The information content and accuracy of the study of umbilical cord blood is much higher than other methods of prenatal diagnostics, however, the method of obtaining it is quite invasive (tissue damage) and, due to this, is associated with the risks of infectious complications and fetal injuries. Therefore, its use has strictly limited indications.
In this test, a swab of the vaginal mucosa is used as a tissue sample. The epithelial cells collected in this way have certain characteristics that are characteristic of a particular phase of the menstrual cycle or pregnancy. Having identified these features, it is possible to retrospectively and only tentatively determine the hormonal background of a woman at the time of the study. The method is mainly applicable for diagnosing the threat of termination of pregnancy.
For this analysis, blood obtained from a peripheral vein is used, in which, in fact, the level of hormones of interest to the doctor is determined. As a minimum during pregnancy, the concentration of chorionic gonadotropin, progesterone and estrogen is usually determined. If necessary, the values of the concentrations of hormones of the pituitary gland, adrenal glands, thyroid gland, parathyroid glands, etc.
This study is carried out in the period from 8 to 12 weeks of pregnancy in order to diagnose genetic diseases of the fetus and certain metabolic abnormalities. Chorionic villus sampling is a rather laborious process. For this, a flexible thin conductor with a hollow needle at the end is inserted through the cervix into the uterine cavity. Under ultrasound control, the tip of the needle is inserted into the base of the placenta, but taking care not to touch the blood vessels of the uterus.
Then, using a syringe attached to the outer end of the catheter, aspiration (pulling, suction) of 3-4 ml of the substance is performed, after which the needle is withdrawn.
This analysis is essential for the pregnant woman and the fetus. If HIV is currently considered an incurable disease, then its carriers should do their best.It is essential that the disease is not passed on to the newborn. For this, there is antiretroviral therapy, which gives a fairly high chance that the virus will not be transmitted to the child in utero or when passing through the birth canal.
The obstetrician is the central figure in the childbirth process, with the exception, of course, of the woman in labor. It is he who bears the main responsibility for controlling the generic process. All junior medical personnel are subordinate to him, and he also has the right to call on himself a neonatologist, anesthesiologist and other specialists, if there is a need for them.
It is he who establishes the main psychological contact with the pregnant woman, which plays an important role in their cooperation. If the patient trusts the doctor, she will unquestioningly follow his instructions, which will help him to more accurately control the process of childbirth.
Based on the available diagnostic data, this specialist chooses the method by which he will deliver the baby. If the pregnant woman has the anatomical ability and is able to give birth in a natural physiological way, then this is the preferred method. Otherwise, delivery is by caesarean section. In the first case, the doctor decides on the time of the onset of labor. If necessary, he doses cialis drugs that enhance or weaken the contractile activity of the uterus.
In the second case, he performs an operation with the participation of an anesthesiologist and a surgical nurse. Thus, it is the obstetrician who first touches the newborn and removes it from the mother's womb.