Ómskoðun fósturs við 11-13 vikur, hnakkaþykktarmæling og líkindamat með tilliti til litningagalla og hjartagalla

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open Ultrasound is currently an integral part of prenatal care. In Iceland, all women are offered one ultrasound examination at 18-20 weeks, to assess fetal health, number of fetuses, placental location and t...

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Bibliographic Details
Main Author: Hildur Harðardóttir
Format: Article in Journal/Newspaper
Language:Icelandic
Published: Læknafélag Íslands, Læknafélag Reykjavíkur 2008
Subjects:
Online Access:http://hdl.handle.net/2336/19534
Description
Summary:Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open Ultrasound is currently an integral part of prenatal care. In Iceland, all women are offered one ultrasound examination at 18-20 weeks, to assess fetal health, number of fetuses, placental location and to calculate the estimated due date. Also, about one third will have an early ultrasound examination due to pain, bleeding or uncertain dates. All women, aged 35 and older, are offered an amniocentesis for fetal karyotyping, due to the increased rate of chromosomal abnormalities with advancing maternal age. Younger women are not routinely offered fetal karyotyping. In this review, a method is described that can estimate the risk of chromosomal abnormalities based on an ultrasound examination at 11-13 weeks. The fetal crown rump length and nuchal translucency are measured in a sagittal view. Based on these measurements as well as maternal age, risk assessment for fetal aneuploidy is performed. A screen positive rate of 8% is expected if risk assessment for fetal aneuploidy is 1:300 or higher. This translates into 8% procedure rate for fetal karyotyping. This approach leads to the diagnosis of the majority of all fetal trisomies. The method was developed by the Fetal Medicine Foundation, London, and is now widely used throughout Europe and Canada. The institution teaches the methodology and offers continuous audit for quality assurance. If this methodology were to be applied in Iceland the procedure rate for fetal karyotyping could be reduced from 13% to 8% while improving diagnosis of trisomy 21 from 30% to 80%. The option of offering all expecting couples an early ultrasound and risk assessment for fetal trisomies should be considered. Ómskoðun á meðgöngu er í dag hluti af hefðbundinni mæðravernd. Á Íslandi er öllum konum boðin ómskoðun við 18-20 vikur en um þriðjungur kvenna fer auk þess í snemmómskoðun, til dæmis vegna blæðinga, verkja eða óvissrar meðgöngulengdar. Konum sem eru 35 ára og eldri er boðið upp á ...