Routine blood tests in pregnancy give the following information:

  • Hemoglobin (Hb) and platelet level (Plt) (blood cells that carry oxygen and stop bleeding)
    • Hb is required for carrying oxygen from the lungs to the whole body as well as the baby. Hb is the component that make blood appear red. Iron is required to make Hb. Iron supplementation helps treat a low Hb. Pre delivery Hb needs to be maintained > 10.5 in preparation for the bleeding after.
    • Plt is a cellular component of blood that plugs holes in vessels and stops bleeding. This helps stops the bleeding after delivery. Plt level falls gradually in pregnancy but rarely to extreme levels. The lower limit of Plt in pregnancy is 100×106. 1% of women have a condition with extremely low Plt. Those with rapidly declining Plt require regular testing.
  • Blood group and Rhesus typing
    • Group: there are 4 blood groups: A,B,AB and O. Knowing the blood group is necessary in pregnancy as 1 in 500 deliveries will require blood transfusion for excessive bleeding. The blood test package includes a free blood group card. This should be carried at all times in case of any emergency.
    • Rhesus (Rh) D: This is a subtype of red cells. Most of us are Rh-D Positive. Up to 5% are Rh negative. In some countries this can be as high as 15%. Moms with Rh Negative blood can sometimes have a reaction towards the Rh Positive blood of the baby they are carrying (depending on the blood type of the father). This potentially life threatening condition of the baby is preventable by knowing your status. Further testing is required if you are Rh Negative.
  • Red cell antibodies
    • 1% of moms carry rare antibodies against blood cells that may harm the baby’s. This is potentially life threatening for the baby.
    • Knowing this help saves baby’s lives.
    • Rarely in-utero blood transfusion is necessary lifesaving procedure. (transfusing blood to the baby in the womb)
  • Indirect diabetes screening: HbA1c levels in the blood tell the tale of recent glucose control. The sugar drink test is only recommended if this is high.
  • Thyroid screening: 1% of women have low or high thyroid hormone levels. Abnormal thyroid hormone levels has negative impacts on pregnancy. Aseana endorses its routine testing in pregnancy.
  • Infection screen:
    • Hepatitis B: This is one of the most common chronic viral infections. If a mom is positive the transmission to baby can be as high as 98%. Once diagnosed, preventive measures bring the transmission rate down to 1%.
    • Syphilis: This is one of the most common sexually transmitted infections. And it is treatable, preventing baby getting it as well. Syphilis infection in the baby usually targets the baby’s brain and nerves. It Is best avoided.
    • HIV: This has no known cure. Treatment can lower the viral leves in the body and prolong life. Moms can transmit it to babies. Preventive measures bring the transmission down to as low as 1%.

Based on your risk profile – other tests may be advised to be added on to this panel.
This panel is the current standard as recommended in the US and EU.

Down Syndrome Testing – Scans and Blood tests

There are standard program and tests for genetic and structural problems. Tests are divided into screening and diagnostic. Screening tests are imperfect with less than 100% detection and small error margins (falsely negative OR falsely positive). Screening tests only involve scans and mom’s blood sampled and has no risk to the baby. Diagnostic test is confirmatory. Diagnostic testing is recommended once the screening is positive (HIGH RISK). Diagnostic tests require invasive sampling and carry a small pregnancy loss risk.

  • Down Syndrome Screening Tests
    • Ultrasound Risk Calculation (week 11-14) – 1st trimester detailed genetic scan (Nt Scan)
      • 90% detection
      • No bleed tests necessary
      • Instant calculation and reporting – Aseana is an accredited centre.
      • RM 250
      • Aseana is accredited by the FMF-UK for NT scans.
    • Combined Ultrasound-Blood Risk Calculation – The FTS (week 11-14)
      • 95% detection
      • 5 days for return of results. (calculated by lab)
    • RM 550Cell-free Fetal DNA – commonly known as NIPT (depending on labs)
      • 99.99% detection rate
      • 10 days for return of results
      • RM 1500
      • Can be done from week 10
      • REsource link: video x3 and leaflet in 3 languages
  • Down Syndrome DIagnostic Tests
    • Karyotype
      • Confirmatory
      • Rarely associated with culture failure
      • 2 weeks for return of result
    • PCR
      • Rapid test
      • 3 days for return of result
  • Structural Assessment – see scan section.

