home › Fashion and beauty › Carrying out invasive procedures. Still, a classic replacement or a mini-invasive one? Diagnosis of heart diseases in Israel

Carrying out invasive procedures. Still, a classic replacement or a mini-invasive one? Diagnosis of heart diseases in Israel

Prenatal diagnosis is a set of methods used to identify pathologies at the stage of intrauterine development. It makes it possible to determine genetic and other fetal disorders with a high degree of probability. If a developmental anomaly is confirmed, parents make a decision on further pregnancy or termination of pregnancy. Thanks to a comprehensive examination, it is possible to determine the paternity of a child and its gender with almost 100% certainty.

Today, prenatal screening represents a new, but dynamically developing and very promising direction in medicine. First of all, it is indicated for pregnant women at risk.

Diagnosis of diseases

Prenatal diagnosis of chromosomal diseases allows us to identify the following pathologies.

Down syndrome

The most common chromosomal disorder, occurring in one in eight hundred newborns. A person with this pathology has an additional 47 chromosome. In addition to the characteristic appearance, children with Down syndrome are often diagnosed with strabismus, hearing impairment, severe pathologies of the cardiac and gastric systems, and mental retardation.

The presence of pathology in the fetus can be determined by an enlargement of the collar area, the absence of a nasal bone, anomalies in certain parts of the intestine and pathological changes in the pregnant woman’s blood test. The final diagnosis is made taking into account the totality of the results obtained using direct and indirect methods of prenatal diagnosis.

Shereshevsky-Turner syndrome

A genetic disease that occurs when one of the X chromosomes is missing or damaged. Found only in females. Symptoms of the disease: growth retardation, short thick neck, abnormally shaped ears and hearing loss, delayed puberty, underdevelopment of the mammary glands, absence of menstruation (). Intellectual development, as a rule, does not suffer. Adult women with Turner syndrome are infertile.

X trisomy syndrome

Occurs only in females. The disease develops due to the presence of three X chromosomes in the genotype. Symptoms of the disease are profound mental retardation, underdevelopment of the genital organs, infertility.

Hemophilia

A hereditary disease associated with blood clotting disorders, which affects mainly men. Women who carry the hemophilia gene pass the disease on to their sons. The likelihood of developing hemophilia increases if the parents are related. Bleeding in the joints and internal organs is possible, which occurs as a result of even minor trauma. The cause of the pathology is a mutation of one gene on the X chromosome.

Klinefelter syndrome

Pathology of chromosomal origin, in which the male genotype has an additional female chromosome. Patients experience delayed physical and speech development, disproportionate physique, underdevelopment of the genital organs, enlarged mammary glands, and poor growth of body hair. Patients with Klinefelter syndrome have an increased risk of developing epilepsy, diabetes mellitus, hypertension, schizophrenia. Some patients have moderate mental retardation, difficulty establishing contacts with other people, and a tendency toward alcoholism.

Prenatal diagnosis congenital pathologies defines:

Disorders in the development of the skull and brain.
Hydrocephalus is an imbalance between the production of cerebrospinal fluid and its absorption, often resulting from fetal hypoxia, previous infectious diseases, and maternal smoking during pregnancy.
Heart defects. Prenatal screening allows you to accurately determine abnormalities in the development of the heart and blood vessels of the unborn child. Based on the data obtained, a decision is made on the need for surgical intervention in the first days and sometimes hours after birth.
Absence of kidneys or severe disturbances in their development. This pathology is diagnosed at 13-17 weeks of gestation. Possible anomalies include the absence of a kidney, the presence of a third organ, and doubling of the kidney. The pathology is accompanied by growth retardation and general development fetus, oligohydramnios, disturbances in the formation of the placenta. Termination of pregnancy is due to medical reasons, and, with the consent of the parents, should be carried out no later than 22 weeks. The risk of premature birth is also high.
Anomalies in the formation of limbs.

Prenatal diagnostic methods

There are non-invasive and invasive methods of prenatal screening.

Non-invasive prenatal diagnostics

It does not pose the slightest danger to both the woman and her unborn child. During its implementation, no surgical procedures are performed that could injure the fetus. Such methods are indicated for all pregnant women, regardless of age, health status or presence hereditary diseases.

These (indirect methods) examinations include ultrasound diagnostics () and examination of the pregnant woman’s blood serum.

Ultrasonography

Ultrasound in prenatal diagnosis is included in the category of planned and mandatory procedures for pregnant women. Refusal of this examination makes no sense: the procedure is safe, painless and can determine how successfully the fetus is developing and whether there is a risk of pathologies.

Ultrasound in the first trimester allows you to most accurately determine the gestational age, the number of fetuses, confirm the degree of embryo viability, and exclude the presence of hydatidiform mole. produced in 6-7 weeks. If a woman has had spontaneous abortions, it is determined how tightly the embryo is implanted in the uterus and whether there is a threat of repeated miscarriage.

An ultrasound in the second trimester, performed at 11-13 weeks, can determine the sex of the child, the presence of defects of the heart, kidneys, limbs and other organs, measure the collar area, determine the presence of fibroids or other neoplasms that interfere with the normal blood supply to the placenta.

Ultrasound diagnostics at a period of 22-26 weeks allows you to see abnormalities that were not previously identified, establish the position of the fetus in the uterus, identify intrauterine growth retardation, diagnose oligohydramnios, or.

Screening for serum factors

Produced on the basis of a study of blood samples taken from a vein of a pregnant woman. Typically, the study is carried out between the 16th and 20th weeks, in in some cases It is allowed to do the analysis up to the 22nd week.

This screening is also called “ triple test” as it provides information on three substances: alpha-fetoprotein, human chorionic gonadotropin and unconjugated estriol.

Screening detects fetal anomalies with an accuracy of 80%, in particular Down syndrome and closure of the neural tube.

At 11-13 weeks, some other developmental pathologies are detected, such as Patau and Edwards syndromes. The second of these diseases is second only to Down syndrome in its frequency.

With Edwards syndrome, a very high mortality rate is diagnosed in the first year of life (90% of cases). Such children rarely survive to adulthood. Congenital defects characteristic of this pathology include: low body weight (about 2 kg in a full-term baby), cardiovascular failure, intestinal obstruction, profound mental retardation.

Diagnosing Edwards syndrome in the early stages of pregnancy is unrealistic, but an ultrasound performed at the 12th week can already detect the presence of an abdominal hernia and choroid plexus cysts. The prognosis for survival of such patients is poor.

Invasive (direct methods)

Invasive methods of prenatal screening - obtaining samples of cells and tissues of the embryo, placenta and fetal membranes for the purpose of studying them.

These are methods such as:

chorionic villus biopsy;
fetal tissue biopsy;
fetoscopy.

Let us consider in more detail when and how these procedures are carried out.

Amniocentesis

Fence amniotic fluid to study their chemical composition. This analysis allows you to determine the degree of maturity of the fetus, identify the lack of oxygen supply (), and determine the Rh conflict between the fetus and mother. The procedure is indicated for 15-16 weeks.

Collection of amniotic fluid during amniocentesis

This prenatal diagnosis identifies more than 60 types of hereditary diseases that can be transmitted to a child from parents. The risk of miscarriage during the procedure is small and amounts to no more than 1%.

Chorionic villus sampling

The optimal period for conducting this study is in the first trimester, up to 12 weeks. The procedure is as follows: using a catheter inserted into the cervix, samples of chorionic tissue materials are taken. The manipulation is carried out under local anesthesia, so it is painless or causes minor discomfort.

After processing and being in the incubator, chromosomes are analyzed for the presence genetic abnormalities. Many women are afraid of a biopsy, believing that the procedure can lead to fetal injury and miscarriage. Such a risk does exist, but it does not exceed 1%.

In some cases, after a biopsy, slight pain in the abdomen and leg and minor bleeding may occur. These phenomena do not indicate a deviation from the norm and do not affect negative influence on fetal development.

