> Protocol ministerial exemption ticket pregnancy

No. 1 Are excluded from participation in the cost performance of Laboratory and other specialist services for the protection of maternityà indicated in the present decree and in annexes A, B, C, consumed at the public health facilities and accredited private, including family counseling.

Are still excluded from participation in the cost of the regular medical examinations in obstetric and gynaecological problems.A prescription for performance of Laboratory and other specialist services is carried out by general practitioners or by specialists working in the accredited structures, public or private, including family counseling.

The prescription of a specialist is mandatory in the cases provided for in article 2 and annexes A, B, and C.

No. 2 In function preconcezionale are excluded from participation in the cost-performance of diagnostic equipment and laboratory and other specialized services that are necessary to ascertain any genetic defects, prescribed by the specialist to the couple, if the medical history, reproductive or family of the couple shows the conditions of risk to the fetus.

Are excluded from participation in the cost-performance of diagnostic equipment and Laboratory and other specialist services necessary and appropriate for the pathologic conditions that carry a risk for maternal or fetal, prescribed usually by the specialist.

Are excluded from participation in the cost-performance of diagnostic equipment and laboratory and other specialist services, as necessary and appropriate for the prenatal diagnosis, in the specific conditions of risk given by annex C, prescribed by the specialist.

In the presence of risk conditions, the performance of diagnostic equipment and Laboratory and other specialist services must indicate the diagnosis, or the diagnosis is suspected.

Art. 3

this decree replaces the Decree of the Ministry of the Sanità of the 6.march 1995.

Annex A specialist services for the protection of maternityà head of, excluded from participation in the cost function preconcezionale

specialist for women

    the

  • Anamnesis and evaluation, defined short: gynecological visit preconcezionale
  • the

  • Antibodies anti-erythrocyte Test (Coombs ‘ indirect): in case of risk of isoimmunisation
  • the

  • Virus Rubella antibodies (IgG, IgM)
  • the

  • Toxoplasma antibodies (E. I. A.) (IgG, IgM)
  • the

  • Blood count: Hb, GR, GB, HCT, PLT, IND. DERIV., F. L.
  • the

  • Resistance osmotic erythrocyte (Test of Simmel): in the case of a reduction of the cell volume average and morphological alterations of the erythrocytes.
  • the

  • Hb and Abnormal (HbS, HbD, HbH, etc): in the case of a reduction of the cell volume average and morphological alterations of the erythrocytes
  • the

  • cytological Examination Cervico-Vaginal (PAP TEST)
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specialist services for man

    the

  • Blood count: Hb, GR, GB, HCT, PLT, IND. DERIV., F. L. in the case of a woman with phenotype heterozygous for hemoglobinopathies
  • the

  • Resistance Osmotic Erythrocyte (Test of Simmel) : in the case of a woman with phenotype heterozygous for hemoglobinopathies
  • the

  • Hb – abnormal Hemoglobins (Hb S, Hb D, Hb, H etc) in the case of a woman with phenotype heterozygous for hemoglobinopathies& lt;

specialist services for the couple

    the

  • Virus Acquired Immunodeficiency (HIV 1-2) Antibodies
  • the

  • Blood Group AB0 and Rh (D)
  • the

  • Treponema Pallidum Antibodies (quantitative Research by means of hemagglutination passive) (TPHA)
  • the

  • Treponema Pallidum Antibodies anti cardiolipin (Flocculation (VDRL) (RPR)

In case of abortività repeated or previous pathologies of pregnancy with perinatal death and on prescription of a specialist obstetrician or geneticist

    the

  • Anamnesis and evaluation, defined short: genetic counseling
  • the

  • Ultrasound trasvaginale
  • the

  • Hysteroscopy. Excludes: Biopsy with dilatation of the cervical canal.
  • the

  • Biopsy of the body of the uterus: endoscopic Biopsy (hysteroscopy) of the endometrial lining
  • the

  • Anticoagulant Lupus – Like (LAC)
  • the

  • Antibodies anti cardiolipin (IgG, IgA, IgM)
  • the

  • Antibodies to microsomes (Ab TMS) or anti Tireoperossidasi (Ab TPO)
  • the

  • Antibodies anti-tg (Ag-TG)
  • the

  • Karyotype from metaphases lymphocyte 1 Technique of banding (Resolution not less than 320 bands): torque

Annex B to the specialist for the control of pregnancy physiological, excluded from participation in the cost (in the case of high-risk pregnancy or threat of miscarriage will include all of the specialist services aimed at an optimal monitoring of the pregnancy)

