Pre marital Screening
Inherited genetic disorders have been a major health concern in the Middle East. In the UAE alone,
- consanguineous marriages increased from 39 per cent to 50.5 per cent in a single generation (1997)
- genetic disorders and congenital anomalies cause for 40.3 per cent of all infant deaths in the country
Most individuals are not fully aware of the exact condition of their health, a person may look healthy, but he/she may have undetected health problems, or be a silent carrier of infectious or hereditary diseases. For couples considering marriage, pre-marital screening helps identify potential health problems and risks for themselves and also their offspring. Couples in a consanguineous marriage run the risk of having children with genetic birth defects such as Down’s syndrome and Thallasemia, as such, it is vital for these couples to be screened in order to aid them to understand their genetics and help them take the necessary precautions or treatments.
Considering the above statistics, Pre-marital screening is made mandatory by the Ministry of Health (MOH), UAE, for the people getting married. Pre marital Screening offered by MOH includes the following tests:
- Thalassemia
- Sickle Cell Anemia
- Hepatitis B
- Sexually Transmitted Diseases
- Screen the hereditary conditions
- Screen for fertility problems
- Identify infectious diseases and
- Assess the over all health status
One of the most common tests is the chromosomal analysis or Karyotyping. Blood Karyotyping is a test to examine chromosomes in a sample of cells, which can help identify genetic problems as the cause of a disorder or disease. This test can:
- Count the number of chromosomes
- Look for structural changes in chromosomes
The sample is placed into a special dish and allowed to grow in the laboratory. Cells are later taken from the growing sample and stained. The laboratory specialist uses a microscope to examine the size, shape, and number of chromosomes in the cell sample. The stained sample is photographed to provide a karyotype, which shows the arrangement of the chromosomes.
Certain abnormalities can be identified through the number or arrangement of the chromosomes. Chromosomes contain thousands of genes that are stored in DNA, the basic genetic material.
Normal Results
- Females: 44 autosomes and 2 sex chromosomes (XX), denoted 46, XX
- Males: 44 autosomes and 2 sex chromosomes (XY), denoted 46, XY
The couples showing the correct number of chromosomes, there is less likely that they have any genetic abnormalities in their chromosomes.
Couples having a family history of a particular disorder should go for further analysis of their chromosomes. There are various different Molecular Cytogenetic or DNA tests which might be helpful for the couples, like:
- Alpha thalassemia – deletions
- Apo E Genotyping
- Ataxia telangiectasia - carrier screening by linkage
- Congenital Adrenal hyperplasia- mutation analysis
- Cystic Fibrosis- mutation
- DMD Carrier test
- Fragile X Screen
- G -6-PD one mutation
- Hemophilia A/B, Carrier test
- Parkinson disease(Gly19 ser mutation, by Sequencing)
- Polycystic Kidney dis. (Aut. Rec. ARPKD) PND by linkage
- Rett syndrome MECP2 deletion / duplication
- Rh Genotyping - Both alleles (+/+ or -/-)
- Spinal muscular Atrophy- Carrier screening for deletion
- Thalassemia beta globin gene sequencing
- Wilson Disease-PND By Linkage etc.
The complete list of the test will be found at: www.easternbiotech.com
Advances in molecular biology have led to an explosion in genetics. On a daily basis a gene associated with disease is identified. Geneticists are laying the foundation for an exciting, advanced concept of predictive and diagnostic medical testing. Still people are unaware and confused to take the risk assessment tests or genetic diagnostic analysis. This is due to the burning need for professionals like genetic counselors who would discuss the couple’s unique concerns regarding potential or present genetic disorders that are encountered by them for which they have either carried out a test or are contemplating having a test. In either circumstance they would benefit greatly through a consultation with a genetic counselor.Genetic counseling
Genetic Counseling for congenital disorders, as we understand would follow sequences to make the potential couples understand the consequences of their union on their offerings. In case of a positive screening test where one or both partners are found to have a transmissible genetic disorder, they must consider the following options:
- They may decide not to get married
- If they do decide to get married in spite of their conditions, they may not wish to have children
- If they wish to have children, they must understand the value of Pre natal Screening of the fetus at an early stage of pregnancy to determine if there has been a genetic transmission or identify the carrier status of the fetus
- They must understand the option of termination of the pregnancy
- If they are unwilling to consider any of the above options, they must understand the social, economic perspectives of having children with genetic disorders.
Eastern Biotech & Life Sciences offers genetic pre marital screening with counseling. The consultations may be conducted either through email, telephone call arranged by us or where possible, in person co-ordinate by our staff.
Please contact us for further details at: 04 3692061 or email us: info@eastrenbiotech.com
News:
- Saudi Arabia Royal Cabinet approved Premarital Screening in 2002 Royal Decree was issued on Premarital Screening and it says, “For Screening of genetic diseases, the premarital examination for both couples is recommended. A certificate of examination is to be issued before wedding. The results of examination need to be explained to the concerned but not to prevent marriage”. Screening of the prospective couples for Thalaessemia and Sickle cell anemia is carried out at the approved governmental hospitals and centers. Genetic counseling is required if the couples are carrier or diseased.
- Premarital Screening launched in Qatar The Ministry of Public Health and Secretary General of the Supreme council of Health (SCH) H E Abdullah bin Kahlid Al Qahtani has urged all desiring couples to benefit from the premarital screening being launched in Qatar on 13th December, 2009. All nationals and residents getting married in Qatar will have to undergo the mandatory tests for their marriage to be legalized.
- Premarital Screening in Turkey A premarital screening program aiming at reducing the incidence of thalassemia major was started under the auspices of the Regional Health Administration in 1995 in the city of Denizli in the Aegean region of Turkey.
- Pre-marital check-ups to be mandatory in Bahrain A pre-marital medical check-up to test couples for infectious diseases such as HIV, hepatitis and genetic ailments will be implemented on December 13, health officials said. Health officials said this would help prevent would-be couples from giving birth to children with complicated diseases or deformities. A media campaign aims to promote awareness as most conservative families, keen on inter-cousin marriages, will have to deal with it. Ahmad Teebi, professor of Paediatrics and Genetics at Well Cornell Medical College-New York and Qatar and adviser to the Supreme Council of Health, said that married couples in the Arab world are usually cousins or distant relatives, which explains why diseases spread in most Arab countries. He added that premarital screening was highly important, regardless of the relationship between couples.
- Mandatory Premarital Screening in Dubai Premarital screening became mandatory from September 9, 2007 in Dubai for both Emiratis and expatriates in Dubai. The step is taken to prevent the spread of genetic blood disorders like thalassaemia and sickle cell which are prevalent in the GCC. Couples are now tested for diseases like thalassaemia, sickle cell, hepatitis B and C and sexually-transmitted diseases. A compatibility certificate is issued within a week if the subjects are normal. If the report is positive, the procedure varies.