Pregnancy 12 weeks. The first ultrasound screening: ktr - 54 mm, tvp (collar space thickness) - 1 mm. The length of the nasal bone is two to four mm. Venous circulation is unchanged. (This means blood circulation in the venous duct and the fact that there is no reverse blood flow - guzov ii) "blood on hcg - 3.59." (So, if you enjoy in mom, you can watch three to five times more than approximately the median team - guzov i.I.) “Papp-a 0.75 (speaking to others words there are many lowered). The combined risk for down syndrome (in other words, trisomy for the 21st pair) is 1:244. Is this very serious? What other examination is needed? Does taking medications lutein, metipred, affect success? ".</>I'll start right at the finish line. Taking medication sometimes affects the effect. But lutein is a proposed remedy, used, according to statistics, by an ophthalmologist. Probably, due to the fact that there are some problems with the retina, perhaps there are some trophic changes present. And metipred is a professor, probably an obstetrician-gynecologist. There, it is necessary to understand why such therapy is carried out? The results of the tests were not directly affected by the process.Conclusion: combined screening 1 to 244. You never wrote how old you are. Pregnancy 12 weeks.I just want to show how people analyze and what a useful thing we prescribe in these cases.So, here is the coccygeal-parietal size ( ktr) - 54 mm. When paying risks, it represents the main for finding the gestational age with someone a day. Because ovulation can start a little earlier, $115% of 200 000 then. However, there is a fairly stable indicator, which over 11-12 weeks suggests the smallest dispersion of emissions. In accordance with the fact that there are almost always observed general physiological processes, features, differences in the path of inflammation begin at a very long time. If there is a coccygeal-parietal value, then the risks are assessed using this: take the gestational age (average for this size). ), And then, in this way, the term, which is calculated according to the ktr, is considered the gestational age.Can there be legal errors here?Sometimes for the reason that coccygeal-parietal size - this is the size of the baby from the crown to the tailbone. Therefore, he knows how to be judged from the level of flexion of the spine. The child should shrink a little - in this case, the crust can decrease a little. It has a little bit to bend - in such circumstances, this bike will be a little more than that. When paying for risks, which is already taken into account by the coccygeal-parietal size, the gestational age. Further, in this case, any other indicators are calculated.These figures are 3.59; 0.75 are values expressed in mom. This is the english abbreviation for a multiple of the median, which means "a multiple of the median."What are we talking about?Let's say we calculated the gestational age. Suppose he calculates when passing the analysis of 11 weeks three days, or 11 weeks 4 days or 12 weeks. We have the coccygeal-parietal size listed. Inside there are numbers expected for any laboratory, characterizing the average median value of the indicator for a similar number, calculated according to the coccygeal-parietal size. Just in real time, with a minimum time interval, you can receive pregnancy information, and the person is corrected for some indicators. This is primarily a spring expectant mother. Payback is important. The presence of risk factors is important, for example, the onset of pregnancy in the event of ivf. There are correction factors depending on this, whether there are endocrine pathologies and the like.There are a number of characteristics that operators add to the network, for inclusion in the temporary "windows" of the program. As a result, we consume mom. For show values, the volume zone in mom is also considered. Most often - all this is not consumption: there is a thick bone thickness of 1 mm - this thickness of the thick bone is fixed in mom, and then we are suitable for the mathematical calculation of the physical one.The length of the nasal bone is two to four mm . This may well be translated into moms, however, a number of programs are simply taught “or not”, “” either a nasal bone is found or not. It wishes and may not be contained here.When we compare such rarities, we begin to analyze from this what characterizes an ultrasound examination. Your ultrasound is good.The thickness of the sampling space is sometimes also called the “neck crease”.The collar space is the region of the posterior surface of the surface at home in a prenatal baby. It doesn't have to be incredibly fat. If there is a thickening of this occipital space, then such a step tells about this the back surface of the neck happens to be edematous. This can increase the risks that are calculated by screening associated with down syndrome. This is a significant value for you.The nasal bone in all cases, when there is a risk of an increased risk of developing down syndrome, is either reduced or absent. In the circumstances of the formation of the nasal bone is present.Venous blood flow. You type: "venous circulation is unchanged." In view of the venous duct. This is a certain vessel that interests the fetus, which (if slightly primitized) drives blood from the placenta, from the umbilical cord towards the heart of the fetus.This blood flow must go to one part, in other words, go from the umbilical cord to side of the fetal heart. Because the child, through this venous duct, actually receives arterial blood, which is further divided throughout the body. The heart of the fetus to help in this direction is infinitely extremely small, therefore, if there is a reverse blood flow, then the reverse blood flow presented means that the blood came to the soul and went back. This has the ability to indicate the fact that there are violations of the emerging valvular apparatus of the heart of the intrauterine fetus. That is, there is an increased risk of an anomaly in the structure of the heart, specifically a violation of the valvular apparatus. The child is also very, extremely micro, its size is only 54 mm, this is a small “boy with a finger”. ". We are not ready to see whether such a bicycle has a certain valvular disorder or does not exist, however, the presence of reverse blood flow, indicating that the blood came to the soul and went back - may be expressed by the presence of signs of the valvular apparatus of the heart in the fetus.