Pregnancy: First-trimester screening
An advanced ultrasound 11 to 14 weeks gestation may be already at this early time information on birth defects, according to experts.
First-trimester screening: Enhanced Ultrasound
Photo: © iStockphoto.com/ Alexraths
The pregnancy as a time of hope and expectation and joy is always a downside: Months of uncertainty as to whether the child is born healthy. For some time, doctors have a way more to estimate the risk of serious congenital malformations: the first-trimester screening. This means that in the first third (First-trimester) pregnancy a comparatively cost-effective, meaningful and accessible to all women analysis (screening) is taken. This ultrasound examination in the 11th to 14th week of pregnancy goes far beyond the already long for this period mandatory ultrasound examination can be found in only if the child lives, is the required size and possibly has gross malformations.
"The first-trimester screening has - at such an early stage - much more meaningful"Said Prof. Dr. Renaldo Faber, head of the department for prenatal and maternity care at the Women's Clinic of the University of Leipzig. "It allows about 80 percent risk assessment in terms of Down syndrome (trisomy 21) and all other common chromosomal abnormalities such as trisomy 18, trisomy 13 or Turner's syndrome. we see less drastic changes in the genetic material with a little less likely." A possible blood test increases the likelihood of this risk determination by another ten percent. Also, multiple pregnancies can assess very early prognosis in this investigation. In addition, the experienced doctor can detect serious congenital malformations at five to eight millimeters tiny heart, at the diaphragm, kidneys, spinal cord or limbs or exclude. Abnormalities are feared all invasive techniques such as placental puncture (chorionic villus biopsy), amniocentesis (amniocentesis) and umbilical blood sampling are performed (cordocentesis) for the production of child (fetal) cells or tissues.
First trimester screening: What is being tested?
The costs are borne by the pregnant woman
If a pregnant woman decides of its own considerations for first-trimester screening, however, they must first have to dig into their private pockets. The ultrasound examination, for example costs between 100 and 150 euros. The health insurance only jump back on when anomalies are detected.
"Certainly there is an ethical question, how I deal with the knowledge of the malformations of my unborn child"Said Prof. Faber. "But 95 percent of women who are confronted with the dramatic news of a Erbmaterialstörung, break the pregnancy from. This opportunity should give those affected, but help them in this difficult decision by supplying fuller information on the likelihood and extent of the expected disease." But even women who are determined from the outset to discharge every unborn child, take advantage of this because they are always present in the majority of cases care taken can be.
Digestion is mainly the nuchal translucency
What exactly might Prof. Faber and his colleagues discovered in a mere 45 to 84 millimeter fetus? And what will the risk calculated? "It is mainly the nuchal translucency, which is measured by ultrasound. Is this Water accumulation in the back area greater than 2.5 millimeters, increases the risk of malformations"So Faber. "The value enters into a complicated risk calculations. In addition to the nuchal translucency the woman's age as playing a role, and the occurrence of hereditary diseases in their family. Were age and family Erbbelastung formerly the only tangible risks associated with Down syndrome, so they are now so only criteria that we can include in the overall statement." That is the strict, conducted solely by the statistics rule that women should decide for amniocentesis over 35, characterized unnecessary. After all, for example, around 70 percent born of all children with Down syndrome of women below the age limit, ie women who have special tests had been offered earlier automatically.
Completely new in medicine is the system that an expert like Prof. Dr. Renaldo Faber responsible draws in central Germany, all physicians who perform a specific investigation to train regularly. "Only those who during the year Refresh rate Leipzig or corresponding other institutions concerned at the University of the latest developments," so Faber, "may apply and make binding statements especially to the pregnant this method." (IDW)