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Ómskoðun við 18-20 vikur

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Authors
Reynir Tómas Geirsson
Útgáfudagur
2001-05-01

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Önnur málmynd
Ultrasound screening at 18-20 weeks
Citation
Læknablaðið 2001, 87(5):403-7
Útdráttur
Ultrasound screening at 18-20 weeks gestation is widely recognized as an integral part of modern antenatal care. It was set up in Iceland between 1984 and 1986 and has become steadily more advanced. The time for this basic dating and fetal assessment scan was selected in accordance with current medical knowledge, based on several cohort studies, later supplemented by results from randomized trials. Icelandic reference standards were established and the suitability of mostly Scandinavian fetal assessment methods for the Icelandic population was evaluated. Gestational age assessment and placental localisation, along with a thoroughly performed evaluation to ascertain normal fetal anatomy, were conducted systematically. Icelandic guidelines and educational standards for conducting ultrasound were published. As most deviations from the normal, including major anomalies, are found in those not perceived to be at risk, a screening approach was necessary. Better dating of pregnancies and prenatal diagnosis allowing either termination of pregnancy in case of severe fetal anomaly or preparation for correct handling of the neonate at birth, have had a major impact on obstetric practice. Most lethal or seriously handicapped fetuses are detected. The screening scan has become a universally accepted and appreciated part of antenatal care in Iceland.
Ómskoðun við 18-20 vikna meðgöngu er víðast hvar talin sjálfsagður hluti nútíma mæðraverndar og hófst á Íslandi á árunum 1984-1986. Skoðunin hefur stöðugt verið endurbætt. Skoðunartíminn var valinn með tilliti til þess sem þá og enn var talið hagkvæmast og það var byggt á allmörgum rannsóknum þar sem árangur skimunar hafði verið metinn, meðal annars í framskyggnum hendingarvalsathugunum. Íslensk viðmiðunargögn voru unnin og borin saman við rannsóknarniðurstöður frá Norðurlöndum til að meta hvort nota mætti rannsóknaraðferðir og önnur viðmið þaðan. Kerfisbundið mat á meðgöngulengd, fylgjustaðsetningu og heilbrigðu útliti allra meginlíffæra fóstursins var kennt og íslenskar leiðbeiningar um ómskoðun í meðgöngu og kröfur um lágmarksmenntun á þessu sviði birtar. Skimun var nauðsynleg þar sem flestar afbrigðilegar meðgöngur eru meðal þeirra kvenna sem ekki teljast hafa neina sérstaka áhættu. Betra mat á meðgöngulengd gerði meðgöngueftirlit og fæðingaraðgerðir markvissari og fósturgreining gat gefið möguleika á að rjúfa meðgöngu ef dauðlegur eða mjög alvarlegur fósturgalli fannst, ellegar að undirbúa viðeigandi aðgerðir til nánari greiningar, eftirlits eða meðferðar við fæðingu barnsins. Flestir alvarlegir fæðingargallar hafa fundist. Skoðunin hefur orðið að nauðsynlegum þætti mæðraverndar, sem almenningur metur.
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http://www.laeknabladid.is/2001/5/fraedigreinar//nr/896/
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