Prenatal diagnostic method - chorionic villus biopsy

Chorionic villus biopsy can detect many disorders, among them cystic fibrosis. This is a serious disease in which the production of a specific protein that transports fats is disrupted. The presence of pathology leads to disruption of the digestive process, decreased immunity, and frequent pneumonia. The disease is incurable, but timely diagnosis makes it possible to provide conditions that allow patients with this pathology to survive to adulthood.

Fetal tissue biopsy

The diagnostic procedure is carried out in the second trimester of pregnancy and is monitored by ultrasound. Its essence is to take samples of fetal skin in order to exclude severe skin diseases that are inherited.

This method of prenatal diagnosis determines the risk of fetal malformations such as ichthyosis, albinism, and hyperkeratosis.

Ichthyosis is a rare genetic disease in which deformation of the skin occurs, taking on an appearance similar to fish scales. Symptoms of the disease: keratinization, peeling and increased dryness of the skin, the presence of small scales and rashes on it, deformation of the nail plates. There are several varieties of this pathology.

In the presence of ichthyosis that develops in utero, there are frequent cases of miscarriage or stillbirth. If the child survives, his life expectancy is no more than a week. If the disease is detected during intrauterine development, parents are advised to terminate the pregnancy due to the non-viability of the fetus.

Cordocentesis

This is a method that analyzes a blood sample obtained from the fetal umbilical cord. The duration of the procedure is after the 20th week, the best time is 22-25 weeks.

Blood sampling from the fetal umbilical cord (cordocentesis)

Manipulation is carried out according to strict indications, when other invasive methods are impossible to use due to the long period:

mother's age over 35 years;
negative results of a biochemical blood test;
high probability ;
the presence of a hereditary disease in one of the parents.

Cordocentesis is not performed if a woman is diagnosed with a threatened miscarriage, in the presence of fibroids, bleeding, or during an exacerbation of infectious and chronic diseases.

The study of umbilical cord blood allows us to identify such anomalies as Down, Edwards, and Klinefelter syndromes. In addition to genetic diseases, it is possible to diagnose Duchchen dystrophy, cystic fibrosis, hemolytic disease of the fetus caused by Rh conflict. To date, this study can determine the presence of more than 6,000 diseases.

Fetoscopy

Examination of the fetus using an inserted probe. A visual examination of the child’s condition is carried out at 18-19 weeks of gestation. Fetoscopy is applicable exclusively for medical reasons, since when an endoscope is inserted, the risk of miscarriage is 7-8%.

Among the others invasive methods placentobiopsy (taking placenta samples for analysis) and fetal urine testing (to determine the severity of kidney pathology) should be distinguished.

Indications for prenatal diagnosis

In what cases is it recommended to undergo an examination to identify possible pathologies fetus and how safe is it? Prenatal diagnostic methods are not recommended for all expectant mothers. Since the use of invasive methods is associated with a certain degree of risk for the child, they are prescribed only for strict medical reasons.

These include:

mature age of parents (mother over 35 years old, father over 45 years old);
suspicion of malformations or developmental disorders detected on ultrasound;
the presence of an older child in the family with chromosomal abnormalities;
transferred infectious diseases in early pregnancy (,);
women carriers of hereditary diseases (hemophilia);
when detecting deviations from the norm in biochemical markers;
the fact that one of the parents was exposed to radiation shortly before pregnancy.

Not all of these factors necessarily lead to fetal developmental disorders. So, if a family has an older child with Down syndrome, the likelihood of having a second child with the same diagnosis is low. But most parents prefer to play it safe and make sure that the child does not have any developmental defects.

As a rule, it is suggested to undergo examination aged parents, although children with Down syndrome are often born to younger women.

Principles of prenatal diagnosis

Prenatal screening results vary high level reliability and validity. They can both refute fears of the presence of pathology and prepare parents for the birth of a sick child.

Diagnostic procedures must be carried out taking into account the main ethical principles:

Availability. All women who have the means to do so should undergo research medical indications. Lack of finance should not be an obstacle to the procedure.
Voluntariness. Doctors are obliged to explain to the pregnant woman and her husband the need to undergo the study and the degree of risk of giving birth to a sick child. However, all appointments are advisory in nature, and the final decision on the need for them is made by the spouses.
Providing the family with complete information about the condition of the fetus. Parents should have a complete understanding of the nature of their unborn child’s disease, the characteristics of its development, treatment methods and further prognosis.
Prenatal diagnostic procedures are carried out primarily to women who have the means to do so. medical indicators. Many impressionable women with high levels of anxiety who are not at risk can also undergo these studies, but with full information about their possible consequences.
The decision to terminate a pregnancy is made solely by the woman and her family members. Any pressure or intimidation from doctors is unacceptable!
If the family decides not to terminate the pregnancy, the doctor must familiarize the parents with the features of caring for the unborn child and mentally prepare the spouses for their future life with the baby.

The decision on the need for diagnostic procedures is made jointly by an obstetrician-gynecologist, geneticist, neonatologist, and pediatric surgeon, taking into account the wishes of the parents themselves.

Prenatal diagnosis is a complex of examinations. The main goal is to identify various pathologies in a baby at the stages of intrauterine development.

The most common methods of prenatal diagnosis: ultrasound, the content of various markers in the blood of a pregnant woman, chorionic villus biopsy, taking umbilical cord blood through the skin, amniocentesis.

Why is prenatal diagnosis needed?

Using various methods of prenatal diagnosis, it is possible to detect disorders in the development of the fetus such as Edwards syndrome, Down syndrome, disorders in the formation of the heart and other abnormalities. It is the results of prenatal diagnostics that can decide future fate child. After receiving diagnostic data, together with the doctor, the mother decides whether the child will be born or the pregnancy will be terminated. Favorable prognosis may allow fetal rehabilitation. Prenatal diagnostics also include establishing paternity using the method genetic examination, which is carried out in the early stages of pregnancy, as well as determining the sex of the fetus. All these services in the capital are provided by the Prenatal Diagnostics Center on Mira Avenue, headed by Professor M.V. Medvedev. Here you can undergo a comprehensive prenatal examination, including ultrasound. The Center uses modern 3D and 4D technologies.

Prenatal diagnostic methods

Modern prenatal diagnostics uses a variety of methods and technologies. The degree as well as the level of opportunity they have is varied. In general, prenatal diagnostics are divided into two large groups: invasive prenatal diagnostics and non-invasive.

Non-invasive, or as they are also called, minimally invasive, methods do not involve surgical interventions and injury to the fetus and mother. Such procedures are recommended for all pregnant women; they are not at all dangerous. Routine ultrasound examinations are a must. Invasive methods involve invasion (intervention) into the pregnant woman’s body, into the uterine cavity. The methods are not entirely safe, so the doctor prescribes them in extreme cases, when there is a question about preserving the health of the unborn child.

Non-invasive methods include ultrasound or prenatal screening, which allows you to monitor the development of the fetus over time. Prenatal diagnosis of the fetus using maternal serum blood factors is also considered non-invasive.

Ultrasound is the most common procedure and has no harmful effects on the woman or the fetus itself. Should all expectant mothers undergo this study? The issue is controversial; it may not be required in every case. An ultrasound scan is prescribed by a doctor for many reasons. In the first trimester, you can determine the number of pregnancies, whether the fetus itself is alive, what kind exact date. In the fourth month, an ultrasound can already show the rough location of the placenta and the amount of amniotic fluid. After 20 weeks, it is possible to determine the sex of the unborn child. Ultrasound allows you to identify various anomalies if the analysis showed a high alpha-fetoprotein in the pregnant woman, as well as if there are any developmental defects in the family history. It is worth noting that no ultrasound result can guarantee a 100% birth of a healthy fetus.

How is ultrasound performed?

Prenatal antenatal diagnostics in the form of ultrasound is recommended for all pregnant women at the following stages:

11-13 weeks of pregnancy;
25-35 weeks of pregnancy.

