What does the invasive procedure mean. Security and results of invasive prenatal diagnostics. Non-invasive diagnostic methods for pregnancy

17.04.2019

In contact with

Odnoklassniki.

A minimally invasive operation is a surgical intervention in the body without cuts. In this case, everything is done through punctures and special equipment. What features and benefits have a similar operation, we will talk later in the article.

infertility in women;
endometriosis;
ovarian cyst;
myoma uterus;
ectopic pregnancy;

During the operation of this type on the front abdominal wall, small incisions are made. The size of them is from half to one and a half centimeters. The incision or puncture is carried out by means of a trocar - a special thin tube.

Description of endoscopy

What is an endoscopic minimally invasive operation? This is a study of human internal organs. This procedure is carried out through endoscopes - special optical instruments.

Minimally invasive operations to remove the horizontal bubble, appendicitis, various tumors in the stomach and intestines are carried out.
Through such surgery, you can remove stones in urinary tracts, prostate adenoma, tumors in the bladder. Also this method restores the passability of ureters.
With the help of the mentioned method, gynecological operations are carried out.
Plastic surgery.
Removal of lymph nodes and tumors.
Treatment of vessels, namely the removal of sclerotic pathology.

Benefits

This operational intervention does not require the hospitalization of the patient.
Man is not prescribed antibiotics before carrying out the procedure.
Minor pain after surgery.
The rapid period of rehabilitation and return to work activity.
The smaller probability of any complications after intervention.
The duration of stay in the hospital is from 1 to 3 days.
Lack of postoperative seams that require dressing and special therapy.

Operations on the heart

Hemorrhoids - the disease of the rectum, which arises due to the expansion of the veins in its walls. The latter leads to the formation of blood clots, which are called hemorrhoidal nodes.

Sclerosis.
Ligation (with this method, latex rings are used).
Laser coagulation.
Photocoagulation. This operation is carried out using IR radiation.
The use of a radiole scalpel.
Cryodestruction.

Conclusion

In this article, we will try to describe items to describe the details and understand what kind of mini-invasive replacement of the hip joint. WORLD STATUS is such that the bulk of joints for the replacement of joints (endoprosthetics) for a number of reasons is accounted for a hip joint. Unlike the knee joint, during the operation on the hip, there is an anatomical ability to conduct it with minimal intervention.

Operational seam size.

If you contact various medical institutions with a request to replace the hip joint, most of them will answer you that the operation is made by a minimally invasive way, but is it always under these words it means that you need? Until now, there are no uniformity of terminology around the world and often performing the operation through a small incision is already called a mini-invasive method. What is the implies in our clinic?

Why do the doctors prefer a mini-invasive method for replacing TB Sestava?

With a minimally invasive replacement of the hip joint, the surrounding muscles surrounding remain saved. In the process of operation, they are moved by a special way.
Seam, as a rule, does not exceed 7-8 cm.
Endoprosthesis used with mini-invasive replacement and classical identical, only their installation techniques differ. Thus, due to the small field of access when surgery, there is no need to use some special prostheses shortened / reduced / lightweight design. Mini invasive access is not made to the detriment of the endoprosthesis type.
Due to lower traumatic, motor functions are restored much faster. After all, if the muscle tissue is cut, it will never be the same properties as intact

The ultimate goal of a joint replacement operation is a speedy return to full-fledged life and motor activity, and a mini-invasive way to carry out this operation makes it possible to achieve it much easier and faster.

When performing prosthetics using the Bertin and Rottinger method, access is carried out through the intermissile space between the wide fascia and the mid-buttock muscle. With this access, theoretically, the results must be perfect, since all the muscles remain intact: the discharge muscles (medium and small butorous), wide fascia and short external rotators. This access is considered the most preferable and are used by a number of surgeons, although it is not widely used, because it requires a special orthopedic table to place the leg and positioning the hips so as to avoid additional cuts to access the masterpiece.

Why do patients choose a mini-invasive way?

In addition to the objective reasons for carrying out operations with a mini-invasive method, there is a psychological component. No patient wants to be operated on a more traumatic way if there is less traumatic. The main thing is that technical and financial capabilities allow. No one wants to remove the tooth, if there is a chance to save it. No one wants to remove the gallbladder by means of a long-term operation if it is possible to do it through endoscopic punctures, etc. That is, if you look from the point of view of the patient, all without exception would like to operate on mini-invasive technology.

Comparison of the size of the operating field in classical and minimally invasive techniques.

Mini-invasive operation is always good?

In addition to positive moments, there is also a negative - the complexity of the operation for the surgeon. The explanation of this is very simple: with this access, the size of the operating field (wounds) is sufficiently small, part of the manipulation of the surgeon spends in conditions of limited visibility. When using a classic method, the size of the operating wound allows you to see much better, which reduces the risk of failure in a less experienced surgeon. In other words, mini-invasive access technology at the endoprosthetics of TB Sustav is available only to first-class surgeons. In this case, qualifications and experience in conducting it is mini-invasive operations to replace the hip joint. Such operations cannot be done, among other things, or among others, for good results it should be the bulk of operations carried out by a separate surgeon.

Is it still a classic replacement or mini-invasive?

For fairness, it is worth noting that if we can take two identical patients and highly and properly conduct operations, one in the usual way, the second mini-invasive, and note the control points after 3, 6, 9 and 12 months, then provided the same lifestyle, The more time it goes from the moment of operation, the more similar to the state of patients, regardless of the method of operation. This means that in six months and, moreover, in a year, these patients will not be distinguished by the level of recovery, except for the seams will be different sizes. During treatment, the second patient (mini-invasive operation) will be slightly less pain, it is easier to pass the early postoperative period, it will restrict a little faster, a little earlier will begin to make the fact that the first patient can afford later, etc. Therefore, despite the not certain advantages of mini-invasive technology, for a particular patient, the operation will be better at which its surgeon specializes.

What does the Czech Republic offer?

In the Czech Republic, like many other countries, there are clinics, where they can carry out mini-invasive operations, for example, Clinic Bullka, as well as presented on our site. But the clinic and the doctor, conducting these operations in priority (that is, all of their patients) in the Czech Republic there is only one - the regional clinic of Kladno and its main surgeon Dr. Deniger. This is a doctor who pays the biggest attention to the mini-invasive replacement of T / B Sustav.

Where do patients turn first of all when they seek the possibility of treating the hip joint abroad? In Israel and Germany. After all, medical tourism is most developed in Israel and Germany. The Israeli clinics are famous for their success around the world, and quite fairly. A huge number of CIS citizens undergo operations on joint joints also, like other types of orthopedic treatment, in Germany, because there are really high-quality operations for the replacement of joints. We are not acquainted with Germanic clinics.

If the programs on the endoprosthetics of any joint in Germany and Israel satisfy all the needs of patients, why then need to be treated in the Czech Republic?

Everything is very simple - due to significantly lower cost and steadily high quality endoprosthetics. For example, an operation on the replacement of the knee joint in Israel is from 17 thousand dollars, Germany from 15 thousand euros, and this is only an operation and several days in the clinic, that is, without rehabilitation. Of course, with such operations, if there is an opportunity, you need to trust yourself with the best specialists in this area. But fortunately, the replacement of the hip joint does not imply high-tech treatment, for diagnosis and treatment does not use super-leading devices, even MRI is not required more often, rather X-ray. Almost all depends on the hands of the surgeon and the subsequent rehabilitation of the hip joint.

