Full screening of the body. Diagnostic programs

Screening - comprehensive examination, which will show the state of development of the fetus 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.

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Screening vs Ultrasound: What's the difference?

The word screening comes from English word screen - "sift, filter, select." In medicine, the term is used to refer to safe research for large populations. Prenatal (prenatal) 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 different groups and then provide them with planned examinations, observations and assistance.

Often, women mistake ultrasound for screening in 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 the blood of a woman, the levels of several hormones are determined, which are indicators of a successful pregnancy and normal development of the fetus. A biochemical blood test is taken twice (double test and triple test): for a period from the 11th to the 14th week and from the 16th to the 20th week. The results make it possible to recognize fetal developmental anomalies as early as possible and identify genetic abnormalities.
Ultrasound examination, which is carried out three times during pregnancy: at terms of 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 dopplerometry, which allows you to assess whether the blood circulation in the uterus and placenta is normal, in what condition is the blood flow in the vessels of the unborn child.
Infectious research. At 10-12 weeks, when a woman registers at the antenatal clinic, and for a period of 30 weeks, the doctor will take a smear of vaginal discharge and cervical canal. In the first and third trimester, blood tests for syphilis, HIV, hepatitis B, and hepatitis C will be required. English titles 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 development of the fetus over time. It 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.

In the antenatal clinic, a pregnant woman fills out a questionnaire, where she indicates the data necessary to calculate the risks of defects prenatal development. When analyzes and studies are ready, all information is entered into a special computer program, where the risk calculation is carried out. There is an age-related risk for pathology, according to 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, a woman will be under closer attention of specialists and will undergo a number of additional consultations and examinations.

Screening steps

Early pregnancy (11th to 14th week) biochemical screening makes it possible to identify genetic abnormalities and severe congenital diseases of the fetus. The analysis 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, prepares the woman's immunity for the adoption of the fetus. Comparing hCG levels on different terms pregnancy, the doctor will timely detect deviations:

If determined elevated level hormone, we can suspect diabetes in a pregnant woman and Down syndrome in a child.
If hCG level lowered, this may indicate ectopic pregnancy, the threat of miscarriage, fetal growth retardation, placental insufficiency.

PAPP-A is a protein necessary for the development of the placenta. If in dynamics there is a decrease in its level in the blood, this indicates the risks of fetal chromosomal abnormalities or the threat of miscarriage. In cases of deviation of indicators from the norm, additional examinations of the pregnant woman are necessary.

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

The optimal period of passage is the period from the 12th to the 13th week. At the 12th week, the length of the embryo is 6-7 cm, weight - 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 determining the gestational age, as well as assessing the risk of miscarriage or premature birth.
At the first ultrasound, the specialist needs to establish whether the fetus is located outside the uterus, whether placental abruption is observed, whether there is a violation of the formation of individual parts or the entire body of the unborn child. It is at an early stage that the number of embryos in the uterus is revealed. If not defined multiple pregnancy on early stage, may occur serious problems further.
One of the most important indicators for ultrasound, this is the thickness of the neck fold. cervical the spine of the embryo is covered soft tissues. Gap between outer surface these fabrics and inner surface The skin of the neck is called the cervical fold. Here there is an accumulation of fluid, and the more its thickness is visible, the more likely the presence of pathology. More precisely, 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 in combination. The age and history of the woman is taken into account. If, according to 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 the medical genetic center, where additional examinations may be recommended. Based on these data, the question of the further bearing of the child will be decided. However, not all abnormalities in the development of the fetus can be detected at the first screening.

Second screening

In the second trimester (16–20 weeks), 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 (spinal hernias, anencephaly, etc.). The woman has 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 liver of a child, it protects the fetus from the action of the mother. 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 do a two-dimensional ultrasound to get an idea of the structure internal organs future child.
A 3D ultrasound is done on prescription and is used to detect superficial defects.
The specialist evaluates amniotic fluid and the state of the placenta, which provides information on uteroplacental blood flow.

During the second ultrasound screening, women are very often asked to do for family archive record a picture 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 consider 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 studies of the first and second screening, the indicators deviate significantly from the norm, then it is likely high risk that pathology develops. This is the reason for the appointment additional research and advice from a geneticist.