Diagnostics of the condition of the mother’s body, as well as the development of the fetus, is provided. The doctor places a transducer or sensor on the surface of the pregnant woman’s abdomen, and sound waves invade. These waves are captured by the sensor, and it transfers them to the monitor screen. In early pregnancy, the transvaginal method is sometimes used. In this case, the sensor is inserted into the vagina. What abnormalities can ultrasound screening detect?
. Congenital defects of the liver, kidneys, heart, intestines and others.
. Before the 12th week, signs of the development of Down syndrome.
Development of pregnancy itself:
. Ectopic or uterine.
. Number of fetuses in the uterus.
. Gestational age.
. Head or breech presentation fetus
. Developmental delay in terms of timing.
. Character of the heartbeat.
. Gender of the child.
. Location and condition of the placenta.
. Blood flow in vessels.
. Uterine tone.

So, ultrasound makes it possible to detect any abnormalities. For example, hypertonicity of the uterus can lead to the threat of miscarriage. Having discovered this anomaly, you can take timely measures to preserve the pregnancy.

Blood screening

Blood serum taken from a woman is examined for the content of various substances:
. AFP (alpha fetoprotein).
. NE (unconjugated estriol).
. HCG (human chorionic gonadotropin).
This method of prenatal screening has a fairly high degree of accuracy. But there are cases when the test shows either a false positive or a false negative result. Then the doctor prescribes additional prenatal screening methods, such as ultrasound or some invasive diagnostic method.

The Prenatal Diagnostics Center on Mira Avenue in Moscow performs an ultrasound in just 1.5 hours and also provides prenatal consultation. In addition to first trimester screening, it is possible to undergo biochemical screening in the second trimester along with counseling and ultrasound examination.

Prenatal diagnosis of hereditary diseases uses a method for determining the level of alpha-fetoprotein in the blood. This screening test allows you to identify the likelihood of having a baby with pathologies such as anencephaly, spina bifida and others. Also, a high alpha-fetoprotein level may indicate the development of several fetuses, or incorrect deadlines, the possibility of miscarriage and even frozen pregnancy. The analysis gives the most accurate results if done at 16-18 weeks of pregnancy. Results before the 14th or after the 21st week are often erroneous. Sometimes repeated blood donation is prescribed. At high rate The doctor prescribes an ultrasound, this allows more reliable confirmation of the disease in the fetus. If ultrasound does not determine the cause high content alpha-fetoprotein, then amniocentesis is prescribed. This test more accurately measures changes in alpha-fetoprotein. If the level of alpha-fetoprotein in the patient's blood is elevated, complications may occur during pregnancy, for example, developmental delay, possible fetal death, or placental abruption. Low alpha-fetoprotein in combination with high hCG and low rate estriol indicate the possibility of developing Down syndrome. The doctor takes into account all indicators: the woman’s age, hormone levels. If required, additional prenatal research methods are prescribed.

hCG

Human or (hCG) during early pregnancy allows you to evaluate the most important indicators. The advantage of this analysis is early detection, when even ultrasound is not informative. After fertilization of the egg, hCG begins to be produced already on days 6-8.
HCG as a glycoprotein consists of alpha and beta subunits. Alpha is identical to pituitary hormones (FSH, TSH, LH); and beta is unique. That is why, to obtain an accurate result, a beta subunit test (beta-hCG) is used. In express diagnostics, test strips are used, which use a less specific hCG test (in urine). In the blood, beta-hCG accurately diagnoses pregnancy already at 2 weeks from fertilization. The concentration for diagnosing hCG in urine matures 1-2 days later than in the blood. The level of hCG in urine is 2 times less.

Factors affecting hCG

When determining hCG during early pregnancy, you should take into account some factors that influence the result of the analysis.
Increased hCG during pregnancy:
. Discrepancy between the expected and actual deadlines.
. Multiple pregnancy (increasing results are proportional to the number of fetuses).
. Early toxicosis.
. Preeclampsia.
. Serious developmental defects.
. Taking gestagens.
. Diabetes.
Demotion hCG level- inconsistency with the timing, extremely slow increase in hCG concentration by more than 50% of the norm:
. Discrepancy between the expected and actual terms (usually due to irregular cycle).
. Threat of miscarriage (level decreases by more than 50%).
. Frozen pregnancy.
. Post-maturity.
. Ectopic pregnancy.
. Chronic placental insufficiency.
. Fetal death in the 2nd-3rd trimester.

Invasive methods

If the doctor decides that invasive prenatal diagnostics should be used to identify hereditary diseases and developmental disorders, one of the following procedures may be used:
. Cordocentesis.
. Chorionic villus biopsy (study of the composition of the cells from which the placenta is formed).
. Amniocentesis (examination of amniotic fluid).
. Placentocentesis (negative consequences after infections are revealed).

The advantage of invasive methods is speed and a one hundred percent guarantee of results. Used in early pregnancy. So, if there is any suspicion of abnormalities in the development of the fetus, prenatal diagnosis of hereditary diseases allows us to draw accurate conclusions. Parents and the doctor can make a decision in time: keep the fetus or terminate the pregnancy. If parents, despite the pathology, still decide to keep the child, doctors have time to properly manage and correct the pregnancy and even treat the fetus in the womb. If the decision to terminate the pregnancy is made, then in the early stages, when abnormalities are detected, this procedure is physically and mentally tolerated much easier.

Chorionic villus biopsy

Involves the analysis of a microscopic particle of the villous chorion - a cell future placenta. This particle is identical to the genes of the fetus, which makes it possible to characterize the chromosomal composition and determine the genetic health of the baby. The analysis is carried out if there is a suspicion of diseases associated with chromosomal errors during conception (Edwards syndrome, Down syndrome, Patau, etc.) or if there is a risk of developing incurable diseases cystic fibrosis, sickle cell anemia, Huntington's chorea. The result of a chorionic villus biopsy allows us to identify 3,800 diseases of the unborn child. But such a defect as a defect in the development of the neural tube cannot be detected using this method. This pathology is detected only during amniocentesis or cordocentesis procedures.
At the time of analysis, the thickness of the chorion should be at least 1 cm, this corresponds to 7-8 weeks of pregnancy. IN Lately the procedure is carried out at 10-12 weeks, it is safer for the fetus. But no later than the 13th week.

Carrying out the procedure

The puncture method (transcervical or transabdominal) is chosen by surgeons. It depends on where the chorion is located relative to the walls of the uterus. In any case, the biopsy is performed under ultrasound control.

The woman lies on her back. The selected puncture site is necessarily numbed by local action. A puncture of the abdominal wall and myometrial wall is made in such a way that the needle enters parallel to the chorion membrane. Ultrasound monitors the movement of the needle. The chorionic villi tissue is collected with a syringe and the needle is removed. With the transcervical method, the woman is positioned on a chair as during a routine examination. Explicit painful sensations not felt. The cervix and vaginal walls are fixed with special forceps. Access is provided by a catheter; when it reaches the chorionic tissue, a syringe is attached and material is taken for analysis.

Amniocentesis

Prenatal diagnostic methods include the most common method for determining pathologies of fetal development - amniocentesis. It is recommended to carry it out at 15-17 weeks. During the procedure, the condition of the fetus is monitored by ultrasound. The doctor inserts a needle into the amniotic fluid through the abdominal wall, sucks out a certain amount for analysis, and the needle is removed. Results are ready in 1-3 weeks. Amniocentesis has little risk for the development of pregnancy. 1-2% of women may experience fluid leakage, which stops without treatment. Spontaneous abortion may occur in only 0.5% of cases. The needle does not damage the fetus; the procedure can be carried out even during multiple pregnancies.

Genetic methods

The DOT test is the latest safe genetic method for studying the fetus; it allows identifying Patau, Edwards, Down, Shereshevsky-Turner, and Klinefelter syndromes. The test is carried out based on data obtained from the mother's blood. The principle is that with the natural death of a certain number of placental cells, 5% of the fetal DNA enters the mother’s blood. This makes it possible to diagnose major trisomies (DOT test).

How is the procedure performed? It is taken from a pregnant woman and fetal DNA is extracted. The result is issued within ten days. The test is performed at any stage of pregnancy, starting from the 10th week. Information reliability is 99.7%.