Our offer is designed to expand the choice, except Israel and Germany, on the excellent alternative in the form of the Czech Republic, where the cost for such treatment is established by clinics within 11-12 thousand euros together with rehabilitation. The question of the replacement of the joints is becoming more urgent for the population, because the average life is constantly increasing. At least, prosthetic manufacturers constantly develop new, more wear-resistant materials and types of structures, globally, the number of suggestions for the replacement of joints does not increase. Our recommendation is to give preference to the clinic and the doctor with the greatest experience and history of specific technologies in the endoprosthetics, which have proven themselves in many satisfied patients.

In more detail about the technical details of the operation, statistics and other features, you can familiarize yourself in the materials of dedicated mini-invasive surgery:

Many people whose alarming symptoms manifested themselves, and who appealed to hospital institutions for consultation, specialists apply invasive diagnostic and treatment methods. Not every patient understands what this term means, therefore, they are forced to either be interested in this issue in attending doctors, or independently search for an answer in open sources of information.

What does invasive meaning meaning

Invasive is the term that took its beginning from the Latin word Invasio.

It can be interpreted as follows:

invasion;
penetration;
implementing inside.

If it is used in the medical sphere, it means any method of penetration into the body of a person. In this context, you can consider both diagnostic procedures and surgical manipulations.

Diagnostics

Invasive techniques used by examining patients to form an accurate diagnosis provide for deep introduction into the body through natural paths of special tools. For example, endoscopic examination of the digestive tract.

Specialists are managed due to the flexible prison, equipped through the esophagus, equipped with a microcamera, carry out the following manipulations:

inspect the state of the mucous;
identify erosive lesions and peptic foci;
the fence of the biological material, which immediately goes to the laboratory for histological studies, etc.

It is worth noting that, despite the high informativeness of such diagnostic techniques, when they are used, there are risks of injury in internal structures. As a result, patients can open bleeding, as well as an infectious damage to organs and systems against the background of traumatic damage.

For invasive research methods, it is possible to calculate the manipulation, which provides for a disruption of the integrity of the skin and mucous membranes. In this case, we are talking about the introduction of any special preparations or microinstruments through veins or muscle tissue.

Invasive diagnostic techniques are involved in specialists in the following sectors of medicine:

gastroenterology;
urology;
cardiology;
pulmonology;
gynecology, etc.

For example, when conducting perinotional diagnostics, it is carried out:

biopsy, in which the fence of the fabrics of the fetus developing in the womb (placentobiopsy) is carried out;
purpose blood pressure (cordocentsis);
receive liquid amniotic plan (amniocentesis).

When conducting a survey of the broncho-pulmonary system, in order to form an accurate diagnosis, specialists involve the following techniques:

biopsy of the lungs, pleura or bronchi;
pleural puncture;
bronchography;
bronchoscopy.

Treatment methods

When conducting complex drug therapy, many drugs are prescribed by patients, and injectable. Therapeutic solutions them are introduced through vein or in muscle tissue. For these purposes, syringes equipped with needles, drip systems, catheters (if the patient is shown to the systematic administration of medicines).

For example, invasive techniques are activated in the treatment of pathologies that accompany pain in the back area. Patients are made epidural injections in the spinal cord, during which the corticosteroid group hormones are introduced. Thanks to this method of introducing medication, many people have been getting rid of pain for five years and more than five years and get the opportunity to lead a normal lifestyle.

Currently, minimally invasive techniques are being introduced into surgery, thanks to which there is a minimal injury to organs and their surrounding tissues. Unlike traditional operations, during which the doctors carried out large cuts, innovative technologies allow you to get to the necessary places through several punctures. Through the hole, the specialist introduces a medical instrument by which all surgical manipulations are carried out. After minimally invasive operational interventions, patients undergo the rehabilitation process, and they return to the usual way of life within one or two weeks.

When conducting minimally invasive operations, specialists must be extremely careful, since the medical instrument injected into the hole is able to damage the integrity of the organs adjacent to the focus. As a result, the patient will open bleeding and will have to get access to the place of damage. Through small-acting surgical interventions today, experts manage to cope with such ailments:

pathological processes occurring in the pancreas;
appendicitis;
gallway disease;
pathologies of 12 pans, stomach, thick intestinal department;
endometriosis;
misa uterus;
pathological processes in bile ducts;
cysts localizing in the ovaries;
adhesive processes occurring in the organs of the small pelvis;
polypami localizing on the cervix and in its cavity;
pipe obstruction;
ectopic pregnancy;
pathological processes, affected by the prostate gland, as well as the genitals of the female and male audience;
hyperplasia;
hernias formed in the esophageal diaphragm hole or on the front wall of the peritoneum;
pathological processes occurring in the bladder, ureter, kidneys or in adrenal glands.

The following functions can be found to the peculiarities of lowraumatic surgery:

Access to organs and systems in which pathological changes are observed, specialists are obtained through the sleeves made of plastic or medical metal, the diameter of which varies in the range from 5mm to 10mm.
Through trocacars, surgeons are introduced a special tool equipped with optics.
The optical system is connected to the monitor, the image from the microcamera is transmitted.
Endoscopic tools are joined to a special optical system, through which doctors carry out the necessary surgical manipulations.

The advantages of small-acting surgical interventions should be counted:

The rapid recovery of patients who are written out of the hospital for the second either on the third day after surgical treatment.
Excellent cosmetic effect. For example, after long-term operations, patients sometimes remain very large and coarse scars. After small-acting interventions on the skin, only a trace from the puncture remains, the size of which does not exceed the diameter of the five-terrible coin.
Minimizes the risk of hernia.
In isolated cases, the infectious damage occurs.
Patients do not experience such painful suffering as after extensive operations.

In this way, a medical and diagnostic study of the affected body can be carried out, during which a specialist takes a fence of biological material and, if necessary, conducts manipulation of the surgical plan.

Invasive procedure

An example of the simplest invasive procedure is any injection, and the most complex is a surgical operation. This is the main way to which the surgeon, in contrast to the therapist, assists the patient.

Invasive procedures can also be applied to diagnosis. Examples of invasive studies are invasive electrophysiological research of the heart and invasive genetic tests of the embryo.

Notes

The main difference of this operation from the usual is that it occurs through point punctures of the fabric or through the natural holes of the body.

A minimally invasive operation is made under local anesthesia. That is, the person is in consciousness. By time, the procedure, as a rule, lasts about an hour. After that, the patient does not need to stay in the hospital.

A minimally invasive operation is two types. Namely, laparoscopy and endoscopy. Now we will talk about each of them.

Description of laparoscopy

Laparoscopy allows us to treat the following diseases through operational intervention:

A minimally invasive operation is two types. Namely, laparoscopy and endoscopy. Now we will talk about each of them.

Description of laparoscopy

Laparoscopy allows us to treat the following diseases through operational intervention:

infertility in women; endometriosis; ovarian cyst; uterine myoma; ectopic pregnancy; cancer.

For the operation make 3 or four punctures. Next, carbon dioxide is introduced through these holes in the body. It is necessary to create the desired space for the operation. In addition, a camera is entered through the cuts, which will display the internal space on the monitor, and the tools.

Description of endoscopy

What is an endoscopic minimally invasive operation? This is a study of human internal organs. This procedure is carried out through endoscopes - special optical instruments.

Unlike laparoscopy, this operation does not imply do special cuts, since endoscopes are introduced through the natural holes of the body. For example, in order to examine the stomach, the device is injected through the mouth and esophagus. If necessary, to make a survey of lungs and bronchi patient, the endoscope is delivered to these organs through the larynx. And in order to propagate the function of the bladder, the device is injected through the urethra.

