{"id":905,"date":"2023-06-28T13:50:46","date_gmt":"2023-06-28T11:50:46","guid":{"rendered":"https:\/\/apolinar.eu\/?page_id=905"},"modified":"2023-06-28T13:50:46","modified_gmt":"2023-06-28T11:50:46","slug":"chci-preventivni-vysetreni-pred-otehotnenim","status":"publish","type":"page","link":"https:\/\/apolinar.capta.cz\/en\/porodnice\/snaha-o-tehotenstvi\/chci-preventivni-vysetreni-pred-otehotnenim\/","title":{"rendered":"Chci preventivn\u00ed vy\u0161et\u0159en\u00ed p\u0159ed ot\u011bhotn\u011bn\u00edm"},"content":{"rendered":" \r\n
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Komplikace v t\u011bhotenstv\u00ed a p\u0159i porodu<\/h2>

\r\n Prekoncep\u010dn\u00ed ambulance <\/h3>\r\n
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Paraleln\u011b s Ambulanc\u00ed pro \u017eeny po opakovan\u00fdch t\u011bhotensk\u00fdch ztr\u00e1t\u00e1ch (prekoncep\u010dn\u00ed) chceme na na\u0161\u00ed klinice sledovat i \u017eeny po patologick\u00fdch t\u011bhotenstv\u00edch (po HELLP, TMA, early preeklampsie do 32+0, early FGR do 32+0, FM, PAS).
\nPokud v\u00e1s zaj\u00edm\u00e1, jak postupovat p\u0159i pl\u00e1nov\u00e1n\u00ed dal\u0161\u00edho t\u011bhotenstv\u00ed po p\u0159edchoz\u00edch komplikac\u00edch v t\u011bhotenstv\u00ed a p\u0159i porodu, a pot\u0159ebujete preventivn\u011b vy\u0161et\u0159it a poradit se s na\u0161imi odborn\u00edky, nav\u0161tivte na\u0161i specializovanou poradnu.<\/p>\n<\/p>\r\n <\/div>\r\n \r\n Zjistit v\u00edce <\/a>\r\n <\/div>\r\n <\/div>\r\n <\/section>\r\n\n\n \r\n

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Opakovan\u00e9 t\u011bhotensk\u00e9 ztr\u00e1ty<\/h2>
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\r\n \r\n tehotenska.ambulance@vfn.cz <\/a>\r\n <\/div>\r\n <\/div>\r\n

\r\n Prekoncep\u010dn\u00ed ambulance <\/h3>\r\n
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V sou\u010dasnosti na\u0161e prekoncep\u010dn\u00ed ambulance mj. nab\u00edz\u00ed p\u00e9\u010di \u017een\u00e1m se z\u00e1va\u017enou formou opakovan\u00fdch t\u011bhotensk\u00fdch ztr\u00e1t, p\u0159ed\u010dasn\u00e9ho porodu p\u0159ed 34.t\u00fddnem a porodem mrtv\u00e9ho plodu v anamn\u00e9ze. U anamn\u00e9zy potratu \/spont\u00e1nn\u00edho, zamlkl\u00e9ho\/ se jedn\u00e1 a o \u017eeny s anamn\u00e9zou t\u0159\u00ed a v\u00edce potrat\u016f v I. trimestru (12+t\u00fdden) nebo anamn\u00e9zou dvou a v\u00edce potrat\u016f, z nich\u017e minim\u00e1ln\u011b jeden je ve II. trimestru (12+ t\u00fdden).<\/p>\n

