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MoonDragon's Pregnancy Information
PREGNANCY SCREENING & LABORATORY TESTS




Pregnancy is the period of time when a fetus develops inside a woman's uterus and ends with the birth of the infant. There are a variety of clinical laboratory tests related to pregnancy, from the time pregnancy is first considered through the initial days of the newborn's life. The following are tests likely to be performed. The purpose of these tests is either to diagnose existing problems or screen for potential problems. Once the baby is born, the testing performed will provide information essential for a healthy start in the baby's life.




PRE-CONCEPTION (PRE-PREGNANCY)

When considering having a child, it is important to be aware of those tests now available to provide information that may impact the decision. Consulting with a health care professional is a good idea. Based on family and medical histories, the health care professional may recommend key laboratory tests, if the prospective mother has not been tested previously. The most common tests that may be suggested are:

RUBELLA IMMUNITY TESTING

Rubella (German Measles) immunity testing is important. Rubella is a contagious disease that is caused by a virus. It is also called German measles or three-day measles. But do not confuse rubella with measles, which is sometimes called rubeola. The two diseases have similar features, including a red rash, but they are caused by different viruses. Rubella is caused by a virus that can be found in the nose and throat secretions, such as saliva, sputum, or nasal mucus, of infected people. You can spread the virus to others (person-to-person) by coughs or sneezes. Any contact with the nasal or throat secretions of an infected person can spread the virus. Women, who have either had the Rubella infection or have received the vaccination, produce an antibody (protein made in response to a foreign substance introduced into the body) in their blood that will usually prevent them from getting the infection a second time. This antibody also protects the unborn baby against the virus; this protection is called immunity.

Rubella infections during childhood usually cause mild and few noticeable symptoms. They may have a fever and a sore throat. Adults are more likely to have a headache, pink eye, and general discomfort 1 to 5 days before the rash appears. Adults also tend to have more complications, including sore, swollen joints and, less commonly, arthritis, especially in women. A brain infection called encephalitis is a rare but serious complication that can affect adults with rubella. However, the most serious consequence from rubella infection is the harm it can cause a pregnant woman's baby. If a woman becomes infected with Rubella during the first three months of her pregnancy and does not have immunity to the virus, the baby is at risk of having serious birth defects or dying.

Pregnant women who get infected with rubella virus also expose their babies. This can cause serious birth defects such as heart problems, hearing and vision loss, intellectual disability, and liver or spleen damage. Serious birth defects are more common if a woman is infected early in her pregnancy, especially in the first 12 weeks. Getting rubella infection during pregnancy can also cause a miscarriage or premature delivery. However, pregnant women should not get the rubella vaccine. Non-immune pregnant women should wait to get vaccinated after they have given birth. Meanwhile, non-immune, unvaccinated pregnant women must pay careful attention during their pregnancy to avoid contact with any potentially rubella infected person (child or adult) or anyone that may have been exposed to the rubella virus.

All women considering a first time pregnancy, or those who are pregnant for the first time, should be tested to see if they have this immunity. A blood specimen is tested to see if a sufficient amount of antibody is present in the blood to protect the mother and the baby. This is called an antibody titer. If a non-pregnant woman does not have enough antibodies and is not immune, she may be given a Rubella vaccination, which will cause her to produce these protective antibodies. Allow at least four weeks or more before getting pregnant. The CDC recommends non-immune children should also be vaccinated on time to prevent rubella from spreading to pregnant women. Some debate has occurred as to whether or not the vaccine will provide the long lasting (life-time) immunity to the virus and whether or not booster vaccinations are required years later. Since the infection is usually mild in children, some parents prefer to expose their non-immune children to rubella-infected children to develop the lifelong immunity that occurs when you actually have an active case of rubella. Do research on vaccinations and make informed choices.

MMR Vaccine: Prevents Rubella Disease and Birth Defects

Rubella vaccine is included in the MMR vaccine, which is a combination vaccine that protects you against measles, mumps, and rubella. MMR vaccine is safe and effective and has been widely used in the United States for over 20 years. In the United States, 2 doses are recommended for children:
  • The first dose at 12 through 15 months old.
  • The second dose, before entering school, at 4 through 6 years old.

In 2004, a second combination vaccine, MMRV (measles, mumps, rubella, and varicella) was licensed. Your child's health care provider can help you choose between getting the MMR vaccine and the varicella (chickenpox) vaccine separately or the combination MMRV vaccine. According to conventional medical approach, vaccinating your child on time is the best way to protect them and others, including pregnant women and their babies, from rubella infection.

MMR Vaccine for Adults: The Responsible Choice

Rubella was declared eliminated from the United States in 2004. However, rubella is still common in other countries. The virus can be brought into the United States at any time by visitors who have rubella. Also, unvaccinated U.S. residents traveling to these countries can become infected and unknowingly bring the disease back home with them. Anyone born during or after 1957 who has not had rubella or been vaccinated against the disease should get at least one dose of MMR vaccine. If you are not sure if you are protected against rubella, ask your health care provider to test your blood to see if you are immune to the disease. MMR vaccine protects you and those around you from getting infected, and it can protect pregnant women and their babies from serious birth defects and death.

MoonDragon's Lab Test Information: Rubella Antibody Titer
MoonDragon's Health & Wellness: Rubella

HIV TESTING

HIV is the virus that causes AIDS (Acquired Immunodeficiency Syndrome). At least 90 to 95 percent of individuals who are infected with the HIV virus will, within three months of exposure, develop enough antibodies to have a positive HIV test; over 99 percent of HIV infected individuals will have a positive test within six months. If the woman has the virus, it can be passed to, and infect the baby. People who have high rish activity such as drug use and/or unprotected sexual encounters with another person, whether one or many, should periodically be tested. Although you may know you are not infected and do not have high risk activity and be in a monogamous relationship, does not mean your partner is safe unless they have been tested at least twice, 6 months to a year between tests and have had no other sexual partners but you. It is good to have your "non-infected" lab paperwork available before you initiate a new sexual encounter with someone and request the same from them. If you or your partner have multiple sexual partners or participate in other risky activity, you should continue to be tested at least yearly, or more frequently, if needed.

The HIV test detects antibodies to HIV in the blood. Although, a positive test HIV could mean a woman may be infected with HIV, the test may be positive for other reasons. The laboratory will automatically perform additional testing to determine conclusively if there is HIV infection. If the confirmatory tests indicates HIV infection, it does not mean the individual has AIDS. A health care provider can discuss this further.