Before carrying out endoscopy, the patient is given sleeping pills. It is necessary in order for the patient during the operation in a relaxed state. The well-being operated is under the control of the anesthesiologist. And after the awakening, the patient, as a rule, does not feel any pain.

Testimony

Consider in what cases this intervention is observed:

Benefits

In modern medicine, there are explicit advantages of minimally invasive operations:

Minimally invasive surgical operations: minuses and consequences

Consider in what cases this intervention is observed:

Minimally invasive operations on the removal of the horizontal bubble, appendicitis, various tumors in the stomach and intestines are carried out. Urgenching such surgery can remove stones in urinary tracts, prostate adenoma, tumors in the bladder. Also, this method restores the passability of ureterals. In the help of the assistance of the mentioned method, gynecological operations are carried out. Plastic surgery. Removal of lymph nodes and tumors. Treatment of vessels, namely, the removal of sclerotic pathology.

Benefits

In modern medicine, there are explicit advantages of minimally invasive operations:

This operational intervention does not require the hospitalization of the patient. The manovel is not prescribed antibiotics before carrying out the procedure. Incorrect pain after surgery. The last period of rehabilitation and return to labor activity. The likelihood of any complications after intervention. The hospital stay is from 1 to 3. -x days. The correspondence of postoperative seams that require dressing and special therapy.

Minimally invasive surgical operations: minuses and consequences

But this method has its drawbacks. So, for the surgeon there is a certain difficulty in carrying out the operation, namely the restriction of space. In addition, the entire operation is carried out by special tools, missing tactile contact, which causes certain difficulties. For example, when overlapping seams to the patient. For such serious procedures, the surgeon must have a certain skill.

Operations on the heart

Minimally invasive heart surgery are considered one of the latest achievements of modern medicine. They allow you to successfully conduct interventions for the treatment of heart defect.

Such procedures are considered the most gentle method. Through modern medicine technologies, it was possible to combine several stages of operation in one. For example, with this method of intervention, it is not necessary to connect a person to the artificial blood circulation apparatus. There is statistics on which it is known that after conducting such surgical interventions, the risk of any complications are significantly reduced.

Minimally invasive operations are carried out to adult patients and children (even the smallest patients). With them, the number of deaths is significantly less.

Operations for the treatment of congenital heart defects with a minimally invasive method allow them to be carried out to very little children. At the same time, the period of rehabilitation is significantly reduced, thanks to which patients have the ability to quickly return to ordinary life.

Multinavasive hemorrhoid removal operations

Another direction of using such a method in medicine is an operation to remove hemorrhoids. Briefly remember what the disease is.

Minimally invasive operations are carried out to adult patients and children (even the smallest patients). With them, the number of deaths is significantly less.

Multinavasive hemorrhoid removal operations

Another direction of using such a method in medicine is an operation to remove hemorrhoids. Briefly remember what the disease is.

Hemorrhoids - the disease of the rectum, which arises due to the expansion of the veins in its walls. The latter leads to the formation of blood clots, which are called hemorrhoidal nodes.

The process of progression of this disease is divided into 4 stages. It is believed that the first stage can be cured without surgery. But the disease in recent stages can be treated only by surgical path.

The essence of the stages of hemorrhoids is that the further the disease is developing, the the formed nodes are increasingly pronounced and, as a result, fall out of the anal hole, delivering many problems and inconvenience to the patient. The operation is appointed at the last stage, when other treatment methods did not give results. The fact that thrombosis develops in the nodes.

In addition to traditional surgical intervention, the hemorrhoid removal operation is carried out by a minimally invasive method. Its essence is that it is held without a scalpel. The patient makes several punctures in the inner fabrics, through which the operational intervention is performed.

There are several types of low-alignment operations to remove hemorrhoids:

Sclerosation. Lugging (with this method, latex rings are used). The laser coagulation. Firmoagulation. This operation is carried out using IR radiation. Application of the radar scalpel. Cryodestruction.

The main advantage of such methods is a short period of recovery of the body.

Conclusion

Recently, many specialists give their preference to minimally invasive endoscopic operations. By the way, some patients can be examined for diagnosis only in this way.

Of the foregoing, it can be concluded that this type of intervention is the modern achievement of medicine. It allows you to choose for patients the most gentle method of operational intervention, which is especially valuable in the presence of additional pathologies in the body.

Thanks to this method, like minimally invasive operations, the risk of complication is reduced to a minimum, the period of rehabilitation of the patient takes less time, and the return to the usual rhythm of life occurs significantly faster than after ordinary surgical intervention.

Important words of this article:

No similar articles.

from your site.

Invasive procedure (from Novolatinsky Invasivus; from Invado - "Inside") - a medical procedure related to penetration through the natural external barriers of the body (leather, mucous membranes).

Notes

Invasive (endovascular) Cardiology - This is a whole science that studies diagnostic and therapeutic procedures by an invasive method, that is, various internal interventions into the work of the cardiovascular system without an open operation. Such methods are already widely developed in various fields of medicine, but we are in this article we will only touch the contemporary invasive methods that are used directly in cardiology. What is invasive cardiology, what is it possible, is there any limitations or contraindications?

In the last quarter of the last century, world cardiology has been subjected to significant indigenous changes, and possibly bypassed all other areas of medicine. These changes largely contributed to the works of Nobel laureates Kurnean, Roberts and Forceman, who devoted themselves to the development of various methods of heart catheterization. Now these methods are widely used for the diagnosis and correction of many congenital heart defects.

The name "Invasive Cardiology" comes from the word "invasion" - invasion. This is, in fact, is the most real invasion of the cardiovascular system. But the invasion is careful - with minimal damage to the vessels and under the strict control of X-ray-graphic and echoscopic methods. The essence of this procedure is that a flexible metallic conductor is injected with a patient through a puncture in the hip or elbow, and a thin one-time probe is introduced. Then this probe is pushed through the vessels in the heart area and then with the help of it, various diagnostic and therapeutic tasks can be solved.

The most common diagnostic task in the UPU is to clarify the nature of the vice, which can be quite complex. In addition, the probe in the heart area using special sensors allows you to measure pressure in various chambers, and allows you to estimate the bandwidth of the vessels and the pumping function of the heart muscle. This information is very important for the forecast of the disease and to address the issue of the operation tactics.

But the main development of invasive technologies takes place for therapeutic purposes. The discoverer of this direction was the Swiss cardiologist Grünzig. He invented a special catheter with a cylinder, which can be inflated to expand the vessels. Recently, such a method is widely used to eliminate coarctations and stenosis. However, this method also has a shadow side: it does not eliminate the cause of the disease, as a result, very often, the narrowing of the vessel is formed again. This phenomenon is called reconvertation, and in many cases it requires a repetimate emergency operation. Unfortunately, doctors often cannot identify signs of reconmarkation in a timely manner therefore parents whose children suffered a balloon plastic vessels should be particularly attentive to the well-being of children.

Another disadvantage of the balloon valvoplasty valves is its damage that later makes it impossible to restore it during surgery. That is, such a valve has to be replaced with a prosthesis. However, in the case of critical stenosis, when for various reasons it is impossible to carry out the valve prosthetics, the balloon holvoplasty is successfully applied and allows you to save the life of the child.

