{"id":3396,"date":"2023-08-14T20:16:38","date_gmt":"2023-08-14T18:16:38","guid":{"rendered":"https:\/\/apolinar.eu\/?page_id=3396"},"modified":"2023-08-14T20:16:38","modified_gmt":"2023-08-14T18:16:38","slug":"screening-v-i-trimestru-12-14-tyden","status":"publish","type":"page","link":"https:\/\/apolinar.capta.cz\/en\/porodnice\/tehotenstvi\/potrebuji-ultrazvukove-vysetreni-v-tehotenstvi\/screening-v-i-trimestru-12-14-tyden\/","title":{"rendered":"SCREENING V I. TRIMESTRU (12.\u201314. t\u00fdden)"},"content":{"rendered":"                <!-- TEXT BLOCK -->\r\n        <section\r\n                class=\"pdt-80 pdb-40 \"\r\n            >\r\n            <div class=\"wrapper2 text_block\">\r\n                <h2 class=\"title_h2 text_center_mdm\">SCREENING V I. TRIMESTRU (12.\u201314. t\u00fdden)<\/h2>                                                                                    <h3 class=\"title_h3 text_center_mdm\">Jak se k n\u00e1m objednat a co je d\u016fle\u017eit\u00e9 v\u011bd\u011bt?<\/h3>\r\n                                                <div class=\"page_content reset_margins\">\r\n                                                                                        <h4><span style=\"color: #f56497;\"><strong>Objednejte se telefonicky hned po zji\u0161t\u011bn\u00ed gravidity va\u0161\u00edm l\u00e9ka\u0159em, a to p\u0159\u00edmo na recepci Centra fet\u00e1ln\u00ed medic\u00edny: +420 224 967 273, PO &#8211; \u010cT 8:00 &#8211; 15:00 a P\u00c1 8:00 &#8211; 14:00.<\/strong><\/span><\/h4>\n<p><span style=\"text-decoration: underline;\">Recep\u010dn\u00ed na telefonu bude po\u017eadovat:<\/span><\/p>\n<ul>\n<li>va\u0161e jm\u00e9no<\/li>\n<li>rodn\u00e9 \u010d\u00edslo a poji\u0161\u0165ovnu<\/li>\n<li>datum posledn\u00ed menstruace<\/li>\n<li>informaci, zda jste byla ji\u017e vy\u0161et\u0159ena ultrazvukem a zda st\u00e1\u0159\u00ed podle posledn\u00ed menstruace odpov\u00edd\u00e1 skute\u010dn\u00e9mu st\u00e1\u0159\u00ed t\u011bhotenstv\u00ed<\/li>\n<li>jm\u00e9no o\u0161et\u0159uj\u00edc\u00edho gynekologa<\/li>\n<li>va\u0161e kontaktn\u00ed \u00fadaje (telefon, e-mail)<\/li>\n<\/ul>\n<p>Recep\u010dn\u00ed v\u00e1m n\u00e1sledn\u011b <strong>sd\u011bl\u00ed term\u00edn vy\u0161et\u0159en\u00ed a p\u0159ed\u00e1 instrukce k vyzvednut\u00ed \u017e\u00e1danky na odb\u011br krve a k odb\u011bru samotn\u00e9mu.<\/strong><\/p>\n                                    <\/div>\r\n            <\/div>\r\n        <\/section>\r\n    \n\n                <!-- TEXT BLOCK -->\r\n        <section\r\n                class=\"pdt-40 pdb-40 bg3\"\r\n            >\r\n            <div class=\"wrapper2 text_block\">\r\n                                                                                                    <h3 class=\"title_h3 text_center_mdm\">Cena<\/h3>\r\n                                                <div class=\"page_content reset_margins\">\r\n                                                                                        <h4>Kombinovan\u00fd test v\u010detn\u011b stanoven\u00ed