Screening v 11.–13.⁺⁶ týdnu těhotenství

English version

Autoři: J. D. Sonek ¹; K. H. Nicolaides ²; Petr 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: Ceska Gynekol 2012; 77(2): 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.

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