Pre marriage check up for diseases

The concept of pre marriage and later pre pregnancy checkup is for the areas of sexually transmitted infections, immunization, contraception, genetic problems, hormonal imbalance and gynecological problems. The diagnosis and treatment has to be done prior to marriage and pregnancy, as after marriage, it is too late.
First is the subject of consanguineous marriage that is, getting married to a close relative such as cousin or uncle (mother or father’s brother) as is a tradition in some communities. This greatly increases the risk of genetic disorders in their children. Prior to arranging such marriages any issues of genetic problems preexisting in the family should be closely looked into. A Karyotyping (blood test for genetic abnormalities) of both partners will pick up any genetic defects, which may be later inherited by their children in a more severe form. Also special tests for thallasaemia should be done. Thallasemia testing prior to marriage is important as both the partners may have thallasemia minor and may not even be aware of it, as it causes no symptoms. However the child born to both parents of thallasemia minor, has a 25% chance of having thallasemia major which is a serious and life threatening disorder. The test for thallasemia is a simple blood test. The subject of doing HIV (AID’s) testing prior to marriage is sensitive but some communities have already made it a compulsory practice. This is a good practice as initially the infection may show no signs and the infected person may be unaware of it. However the risk of transmission through intercourse later on is high and not only the partner but their children later may also acquire the disease and hence testing is a good idea. Hepatitis B is another serious infection which can be sexually transmitted and about which the infected person may not even be aware. The partner can be protected by taking hepatitis B vaccine prior to marriage in these cases. If the women is hepatitis B positive, there is a high risk of her child getting infected during pregnancy and delivery or soon after, if due care is not taken. Therefore Hepatitis B vaccination in all hepatitis B negative patients prior to marriage is a good idea. Also the women would be tested for rubella and chicken pox and if negative should take the vaccinations pre-marriage as these infections if they occur during pregnancy later, can be dangerous. Nowadays one sees a lot of other sexually transmitted diseases (STD’s) such as herpes and syphilis. These can be easily checked and diagnosed either by an examination or by blood tests and treatment done prior to marriage and conception. Many gynaecological problems such as fibroids, endometriosis,
adenomyosis and ovarian cysts occur in young women. These if diagnosed and treated early can be completely cured. A routine gynaecologial examination andsonography will be able to diagnose all these problems. Also if the woman has heavy, painful or irregular periods, she should get a check up done. Hormone problems are common in young women. Polycystic ovarian syndrome (PCOS) is seen in 25 – 30% of young women. This can cause weight gain, acne, facial hair growth, irregular periods, infertility and miscarriages. If diagnosed early, it can be successfully managed. Also thyroid disorders are easy do diagnose and treat and should be checked regularly. Diabetes and high blood pressure can exist in young woman and men today and simple check up and tests will be able to diagnose the problem, so early treatment can be initiated. Also disorders such as epilepsy, blood disorders etc should be diagnosed and treated. Tuberculosis should be diagnosed and treated early. There can even be tuberculosis of the uterus (womb) and tubes in women. Infections such as Chlamydia are difficult to diagnose but can cause severe damage to the tubes in women and can cause infertility therefore if there is any suggestion of pelvic infection such as abdominal pain and fever ,these tests should be done. Human papilloma virus (HPV) is a viral infection which is sexually transmitted and known to cause cancer of the cervix (mouth of the womb). This can be easily tested by taking smears from the vagina. Man, may have problems which such as impotence or some abnormality of the penis, hydrocoele or hernia which they are embarrassed to reveal. An andrological examination will reveal these problems, most of which can be treated. Blood group testing is not very relevant as if the wife is Rh negative and the husband is Rh positive, the management is very simple- one injection of Anti-D during pregnancy or after delivery is all that is required to prevent problems. Other blood group combinations are of no importance.

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