Full body screening. Diagnostic programs

Screening – comprehensive examination, which will show the state of fetal development on certain moment. Based on the screening results, the doctor observing the woman draws conclusions about the course of pregnancy and, if necessary, prescribes more detailed examinations or consultations in specialized centers.

Show all

Screening and ultrasound: what's the difference?

The word "screening" comes from English word screen - “to sift, filter, select.” In medicine, this term is used to refer to safe research for large groups of the population. Prenatal (antenatal) screening allows you to determine the degree of risk of developing congenital pathologies fetus Initially, such a diagnostic system was created in order to identify women who may experience complications during pregnancy, distribute them according to various groups, and then provide them with planned examinations, observations and assistance.

Women often mistake ultrasound diagnostics for screening in a broad sense. But ultrasound is called screening because it is carried out as part of this study and is an integral part of it. The whole complex includes:

Biochemical blood test for certain hormones and other serum markers. In a woman’s blood, the levels of several hormones are determined, which are indicators of a successful pregnancy and appropriate fetal development. A biochemical blood test is taken twice (double test and triple test): from the 11th to the 14th week and from the 16th to the 20th week. The results make it possible to recognize fetal development abnormalities as early as possible and identify genetic abnormalities.
An ultrasound examination is carried out three times during pregnancy: at 12–14 weeks, at 21–24 weeks and at 30–34 weeks. Three procedures are mandatory, but there may be more if the doctor deems it necessary. The third screening ultrasound is performed with Doppler ultrasound, which makes it possible to assess whether blood circulation in the uterus and placenta is normal, and what is the condition of the blood flow in the vessels of the unborn child.
Infectious diseases research. At 10-12 weeks, when a woman registers with the antenatal clinic, and at 30 weeks, the doctor will take a smear of vaginal discharge and cervical canal. In the first and third trimester, you will need to take blood tests for syphilis, HIV, hepatitis B and hepatitis C. In the first trimester, you will need to be tested for TORCH infections (the abbreviation stands for English names infections: toxoplasmosis, rubella, cytomegalovirus, herpes virus and others).

Prenatal screening consists of several stages in order to provide medical professionals and the expectant mother with the necessary information about the dynamic development of the fetus. This is one of the safest and available funds diagnostics: the procedures do not affect the course of pregnancy, as they are carried out without intervention in the uterine cavity.

At the antenatal clinic, a pregnant woman fills out a questionnaire, which indicates the data necessary to calculate the risk of defects intrauterine development. Once analyzes and studies are ready, all information is entered into a special computer program, where risks are calculated. There is an age-related risk for pathology, biochemical parameters, by disease. The presence of a high risk does not mean one hundred percent presence of a defect in the fetus. During pregnancy, the woman will be under closer attention from specialists and will undergo a number of additional consultations and examinations.

Screening stages

In early pregnancy (from 11th to 14th week) biochemical screening makes it possible to identify genetic abnormalities and severe congenital diseases of the fetus. The test determines the amount of two substances significant for pregnancy in a woman’s blood:

1. Human chorionic gonadotropin (hCG);
2. Plasma protein associated with pregnancy A (PAPP-A).

HCG is a hormone produced by one of the components of a fertilized egg. After implantation to the wall of the uterus, it stimulates the development of the placenta, preparing the woman’s immunity to accept the fetus. Comparing hCG levels between different dates pregnancy, the doctor will promptly identify abnormalities:

If determined increased level hormone, then one might suspect diabetes in a pregnant woman and Down syndrome in a child.
If hCG level lowered, this may indicate ectopic pregnancy, threat of miscarriage, delayed fetal development, placental insufficiency.

PAPP-A is a protein essential for the development of the placenta. If there is a decrease in its level in the blood over time, this indicates the risk of chromosomal abnormalities of the fetus or the threat of miscarriage. In cases where indicators deviate from the norm, additional examinations of the pregnant woman are necessary.

