Hello
Thanks for your query.
I will briefly detail the various stages of antenatal care , which should ideally be gone through :

1. Pre conceptional care is important. Ideally, all women planning a pregnancy should consume folic acid for 3 months prior to conceiving.

2. The first visit is generally before 11 - 12 weeks. An early visit, at 6 - 7 weeks, as you did, is highly recommended, as it provides pregnancy dating. At this visit, the complete history is detailed - medical history, habits like smoking etc, any family history, age, BMI, blood pressure, height and weight, thorough check up of all bodily systems. ALso a dating ultrasound is done.

3. Further visits are recommended every month till 28 weeks, every 15 days till 36 weeks and then every week until term ( 40 weeks ).
At each visit , the weight, B.P. and growth of pregnancy clinically is documented. Further tests are

First visit - Complete blood count, blood grouping and Rhesus factor typing, complete urine analysis, early glucose challenge test, thalassemia screening, viral markers such as HIV, Hepatitis B and syphilis, testing for rubella antibodies , Chlamydia and other sexually transmitted diseases, thyroid screening, vitamin D levels and dating ultrasound.

Since you are specifically interested in the genetic testing, a double marker test is recommended at 12 weeks.

Between 16 - 18 weeks, triple test for genetic screen and by 18 - 20 weeks, quadruple marker for genetic screen plus targetted ultrasound to screen for fetal anomalies can be performed.
Folic acid supplementation in the first trimester and iron and calcium supplementation from second trimester onwards is recommended. In endemic areas, vaccination against tetanus is recommended.

4. At 24 - 28 weeks, a repeat complete blood count, glucose challenge test, repeat TSH is done.

5. Ultrasound is repeated in the third trimester. Between 28 - 36 weeks, meticulous assessment of pregnancy growth by clinical examination is done. Also, various additional tests or ultrasounds maybe done at the discretion of the obstetrician, depending on the risk factors.

6. After 32 weeks, screening for Group B streptococcal infection is done.

7. The brain development of a baby depends on conditions inside the uterus, on birth and most importantly, on the crucial first few years of life. No test can assess the brain function or IQ of a child, only the structural development of the brain.

8. Normal chromosomes are indicated only by amniocentesis, which is not a routine procedure, and should be done, only if any of the tests for genetic screening, which I enumerated earlier, are abnormal.

9. By performing all the genetic tests, you can be reasonably sure of the baby being free from birth defects, but no test can give you 100 % assurance. Avoid smoking/drinking/heavy caffeine intake/ teratogenic drugs and follow all precautions as advised by your doctor. Take regular antenatal supplements as advised.

9. Depression is thought to be partially heritable, but none of the genes for depression has been yet concretely identified, so it is impossible to predict your baby's risk for inheriting depression. As your wife is not having this condition and has not taken any drugs for it, you should not worry about the risk to your baby. Provide adequate vitamin D supplements to your wife, as it is linked with depression. Talk to your obstetrician about it, so that regular psychological screening can be offered to your wife .

I hope I have answered all your queries.
Feel free to ask for further clarifications.

---

Hello
Thanks for your appreciation.
As far as genetic tests such as double marker, triple and quadruple marker are concerned, they are biochemical tests, and have zero risk of miscarriage, as is also the case with genetic ultrasound.
Amniocentesis is recommended only if any of these are positive, or there is a strong history such as very advanced maternal age, uncontrolled diabetes in mother, previous abnormal child in family etc.
Risk of miscarriage with amniocentesis is approximately 1 in 100.
Take care.

---

Hello
As your wife is disease free now, the risk for the current pregnancy is almost nil. Most of the drugs given to treat schizophrenia are harmful to the baby, but if she has not been on treatment in the few months prior to conception, and is not so now, there is no risk to the pregnancy.
For the mother, some patients exhibit an exacerbation of schizophrenia, that is , a flare up of the disease, so please make sure your wife is under close surveillance. However, most patients go through pregnancy uneventfully.
For a healthy baby, have regular antenatal check ups as advised earlier, all the routine tests, genetic tests, avoid smoking, alcohol and drugs, maintain a healthy lifestyle and nutritious diet. Take all supplements as advised. Continue taking folic acid throughout pregnancy.
Schizophrenia is a psychiatric and behavioural disorder - no test can diagnose it while the baby is inside the uterus, and even in infancy , because it does not manifest that early. Also, no definite proof or percentage of heredity in schizophrenia is proved yet.
The next step is to remain cautious and compliant with all medical advice, and relax.
Take care.

---

Hello
Thanks for writing back.
The baby is still risk free, because no medications have been consumed that harm the baby, atleast, it is risk free from the teratogenic side effects of anti schizophrenia drugs.
For your wife, she is definitely at risk, because stopping medications without doctor's consent is a grave mistake, she might have had episodes that you are not aware of, or is at risk for recurrence anytime.
There is no option, but to consult a specialist for this issue, as only a Specialist can assess the current status of her disease, need for drugs etc.

Take care

---