Takov\u00fdm \u017een\u00e1m nab\u00edz\u00edme imunologick\u00e9 vy\u0161et\u0159en\u00ed. To m\u016f\u017ee \/ nemus\u00ed odhalit takovou dispozici, kter\u00e1 dramaticky zvy\u0161uje pravd\u011bpodobnost, \u017ee se budou takov\u00e9 t\u011bhotensk\u00e9 komplikace opakovat.\u00a0\u00a0U \u017een, kter\u00e9 maj\u00ed dva potraty v I. trimestru p\u00e9\u010di (a tedy imunologick\u00e9 vy\u0161et\u0159en\u00ed) v prekoncep\u010dn\u00ed ambulanci nenab\u00edz\u00edme a \u017e\u00e1d\u00e1me t\u00edmto, aby se na n\u00e1s s \u017e\u00e1dost\u00ed o vy\u0161et\u0159en\u00ed neobracely. P\u00e9\u010di v t\u00e9to oblasti by m\u011bl zvl\u00e1dnout praktick\u00fd gynekolog, kter\u00fd v takov\u00e9 situaci \u017een\u00e1m doporu\u010d\u00ed vylou\u010den\u00ed vrozen\u00e9 vady d\u011blohy (hysteroskopie \/ laparoskopie) a vy\u0161et\u0159en\u00ed \u0161t\u00edtn\u00e9 \u017el\u00e1zy. Nicm\u00e9n\u011b, pokud o\u0161et\u0159uj\u00edc\u00ed gynekolog t\u011bmto \u017een\u00e1m uveden\u00e9 nenab\u00eddne, je mo\u017en\u00e9 obr\u00e1tit se s pozitivn\u00edm t\u011bhotensk\u00fdm testem na na\u0161i ambulanci \u2013 tehotenska.ambulance@vfn.cz \u2013 ide\u00e1ln\u011b \u00fater\u00fd a \u010dtvrtek \u2013\u00a0 a doporu\u010d\u00edme zaji\u0161t\u011bn\u00ed t\u011bhotenstv\u00ed n\u00ed\u017ee uveden\u00fdmi l\u00e9ky, jak je uvedeno n\u00ed\u017ee. Podm\u00ednkou je v\u0161ak pl\u00e1nov\u00e1n\u00ed porodu v na\u0161\u00ed porodnici.<\/p>\n

Pro \u017eeny se z\u00e1va\u017en\u00fdmi, v\u00fd\u0161e uveden\u00fdmi komplikacemi plat\u00ed,\u00a0 \u017ee po absolvov\u00e1n\u00ed vy\u0161et\u0159en\u00ed si sd\u011bl\u00edme dal\u0161\u00ed postup. \u00a0I p\u0159i negativn\u00edch\u00a0v\u00fdsledc\u00edch imunologick\u00fdch\u00a0 vy\u0161et\u0159en\u00ed je nepodkro\u010diteln\u00e9 minimum zaji\u0161t\u011bn\u00ed\u00a0\u00a0n\u00e1sledn\u00e9ho\u00a0\u00a0t\u011bhotenstv\u00ed n\u00edzkomolekul\u00e1rn\u00edm heparinem a progesteronem.<\/p>\n<\/p>\r\n <\/div>\r\n \r\n Zjistit v\u00edce <\/a>\r\n <\/div>\r\n <\/div>\r\n <\/section>\r\n\n\n \r\n \r\n