rizika preeklampsie:<\/h4>\n<ul>\n<li>1400,- K\u010d jedno\u010detn\u00e9 t\u011bhotenstv\u00ed<\/li>\n<li>1400,- K\u010d v\u00edce\u010detn\u00e9 t\u011bhotenstv\u00ed<\/li>\n<li><strong>P\u0159i vy\u0161et\u0159en\u00ed v I. trimestru lze zakoupit zv\u00fdhodn\u011bn\u00fd bal\u00ed\u010dek na ob\u011b vy\u0161et\u0159en\u00ed za 2.500,- (u\u0161et\u0159\u00edte 300 K\u010d), Platba je vratn\u00e1 pouze v p\u0159\u00edpad\u011b zji\u0161t\u011bn\u00ed neprosperuj\u00edc\u00edho t\u011bhotenstv\u00ed p\u0159i screeningu v I. trimestru. V jin\u00fdch p\u0159\u00edpadech pen\u00edze nevrac\u00edme.<\/strong><\/li>\n<\/ul>\n<p><strong>Uveden\u00e9 specializovan\u00e9 ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed nen\u00ed hrazeno z prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. <\/strong><strong>Z fondu prevence poji\u0161\u0165oven lze z\u00edskat kompenzaci plateb, dle jejich aktu\u00e1ln\u011b platn\u00fdch podm\u00ednek.<\/strong><\/p>\n                                    <\/div>\r\n            <\/div>\r\n        <\/section>\r\n    \n\n                <!-- TEXT BLOCK -->\r\n        <section\r\n                class=\"pdt-20 pdb-20 \"\r\n            >\r\n            <div class=\"wrapper2 text_block\">\r\n                                                                                                    <h3 class=\"title_h3 text_center_mdm\">Odb\u011br krve:<\/h3>\r\n                                                <div class=\"page_content reset_margins\">\r\n                                                                                        <h4><strong>Odb\u011br krve v\u00e1m provedou v\u00a0Odb\u011brov\u00e9m centru v\u00a0budov\u011b Fakultn\u00ed polikliniky VFN, Karlovo n\u00e1m. 32, Praha 2, p\u0159\u00edzem\u00ed vpravo, denn\u011b od 7,00 do 14,00 hod.<\/strong><\/h4>\n<ul>\n<li>K\u00a0odb\u011bru si s\u00a0sebou p\u0159ineste \u017e\u00e1danku, kterou si vyzvednete na recepci na\u0161eho Centra fet\u00e1ln\u00ed medic\u00edny.<\/li>\n<li>Na odb\u011br krve nemus\u00edte b\u00fdt nala\u010dno.<\/li>\n<li>Odb\u011br se prov\u00e1d\u00ed nejpozd\u011bji t\u00fdden p\u0159ed pl\u00e1novan\u00fdm ultrazvukov\u00fdm vy\u0161et\u0159en\u00edm, abychom ji\u017e znali v\u00fdsledek vy\u0161et\u0159en\u00ed krve.<\/li>\n<\/ul>\n                                    <\/div>\r\n            <\/div>\r\n        <\/section>\r\n    \n\n                <!-- TEXT BLOCK -->\r\n        <section\r\n                class=\"pdt-40 pdb-40 bg3\"\r\n            >\r\n            <div class=\"wrapper2 text_block\">\r\n                                                                                                    <h3 class=\"title_h3 text_center_mdm\">Jak prob\u00edh\u00e1 samotn\u00e9 ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed na na\u0161em odd\u011blen\u00ed: <\/h3>\r\n                                                <div class=\"page_content reset_margins\">\r\n                                                                                        <ul>\n<li>Zm\u011b\u0159\u00edme v\u00e1m krevn\u00ed tlak.