Third screening

The focus of ultrasound in the third trimester (30-34th week) is fetal biometry (measured head size, abdominal circumference, length femur) and assessment of the state and functions of the placenta. The doctor needs to establish the compliance of the child's weight with the norms for a given period of pregnancy, determine how the development of the fetus is proportional and harmonious, clarify the features physical condition fetus, identify entanglement with the umbilical cord, if present. In the case of placental insufficiency, a manifestation of intrauterine growth retardation is likely, which must be treated. The doctor will prescribe means aimed at normalization metabolic processes and support vital functions fetus. It is possible that malformations of intrauterine development can be detected at this stage as well. 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.

Doppler fetal sensations for a woman do not differ from standard ultrasound. This study reveals defects in the heart and blood vessels of the child and shows whether the child suffers from a lack of oxygen (hypoxia). If yes, then the doctor will be able to determine where the blood flow is disturbed: in the uterus, placenta, or umbilical cord. In this case, the woman is prescribed appropriate treatment. After treatment, a woman must undergo control Doppler, which will show the results of therapy.

Microscopic examination of discharge from the vagina and cervical canal and blood tests for infections suggest whether there is a possibility of infection of the child during childbirth.

Raising questions about the safety of ultrasound

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

Ultrasound is one of safe methods diagnostics. You can go through these studies without fear, even if they are prescribed repeatedly, 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 under study on the monitor. Many are afraid that the frequency of 20 Hz, at which the ultrasound machine's 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 a lot of research has been (and is still being done) on the topic of the safety 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 after ultrasound were not registered.

Some women insist on giving up ultrasound. In this case, it is necessary to refuse it in writing in the office of a gynecologist. Even if a woman believes that the risk of fetal developmental pathologies is minimal, it is still recommended to undergo biochemical studies and get advice at a medical genetic center.

Ultrasound should not be abandoned as part of prenatal screening if one or more of the following is true:

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

How to Prepare for Screening Tests

Blood sampling for biochemical research produced from a vein. This is done both in the antenatal clinic and in a specialized laboratory. Pass the analysis on an empty stomach. Dinner the day before is recommended until 19:00. A large and late dinner, as well as breakfast, can provoke changes in performance. It is recommended to ask your doctor in advance if you should follow a certain diet before taking the test, or if you can eat your usual food. The doctor will ask you to exclude foods containing glucose from the diet on the eve of the analysis. These are grapes, pear, melon, figs, honey, sugar, sweets and other sweets, White bread, cereals, legumes. In the morning you can drink non-carbonated water.

Don't donate blood after physical activity, physiotherapy 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 front wall of the abdomen). Before the procedure, if possible, it is desirable to perform hygiene procedures- take a shower and wash. If the diagnosis is carried out abdominally, then it is necessary to come to the procedure with full bladder. To do this, you need to drink two glasses of plain water half an hour before the study. If the specialist then needs to continue the study transvaginally, the woman will be asked to go to the toilet before doing so.

At the second stage of screening, ultrasound is done abdominally, but there is no need to drink water anymore: amniotic fluid is enough to study the condition of the fetus. At the third stage, the study is carried out through the abdomen, preparation for this is not needed.

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

Reliability of results

According to the results integrated research an 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 time. However, screening results cannot be 100% exact result. Efficiency of using the method of ultrasound research in diagnostics congenital anomalies is 70–80%.

There is a possibility that the result will be false positive, which will give cause for alarm, conduct additional surveys, unnecessary stress for a woman. A false negative result will prevent reversal Special attention for the course of pregnancy. Experts note that sometimes it is necessary to meet situations when pathological process develops too quickly and does not allow timely diagnosis. An example is the case of a transient flow intrauterine infection in late pregnancy, which led to life-incompatible changes in the internal organs of the fetus.

With multiple pregnancy currently screening is not informative, as it has not been studied yet enough women, which would allow correct interpretation of the results. The indicators developed for a singleton pregnancy will not be reliable in this case.

If obvious pathology not identified, but the results of the examinations refer the woman to 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, then do it on early dates much safer for a woman's health. Not everyone finds this method ethical. Two thousand children with Down syndrome are born in Russia every year. According to the Center for Curative Pedagogics in Moscow, this figure does not seriously decrease, but does not increase either, which speaks in favor of the information content of prenatal screening, especially at gestational ages up to 12 weeks.