A negative test for the antibody to HIV means either there is no infection, or a sufficient amount of the antibody has not yet been produced to be detected. If a woman participates in high risk activities that may transmit HIV, such as unprotected sexual contact or intravenous drug use, it is recommended that she be retested later.

MoonDragon's Lab Test Information: HIV Antibody Test
MoonDragon's Health & Wellness: HIV & AIDS
MoonDragon's Health & Wellness: HIV/AIDS Additional Treatment Information
MoonDragon's Health & Wellness: HIV/AIDS Nutritional Recommendations
MoonDragon's Health & Wellness: HIV/AIDS & Women
MoonDragon's ObGyn Information: HIV & AIDS

HEPATITIS B SCREENING

Infection with the Hepatitis B virus causes an inflammation of the liver. If left untreated, this disease can develop into liver cancer or cause death. It is recommended that a woman who is thinking of becoming pregnant, or who is already pregnant, have a simple blood test for the Hepatitis B virus. If the disease is detected before pregnancy, the woman can be treated so that a future baby is not at risk for infection. If already pregnant when the infection is detected, treatment should start, and the baby would receive treatment at birth to make sure the disease does not develop. A negative test for the virus means either there is no current infection, or there is not yet a sufficient amount of the marker to be detected. If a woman participates in high risk activities that may transmit the Hepatitis B virus, such as unprotected sexual contact or intravenous drug use, it is recommended that she be retested later.

MoonDragon's Lab Test Information: Hepatitis B Viral Test
MoonDragon's Lab Test Information: Hepatitis C Viral Test

HEMOGLOBIN TEST

Hemoglobin is the protein in red blood cells (RBCs) that gives blood its red color. Its most important function is to carry oxygen from your lungs to the rest of your body. Hemoglobin is vital to life, and must remain at a healthy level for your organs to function properly. During pregnancy, the hemoglobin in a pregnant woman's rbcs carries oxygen throughout her body, and also provides oxygen to her unborn baby. Anemia is a condition where the amount of hemoglobin in the blood is too low to supply sufficient oxygen to the body. Mild anemia can make you feel tired and weak while severe anemia may cause you to become unconscious. Anemia in a pregnant mother can cause a fetus to receive too little oxygen to support normal development. To prevent these problems, the hemoglobin level of a woman's blood should be monitored frequently before and during pregnancy. Iron deficiency is the most common cause of anemia, but vitamin deficiency, kidney disease, inherited hemoglobin disorders and other illnesses also cause anemia. It is also possible to have a higher than normal hemoglobin level. This is usually caused by dehydration, but may also result from a variety of diseases. Treatment for the unexpected hemoglobin level will depend upon the medical cause of the problem.

MoonDragon's Lab Test Information: Hemoglobin Test #1 - Talquist Method
MoonDragon's Lab Test Information: Hemoglobin Test #2 - Hemoglobinometer
MoonDragon's Lab Test Information: Hemoglobin Deterimination - Drabkin's Reagent
MoonDragon's Lab Test Information: Hematocrit

GENETIC SCREENING & TESTING

Certain conditions are found much more often in individuals of a particular ethnic background than in the general population. Pre-conception testing of prospective parents can help predict the chances of their baby developing these diseases. Based on the ethnic background of the prospective parents, the option to have specific testing may be discussed. In the event that potential problems are identified by genetic tests, a health care provider or genetic counselor will be able to discuss the possible risks to their children.

MoonDragon's ObGyn Procedures: Genetic Screening

Your health care provider may offer you the option of genetic testing. A basic knowledge of genetics will help you understand the value of these tests.

For every trait, (eye or hair color, height, etc.), a child inherits from each parent a ĒpackageĒ of information, called a gene. Genes are grouped together as chromosomes; humans have 23 pairs, each parent gives the child one of each of the 23 pairs of chromosomes. Since a person inherits two genes (one from each parent) for each trait, the resulting appearance from these genes is either due to a combination of the two genes, or to one gene being more dominant than the other. Whereas, in some genetic conditions symptoms of a disorder may occur when there is only one abnormal gene, other genetic diseases may only show symptoms when there are two abnormal genes. If an individual has one abnormal gene, but does not display symptoms, the individual is referred to as a carrier. Most genetic conditions described in this informational pamphlet require that a child inherit two abnormal genes for a disease to show symptoms.

Genetic testing may also determine if there are chromosomal disorders. Chromosomal disorders refer to conditions where there is either an extra or a missing piece of the chromosome, as is seen in Down syndrome. Chromosomal disorders may or may not be an inherited condition.

  • Genetic Hemoglobin Disorders: Hemoglobinopathies & Thalessemias: Each person inherits genes that make hemoglobin from both of their parents. Some individuals inherit abnormal genes that can cause hemoglobin disorders. In diseases called thalassemias, the hemoglobin genes make normal hemoglobin but not enough to supply the body with sufficient oxygen. Inheriting one or more thalassemia genes from one or both parents can cause mild to severe anemia. In diseases called hemoglobinopathies, the hemoglobin genes make abnormal hemoglobins that may not function like normal hemoglobin. Unlike the thalassemias, usually two abnormal genes must be inherited to cause disease. The best known example is Sickle Cell Disease, a serious hemoglobinopathy that causes anemia, susceptibility to infection, and organ damage in infants who inherit a gene for sickle hemoglobin from each parent. Carriers of the sickle cell disease (have inherited only one sickle hemoglobin gene) do not get the disease, but can pass their abnormal gene onto their children. If a carrier of the disease has a child with another carrier, their child is at risk for inheriting the sickle cell gene from each parent and having the disease.

    Unless carriers of genetic hemoglobin disorders are identified prior to conception, they may not know that they can have a child with the disease. The decision to test for abnormal hemoglobins is usually based on the heritage of the parents. For example, Sickle Cell Disease is most common in people of African heritage. Thalassemias are most common in people of Mediterranean, African, or Asian descent. Medical and family histories that reveal other family members have a hemoglobin disease, or are known to be carriers, are reasons genetic testing should be considered.

    MoonDragon's Anemia Information: Sickle Cell Anemia
    MoonDragon's Anemia Information: Sickle Cell Anemia - Neonatal Screening
    MoonDragon's Anemia Information: Sickle Cell Anemia - Pregnancy & Contraception
    MoonDragon's Anemia Information: Sickle Cell Anemia - Prenatal Diagnosis
    MoonDragon's Anemia Information: Thalassemia

  • Tay-Sachs, Gaucher, & Canavan Disease: Individuals of Ashkinazi (East European) Jewish descent are at increased risk for inheriting Tay-Sachs, Gaucher, and Canavan diseases. These genetic diseases can occur when both parents give an abnormal gene that causes the disease in the child.

