Screening v 11.–13.+6 týdnu těhotenství


Autoři: J. D. Sonek 1;  K. H. Nicolaides 2;  P. Janků 3
Působiště autorů: Department of Maternal Fetal Medicine, Wright State University, Dayton, Ohio, USA 1;  Department of Fetal Medicine, King’s College Hospital and University College Hospital, London, UK 2;  Department of Obstetrics and Gynecology, University Hospital Brno, Masaryk University, Czech Republic 3
Vyšlo v časopise: Čes. Gynek.2012, 77, č. 2 s. 92-104
Kategorie: Původní práce

Souhrn

Ultrazvukové vyšetření plodu a krevního zásobení dělohy mezi 11. a 13. týdnem těhotenství přináší důležité informace o stavu gravidity včetně výhledu do budoucnosti. Nuchální projasnění ve spojení s mateřskými sérovými markery (volná podjednotka β-hCG a pregnancy-associated plasma protein-A) se ukazují jako vysoce efektivní markery aneuploidií. To je dále posíleno dalšími ultrazvukovými markery I. trimestru, což vede k záchytu přesahujícímu 90 % s falešnou pozitivitou 2,5 %. Většina závažných strukturálních vad může být odhalena již v tomto období. Popsané vyšetření zadního mozku (intracranial translucency (IT)) v I. trimestru je efektivní screeningovou metodou pro vady neurální trubice. Dopplerovské vyšetření pulzatilního indexu uterinních arterií ve spojení s mateřskou anamnézou a biochemickým vyšetřením mateřského séra pomůže upřesnit riziko vývoje preeklampsie.

Klíčová slova:
screening v I. trimestru těhotenství, trisomie 21, aneuploidie, nuchální projasnění, dodatečné markery PAPP-A, free β-hCG, vady neurální trubice, preeklampsie.


Zdroje

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Štítky
Dětská gynekologie Gynekologie a porodnictví Reprodukční medicína

Článek vyšel v časopise

Česká gynekologie

Číslo 2

2012 Číslo 2

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