An ultrasound examination is aimed at assessing the vital activity of the embryo, determining its location and comparing its size with norms. Ultrasound at this stage allows you to name the date of birth with an accuracy of 1-2 days, thereby establishing the duration of pregnancy, as well as assessing the risk of miscarriage or premature birth:

The optimal period for completion is the period from the 12th to the 13th week. At the 12th week, the length of the embryo is 6–7 cm, weight is about 10 grams; A pulse with a frequency of 100–160 beats per minute is also heard.
Ultrasound at this stage allows you to name the date of birth with an accuracy of 1-2 days, thereby establishing the duration of pregnancy, as well as assessing the risk of miscarriage or premature birth.
At the first ultrasound, the specialist needs to determine whether the fetus is located outside the uterus, whether placental abruption is observed, or whether there is a disruption in the formation of individual parts or the entire body of the unborn child. It is at an early stage that it is revealed how many embryos are in the uterus. If not determined multiple pregnancy on early stage, may arise serious problems further.
One of the most important indicators for ultrasound, this is the thickness of the cervical fold. Cervical region the embryo's spine is covered soft tissues. Interval between outer surface these fabrics and inner surface skin of the neck is called the cervical fold. There is an accumulation of fluid here, and the greater its thickness is visible, the more likely the presence of pathology. More accurately, the degree of risk can be calculated by considering this indicator in conjunction with data from other surveys.
Ultrasound also evaluates the visualization of the nasal bone. If the length of the nasal bone is less than the norm established for a given period, then this may be a sign of chromosomal abnormalities.

Medical professionals examine the results of biochemical tests and ultrasound together. The woman's age and medical history are taken into account. If, based on the results of tests and ultrasound, a high degree of risk of pathologies such as Down syndrome, neural tube defects, Edwards syndrome, Patau syndrome, etc. is determined, the woman is sent for a consultation to a medical genetic center, where additional examinations may be recommended. Based on these data, the issue of further bearing the child will be decided. However, not all abnormalities in fetal development may be detected at the first screening.

Second screening

In the second trimester (week 16–20), a screening examination excludes malformations of the heart, kidneys, lungs, brain, limbs, bone tissue. The triple biochemical test is again aimed at calculating the risks of having a child with a genetic pathology and congenital diseases (spina bifida, anencephaly, etc.). The woman takes a blood test for alpha fetoprotein (AFP), free estriol and a second test for hCG. Alpha-fetoprotein is a protein that is produced in the child’s liver; it protects the fetus’s body from the effects of maternal immune system. Free estriol is a hormone whose level in the blood increases in proportion to the duration of pregnancy. In the normal state, its content is minimal.

Ultrasound is performed in two-dimensional or three-dimensional mode:

Usually they do a two-dimensional ultrasound to get an idea of the structure internal organs future child.
Three-dimensional ultrasound is done as prescribed by a doctor and is used to detect surface defects.
The specialist estimates the quantity amniotic fluid and the condition of the placenta, which provides information about uteroplacental blood flow.

During the second ultrasound screening, women are very often asked to do family archive Record an image of the unborn child and name its gender. It is usually possible to determine the sex: the size of the fetus already allows the specialist to examine its basic anatomy. But it should be remembered that this is not the main purpose of ultrasound in the second trimester.

If, as a result of the first and second screening studies, the indicators deviate significantly from the norm, then it is likely high risk that pathology is developing. This is the reason for the appointment additional research and consultation with a genetic specialist.

Third screening

The focus of ultrasound in the third trimester (30–34th week) is fetal biometry (head size, abdominal circumference, length are measured). femur) and assessment of the condition and functions of the placenta. The doctor needs to establish whether the child’s weight corresponds to the norms for a given stage of pregnancy, determine how proportionate and harmonious the development of the fetus is, and clarify the features physical condition fetus, identify umbilical cord entanglement, if present. In the case of placental insufficiency, a manifestation of intrauterine growth retardation is likely, which must be treated. The doctor will prescribe medications aimed at normalizing metabolic processes and support vital functions fetus It is possible that intrauterine developmental defects may be detected at this stage. Based on the results, doctors will be able to prepare for the birth of the child and provide him with medical care immediately after birth.

For a woman, fetal Doppler testing does not feel different from a standard ultrasound. This test identifies defects in the child's heart and blood vessels and shows whether the child is suffering from a lack of oxygen (hypoxia). If so, the doctor will be able to determine where the blood flow is being disrupted: in the uterus, placenta or umbilical cord. In this case, the woman is prescribed appropriate treatment. After treatment, the woman must undergo control Doppler testing, which will show the results of therapy.

