Optimization of prenatal diagnostics is with the use of echography and biochemical screening

Abstract

DOI: 10.52705/2788-6190-2024-03.2-03
УДК 618.3/5-007-056.7-073

The objective: to learn the comparative aspects of role of ultrasonic and biochemical screening in prenatal diagnostics of congenital malformations and chromosomal anomalies in fetus.
Materials and methods. The investigated group – 251 pregnant was formed. For the study of factors of risk of forming more frequent all, that meet, and chromosomal anomalies in fetus and determination of possibility of their prognostication of pregnant parted on a basic group and group of comparison. A basic group was made by women, selected in obedience to the criteria of
including: diagnosed congenital malformations in fetus during pregnancy or at once after births (n = 163). The group of comparison was made by patients which had during pregnancy a risk of birth of child with an congenital anomaly, but gave healthy children (n = 88). A control group was formed from women, which did not have a risk of birth of children with an congenital anomaly,
which appealed after the inspection of own free will (n = 59). Distributing of patients of basic group and comparison on sub-groups was conducted taking into account the concrete variant of congenital malformations. Ultrasonic research was conducted by three-stage in 10–14 weeks, 20–24, 32–34 weeks pregnancy. In the first trimester of pregnancy researches conducted with the use of transabdominal and transvaginal sensors and foresaw biometrics of fertile egg, measuring coccygeal-parietal to the size of
embryo.
Results. Ultrasonic markers occupy a leading place in early diagnostics of congenital malformations and chromosomal anomalies. During analysis of structure of ultrasonic markers at 1,9 time combination is more frequent marked a few as compared to the isolated changes, chromosomal anomalies found out in 13,3% at the isolated ultrasonic markers and in 9,4% at
combination a few.
Most specific gravity in the structure of all ultrasonic markers belongs to the congenital heartdiseases (11,7%), among them the high level of chromosomal anomalies is marked – 57,1% at the isolated congenital malformations and 20,7% at combination of them with other ultrasonic markers. The high level of chromosomal pathology is marked at the delay of development of fetus (66,7%) and cystic hygroma of the neck (37,5%) in combination with other ultrasonic markers.
Specific deviations from the norm of serum markers of pregnancy at the different types of congenital malformations had 16-71% patients, the combined changes of serum markers of pregnancy are marked in 19,2% in the basic group of patients and in 10,0% - in the group of comparison.
Conclusions. The got results must be taken into account at development of algorithm of prognostic measures for women with the factors of risk.