Invasive methods of perinatal diagnostics are methods of obtaining samples of cells and tissues of the embryo, fetus and provisional organs (placenta, membranes) with subsequent study of the obtained materials. Currently, the following invasive methods are used in world practice: chorion and placentobiopsy, obtaining amniotic fluid (amniocentesis), biopsy of fetal tissue, taking fetal blood (cordocentesis). Invasive methods must be safe for the pregnant woman and fetus and applicable in early pregnancy.

Amniocentesis (puncture of the amniotic sac) to obtain amniotic fluid and the desquamated cells of the amnion and fetus contained in it has been used for prenatal diagnosis since the early 70s. The procedure is performed at 15-18 weeks of pregnancy. Puncture of the amniotic sac is performed through the anterior abdominal wall (less commonly, transvaginal access is used) under ultrasound guidance. Currently, amniocentesis is used to diagnose all chromosomal abnormalities, over 60 hereditary metabolic diseases, and incompatibility of mother and fetus with erythrocyte antigens.

Chorionic sampling and placentobiopsy have been used since the late 80s. These methods are used to obtain small amounts of chorionic villi or pieces of placenta during the 8th to 16th week of pregnancy. No disturbances of the placenta, fetal growth, the appearance of congenital malformations and an increase in prenatal mortality are observed after chorionic villus biopsy. Unlike amniocentesis, the possibility of conducting the study in the first third of pregnancy allows it to be terminated (if indicated) at an earlier date. However, the risk of complications with chorionic villus sampling is greater than with amniocentesis.

Cordocentesis - taking blood from the umbilical cord is carried out from the 20th week of pregnancy. The procedure is carried out under ultrasound control. Blood samples are the subject of cytogenetic (lymphocytes are cultured), molecular genetic and biochemical methods for diagnosing hereditary diseases.

Fetal tissue biopsy as a diagnostic procedure is carried out in the second trimester of pregnancy under ultrasound guidance. To diagnose severe skin lesions (ichthyosis, epidermolysis), a biopsy of the fetal skin is performed, followed by a pathomorphological examination.

Fetoscopy (insertion of a probe and examination of the fetus) does not present any great difficulties with modern flexible optical technology. However, the method of visual examination of the fetus to detect congenital malformations is used only for special indications. It is carried out at 18-19 weeks of pregnancy. Fetoscopy requires insertion of an endoscope into the amniotic cavity, which can cause pregnancy complications. Miscarriages occur in 7-8% of cases.

Preplacental diagnosis

Since the mid-80s, research has been carried out in the direction of preimplantation diagnostics. At the same time, it is proposed to use the embryo as an object for diagnosing hereditary diseases. early stages development. Such diagnostics refers to methods of primary prevention of hereditary diseases. Thanks to it, it is possible to avoid repeated abortions in families with high risk hereditary pathology. Obtaining preimplantation embryos is possible in two ways: non-surgical uterine lavage and in vitro fertilization.

The second method - in vitro fertilization and fragmentation of the zygote is well known and has long been used in obstetric practice in cases of overcoming infertility caused by obstruction of the fallopian tubes.

Diagnosis at the single cell level is now feasible for some diseases. It is carried out using microanalytical methods. There are reports of successful diagnosis at the preimplantation stage of diseases such as Marfan syndrome, myotic dystrophy, cystic fibrosis, thalassemia, Huntington's chorea, Duchenne muscular dystrophy and a number of other diseases. We can hope that in the near future methodological possibilities preimplantation diagnostics will expand both in the field of obtaining diagnostic material and analytical methods.

CONCLUSION

During our work, we faced the following tasks:

1.Analyze literary sources on assessing the condition of the fetus.

2.Describe methods of prenatal diagnosis.

3. Describe the different modern methods assessing the condition of the fetus.

In conclusion, we came to the following conclusions.

The most significant trends in the development of prenatal medicine are less invasiveness, greater information content, the earliest possible examination and minimal risk for the fetus.

Timely diagnosis of malformations and chromosomal abnormalities of the fetus makes it possible to make a decision on the advisability of prolonging pregnancy until the fetus reaches viability.

Thanks to the successes of reproductive biology and the introduction of new technologies into clinical practice, there has been significant progress in the accumulation and use of knowledge about the laws of development of the embryo and fetus.

Ultrasonography is the most reliable and precise method antenatal diagnosis of the fetal condition.

The method allows for dynamic fetometry, assessment of general and respiratory movements of the fetus, fetal cardiac activity, thickness and area of the placenta, volume of amniotic fluid, and measurement of the rate of fetal-uterine circulation.

In clinical practice, the most common are external sensors, the use of which has virtually no contraindications and is devoid of any complications or side effects.

Modern fetal cardiac monitors provide an indicator that demonstrates the quality of fetal heartbeat recording. The use of external cardiotocography allows continuous monitoring of fetal cardiac activity over a long period of time.

Thus, cardiotocography, especially in the presence of computer analysis, provides valuable information about the condition of the fetus.

Currently, some of the fairly common methods for assessing fetal cardiac activity are electrocardiography (ECG) and phonocardiography (PCG). There are direct and indirect fetal ECG. An indirect ECG is performed by placing electrodes on the anterior abdominal wall of a pregnant woman. This method is used mainly in the antenatal period.

When choosing a rational screening program for pregnant women, it is important to remember that the accuracy of prenatal diagnosis increases when multiple diagnostic tests are used and careful assessment of several risk factors.

After reading the article about invasive diagnostic methods during pregnancy, You will learn:

1
Invasive diagnostic methods, indications and contraindications
2
Invasive diagnostic methods
3
Chorionic villus biopsy
4
Placentocentesis
5
Amniocentesis
6
Cordocentesis
7
Fetoscopy.

Invasive diagnostic methods are a group of studies that make it possible to obtain biological material of fetal origin for analysis (amniotic fluid, chorionic or placental villi, skin areas and fetal blood). The purpose of such diagnostics is to identify fetal malformations, diagnose chromosomal (anomalies in the number and structure of chromosomes) and monogenic (changes in gene structure) diseases.

The choice of method is carried out jointly by a geneticist and an obstetrician-gynecologist, taking into account the duration of pregnancy and the specific pathology. These methods are dangerous in terms of possible complications, therefore they are prescribed only if there are appropriate indications.

Indications

The age of the woman is over 35 years (Down syndrome is detected in approximately one case out of 700 births in the population as a whole, in women over 35 years old - in approximately one case out of 50-150 births, the same situation is typical for a number of other chromosomal diseases).
A previous child(ren) has a history of Down's disease or other chromosomal diseases, or multiple congenital malformations.
Ultrasound markers of fetal chromosomal diseases.
High risk of having a child with chromosomal pathology according to the results of biochemical screening.
The presence of a chromosomal rearrangement, hereditary disease or developmental defect in one of the spouses.
Consanguineous marriage.
Presence in anamnesis spontaneous miscarriages, stillbirths, primary amenorrhea, primary infertility in spouses.
Adverse effects of factors environment in the early stages of pregnancy (radioactive radiation, inhalation of vaporous poisons, etc.).
Taking embryotoxic drugs in early pregnancy.
X-ray examination in early pregnancy.
Group or Rh incompatibility of mother and fetus.

Contraindications

Contraindications to invasive research are relative, that is, even if there are contraindications, it may be possible and necessary to conduct research. For example, one of the main contraindications is the threat of termination of pregnancy, but the cause of the threat may be fetal malformations, and the study is necessary to determine further tactics for pregnancy management, but the study is carried out against the background of appropriate therapy.

Also contraindications are malformations of the uterus, heat, active infectious diseases, fibroid nodes and the location of the placenta along the path of needle insertion.

Invasive diagnostic methods are prescribed only if the risk of severe illness in the fetus exceeds the risk of complications from such diagnostics. In any case, the decision to conduct the study is made by the family based on the information provided by the doctor; the pregnant woman has the right to refuse the prescribed study.