</> Why is reversed blood flow and thickening of the annular spaces related to the risk of down syndrome?This is due to the fact that this trisomy of the 21st pair (down syndrome) is often accompanied by the presence of identified anomalies of the child, and for a wide the percentage of cases of violations of the formation of the soul and heart of a child, in other words, there are heart defects. And already heart defects disrupt the blood supply in the end of the fetus, and this will be accompanied by an expansion of the vessels of the gray matter and the presence of reverse blood flow. Pregnancy on an excellent ultrasound machine valvular apparatus. Then it is already clearly visible: whether any vices are possible or not. Exactly what we are carefully watching the first trimester screening.This assessment of the general anatomical structure of the fetus states that the baby has formed quite effectively in the victim and the ultrasound signs of the phenomenon that something is going on - probably not even very no.What is missing in ultrasound? It is definitely necessary to monitor the blood flow of the uterine arteries, due to the fact that our company in such screening observes not only diseases that are associated with chromosomal abnormalities. We are looking at the risks borne with dysfunction of the placental function. Therefore, absolutely durable - for the fetus, the determination of blood circulation in the uterine arteries today becomes a legitimate element in ultrasound screening of the first trimester of pregnancy. , We find increased risks associated with a number of complications of the 2nd half of pregnancy, already long terms. These are intrauterine retention, the risk of preeclampsia, the risk of antenatal fetal death, and the increased risk of prematurity over long periods. Exist in ultrasound screening to determine the blood flow of the uterine arteries. This is a very important attribute. We are talking about this state, but from now on we are talking in relation to the percentage analysis that will have to be carried out.When we evaluate the biochemical risk, hcg 3.59 is encountered. Thus, in the case of hcg, it is three.6 times higher than the average.Rarp-a is slightly reduced, 0.75, or rather 75% of the conditional median. If you choose the direction of those points: stabilization of the quality of hcg, a decrease in the level Percentage Calculator of papp, sometimes we have scissors, which can be characterized by a pattern of increased risk of trisomy for the 21st pair. However, since the risk of trisomy 21 is a purely algebraic or arithmetic study, in other words, several moms are laid down: tvp, the presence of nasal bone, mom for hcg and mom for papp-a. Accordingly, all of the above is evaluated together, here we have a cumulative risk - 1 to 244, as if they answered you that the same is correct and nothing is worth doing.Most likely, it even is. Because the program thinks so.She thinks stupidly, but this program takes into account that there is an absolutely normal unaltered structure of the fetus, but at the same time a disorder is theoretically possible that can reveal a problem that carries some kind of chromosomal abnormality, but there are no heart defects.And in those days, this ultrasound provokes a normal tbp, a normal nasal grass and a normal blood circulation, can lower the threshold of well-being, when we find these statistics.Often, the antenatal clinic doctor looks at conclusion and declares that the victim is doing well, or there is something on the road. Of course, with such a serious nature of the indicators of indicators, i would simply recommend removing this “worm of doubt” about the slightest obstacles in a certain way. , Here you wrote about this fact. Also, i would still prefer to donate, if such a possibility is found, blood for nipt. This is exactly the moment when nipt (non-invasive prenatal screening) helps to remove the last “worm suspicions”: what if there is something, some questions, microbial chromosome abnormalities. , According to the likelihood of some chromosomal abnormalities, specifically, trisomy for the 21st pair, has a fairly low risk. But the risk presented at once is approximately in the population. Your personal risk is 1 in 244, the risk for the population may be 1 in 500, 1 in 600. In such circumstances, you should donate blood for nipt, if there are no big questions on the 21st pair, or the question is hidden. I guess everything is fine.In any case, with these indicators, i would prefer to do an ultrasound also even at 16 weeks of pregnancy. Just in case, to guarantee the fact that everything is clearly formed in them.Suppose that the same thing will be something to do (i almost think how good everything is for them on such a chromosomal basis), what, among other things, is an infection higher than the average for the population, the figure of hcg?Why is it possible that the level of hcg is three.5 times? . Maybe the hacking is due to the statement that the genes are so in, the increase in placentation, inherited by the child from the father. It is in the course of our previous conversations that sometimes higher numbers of hcg are simply found on many guys. The hcg and number associated with placentation are somewhat controlled by genes inherited by the child from his own father. Often there may be higher numbers associated with the statement that the baby received such a gene, and are never associated with either chromosomal abnormalities or some other problems. So as not to spit out the problem. If there are extraneous indicators that characterize