Majority medical workers believes that it is necessary to use the opportunity to identify the emerging pathology as early as possible. If a malformation is detected 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 medically. Parents will try to get as much information as possible and mentally prepare 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. According to statistics, the decision is usually made in favor of surveys.

When a woman is expecting a baby, she has to take multiple tests and undergo scheduled examinations. Every expectant mother can be given different recommendations. The screening test is the same for everyone. It is about him that will be discussed in this article.

Screening study

This analysis is assigned to all expectant mothers, regardless of age and social status. Screening examination is carried out three times during the entire pregnancy. In this case, it is necessary to observe certain deadlines for the delivery of tests.

Screening research methods are known to medicine, which are divided into two types. The first of these is analysis It determines the possibility various pathologies at the fetus. The second analysis is an ultrasound screening study. The evaluation should take into account the results of both methods.

What diseases does the analysis reveal?

Screening during pregnancy is not an accurate way to make a diagnosis. This analysis can only reveal the 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 assigned 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, notes the location of the placenta. Also, the doctor must make sure that the child has all the limbs. One of important points is the presence of the nasal bone and It is on these points that the doctor will subsequently rely when deciphering the result.

Second survey

Screening 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 after that undergo an ultrasound scan. It is worth noting that the established terms for this diagnosis are somewhat different.

Blood test for second screening

In some regions of the country, this study is not carried out at all. The only exceptions are those women whose first analysis gave disappointing results. In this case, the most favorable time for blood donation 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 for a period of 20 to 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, stomach of the unborn baby. The specialist counts the fingers and toes of the crumbs. It is also very important to note the condition of the placenta and cervix. In addition, dopplerography can be performed. During this survey the doctor monitors the blood flow and notes possible defects.

During the second ultrasound screening, it is necessary to inspect the water. They should be normal for a given period of time. Inside the fetal membranes there should be no suspensions and impurities.

Third survey

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

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

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

Deviations from the norm

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

In most cases, the possible risks are not a 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 the amniotic fluid or blood from the umbilical cord. It should be noted 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 abortion 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 baby will undergo neonatal screening, which will absolutely accurately show the presence or absence of any disease.

IT IS POSSIBLE TO SAY THAT IN THE PREVIOUS QUESTION +THIS!!!

Wikipedia( Various screening tests are used to possibly early diagnosis malignant neoplasms. Among the fairly reliable oncological screening tests:

Papanicolaou test- to detect potentially precancerous changes and prevent cervical cancer;

Mammography- to detect cases breast cancer;

Colonoscopy- to exclude colorectal cancer;

Dermatological examination for exclusion melanoma.)

BOOK

Methods used for mass population screening include: honey. preventive examinations (. an obligatory component of which is an oncological component. It includes an active survey, clinical examination with an assessment of the state of all areas of peripheral lymph nodes, x-ray examination, lab tests, cytological examination, etc.). In relation to the inspected contingents

preventive examinations are divided into massive And individual.

MASS PREVENTIVE EXAMINATIONS

Mass medical examinations are carried out according to a predetermined plan by a team of doctors of various specialties and mainly cover organized contingents of the population working at enterprises. Depending on the tasks and volume of surveys, they are divided into preliminary, periodic, comprehensive and targeted.

preliminary professional examinations - upon admission to work - determine the suitability of workers and employees for the chosen work with a chain of prevention of occupational diseases. At the same time, an oncological component of the examination is carried out. Periodic professional 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 detection of common diseases that impede the continuation of work during harmful conditions labor. In the course of their conduct, each doctor must carry out an examination with the aim of detection of malignant neoplasms. Complex screenings are aimed at identifying various diseases including oncological, among fairly large contingents of workers and unorganized population, are carried out most often by the method of mobile teams of doctors of various specialties. At present, mass comprehensive examinations carried out in multi-stage are predominantly widespread. With one-stage, the medical team examines the entire contingent: with two-stage, at the first stage, the entire population is examined by paramedical staff, and at the second, the part of the population already selected by them (-20%) with suspicion of oncopathology and precancerous diseases examined by a visiting team of doctors. Three-stage preventive examinations are carried out according to the scheme: paramedical staff - doctor of the medical section - mobile team of doctors. Target professional examinations - are carried out to identify one or a group of homogeneous diseases (for example, examination of the mammary glands).

