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Healthy posterity

ON THE WAY TO HEALTHY POSTERITY

According to medical statistics, the absolutely healthy young people have a risk to give birth to the child with gene or chromosomal violations is 5%. A married couple, preparing for pregnancy, has to pass full medical examination even before child conception to prevent possible problems in the future. But no family is insured from the child's birth with chromosomal anomalies. Pathology can arise at the time of chromosomes divergence during the process of cell fission. However, even the embryo, bearing the abnormal set of chromosomes is capable for implantation. Pregnancy fading, spontaneous abortion or birth of sick child can be a consequence of it (for example, a Down's syndrome).
Providing the IVF program is not only a method of infertility treatment, but also the possibility of choice of genetically healthy embryo. Modern technologies allow to provide the detailed genetic embryo analysis at its preimplantation stage. The most informative and modern approach to the preimplantation genetic diagnostics (PGD) is the method with the use of microchips (array comparative genomic hybridization, array-CGH). The application of array-CGH allows to provide the detailed analysis of all chromosome set an embryo until its transfer to the uterus cavity. The method gives the chance to reveal gross numerical violations of embryo karyotype (aneuploidy), and small unbalanced structural violations of chromosomes (translocation, deletion, duplication).
After receiving the pregnancy the following step is timely providing the 1st biochemical and ultrasonic screenings with use of the ultrasound diagnostics device of expert class (Voluson E8) that gives the chance to reveal markers of chromosomal anomalies of fetus. In case of identification the deviations of indicators of the 1st biochemical and 1st ultrasonic screening it is necessary to provide the individual calculation of aneuploidies risk with the help of the computer program ASTRAIA.
It is important to note that identification of high individual risk of chromosomal pathology development is the indication to invasive methods of diagnostics (amniocentesis, cordocentesis with the subsequent research of fetus karyotype). If there are no violations in chromosomes set of fetus (normal karyotype), and values of biochemical screening have abnormalities - it is necessary to pay more attention to pregnancy bearing, because such women more often have problems connected with violation of the curtailing and anticurtailing blood system and not connected with fetus pathology.
The 2nd ultrasonic screening is provided at the term of 18-20 weeks of pregnancy which allows to reveal fetus heart diseases. Pregnancy in Ukraine, according to medical indications, is possible to be interrupted till 22 weeks of pregnancy according to the order of Ministry of Health No. 620 from 29.12.2003.
The 3d ultrasonic screening is provided at 30-32 weeks. At this term the research of fetus condition and doppler research of blood circulation is made, that allows to reveal group of women with violations of placental blood-groove and to make dynamic observation of them with the purpose of prevention of fetus hypoxia, heavy forms of placental insufficiency, and sometimes even prevention of fetus death.
Given tactics allows to avoid the risk of giving birth to a child with chromosomal pathology, and also to provide the correction of revealed violations during the pregnancy.

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Блажко Елена Васильевна

Elena Blazhko

head of the department of hospital for in-patients

Зозулина Александра Николаевна

Alexandra Zozulina

doctor obstetrician-gynecologist

Чумакова Наталья Александровна

Natalia Chumakova

doctor obstetrician-gynecologist

Феськова Ирина Анатольевна

Irina Feskova

medical director of the Center of Human Reproduction

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