<\/li>\n<li>L\u00e9ka\u0159 provede ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed a zhodnot\u00ed jej spole\u010dn\u011b s v\u00fdsledkem biochemick\u00e9ho vy\u0161et\u0159en\u00ed krve, kter\u00fd m\u00e1me ji\u017e p\u0159i proveden\u00ed ultrazvuku k dispozici.<\/li>\n<li>V r\u00e1mci ultrazvukov\u00e9ho vy\u0161et\u0159en\u00ed m\u011b\u0159\u00edme d\u00e9lku plodu pro ov\u011b\u0159en\u00ed st\u00e1\u0159\u00ed t\u011bhotenstv\u00ed, prohl\u00ed\u017e\u00edme detailn\u011b cel\u00fd plod a jeho org\u00e1ny, m\u011b\u0159\u00edme \u0161\u00ed\u0159ku \u0161\u00edjov\u00e9ho projasn\u011bn\u00ed (NT \u2013 nuchal translucency). V\u00a0p\u0159\u00edpad\u011b pot\u0159eby vy\u0161et\u0159ujeme dal\u0161\u00ed ultrazvukov\u00e9 markery jako nosn\u00ed kost, pr\u016ftok p\u0159es trojc\u00edpou chlope\u0148 srdce plodu a pr\u016ftok ductus venosus plodu. M\u011b\u0159\u00edme i d\u00e9lku d\u011blo\u017en\u00edho hrdla a pr\u016ftok d\u011blo\u017en\u00edmi c\u00e9vami.<\/li>\n<li>Sd\u011bl\u00edme v\u00e1m a vysv\u011btl\u00edme v\u00fdsledek vy\u0161et\u0159en\u00ed a navrhneme dal\u0161\u00ed postup.<\/li>\n<\/ul>\n                                    <\/div>\r\n            <\/div>\r\n        <\/section>\r\n    \n\n                <!-- TEXT BLOCK -->\r\n        <section\r\n                class=\"pdt-40 pdb-40 \"\r\n            >\r\n            <div class=\"wrapper2 text_block\">\r\n                                                                                                    <h3 class=\"title_h3 text_center_mdm\">Prvotrimestr\u00e1ln\u00ed screening t\u011bhotensk\u00fdch komplikac\u00ed (struktur\u00e1ln\u00edch a chromozom\u00e1ln\u00edch vad plodu, rizika rozvoje preeklampsie ve II. a III. trimestru a r\u016fstov\u00e9 restrikce ve III. trimestru)<\/h3>\r\n                                                <div class=\"page_content reset_margins\">\r\n                                                                                        <p>Prvn\u00ed screeningov\u00e9 vy\u0161et\u0159en\u00ed se prov\u00e1d\u00ed ve st\u00e1\u0159\u00ed plodu 12 t\u00fddn\u016f a\u017e 13 t\u00fddn\u016f + 6 dn\u00ed (13 + 6 dn\u00ed), kdy lze ur\u010dit vitalitu, po\u010det plod\u016f, u v\u00edce\u010detn\u00e9ho t\u011bhotenstv\u00ed\u0301 chorionicitu a amnionicitu, st\u00e1\u0159\u00ed t\u011bhotenstv\u00ed zm\u011b\u0159en\u00edm vzd\u00e1lenosti mezi temenem a kostr\u010d\u00ed plodu (CRL), a stanovit tak term\u00edn porodu.<\/p>\n<p>Ultrazvukov\u00fdm zobrazen\u00edm um\u00edme ji\u017e na konci prv\u00e9ho trimestru diagnostikovat v\u011bt\u0161inu anatomick\u00fdch (morfologick\u00fdch) abnormalit u plodu. Sou\u010dasn\u011b um\u00edme stanovit rizika t\u011bhotensk\u00fdch komplikac\u00ed: p\u0159ed\u010dasn\u00e9ho porodu, preeklampsie a r\u016fstov\u00e9 retardace plodu a v neposledn\u00ed \u0159ad\u011b chromozom\u00e1ln\u00edch poruch (Downova syndromu aj.).