Microscopic examination of vaginal and cervical discharge and blood tests for infections can suggest whether the baby is likely to become infected during childbirth.

Concerning questions about the safety of ultrasound

Every woman preparing to become a mother worries whether the tests prescribed by the doctor will harm the health of the unborn baby. And if women treat taking blood from a vein as an unpleasant, but familiar and harmless procedure, then ultrasound diagnostics has its supporters and opponents. Many people consider ultrasound dangerous to health and pass on myths about the dangers of this study.

Ultrasound is one of the safe methods diagnostics You can undergo these studies without fear, even if they are prescribed more than once, since ultrasound waves do not have harmful effects, unlike X-rays. Ultrasound is based on the principle of echolocation. Specially tuned sensors emit ultrasonic vibrations, which are reflected from the object under study and received back by the same sensors. A computer program analyzes the information received and displays an image of the organ being studied on the monitor. Many are afraid that the 20 Hz frequency at which the ultrasound machine sensor operates stimulates growth cancer cells, in other words, can provoke the development oncological pathology even in healthy body. To date, there is no substantiated evidence for this theory, although many studies have been (and still are) conducted on the topic of the harmlessness or harm of ultrasound. The harmlessness of ultrasound is confirmed by scientists and famous medical specialists in the field of oncology. Ultrasound waves do not have a pathogenic effect on tissues, including the skin. Dermatitis, pigmentation disorders, redness, peeling and other skin changes were not recorded after ultrasound.

Some women insist on giving up ultrasound examination. In this case, you must refuse it in writing in the gynecologist's office. Even if a woman believes that the risk of fetal development pathologies is minimal, it is still recommended to undergo biochemical tests and get a consultation at a medical genetic center.

You should not refuse ultrasound as part of prenatal screening if one or more factors occur:

pregnant woman over 35 years of age: the risk of complications increases with age;
the woman has had (especially in the first trimester) hepatitis, rubella, chickenpox, and is a carrier of the herpes virus;
sinusitis, otitis, pneumonia or other serious bacterial disease in a woman during pregnancy;
the woman was taking medical supplies prohibited during pregnancy;
the woman has had more than two miscarriages or previous pregnancies had an unfavorable outcome;
a child from previous pregnancies was born with pathology or developmental defects;
one of the parents was exposed to ionizing radiation;
one of the future parents had children with pathologies.

How to prepare for screening tests

Blood collection for biochemical research produced from a vein. This is done both in the antenatal clinic and in a specialized laboratory. Take the test on an empty stomach. It is recommended to have dinner before 19:00 the night before. A large and late dinner, as well as breakfast, can provoke changes in indicators. It is recommended to ask your doctor in advance whether you should follow a certain diet before taking the test or whether you can eat your usual food. The doctor will ask you to exclude foods containing glucose from your diet on the eve of the test. These are grapes, pears, melons, figs, honey, sugar, candies and other sweets, White bread, cereals, legumes. In the morning you can drink still water.

You should not donate blood after physical activity, physiotherapeutic procedures, x-ray examination, intravenous administration medicines. Tablets that need to be taken in the morning can be taken.

Preparing for an ultrasound for screening is also simple. The first ultrasound is performed both transvaginally (through the vagina) and abdominally (through the anterior wall of the abdomen). Before the procedure, if possible, it is advisable to perform hygiene procedures- take a shower and wash yourself. If the diagnosis is carried out abdominally, then it is necessary to come to the procedure with a full bladder. To do this, you need to drink two glasses of plain water half an hour before the test. If the specialist then needs to continue the examination transvaginally, the woman will be asked to go to the toilet first.

At the second stage of screening, an ultrasound scan is performed abdominally, but there is no need to drink water: amniotic fluid is sufficient to study the condition of the fetus. At the third stage, the examination is carried out through the abdomen; no preparation is needed.

Often both blood sampling and ultrasound examination are performed on the same day.

