An “assessment request” needs to be created in the hospital electronic system in order a sample to be taken from you. This may be done at the Registration Desk, in the department you are placed at, at the office of your treating physician or in the Emergency Room.
Tests paid by the Bulgarian National Health Insurance Fund
No additional fee is required for tests of patients hospitalized under clinical pathways.
Fees and payment methods:
Assessment fees are comparable with the average fees in Bulgaria.
A great part of the tests are included in the overall fee for hospitalization or service packs and patients do not pay them separately. Some of the tests are funded by the Bulgarian National Health Insurance Fund, Assisted Reproduction Centre to the Ministry of Health and private health insurance funds.
List of tests performed at the Clinical Lab ofNadezhdaWomen's Health Hospital:
1. Hematology – SIEMENS ADVIA 2120i hematology analyzer
- Full blood count (FBC) test with 10 or 24 parameters: the main ones being leucocytes, erythrocytes, haemoglobin, haematocrit, platelets.
- Differential blood count (DBC)
- Erythrocyte sedimentation rate (ESR): children and adults
- Microscopic count of leukocytes using high-class OLIMPUS microscope
- Erythrocytes morphology
2. Coagulation – prothrombin time and INR, fibrinogen and АРТТ
3. Immunology - ROCHE Cobas e411 and Beckman Coulter immunological analyzers
- Estradiol, Progesterone, LH /luteinising hormone/, FSH /Follicle stimulating hormone/
- Thyroid hormones: fT3, fT4, TSH
- Anti-TG (TAT)and Anti-TPO (MAT)
- Total hCG – pregnancy blood test
4. Tumor markers – ROCHE
- CA 15-3
- CA 125
- CA 19-9
5. Urine – general assessment and sediment – fresh urine sample required
6. Biochemical tests, Immunochemistry:
- Glucose /also known as blood sugar/
- Uric acid
- Total and direct bilirubin
- Total protein
- Enzymes - transaminases ASAT and ALAT, GGT, Alkaline phosphatase, Creatine phosphokinase, Amylase, Lipase, LDH /Lactate dehydrogenase/
- Serum Iron
- Total iron-binding capacity
- Electrolytes – Potassium, Sodium, Chlorides
- Total calcium, ionized calcium
- СRP /С-reactive protein/
- Lipid Profile- total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol
7. Urine quantitative analyses:
- 24-hour urine protein test or protein quantity in a single-void urine sample:
- 24-hour urine calcium
- 24-hour urine phosphorus test
- 24-hour urine potassium test
- 24-hour urine sodium test
- Creatinine urine testest
- Uric acid urine test
8. Serology, Infectious diseases
- Urgent Hepatitis B screening - HBsAg
- Urgent Hepatitis C screening
- Urgent Syphilis screening
- Urgent HIV screening
- Cytomegalovirus - IgG and IgM
- Toxoplasmosis - IgG and IgM
- Rubella - IgG and IgM
If the results from the urgent tests are positive, the blood samples are sent for confirmation to the relevant national reference laboratories. For Hepatitis viruses this is the National Reference Virology Laboratory at the NCIPD /National Center of Infectious and Parasitic Diseases/; for HIV virus – the HIV National Reference Laboratory, NCIPD; for Syphilis – the Center for Skin and Venereal Diseases, Sofia.
9. Blood gas analysis - Siemens
For all other examinations the Clinical Laboratory has contracted agreements with external laboratories.
Besides the routine clinical laboratory tests which cover the needs of any general hospital, testings related to the needs of the reproductive medicine are also conducted.
In addition to the abovementioned urgent tests, the lab also provides preparation of biological material in order to be sent to partner laboratories where more rare tests are performed.
Requirements to patients before being tested:
In most lab analyses it is common to say that blood is taken in “standard conditions”. This means the following:
- from 8 am to 10 am
- fasting, 12 hours after your last food intake, no coffee or cigarettes
- sitting, after 10-15 min rest and no intensive physical exercise prior the procedure.
It should be noted that most parameters can be tested at all times around-the-clock, provided that your physician takes into account your circadian rhythms, effects of the therapy, diet, physical effort, etc.
FOR SOME TESTS LIKE THESE PERFORMED FOR URINE COLLECTED WITHIN A CERTAIN PERIOD OF TIME, THERE ARE ADDITIONAL REQUIREMENTS:
DIURESIS FOR QUALITATIVE ANALYSIS
After getting up, the patient urinates and disposes of the first portion of urine for the day. Then the 24-hour collection period begins. A well cleaned vessel is used, which has to be kept in fridge in the intervals between adding the portions of urine. We recommend a container provided by the laboratory or a bottle of Coca Cola. When collecting with a preservative, for example 10 ml 6N HCl, this preservative is put in the container in advance. When adding a new portion, the urine in the vessel should be shaken gently (no foam should be formed). At the next morning, the first morning portion is added to the total amount. The urine is measured accurately, the quantity is recorded and 10 ml are brought to the laboratory. Throughout the assessment day, the patient shall not take more liquids than usual and shall not miss one single portion of urine.
COLLECTING 24-HOUR URINE FOR CATECHOLAMINE, METANEPHRINE, SEROTONIN and 5-HIAA
At least 2 (two) days before blood collection and/or the beginning of collection of urine, you shall not consume: bananas, tomatoes, aubergine, melon, pineapple, grapes, plums, raisin, avocado, kiwi, walnuts, orange, coffee, tea, chocolate, cocoa, red wine, vanilla, red peppers.
It is advisable to exclude temporarily the following medication from the therapy, if possible: Са-antagonists, АСЕ-inhibitors, Benzodiazepines, Tetracycline, Quinidine, Methylxanthines, L-DOPA, Methocarbamol, Mephenesin, Guaifenesin, Paracetamol, Acetylsalycilic acid (aspirin), Coumarin, Phenobarbital, Acetanilide, Ephedrine-HCl, Metamphetamine, Nicotine, Phentolamin, Phenacetin.
In HIV and Hepatitis patients:
The personnel is trained and uses personal protection and special “Safety” products which allow safety manipulation of the biological material.