But the development of medicine does not stand still, and the methods of invasive cardiology continue to evolve. One of the meaningful achievements in this area of \u200b\u200bmedicine is the development of a new method of introducing inside the springs or frame vessel, which is called the stent. Such a frame prevents the resolution of the vessel and the formation of the stenosis, which allows to radically eliminate the problem. However, here also has its drawbacks: the presence of a foreign body inside the blood flow leads to the active formation of thrombus, which is why patients who moved such a type of intervention has to take anticoagulants for a long time. But we hope that this problem will soon be solved in the near future - for example, by the use of special materials that do not cause thrombosis.

Finally, we consider the most common type of endovascular intervention - occlusion of septal ducts. In fact, for this wise phrase, the most common elimination of holes and defects is hidden, the corkscale holes. Indeed, the probe introduced into the heart allows you to deliver a special metal object to the place of hole - an occluder, which looks like a ripples. If the hole in the heart has good edges, the occluder is revealed and like a cloud closes this hole. In the future, this ripper is in front of calcium, blood closures, the muscle is wounded and thus reliably fixed inside the heart for life. To close open arterial duct instead of an occluder, a helix can use, if the hole is too small.

The emergence of endovascular methods for closing defects is a real revolution in cardiac surgery, since it has made it possible to close such small defects that cannot be closed by the usual operation. Given that such defects will enlighten the most common type of UPU in children, this achievement is difficult to overestimate. Nevertheless, in our country there are still cardiillers who do not know anything about endovascular methods and tell about these terrible disadvantages of frightening parents with all complications. In fact, this is not like this: a huge number of endovascular operations have already been conducted in the world, while the number of complications is minimal and less than in normal extensive operations. Therefore, I recommend all the parents of children from the UPU before making a choice in favor of a particular operation, be sure to consult in qualified cardiac surgeons! If you live far from a major cardiocenter, then get primary consultation from leading experts can be possible through the Internet on the forum of parents of children from the UPU Club "Good Heart".

Important words of this article:

invasive kardiologiyakardiologiya detski zdelat operatsyyu child how much will stoitêàðäèîëîãèÿ äåöêàÿ çäåëàòü îïåðàöûþ ðåáåíêó ñêîëüêî áóäåò ñòîèòüinvazivny kardiologrOfshyuyyuush fhЎr chfhyrЄ№ yuyahOrЎ√ ■ Ohskheє oyuy№yu sєfhЄ oЄyushЄ№otverstie in serdtseAklyuderinvaziya that etoInvazivnaya operatsiyainvazivny cardiologist is

No similar articles.

from your site.

An example of the simplest invasive procedure is any injection, the most complex is a surgical operation. This is the main way to which the surgeon, in contrast to the therapist, assists the patient.

Invasive procedures can also be applied to diagnosis. Examples of invasive studies are invasive electrophysiological research of the heart) and invasive genetic tests of the embryo.

In contact with

DorodalPrenatal diagnosis of the intrauterine development of the fetus is carried out in order to determine and prevent possible deviations and is invasive and non-invasive.

Double and triple test when the health of the fetus is determined, as well as the most widespread non-invasive methods. For invasive diagnostics, readings are needed, since this method is considered dangerous. For medical purposes, research is carried out for free. If doctors have no suspicion of developing severe diseases, however, the future mother wants to be additionally reinforced, it can voluntarily pass this procedure on a fee basis.

There are such types of invasive prenatal research:

chorion's biopsy, which allows to determine genetic deviations for a period of up to 14 weeks with an accuracy of 99%;
plocentogenesis, which is carried out in case the pregnant woman missed the period of biopsy;
amniocentesis, or the study of the fruit bubble, containing particles of the toddler epithelium and its powder hair, is carried out on the period of up to 19 weeks and has accuracy of 99.4%;
cordocentsis, which allows to determine possible pathologies, exploring the blood of the kid himself with an accuracy of almost 100%.

Prenatal diagnostics of hereditary diseases

Prenatal fetal surveys are carried out in cases:

detecting structural rebuilding chromosomes (translocations) in one of the parents;
if parents have a dominant hereditary disease;
in the presence of children in the family with a recessive hereditary disease, which indicates the heterozygousness of the parents;
at the age of the mother over 35 years, which progressively increases the likelihood of her offspring with hereditary pathology;
with familiar miscarriages, causing suspicion of the incompatibility of mother and fetus on erythrocyte antigens;
if there are children with congenital defects in the family.

Since many methods of prenatal fruit surveys are not absolutely harmless, and in addition, they are laborious and expensive, the testimony for such a survey should be justified.

Biopsy Chorione

This is an invasive method of prenatal (prenatal) diagnostics. The essence of the method is as follows: under the control of ultrasound scanning in the cervical channel of a pregnant woman introduced a thin tube (catheter). The doctor gently promotes the tube towards the fetal egg. Moving the tube is tracked on the screen of the ultrasonic apparatus. After contacting the end of the catheter with chorion (so-called special veins at the end of the umbilical cord, which connect it from the wall of the uterus), a very small amount of chorional tissue is satisfied with a syringe with a syringe. It is this fabric (and not the fabric itself properly an embryo) is investigated in the laboratory with different methods.

There is another way of the fence of Choriona: while the sample of the fabric suck into the syringe through a long needle, entered into the uterine cavity through the abdominal wall of a woman. Naturally, also under the control of the ultrasound.

Chorion's biopsy makes it possible to determine the presence of Down syndrome and other fetus. The results of prenatal diagnostics are obtained within 3-4 days after the taking of the material. In the presence of a molecular genetic laboratory, diagnosis of gene diseases is possible. Along the way, you can determine the gender of the fetus. The procedure takes a little time and is carried out in an outpatient basis (that is, without hospitalization of a woman).

Chorion's biopsy is carried out at 10 - 11 weeks of pregnancy. It is during this period that there is sufficient effectiveness and safety of the method. In general, I must say that complications are possible after this procedure for prenatal diagnosis.

Risk of miscarriage (from 2 to 7% by materials of different clinics)
Risk of fetal infection (low)
Women's Bleeding Risk (Low)

Therefore, the biopsy of chorion is prescribed only when the risk of severe disease in the fetus is comparable to the risk of miscarriage after the prenatal diagnosis. And of course, it should not be resorted to this study only for the sake of determining the gender of the fetus. In addition, random damage to the fruit bubble is possible, adverse effects in the rhesus conflict between the mother and the fruit, the long-term exposure to the ultrasound on the fetus, some deviations in the development of the fetus. Sometimes, for a number of technical reasons, it is not possible to analyze the tissue samples. Summarizing, it can be said that in general the risk of the above complications of low (no higher than 2%). But this risk is still there, and you need to know about it.

The main advantage of the biopsy of Chorion is that the diagnosis of severe disabled disease in the fetus can be installed in the period up to the 12th week of pregnancy. On this period, the abortion of pregnancy occurs with a smaller number of complications for a woman, besides, a stress load on family members is reduced.

The direction of the chorion biopsy mate is most often given by a genetic biopsy in the prenagel diagnosis. Considering that the procedure needs to go through some examination (blood tests, smears, etc.), it is better to apply to the medical and genetic consultation as soon as possible.

Plazentogenesis

Another invasive prenatal diagnosis. The technique of their holding is universal: the puncture of the needle of the front abdominal wall of the woman and under the control of the ultrasonic apparatus, taking a piece of placenta (with placentocentsis) or cord blood of the fetus (with cordocentsis).