Reliability of results

According to the results comprehensive research The obstetrician-gynecologist draws conclusions about the course of pregnancy, the state of health of the woman and the fetus and, if necessary, corrects deviations in a timely manner. However, screening results cannot be 100% accurate. exact result. The effectiveness of using the ultrasound research method in diagnostics congenital anomalies is 70–80%.

There is a possibility that the result will be false positive, which will give cause for alarm and additional examinations, unnecessary stress for a woman. A false negative result will prevent reversal Special attention during pregnancy. Experts note that sometimes we encounter situations where pathological process develops too quickly and does not allow timely diagnosis. An example would be the case of transient flow intrauterine infection in late pregnancy, which led to changes in the internal organs of the fetus that are incompatible with life.

In case of multiple pregnancy currently screening is not informative, since it has not yet been studied sufficient quantity women, which would allow for a correct interpretation of the results. Indicators developed for singleton pregnancies will not be reliable in this case.

If obvious pathology has not been identified, but the examination results place the woman in a high-risk group, then she will have to make a decision on the advisability of further carrying the pregnancy. If a decision is made to terminate the pregnancy, it should be done early stages much safer for a woman’s health. Not everyone finds this method ethical. Every year in Russia two thousand children are born with Down syndrome. According to the Moscow Center for Curative Pedagogy, this figure is not seriously decreasing, but it is not increasing either, which speaks in favor of the information content of prenatal screening, especially during pregnancy up to 12 weeks.

Majority medical workers believes that the opportunity should be used to identify emerging pathology as early as possible. If a malformation is discovered during examinations, in many cases specially selected tactics for managing pregnancy and childbirth can minimize the identified complications. If diagnosed chromosomal abnormality, then it is impossible to influence the situation with medication. Parents will try to get as much information as possible and prepare mentally for the birth of a potentially unhealthy child. Each pregnant woman decides for herself whether she wants to be sufficiently informed about the health of her unborn child. Statistically, the decision is usually made in favor of surveys.

When a woman is expecting a child, she has to undergo multiple tests and undergo prescribed examinations. Every expectant mother can be given different recommendations. The screening test is the same for everyone. This is what will be discussed in this article.

Screening study

This analysis is prescribed to all expectant mothers, regardless of age and social status. A screening test is carried out three times throughout the pregnancy. In this case, it is necessary to adhere to certain deadlines for taking tests.

Medicine knows screening research methods, which are divided into two types. The first of these is analysis. It determines the possibility various pathologies in the fetus. The second test is an ultrasound screening test. The evaluation must take into account the results of both methods.

What diseases does the test detect?

A screening test during pregnancy is not an accurate way to make a diagnosis. This analysis can only identify predisposition and establish the percentage of risk. To obtain a more detailed result, it is necessary to conduct a screening study of the fetus. It is prescribed only when the risks possible pathology very high. So, this analysis may reveal the possibility of the following diseases:

During the examination, the doctor measures the growth of the fetus and notes the location of the placenta. The doctor must also make sure that the child has all limbs. One of important points is the presence of a nasal bone and it is these points that the doctor will subsequently rely on when deciphering the result.

Second examination

A screening test during pregnancy in this case is also carried out in two ways. First, a woman needs to take a blood test from a vein and only then undergo an ultrasound. It is worth noting that the established time frames for this diagnosis are somewhat different.

Blood test for second screening

In some regions of the country this research is not carried out at all. The only exceptions are those women whose first analysis gave disappointing results. In this case, the most favorable period for donating blood is in the range from 16 to 18 weeks of fetal development.

The test is carried out in the same way as in the first case. The computer processes the data and produces the result.

Ultrasound examination

This examination is recommended between 20 and 22 weeks. It is worth noting that, unlike a blood test, this study is carried out in all medical institutions in the country. At this stage, the height and weight of the fetus are measured. The doctor also examines the organs: the heart, brain, and stomach of the unborn baby. The specialist counts the baby’s fingers and toes. It is also very important to note the condition of the placenta and cervix. In addition, Doppler sonography may be performed. During this survey the doctor monitors the blood flow and notes possible defects.

During the second ultrasound screening, it is necessary to examine the waters. There should be a normal number of them for the given period. There should be no suspensions or impurities inside the membranes.