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Principy diagnostiky a l\u00e9\u010dby<\/h3>\r\n
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Mezi nejv\u00fdznamn\u011bj\u0161\u00ed p\u0159\u00ed\u010diny z\u00e1va\u017en\u00fdch komplikac\u00ed v t\u011bhotenstv\u00ed a t\u011bhotensk\u00fdch \u201eztr\u00e1t\u201c pat\u0159\u00ed chybn\u00e1 komunikace mezi imunitou matky a plodem. V ambulanci v\u00e1s nejprve vy\u0161et\u0159\u00edme, a pokud vylou\u010d\u00edme jin\u00e9 p\u0159\u00ed\u010diny komplikac\u00ed v t\u011bhotenstv\u00ed, jako jsou syst\u00e9mov\u00e1 onemocn\u011bn\u00ed, abnorm\u00e1ln\u00ed anatomie d\u011blohy (vrozen\u00e9 vady, myomy apod.), nab\u00eddneme v\u00e1m imunologick\u00e9 vy\u0161et\u0159en\u00ed. Imunologie m\u016f\u017ee odhalit r\u016fzn\u00e9 poruchy, kter\u00e9 sice v naprost\u00e9 v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f neohroz\u00ed v\u00e1\u0161 \u017eivot, ale mohou m\u00edt z\u00e1sadn\u00ed vliv na prosperitu a pr\u016fb\u011bh t\u011bhotenstv\u00ed. V p\u0159\u00edpad\u011b nep\u0159\u00edzniv\u00e9ho imunologick\u00e9ho v\u00fdsledku vy\u0161et\u0159en\u00ed v\u00e1m navrhneme soubor opat\u0159en\u00ed, kter\u00e1 v\u00fdznamn\u011b zlep\u0161uj\u00ed \u0161anci na \u00fasp\u011b\u0161n\u00e9 t\u011bhotenstv\u00ed. Jedn\u00edm z nich je tzv. imunomodula\u010dn\u00ed opat\u0159en\u00ed, kdy si \u017eena sama denn\u011b, ji\u017e od \u010dasn\u00e9ho t\u011bhotenstv\u00ed, aplikuje p\u0159edev\u0161\u00edm n\u00edzkomolekul\u00e1rn\u00ed heparin (injekce pod k\u016f\u017ei) a progesteron ve form\u011b vagin\u00e1ln\u00edch tablet. Pokud je situace slo\u017eit\u011bj\u0161\u00ed a n\u00e1lez v r\u00e1mci imunologick\u00fdch vy\u0161et\u0159en\u00ed abnorm\u00e1ln\u00ed, pacientku nasm\u011brujeme ke konzultaci s reproduk\u010dn\u00edm imunologem. Ten m\u016f\u017ee k uveden\u00fdm opat\u0159en\u00edm nab\u00eddnout dal\u0161\u00ed, velmi efektivn\u00ed imunomodula\u010dn\u00ed opat\u0159en\u00ed, nap\u0159\u00edklad aplikaci tzv. intramuskul\u00e1rn\u00edho \u010di intraven\u00f3zn\u00edho imunoglobulinu.<\/p>\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":3,"featured_media":0,"parent":3958,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-905","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\nChci preventivn\u00ed vy\u0161et\u0159en\u00ed p\u0159ed ot\u011bhotn\u011bn\u00edm - Porodnice U Apolin\u00e1\u0159e<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Chci preventivn\u00ed vy\u0161et\u0159en\u00ed p\u0159ed ot\u011bhotn\u011bn\u00edm - Porodnice U Apolin\u00e1\u0159e\" \/>\n<meta property=\"og:url\" content=\"https:\/\/apolinar.capta.cz\/en\/porodnice\/snaha-o-tehotenstvi\/chci-preventivni-vysetreni-pred-otehotnenim\/\" \/>\n<meta property=\"og:site_name\" content=\"Porodnice U Apolin\u00e1\u0159e\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/apolinar.capta.cz\/en\/porodnice\/snaha-o-tehotenstvi\/chci-preventivni-vysetreni-pred-otehotnenim\/\",\"url\":\"https:\/\/apolinar.capta.cz\/en\/porodnice\/snaha-o-tehotenstvi\/chci-preventivni-vysetreni-pred-otehotnenim\/\",\"name\":\"Chci preventivn\u00ed vy\u0161et\u0159en\u00ed p\u0159ed ot\u011bhotn\u011bn\u00edm - Porodnice U Apolin\u00e1\u0159e\",\"isPartOf\":{\"@id\":\"https:\/\/apolinar.capta.cz\/en\/#website\"},\"datePublished\":\"2023-06-28T11:50:46+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/apolinar.capta.cz\/en\/porodnice\/snaha-o-tehotenstvi\/chci-preventivni-vysetreni-pred-otehotnenim\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/apolinar.capta.cz\/en\/porodnice\/snaha-o-tehotenstvi\/chci-preventivni-vysetreni-pred-otehotnenim\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/apolinar.capta.cz\/en\/porodnice\/snaha-o-tehotenstvi\/chci-preventivni-vysetreni-pred-otehotnenim\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Dom\u016f\",\"item\":\"https:\/\/apolinar.capta.cz\/en\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Chci preventivn\u00ed vy\u0161et\u0159en\u00ed p\u0159ed ot\u011bhotn\u011bn\u00edm\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/apolinar.capta.cz\/en\/#website\",\"url\":\"https:\/\/apolinar.capta.cz\/en\/\",\"name\":\"Porodnice U Apolin\u00e1\u0159e\",\"description\":\"Klinika gynekologie, porodnictv\u00ed a neonatologie 1. 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