Placentetsis is usually carried out in the second trimester of pregnancy, like amniocentesis. Cordsenthesis are more often performed after 20 weeks of pregnancy. Both procedures have proven themselves as fairly safe for women and fruits. Studies are performed under anesthesia, outpatient or short-term hospitalication.

Complications after prenatal diagnosis by methods are very rare. This is a significant advantage of these methods. The disadvantage is a long period of pregnancy, in which these studies are conducted. In case of defering the diagnosis of coarse pathology, the abortion of pregnancy during this period requires long-term hospitalization and is fraught with complications.

The testimony for these studies of prenatal diagnostics is usually established by a genetic physician in the course of medical and genetic counseling.

Amniocentesis

It is also an invasive method of prenatal prenatal diagnostics. When carrying out amniocentes under the control of the ultrasound (so as not to hurt the fetus), a needle with a syringe is introduced into the uterine cavity (by puncture of the abdominal wall of a woman). Through the needle in the syringe is gaining an oily fluid.

In the laboratory, you can explore both the fluid itself (its chemical composition) and the fetal cells, which usually float it. In the surrounding waters there are broken fetal skin cells, epithelialocytes from urinary tract, etc. Therefore, the possibilities of amniocentes are somewhat larger than the biopsy of Chorion. In addition to the prenatal diagnosis of chromosomal and gene diseases, it is also possible:

determination of the degree of maturity of light fetus
determination of oxygen fasting fetus
determination of the severity of the rhesus conflict between mother and fruit
more efficient diagnosis of hereditary metabolic diseases
diagnostics of developmental defects (for example, nervous tube closing defects)

However, there is also their own minuses:

This method of prenatal diagnostics is quite "capricious". Since the fetal cells in the polar sample are very little, it is necessary to give them the opportunity to multiply in artificial conditions. This requires special nutrient media, temperature, reagents, complex equipment. Well, time, of course. In particular, for sufficient cell growth, it may be necessary to be required from 2 to 6 weeks of cultivation in special conditions. Therefore, the results of the study are not received soon, on average - by 20-22 weeks. If the diagnosis is confirmed, the interruption of pregnancy on this term is accompanied by a large number of complications than, for example, on the 12th week. Stronger and moral injury to family members.

The risk of losing the fetus after the amniocense is somewhat less than that when the chorion biopsy. This risk is only 0.5-1% higher than in pregnant women, which amniocentesis has not been carried out at all. An undesirable moment is a long-term impact of ultrasound on the fruit. Several risk of the risk of birth of a small child and a very weak (less than 1%) risk of respiratory disorders in a newborn.

Amniocentesis is usually carried out on the 15th - 16 week of pregnancy. The testimony for its implementation is usually a genetics physician during medical and genetic counseling.

Cordocentsis

The method refers to invasive prenatal diagnostics, which are to a certain extent, surgical intervention. It lies in the introduction of a special needle in the uterus cavity in order to intimidate the vane of the placenta, amniotic fluid or cord blood for further conducting various analyzes. The need for invasive prenatal or, so-called prenatal diagnostics is due to the ability to prevent birth to children with various innate or hereditary diseases.

The diagnostic capabilities of the cordo-beer is somewhat larger than placentatence. Both, and other methods allow diagnosing down syndrome and other diseases associated with a change in quantity and quality chromosome, and with a molecular genetic laboratory and many gene diseases.

Reliability of the results of prenatal diagnostics

The results of prenatal screening are distinguished by a high level of reliability and reliability. They can, either refute the concerns of the presence of pathology, and prepare parents to the birth of a sick child.

Conducting diagnostic procedures should be taking into account the main ethical principles:

Availability. Study should all women who have medical testimony for this. The lack of finance should not be an obstacle to the procedure.
Voluntaryness. Doctors are obliged to explain to a pregnant woman and her husband the need to pass research and the risk of the birth of a patient child. However, all appointments are a recommendatory nature, the final decision on the need for their passage takes the spouses.
Doctors are required to provide seven full information about the state of the fetus. Parents should also have a complete picture of the nature of the disease of their future child, the peculiarities of its development, treatment methods and further forecast.
Prenatal diagnostic procedures are carried out primarily to women who have medical records for this. Many impressionable women with an elevated level of anxiety that are not included in the risk group can also pass research data, but with full informs of their possible consequences.
The decision to interrupt pregnancy can be made exclusively the most woman and members of her family.
If the family decides not to interrupt pregnancy, the doctor must acquaint his parents with the peculiarities of the future child and morally prepare spouses to their future life with the baby.

It is important to remember that the decision on the need for diagnostic procedures is made jointly by an obstetrician-gynecologist, genetic, neonatologist, a children's surgeon, taking into account the wishes of the parents themselves.

Prenatal diagnostics is a complex of surveys The main goal is to identify various pathologies in the infant at the stages of intrauterine development.

The most common methods of prenatal diagnostics: Conducting an ultrasound, the content of various markers in the blood in a pregnant woman, biopsy of chorion, taking through the skin of cord blood, amniocentesis.

What is needed prenatal diagnostics

Applying various methods for prenatal diagnostics, actually detect in the development of fetus such disorders such as Edwards syndrome, Down syndrome, impairment in the formation of the heart and other deviations. It is the results of prenatal diagnostics that can solve the further fate of the child. After receiving the diagnostic data, together with Dr., the mother decides, a child or pregnancy will be born. Favorable predictions can afford to rehabilitate the fetus. The prenatal diagnosis also includes the establishment of paternity by the method of genetic examination, which is carried out in the early period of pregnancy, as well as the definition of sex of the fetus. All these services in the capital provides the center of prenatal diagnostics on the Peace Prospect, heads which Professor M.V. Medvedev. Here you can get a comprehensive prenatal examination, including ultrasound. Used in the center of modern 3D technologies, 4D.

Predatal diagnostic methods

Modern prenatal diagnostics applies a variety of methods and technologies. The degree, as well as the level of opportunity they are diverse. In general, the prenatal diagnosis is divided into two large groups: invasive prenatal diagnostics and non-invasive.

Non-invasive, or as they are also called, minimally invasive, methods do not provide for surgical interventions and injury to the fetus and mother. Such procedures are recommended to carry out all pregnant women, they are not dangerous at all. Ultrasound scheduled inspections must be used. Invasive methods involve the invasion (intervention) in the body of a pregnant woman in the uterus. Methods are not quite safe, so appoints their doctor in extreme cases when it is the question of maintaining the health of the future child.

Non-invasive methods include ultrasound research or prenatal screening, which allows you to observe in the dynamics of the development of the fetus. Non-invasive is also considered to be the prenatal diagnosis of the fetus for serum factors of the mother's blood.

The ultrasound is the most common procedure, has no harmful effects on a woman and the fruit itself. Does all future mothers have to undergo this study? The question is controversial, maybe it is not required in each case. Uzi appoints a doctor for many reasons. In the first trimester, you can determine the number of pregnancies, whether the fruit itself is alive, what exact period. In the fourth month, the ultrasound can already show the coarse layout of the placenta, the amount of amniotic fluid. After 20 weeks, it is possible to define the floor of the future child. Allows ultrasound to identify various anomalies if the analysis showed a high alpha-fetoprotein in pregnant women, as well as if there are some malformations in the history of families. It is worth noting that no result of the ultrasound can guarantee a hundred percent birth of a healthy fetus.

How ultrasound is held

Prenatal prenatal diagnostics in the form of an ultrasound is recommended for all pregnant women in the following timing:

11-13 week of pregnancy;
25-35 week of pregnancy.