Third examination

This type of diagnosis is carried out after the most suitable period is 32-34 weeks. It is worth noting that at this stage the blood is no longer examined for defects, but only ultrasound diagnostics are performed.

During the manipulation, the doctor carefully examines the organs of the unborn baby and notes their features. The baby's height and weight are also measured. An important point is normal physical activity during the study. The specialist notes the amount of amniotic fluid and its purity. The protocol must indicate the condition, location and maturity of the placenta.

This ultrasound is in most cases the last one. Only in some cases, re-diagnosis is prescribed before birth. This is why it is so important to note the position of the fetus (head or pelvic) and the absence of umbilical cord entanglement.

Deviations from norms

If during the examination various deviations and errors were identified, the doctor recommends seeing a geneticist. At the appointment, the specialist must take into account all the data (ultrasound, blood and pregnancy characteristics) when making a specific diagnosis.

In most cases, possible risks do not guarantee that the child will be born sick. Often such studies are erroneous, but despite this, doctors may recommend additional studies.

More detailed analysis is a screening study of the microflora of amniotic fluid or blood from the umbilical cord. It is worth noting that this analysis entails Negative consequences. Quite often, after such a study, every woman has the right to refuse such a diagnosis, but in this case, all responsibility falls on her shoulders. If poor results are confirmed, doctors suggest an artificial termination of pregnancy and give the woman time to make a decision.

Conclusion

Screening during pregnancy is very important analysis. However, we must not forget that it is not always accurate.

After birth, the child will undergo neonatal screening, which will absolutely accurately show the presence or absence of any disease.

YOU CAN SAY WHAT IS IN THE PREVIOUS QUESTION + THIS!!!

Wikipedia( Various screening tests are used to possibly early diagnosis malignant neoplasms.

Among the fairly reliable cancer screening tests: Pap test - to identify potentially precancerous changes and prevent;

cervical cancer Mammography - to identify cases;

breast cancer Colonoscopy - for exclusion;

colorectal cancer Dermatological examination to rule out.)

melanoma

BOOK Methods used for mass screening of the population include: honey. preventive examinations (an obligatory component of which is the oncological component. It includes an active survey, clinical examination, with assessment of the condition of all peripheral zones, lymph nodes X-ray examination

lab tests , cytological examination, etc.). In relation to the inspected contingents preventive examinations are divided into massive

And

Mass medical examinations are carried out according to a predetermined plan by a team of doctors of various specialties and mainly cover organized populations working in enterprises. Depending on the objectives and scope of the surveys, they are divided into, preliminary.

periodic, complex and targeted Preliminary medical examinations - upon entry to work - determine the suitability of workers and employees for their chosen work with the aim of preventing occupational diseases. At the same time, the oncological component of the examination is carried out. Periodic

medical examinations provide dynamic monitoring of the health status of workers in conditions of occupational hazards and their temporary establishment initial signs occupational diseases, their prevention and identification of common diseases that prevent the continuation of work harmful conditions labor. In the process of conducting them, each doctor must carry out an examination with the aim of detection of malignant neoplasms. Complex medical examinations - aimed at identifying various diseases including oncological ones, among fairly large contingents of workers and the unorganized population, are most often carried out by visiting teams of doctors of various specialties. Currently, mass comprehensive examinations carried out in multi-stages have become prevalent. With one-stage, the medical team examines the entire contingent: with two-stage, in the first stage the entire population is examined by nursing staff, and in the second - a part of the population already selected by them (-2 0%) with suspected oncopathology and precancerous diseases examined by a visiting team of doctors. Three-stage preventive examinations are carried out according to the following scheme: nursing staff - a doctor at the medical site - a visiting team of doctors.

Target medical examinations - carried out to identify one or a group of similar diseases (for example, examination of the mammary glands).

Subject to inspection

cological diseases among individuals. those who have applied to outpatient clinics or are undergoing inpatient treatment.

