Additional examinations during pregnancy

Igel Leistungen (Services)

Basic Care in Germany

It is important that you know that the basic care in Germany is very good. The most important examinations during your pregnancy are of course covered by the health insurance companies. If there are any abnormalities, the health insurance company will of course also pay for further necessary examinations, for example with a specialist for prenatal diagnostics.

IGEL - Leistungen (Services) 

During the first examination during pregnancy you might hear this word: IGel... these are additional examinations.
But what exactly does this mean?

These are examinations whose costs are not always covered by the health insurance and which you must therefore pay for by yourself. Such additional examinations are called IGel. Usually your OB-Gyn will talk to you about these possible options.

The following additional examinations are offered in most practices (prices vary slightly from practice to practice):

Cytomegaly infection test (early pregnancy)

The cytomegaloviruses belongs to the herpes virus. An infection is usually completely harmless and most adults are immune to them. But a new infection during pregnancy is dangerous, because it can harm the unborn child.

Here a link to a more detailed blog post.

The blood test, which determines immunity, costs about 25-75 Euros (if there is no immunity, the blood test is repeated every trimester of pregnancy to exclude an acute infection).

Toxoplasmosis test (early pregnancy)

Toxoplasmosis is a bacterial infectious disease that is transmitted from animals to humans and mainly affects cats. If you have a cat or work with animals, a test is useful. 

Here a link to a more detailed blog post. 

The blood test, which determines immunity, costs about 25-75 Euros (if there is no immunity, the blood test is repeated in every trimester of pregnancy to exclude an acute infection).

First trimester screening (10-14.SSW)

First-trimester screening provides information on possible malformations or trisomies, such as trisomy 21 (Down Syndrome). This is included:

• Nuchal translucency (thickness) of the child in ultrasound (13th-14th weeks)
• Mother's blood value analysis (PAPP-A and ß HCG) (10-11. SSW)

From the values of the neck fold measurement, the blood results, the gestational age and your age, a risk for a possible chromosomal abnormality in the unborn child is calculated.

This test only provides a risk classification - not a reliable diagnosis!
Should the result be abnormal, further examinations would follow.

The costs for the complete first trimester screening are between 120 and 200 Euros. This examination is completely risk-free, but you have to keep in mind that children with a low risk can still have diseases. And even with a higher risk, it is not certain that the child is really ill.

Blood test for chromosomal abnormalities (NIPT) - including Harmony Test (from 10th SSW)

Traces of the child's genetic material are filtered out of the blood of pregnant women. Here too, the probabilities of chromosomal aberrations can be determined. The most frequent trisomies (21, 18 and 13) and, in some cases, the deviations of the sex chromosomes X and Y are examined. In most cases, the gender of the child is also reported in this test.

This non-invasive method has a higher detection rate than first trimester screening. Nevertheless, in case of abnormal values, further diagnostics must be performed.

The costs are about 130-480 Euro (Harmony Test between 199 and 299 Euro).

 Malformation ultrasound (20.-22. SSW) - Prenatal diagnostician

In addition to the usual 3 ultrasound examinations, it is also possible to have an ultrasound examination performed by a special prenatal diagnostician without any conspicuous findings before
If there has been detected anything in any of the examinations before, the health insurance company will pay for the examination.

Depending on the expert, this examination costs about 270€.

Additional ultrasound - at your OB/GYN

Your health insurance will cover three ultrasound examinations during your pregnancy, or more if there are any abnormalities.
If you would like to have an ultrasound scan at every check-up appointment, you will have to pay for it yourself (again depending on your health insurance).
Here the OB Gyn assesses whether your child is growing well, what the placenta looks like and whether there is enough amniotic fluid.

The costs are about 100-150 Euro for the whole preganancy.

Major test for gestational diabetes (diabetes) (24.SSW-27.SSW)

In connection with pregnancy, a sugar disease can occur, which usually improves after delivery. A test for gestational diabetes is covered by health insurance companies. However, this is a screening test that does not cover all cases. About 20% remain undetected. If you decide to take the more detailed test, you will have to plan a good two hours' stay in the practice.

The costs are between 30 and 50 Euros.

Streptococcus B test (35.-37. SSW)

When we carry streptococci in us, we sometimes do not even notice. But for the baby these bacteria can be very dangerous. Possible complications are serious infections such as meningitis or blood poisoning. A vaginal swab taken at the end of pregnancy will determine whether you are carrying these bacteria. If the test is positive, you will be given an antibiotic to minimize the risk of infection.

Here is a link to a more detailed blog post.

The costs are between 25 and 50 euros.

Summary

These alternatives will be explained to you during your first appointment with your gynecologist. Not all examinations are necessarily useful in your personal case. Therefore, it is highly recommended to weigh them up together with your partner.

What is relevant for us? What would we draw a conclusion from? And from what not? Is there a consequence for us at all (abortion or further invasive diagnostics like amniotic fluid puncture)?  Where do we have particular fears? Is there something we absolutely want to know? Do additional examinations give us the security we need for a relaxed pregnancy?

Every pregnancy, every pregnant woman is different and every pregnant woman needs different care. That is why additional services are definitely sensible. Everybody has the choice and with the necessary information you can make the right decision for your individual situation.

If you are looking for a prenatal diagnostician in Stuttgart - here is a direct link to our Partner Dr. med. Tekesin , who speaks English & Turkish.
Of course there are also other prenatal diagnosticians you can go to.

And last but not least a link to a Vaccination (pertussis) which should be done being pregnant.

November 2020 Dr. Christine Krämer
This blog post has been prepared with the greatest possible care and does not claim to be correct, complete or up-to-date.“

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