It provides for the diagnosis of the state of the body of the mother, as well as the development of the fetus. A transducer or sensor The doctor sets to the surface of the belly of a pregnant woman, an invasion of sound waves occurs. These waves are captured by the sensor, and it transfers them to the monitor screen. On the early period of pregnancy sometimes use a transvaginal method. In this case, the sensor is entered into the vagina. What deviations allows you to reveal the screering ultrasound?
. Congenital vices of liver, kidneys, heart, intestines and others.
. Up to 12 weeks signs of the development of Down syndrome.
Development of pregnancy itself:
. Ectopic or uterine.
. The number in the fruit uterus.
. Gestational age.
. Head or pelvic prevention of the fetus.
. Development lag in terms.
. Character of heartbeat.
. Paul baby.
. The location and state of the placenta.
. Bloodstock in vessels.
. Tone uterus.

So, ultrasound examination makes it possible to identify any deviations. For example, the uterus hypertonus can lead to a threat of miscarriage. Finding this anomaly, you can take measures to preserve pregnancy in time.

Blood screering

Blood serum, taken by a woman, is investigated on the content of various substances in it:
. AFP (alpha fetoprotein).
. NE (unconjugated estriol).
. Xg (chorionic gonadotropin).
This method of prenatal screening has a sufficiently high degree of accuracy. But there are cases when the test shows or a false positive, or a false negative result. Then the doctor prescribes additional methods for prenatal screening, such as an ultrasound or any invasive diagnostic method.

The center of prenatal diagnostics on the prospect of the world in Moscow spends only 1.5 hours of ultrasound, and also gives a prenatal consultation. In addition to the screening of the first trimester, it is possible to undergo a biochemical screening of the second trimester along with consulting and ultrasound.

The prenatal diagnosis of hereditary diseases uses the method of determining the level of alpha-fetoprotein in the blood. This screening test allows you to identify the likelihood of the birth of a baby with such pathology, like Anedsephalia, spine cleft and others. Also, the high indicator of alpha-fetoprotein may indicate the development of several fruits, on incorrectly set deadlines, the possibility of miscarriage and even a frasonal pregnancy. The most accurate results of the analysis gives if it is made on the 16-18th week of pregnancy. Results until the 14th or after the 21st week are often erroneous. Sometimes repeated blood delivery is prescribed. With a high indicator, the doctor prescribes an ultrasound, it allows you to significantly obtain confirmation of the disease of the fetus. If the ultrasound does not determine the cause of the high content of alpha fetoprotein, amniocentesis is assigned. This study more accurately determines the change in alpha fetoprotein. If the patient's blood is elevated the level of alpha-fetoprotein, then complications may occur during pregnancy, for example, developmental delay, maybe the death of the fetus, or the placenta detachment. Low alpha fetoprotein in combination of high xg and low estriol indicator indicate the possibility of the development of Down syndrome. The doctor takes into account all the indicators: the age of a woman, the content of hormones. If required, additional prenatal research methods are assigned.

Hgch.

A person or (hCG) during pregnancy in early terms allows you to evaluate the most important indicators. Plus this analysis is the early deadlines of the definition, when even ultrasound is not informative. After fertilization of the egg, the hCG begins to be produced for 6-8 days.
HCG as glycoprotein consists of alpha and beta subunits. Alpha is identical with pituitary hormones (FSH, TG, LH); And beta is unique. That is why it is used to accurately obtain a result of a beta subunit (beta-hCG). In rapid diagnostics, test strips are used, where there is not such a specific HCG test (urine). In the blood of Beta-HCG accurately diagnoses pregnancy for already 2 weeks from fertilization. The concentration for the diagnosis of hCG in the urine ripens 1-2 days later than in the blood. In the urine, the level of hCG is 2 times less.

Factors affecting hCG

Determining the HCG during early pregnancy, some factors affect the result of the analysis should be taken into account.
Increased hCG during pregnancy:
. The discrepancy between the alleged and real term.
. Multiple pregnancy (increasing the result is proportional to the number of fruits).
. Early toxicosis.
. Gestosis.
. Serious malformations.
. Reception of gestagens.
. Diabetes.
Lowering the level of HCG - the term inconsistency, the extremely slow down increase in the CHG concentration by more than 50% of the norm:
. Non-compliance of the alleged and real term (more often due to the irregular cycle).
. The threat of miscarriage (the level is reduced by more than 50%).
. Measuring pregnancy.
. Running.
. Ectopic pregnancy.
. Chronic placental insufficiency.
. Fruit death in 2-3 trimester.

Invasive methods

If the doctor decides that invasive prenatal diagnostics should be used to identify hereditary disorders in development, one of the following procedures can be applied:
. Cordocentsis.
. Horion's biopsy (the study of the composition of cells from which the placenta is formed).
. Amniocentesis (survey of arrogant water).
. Placentzetz (negative consequences have been detected after infections).

The advantage of invasive methods is the speed and one hundred percent warranty of the result. Used in early pregnancy. So, if there are any suspicions of deviations in the development of the fetus, the prenatal diagnosis of hereditary diseases allows you to make accurate conclusions. Parents and Doctor can make a decision on time: leave the fruit or interrupt pregnancy. If parents, despite the pathology, still decide to leave the child, doctors have time to maintain and adjust the pregnancy and even treat the fruit in the womb. If the decision to interrupt pregnancy is accepted, then in the early deadlines, when deviations, physically and morally, this procedure is carried out much easier.

Biopsy Chorione

Analysis of the microscopic particle of the felling chorion is the cells of the future placenta. This particle is identical to the genes of the fetus, which allows the characteristic of the chromosomal composition, to determine the genetic health of the kid. The analysis is carried out in suspected diseases associated with chromosomal errors at conception (Edwards syndrome, Down syndrome, Patau, etc.) or at risk of developing incurable diseases of cystic diseases, sickle cell anemia, George Gentigton. The result of a chorion biopsy allows you to identify 3,800 diseases of the future child. But such a vice, as a defect of the development of the nervous tube, is impossible to identify this method. This pathology is detected only under the procedures of amniocente or cordo-beacon.
At the time of analysis, the thickness of the chorion should be at least 1 cm, this corresponds to 7-8 weeks of pregnancy. Recently, the procedure is carried out on the 10-12th week, it is safer to the fetus. But no later than the 13th week.

Procedure

The method of puncture (transcervical or transabdomomotional) choose surgeons. It depends on where it is localized relative to the chorion uterus walls. In any case, the biopsy is carried out when controlling ultrasound.

A woman is lying lying on his back. The selected place for the puncture is necessarily anesthetized by local exposure. The puncture of the abdominal wall, the walls of the myometrium are produced in such a way that the needle is in parallel with the chorion shell. The needle movement is controlled on ultrasound. The syringe makes a fence of the fabrics of Vorsin Chorion, the needle is extracted. With a transcervical way, a woman is located on the chair as under the usual inspection. Explicitly pronounced painful sensations is not felt. The cervix and walls of the vagina are fixed with special forceps. Access is provided by the catheter, when the chorionic tissue is reached, the syringe is attached and the material for analysis is taken.

Amniocentesis

The methods of prenatal diagnosis include the most common - the method of determining the pathologies of the development of the fetus - amniocentesis. It is recommended to hold it for 15-17 weeks. When conducting the procedure, the state of the fetus controls the ultrasound. The doctor through the abdominal wall introduces the needle into an amniotic fluid, sucks some amount for analysis and needle removed. Prepare results for 1-3 weeks. Amniocentesis is little dangerous for the development of pregnancy. In 1-2% of women, fluid leakage may be observed, it stops without treatment. Spontaneous abortion can occur only in 0.5% of cases. The needle is not damaged, it is possible to carry out the procedure even with multiple pregnancy.

Genetic methods

Dot-test is the newest safe genetic method when studying the fetus, allows you to identify Pataau, Edwards, Downner, Shereeshevsky-Turner, Klinfelter. The test is carried out on the basis of data that is obtained from the mother's blood. The principle is that with the natural death of some kind of cells, the placenta falls into the blood of the mother of 5% of the fetus DNA. This makes it possible to diagnose the main trisomy (dot-test).

How is the procedure? A pregnant woman is taken, the DNA of the fetus is distinguished. The result is issued within ten days. The test is carried out on any gestation period, starting from 10 weeks. Accuracy of information 99.7%.

Non-invasive methods

Predatal diagnostic methods

Methods of preimplant diagnostics

Special clinical instrumental and clinicolator methods

Special clinical and instrumental and clinicolator methods include methods of preimplantation and prenatal diagnosis of hereditary and congenital diseases. Among these methods are distinguished: non-invasive (without penetration into the body) and invasive (with penetration into the body).

Preimplantation diagnostics is the study of the DNA molecule in the elevation cells at the early stage of development of the zygota -

diI blastocyst (6-8 cells obtained in fertilization in vitro.- non-invasive method) or with the help of uterine lavage in the period 90-130 h after fertilization (invasive method).

The essence of these methods is that with the help of microsurgical intervention from the embryo, one or two cells are separated for subsequent genetic analysis.

The remaining germinal cells are frozen until the end of the analysis. If the hereditary pathology is excluded in the analyzed cells, then the remaining cells are defined and conditions are created for them are optimal for normal development, after which they are implanted in the uterus in the appropriate period of the menstrual cycle.

The advantage of these methods is the ability to interrupt pregnancy when a hereditary pathology is found.

The lack of these methods is a low percentage of successful implants (only 10-20%), as well as possible complications during pregnancy after successful implantation of the embryo.

With this method, for example, the diagnosis of marfane syndrome, based on PCR with reverse transcription, allowing you to identify mutations in the Fibriline gene.

Non-invasive PD methods are as follows:

Ultrasound is the most effective method. It is carried out at various times of pregnancy, including 18-22 weeks - the first ultrasound, 25-29 weeks - the second ultrasound, 32-36 weeks - the third ultrasound. Using ultrasounds are detected: congenital heart defects, neural tube defects, kidney polycystic, skeletal dysplasia, cleft lip, soft and / or solid waste, cell hygroma, meningocele, microcephaly, polydactylis, facial flavors and outdoor genitals. Ultrasound can be carried out in early pregnancy terms (12-14 weeks) in order to identify defects of a neural tube.

Electro (Echo) Fruit Cardiography. It is used in the third trimester of pregnancy for the diagnosis of congenital heart defects.

Fetoscopy and fetoamnyography. Used in the II trimester of pregnancy for biopsy cells of placenta and fetal skin cells (bullous epidermolysis).

Invasive PD methods are based on two approaches, with the help of the fences of embryo and fetus cells (under the control of the ultrasound).

First approach- Transcervical (through the vagina and the cervix).

Second approach -transabdominal (through the front abdominal wall).

In the early periods of pregnancy (8-12 weeks) for laboratory analysis, cells are used isolated from the material of chorion (chorion biopsy) or placenta (placentobiopsy). In the late period of pregnancy for laboratory analysis, cells obtained from amniotic (oloplodic) fetal fluid, or cells isolated from fetal cord blood (see "Cordsenthesis") are used.

Briefly consider basic invasive methods.

Amniocentesis. It is carried out at the deadlines of pregnancy up to 12 weeks, as well as 16-18 weeks. Allows you to analyze in the culture of embryo cells or fetus the condition of the karyotype and DNA molecule; In the amniotic fluid fluid, the level of alfactophetoprotein (AFP) is determined, and the serum of the fetus is the level of 17-oxyprogesterone.

Chorion's biopsy. It is carried out in terms of 8-12 weeks of pregnancy. Native cells and cells are analyzed in chorion tissue cultures. The same is investigated as at amniocentsis, except

Cordocentsis. It is held for 20-22 weeks of pregnancy by analyzing the fetal bodies, taken from umbilical vessels under the control of ultrasound.

Both amniocentesis and chorion biopsy are used in developed countries around 10% of all pregnancies. These methods are associated with the smallest risk for the embryo and fetus. They are diagnosed with: Down syndromes, Patau and Edwards, Triplo-X, violations of Y-chromosome, as well as more than 100 MB (the-sacca disease, hypophosphatemia, leucine, methylmalonia, insufficiency of adenosine formation, citrullinemia, etc.).

The final diagnosis of the hereditary and congenital disease, the doctor puts with the full conclusion of the clinical and paraklinic stages of the test of the sample.

These methods are more dangerous in terms of possible complications and more labor-intensive in conducting, so the doctor appoints them only with tough indications.

Invasive prenatal diagnostics 1 is divided into several types. Her task is to get a sample of fabrics belonging to the fetus.

Who is appointed invasive diagnostics?

The risk of developing chromosomal and genetic diseases is raised in the following cases:

mother's age is 35 years old and older;
birth in the family of a child with chromosomal pathology;
identifies the semicircle chromosomal anomaly;
monogenic diseases who are also identified in the family and the nearest relatives;
if the woman accepted a number of pharmacological preparations before pregnancy or on her early periods (antitumor and other);
transferred viral infections (hepatitis, rubella, toxoplasmosis and other);
irradiation of someone from spouses before conception;
the presence of at least two spontaneous abortions in the early periods of pregnancy in the past.

These women, as well as all pregnant women, conduct non-invasive prenatal diagnostics. These are screening biochemical tests: double - in 11-13 weeks (biochemical blood test + ultrasound) and triple, as well as a quadruple (with inhibit a) tests in 16-18 weeks. If the results of screening studies are alarming and at the same time a woman is included in the risk group, the doctor determines the need for invasive procedures.

If a woman is not included in the risk group, but the results of the analyzes and ultrasound were dubious, then it is also prescribed one of the methods of invasive diagnostics.

The decision to conduct a study takes a family on the basis of the information provided by the doctor. The doctor recommends research only if the risk of severe disease in the fetus exceeds the risk of complications from invasive diagnostics. At the same time, they are taken into account and the "prices" of risks, various in different cases. For example, a 7% risk for a woman with three children, and the same risk for a woman who has no children (this pregnancy is the first after 10 years of infertility or previous pregnancy ended with miscarriages) will be estimated differently.

Contraindications for amniocentesis, biopsy Vorsin Chorione

Contraindications for invasive studies are relatively relative, that is, even if there is contraindications, it may arise and the need for a study. So, among the contraindications - the threat of interrupting pregnancy, but it is known that a similar threat often occurs if there are certain defects for the development of the fetus, and the study is necessary to determine the further tactics of pregnancy, and to preserve pregnancy, research is carried out against the background of appropriate therapy.

The contraindications may also be malformations of the uterus, high temperature, active infectious diseases, nodes of moma - a benign muscle tissue tumor, located on the path of implementing the needle, as well as the location of the placenta on the way of introducing the needle.

How is the amniocentsis and biopsy Vorsin Chorion?

Invasive studies are usually carried out in an outpatient basis. At the same time, it is necessary to have the results of laboratory studies (blood and urine test, tests for syphilis, AIDS, hepatitis B and C, the analysis of the vaginal smear and otherwise indicated).

Invasive manipulations should be an experienced specialist. Studies are conducted under local anesthesia under the control of the ultrasound image. The puncture of the puncture) is performed) the front abdominal wall or access is carried out through the channel b cervix: the choice depends on the place of attachment of the placenta in the uterus. Next, not touching the fetus, the material is taken out for the study - particles of chorion or placenta, amniotic fluid or blood vein. To the fetus in invasive studies do not touch, if the purpose of the study is not the biopsy of the fetus fabrics! Next, pregnant for some time (4-5 hours) remains under the supervision of specialists. Special medicines can be assigned to the prevention of possible complications. If there are certain complications in the course of observation: there is a threat of interrupting pregnancy, detachment of the placenta and others. "The woman is hospitalized into the hospital and treat complications.

Types of invasive diagnosis

The following types of invasive prenatal diagnostics are distinguished:

chorionbiopsy (biopsy of the village of Chorion);
placentcentesis;
amniocentesis;
cordocentsis;
fetal tissue biopsy.

Biopsy Vorsin Chorione

It allows you to conduct studies of a chromosomal set of fetus (for example, the diagnosis of Down syndromes, Edwards, Patau) and gene mutations. The first way to conduct a study involves vaginal access: under the control of the ultrasound through the cervix to the fetal egg, the catheter (thin tube) is introduced. After contact with chorion, a certain amount of chorion fabric is satisfied with it. The second way of the fence of chorial tissue is abdominal - a syringe through the front abdominal wall. Such a study is also conducted under the control of the ultrasound. Biopsy Vorce Horion is held on the period of 11-12 weeks of pregnancy.

The result of the analysis is known 3-4 days after taking the material. Since the study is carried out up to 12 weeks of pregnancy, then if necessary, the interruption of pregnancy is also held up to 12 weeks, which is most safe for the body of a woman.

When conducting a biopsy of chorion, there is a risk of false-positive or false negative results, which is explained by the phenomenon of "placental mosaicism" - the inadenticity of the genome of the embryo cells and chorion.

There is also a risk of miscarriage, the risk of bleeding in a woman, the risk of fetal infection, as well as the risk of adverse flow of pregnancy at the rhesus conflict. With a rhesus conflict, antibodies that destroy the erythrocytes of the fetus are produced in the organism of the reserves-negative mothers. Conducting a biopsy of chorion can stimulate the production of antibodies.

It should be noted that in general the risk of all listed complications is small: it is no more than 2%.

Placentocentsis

Placentocentsis (Placety biopsy) is the taking to study the sample of particles of placenta containing fetal cells, and therefore all its chromosomal genetic material. Placentzetsis is similar to chorion biopsy, because The placenta is what the chorion is developing over time, but it is carried out in a later date - 12-22 weeks of pregnancy. The analysis is preparing for several days. The main objective of placentatence is to identify chromosomal and gene diseases in the fetus.

Under the control of ultrasound examination, the doctor makes a puncture of the pemer abdominal wall of a woman and takes a piece of placenta for further research. Since the study is carried out in the second trimester of pregnancy, then in the event of a pathology detection, the interruption of pregnancy is more traumatic than early time.

Complications of placentatette may be a detachment of the placenta, the threat of interrupting pregnancy, but the probability is minimal.

Amniocentesis

Amniocentesisrepresents a method for producing an oily fluid. This method makes it possible to determine a larger number of indicators. In addition to gene and chromosomal diseases, it is possible to define biochemical indicators (metabolism indicators), which can be judged by possible disorders of metabolism, the availability of certain diseases. For example, with the help of amniocentes, the degree of maturity of light fetus (lecithin and sphingomyelin hold), the presence of hypoxia (oxygen starvation), the reserves conflict is a state in which antibodies to the rhesus-positive erythrocytes of the fetus are produced in the organism The fetus is destroyed and the spree products of red blood cells fall into the oily water.

Research is possible from 15-16 weeks of pregnancy. Under the control of ultrasound in the uterine cavity through the front abdominal wall, a syringe is injected into which a material of 20-30 ml is gaining. In addition to the smallest fluid in the syringe itself, a small number of fetal cells (condensed epithelium) also falls, which are also exposed to research.

The result of an analysis after amniocentesis is ready after 2-3 weeks (special nutrient media requires, since the cells obtained are small and they need to multiply, as well as certain development techniques and a sufficient amount of time).

Among possible complications are the interruption of pregnancy, the leakage of spindle water, infectious complications, bleeding from the genital tract, weighting of the flow of the rhesus conflict. The probability of complications with this study is less than when conducting a biopsy of chorion.

Cordocentsis - This is the puncture of cord vessels. The material fence is carried out by puncture of the front abdominal wall of the pregnant woman (under the control of the ultrasound) and the production of umbilical blood. The study is carried out after the 20th week of pregnancy. Cordsenthesis allows you to perform almost all analyzes that can be made from the usual analysis of blood (hormonal examination, biochemical indicators, infections, immulogical states, etc.), as well as, like all other methods, helps to identify gene and chromosomal diseases. This method is used not only as a diagnostic procedure, but also as therapeutic - for the introduction of drugs, intrauterine blood transfusion, for example, with severe rhesv conflict.

With the help of amniocente and cordo-beerocente, you can also conduct diagnostics of infections (if infection is assumed). The complication of the procedure may also be a pregnancy interrupt.

Biopsy of fabrics of fruit As a diagnostic procedure is carried out in the second trimester of pregnancy under the control of ultrasound. For the diagnosis of heavy hereditary skin diseases (hyperkeratose, ichthyosis - diseases, in which the process of skin orog is disturbed, the surface layer of the skin is impaired, the skin becomes like fishing scales) make the biopsy of the fetus. The method of obtaining the material is similar to those described above, but at the end of the special needle, which is introduced into the uterine cavity, there are tweezers that allow you to get a small piece of skin of the fetus. Next, a study is carried out, which allows you to clarify the presence of hereditary skin diseases. For the diagnosis of muscle diseases produce biopsy of the muscles of the fetus.

How do the material obtained? The fabric obtained as a result of a particular procedure is used to study. Transfer main types:

Cytogenetic - With the help of this method, the presence of additional or absent chromosomes (the detection of Down syndrome is the excess 21th chromosome, the clanfelter is an extra x chromosome, the Turner syndrome is the lack of X-chromosome in the female fruit).

Molecular genetic - With this method, the presence of defects inside chromosomes are determined, that is, the presence of gene mutations caused by certain diseases: hemophilia, phenylketonuria, muscular dystrophy of Duzhenna, fiberglass.

Biochemical(definition of the maturity of light fetus, fetal hypoxia) and others (definition of the presence and severity of rhesv conflict).

Subject to all norms and rules for invasive diagnostics, the main risk of listed procedures is the threat of miscarriage. In the quantitative value, it is 2-3%. But these indicators do not exceed the risk of the same problem among other pregnant women. Meanwhile, the resulting result is extremely important for the forecast of the health of the future child, because these diagnostic methods are the most accurate.

1 Prenatal diagnostics (Pre - "to", Natalis - "related to childbirth") allows you to establish a state of the fetus before delivery.

2 Chorion is the predecessor of the placenta, it is attached to the wall of the uterus.