In this case, a local doctor or a doctor of any specialty, when collecting anamnesis, finds out the possibility of the presence of initial signs of cancer,, if necessary, conducts laboratory and instrumental examinations and consults these individuals with specialists in the appropriate field. Latent oncological diseases identified in this way are taken into account and recorded in the appropriate accounting forms as identified during an individual medical examination. Individual examinations can roughly include advisory pulmonology commissions, as well as preventive examinations of women in examination rooms

In the country, the frequency of identifying cancer patients during medical examinations has increased in recent years (from 7.5% in 1993 to 23.4% in 2004).

The relatively low effectiveness of medical examination is due to a number of factors: 1) insufficient oncological literacy and qualifications of doctors in the medical network; 2) high workload of doctors therapeutic activities ; 3) insufficient equipment of small and medium-sized medical institutions modern diagnostic equipment; 4) shortcomings of accounting and subsequent

dispensary observation for patients with identified precancerous diseases. program

step-by-step screening

, including 1) automated questionnaire screening; 2) laboratory screening; 3) clarifying diagnostics. 4) medical examination and correction of groups cancer risk. A mother should begin to take care of her baby even during the period when he is under her heart. I must take care of my health, do gymnastics, eat right and walk a lot. fresh air

. Also, during pregnancy, absolutely all representatives of the fair sex are prescribed

special examination -screening. What it is and why such procedures are necessary will be discussed in this article. Why is screening needed? Screening is special. medical examination, which is prescribed to pregnant women and newborns to identify various pathologies and

hereditary diseases

If tests during pregnancy did not reveal possible deviations in the development of the fetus, then after birth the child is also screened. What is it and how is this procedure performed?

Absolutely all newborn babies undergo an examination; it makes it possible to determine whether the child has one. Usually the procedure is carried out on the 3-4th day after the baby is born (in premature babies on the seventh day). To do this, blood is taken from the newborn's heel and applied to a special sheet. The form has circles printed on it that need to be filled in with blood. Next, the test sheet is sent to the laboratory, where all tests are carried out necessary research, the results of which will be ready in ten days.

Prenatal screening

This procedure is prescribed to pregnant women, it includes and This examination allows to identify the risk of such abnormalities as Down syndrome, Patau syndrome, Edwards syndrome, Turner syndrome, Carnelia de Lange syndrome, Smith-Lemli-Opitz syndrome, triploidy and neural tube defects.

During pregnancy, ultrasound screening is performed at different stages (10-14 weeks, 20-24 weeks, 30-32 weeks). What it is, probably everyone knows - it’s regular ultrasound. Also prescribed at certain stages of pregnancy. For this study, blood is taken from a pregnant woman.

What else you should know

The first screening is carried out at 10-13 weeks. The results of this procedure are also taken into account in the second trimester. The second screening is done at 16-18 weeks. This procedure allows us to identify up to 90% of cases of possible abnormalities in the development of the neural tube. It should be noted that the following factors may affect the results of these tests:

It must be said that the greatest advantage of screening is that at an early stage it is already possible to monitor the development of the unborn baby, and the mother, based on the data obtained, can make an informed decision: to terminate or continue her pregnancy.

Screening is one of the most accurate and modern research. The doctor may prescribe screening of the heart, liver, stomach, examination of the mammary glands in women, screening to determine pregnancy pathologies. Each procedure must be justified medical point vision.

Recently, all categories of the population have been screened. This procedure is called medical examination, and all residents of the country participate in it. General screening allows early detection of many serious diseases. The standard procedure includes:

The screening itself, that is, collecting data about the patient, his state of health, chronic diseases, allergies and other characteristics of the body, measuring height and weight. All data is entered into the form and medical card patient;
Blood pressure measurement;
Taking blood from a vein and from a finger to analyze the level of glucose, cholesterol, and biochemical analysis;
Stool and urine analysis;
Electrocardiogram of the heart;
Fluorography;
Cervical smear and breast examination in women.

The list of tests may include other studies if there are deviations in the patient’s health condition. The screening is summed up by a therapist who looks at the tests as a whole and makes a diagnosis of the presence or absence hidden diseases And general condition body. As a result preventive measures It is possible to detect diseases at the earliest stages, and monitor the health status of not only each patient, but also the entire population.