Diagnostic Genetic Testing
Diagnostic testing is required when:

  1. The DS risk calculation indicates HIGH RISK
  2. Fetal abnormality detected on ultrasound
  3. Parents are carriers of genetic conditions

Diagnostic testing is invasive as tissue sample is required from the placenta or amniotic fluid and rarely baby’s blood. The testing is considered invasive because they are ultrasound guided needle based sampling. Chorionic villous sampling (CVS) is medical term for biopsy of the placenta which has almost the same genetic make-up as the baby. Amniocentesis is sampling of the amniotic fluid which contain fetal skin cells. Diagnostic procedures carry with them a small pregnancy loss rate. The following arethe common procedures to obtain tissue samples for diagnostic testing:

  1. CVS –  video box – youtube link
    1. Can be done from the 10th week of pregnancy
    2. RM 750 (Consultation and procedure)
  2. Amniocentesis – video box – youtube link
    1. Performed from the 15th week onwards
    2. RM 750 (Consultation and procedure)
  3. Fetal Blood Sampling
    1. Performed from the 16th week onwards
    2. Occasionnally necessary
    3. RM 1500 (Consultation and procedure

Diagnostic Tests
Placental biopsy, amniotic fluid and fetal blood contain genetic material for tests. There are various tests commonly used. Each test has a differing resolution of analysis.

Graphic here:

Test % yield Cost
Karyotype 20% RM 1500
PCR For DS rapid only RM 600
WES (exome sequencing) 37% RM 3000 (Parental analysis costing RM 1000 each may be necessary in 4%)
Focused Testing Only when defect is known / suspected RM 1500
WGS (whole genome) 8%
Used in specific cases only		 RM 15000
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Scans

Tests  Lab Costs
(Procedure and scan costs are not included in the listing – where applicable.)		 
Routine Pregnancy Tests - BasicAs Per KKIARM100Make Appointment
Routine Pregnancy Tests Package - ComprehensiveAvoid the early pregnancy sugar drink test with this package.

This test is only done once in pregnancy.		1. Hemoglobin and platelet level (blood cells that carry oxygen and stop bleeding)
2. Blood group and Rhesus typing
3. Red cell antibodies
4. Indirect diabetes screening
5. Thyroid screening
6. Infection screen:
a. Hepatitis B
b. Syphilis
c. HIV
(EU and UK comprehensive)
RM285Make Appointment
Down Syndrome – Scan Only Risk Calculation (uFTS)This is a screening test providing calculated risk. There is a 10% false negative and 5% false positive rate. Diagnostic testing is advised if this test return a high calculated risk. (> 1 in 250)Week 11-14 FTScan Required
1. 88% detection
2. No bleed tests necessary
3. Instant calculation – Aseana is an accredited centre.		RM100Make Appointment
Down Syndrome – Combined Ultrasound+blood  FTS (cFTS)This is a screening test providing calculated risk. There is a 5% false negative and 5% false positive rate. Diagnostic testing is advised if this test return a high calculated risk. (> 1 in 250)Week 11-14 FTScan Required
1. 95% detection
2. 3 working days for return of results. (calculated by lab)
3. RM 550		RM300Make Appointment
High Risk Pregnancy AssessmentWeek 11-14 FTScan RequiredRM300Make Appointment
Combined uFTS + blood(RM 100 if add on to cFTS)Make Appointment
Down Syndrome: NICC
99.5% detection		M’sia-Hong Kong Collaboration (BGI)10th week onwards
10 working days		RM1,500Make Appointment
Down Syndrome: NIPT Panorama (US)
99.99% detection		Panorama by Natera (U.S)9th week onwardsRM1,800Make Appointment
Preterm Birth Predictor KitExam + Swab KitIdeal 15-20 weeks – see package section.
Pre travel / Event		RM120Make Appointment