<\/p>\n<p><strong>Kombinovan\u00fd screening v I. trimestru<\/strong>, tedy vy\u0161et\u0159en\u00ed kombinuj\u00edc\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed plodu, biochemick\u00e9 vy\u0161et\u0159en\u00ed krve t\u011bhotn\u00e9 a anamnestick\u00e9 \u00fadaje t\u011bhotn\u00e9, m\u00e1 v sou\u010dasn\u00e9 dob\u011b \u010dty\u0159i z\u00e1kladn\u00ed c\u00edle:<\/p>\n<ol>\n<li>Ov\u011b\u0159en\u00ed st\u00e1\u0159\u00ed t\u011bhotenstv\u00ed, resp. up\u0159esn\u011bn\u00ed stanoven\u00e9ho term\u00ednu porodu<\/li>\n<li>Stanoven\u00ed rizika t\u011bhotensk\u00fdch komplikac\u00ed, a to p\u0159edev\u0161\u00edm preeklampsie<\/li>\n<li>Posouzen\u00ed struktury plodu<\/li>\n<li>Stanoven\u00ed osobn\u00edho \u2013 individualizovan\u00e9ho rizika nej\u010dast\u011bj\u0161\u00edch genetick\u00fdch syndrom\u016f (Downova, Edwardsova, Patauova)<\/li>\n<\/ol>\n                                    <\/div>\r\n            <\/div>\r\n        <\/section>\r\n    \n\n    <!-- ACCORD -->\r\n    <section\r\n            class=\"pdt-20 pdb-80 \"\r\n        >\r\n        <div class=\"wrapper2 anim_delay anim_drop1 observe\">\r\n                                                    <div class=\"accord mgt-30\">\r\n                                            <!-- ITEM -->\r\n                        <div class=\"item_accord item\">\r\n                            <a href=\"#\" role=\"button\" class=\"item_accord_head head\">\r\n                                <h3 class=\"item_accord_title\">V\u00edce informac\u00ed o screeningu v prvn\u00edm trimestru t\u011bhotenstv\u00ed <\/h3>\r\n                                <div class=\"item_accord_arrow\">\r\n                                    <svg class=\"sicofill\">\r\n                                        <use href=\"https:\/\/apolinar.capta.cz\/wp-content\/themes\/apolinar\/assets\/layout\/icons.svg#s_ar2_d\"\/>\r\n                                    <\/svg>\r\n                                <\/div>\r\n                            <\/a>\r\n                            <div class=\"expand\">\r\n                                <div class=\"item_accord_inner page_content reset_margins\">\r\n                                                                                                                                                        <p>Jako prvn\u00ed jsme v \u010cesk\u00e9 republice zavedli v roce 2003 <strong>tzv. kombinovan\u00fd prvotrimestr\u00e1ln\u00ed screening<\/strong> do rutinn\u00edho klinick\u00e9ho provozu na velk\u00e9m univerzitn\u00edm pracovi\u0161ti. M\u00e1me tedy bezm\u00e1la dvacetilet\u00e9 zku\u0161enosti jak s prov\u00e1d\u011bn\u00edm tohoto testu, tak s konzultac\u00ed v\u00fdsledk\u016f.<\/p>\n<p>Ultrazvukov\u00fdm zobrazen\u00edm um\u00edme ji\u017e na konci prv\u00e9ho trimestru diagnostikovat v\u011bt\u0161inu anatomick\u00fdch (morfologick\u00fdch) abnormalit u plodu. Sou\u010dasn\u011b um\u00edme stanovit <strong>rizika t\u011bhotensk\u00fdch komplikac\u00ed: p\u0159ed\u010dasn\u00e9ho porodu, preeklampsie a r\u016fstov\u00e9 retardace plodu a v neposledn\u00ed \u0159ad\u011b chromozom\u00e1ln\u00edch poruch<\/strong> (Downova syndromu aj.).