Consultative – diagnostic unit

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Aleksiychuk Nataliia Mykhaylivna

The head of consultative and diagnostic unit
Obstetrician-gynecologist highest category
Experience of 20 years

 

Prenatal Diagnostics and Family Planning Department (PDFPD) is a structural subdivision of Zhytomyr Oblast Perinatal Centre that renders outpatient specialized obstetrical-gynecological medical assistance to population of Zhytomyr oblast.

Prenatal Diagnostics and Family Planning Department consists of 3 structural divisions:

  1. Outpatient department
  2. Laboratory
  3. Oblast Medical Genetic Centre

Prenatal Diagnostics and Family Planning Department is visited by 150-200 patients daily.

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There are obstetrician-gynaecologists, physician, psychotherapist, ultrasonic medical investigation specialists, sexual health specialist working in the outpatient department.

The major fields of activity of Prenatal Diagnostics and Family Planning Department are:

  • pregnancy pre-treatmen;
  • diagnosis of congenital development defects, congenital and chromosomal defects;
  • diagnosis and treatment of cervical pathological processes;
  • diagnosis and treatment of gynecologic diseases of children and teenagers;
  • diagnosis and treatment of extragenital diseases in pregnancy;
  • diagnosis and treatment of couples with infertility problems and habitual miscarriage;
  • diagnosis and treatment of reproductive system endocrine disorders of all age groups of women;
  • counseling, sanitary-educational and propaganda activities related to family planning issues, contraception, sex education of teenagers;
  • organizational-methodological and scientific activities.

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Geneticists consult various categories of population. Priority area of Medical Genetic Centre’s activity is prevention and early detection of congenital disorders, counselling provided in obstetrical inpatient department of oblast, district and city hospitals, medical and children’s institutions.

Physician consults pregnant women with extragenital pathologies and couples, who plan pregnancy.

24-6An important aspect of department’s work is counseling of the pregnant by psychotherapist. Individual classes include prenatal training, husband’s (partner’s) role during and after labour, changes of psycho-emotional state of a pregnant woman, etc. Complex of methods of working with pregnant women include talks, art-therapy, meditation, music therapy, haptonomy.

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Substantial aid in diagnosing, differential diagnosis of various states is provided by the laboratory that carries out wide range of analyses:

  • enzyme multiplied immunoassay (hormonal panel, TORCH-infections, genital infections, markers of congenital and chromosomal defects in 1st and 2nd trimester);

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  • polymerase chain reaction (PCR) (genital infections, TORCH-infections) testing;
  • cytogenic assays (buccal swab, determination of human chromosome karyotype (cultivation of blood lymphocytes) determination of fetus karyotype (cultivation of amniotic fluid cells or placenta);
  • cytologic analyses;
  • biochemical genetic analyses of various types of congenital metabolism disorders (detection of amino acids and carbons through thin layer chromatography, administration of tests to detect metabolism disorders of connective tissue, sweat test and screening-test urinalysis, detection of lactic acid in blood).

All divisions of PDFPD are equipped by modern medical apparatus and diagnostic equipment:

  • ultrasonic complexes of expert-class – Toshiba XARIO, Volusion E8 Expert, Philips HD11XE;

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  • cytogenic complex with Ikaros software and high-accuracy optical equipment made by Carl Zeiss;
  • fetal cardiac monitor;

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  • portable fetal monitor;
  • semi-automatic immunoenzymometric analyzer;
  • program complex for analysis polymerase chain reaction (PCR) testing;
  • microscopes;
  • colposcopes;
  • gynaecologic examination chair “Gracia” equipment with installed colposcope and video device and colour photographs printing option;

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  • equipment for cryotherapy (Cryopuls, Cryoton);
  • computer program complex for genetic risk estimation “Astraya”. 

Doctors working at the department participate in a number of state programs, cooperate with state and private institutions and services within the framework of propaganda and sanitary-educational work related to sex education, contraception, safety motherhood and responsible parenting issues.

Doctors working at Family Planning and Human Reproduction Centre are national and international coaches in antenatal protection of fetus, evidence based medicine

Further development of specialized medical assistance rendering is tied to introduction of modern diagnostics methods, educational and scientific work:

  • invasive prenatal diagnostics of chromosome diseases of fetus;
  • training specialists for prenatal diagnostics of congenital defects of heart;
  • extension of complex of laboratory analyses;
  • preparation of methodological recommendations, information sheets for oblast doctors according to major fields of department’s activity.

Invasive prenatal diagnostics

Invasive methods help to receive cells and tissues of fetus.  Sampling is carried out transabdominally (through anterior abdominal wall) under ultrasound control.

Invasive methods of prenatal diagnostics include:

  • chorion biopsy – recovery of cells that form placenta (10-14 pregnancy weeks);
  • placentobiopsy – recovery of placenta cells (14-20 pregnancy weeks);
  • amniocentesis – puncturing of caul and amniotic fluid sampling (15-18 pregnancy weeks);
  • cordocentesis – fetus cord blood sampling (since 20th week of pregnancy).

Risk of complications from chorion biopsy and placentocentesis does not exceed 1% and after amniocentesis – 0.2 % appr.

Indications for invasive prenatal diagnostics:

  1. pregnant women 35 years old and older,
  2. Down syndrome in anamnesis of previous children or other chromosomal pathologies, congenital defects of development in anamnesis of previous children,
  3. ultrasound markers of chromosomal pathology of fetus,
  4. balanced chromosomal pathology of parents,
  5. deviants in serum blood markers (PAPP-A, β-HGL, estriol, α-fetoprotein),
  6. congenital defects of development and numerous congenital defects in fetal development.

Invasive prenatal diagnostics is used mostly to rule out chromosome diseases (Down syndrome, Turner and Edward’s syndromes).

For these reasons we conduct karyotype testing of chorion, placenta and amniocyte cells.

Analysis of chromosome complement set of cells allows detecting chromosomal pathology of fetus and correcting further prenatal care practically in up to 98.6% of cases.

In October 2012 Prenatal Diagnostics and Family Planning Department introduced invasive prenatal diagnostics.