Subject to inspection the entire population aged 40 and over. To detect oncological and other diseases of the mammary glands, examinations of women should be carried out at the age of 30 years and older. The frequency of professional examinations is also established - at least once a year.

INDIVIDUAL (PARALLEL) PREVENTIVE EXAMINATIONS are aimed at identifying he

oncological diseases among individuals. who applied to polyclinics or are on inpatient treatment. At the same time, the district doctor or a doctor of any specialty, when collecting an anamnesis, finds out the possibility of the presence of initial signs of cancer, if necessary, conducts a laboratory and instrumental examination and consults these persons with specialists of the appropriate profile. The latent oncological diseases established in this way are taken into account and recorded in the appropriate accounting forms as identified during an individual medical examination. Individual examinations can conditionally include advisory pulmonological commissions, as well as preventive examinations of women in examination rooms.

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

The comparatively low effectiveness of a medical examination is due to a number of factors:

1) insufficient oncological literacy and qualifications of medical doctors; 2) high workload of doctors medical activity; 3) insufficient equipment of small and medium medical institutions modern diagnostic equipment; 4) shortcomings of accounting and subsequent dispensary observation for patients with diagnosed precancerous diseases.

program step-by-step screening, including 1) automated questionnaire screening; 2) laboratory screening; 3) clarifying diagnostics. 4) clinical examination and correction of groups

cancer risk.

A mother should begin to take care of her baby even at a time when he is under her heart. must take care of her health, do gymnastics, eat right and walk a lot on fresh air. Also, during pregnancy, absolutely all the fair sex is prescribed special examination-screening. What it is, and why such procedures are necessary, we will consider 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. This study allows you to calculate the risk and establish the likelihood that the fetus may have any developmental abnormalities. Here is the screening. What is it really? For screening, a pregnant woman takes a blood test, and she is carried out. In addition, using these procedures, you can set the sex of the unborn baby.

Newborn screening

If during pregnancy the tests 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 carried out?

Absolutely all newborn babies undergo an examination, it allows you to determine whether the child has it. Usually, the procedure is carried out on the 3-4th day after the birth of the baby (in premature babies on the seventh day). For this, blood is taken from the heel of the newborn and applied to a special sheet. Circles are printed on the form, which must be painted over 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 for pregnant women, it includes this examination. This examination reveals the risk of abnormalities such as Down syndrome, Patau, Edwards, Turner, Carnelia de Lange, Smith-Lemli-Opitz, triploidy and neural tube defects.

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

What else should you know

The first screening is carried out for a period of 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 you to establish up to 90% of cases of possible deviations in the development of the neural tube. It should be noted that the following factors can affect the results of these tests:

I must say that the biggest 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 a deliberate decision: to terminate or maintain her pregnancy.

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

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

Screening itself, that is, collecting data about the patient, his state of health, chronic diseases, allergies and other features of the body, measuring height and weight. All information is entered into the questionnaire and medical card the patient;
Blood pressure measurement;
Blood sampling from a vein and from a finger for analysis of glucose, cholesterol, and biochemical analysis;
Analysis of feces and urine;
Electrocardiogram of the heart;
Fluorography;
Pap smear from the cervix and examination of the mammary glands in women.

The list of analyzes may include other studies if there are deviations in the patient's state of health. The screening is summed up by the therapist, who looks at the tests in the complex, and makes a diagnosis of the presence or absence of hidden diseases And general condition organism. 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 the entire population.

Screening during pregnancy

If the medical examination of the population is a new event, and not every person passes it on time, then during pregnancy, doctors recommend that all expectant mothers, without exception, pass all the 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 the first trimester, during which several serious illnesses, incompatible with further development fetus, and threatening mother's life.

1st trimester screening includes:

Ultrasound examination of the fetus and uterine cavity;
A woman's blood test per level chorionic gonadotropin and pregnancy-associated protein-A.

The first stage is ultrasound diagnostics. It allows you to trace the development of pregnancy already in the early stages, determine an ectopic, frozen or multiple pregnancy, and identify abnormalities in the development of the fetus.

Research is being conducted at 11-13 obstetric week pregnancy, as at a later or earlier date the test will be less informative.