<\/p>\n<p><strong>Preeklampsie<\/strong> (PE), kter\u00e1 postihuje asi 2 % t\u011bhotenstv\u00ed, m\u016f\u017ee b\u00fdt p\u0159\u00ed\u010dinou p\u0159ed\u010dasn\u00e9ho porodu, ale i z\u00e1va\u017en\u00fdch mate\u0159sk\u00fdch komplikac\u00ed. Riziko t\u011bhotn\u00e9 pro rozvoj preeklampsie m\u016f\u017ee b\u00fdt stanoveno kombinac\u00ed informac\u00ed o t\u011bhotn\u00e9, krevn\u00edho tlaku, ultrazvukov\u00e9ho vy\u0161et\u0159en\u00ed d\u011blo\u017en\u00ed tepny a hormon\u016f z krve t\u011bhotn\u00e9 (PAPP-A, PLGF). Screening pomoc\u00ed tohoto kombinovan\u00e9ho p\u0159\u00edstupu m\u016f\u017ee identifikovat asi 95 % t\u011bhotn\u00fdch s n\u00e1sledn\u00fdm rozvojem \u010dasn\u00e9 preeklampsie a asi 45 % t\u011bhotn\u00fdch s pozdn\u00ed preeklampsi\u00ed p\u0159i hladin\u011b fale\u0161n\u00e9 pozitivity 10 %. Co je v\u0161ak nejd\u016fle\u017eit\u011bj\u0161\u00ed, preventivn\u00edm pod\u00e1v\u00e1n\u00edm n\u00edzk\u00fdch d\u00e1vek aspirinu m\u016f\u017eeme sn\u00ed\u017eit riziko \u010dasn\u00e9 PE a\u017e o 82 %. Preventivn\u011b se kyselina acetylsalicylov\u00e1 (aspirin 100\u2013150 mg) pod\u00e1v\u00e1 denn\u011b a\u017e do 36. t\u00fddne t\u011bhotenstv\u00ed.<\/p>\n<p><strong>Down\u016fv syndrom <\/strong>(trizomie 21) je jednou z nej\u010dast\u011bj\u0161\u00edch vrozen\u00fdch vad plodu, charakterizovan\u00fdch ment\u00e1ln\u00ed zaostalost\u00ed, probl\u00e9my s u\u010den\u00edm, struktur\u00e1ln\u00edmi a degenerativn\u00edmi poruchami (d\u0159\u00edve se mu tak\u00e9 \u0159\u00edkalo mongolismus). Jedn\u00e1 se o vadu, kter\u00e1 nen\u00ed smrt\u00edc\u00ed, ale posti\u017een\u00ed jedinci pot\u0159ebuj\u00ed asistenci a speci\u00e1ln\u00ed edukaci. Dosud nen\u00ed zn\u00e1ma l\u00e9\u010dba tohoto onemocn\u011bn\u00ed. Bohu\u017eel jedin\u00fdm zp\u016fsobem, jak zabr\u00e1nit d\u016fsledk\u016fm a komplikac\u00edm tohoto onemocn\u011bn\u00ed, je \u010dasn\u00e1 detekce pomoc\u00ed prenat\u00e1ln\u00ed diagnostiky. Tato problematika m\u00e1 jak medic\u00ednsk\u00fd, tak etick\u00fd rozm\u011br.<\/p>\n<p>Screeningov\u00e9 vy\u0161et\u0159en\u00ed ve 12.\u201313<sup>+6<\/sup>. t\u00fddnu t\u011bhotenstv\u00ed umo\u017e\u0148uje p\u0159esun diagnostiky v\u011bt\u0161iny posti\u017een\u00ed plodu v\u010detn\u011b Downova syndromu na konec prvn\u00edho trimestru.<\/p>\n<p><strong>Kombinovan\u00fd screening v I. trimestru<\/strong>, tedy vy\u0161et\u0159en\u00ed kombinuj\u00edc\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed plodu, biochemick\u00e9 vy\u0161et\u0159en\u00ed krve t\u011bhotn\u00e9 a anamnestick\u00e9 \u00fadaje t\u011bhotn\u00e9, m\u00e1 v sou\u010dasn\u00e9 dob\u011b \u010dty\u0159i z\u00e1kladn\u00ed c\u00edle:<\/p>\n<ol>\n<li>Ov\u011b\u0159en\u00ed st\u00e1\u0159\u00ed t\u011bhotenstv\u00ed, resp. up\u0159esn\u011bn\u00ed stanoven\u00e9ho term\u00ednu porodu<\/li>\n<li>Stanoven\u00ed rizika t\u011bhotensk\u00fdch komplikac\u00ed, a to p\u0159edev\u0161\u00edm preeklampsie<\/li>\n<li>Posouzen\u00ed