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Obstetrics and Gynecology

Obstetrics
and Gynecology

Currently, with the coming of Molecular Biology and the application of accurate laboratory techniques, the Centro Latinoamericano de Diagnóstico Genético Molecular –CELAGEM, provides its patients and healthcare specialists, a range of laboratory tests that may help to offer a more modern, less invasive, and more accurate medicine in the pregnancy control area and gynecology. Such laboratory tests are clearly and simply described below:

Fetal sexing from the eighth week of pregnancy


When couples observe how one of the most incredible and perfect nature events is taking place, which is to create life from life, they feel curious and the need to know what the gender of their child is, so they can start an emotional and affective relationship with their unborn child. Reason for which CELAGEM designed a test called Fetal Sexing in Maternal Peripheral Blood, which is a test capable of bring early information to the couple about the gender of their child from the eighth (8th) week of pregnancy with only a mother’s peripheral blood sample. In current medicine, determination of fetus gender is just possible by means of serial ultrasound controls or cytogenetics from the 16th week of pregnancy.

This test is based on, that from the seventh week of pregnancy, there is a cell and nutrient exchange between mother and child. Such cells can be identified in maternal blood, as well as the free DNA of the unborn child. Sensitivity of this test is around 98% as well as its specificity in primigravida (first pregnancies) mothers, or in their second pregnancy, in case that a girl had been born from their first pregnancy. Since the test is designed to seek the presence of the Y chromosome (male chromosome) in maternal blood, if a boy was born from a woman’s first pregnancy, his DNA may remain in her blood for 2 or more years, reason for which false values may result from this test. Similarly, all those women with miscarriages older than seven weeks of pregnancy have the same risk of erroneous results, as gender of their first pregnancy is unknown.

These limitations require CELAGEM to design a much more complex test, not only with the potential of detecting baby’s gender from the eighth week of pregnancy with no presence of limitations in sexing in peripheral blood –as described above, regarding whether primigravida mothers or not; but also to provide greater clinical information, since this tests is capable of analyzing the number of autosome and sex chromosomes, which are responsible for 98% of the most common genetic diseases (aneuploidy) related to chromosomes 21, 13, 18, X and Y. This test has a 98% of sensitivity and is called FISH in fetal erythoblasts in the maternal peripheral blood.

Furthermore, it is well known by healthcare specialists, that there are microorganisms responsible for the rupture of premature membranes during pregnancy. Some of these microorganisms can be detected by means of conventional bacteriological cultures. In many European and North American countries, a four-microorganism detection involved in rupture of premature membranes –such as Chlamydia Trachomatis, Ureaplasma Urealyticum, Mycoplasma Genitalium and Streptococcus Agalactiae (Beta hemolytic), which represent the most common microorganisms related to this phenomenon, is routinely requested in third-quarter pregnancy controls. Such Multiplex is called rupture of premature membranes test.

Within its list of conventional tests, CELAGEM also has cytogenetic studies such as amniotic fluid interphase fluorescence in situ hybridization (FISH) and neonatal aneuploidy detection, FISH analysis (peripheral blood), which are tests widely spread in perinatal and puerperium studies.

Human Papillomavirus (HPV) Prevention


With the intention to meet the needs of specialists in women’s health, CELAGEM provides, as an accurate diagnostic alternative, the human papillomavirus (HPV) typing, which is one of the most commonly transmitted sexual diseases affecting between 20% and 46% of sexually active women around the world and that can be related to one of the most common cancers in women, such as cervical or uterine cancer. For this reason, in many developed countries a pathology screening is used, after a cytological study suggesting HPV presence, the strain typing in the cervix to determine whether it is a high-risk (16,18, 31 and 45), medium-risk (33, 35, 39, 51, 52, 56, 59, 68) or low-risk (6, 11, 42 y 44) strain, regarding to a cervix cancer.

Other infectious microorganisms that may cause complications in pregnancy and in the baby are the hemoparasites and viruses that spread during pregnancy and are responsible for producing some alterations in the fetus. These microorganisms are: Toxoplasma Gondii, Cytomegalovirus (CMV) and Epstein - Barr virus (EBV).

CELAGEM works in designing molecular biology tests that serve as laboratory support to all specialists in reproductive medicine, trying to meet population needs regarding the design of a range of useful tests for the specialist responsible for the care of the couple and the baby.


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