Ultrasound diagnosis of the uterine cavity of a pregnant woman allows you to determine:

Exact gestational age up to one day;
Condition of the cervix and uterine cavity;
The location of the fetus in the uterine cavity;
The coccyx-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;
The thickness of the collar space of the child and the size of the nasal bone.

All these data taken together make it possible to accurate diagnosis and predict the course of pregnancy. The size of the fetus at the first screening determines several serious pathologies, such as Down syndrome, micro-, macro- and anencephaly, Evards 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 method of research gives a more accurate result, it is more preferable for the first screening in early pregnancy.

It is equally important during the diagnosis to assess 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 vessels of the umbilical cord as early as possible, since the baby receives oxygen from the mother's blood and nutrients, and their lack adversely affects its growth and development.

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

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

This is important for correct setting diagnosis, because the content of hormones changes every day, and the wrong date can confuse the doctor. As a result, the analyzes will be recognized as not corresponding to the norm, and the patient will be declared an erroneous diagnosis. During the test, the amount of chorionic gonadotropin and protein-A in the blood is evaluated.

Chorionic gonadotropin is a substance that is produced by the fetal membrane.

According to its presence in the patient's body, doctors determine the very presence of pregnancy already in its first weeks. The maximum content of chorionic gonadotropin reaches the 13th week, and then the level of the hormone gradually decreases. Depending on whether the level of hCG is increased or decreased, doctors can draw a conclusion about the pathologies of the fetus and the 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. In fact, 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 deriving the coefficient, the height, weight and age of the mother, her bad habits and previous pregnancies. All the information collected during the screening gives 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 has established itself as one of the most exact ways research.

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

But follow-up screenings are not necessary if the woman is healthy, younger than 35, and has had no previous problems with pregnancy and childbearing.

Breast examination

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

It allows early diagnosis of benign or malignant tumors mammary gland, reveal seals in the chest, dark spots on the pictures, and start their treatment as soon as possible.

Breast examination is optional 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 tissues of the gland are the most loose, and even small nodules are palpable. Doctors recommend doing this even to young girls, and from the age of twenty, an independent examination of both mammary glands becomes mandatory.

Clinical breast examination is carried out in medical institutions. Most often it is carried out 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 all of it gets into focus of the X-ray machine. rib cage and her internal cavity but only the patient's breasts.

A woman for a mammogram 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 picture showing homogeneous tissues and lesions increased density, is transferred to a radiologist or mammologist, who makes an accurate diagnosis for the patient.

Mammography should be carried out regularly, starting from the age of 35-40 - at least once a year.

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

This method of studying the mammary glands among doctors and scientists has many opponents. 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 about 20% of cases, mammography is false positive, which leads to nervous breakdowns in patients, and the need for painful biopsies. Therefore, despite the fact that most doctors recommend regular mammograms to prevent the risk of developing diseases, more and more patients refuse to undergo breast examinations unless absolutely necessary.

Screening heart test

If a person has a congenital or acquired heart disease, chronic diseases, overweight, poor heredity, or routine screening revealed abnormalities in the work of the heart muscle, the doctor may recommend that the patient conduct additional research.

The first and one of the most accurate methods for diagnosing heart diseases is electrocardiography. This study has been conducted for more than fifty years, and during this time it has managed to establish itself as one of the most accurate diagnostic methods.

The method is based on fixing 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 occurs during the operation of the body, and the second part of the device captures changes in electric fields.

With this method, even the most insignificant deviations from the norm in the work of the heart can be detected.

Second, more exact method study of the work of the heart - ultrasound. For diagnosis, the patient takes horizontal position, gel is applied to his chest, designed to facilitate the sliding of the sensor on the skin and remove air, and a test is performed. On the monitor, the doctor sees the outlines of the organ in statics and dynamics, can track the presence pathological changes, thickening or thinning of the muscles, irregular rhythm, indicating the presence of diseases.

The second screening method is a transesophageal heart examination.

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

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

During the 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, introduces the probe and examines its internal organs.

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

Ultrasound examination by the method through the esophagus is recommended for diagnosing the disease 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 in this way.

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

Timely passage of screenings prescribed by age and health status will allow each person to save good health. It is especially important to detect and diagnose health problems during childbearing, as screening during pregnancy can help not only the mother, but also the fetus. Equally important are regular examinations in old age, after past illnesses or operations. A simple screening procedure, which can be done at a district clinic, can bring great benefit person and maintain health.