struktury plodu<\/li>\n<li>Stanoven\u00ed osobn\u00edho \u2013 individualizovan\u00e9ho rizika nej\u010dast\u011bj\u0161\u00edch genetick\u00fdch syndrom\u016f (Downova, Edwardsova, Patauova)<\/li>\n<\/ol>\n<p><strong>Ov\u011b\u0159en\u00ed st\u00e1\u0159\u00ed t\u011bhotenstv\u00ed<\/strong> je d\u016fle\u017eit\u00e9 pro spr\u00e1vn\u00e9 hodnocen\u00ed pr\u016fb\u011bhu t\u011bhotenstv\u00ed a pro p\u00e9\u010di kolem samotn\u00e9ho porodu. Bez spr\u00e1vn\u00e9ho datov\u00e1n\u00ed t\u011bhotenstv\u00ed nejsme schopni posoudit, kdy se jedn\u00e1 o p\u0159ed\u010dasn\u00fd porod a zda plod spr\u00e1vn\u011b roste. V neposledn\u00ed \u0159ad\u011b je skute\u010dn\u00e9 st\u00e1\u0159\u00ed t\u011bhotenstv\u00ed nezbytn\u00e9 pro rozhodov\u00e1n\u00ed o p\u0159\u00edpadn\u00e9m vyvol\u00e1v\u00e1n\u00ed porodu pro p\u0159en\u00e1\u0161en\u00ed, resp. jeho optim\u00e1ln\u00ed na\u010dasov\u00e1n\u00ed.<\/p>\n<p>Z <strong>t\u011bhotensk\u00fdch komplikac\u00ed<\/strong>, jejich\u017e rizika v r\u00e1mci screeningu v prvn\u00edm trimestru stanovujeme, je nejd\u016fle\u017eit\u011bj\u0161\u00ed preeklampsie.<\/p>\n<p><strong>Preeklampsie<\/strong> je onemocn\u011bn\u00ed vyskytuj\u00edc\u00ed se pouze v t\u011bhotenstv\u00ed a kr\u00e1tce po porodu. Projevuje se tak, \u017ee se t\u011bhotn\u00e9 zv\u00fd\u0161\u00ed krevn\u00ed tlak (hypertenze), kter\u00fd je spojen\u00fd s dal\u0161\u00edmi org\u00e1nov\u00fdmi komplikacemi. Vyskytuje se u 2\u20135 % t\u011bhotenstv\u00ed. M\u016f\u017ee b\u00fdt p\u0159\u00ed\u010dinou z\u00e1va\u017en\u00fdch komplikac\u00ed u t\u011bhotn\u00e9 i plodu a \u010dasto vede k p\u0159ed\u010dasn\u00e9mu porodu. Vzhledem k tomu, \u017ee um\u00edme zabr\u00e1nit vzniku tohoto onemocn\u011bn\u00ed prevenc\u00ed, je d\u016fle\u017eit\u00e9 rozpoznat rizikovou skupinu t\u011bhotn\u00fdch, tj. stanovit riziko rozvoje preeklampsie a rizikov\u00fdm t\u011bhotn\u00fdm tuto prevenci nab\u00eddnout. Riziko pro rozvoj preeklampsie se stanovuje z kombinace r\u016fzn\u00fdch informac\u00ed: anamn\u00e9zy (informace o zdravotn\u00edm stavu), zm\u011b\u0159en\u00ed krevn\u00edho tlaku, ultrazvukov\u00e9ho vy\u0161et\u0159en\u00ed pr\u016ftoku d\u011blo\u017en\u00edmi tepnami a hormon\u016f z krve t\u011bhotn\u00e9 (PAPP-A nebo PLGF). Screening pomoc\u00ed tohoto kombinovan\u00e9ho p\u0159\u00edstupu m\u016f\u017ee identifikovat asi 95 % t\u011bhotn\u00fdch s n\u00e1sledn\u00fdm rozvojem \u010dasn\u00e9 preeklampsie.<\/p>\n<p><strong>Prevence preeklampsie<\/strong><\/p>\n<p>Pokud rizikov\u00fdm t\u011bhotn\u00fdm pod\u00e1me preventivn\u011b kyselinu acetylsalicylovou (aspirin v d\u00e1vce 100\u2013150 mg denn\u011b), sn\u00ed\u017e\u00edme riziko onemocn\u011bn\u00ed a\u017e o 82 %. To znamen\u00e1, \u017ee v\u011bt\u0161ina t\u011bhotn\u00fdch, kter\u00e9 by bez preventivn\u00edho pod\u00e1v\u00e1n\u00ed kyseliny acetylsalicylov\u00e9 m\u011bly v t\u011bhotenstv\u00ed preeklampsii, ji v p\u0159\u00edpad\u011b nasazen\u00ed prevence bu\u010f nebude m\u00edt v\u016fbec, nebo se n\u00e1stup obt\u00ed\u017e\u00ed posune do vy\u0161\u0161\u00edho st\u00e1\u0159\u00ed t\u011bhotenstv\u00ed, kdy ji\u017e nehroz\u00ed p\u0159ed\u010dasn\u00fd porod. Kyselinu acetylsalicylovou je t\u0159eba nasadit co nejd\u0159\u00edve po proveden\u00e9m screeningu, tj. p\u0159ed 16. t\u00fddnem t\u011bhotenstv\u00ed, a pod\u00e1vat ji do 36. t\u00fddne.