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Fósturgreining og meðgöngusjúkdómar, undirsérgrein fæðingaog kvensjúkdómalækninga - Yfirlitsgrein

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Authors
Hildur Harðardóttir
Issue Date
2020-01

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Other Titles
Maternal Fetal Medicine, a review article
Citation
Hildur Harðardóttir. Fósturgreining og meðgöngusjúkdómar, undirsérgrein fæðingaog kvensjúkdómalækninga - Yfirlitsgrein. 2020; 106(1): 19-27.
Abstract
Læknisfræði fósturs er undirsérgrein fæðinga- og kvensjúkdómalækninga og lýtur að rannsóknum á þróun, vexti og sjúkdómum fóstra. Það má telja eðlilegt að hafa eina sérgrein fyrir þá órjúfanlegu heild sem móðir og fóstur mynda og er íslenska undirsérgreinin í samræmi við það og ber heitið fósturgreining og meðgöngusjúkdómar (FM). Stórstígar framfarir hafa átt sér stað í FM hvað varðar myndgreiningu fóstra með ómskoðun og segulómun. Einnig á sviði erfða- og sameindalæknisfræði við sjúkdómsgreiningar með kjarnsýrutækni auk þess sem aðgerðir á fóstrum eru nú mögulegar í vissum tilfellum. Í vinnu við fósturgreiningar er samstarf við fjölmarga aðra sérfræðinga mikilvægt, til dæmis nýburalækna, barnalækna í ýmsum undirsérgreinum, barnaskurðlækna, erfðalækna og lækna sem vinna á sviði myndgreiningar. Í stærri samfélögum starfa FM-læknar gjarnan sem ráðgefandi fyrir fæðingalækna og aðra sérgreinalækna auk þess að vinna við fósturskimanir, greiningar og meðferð. Hér á landi er sérhæfing styttra á veg komin. Hér eru tekin dæmi um verkefni FM-lækna og lýst hvernig tækniframfarir hafa breytt fósturskimun fyrir litningafrávikum, eftirliti og meðferð við rhesus-varnir auk aðgerða á fósturskeiði. Þá er sagt frá samstarfi norrænna FM-lækna.
Fetal medicine is a subspecialty of obstetrics investigating the development, growth and disease of the human fetus. Often, the mother is part of the definition of the subspecialty where maternal diseases specific to pregnancy are included and therefore named MaternalFetal Medicine (MFM). It is appropriate to have one subspecialty for the maternal-fetal unit and the Icelandic subspecialty is named accordingly; “Prenatal diagnosis and maternal diseases”. The subspecialty was acknowledged in Iceland in 2015 when physician specialty regulations were changed. The advances in fetal imaging, both ultrasonography and MRI, and molecular diagnostic techniques, together with the possibility of interventions in utero, make fetal medicine an important, rapidly developing field within women’s healthcare. A variety of specialists, such as neonatologists, pediatric cardiologists, medical geneticists, radiologists and pediatric surgeons, are necessary to adjunct in the diagnosis and treatment of the fetus as a patient. In larger communities MFM physicians work as consultants besides working on fetal screening, diagnostics and treatment of mothers and their fetuses. In Iceland the subspecialization is less advanced. This article describes common tasks of the fetal medicine physician and examples are given where advances in technology have changed management for instance in aneuploidy screening, Rhesus allo-immunization and fetal interventions. Finally, the establishment of the Nordic Network of Fetal Medicine is described.
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https://www.laeknabladid.is/tolublod/2020/01/nr/7220
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Icelandic Journal Articles (Peer Reviewed)

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