Invasive diagnostic methods

Invasive diagnostics are possible in any trimester of pregnancy. In the first trimester, as a rule, a chorionic villus biopsy (chorionic biopsy) is performed; as a rule, this research method is carried out at 8 - 12 weeks of pregnancy. It is also possible to perform amniocentesis in the first trimester, but since the risk of miscarriage is high, this study is often performed in the second trimester.

In the second trimester of pregnancy are carried out:

Amniocentesis- this is an operation by which amniotic fluid is obtained for research, as a rule, it is carried out at 17 - 22 weeks of pregnancy, but sometimes the study is carried out up to 34 weeks.
Amnioscopy- this is a method of visual inspection of the lower pole of the ovum using a thin endoscope; this study can be carried out from 17 weeks of pregnancy until birth.
Cordocentesis- this is taking fetal blood from the umbilical cord for testing to diagnose hereditary blood diseases, intrauterine infections, as well as treatment hemolytic disease fetus, carried out from 18 weeks of pregnancy.
Placentocentesis- this is a procedure for taking placental cells for analysis to diagnose chromosomal diseases; this research is carried out at 14 - 22 weeks of pregnancy.
Fetoscopy- this is an examination of the fetus in the uterus to identify congenital anomalies development, as well as the study of hereditary and congenital deformities by examining fetal blood, skin and amniotic fluid, as a rule, is carried out at 18 - 24 weeks of pregnancy.

In the third trimester of pregnancy, as a rule, invasive diagnostic methods are not used due to the high risk of premature birth, but sometimes, if there are strict indications, it is possible to perform amnioscopy, amniocentesis and cordocentesis before birth.

Depending on the location of the placenta, the following types of access are distinguished: transabdominal (insertion of the instrument through the anterior abdominal wall), transcervical (the uterine cavity is penetrated through the cervical canal), transvaginal (the anterior or posterior fornix of the vagina is pierced). Chorionic villus biopsy

Chorion- this is the organ of the fetus, from which the placenta is then formed; its cells are identical to the cells of the fetus.

Chorionic villus biopsy- this is taking several villi from the fetal chorion under ultrasound control, followed by counting the number of chromosomes in its cells. If the number and structure of chromosomes in chorion cells are normal, then chromosomal diseases in the fetus are excluded with a probability of more than 99%.

The advantages of this method are the duration of up to 12 weeks; if necessary, termination of pregnancy is carried out in the early stages of pregnancy, which is safest for the woman’s body. When performing chorionic biopsy, it is possible to identify about 100 hereditary diseases and pathologies, including cystic fibrosis, hemophilia, Down syndrome, Edwards syndrome, Turner syndrome, Klinefelter syndrome, etc.

An injection is made with a thin needle through the anterior abdominal wall, the needle passes into the chorion and several chorionic villi enter it. The procedure is performed on an outpatient basis, disposable gloves and sterile needles are used, so the risk of infection during the procedure is very small, no more than 0.3%.

When performing chorionic biopsy, there is a risk of miscarriage, but if all the rules of the procedure are followed, this risk does not exceed 1%. There is also a risk of an unfavorable course of pregnancy in case of Rh conflict (possibly stimulating the production of antibodies), and a risk of bleeding.

When performing a chorionic villus biopsy, there is a risk of false positive or false negative results, which is explained by the phenomenon of “placental mosaicism” - the non-identity of the genome of the embryonic and chorion cells.

Chorionic biopsy can be performed up to 14 weeks of pregnancy, after this period a placenta forms in place of the chorion and then placentocentesis (placenta biopsy) is performed.

Placentocentesis

Placentocentesis is a procedure in which cells from the placenta are obtained to study their chromosomal and genetic structure. Placentocentesis is similar to chorionic villus sampling, since the placenta is what the chorion develops into over time, but is performed in more detail. late dates(14-20 weeks of pregnancy).

Under the control of an ultrasound machine, a puncture is made with a long needle in the abdominal area of the pregnant woman; this special needle is inserted into the placenta, as a result, a column of placental cells remains in it, which will be further examined.

The main purpose of placentocentesis is to obtain fetal material to identify chromosomal and gene diseases in the fetus. If a pathology is detected, it is possible to terminate the pregnancy for medical reasons.

Complications with placentobiopsy are similar to those with chorionic villus biopsy. Placentobiopsy leads to premature termination of pregnancy in 1-3% of cases, this occurs due to reflex contraction of the uterine walls.

Amniocentesis

Amniocentesis- This is a puncture of the amniotic sac with the collection of a small amount of amniotic fluid. This method makes it possible to determine a larger number of indicators. In addition to gene and chromosomal diseases, it is possible to determine biochemical indicators by which one can judge possible violations metabolism, the presence of certain diseases. For example, amniocentesis is used to determine the degree of maturity of the fetal lungs, the presence of hypoxia, and Rh conflict.

Under ultrasound control, a syringe is inserted into the uterine cavity through the anterior abdominal wall, into which material with a volume of 20-30 ml is drawn. In addition to the amniotic fluid itself, a small amount of fetal cells (thickened epithelium) also enters the syringe, which are also examined. The analysis result is usually ready in 2-3 weeks.

Possible complications of amniocentesis: miscarriage, leakage of amniotic fluid, infectious complications, bloody issues from the genital tract, worsening the course of the Rhesus conflict, but the likelihood of complications with this study is less than with a chorionic villus biopsy.

Cordocentesis

Cordocentesis is a puncture of the umbilical cord vessels. The material is collected by puncturing the anterior abdominal wall under ultrasound guidance and obtaining cord blood. The study can be carried out after the 18th week of pregnancy. Cordocentesis allows you to perform almost all the tests that can be done from a regular blood test (hormonal examination, biochemical indicators, infections, immunological conditions, etc.), and, like all other invasive diagnostic methods, it helps to identify gene and chromosomal diseases. But this method is used not only as a diagnostic procedure, but also as a therapeutic one (administration of drugs, intrauterine transfusion blood to the fetus, for example, in case of severe Rh conflict). Amniocentesis and cordocentesis can be used to diagnose infections.

A complication of cordocentesis can also be termination of pregnancy. As a rule, the analysis is completed within 4-5 days.

Fetoscopy

Fetoscopy is a fetal examination method that allows you to directly examine the fetus through a thin endoscope and obtain blood or pieces of skin for analysis. This method is used as the last stage of genetic examination in cases of suspected congenital malformations and hereditary skin diseases. As a rule, the study is carried out at 18 - 24 weeks of pregnancy, after using other invasive methods for diagnosing hereditary diseases of the fetus.

Fetoscopy is performed under mandatory ultrasound control and only in a hospital setting. An incision is made on the skin of the anterior surface of the abdomen and the wall of the uterus and a special device is inserted into the uterine cavity - a fetoscope, which allows you to examine the fetus for the presence of gross malformations, and with the help of special forceps you can take a piece of fetal skin for examination; if necessary, blood is taken from a thin hollow with a needle from the umbilical cord artery, as with cordocentesis.

Possible complications: termination of pregnancy (in 5 - 10% of cases, so this method is used very rarely), bleeding, hematomas on the skin of the fetus, infection of the fetus.

If you have a question for your doctor, you can ask it right now. The best specialists on our site are ready to provide professional advice.

Leave comments on the article, we will answer your questions.

In contact with

Classmates

Minimally invasive surgery is a surgical intervention in the body without incisions. In this case, everything is done through punctures and special equipment. We will talk about what features and advantages of such an operation later in the article.

infertility in women;
endometriosis;
ovarian cyst;
uterine fibroids;
ectopic pregnancy;

During this type of surgery, small incisions are made on the anterior abdominal wall. Their size ranges from half to one and a half centimeters. An incision or puncture is made using a trocar - a special thin tube.

Description of endoscopy

What is endoscopic minimally invasive surgery? This research internal organs person. This procedure is carried out using endoscopes - special optical devices.