an increase in the risk of problems, it is better to make sure of it. Meaning that this can become an absolutely normal turnover. But unless this is due to the genetics of the father? What are the options now? There is also a case when there were 2 fetal eggs. It causes developmental gestation, because there was a serious problem, the second gestation continues. The "disappeared support twin" can give its increased hcg figure for a certain time, and this is able to provide an increase in this moma. It's real.We need to remind you that hcg is a human chorionic hormone. During pregnancy it has its own dynamics. It can be said that it will become serious during pregnancy almost from the beginning of pregnancy. However, in the subcortex of the mother begins after implantation after about 7-9 days of pregnancy. For some episodes, after ten days of pregnancy, our company has long been observing minor phenomena. When implantation occurs, there is an interaction in the environment between the organ and the organ, fruiting is completely carried out in the mucous membrane of the uterus and the quality of the connection is sent to the center of the mother - hcg.This hormone stops menstruation, causes a yellow organism, in other words formation inside the ovary formed after ovulation), to produce progesterone. The first 7 days of pregnancy develops due to the fact that it is important for the hormone progesterone produced by the corpus luteum inside the ovary to continue to produce progesterone, regularly monitor the preparation of the mucous membranes of the uterus, observe the normal development of the heart during pregnancy. Therefore , as it becomes the cause for the primary villi of the fetus, if the implantation procedure is underway, we observe a sharpness and a rather high increase in the level of hcg, which is normal in the starting eight, ten weeks of pregnancy. Somewhere in these years, it reaches too high values observed at the same time as the development of pregnancy.At the same time, even a small child’s appointment for hcg disappears, most often during the formation of the placenta, the placenta itself begins to produce progesterone.If we take the totality of progesterone, then about seven, eight weeks of pregnancy is a person's time when the corpus luteum begins to "lose position" and produces less progesterone, and the placenta itself produces an increasing amount of progesterone. After 11-12 weeks of pregnancy, yellow health products play no role. The placenta produces so much progesterone that circumstances occur in which, for example, a specific ovarian tumor is detected and the telephone is removed, and the pregnancy continues normally.In ivf, when a donor egg is used, if not in new eggs, it is better to say that the ovary is completely disabled in girls due to menopause or with premature menopause, or due to the removal of the ovaries, progesterone support goes up to about 12-13, maybe 14 weeks. And then this support is not necessary, since the child himself, producing progesterone, completely absorbs his desires. He will fall. When it hangs on your higher numbers, even then, in certain situations, it is a sign, a "warning signal", that something is too little. For example, this is how they call themselves hcg. When we often evaluate the numbers of this parameter, we say that it’s great that there is a lot of progesterone. And if there is a lot of hcg, it’s not great at all, ”that the baby is able to give an alarm signal in our body that its use represents higher hcg numbers for the body.I think that in addition to other than that, in order for us to be perfectly and completely sure of the fact that any is beneficial, we need to check the flow of human blood in the uterine arteries. Find the best indicator, called placental growth (plgf). And then this screening will be complete and exhaustive. And people will not miss the situation, the nature of which, for the risk of complications with an impressive size of pregnancy, will have time to prescribe the prevention of placental function disorders. As a rule, in such cases, low-dose aspirin is encountered.This is standard international practice, which i described. So i would go that route. And in order to still not assume when the risk of trisomy in the 21st pair is greater than the loss in approximately the population. There is now such a heavy powerful finding and noticeably more informative regarding this analysis as nipt, i prefer to overcome it just in case. It is up to us not to constantly dream about the conditions that were in one trimester. Growth, take a test for nipt. Just for the sake of completely protecting the consumer from your tasks, and at the same time predicting the placental function, not to tighten certain items.Here are these 0.75 mom according to papp-a. Papp-a is an absolutely placental indicator, which in everything characterizes the extent to which placentation took place. You have it slightly reduced, but not critically reduced. Usually, if the decrease reaches up to 30%, then such a step is packaged in a spread of the usual norms. But still "arrow" violations aside beautiful. Wishing to help, i spoke little about the present on papp, and therefore did not concentrate your interest. The current moment, just in case, of course, you need to remember. I showed how it will be necessary in the plan to analyze this screening. You do not have to intimidate yourself, do not draw scary pictures. It is necessary to take and conduct these 3 tests in order to decide for sure, and on the risk of trisomy on the 21st pair.Although, such things are extremely unpleasant, of course, to expect. And the threat of preeclampsia can also be taken into account. Naturally, in the following situations, a simple examination by an obstetrician-gynecologist may not be sufficient. Cir. Over the years of our products, over 16,000 patients have carried out their pregnancy in the cir. Postpone your baby during the whole pregnancy, observe by professional doctors. We show attention and also take pleasure in wishes.