Port Moresby Medical Laboratories (POMMEDLAB)

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A blood specimen should be taken from every newborn before hospital release, usually at 24 to 48 hours of life. Well infants are usually tested just before they go home from the hospital, but not later than 72 hours after birth. Sick or premature infants are tested at 1 week of age (earlier if a screenable disease is suspected). Babies born outside the hospital should have newborn screening tests done before the seventh day of life.

 

If your baby needs a blood transfusion, the blood for the tests should be collected before the transfusion.

POMMEDLAB provide a second set of newborn screening tests between 1 and 2 weeks of age. This is particularly important if the newborn leaves the hospital less than 24 hours after birth.

Neonatal Screen-TSH

In PNG, POMMEDLAB is the only centre providing service for laboratory Newborn Screening. Newborn Screening tests newborns for treatable diseases immediately after birth. The laboratory tests detects certain diseases before they cause serious damage or death. Newborns can then be given preventive treatment.  Diseases screened at birth vary somewhat from country to country depending on prevalence of disease and availability of simple and cheap technology for diagnosis and treatment.

 

Question 1. What neonatal Screening?

 

Question 4. How soon after birth should screening tests be done?

Question 6. How is TSH Measured?

Question 7. How long Should I wait For the Test result?

 

Newborn Screen is performed on one tiny sample of blood obtained by pricking the baby's heel. The blood is allowed to dry on a piece of filter paper which is send to laboratory for testing.

The testing takes up to 24 hrs depending on laboratory workload. You may return to our Result Review Centre or see your doctor on the next appointment day for discussion of results. Patient or doctor will be contacted for urgent results. All reports are kept confidential and only accessed by patient or his/her doctor.  

Question 8. What does the test report mean?

 

Tests are reported as normal or abnormal. If a test does suggest your child has the disease, POMMEDLAB will contact you and your baby's doctor. If the tests do not show any diseases, you will generally not be contacted. Your baby's doctor usually has copies of the newborn screening test results.

 

Parents should not be overly alarmed by abnormal test results, as the initial screening tests give only preliminary information that must be immediately followed by more precise testing. Most babies with abnormal newborn screening test results prove normal in further testing.

Therefore, all children who test positively for a disease should be tested again. Rarely, tests are normal in patients that do actually have the disease

Question 9. How Is it Treated?

 

Hypothyroidism is treated with medication, in tablet form, as prescribed by the doctor. For newborns, the tablet may be crushed, mixed with a liquid and given to the baby with a medicine dropper. Once the child starts eating solid foods, the medication may be mixed with fruit or cereal, on a spoon. This simple, daily feeding provides all the hormone needed for the baby's growth and development.

Question 3. What Causes Congenital Hypothyroid?

 

The thyroid hormone is produced by the thyroid gland, located in the neck. A few babies, however, are born without thyroid glands. A few others are born with the thyroid gland in the wrong place (for example, near the base of the tongue). In still others, the thyroid gland is in the right place, but simply doesn't function properly.

Normally, the correct amount of the hormone is produced when the pituitary gland, located in the brain, releases a thyroid-stimulating hormone (TSH), which causes the thyroid gland to become active. In rare instances, the thyroid gland is normal, but the pituitary gland doesn't function properly, and can't produce enough TSH to stimulate the thyroid gland to work.

Congenital hypothyroidism usually is not inherited from parents . The siblings of those who have this disorder are seldom affected

Question 5. Who should be tested?

 

It is recommended that all newborns should be screened for congenital hypothyroid. However, babies with the following should have thyroid screen performed: 

poor appetite;

extreme sleepiness and inactivity;

rough, dry skin;

prolonged jaundice (yellowish skin);

constipation;

umbilical hernia; or

 facial swelling

Large protruding tongue

Question 10. Is there a cure?

 

In most cases, the child will never be able to produce sufficient thyroid hormone. In this sense, hypothyroidism is permanent and treatment must be continued throughout life. Frequent medical check-ups are essential to ensure that the child continues to receive enough thyroid hormone for normal growth and development.

Question 2. What diseases are tested for?

POMMEDLAB routinely provide tests for Congenital hypothyroidism

Thyroid hormone is very important in early development of brain tissue at infancy and delayed treatment or untreated hypothyroid causes permanent brain damage and mental retardation. The incidence of congenital hypothyroid ranges from 1:3500-1:5000, prevalence being highest in countries known to have high rates of iodine deficiency. In PNG, we do not know the yearly incidence of congenital hypothyroid but  iodine deficiency have been well documented and congenital hypothyroid rate could be much higher. In Port Moresby alone where 10 000 babies are born yearly, 10 babies with hypothyroid could be born yearly and potentially be missed and treated late resulting in permanent brain damage.   Once diagnosed early, effective and cheap treatment is available.

In many countries other diseases such as sickle cell, phenylketonuria, CAH and cystic fibrosis are also screened.