Minimally invasive operations are performed to remove the gallbladder, appendicitis, and various tumors in the stomach and intestines.
Through such surgery, it is possible to remove stones in the urinary tract, prostate adenoma, tumors in bladder. This method also restores the patency of the ureters.
Using this method, gynecological operations are performed.
Plastic surgery.
Removal of lymph nodes and tumors.
Treatment of blood vessels, namely removal of sclerotic pathology.

Advantages

This surgical intervention does not require hospitalization of the patient.
The person is not prescribed antibiotics before the procedure.
Minor pain after surgery.
Quick rehabilitation period and return to work.
Less chance of any complications occurring after the intervention.
The length of hospital stay is from 1 to 3 days.
There are no postoperative sutures that require dressing and special therapy.

Heart surgery

Hemorrhoids are a disease of the rectum that occurs due to dilation of the veins in its walls. The latter leads to the formation of blood clots, which are called hemorrhoids.

Sclerosis.
Ligation (this method uses latex rings).
Laser coagulation.
Photocoagulation. This operation is performed using infrared radiation.
Use of a radiobeam scalpel.
Cryodestruction.

Conclusion

In this article we will try to describe the details in clear language and understand the question of what minimally invasive replacement is. hip joint. World statistics are such that the bulk of joint replacement operations (endoprosthetics) for a number of reasons are performed on the hip joint. Unlike knee surgery, hip surgery has the anatomical ability to be performed with minimal intervention.

The size of the surgical suture.

If you contact various medical institutions with a request for hip replacement, most of them will tell you that the operation is performed in a minimally invasive way, but do these words always mean what you need? Until now, there is no uniformity of terminology around the world and often performing an operation through a small incision is already called a mini-invasive method. What do we mean by this in our clinic?

Why do doctors prefer a minimally invasive method of TB joint replacement?

With minimally invasive hip replacement, all the muscles surrounding the joint remain intact. During the operation, they are moved apart in a special way.
The seam, as a rule, does not exceed 7-8 cm.
The endoprostheses used for minimally invasive and classical replacement are identical, only the technique of their installation differs. Thus, due to the small access field during surgery, there is no need to use any special prostheses of a shortened/reduced/lightweight design. Minimally invasive access is not carried out to the detriment of the type of endoprosthesis.
Due to less trauma, motor functions are restored much faster. After all, if muscle tissue is cut, then at the site of fusion it will never have the same properties as intact

The ultimate goal of joint replacement surgery is a quick return to full life And motor activity, and the minimally invasive method of performing this operation makes it possible to achieve this much easier and faster.

When performing prosthetics using the Bertin and Rottinger method, access is made through the intermuscular space between the tensor fasciae lata and the gluteus medius muscle. With this approach, theoretically, the results should be ideal, since all muscles remain intact: the abductors (gluteus medius and minimus), fascia lata and short external rotators. This approach is considered the most preferred and is used by a number of surgeons, although it is not widely used because it requires a special orthopedic table to place the leg and position the hip so as to avoid additional incisions to access the acetabulum.

Why do patients choose a minimally invasive method?

In addition to the objective reasons favoring minimally invasive operations, there is a psychological component. No patient wants to be operated on in a more traumatic way if there is a less traumatic way. The main thing is that technical and financial possibilities allowed. No one wants to have a tooth removed if there is a chance to save it. No one will want to remove the gallbladder through abdominal surgery if it is possible to do this through endoscopic punctures, etc. That is, if you look from the patient’s point of view, everyone, without exception, would like to undergo surgery using minimally invasive technology.

Comparison of the size of the surgical field with classical and minimally invasive techniques.

Is minimally invasive surgery always a good thing?

In addition to the positive aspects, there is also a negative one - the complexity of the operation for the surgeon. The explanation for this is very simple: with this access, the size of the surgical field (wound) is quite small, and the surgeon performs some of the manipulations in conditions of limited visibility. Using classic way the size of the surgical wound allows you to see much better, which reduces the risk of failure for a less experienced surgeon. In other words, the technology of minimally invasive access for TB joint replacement is available only to first-class surgeons. IN in this case qualifications and experience in carrying out namely minimally invasive hip replacement surgeries. Such operations cannot be performed including, sometimes or among others; for good results this should be the bulk of operations performed by a single surgeon.

Still, a classic replacement or a mini-invasive one?

In fairness, it is worth noting that if we take two identical patients and perform high-quality and correct operations, one in the usual way, the other in a minimally invasive way, and mark control points after 3, 6, 9 and 12 months, then provided they have the same lifestyle, The more time passes from the moment of surgery, the more similar the patients’ conditions will be, regardless of the method of surgery. This means that after six months and, even more so, after a year, these patients cannot be distinguished by the level of recovery, unless the stitches are different sizes. During treatment, the second patient (minimally invasive surgery) will have a little less pain, he will endure the early postoperative period easier, he will recover a little faster, he will start doing things a little earlier that the first patient will be able to do later, etc. Therefore, despite the uncertain advantages of minimally invasive technology, for a particular patient the operation in which his surgeon specializes will be better.

What does the Czech Republic offer?

In the Czech Republic, like many other countries, there are clinics where they can perform minimally invasive operations, for example, the Bulovka Clinic, also presented on our website. But there is only one clinic and doctor who perform these operations as a priority (that is, to all their patients) in the Czech Republic - the regional clinic in Kladno and its chief surgeon, Dr. Deniger. This is a doctor who pays the greatest attention to minimally invasive hip joint replacement.

Where do patients turn first when looking for hip treatment options abroad? To Israel and Germany. After all, medical tourism is most developed in Israel and Germany. Israeli clinics all over the world are famous for their success, and rightly so. A huge number of CIS citizens undergo joint replacement surgery, as well as other types of orthopedic treatment, in Germany, because they offer truly high-quality joint replacement surgeries. We are familiar with German clinics firsthand.

If the programs for endoprosthetics of any joint in Germany and Israel satisfy all the needs of patients, then why is it necessary to undergo treatment in the Czech Republic?

Everything is very simple - due to the significantly lower cost and stable High Quality endoprosthetics. For example, an operation to replace a knee joint in Israel costs from 17 thousand dollars, in Germany from 15 thousand euros, and this is only an operation and a few days in the clinic, that is, without rehabilitation. Of course, with such operations, if possible, you need to trust yourself to the best specialists in this field. But fortunately, hip replacement does not involve high-tech treatment; super-expensive devices are not used for diagnosis and treatment; even an MRI is often not required; X-rays are sufficient. Almost everything depends on the hands of the surgeon and the subsequent rehabilitation of the hip joint.

Our proposal is intended to expand the choice, in addition to Israel and Germany, to an excellent alternative in the form of the Czech Republic, where the cost for such treatment is set by clinics at 11-12 thousand euros, including rehabilitation. The issue of joint replacement is becoming more and more pressing for the population, because the average lifespan is constantly increasing. Although prosthetic companies are constantly developing new, more wear-resistant materials and types of designs, the number of joint replacement offerings globally is not increasing. Our recommendation is to give preference to the clinic and doctor with the most experience and history of using specific technologies in endoprosthetics, which have proven themselves with many satisfied patients.

More details about technical details You can find information about the operation, statistics and other features in the materials devoted to minimally invasive surgery:

For many people who have developed alarming symptoms and who have gone to hospitals for consultation, specialists use invasive diagnostic and treatment methods. Not every patient understands what this term means, so they are forced to either ask their attending physicians about this issue, or independently look for the answer in open sources of information.

What does invasive mean?

Invasive is a term that originates from the Latin word invasio.

It can be interpreted as follows:

invasion;
penetration;
penetration inside.

If it is used in the medical field, it means any method of penetration into the human body. In this context, both diagnostic procedures and surgical procedures can be considered.

Diagnostics

Invasive techniques used in examining patients in order to make an accurate diagnosis involve deep penetration into the body through natural ways special tools. For example, endoscopic examination of the digestive tract.

Thanks to a flexible probe equipped with a microchamber inserted through the esophagus, specialists are able to carry out the following manipulations:

examine the condition of the mucous membranes;
identify erosive lesions and ulcerative lesions;
collect biological material, which is immediately sent to the laboratory for histological studies, etc.