At the beginning of the pregnancy, possibly before the 13° week and the first control

    the

  • Blood count: Hb, GR, GB, HCT, PLT, IND. DERIV., F. L.
  • the

  • Group SanguignoAB0 and Rh (D) should not run in function preconcezionale
  • the

  • Aspartate Aminotransferase (AST) (GOT) (S)
  • the

  • and Alanine Aminotransferase (ALT) (GPT) (S/U)
  • the

  • Virus Rubella antibodies (IgG, IgM)
  • the

  • Toxoplasma Antibodies (E. I. A.): in the case of IgG negative repeat every 30-40 days until delivery
  • the

  • Treponema Pallidum Antibodies (quantitative Research by means of hemagglutination passive) (TPHA): if not performed in the function preconcezionale extended to partners
  • the

  • Treponema Pallidum Antibodies anti cardiolipin (Flocculation) (VDRL) (RPR): if not performed in the function preconcezionale extended to partners
  • the

  • Virus Immunodeficiency Acqisita (HIV 1-2) Antibodies
  • the

  • Glucose(S/U/dU/)
  • the

  • Urine chemical Examination of the physical, and microscopic
  • the

  • obstetric Ultrasound
  • the

  • Antibodies anti-erythrocyte Test (Coombs ‘ indirect) : in the case of women Rh negative is at risk of immunization, the test should be repeated every month; in the case of incompatibilità AB0, the test should be repeated at 34°- 36°week
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Between the 14° 18° week

    the

  • Urine Examination chemical, physical and microscopic (*)

Between 19° and 23° week

    the

  • obstetric Ultrasound

Between 24° and 27° week

    the

  • Glucose(S/U/dU/)
  • the

  • Urine Examination chemical, physical and microscopic (*)

Between the 28° and 32° week

    the

  • Blood count: Hb, GR, GB, HCT, PLT, IND. DERIV., F. L.
  • the

  • Ferritin (P/Sg/Er) in the case of a reduction of the volume of the globular middle
  • the

  • Urine Examination chemical, physical and microscopic (*)
  • the

  • Obstetric Ultrasound

Between 33° 37° week

    the

  • Hepatitis Virus B (HBV) antigen HbsAg
  • the

  • Hepatitis C Virus (HCV) Antibodies
  • the

  • Blood count: Hb, GR, GB, HCT, PLT, IND. DERIV., F. L.
  • the

  • Urine Examination chemical, physical and microscopic (*)
  • the

  • Virus Acquired Immunodeficiency (HIV 1-2) Antibodies in the case of anamnestic risk factors

Between the 38° and 40° week

    the

  • Urine chemical Examination of the physical, and microscopic

41° week

    the

  • Obstetric Ultrasound
  • the

  • Cardiotocography: at the specific request of the specialist; if necessary, monitor until delivery

* In case of Bacteriuria significant: Examination of the cultivation of the urine (urine culture) complete Research micro-organisms and pathogenic yeasts. Included: bacterial count

Annex C Indications for prenatal diagnosis (derived from the guidelines for genetic testing approved by the National Committee for Biosafety and Biotechnology of the Presidency of the Council of Ministers)The indications for prenatal diagnosis are exempt from the payment fall into two categories:

the Presence of risk procreative predictable a priori:

    the

  • età maternal avanzatagenitore carrier heterozygous chromosomal abnormalities strutturaligenitori carriers of genetic mutations
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the Presence of fetal risk became evident in the course of gestation:

    the

  • malformations highlighted by the examination ecograficomalattie infectious arisen in gravidanzapositività of the biochemical tests for abnormalities cromosomichefamiliarità for genetic diseases.

directions for investigations cytogenetic for chromosomal abnormalities fetal during pregnancy are:

    the

  • età advanced maternal ( >= 35 years)
  • the

  • parents with a previous child affected by a chromosomal pathology
  • the

  • parent is a carrier of a structural rearrangement that is not associated with phenotypic defect
  • the

  • parent is not aneuploid of the sex chromosomes are compatible with the fertilityà
  • the

  • anomalies, malformations highlighted sonographically
  • the

  • probabilityà of 1/250 or greater that the fetus is affected by Down Syndrome (or other aneuploidy) on the basis of the biochemical parameters assessed on maternal blood or ultrasound, carried out with specific programmes of regional centres identified by the Regions and subjected to continual verification of the qualityà.

Amniocentesis free of charge only after other blood tests

Calendar of pregnancy online

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