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THE prenatal checkup aims at the early diagnosis of diseases and syndromes of mother and fetus, with the aim of ensuring their good health, but also to give as much information as possible to parents, regarding the existence of a disease, its prognosis and the possible effects on the fetus.
THE Uterine Medicine or Fetal Medicineconstitutes that sub-specialty – specialization of Obstetrics, which, in the prenatal check-up, checks the fetus in detail.
The test is done either to diagnose some syndromes in the fetus, or to prevent possible future problems in the fetus or the mother, or to treat in an invasive way. That is, if, for example, the fetus has fluid in the lungs, which do not develop properly during pregnancy, we place a “tube” in the chest of the fetus, which empties this fluid, as a result of which the lungs develop and normal growth continues. its development.
Specialized ultrasound examinations in pregnancy
The three serious, necessary and specialized ultrasound examinations are performed approximately every three months during pregnancy and are cervical transparencythe Level B (analytical ultrasound) and the color Doppler ultrasound.
1st trimester
The ultrasound of the cervical transparency is done by 11th to 14th week, and we measure the thickness of the fold of the neck of the fetus, we roughly check its anatomy, we look for markers (signs) that may indicate a problem in the fetus and blood is taken to check hormones (PAPPA, free-BHCG and optionally the hormone PLGF) .
In this way we determine the probabilities for Down syndrome (trisomy 21), the Edwards syndrome (trisomy 18) and the Patau’s syndrome (trisomy 13).
These tests are necessary, as the result determines whether the pregnant woman should proceed with further invasive testing with amniocentesis (or trophoblast) or not. Also, in this ultrasound with the hormone PLGF and some parameters, we check the possibility for pre-eclampsia, if the parents request it. Preeclampsia is the most common complication of pregnancy and occurs in 1-2 per 20 pregnant women. Manifested with hypertension (raised blood pressure) in the woman in the 2nd trimester of pregnancy usually. The result is that the fetus does not develop normally and, in many cases, when the drugs do not help, we need to intervene and “take” the fetus by caesarean section prematurely, since it is not properly nourished and its life is in danger, but also to we can treat the pregnant woman who is at risk of eclampsia.
Early prevention of pre-eclampsia in cervical transparency ultrasound can save the mother, but also the fetus from all those problems that can be caused by prematuritysince with the ultrasound of the cervical transparency and with the examination of the PLGF hormone in the pregnant woman’s blood, we can predict the possibility of pre-eclampsia and reduce up to 90% the possibility of its manifestation with drugs.
Also, in the cervical scan, we do a basic anatomy check of the fetus and check the possibility of premature birth, with some parameters that we measure.
2nd trimester
In the 2nd trimester, the Level 2 ultrasound is done between 20 and 24 weeks. The anatomy of the fetus, its development is checked in detail and the possibility of Down syndrome and premature birth is rechecked.
If there is an indication or suspicion of a syndrome in the fetus from the cervical transparency or from Level B, or even if both parents have a hereditary disease, such as Mediterranean or cystic fibrosis stigma and want to check if their child also has that stigma or the disease, then it is recommended to do either Trophoblast Extraction in the 1st trimester or Amniocentesis in the 2nd trimester to check the chromosomes and genes of the fetus.
3rd trimester
In the 3rd trimester, the color Doppler ultrasound is performed at approximately 28-32 weeks. It controls the good development of the fetus. Again, the anatomy of the fetus is carefully checked, because there are problems that manifest after the 2nd trimester. Also, the perfusion of the fetus and the placenta is checked, in order to make sure that the fetus is properly nourished by receiving the necessary amount of blood, to be able to predict situations that can endanger the development of the fetus or even cause and fetal death.
Problems that the fetus may have, either chromosomal or genetic and diagnosed only by amniocentesis or trophoblast, may be present in 1 in 70 fetuses. That’s a big percentage, considering we’re doing an amniocentesis when the chance of Down syndrome is 1 in 300 or higher.
There are, of course, other syndromes, apart from the well-known Down syndrome, which are not diagnosed by ultrasound but only by amniocentesis or trophoblast and of course are not related to the age of the woman.
It is important that at least the special ultrasounds are done by doctors specialized in Prenatal control. Our goal is always to protect the health of the mother and the fetus from any problems that may occur in a pregnancy, to help the pregnancy progress smoothly and to ensure the birth of healthy babies.