It is worth noting that, despite the high information content of such diagnostic techniques, there are risks of injury when using them. internal structures. As a result, patients may experience bleeding, as well as infectious damage to organs and systems due to traumatic injury.

Invasive research methods also include manipulations that involve violating the integrity of the skin and mucous membranes. In this case, we are talking about the introduction of any special drugs or micro-instruments through veins or muscle tissue.

Invasive diagnostic techniques are used by specialists in the following branches of medicine:

gastroenterology;
urology;
cardiology;
pulmonology;
gynecology, etc.

For example, when carrying out perinotal diagnostics the following is carried out:

biopsy, in which tissue is taken from the fetus developing in the womb (placentobiopsy);
perform blood sampling from the fetus (cordocentesis);
amniotic fluid is obtained (amniocentesis).

When conducting an examination of the organs of the bronchopulmonary system, in order to make an accurate diagnosis, specialists use the following methods:

biopsy of the lungs, pleura or bronchi;
pleural puncture;
bronchography;
bronchoscopy.

Treatment methods

When carrying out complex drug therapy, many medicines patients are prescribed not orally, but by injection. Therapeutic solutions are injected into them through a vein or into muscle tissue. For these purposes, syringes equipped with needles, drip systems, and catheters are used (if the patient is indicated for systematic administration of medications).

For example, invasive techniques are used in the treatment of pathologies that accompany pain in the back. Patients undergo epidural injections into the spinal cord, during which corticosteroid hormones are administered. Thanks to this method of administering the medicine, many people have been pain-free for five years or more and are able to lead a normal life.

Currently, minimally invasive techniques are being introduced into surgery, thanks to which there is minimal trauma to organs and surrounding tissues. Unlike traditional operations, during which doctors made large incisions, innovative technologies make it possible to reach the desired places through several punctures. Through the hole, the specialist inserts a medical instrument, through which all surgical procedures are performed. After minimally invasive surgical interventions, patients undergo a much faster rehabilitation process, and they return to their normal lifestyle within one to two weeks.

When performing minimally invasive operations, specialists must be extremely careful, since a medical instrument inserted into the hole can damage the integrity of organs adjacent to the lesion. As a result, the patient will begin to bleed and will have to gain access to the site of injury in the traditional way. Today, through low-traumatic surgical interventions, specialists are able to cope with the following ailments:

pathological processes occurring in the pancreas;
appendicitis;
gallstone disease;
pathologies of the duodenum, stomach, large intestine;
endometriosis;
uterine fibroids;
pathological processes in the bile ducts;
cysts localized in the ovaries;
adhesive processes occurring in the pelvic organs;
polyps localized on the cervix and in its cavity;
tubal obstruction;
ectopic pregnancy;
pathological processes affecting the prostate gland, as well as the genitals of female and male audiences;
hyperplasia;
hernias formed in the esophageal diaphragmatic opening or on the anterior wall of the peritoneum;
pathological processes occurring in the bladder, ureter, kidneys or adrenal glands.

The features of low-traumatic surgical interventions include the following:

Specialists gain access to organs and systems in which pathological changes are observed through sleeves made of plastic or medical metal, the diameter of which varies from 5mm to 10mm.
Through trocars, surgeons insert a special instrument equipped with optics.
The optical system is connected to a monitor, onto the screen of which an image is transmitted from a microcamera.
Endoscopic instruments are attached to a special optical system, through which doctors carry out the necessary surgical procedures.

The advantages of low-traumatic surgical interventions include:

Rapid recovery of patients who are discharged from the hospital on the second or third day after surgical treatment.
Excellent cosmetic effect. For example, after abdominal surgery, patients are sometimes left with very large and rough scars. After low-traumatic interventions, only a puncture mark remains on the skin, the size of which does not exceed the diameter of a five-kopeck coin.
The risk of hernia formation is minimized.
In isolated cases, wound infections occur.
Patients do not experience such excruciating suffering as after abdominal surgery.

In this way, a therapeutic and diagnostic study of the affected organ can be carried out, during which a specialist collects biological material and, if necessary, performs surgical manipulations.

Invasive procedure

An example of the simplest invasive procedure is any injection, and the most complex is surgery. This is the main way in which a surgeon, as opposed to a therapist, provides care to a patient.

Invasive procedures can also be used for diagnosis. Examples of invasive tests are invasive cardiac electrophysiological testing and invasive genetic testing of the embryo.

Notes

The main difference between this operation and the usual one is that it occurs through pinpoint punctures of the tissue or through the natural openings of the body.

The minimally invasive operation is performed under local anesthesia. That is, the person is conscious. The procedure usually lasts about an hour. After which the patient does not need to stay in the hospital.

There are two types of minimally invasive surgery. Namely, laparoscopy and endoscopy. Now we will talk about each of them.

Description of laparoscopy

Laparoscopy allows through surgical intervention treat the following diseases:

There are two types of minimally invasive surgery. Namely, laparoscopy and endoscopy. Now we will talk about each of them.

Description of laparoscopy

Laparoscopy allows surgical intervention to treat the following diseases:

infertility in women; endometriosis; ovarian cyst; uterine fibroids; ectopic pregnancy; cancer.

To perform the operation, 3 or four punctures are made. Carbon dioxide is then introduced into the body through these holes. It is necessary to create the necessary space for the operation. In addition, a camera is inserted through the incisions, which will display the internal space on a monitor, and instruments.

Description of endoscopy

What is endoscopic minimally invasive surgery? This is a study of human internal organs. This procedure is carried out using endoscopes - special optical devices.

Unlike laparoscopy, this operation does not involve making special incisions, since endoscopes are inserted through the natural openings of the body. For example, in order to examine the stomach, the device is inserted through the mouth and esophagus. If it is necessary to examine the patient’s lungs and bronchi, the endoscope is delivered to these organs through the larynx. And to diagnose bladder function, the device is inserted through the urethra.

Before endoscopy, the patient is given a sleeping pill. This is necessary so that the patient is in a relaxed state during the operation. The patient's well-being is under the control of the anesthesiologist. And after waking up, the patient, as a rule, does not feel any pain.

Indications for surgery

Let's consider in what cases this intervention is observed:

Advantages

In modern medicine there are clear advantages minimally invasive operations:

Minimally invasive surgical operations: disadvantages and consequences

Let's consider in what cases this intervention is observed:

Minimally invasive operations are performed to remove the gallbladder, appendicitis, and various tumors in the stomach and intestines. Through such surgery, stones in the urinary tract, prostate adenoma, and tumors in the bladder can be removed. Also, this method restores the patency of the ureters. Using this method, gynecological operations are performed. Plastic surgery. Removal of lymph nodes and tumors. Treatment of blood vessels, namely the removal of sclerotic pathology.

Advantages

In modern medicine, there are clear advantages of minimally invasive operations:

This surgical intervention does not require hospitalization of the patient. The person is not prescribed antibiotics before the procedure. Minor pain after the operation. Quick rehabilitation period and return to work. Less likely to have any complications after the intervention. Length of hospital stay is from 1 to 3 - days. Absence of postoperative sutures that require dressing and special therapy.

Minimally invasive surgical operations: disadvantages and consequences

But this method also has its drawbacks. Thus, for the surgeon there is a certain difficulty in performing the operation, namely the limitation of space. In addition, the entire operation is carried out with special instruments; there is no tactile contact, which causes certain difficulties. For example, when stitching a patient. To carry out such serious procedures, the surgeon must have a certain skill.

Heart surgery

Minimally invasive heart surgery is considered one of the latest achievements of modern medicine. They allow successful interventions to treat heart disease.

Such procedures are considered the most gentle method. Through modern technologies medicine, it became possible to combine several stages of an operation into one. For example, with this method of intervention it is not necessary to connect a person to a heart-lung machine. There are statistics that show that after such surgical interventions the risk of any complications is significantly reduced.

Minimally invasive surgeries are performed on adult patients and children (even the youngest patients). With them, the number of deaths is significantly lower.