<\/p>\n<p>V r\u00e1mci screeningu v prvn\u00edm trimestru stanovujeme i <strong>riziko p\u0159ed\u010dasn\u00e9ho porodu<\/strong> a <strong>r\u016fstov\u00e9 retardace plodu<\/strong>. T\u011bhotn\u00fdm s vy\u0161\u0161\u00edm rizikem doporu\u010dujeme dal\u0161\u00ed vy\u0161et\u0159en\u00ed a sledov\u00e1n\u00ed nad r\u00e1mec dosud b\u011b\u017en\u00e9 t\u011bhotensk\u00e9 p\u00e9\u010de (ultrazvukov\u00e9 m\u011b\u0159en\u00ed d\u00e9lky d\u011blo\u017en\u00edho hrdla v \u010dasn\u00e9m druh\u00e9m trimestru, ultrazvukov\u00e1 kontrola r\u016fstu plodu atd.).<\/p>\n<p>Ultrazvukov\u00fdm vy\u0161et\u0159en\u00edm ve 12.\u201313<sup>+6<\/sup>. t\u00fddnu t\u011bhotenstv\u00ed m\u016f\u017eeme v sou\u010dasn\u00e9 dob\u011b diagnostikovat v\u011bt\u0161inu <strong>z\u00e1va\u017en\u00fdch struktur\u00e1ln\u00edch<\/strong><strong> vad plodu<\/strong> a d\u00e1le stanovit <strong>rizika nej\u010dast\u011bj\u0161\u00edch genetick\u00fdch vad plodu (Downova, Edwardsova a Patauova syndromu)<\/strong>. Z\u00e1kladn\u00edm screeningov\u00fdm markerem je ultrazvukov\u00e9 m\u011b\u0159en\u00ed tlou\u0161\u0165ky \u0161\u00edjov\u00e9ho projasn\u011bn\u00ed plodu. V\u00a0ur\u010dit\u00fdch p\u0159\u00edpadech vyu\u017e\u00edv\u00e1me i dal\u0161\u00ed ultrazvukov\u00e9 zn\u00e1mky plodu: p\u0159\u00edtomnost nosn\u00ed k\u016fstky (plody s Downov\u00fdm syndromem ji \u010dasto nemaj\u00ed nebo ji maj\u00ed m\u00e1lo vyvinutou), nedomykavost trojc\u00edp\u00e9 chlopn\u011b srdce a rychlost toku ve ven\u00f3zn\u00ed du\u010deji plodu. Tyto pomocn\u00e9 zn\u00e1mky umo\u017e\u0148uj\u00ed je\u0161t\u011b p\u0159esn\u011bji spo\u010d\u00edtat riziko posti\u017een\u00ed plodu Downov\u00fdm syndromem, ale o jejich pou\u017eit\u00ed p\u0159i v\u00fdpo\u010dtu rozhoduje l\u00e9ka\u0159, kter\u00fd vy\u0161et\u0159en\u00ed prov\u00e1d\u00ed.<br \/>\nScreening v prvn\u00edm trimestru m\u016f\u017ee upozornit i na rizika vz\u00e1cn\u00fdch genetick\u00fdch posti\u017een\u00ed plodu.<\/p>\n<p>V\u00fdhodou screeningu v prvn\u00edm trimestru je vysok\u00fd z\u00e1chyt hledan\u00fdch komplikac\u00ed p\u0159i velmi n\u00edzk\u00e9 fale\u0161n\u00e9 pozitivit\u011b, a to ji\u017e na konci t\u0159et\u00edho m\u011bs\u00edce t\u011bhotenstv\u00ed. V praxi to znamen\u00e1, \u017ee naprost\u00e1 v\u011bt\u0161ina t\u011bhotn\u00fdch bude m\u00edt v\u00fdsledek norm\u00e1ln\u00ed, tj. n\u00edzk\u00e9 riziko, a nebude t\u0159eba \u017e\u00e1dn\u00e9 zvl\u00e1\u0161tn\u00ed p\u00e9\u010de. Jen mal\u00e9mu procentu t\u011bhotn\u00fdch s vy\u0161\u0161\u00edm rizikem pak m\u016f\u017eeme nab\u00eddnout odpov\u00eddaj\u00edc\u00ed dopl\u0148uj\u00edc\u00ed vy\u0161et\u0159en\u00ed a p\u00e9\u010di.