic ultrasound, diabetes screening can be used to examine whether the pregnancy has any effects on the mother’s sugar metabolism. After drinking sugar solution, the blood sugar level is measured in the blood. 

If this is noticeable, a second test may be necessary, followed by therapy to minimize the risks for the child’s development or the birth. 

In addition, there is a second antibody search test: If no antibodies can be detected and the Rhesus factor of the pregnant woman is negative, a test between the 28th and 30th Week of pregnancy with a so-called anti-D prophylaxis. This prevents sensitization of the body and thus complications in a subsequent pregnancy. In addition, a hepatitis B test is done: if this is positive, the child is vaccinated actively and passively after birth. 

The cardiotocography (CTG) procedure is used to record the child’s heart rate and contractions. In addition to these basic examinations, a vaginal swab can be used to test for beta streptococci. If the test is positive, an antibiotic can be given during the birth to protect the baby from infection as much as possible. 

Contagion can have dire consequences, such as blood poisoning or meningitis. Another additional examination is a blood test for thyroid function. In addition to these basic examinations, a vaginal swab can be used to test for beta streptococci. If the test is positive, an antibiotic can be given during the birth to protect the baby from infection as much as possible. 

Is is sensible?

Recommended, because the basic examinations can minimize complications during pregnancy and childbirth. The German Society for Endocrinology recommends the thyroid test (TSH test) to pregnant women: a malfunction of the thyroid increases the risk of a miscarriage and a developmental disorder of the child. The German Society for Gynecology and Obstetrics recommends that all pregnant women have the beta streptococcal smear taken, although this does not provide 100 percent valid results.

What are the costs?

The basic examinations are cash benefits. The health insurance company usually only pays for the TSH test if the doctor deems it medically necessary – for example if there are signs of a malfunction. Otherwise, the test costs between 17 and 21 euros. Some health insurances subsidize or take over the beta streptococcal test. As an IGel, it costs between 10 and 30 euros.

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