Diagnostic Genetic Testing (after invasive sampling)

TestsDescription Cost 
KaryotypeThe basic genetic test20% yield
2 weeks Turn around		RM1,500Make Appointment
PCRRapid Down Syndrome Test
3 days Turn around		RM600Make Appointment
MicroarrayHigher resolution analysis
2 weeks Turn around		25% yieldRM2,500Make Appointment
WESAdvanced High Resolution Exome sequencing
8 weeks Turn around		35% yield
Including Parental analysis		RM3,000Make Appointment
Focused TestingTargeted testing4 weeks Turn aroundRM1,500Make Appointment

Packages

(Inclusive of Counseling, Scan,Testing and Report) - See Packages section for details

TestsDescription Cost (Inclusive of all listed in description.) 
Pregnancy Booking - Basic- Basic Assessment
- Scan
- Labs - Basic
- Report		Background Risk assessment and Check up.
Early Pregnancy Scan.
Pregnancy Basic Lab Test (KKIA model)
Counseling: Pregnancy General Careplan		RM300Make Appointment
Pregnancy Booking - Comprehensive- Basic Assessment
- Scan
- Labs - Basic
- Report		Background Risk assessment and Check up.
Early Pregnancy Scan.
Pregnancy comprehensive blood test.
Counseling:
1. Fetal anomaly
2. Down Syndrome
3. Pregnancy RIsk Assessment
4. Preterm birth
5. Diet and lifestyle
6. Supplements
RM550Make Appointment
Preterm Screening Package - Basic
(Scan and Swab testing)
Week 16-20		Scan and Urine and Vaginal SwabCervical length
Urine test
Vaginal Swab
- Culture
- Vaginosis (BV)
Detailed prevention counselling.

Repeat scan 1 month		RM395Make Appointment
Preterm Screening Package - Comprehensive
(Scan and Swab testing)
Week 16-20		Scan and Urine and Vaginal SwabCervical length
Urine test
Vaginal Swab
- Culture
- Vaginosis (BV)
- STD screen
Detailed prevention counselling.

Repeat scan 1 month		RM850Make Appointment
Stillbirth Assessment - Assessment
- Scan
- Labs		RM 1700 – Previous Stillbirth
RM 4720 – Current stillbirth
(Includes genetic testing of baby sample.)		Make Appointment
Miscarriage Assessment- Assessment
- Scan
- Labs
- Report		RM 2500 – Previous Miscarriage

RM – 4720 – Current Miscarriage
(Includes genetic testing of miscarriage sample.)		Make Appointment
Pre-Pregnancy Assessment

Know your pregnancy risks before pregnancy. Prevent complications and optimize your pregnancy outcome.		- Assessment
- Scan
- Labs
- Report		RM 3500 Comprehensive
Basic + intermediate + comprehensive genetic career status in Couple

RM 1500 Intermediate
Basic + genetic carrier status of basic conditions in couple, gynae check up, sperm check. Infectious screen and more.

RM 750 Basic
Routine gynae scan, pap smear, pregnancy blood set, medical consult
Make Appointment
Pre Marital Check- Assessment
- Scan
- Labs
- Report		RM 3500 Comprehensive
Basic + intermediate + comprehensive genetic career status in Couple (Horizon)

RM 1500 Intermediate
Basic + basic genetic carrier status of basic conditions in couple and STD check.

RM 455 Basic
Routine gynae scan, pap smear, pregnancy blood set, medical consult		Make Appointment
Routine Check Up Scan & Pap Smear- Assessment
- Scan
- Labs
- Report		RM 555
Consult, Scan and comprehensive Pap smear labs

RM 360
Risk Consult, scan and basic pap smear labs		Make Appointment
Pap Smear OnlyRM 148
Basic Lab (LBC)		Make Appointment
Pap Smear OnlyRM 337
Comprehensive (LBC + HPV)		Make Appointment

Published rates may be subject to reviews depending on foreign currency exchange rate and provider’s policy. Call HQ for confirmation.

Paternity testing – call HQ for consultation.

Female staff available for pap smears – depending on MCO status – please check with HQ for availability.