Screening during pregnancy

If medical examination of the population is a new event, and not every person undergoes it on time, then during pregnancy doctors recommend that all expectant mothers, without exception, undergo all tests. The examination includes a blood test and ultrasound, and often this is enough to accurately determine the gestational age, the weight and size of the child, its growth rate and developmental pathologies, if any. The most important screening is considered to be the first trimester, during which several serious illnesses , incompatible with further development fetus, and posing a threat

mother's life.

1st trimester screening includes:
Ultrasound examination of the fetus and uterine cavity; Testing a woman's blood level human chorionic gonadotropin

and pregnancy-associated protein-A.

The first stage is ultrasound diagnostics. It allows you to monitor the development of pregnancy in the early stages, identify ectopic, frozen or multiple pregnancies, and identify abnormalities in the development of the fetus. The study is carried out at 11-13 obstetric week

pregnancy, since at a later or earlier stage the test will be less informative.

Ultrasound diagnostics of the uterine cavity of a pregnant woman allows you to determine:
The exact duration of pregnancy is up to one day;
Condition of the cervix and uterine cavity;
The location of the fetus in the uterine cavity;
Coccygeal-parietal size of the fetus and its total length;
Fetal head circumference and biparental size, as well as the symmetry and level of development of the cerebral hemispheres;

All these data together make it possible to put accurate diagnosis and predict the course of pregnancy. Based on the size of the fetus at the first screening, several serious pathologies, such as Down syndrome, micro-, macro- and anencephaly, Edwards syndrome, Patau, and a number of other diseases that are incompatible with life in most cases.

Ultrasound diagnostics is carried out both transvaginally and through the abdominal wall. Since the first research method gives a more accurate result, it is more preferable for the first screening in early pregnancy.

It is equally important during diagnosis to evaluate the blood flow and heart function of the fetus. A rapid or slow heartbeat is most often also a sign of pathology. It is important to notice poor blood flow in the umbilical cord vessels as early as possible, since the baby receives oxygen and nutrients, and their lack has a detrimental effect on its growth and development.

The second stage of screening during pregnancy is a detailed biochemical blood test.

You can donate blood only after ultrasound diagnostics, since ultrasound allows you to accurately determine the age of the fetus.

This is important for correct setting diagnosis, since the content of hormones changes every day, and an incorrect date can confuse the doctor. As a result, the tests will be considered abnormal, and the patient will be given an erroneous diagnosis. During the test, the amount of human chorionic gonadotropin and protein A in the blood is assessed.

Human chorionic gonadotropin is a substance produced by the fetal membrane.

Based on its presence in the patient’s body, doctors determine the very presence of pregnancy already in its first weeks. The maximum content of human chorionic gonadotropin reaches the 13th week, and then the level of the hormone gradually decreases. Depending on whether the hCG level is increased or decreased, doctors can draw a conclusion about fetal pathologies and upcoming difficulties with bearing the fetus.

The second hormone, the content of which is assessed during the first screening, is protein-A. The development of the placenta and the body’s immunity depend on it. Essentially, this hormone rebuilds a woman’s body, adapting it to bearing a fetus.

Based on the results of all three studies, the MoM index is derived, which shows the risk of developing pathologies and abnormalities. When calculating the coefficient, the height, weight and age of the mother, her bad habits, and previous pregnancies. All information collected during screening provides an accurate picture, according to which the doctor can make an accurate diagnosis. This method has been used for more than 30 years, and during this time it has established itself as one of the most exact ways research.

If the patient is at risk, she is recommended to undergo screening during the second and third trimester of pregnancy.

But subsequent screenings are not necessary if the woman is healthy, under 35 years old, and has not previously had problems with pregnancy and childbirth.

Breast examination

Breast screening, or mamography, is one of the most important for women.

It allows early diagnosis of benign or malignant tumors mammary gland, identify lumps in the breast, dark spots in the pictures, and begin their treatment as early as possible.

Breast examination is not necessary medical procedure. The easiest way to diagnose breast diseases is self-palpation. It is recommended to carry it out a week after the end of menstruation, when the gland tissue is most loose and even small nodules can be felt. Doctors recommend that even young girls do this, and from the age of twenty, independent examination of both mammary glands becomes mandatory.

