OT\u00c1ZKA: Na jak\u00e1 vy\u0161et\u0159en\u00ed m\u00e1m jako t\u011bhotn\u00e1 n\u00e1rok? Na dotaz odpov\u00edd\u00e1 V\u0161eobecn\u00e1 zdravotn\u00ed poji\u0161\u0165ovna…<\/b><\/p>\n
ilustra\u010dn\u00ed foto: Photoxpress<\/p>\n
ODPOV\u011a\u010e:<\/b><\/p>\n
Ka\u017ed\u00e1 \u017eena je ode dne zji\u0161t\u011bn\u00ed t\u011bhotenstv\u00ed dispenzarizov\u00e1na (tj.\u00a0aktivn\u011b a dlouhodob\u011b sledov\u00e1na) u\u00a0sv\u00e9ho gynekologa. V\u0161echna dispenz\u00e1rn\u00ed p\u00e9\u010de je hrazena zdravotn\u00ed poji\u0161\u0165ovnou, ale jej\u00ed <\/span>rozsah se li\u0161\u00ed podle zdravotn\u00edch pot\u0159eb a\u00a0rizik t\u011bhotn\u00e9 \u017eeny.<\/b><\/span> O\u00a0<\/span>m\u00ed\u0159e rizika rozhoduje o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159 na z\u00e1klad\u011b anamnestick\u00fdch \u00fadaj\u016f a\u00a0aktu\u00e1ln\u00edho klinick\u00e9ho n\u00e1lezu u\u017e p\u0159i prvn\u00edm vy\u0161et\u0159en\u00ed v\u00a0t\u011bhotensk\u00e9 poradn\u011b. P\u0159i ka\u017ed\u00e9 n\u00e1v\u0161t\u011bv\u011b poradny l\u00e9ka\u0159 znovu m\u00edru rizika zva\u017euje; v\u017edy prov\u00e1d\u00ed vy\u0161et\u0159en\u00ed t\u011bhotn\u00e9 (v\u010detn\u011b zji\u0161t\u011bn\u00ed hmotnosti a\u00a0krevn\u00edho tlaku) a\u00a0chemickou anal\u00fdzu mo\u010di, sleduje zn\u00e1mky vitality plodu.<\/p>\n T\u011bhotn\u00e9 s\u00a0mal\u00fdm rizikem <\/b>jsou pacientky bez rizikov\u00fdch faktor\u016f v\u00a0anamn\u00e9ze, kter\u00e9 maj\u00ed v\u00a0pr\u016fb\u011bhu t\u011bhotenstv\u00ed norm\u00e1ln\u00ed v\u00fdsledky v\u0161ech klinick\u00fdch i\u00a0laboratorn\u00edch vy\u0161et\u0159en\u00ed. Chod\u00ed do poradny do 36.\u00a0t\u00fddne gravidity v\u00a0intervalu 4\u20136 t\u00fddn\u016f (optim\u00e1ln\u011b 1x\u00a0m\u011bs\u00ed\u010dn\u011b), od 37.\u00a0t\u00fddne do term\u00ednu porodu jedenkr\u00e1t t\u00fddn\u011b.<\/b><\/p>\n T\u011bhotn\u00e9 se st\u0159edn\u00edm rizikem <\/b>maj\u00ed anamn\u00e9zu s\u00a0rizikov\u00fdmi faktory a\u00a0v\u00fdsledky jejich vy\u0161et\u0159en\u00ed jsou sice norm\u00e1ln\u00ed, ale vy\u017eaduj\u00ed opakov\u00e1n\u00ed. Frekvence n\u00e1v\u0161t\u011bv u\u00a0l\u00e9ka\u0159e je z\u00e1visl\u00e1 na aktu\u00e1ln\u00edm v\u00fdvoji jejich zdravotn\u00edho stavu, stejn\u011b jako rozsah a\u00a0frekvence laboratorn\u00edch \u010di konzili\u00e1rn\u00edch vy\u0161et\u0159en\u00ed. T\u011bhotn\u00e9 s\u00a0vysok\u00fdm rizikem <\/b>m\u00edvaj\u00ed rizikov\u00e9 faktory v\u00a0anamn\u00e9ze a\u00a0hlavn\u011b maj\u00ed patologick\u00e9 klinick\u00e9 \u010di laboratorn\u00ed v\u00fdsledky. Frekvence n\u00e1v\u0161t\u011bv i\u00a0rozsah vy\u0161et\u0159en\u00ed jsou zcela individu\u00e1ln\u00ed a\u00a0rozhoduje o\u00a0nich o\u0161et\u0159uj\u00edc\u00ed gynekolog podle charakteru a\u00a0z\u00e1va\u017enosti klinick\u00e9ho stavu t\u011bhotn\u00e9.<\/p>\n P\u00e9\u010de o\u00a0t\u011bhotnou za\u010d\u00edn\u00e1 komplexn\u00edm prenat\u00e1ln\u00edm vy\u0161et\u0159en\u00edm, kter\u00e9 m\u00e1 \u017eena absolvovat do 14.\u00a0t\u00fddne t\u011bhotenstv\u00ed. <\/b>Jeho sou\u010d\u00e1st\u00ed je i\u00a0vystaven\u00ed t\u011bhotensk\u00e9 pr\u016fkazky<\/b> s\u00a0podrobnou informac\u00ed o\u00a0dal\u0161\u00edm pr\u016fb\u011bhu prenat\u00e1ln\u00ed p\u00e9\u010de. L\u00e9ka\u0159 m\u00e1 \u017een\u011b nab\u00eddnout screening nej\u010dast\u011bj\u0161\u00edch vrozen\u00fdch v\u00fdvojov\u00fdch vad plodu<\/b> a\u00a0poskytnout informace o\u00a0jeho metod\u00e1ch i\u00a0mo\u017enostech \u00fahrady. Nap\u0159. odborn\u00edky doporu\u010dovan\u00fd tzv. prvotrimestr\u00e1ln\u00ed screening sice nen\u00ed hrazen z\u00a0prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed, ale VZP na n\u011bj \u017een\u00e1m p\u0159isp\u00edv\u00e1<\/a><\/span><\/span>.