<\/p>\n<p>&nbsp;<\/p>\n                                                                    <\/div>\r\n                            <\/div>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n    <\/section>\r\n\n\n    <!-- BLOK K -->\r\n    <section\r\n            class=\"pdt-40 pdb-80 \"\r\n        >\r\n        <div class=\"wrapper2\">\r\n                                                                                            <div class=\"grid small-space\">\r\n                                                                                <!-- ITEM 1 -->\r\n                            <div class=\"col1 bg3 radius10 pd-35 pd-25md observe anim_drop1 anim_delay dflex flex-dir-column offset_dist\">\r\n                                <div class=\"text_block w100p mgb-auto\">\r\n                                    <h3 class=\"title_h3\">Formul\u00e1\u0159 pro poji\u0161\u0165ovnu &#8211; potvrzen\u00ed o uhrazen\u00ed n\u00e1kladu na vy\u0161et\u0159en\u00ed<\/h3>\r\n                                                                                                        <\/div>\r\n                                <div class=\"pdt-20 w100p\">\r\n                                    <div class=\"grid small-space\">\r\n                                        <div class=\"col_default offset_half\">\r\n                                            <a href=\"#\"\r\n                                               title=\"Formul\u00e1\u0159 pro poji\u0161\u0165ovnu - potvrzen\u00ed o uhrazen\u00ed n\u00e1kladu na vy\u0161et\u0159en\u00ed\"\r\n                                               target=\"_blank\"\r\n                                               class=\"btn_basic\">\r\n                                                Zobrazit                                            <\/a>\r\n                                        <\/div>\r\n                                        <div class=\"col_default offset_half\">\r\n                                            <a href=\"#\"\r\n                                               title=\"Formul\u00e1\u0159 pro poji\u0161\u0165ovnu - potvrzen\u00ed o uhrazen\u00ed n\u00e1kladu na vy\u0161et\u0159en\u00ed\"\r\n                                               download\r\n                                               class=\"btn_basic border\">\r\n                                                St\u00e1hnout                                            <\/a>\r\n                                        <\/div>\r\n                                    <\/div>\r\n                                <\/div>\r\n                            <\/div>\r\n                                            <\/div>\r\n                                    <\/div>\r\n    <\/section>\r\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":6,"featured_media":0,"parent":3384,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3396","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>SCREENING V I. 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