Clinical breast examination is carried out in medical institutions. Most often it is performed by a gynecologist during routine examinations.

Based on the results of the examination, the doctor can either refer the patient for a detailed examination of the mammary glands, or decide that she is healthy.

The third and most accurate screening is mammography. It is carried out by a mammologist who makes an accurate diagnosis. In some ways, mammography is similar to fluorography, but not everything is “in focus” of the X-ray machine. rib cage and her internal cavity, but only the patient’s chest.

To undergo a mammogram, a woman must undress and press tightly against the device. The exposed mammary glands are pressed tightly on both sides with special plates, and the laboratory assistant takes a picture. Later, a photograph showing homogeneous tissues and fates increased density, is transferred to a radiologist or mammologist, who makes an accurate diagnosis for the patient.

Mammography should be performed regularly, starting from 35-40 years - at least once a year.

For older women, after menopause, mammography is recommended once every two years.

This method of examining the mammary glands has many opponents among doctors and scientists. This is due to the fact that X-ray radiation, even in small doses, can provoke the development of breast cancer. The second argument against the examination procedure mammary gland– low reliability of screening. Studies have shown that in approximately 20% of cases, mammography is false positive, which leads to nervous breakdowns in patients and the need to undergo painful biopsies. Therefore, despite the fact that most doctors recommend regular mammography to prevent the risk of developing diseases, more and more patients refuse to undergo breast examinations unless absolutely necessary.

Heart screening test

If a person has a congenital or acquired heart defect, chronic diseases, excess weight, poor heredity, or routine screening reveals abnormalities in the functioning of the heart muscle, the doctor may recommend that the patient undergo additional research.

The first and one of the most accurate methods for diagnosing heart disease is electrocardiography. This study has been carried out for more than fifty years, and during this time it has established itself as one of the most accurate diagnostic methods.

The method is based on recording the difference in electrical potentials in tense and relaxed muscles, in this case the heart muscle.

Sensitive sensors that are installed on left side chest, wrist and abdominal wall of the patient, capture the electric field that arises during the operation of the organ, and the second part of the device records changes in the electric fields.

This method can detect even the most minor deviations from the norm in the functioning of the heart.

Second, more exact method studies of heart function - ultrasound. To carry out diagnostics, the patient takes horizontal position, a gel designed to help the sensor glide over the skin and remove air is applied to his chest, and a test is performed. On the monitor, the doctor sees the outlines of the organ in statics and dynamics, and can track the presence pathological changes, thickening or thinning of muscles, irregular rhythm, which indicates the presence of diseases.

The second screening method is transesophageal cardiac examination.

This study is less pleasant for the patient, but thanks to high precision and the reliability of the result, screening is recommended using this method.

The need to insert a probe into the patient’s esophagus is associated with the characteristics of ultrasound examinations. Thus, bone is an insurmountable obstacle for ultrasound, and the muscles that create a dense frame on the chest and ribs partially absorb the radiation. It must be remembered that ultrasound used for medical purposes has a small radius of propagation, and therefore transesophageal examination of the heart is recommended even if the patient suffers from severe obesity.

During insertion of the probe, the patient lies on his side on the couch, and the doctor applies to the throat and oral cavity anesthetic drug, inserts a probe and examines his internal organs.

When diagnosing the heart through the esophagus, the organ becomes visible in more detail, for example, the aorta, large vessels, myocardial tissue and the heart muscles themselves can be clearly distinguished. In the same way, patients are examined before heart surgery or if repair of an implanted pacemaker is necessary.

Ultrasound examination through the esophagus is recommended for diagnosing diseases of all organs located in chest cavity, behind the ribs.

These include the stomach, liver, lungs, spleen, and in some cases even the kidneys are examined this way.

During screening, the abdominal organs can be examined much easier - ultrasound easily penetrates the tissues of the anterior abdominal wall into the abdominal cavity.

Timely completion of screenings required by age and health status will allow each person to maintain wellness. Detection and diagnosis of health problems during pregnancy is especially important, since screening during pregnancy can help not only the mother, but also the fetus. Regular examinations in old age are no less important, after past diseases or operations. A simple screening procedure, which can be done at a local clinic, can bring great benefit person and maintain health.