<\/p>\n Do 14.\u00a0t\u00fddne<\/b> m\u00e1 \u017eena rovn\u011b\u017e absolvovat laboratorn\u00ed vy\u0161et\u0159en\u00ed<\/b> (hlavn\u011b vy\u0161et\u0159en\u00ed krve v\u010detn\u011b stanoven\u00ed krevn\u00ed skupiny a\u00a0RhD, screening nepravideln\u00fdch antierytrocyt\u00e1rn\u00edch protil\u00e1tek, stanoven\u00ed hematokritu a\u00a0po\u010dtu erytrocyt\u016f, leukocyt\u016f i\u00a0trombocyt\u016f, hladiny hemoglobinu, s\u00e9rologick\u00e9 vy\u0161et\u0159en\u00ed HIV, HBsAg a\u00a0protil\u00e1tek proti syfilis, glyk\u00e9mie na la\u010dno) a\u00a0ultrazvukov\u00e9 vy\u0161et\u0159en<\/b>\u00ed, p\u0159i kter\u00e9m se zji\u0161\u0165uje po\u010det plod\u016f a\u00a0jejich vitalita.<\/p>\n Dal\u0161\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed<\/b><\/a><\/span><\/span> <\/b>n\u00e1sleduje cca ve 20. a\u00a0ve 30. t\u00fddnu<\/b> t\u011bhotenstv\u00ed. Mezi 24. a\u00a028. t\u00fddnem se prov\u00e1d\u00ed or\u00e1ln\u00ed gluk\u00f3zo-toleran\u010dn\u00ed test. Laboratorn\u00ed vy\u0161et\u0159en\u00ed<\/b> se stanoven\u00edm hematokritu a\u00a0po\u010dtu erytrocyt\u016f, leukocyt\u016f i\u00a0trombocyt\u016f a\u00a0hladiny hemoglobinu se d\u011bl\u00e1 ve 27. a\u00a032.\u00a0t\u00fddnu. <\/b>U\u00a0RhD negativn\u00edch \u017een se prov\u00e1d\u00ed tzv. RhD aloimunizace<\/b><\/span><\/span>,<\/span><\/span><\/a> a\u00a0to ve 27.-28. t\u00fddnu. Od 38. t\u00fddne a\u017e do term\u00ednu porodu \u010dek\u00e1 \u017eenu 1x\u00a0t\u00fddn\u011b kardiotokografick\u00fd <\/b>non-stres <\/b>test<\/b>, kter\u00fd zji\u0161\u0165uje srde\u010dn\u00ed akci plodu a\u00a0d\u011blo\u017en\u00ed \u010dinnost.<\/p>\n V\u00fd\u0161e uveden\u00e1 vy\u0161et\u0159en\u00ed jsou stanovena pro dispenz\u00e1rn\u00ed p\u00e9\u010di o\u00a0nerizikov\u00e9 t\u011bhotn\u00e9 \u017eeny. \u017deny s\u00a0rizikov\u00fdm nebo tzv. patologick\u00fdm t\u011bhotenstv\u00edm jsou samoz\u0159ejm\u011b sledov\u00e1ny podrobn\u011bji a \u010dast\u011bji, p\u0159i\u010dem\u017e ve\u0161kerou l\u00e9ka\u0159em indikovanou p\u00e9\u010di poji\u0161\u0165ovna hrad\u00ed<\/b>.<\/p>\n \u017d\u00e1dn\u00e1 nast\u00e1vaj\u00edc\u00ed maminka by tak\u00e9 nem\u011bla zapomenout na preventivn\u00ed prohl\u00eddky u\u00a0stomatologa<\/b>, m\u00e1 na n\u011b n\u00e1rok dvakr\u00e1t v pr\u016fb\u011bhu t\u011bhotenstv\u00ed.<\/b> K t\u011bmto dv\u011bma „t\u011bhotensk\u00fdm“ m\u016f\u017ee ve stejn\u00e9m kalend\u00e1\u0159n\u00edm roce absolvovat nav\u00edc jednu „b\u011b\u017enou“ preventivn\u00ed zubn\u00ed prohl\u00eddku.<\/p>\n Mgr. Old\u0159ich Tich\u00fd OT\u00c1ZKA: Na jak\u00e1 vy\u0161et\u0159en\u00ed m\u00e1m jako t\u011bhotn\u00e1 n\u00e1rok? Na dotaz odpov\u00edd\u00e1 V\u0161eobecn\u00e1 zdravotn\u00ed poji\u0161\u0165ovna…<\/p>\n<\/div>","protected":false},"author":1,"featured_media":16282,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-17996","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/17996","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=17996"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/17996\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/16282"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=17996"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=17996"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=17996"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\n<\/b>vedouc\u00ed tiskov\u00e9ho odd\u011blen\u00ed a tiskov\u00fd mluv\u010d\u00ed VZP<\/p>\n","protected":false},"excerpt":{"rendered":"