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Procedures


  1. Gestational weeks Гестационни седмици
Screening and follow up of multiple pregnancy
Invasive Diagnostics – Chorion Villus Sampling (CVS) and Amniocentesis (Amnio)
Screening by fetal DNA in maternal serum during the whole period of pregnancy

Viability scan

This is the earlyest period of the pregnancy that we are able to "see" the well defined embrio and its heardbeat in the uterus by ultrasoun examination. Before that we can see only the gestational sac, but not the embrionic structures. That's why you have to wait at least 2 weeks from the day of the expected menstrual period before coming to us for a scan, in that time you can do a pregnancy test.

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First trimester Screening for Down syndr.

Nuchal scan This scan is carried out from 11 weeks to 13 weeks and six days. The scan is usually performed transabdominally but in a few cases it may be necessary to do the examination transvaginally. Aims of the nuchal scan To date the pregnancy accurately. This is particularly relevant for women who cannot recall the date of their last period, have an irregular menstrual cycle, or who have conceived whilst breastfeeding or soon after stopping the pill. We measure the size of the fetus and from this we calculate the expected date of delivery. To diagnose multiple pregnancy. Approximately 2% of natural conceptions and 10% of assisted conceptions result in multiple pregnancy. Ultrasound scanning can determine if both babies are developing normally and if the babies share the same placenta which can lead to problems in the pregnancy. In such cases it would be advisable to monitor the pregnancy more closely. To diagnose major fetal abnormalities. Some major abnormalities may be visible at this gestation. However it will still be necessary to have a 20 week anomaly scan. To diagnose early miscariage. Unfortunately, in 2% of women who attend for a nuchal scan it is found that the fetus has died, often several weeks before and without any warning. Couples will receive full counselling as to the possible causes of this problem and the options for subsequent measures that may be necessary. To assess the risks of Down's syndrome and other chromosomal abnormalities. Each woman will be given an estimate of her individual risk for this pregnancy. This is calculated by taking into account the age of the mother, measurement of two hormones in the mothers blood and the scan findings of nuchal translucency thickness, nasal bone, blood flow through the fetal heart and ductus venosus and fetal abnormalitites. Parents will receive full counselling concerning the significance of these risks and the various options for further investigations including invasive testing or the Panorama test.

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Fetal Anomaly scan

The aim of this exam is to make sure that the fetus does not have any anatomical defects and it's growth is adequate to the gestational age. The name 3D-4D is not appropriate for this scan, becouse in fact this is only a name of a ultrasound function. Even more for the Anomaly scan we are using very high definition 2D preset and the 3D-4D we are using just to show you the face of the baby, or in a very rare situations for visualisation of a specific defects.

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Fetal Cardiac scan

During the nuchal scan (11-13 weeks), the anomaly scan (20-24 weeks) and wellbeing scan (30-34 weeks) we routinely examine the fetal heart and connecting blood vessels. A specialist examination of the fetal heart is recommended for: •Women with family history of congenital heart abnormalities, those with diabetes mellitus and those taking antiepileptic drugs •Fetuses with suspected heart defect and those with increased nuchal translucency or certain non-cardiac abnormalities detected during the routine scans

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Fetal wellbeing scan, Fetal growth and Doppler evaluation

Some obstetricians advise that this scan is offered to all women. Others reserve such scans for those women who have had previous complications of pregnancy such as pre-eclampsia, growth restriction, diabetes, stillbirth, and for those women who develop a problem during the course of their current pregnancy.

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Screening and follow up of multiple pregnancy

Multiple pregnancy occurs when two or more ova are fertilised to form DIZYGOTIC (non-identical) twins or a single fertilised egg divides to form MONOZYGOTIC (identical) twins. In DIZYGOTIC multiple pregnancies, each fetus has its own placenta (either separate or fused), amnion and chorion. In MONOZYGOTIC multiple pregnancies, the situation is more complex depending on the timing of the division of the ovum. In monochorionic twin pregnancies, one twin can receive a reduced blood supply and have a slower growth rate (twin-twin transfusion). Sometimes, one fetus dies and forms a mummified fetus papyraceous or is reabsorbed.

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Invasive Diagnostics – Chorion Villus Sampling (CVS) and Amniocentesis (Amnio)

What is chorion villus sampling? Chorion villus sampling (CVS) involves the examination of chorionic villi (placental tissue). Both the baby and placenta (afterbirth) originate from the same cell and so the chromosomes present in the cells of the placenta are the same as those of the baby. What is amniocentesis? Amniocentesis involves the examination of cells in the fluid from around the fetus (amniotic fluid). The cells in the amniotic fluid originate from the baby and so the chromosomes present in these cells are the same as those of the baby.

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Screening by fetal DNA in maternal serum during the whole period of pregnancy

PanoramaTM Non-Invasive Prenatal Test (NIPT) - The purpose of the PanoramaTM Non-Invasive Prenatal Test (NIPT) is to screen the fetus for the chromosome abnormalities. You have the option of requesting a screen and reporting of the fetal sex as well. Panorama is performed on a maternal blood sample which contains DNA (genetic material) from both the mother and fetus. The fetal DNA tested comes from the placenta; this DNA is identical to the DNA found in the actual cells of the fetus in about 98% of all pregnancies. Panorama is available for women who are at least 9 weeks pregnant. Your health care provider can provide you with more details about the chromosome abnormalities screened with this test.

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