  • In both Tay-Sachs and Canavan diseases there is a buildup of a substance in the childís brain that prevents normal development. There is no known cure for either disease. Children with Tay-Sachs rarely live past five years of age; children with Canavan disease may live to early adolescence. There are three types of Gaucher disease, each causing too much fatty substance to be stored in the bone marrow, spleen and liver. Although one type of Gaucher disease is fatal, the most common type is not. Treatments are available for individuals with Gaucher disease.

    Jewish women of East European descent may want to consider being tested for the abnormal genes that cause these diseases and to assess the risk of her child being affected. If the woman does not have the gene for any of these diseases, the baby will not have the disease. However, if the woman has inherited the gene, the father also should be tested. If both parents have the same disease gene, the baby is at risk of having the disease. A genetic counselor will be able to provide additional information to make an educated decision about the risk of having a child born with the disease.

  • Cystic Fibrosis: Cystic Fibrosis is an inherited disorder that affects a personís ability to breath, digest food, and have children. This disease occurs most frequently in families of Northern European Caucasian descent. At present, there is no known cure, but new treatments are increasing the life expectancy of Cystic Fibrosis patients.

  • Like many inherited conditions, an individual may be a carrier of the abnormal gene for this disease, but not experience the symptoms. Laboratories are now able to perform complex testing to see if individuals without disease symptoms carry the Cystic Fibrosis gene. If the woman lacks this gene, the baby will not have the disease. However, if the both the mother and father carry the Cystic Fibrosis gene, the baby is at risk of having the disease. A genetic counselor will be able to provide additional information to make an educated decision about the risk of having a child born with Cystic Fibrosis.

    MoonDragon's Health & Wellness: Cystic Fibrosis (CF)

PAP TEST & PELVIC EXAMINATION

A Pap test is performed to screen the cervix (opening to the uterus) for cancer, pre-cancerous changes, inflammation and some sexually transmitted diseases. A health care provider gently scrapes the cervix to obtain cervical cells that are examined for the presence of abnormal cells. In the traditional Pap smear, cervical cells are spread (smeared) onto a glass slide by hand.

A newer technology called ThinPrepģ Pap Testô overcomes the potential problems of the Pap smear. A special laboratory instrument processes the specimen and thinly spreads the cervical cells onto a slide. This preparation allows the laboratory technologist to more clearly examine the cells.

Early detection of abnormal cervical cells, and early treatment (if necessary) offer the best chance to prevent the problem from become worse.

MoonDragon's Women's Health Procedures: Pap Smear - Pictorial Description
MoonDragon's Women's Health Procedures: Pelvic Exam - Pictorial Description
MoonDragon's Women's Health Procedures: Pelvic Exam & Pap Smear





FIRST TRIMESTER (UP TO 12 WEEKS)

If a pre-conception medical checkup was not done, at the time of the first prenatal visit, the health care provider may order the tests described in the Pre-conception section above, and also talk about other tests. These additional tests will be used to further evaluate the health and future medical care needs of the mother.

In addition to the tests listed in the Pre-conception section, the following tests may be offered:

PREGNANCY TEST

If pregnancy is only suspected, or if the pregnancy test was not performed through the health care provider, a pregnancy test may be requested. Approximately two weeks after conception, a Human Chorionic Gonadatropin (hCG) hormone is produced and can be detected by a test.

The most sensitive and informative pregnancy test is performed by a laboratory using a blood specimen. A negative blood pregnancy test indicates either there is no pregnancy, or the amount of hCG is not yet sufficient to be detected. If the test is positive, it confirms the pregnancy. The blood test not only detects the presence of this hormone (qualitative test), but also measures the amount that is present (quantitative test). The amount of hCG produced during pregnancy doubles every two to three days, and levels off in the second or third month. When the health care provider receives the results of a patient's positive pregnancy test, the amount of detected hCG is compared to what is expected for that week of gestation. A level of hCG lower than expected may be due to incorrect calculation of gestational age, or a problem in fetal development, which may lead to miscarriage. The test may be repeated, or an ultrasound done, to compare the size of the developing baby to the expected size for the gestation.

There are over-the-counter pregnancy tests that detect hCG in urine. These tests are more convenient than a visit to a health care provider. However, these tests do not measure the amount of hormone and cannot determine if the pregnancy is developing as expected.

MoonDragon's Pregnancy Information: Home Pregnancy Tests

GONORRHEA (GC), CHLAMYDIA & SYPHILIS

These are the three most common sexually transmitted diseases (STDs). These diseases are caused by bacterial infections and can lead to a miscarriage, or infect the baby prior to, or during delivery.

Pregnant women may be tested for these infections at the time of the first prenatal visit, and at additional times during the pregnancy if they engage in high risk activities, such as unprotected sexual contact. A positive test usually means the individual has been infected in the past or is currently infected. A negative test result usually means the woman is not currently infected, however, it is possible that an infection is too new to detect. Some states require a woman to have these tests repeated just prior to delivery so that appropriate treatment can be given to the baby immediately after birth.

MoonDragon's Women's Health Procedures: Vulva Lesions
MoonDragon's Women's Health Information: STDs - Chlamydia
MoonDragon's Lab Test Information: Chlamydia Trachomatis Testing
MoonDragon's Lab Test Information: Chlamydia Test & Pregnancy
MoonDragon's Women's Health Information: STDs - Gonorrhea
MoonDragon's Lab Test Information: Gonorrhea Testing
MoonDragon's Women's Health Information: STDs - Syphilis
MoonDragon's Lab Test Information: Syphilis Test

OTHER STDs

MoonDragon's Women's Health Information: STDs - Genital Herpes
MoonDragon's Women's Health Information: STDs - Genital Warts
MoonDragon's Women's Health Information: STDs - Trichomonal Vaginitis

BLOOD TYPING & ANTIBODY SCREEN

Blood types are either A, B, AB, or O, and Rh positive or negative. Both the mother and baby may experience problems if their blood types are different, or if the mother has antibodies that will react with factors on the babyís blood cells. The best know example is when an Rh-negative woman is pregnant with an Rh-positive baby. The womanís immune system can develop an antibody that reacts negatively with the Rh-positive factor on her babyís blood. Although it is unusual for her first Rh-positive baby to become ill, the antibodies produced during that first pregnancy may cause problems in a future pregnancy, if again, the baby would be Rh-positive.