Surgeries for the treatment of congenital heart defects using a minimally invasive method can be performed on very young children. At the same time, the rehabilitation period is significantly reduced, thanks to which patients are able to quickly return to normal life.

Minimally invasive surgery to remove hemorrhoids

Another area of using this method in medicine is surgery to remove hemorrhoids. Let us briefly remember what kind of disease this is.

Such procedures are considered the most gentle method. Thanks to modern medical technologies, it has become possible to combine several stages of the operation into one. For example, with this method of intervention it is not necessary to connect a person to a heart-lung machine. There are statistics that show that after such surgical interventions the risk of any complications is significantly reduced.

Minimally invasive surgeries are performed on adult patients and children (even the youngest patients). With them, the number of deaths is significantly lower.

Minimally invasive surgery to remove hemorrhoids

Another area of using this method in medicine is surgery to remove hemorrhoids. Let us briefly remember what kind of disease this is.

Hemorrhoids are a disease of the rectum that occurs due to dilation of the veins in its walls. The latter leads to the formation of blood clots, which are called hemorrhoids.

The progression of this disease is divided into 4 stages. It is believed that the first stage can be cured without surgery. But the disease in its final stages can only be treated surgically.

The essence of the stages of hemorrhoids is that the further the disease develops, the more formed nodes protrude and, as a result, fall out of the anus, causing a lot of problems and inconvenience to the patient. The operation is prescribed at the last stage, when other treatment methods have failed. The fact that thrombosis develops in the nodes is also taken into account.

In addition to traditional surgery, hemorrhoid removal surgery is performed using a minimally invasive method. Its essence lies in the fact that it is carried out without a scalpel. The patient is given several punctures in the internal tissues, through which the surgical intervention is performed.

There are several types of minimally invasive surgeries to remove hemorrhoids:

Sclerosis. Ligation (this method uses latex rings). Laser coagulation. Photocoagulation. This operation is performed using infrared radiation. The use of a radio-beam scalpel. Cryodestruction.

The main advantage of such methods is the short recovery period of the body.

Conclusion

Recently, many specialists have given preference to minimally invasive endoscopic operations. By the way, some patients can be examined to make a diagnosis only in this way.

From all of the above we can conclude that this type intervention is modern achievement medicine. It allows you to choose the most gentle method of surgical intervention for patients, which is especially valuable in the presence of additional pathologies in the body.

Thanks to a method such as minimally invasive surgery, the risk of complications is minimized, the patient’s rehabilitation period takes less time, and the return to the normal rhythm of life occurs much faster than after conventional surgery.

Important words of this article:

There are no similar articles.

from your site.

Invasive procedure(from the New Latin invasivus; from invado - “I go inside”) - a medical procedure associated with penetration through the natural external barriers of the body (skin, mucous membranes).

Notes

From all of the above, we can conclude that this type of intervention is a modern achievement of medicine. It allows you to choose the most gentle method of surgical intervention for patients, which is especially valuable in the presence of additional pathologies in the body.

Invasive (endovascular) cardiology is a whole science that studies diagnostic and healing procedures invasive method, that is, various internal interventions in the functioning of the cardiovascular system without open surgery. Similar methods are already widely developed in various fields of medicine, but in this article we will only touch on those modern invasive methods that are used directly in cardiology. What is invasive cardiology, what are its capabilities, are there any limitations or contraindications?

In the last quarter of the last century, world cardiology has undergone significant fundamental changes, and may have surpassed all other areas of medicine. These changes were greatly facilitated by the work of Nobel laureates Cournand, Roberts and Forsman, who devoted themselves to the development various methods cardiac catheterization. Now these methods are widely used for the diagnosis and correction of many birth defects hearts.

The name “invasive cardiology” comes from the word “invasion” - invasion. This is indeed a real invasion of the functioning of the cardiovascular system. But the invasion is careful - with minimal damage to blood vessels and under the strict control of radiographic and echoscopic methods. The essence of this procedure is that a flexible metal conductor is inserted into the patient through a puncture in the thigh or elbow, and a thin disposable probe is inserted through it. Then this probe is pushed through the vessels into the heart area and then it can be used to solve various diagnostic and therapeutic problems.

The most common diagnostic task for congenital heart disease is to clarify the nature of the defect, which can be quite complex. In addition, a probe in the heart area, using special sensors, allows you to measure pressure in various chambers, and allows you to evaluate the capacity of blood vessels and the pumping function of the heart muscle. This information is very important for prognosis of the disease and for deciding on surgical tactics.

But the main development of invasive technologies occurs for therapeutic purposes. The pioneer of this direction was the Swiss cardiologist Grünzig. He invented a special catheter with a balloon that can be inflated to dilate blood vessels. Recently, a similar method has been widely used to eliminate coarctation and stenosis. However, this method also has a shadow side: it does not eliminate the cause of the disease, and as a result, very often, the narrowing of the vessel forms again. This phenomenon is called recoarctation, and in many cases it requires a second emergency operation. Unfortunately, doctors often cannot identify signs of recoarctation in a timely manner, so parents whose children have undergone balloon angioplasty should be especially attentive to the well-being of their children.

Another disadvantage of balloon valve valvuloplasty is its damage, which subsequently makes it impossible to restore it during surgery. That is, such a valve has to be replaced with a prosthesis. However, in the case of critical stenoses, when various reasons It is impossible to perform valve replacement; balloon valvuloplasty is successfully used and saves the child’s life.

But the development of medicine does not stand still, and methods of invasive cardiology continue to develop. One of the significant achievements in this field of medicine is the development new technique inserting a spring or frame called a stent into the vessel. This frame prevents re-narrowing of the vessel and the formation of stenosis, which allows you to radically eliminate the problem. However, this also has its drawbacks: the presence foreign body inside the blood stream leads to active formation of blood clots, which is why patients who have undergone this type of intervention have to long time take anticoagulants. But we hope that this problem will be solved in the near future - for example, by using special materials that do not cause blood clots.

And finally, let's look at the most common type of endovascular intervention - occlusion of the septal ducts. In fact - behind this wise phrase the most common elimination of holes and defects is hidden, that is, darning holes. Indeed, a probe inserted into the heart allows a special metal object to be delivered to the hole - an occluder, which looks like rivets. If the hole in the heart has good edges, then the occluder opens and, like a rivet, closes this hole. Subsequently, this rivet becomes overgrown with calcium, blood clots, gets wrapped around the muscle and is thereby securely fixed inside the heart for life. To close a patent ductus arteriosus, a coil may be used instead of an occluder if the opening is too small.

The advent of endovascular methods for closing defects represents a real revolution in cardiac surgery, as it has made it possible to close such small defects that cannot be closed with conventional surgery. Considering that such defects are the most common type of congenital heart disease in children, this achievement is difficult to overestimate. Nevertheless, in our country there are still cardiologists who know nothing about endovascular methods and tell terrible tales about it, scaring parents with all sorts of complications. In fact, this is not so: a huge number of endovascular operations have already been performed in the world, while the number of complications is minimal, and much less than with conventional abdominal operations. Therefore, I recommend that all parents of children with congenital heart disease, before making a choice in favor of one or another operation, Be sure to consult with qualified cardiac surgeons! If you live far from a large cardiac center, then you can get an initial consultation with leading specialists via the Internet at the forum of parents of children with congenital heart disease of the “Kind Heart” club.

Important words of this article:

Invasive cardiology cardiology, densel to a child, how much it will cost to cost a packed child. ■ Yokhshey ёyuy №uyu sfhє yuush № Hollow in the heart of the heart adopriinia that this this invasive operational cardiologist is

There are no similar articles.

from your site.

An example of the simplest invasive procedure is any injection, the most complex is surgery. This is the main way in which a surgeon, as opposed to a therapist, provides care to a patient.

Invasive procedures can also be used for diagnosis. Examples of invasive tests are invasive cardiac electrophysiological testing) and invasive genetic testing of the embryo.

In contact with

Popular in the category: