How are the first, second and third screenings. What screening and how to decipher them?
For many women the word "screening" inspiresfear. In fact, there is nothing wrong, dangerous or unknown. This word comes from the term "screening". That is, in medicine, the word refers to the mass screening survey to identify the disease as the mom and the baby. That is screening in pregnancy is a test expectant mothers to determine the health and full development of their future children.
With such a study at an early andmiddle stages of pregnancy reveal the so-called congenital conditions. That is, you will know in advance whether your baby is healthy and he will need help doctors after birth.
The main observations aimed at identifying such complex pathologies like Down syndrome (trisomy 21), Edwards syndrome (trisomy 18) and neural tube defects (NTDs).
In addition, prenatal screening allows you to learn in advance about such pathologies as the Cornelia de Lange syndrome, Smith-Lemli-Opitz syndrome, triploidy nemolyarnaya, Patau syndrome.
Screening during pregnancy consists of a series of analyzes and carried out in parallel with ultrasound baby with extra dimensions.
Consider everything in order, and more.
The first comprehensive screening in pregnancyIt includes biochemical analysis of venous blood for determination of the subunit of human chorionic gonadotropin and PAPP-A - plasma protein associated with pregnancy.
This analysis is done to identify the earlystages abnormalities in fetal development. If tests showed not the norm, it may indicate congenital pathology or genetic abnormalities in the child.
In this case, mom sent for additional investigation - such as amniocentesis (amniotic fluid with a special needle taken for analysis) and chorionic villus sampling.
In the first screening, as a rule, sent to women at risk:
- At the age of 35 years;
- Those in the family who have Down syndrome or other genetic diseases;
- Those who in the past had miscarriages, stillbirths, missed abortion, children with congenital abnormalities or genetic abnormalities;
- Women who have suffered at the beginning of pregnancy viral diseases, taking dangerous drugs for embryo or have been exposed to radiation.
At the first ultrasound screening (11-13 weeks gestation) are determined by:
- The number of embryos in the uterus of a woman, and their ability to survive;
- Clarifies the term of pregnancy;
- Are revealed grave defects of organs of the child;
- Determined thickness for collar zone, which involves the measurement of subcutaneous fluid in the back of the neck and shoulders;
- We investigate the nasal bone.
Deviation from the norm in the first screeningIt indicates the probability of risk of various chromosomal and some not chromosomal aberrations. It should be noted that the increased risk is not a reason to worry about the defects in the fetus.
These studies suggest a closerfor pregnancy monitoring and full development of the child. Often, if the result of the first screening showed an increased risk for some indicators, the conclusions can only be made after the date of the second test. And in case of serious deviations from the norm a woman consults a physician-geneticist.
The second screening
The second comprehensive screening in pregnancyIt runs from 18 to 21 weeks. This study includes a "triple" or "quadruple test". Running it in the same way as in the first trimester - a woman delivers a biochemical analysis of venous blood.
But, the second screening involves the use of test results to determine the three or at least four parameters:
- Free beta subunit of hCG;
- Free estriol;
- Quadruple test - inhibin A.
Interpretation of results is based on the deviationthe resulting figures from the average norm according to certain criteria. Calculations are performed by a computer program then analyzes the doctor who takes into account the number of individual parameters (race, to which belongs the pregnant and the father of the child, the presence of chronic, including inflammatory diseases, the number of embryos; weight women, the presence or absence of bad habits).
That such secondary factors can affect a change in the values of the studied parameters.
For maximum reliability of the results,certainly compared with the data of prenatal screening in the first trimester. And besides biochemical analysis is also carried out ultrasound, which look already formed organs of the baby.
If the results of the first and second screenings revealed abnormalities in the development of the baby, the woman may be asked to re-study or referral to a specialist genetics.
The third screening
The third screening is carried out at 30-34 weeks of pregnancy. It is held in order to assess the functional status of the child, and ensure that the baby and the placenta interact effectively.
It is estimated as the position of the baby. This will determine how it will behave during labor, childbirth, and what tactics to choose a doctor. In addition, the state is estimated and the location of the placenta, which is also important for future delivery.
In the third study, the women again appoint a triple biochemical analysis venous blood, and can also send additional studies such as Doppler and cardiotocography.
Doppler allows the doctor to assess the capacity ofblood flow in uterine and placental vessels and great vessels in the child. It provides an understanding of how much oxygen and nutrition the baby gets and whether they suffice him.
Cardiotocography (CTG) registers frequencyheart rate of the child, even in the process of childbirth. Pulse of the child is determined by a sensor. This test is performed only after 32 weeks, because the timing of the wound 32 weeks the results will be inaccurate.
The first, second and third screenings are held forIn order to evaluate the health of your baby and his willingness to leave, because in them he must actively "work". Research can prevent some of the potential problems.
After all, any problem is easier to prevent thanthen the long and hard to treat. In any case, to carry out the prescribed inspection at a particular stage of pregnancy is necessary. Objectively, this is the only opportunity to learn about the health of the baby in advance.
And do not believe the "popular" rumors thatultrasound is harmful to the baby or irritating it. This is absolutely not true, especially if you obsleduetes in the clinic, which has modern equipment and highly qualified specialists.
Even if the doctor said that you have a high risk of pathologies - do not despair. Not always it is something highly significant, requiring global solutions to keep the pregnancy or not.
Sometimes a child can detect pathology requiring surgery after birth.
And, if you and the doctor know about it in advance, then the chances of the most effective treatment and good health of your baby increase considerably.
You as a mother in the first place are carryingresponsibility for the future of your baby, so Treat screenings responsibly. Find a specialist who competently and available to explain to you what's going on with you and your child, and thus dispel all your fears and doubts.
And let everything you and your baby will be fine!