To greatly reduce the likelihood that an Rh-negative mother will develop this antibody, she may be given a routine injection of Rh immune globulin (RhoGam) at approximately 28 weeks gestation. Additional injections may be necessary during the pregnancy if she has an amniocentesis, Chorionic Villi Sampling or an abdominal injury, and after delivery, if the baby is Rh-positive.

In addition to Rh-negative women who have had an Rh-positive baby, any woman who has had a blood transfusion or had prior pregnancies, may produce an antibody to blood factors, other than Rh, that can potentially harm an unborn baby. An antibody screen, during the first trimester, is ordered to determine if potentially harmful antibodies are already present in the motherís blood. If a harmful antibody is detected, the babyís father should be tested, if possible, to see if his blood reacts with the mother's antibody. If his blood reacts badly, so may the baby's. If there is a possibility that the antibody could react with the baby's, then it is advisable for the health care provider to monitor the mother's antibody level, and also, the progress of the baby for the duration of the pregnancy. Signs the baby is becoming ill may necessitate it receive treatment before birth (i.e., an intrauterine transfusion) or, require an early delivery.

Limitation of Antibody Screen: An antibody may be present but in an amount too low to be detected. The baby's blood may react with the antibody even if the test is negative.

MoonDragon's Pregnancy Information: Rh Isoimmunization (Erythroblastosis Fetalis)
MoonDragon's Pregnancy Information: RhoGam Question & Rh Isoimmunization
MoonDragon's Lab Test Information: ABO Blood Typing - EldonCard Method
MoonDragon's Lab Test Information: ABO-Rh Blood Typing & Incompatibilities

GLUCOSE & PROTEIN URINE SCREENING

At each prenatal visit, the expectant mother will be asked to give a urine specimen that will be screened for the presence of sugar and/or protein.

Although a small amount of sugar may normally be present in urine, high levels may be a sign of diabetes. A positive urine test for sugar will usually be followed by a confirmatory blood test. Approximately four percent of women with no prior history will develop diabetes during the later part of pregnancy. Diabetes during pregnancy is referred to as gestational diabetes. The condition does not continue following delivery; however, approximately fifty percent of women who have had gestational diabetes will later develop diabetes. A more extensive blood glucose test is routinely performed during the second trimester.

A special diet, insulin, or both may be needed to adjust the sugar level down to normal. If the diabetes is not controlled, the mother may develop pre-eclampsia. Pre-eclampsia, also called toxemia, usually does not occur until the second half of pregnancy. The symptoms include high blood pressure (hypertension), swelling that does not go away, infections, and large amounts of protein in the urine. Maternal high sugar levels can also cause abnormal growth and development of the unborn baby. Complications of high uncontrolled blood sugar may require the baby to be delivered prematurely.

Although small amounts of protein are normally present in the urine, high levels may indicate infection of the bladder and kidneys, which can lead to hypertension and pre-eclampsia.

MoonDragon's Pregnancy Information: Urinary Tract Infection (UTI) & Pregnancy
MoonDragon's Pregnancy Information: Toxemia (Preeclampsia & Eclampsia)
MoonDragon's Lab Test Information: Diabetes & Glucose Testing
MoonDragon's Women's Health Information: Pregnancy & Diabetes Mellitus, Pregestational
MoonDragon's Pregnancy Information: Gestational Diabetes Index & Links

URINE CULTURE & SENSITIVITY

Bacterial infections frequently cause symptoms that require the mother to seek treatment. It is common for pregnant women to have bacteria in their urine without symptoms.

If untreated, the bacteria can spread from the bladder to the kidneys. Decreased kidney function can result in pre-clampsia with associated problems affecting the unborn baby. If bacteria are found, antibiotics may be prescribed. After the antibiotic treatment has been completed, a new urine specimen may be needed to confirm the bacteria are no longer present.

Limitations of Urine Culture: Improper cleaning of the area prior to collection of the urine specimen may result in a contaminated specimen. Harmful bacteria may be masked by an abundant presence of insignificant bacteria.

MoonDragon's Lab Test Information: Complete Urine Analysis Test - Visual & Microscopic
MoonDragon's Lab Test Information: Chemical Examination of Urine Test
MoonDragon's Lab Test Information: Urine Collection & Preservation
MoonDragon's Lab Test Information: Urine Microscopic Examination
MoonDragon's Lab Test Information: Urine Physical Examination
MoonDragon's Lab Test Information: Urine Sediment Identification Test
MoonDragon's Lab Test Information: UTI Specimen Collection

BACTERIAL VAGINOSIS SCREENING

It is not uncommon for pregnant women to have a vaginal discharge due to a bacterial infection. If this occurs, a woman should notify her health care provider, who may test her in the office for these symptoms:
  • Vaginal discharge that is not clear in appearance.
  • Presence of a specific type of cell when examined microscopically.
  • Amine (fishy) odor when the discharge is tested with a chemical.
  • A decrease in acidity of the vagina.

If the patient has three of these four symptoms, she is diagnosed with Bacterial vaginosis (bacteria in the vagina). It is usually cured with a seven-day treatment of a prescribed antibiotic. Untreated bacterial vaginosis, during pregnancy, can result in amniotic fluid infection, premature rupture of the membranes, premature delivery, low birth weight of the baby and may cause inflammation in the motherís pelvic area (pelvic inflammatory disease).

MoonDragon's Women's Health Procedures: Vaginal Inflammations
MoonDragon's Women's Health Procedures: Cervical Abnormalities
MoonDragon's Women's Health Information: Bacterial Vaginitis
MoonDragon's Women's Health Information: Candida (Yeast) Infection
MoonDragon's Lab Test Information: Collection & Handling of Bacteriological Specimens
MoonDragon's Lab Test Information: Bacteria - The Gram Stain
MoonDragon's Lab Test Information: Identification of Stained Bacteria
MoonDragon's Lab Test Information: Bacteriology - Inoculation of Media
MoonDragon's Lab Test Information: Preparation of a Bacterial Smear
MoonDragon's Lab Test Information: Transfering A Urine & Throat Culture To Growth Media

CHORIONIC VILLI (VILLUS) SAMPLING

Most pregnancies produce healthy babies; however, there is always a risk of a baby having a birth defect caused by a genetic abnormality. Although available to anyone, the usual indications for this procedure, and the genetic testing of the specimen obtained, include:
  • Mother is 35 years of age or older.
  • Close family history of genetic disorder.
  • Both parents possess a gene for an inherited disorder.

The results of genetic tests performed on the prospective parents are used to determine the likelihood of their child inheriting a disorder. Between the tenth and twelfth week after a womanís last menstrual period, a Chorionic Villi Sampling (CVS) procedure can be performed to obtain cells from the placenta that have the same genetic make-up as the fetus. These cells are analyzed for chromosomal disorders, such as is seen in Down syndrome, and gene abnormalities that cause metabolic disorders, such as Tay-Sachs and Cystic Fibrosis, and determines the actual condition of the baby.

Complications Associated with CVS: There is a risk of miscarriage associated with the CVS procedure. An infection may develop.

Limitation of Testing: Not all genetic disorders can be detected. For certain genetic tests, there is greater reliability of results when testing individuals of Jewish descent than other ethnic backgrounds.

MoonDragon's Women's Health Procedures: Chorionic Villi Sampling (CVS)
MoonDragon's Women's Health Procedures: Genetic Screening

TOXOPLASMOSIS

Toxoplasmosis is a disease caused by a parasite infection usually occurring after consuming undercooked meat from an infected animal, after exposure to cat feces where the parasite egg is frequently found, or in mother-to-child transmission when the mother becomes infected during pregnancy. An infected mother may develop swollen lymph nodes, fatigue and flu-like symptoms. Fetuses infected during early gestation are more adversely affected than if exposed later in the pregnancy. Newborns infected with toxoplasmosis appear normal at birth, but, as the baby becomes older, may develop vision or hearing loss, display learning disabilities, mental retardation, or seizures. Severe cases may result in death.

Diagnosis of this condition can be difficult. A test for toxoplasmosis detects the antibodies that are produced after exposure to the parasite; however, a positive result does not distinguish between current or prior parasite infections. A positive test should be repeated every few weeks to see if the amount of antibody is increasing, which means there is a current infection needing treatment. If the amount remains the same, there is no new infection. A negative test means either there is not a current infection, or the amount of antibody produced is not yet sufficient to be detected.

If the woman is in frequent contact with a cat, but does not yet have a positive test for toxoplasmosis, the health care provider may recommend that she be tested for antibodies periodically during the pregnancy.

MoonDragon's Women's Health Information: Toxoplasmosis
MoonDragon's Lab Test Information: Toxoplasmosis Testing





SECOND TRIMESTER (13 TO 27 WEEKS)

The tests performed during the second trimester provide information to evaluate both actual and potential medical problems in the baby. These tests include:

URINE SCREEN FOR GLUCOSE (SUGAR) & PROTEIN

At each prenatal visit during this trimester, a urine specimen will be tested for the presence of glucose and/or protein. (Refer to First Trimester section for further information.)

TRIPLE MARKER SCREENING

Between 15 and 20 weeks gestation, the mother may be given the option to have a screening test for Down syndrome and open neural tube defects (such as spina bifida). Included in the Triple Marker Screen are tests for alpha-fetoprotein (AFP), and two hormones, human chorionic gonadotropin (hCG); and unconjugated estriol. This blood screening test provides an opportunity to assess the risk of these conditions occurring without performing the more invasive amniocentesis procedure. Only those patients whose blood screening results indicate a potential problem need be referred for the amniocentesis.

During the second trimester, it is expected that the levels of AFP and unconjugated estriol will increase, and the amount of hCG decreases. AFP is produced by the baby; it then crosses into the motherís blood. A baby with a neural tube defect has an opening in its spine, head, or abdominal wall that allows an increased amount of AFP to pass into the motherís blood stream. An elevated AFP could also result from multiple fetuses, miscalculation of gestation, or for no known reason. An ultrasound may be requested to determine the baby's age, and confirm the number of babies. In pregnancies where the fetus is carrying the chromosomal defect that causes Down syndrome, the results of the Triple Marker Screen tend to show decreased levels of AFP and unconjugated estriol, and increased level of hCG.

The AFP and other test results are interpreted based on the mother's age, weight, and ethnic background to assess the risk of the child having chromosomal problems. Of all reported cases of elevated AFP, only a very small percentage of babies truly have a defect. But if the test result is abnormal, a genetic counselor should be consulted to discuss an amniocentesis to further assess the likelihood of a birth defect in the baby.

Limitations of the Triple Marker Screen: This screening test is not conclusive for the presence of a birth defect, but rather predicts the likelihood of a problem. More conclusive tests must be performed to confirm the babyís condition. Since only a small percentage of pregnancies that have an elevated AFP produce a baby with a problem, parents may undergo undue anxiety.

Related Tests: AFP Maternal, hCG, Unconjugated Estriol.

MoonDragon's Women's Health Procedures: Genetic Screening
MoonDragon's Women's Health Procedures: Alpha-Fetoprotein Assessement
MoonDragon's Lab Test Information: AFP, How To

AMNIOCENTESIS

Offered approximately between 15 and 20 weeks gestation, amniocentesis is a procedure used to obtain an amniotic fluid specimen to test for birth defects. Amniocentesis is an optional procedure available to anyone. The indications for this procedure are the same as those listed for CVS (refer to First Trimester section), but also include:
  • The level of maternal AFP, either lower or higher than expected.
  • Assessing the degree of lung development of babies at-risk for a premature delivery.

The amniotic fluid contains AFP produced by the baby and fetal cells. Unlike the maternal blood sample, the amniotic fluid specimen allows for the direct measurement of the baby's AFP. Fetal cells in the fluid can be tested for chromosomal or genetic abnormalities. A gene analyses may be performed based on family history (i.e., another child born with a defect, or hemoglobinopathies) or the results of screening tests performed on the parents, (i.e., cystic fibrosis). Approximately two weeks are needed to complete the testing.

Complications Associated with Amniocentesis: The procedure has a slight risk that the needle inserted into the amniotic sac may puncture the baby. The procedure may cause an infection.

Limitation of Testing: An elevated amniotic fluid AFP is not conclusive for neural tube defects. For certain genetic tests, there is greater reliability of results when testing individuals of Jewish descent than other ethnic backgrounds. Not all genetic disorders can be detected.

MoonDragon's Women's Health Procedures: Amniocentesis
MoonDragon's Women's Health Procedures: Amniocentesis - How To
MoonDragon's Pediatric Information: Down Syndrome
MoonDragon's Pediatric Information: Trisomy (Edwards Syndrome)

GLUCOSE TESTING

The pancreas produces a hormone called insulin that regulates the breakdown of blood sugar (glucose). Between 24 and 28 weeks gestation, the placenta produces hormones that may impair the function of the womanís insulin causing the blood sugar to increase. The maternal blood sugar passes to the unborn baby potentially causing macrosomia, or "fat baby." These infants are at risk for breathing problems and later becoming obese and diabetic.

To identify gestational diabetes at this point in the pregnancy, a special screening blood glucose test may be ordered. The mother is asked to consume a drink containing a known amount of sugar, and an hour later, a blood specimen is collected. If the level of glucose is acceptable, it is unlikely she has gestational diabetes. If the level is moderately elevated, a more conclusive glucose tolerance test (GTT) may be discussed. If the level is significantly elevated, the results are considered conclusive for diabetes and a GTT may not be recommended.

Diet control and/or insulin injections may be discussed as a treatment for gestational diabetes.

Limitations to the Glucose Testing: In some cases, gestational diabetes may not be detected during the time between the 24 and 28 weeks gestational period.

MoonDragon's Pregnancy Information: Gestational Diabetes Index & Links





THIRD TRIMESTER (28 WEEKS TO DELIVERY)

Testing during this period is primarily directed toward preparation for the birth of a healthy baby and may include:

URINE SCREEN FOR GLUCOSE (SUGAR) & PROTEIN

At each prenatal visit during this trimester, a urine specimen will be tested for the presence of sugar and/or protein. (Refer to First Trimester section for further information.)

ANTIBODY SCREENING

At approximately 28 weeks gestation, it is not unusual for a small amount of fetal cells to pass into the mother's blood stream, which can then cause her to produce an antibody. Although this can occur in all mothers, it is more likely to occur in an Rh-negative mother who has an Rh-positive baby. At this point in the pregnancy, a second antibody screen may be requested to see if the mother has developed an antibody that was not detected during the first prenatal visit.

An Rh immune globulin injection, (also referred to as RhoGAM), may be given to an Rh-negative mother to prevent her from reacting to the baby's cells. Additional injections may be administered following invasive procedures, (i.e., amniocentesis or CVS), and following any event where there is the possibility of baby blood transferring to the mother (i.e., trauma to the mother's abdomen). If the mother has already developed the antibody to the Rh factor another injection is not necessary.

Limitations to Antibody Screen: An antibody screen will be positive if an Rh immune globulin injection was given within the prior six months. An accurate history of prior Rh immune globulin injections is important in deciding if the positive test is due to the injection or the mother having produced the antibody to the Rh factor.

MoonDragon's Pregnancy Information: Rh Isoimmunization (Erythroblastosis Fetalis)
MoonDragon's Pregnancy Information: RhoGam Question & Rh Isoimmunization

GROUP B STREPTOCOCCUS

Frequently confused with Group A streptococcus (strep) that causes a sore throat, Group B strep is a bacterium that is present in the vagina and gastrointestinal areas of 10 to 30 percent of pregnant women, though it rarely causes an infection. If an infection does develop, the bacteria may infect the uterus, amniotic fluid, urinary tract, and any incision made during a cesarean section. At delivery, when the baby passes through the birth canal, the bacteria can be inhaled or ingested.

Infected infants may display symptoms within six hours of birth or as late as two months of age. If untreated, the baby may become septic (infection in blood), develop pneumonia, hearing or vision loss, or develop varying degrees of physical and learning disabilities.

To best assess the risk of infecting the baby at delivery, the mother is screened for Group B strep between 35 and 37 weeks gestation. Specimens from the motherís vaginal and rectal areas are collected and within 24 to 48 hours, the laboratory can determine if bacteria are present. If present, the laboratory will identify which antibiotics are effective treatments.

For women with Group B strep, and for women who have not been tested, the recommendation is to receive antibiotics intravenously during labor. Treatment with oral antibiotics taken prior to labor has not proven to be effective in preventing Group B strep infections in the newborn.

Limitations of Group B strep screening: The screen may not detect a small percentage of women with Group B strep. Labor may begin before the test results are available.

MoonDragon's Birthing Guidelines: Group B Strep - Pregnancy
MoonDragon's Birthing Guidelines: Group B Strep - Labor & Birth
MoonDragon's Lab Test Information: Streptococcus B - Vaginal Strep Testing
MoonDragon's Lab Test Information: Vaginal Streptococcus (Strep-B)
MoonDragon's Lab Test Information: Streptococcus A - Strep Throat Testing

GONORRHEA (GC), CHLAMYDIA & SYPHILIS

It is recommended, and in some states required, that testing for sexually transmitted diseases be performed, or repeated, in the third trimester. (Refer to First Trimester section for additional information).

HEMOGLOBIN & PLATELET COUNT

All women lose a small amount of blood during delivery. Although this is usually not a problem, even a small blood loss can be harmful to women with anemia. A health care provider may want to know the level of hemoglobin of a pregnant woman's blood prior to delivery to assess the possible impact of the expected blood loss. (Refer to the First Trimester section for additional information).

Platelets are cells found in blood that help form clots to stop bleeding. Women with low platelet counts, or who have platelets that do not function properly to form clots, are at risk of life-threatening bleeding during delivery. Follow-up testing may be needed to help determine treatment options if a platelet problem is detected.

MoonDragon's Lab Test Information: Platelet Count Test





NEWBORN TESTING

Each state in the U.S. establishes a policy for which tests should be performed on newborns. Health care providers may choose to perform additional testing. These serve to detect an infant with metabolic illness, assess the likelihood of anemia, detect abnormal genes, and, if applicable, determine the maternal need for Rh immune globulin and may include:

CONGENITAL HYPOTHYROIDISM SCREENING

Congenital hypothyroidism occurs when an infant is born with a thyroid gland that is not producing enough thyroid hormones. Untreated congenital hypothyroidism is the most common cause of mental retardation. If the thyroid testing results indicate congenital hypothyroidism, the health care professional may prescribe thyroid supplements.

Limitations of Congenital Hypothyroidism Screen: The thyroid test measures the amount of a hormone that is present in the baby's blood at the time the test is performed. At birth, however, there are thyroid hormones from the mother present in the baby's circulation that can mask the baby's low thyroid hormone level. Discharging a baby shortly after delivery does not allow enough time for the mother's thyroid substance to disappear from the baby's circulation. To more accurately diagnose congenital hypothyroidism, it is recommended that:
    1.The specimen be collected between two and six days of age.

    2.If the baby is discharged prior to 48 hours of age, thyroid testing should be performed as close to the time of discharge as possible, but no later than seven days of age.

    3. If the baby's blood was collected before 24 hours of age, a second specimen should be tested before two weeks of age.

MoonDragon's Health & Wellness: Hypothroidism

HEMOGLOBIN ABNORMALITIES SCREEN (HEMOGLOBINOPATHIES)

Infants with Sickle Cell Disease or other hemoglobinopathies are high susceptible to viral and bacterial infections that significantly effect their long-term health and survival. Newborn screening for hemoglobinopathies is routine in the United States and many other countries because early diagnosis and treatment improves both survival and long-term outcome of the baby.

METABOLIC DEFICIENCY SCREENING

Metabolic deficiencies can cause symptoms that range in the degree of severity. At present, all states require screening for phenylketonuria (PKU). Most states require testing for galactosemia, a form of milk intolerance, and also, hemoglobinopathies based on the babyís ethnic background. In addition to these individual metabolic deficiencies, a screen for about 30 different deficiencies is now available. A few drops of the babyís blood are tested using a new technique called tandem mass spectrometry. A few hospitals offer this test to all parents, but, in most cases, the parents must request that this extensive, but relatively inexpensive, screening be performed. Other metabolic screening tests are available and may be performed based on state requirements, family history, or to diagnose the cause of symptoms displayed by the baby

PKU (PHENYLKETONURIA)

Inheritance of this disorder results in a build-up of phenylalanine (a protein component) that results in developmental delays, seizures, severe mental retardation, and acid odor. This condition is not usually fatal.

Restricting phenylalanine in the diet (abundant in meats, fish and eggs, and a predominant component of the artificial sweetener, aspartame), and monitoring serum levels has proven effective in treating this condition if initiated as soon as possible and certainly, before four weeks of age. This treatment must continue throughout the patient's life.

Limitation of PKU Test: Collection of an insufficient amount of specimen will affect the test result. Specimens should be collected from infants older than 24 hours and younger than 7 days. Screening prior to 24 hours of age may result in an inaccurate result.

MoonDragon's Lab Test Information: Newborn PKU Test

GALACTOSEMIA

This test is performed in the majority of states. This is an inherited disorder that results in the inability to break down galactose, a sugar found in all milk and milk products. Within the first two weeks of life, untreated infants born with this condition experience vomiting, liver disease, mental retardation, and failure to thrive, which may result in death.

Providing a milk-free diet is the recommended treatment.

Limitations of Galactosemia Screen: The test does not detect carriers of this condition.

BLOOD TYPING & DIRECT ANTIGLOBULIN TEST

These tests are appropriate in neonates in the following situations:
  • When the mother is group O blood type.
  • When the mother is Rh-negative.
  • When the motherís blood has an antibody that could be harmful to the baby.
  • When the baby has clinical symptoms that might be explained by the results of these tests.

There are two main reasons to perform these tests on a newborn. The first is to determine if an Rh-negative mother should receive Rh immune globulin after delivery. As described earlier, this treatment helps prevent the development of antibodies in the mother that could be harmful to a fetus in future pregnancies. Only Rh-negative mothers of Rh-positive infants receive the treatment. The second reason to perform these tests is to identify newborns that may be at risk of anemia due to harmful antibodies from the motherís blood. For example. babies with either group A or B blood type may react with antibodies produced by mothers with group O blood type. A direct antiglobulin test is used to determine if the mother's antibodies have reacted with the baby's blood cells. A negative test usually means that the motherís antibodies are not affecting the babyís blood and the infant is not at risk. A positive test means the baby is at risk of developing anemia. Many reactions to maternal antibodies produce only mild symptoms in the newborn. Some reactions, however, can cause moderate to severe anemia, which left untreated, can cause brain damage and death. A health care provider may request a hemoglobin test on a baby's blood to determine if the baby is anemic.

Limitation of Direct Antiglobulin Test: Even though maternal antibodies may be present on the baby's cells, there may be too few to be detected. Therefore, a negative direct antiglobulin test does not rule out the possibility of anemia. The baby's health care provider may choose to do additional testing if the baby has symptoms.

A positive direct antiglobulin test does not necessarily mean the baby will develop anemia.

MoonDragon's Pregnancy Information: Rh Isoimmunization (Erythroblastosis Fetalis)
MoonDragon's Pregnancy Information: RhoGam Question & Rh Isoimmunization
MoonDragon's Lab Test Information: ABO Blood Typing - EldonCard Method
MoonDragon's Lab Test Information: ABO-Rh Blood Typing & Incompatibilities





MoonDragon's Pregnancy Information Index
MoonDragon's Pregnancy Information & Survival Tips






MoonDragon's Womens Health Index

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Health & Wellness Index





AROMATHERAPY: ESSENTIAL OILS DESCRIPTIONS & USES


Allspice Leaf Oil
Angelica Oil
Anise Oil
Baobab Oil
Basil Oil
Bay Laurel Oil
Bay Oil
Benzoin Oil
Bergamot Oil
Black Pepper Oil
Chamomile (German) Oil
Cajuput Oil
Calamus Oil
Camphor (White) Oil
Caraway Oil
Cardamom Oil
Carrot Seed Oil
Catnip Oil
Cedarwood Oil
Chamomile Oil
Cinnamon Oil
Citronella Oil
Clary-Sage Oil
Clove Oil
Coriander Oil
Cypress Oil
Dill Oil
Eucalyptus Oil
Fennel Oil
Fir Needle Oil
Frankincense Oil
Geranium Oil
German Chamomile Oil
Ginger Oil
Grapefruit Oil
Helichrysum Oil
Hyssop Oil
Iris-Root Oil
Jasmine Oil
Juniper Oil
Labdanum Oil
Lavender Oil
Lemon-Balm Oil
Lemongrass Oil
Lemon Oil
Lime Oil
Longleaf-Pine Oil
Mandarin Oil
Marjoram Oil
Mimosa Oil
Myrrh Oil
Myrtle Oil
Neroli Oil
Niaouli Oil
Nutmeg Oil
Orange Oil
Oregano Oil
Palmarosa Oil
Patchouli Oil
Peppermint Oil
Peru-Balsam Oil
Petitgrain Oil
Pine-Long Leaf Oil
Pine-Needle Oil
Pine-Swiss Oil
Rosemary Oil
Rose Oil
Rosewood Oil
Sage Oil
Sandalwood Oil
Savory Oil
Spearmint Oil
Spikenard Oil
Swiss-Pine Oil
Tangerine Oil
Tea-Tree Oil
Thyme Oil
Vanilla Oil
Verbena Oil
Vetiver Oil
Violet Oil
White-Camphor Oil
Yarrow Oil
Ylang-Ylang Oil
Aromatherapy
Healing Baths For Colds
Aromatherapy
Herbal Cleansers
Using Essential Oils


AROMATHERAPY: HERBAL & CARRIER OILS DESCRIPTIONS & USES


Almond, Sweet Oil
Apricot Kernel Oil
Argan Oil
Arnica Oil
Avocado Oil
Baobab Oil
Black Cumin Oil
Black Currant Oil
Black Seed Oil
Borage Seed Oil
Calendula Oil
Camelina Oil
Castor Oil
Coconut Oil
Comfrey Oil
Evening Primrose Oil
Flaxseed Oil
Grapeseed Oil
Hazelnut Oil
Hemp Seed Oil
Jojoba Oil
Kukui Nut Oil
Macadamia Nut Oil
Meadowfoam Seed Oil
Mullein Oil
Neem Oil
Olive Oil
Palm Oil
Plantain Oil
Plum Kernel Oil
Poke Root Oil
Pomegranate Seed Oil
Pumpkin Seed Oil
Rosehip Seed Oil
Safflower Oil
Sea Buckthorn Oil
Sesame Seed Oil
Shea Nut Oil
Soybean Oil
St. Johns Wort Oil
Sunflower Oil
Tamanu Oil
Vitamin E Oil
Wheat Germ Oil





HELPFUL RELATED MOONDRAGON NUTRITION BASICS LINKS

  • MoonDragon's Nutrition Basics Index
  • MoonDragon's Nutrition Basics: Amino Acids Index
  • MoonDragon's Nutrition Basics: Antioxidants Index
  • MoonDragon's Nutrition Basics: Enzymes Information
  • MoonDragon's Nutrition Basics: Herbs Index
  • MoonDragon's Nutrition Basics: Homeopathics Index
  • MoonDragon's Nutrition Basics: Hydrosols Index
  • MoonDragon's Nutrition Basics: Minerals Index
  • MoonDragon's Nutrition Basics: Mineral Introduction
  • MoonDragon's Nutrition Basics: Dietary & Cosmetic Supplements Index
  • MoonDragon's Nutrition Basics: Dietary Supplements Introduction
  • MoonDragon's Nutrition Basics: Specialty Supplements
  • MoonDragon's Nutrition Basics: Vitamins Index
  • MoonDragon's Nutrition Basics: Vitamins Introduction


  • NUTRITION BASICS ARTICLES

  • MoonDragon's Nutrition Basics: 4 Basic Nutrients
  • MoonDragon's Nutrition Basics: Avoid Foods That Contain Additives & Artificial Ingredients
  • MoonDragon's Nutrition Basics: Is Aspartame A Safe Sugar Substitute?
  • MoonDragon's Nutrition Basics: Guidelines For Selecting & Preparing Foods
  • MoonDragon's Nutrition Basics: Foods That Destroy
  • MoonDragon's Nutrition Basics: Foods That Heal
  • MoonDragon's Nutrition Basics: The Micronutrients: Vitamins & Minerals
  • MoonDragon's Nutrition Basics: Avoid Overcooking Your Foods
  • MoonDragon's Nutrition Basics: Phytochemicals
  • MoonDragon's Nutrition Basics: Increase Your Consumption of Raw Produce
  • MoonDragon's Nutrition Basics: Limit Your Use of Salt
  • MoonDragon's Nutrition Basics: Use Proper Cooking Utensils
  • MoonDragon's Nutrition Basics: Choosing The Best Water & Types of Water





  • RELATED MOONDRAGON HEALTH LINKS & INFORMATION

  • MoonDragon's Nutrition Information Index
  • MoonDragon's Nutritional Therapy Index
  • MoonDragon's Nutritional Analysis Index
  • MoonDragon's Nutritional Diet Index
  • MoonDragon's Nutritional Recipe Index
  • MoonDragon's Nutrition Therapy: Preparing Produce for Juicing
  • MoonDragon's Nutrition Information: Food Additives Index
  • MoonDragon's Nutrition Information: Food Safety Links
  • MoonDragon's Aromatherapy Index
  • MoonDragon's Aromatherapy Articles
  • MoonDragon's Aromatherapy For Back Pain
  • MoonDragon's Aromatherapy For Labor & Birth
  • MoonDragon's Aromatherapy Blending Chart
  • MoonDragon's Aromatherapy Essential Oil Details
  • MoonDragon's Aromatherapy Links
  • MoonDragon's Aromatherapy For Miscarriage
  • MoonDragon's Aromatherapy For Post Partum
  • MoonDragon's Aromatherapy For Childbearing
  • MoonDragon's Aromatherapy For Problems in Pregnancy & Birthing
  • MoonDragon's Aromatherapy Chart of Essential Oils #1
  • MoonDragon's Aromatherapy Chart of Essential Oils #2
  • MoonDragon's Aromatherapy Tips
  • MoonDragon's Aromatherapy Uses
  • MoonDragon's Alternative Health Index
  • MoonDragon's Alternative Health Information Overview
  • MoonDragon's Alternative Health Therapy Index
  • MoonDragon's Alternative Health: Touch & Movement Therapies Index
  • MoonDragon's Alternative Health Therapy: Touch & Movement: Aromatherapy
  • MoonDragon's Alternative Therapy: Touch & Movement - Massage Therapy
  • MoonDragon's Alternative Health: Therapeutic Massage
  • MoonDragon's Holistic Health Links Page 1
  • MoonDragon's Holistic Health Links Page 2
  • MoonDragon's Health & Wellness: Nutrition Basics Index
  • MoonDragon's Health & Wellness: Therapy Index
  • MoonDragon's Health & Wellness: Massage Therapy
  • MoonDragon's Health & Wellness: Hydrotherapy
  • MoonDragon's Health & Wellness: Pain Control Therapy
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  • MoonDragon's Health & Wellness: Therapy - Herbal Oils Index







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    A website map to help you find what you are looking for on MoonDragon.org's Website. Available pages have been listed under appropriate directory headings.




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