General Considerations

It is important to review with pregnant refugee patients how prenatal care is delivered in Canada. Some women might not be prepared for the multitude of appointments, lab tests and ultrasounds involved in our prenatal care model.

When a new refugee patient is pregnant, we add our recommended refugee-specific initial screening tests to the usual first trimester prenatal tests.

 

VITAMIN B12 DEFICIENCY SCREENING

We also screen our pregnant patients for vitamin B12 deficiency. B12 deficiency in vegetarian and malnourished mothers can lead to deficiency in the newborn with subsequent complications.

 

HYPOTHYROIDISM SCREENING

While routine TSH screening in asymptomatic pregnant patients (including refugees) is still controversial, we do recommend screening for subclinical hypothyroidism (with TSH levels) in pregnant patients from countries known for iodine deficiency (see Map).

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CHAGAS DISEASE

While there are no official screening recommendations for Chagas disease in Canada, it is reasonable to screen pregnant women and women of childbearing age planning a pregnancy if they are from an endemic area (see Map). See Chagas Disease for more information.

 

FEMALE GENITAL CUTTING

Because of the risk of obstetrical complications, pregnant patients from countries where female genital cutting is prevalent (see Map) should be screened for this. See Female Genital Cutting for more informaton on screening and management.