• Protein diets
• vitamins
• Diets
• For multicooker
• For weight loss

MCO test during pregnancy is the rate of resorption. Marking, hallmarking and testing of jewelry

Toxicosis in the last trimester, called preeclampsia, is one of the most serious complications of pregnancy.

Despite this, gestosis is by no means considered a rare occurrence: about every third expectant mother has to face it, which it threatens with problems in the kidneys, cardiovascular system, blood flow disorders and other unpleasant consequences for both the woman herself and her baby.

Prices for pregnancy support programs

• 3 500 R Primary consultation of an obstetrician-gynecologist + ultrasound
• 114 000 R Pregnancy management contract
• 136 000 R Contract for the management of multiple or complicated pregnancies

Symptoms of gestosis during pregnancy

• visible swelling on the face and limbs of a woman;
• excessive weight gain;
• the appearance of protein in the urine;
• increase in pressure;
• edema of the placenta detected during ultrasound examination.

Most of these signs can go unnoticed for a long time, and when a woman feels changes in her health, the disease can already lead to serious consequences. Therefore, it is important not to miss preventive appointments with a gynecologist and to undergo the prescribed examinations on time.

Specialists

Preeclampsia in the second half of pregnancy (preeclampsia)

Preeclampsia can occur as early as 20 weeks after the last menstrual period. Its additional signs are dizziness, nausea, headaches, and in complicated cases - changes in the mental state and visual impairment.

They indicate that in the absence of effective treatment, eclampsia can occur - a convulsive attack that is very dangerous for the expectant mother, as a result of which pulmonary edema, renal failure, stroke, placental abruption and other life-threatening and pregnancy-preserving conditions often develop.

Diagnostics

Preventive examinations and laboratory diagnostics during pregnancy allow you to recognize preeclampsia in time. During each visit to the doctor, the expectant mother is weighed, her pressure is measured, and regular referrals are given for a urine test.

If there is a suspicion of gestosis, and its signs in a woman are doubtful, the gynecologist may prescribe an MCO test for her. During this study, the time of resorption of subcutaneously administered saline is calculated. If it is less than thirty minutes, this indicates the presence of hidden edema.

Treatment of preeclampsia during pregnancy

If preeclampsia of the second half of pregnancy is detected, it is necessary to undergo a course of treatment in a hospital. The woman will be prescribed special medications, as well as droppers to restore protein losses and lack of fluid in the vessels.

The duration of treatment for preeclampsia during pregnancy depends on the severity of the symptoms and some other factors. If therapy does not bring the desired results and the disease threatens the life of the expectant mother or her child,

If a pregnant woman has greatly gained weight, obstetricians are not worried about her appearance, but about the health of the expectant mother and her baby. Preeclampsia during pregnancy is a serious disease, in order to recognize it in the early stages, doctors weigh expectant mothers at each examination. Of course, this causes numerous indignations, one asks, what difference does it make to the doctor, if I add 10-12 kilograms (this is the norm) or 20, is my figure? So doctors have to explain that pathological weight gain is one of the symptoms of a serious pathology of preeclampsia in pregnant women.

This disease is insidious, occurs only in expectant mothers. Almost a third of expectant mothers suffer from preeclampsia, it is difficult to detect in the early stages and poses a threat to the mother and fetus. The first signs of preeclampsia can be seen only from the 20th week, most often many doctors begin to notice changes only in the third trimester, from the 28th week. The reason that preeclampsia occurs in pregnant women is a change in the body of the expectant mother, substances are produced in the placenta that are capable of making small holes in the vessels, it is through them that fluid and plasma penetrate from the blood into the tissue, which leads to swelling. The more holes are formed in the vessels, the more the woman loses protein, and, accordingly, the disease is aggravated. Doctors often prescribe a general urine test to understand if there is a protein there and, based on this, determine whether preeclampsia occurs during pregnancy or not.

Symptoms of preeclampsia in pregnancy

Since the fluid disappears from the vessels, the body increases blood pressure in order to quickly pump the rest of the fluid through the body, it is not for nothing that the symptoms of preeclampsia do not exclude high blood pressure.

The blood thickens, its clotting decreases, which can cause blood clots.

The insidiousness of gestosis of pregnant women lies in the fact that a woman feels healthy for a long time. Well, just think, protein in the analyzes and excess weight - is this an indicator? After all, the kidneys do not bother, and the head does not hurt, swelling is not visible. But puffiness can manifest itself not only on the arms and legs, but also in the placenta, which means that the fetus simply does not have enough oxygen, in the future this will manifest itself as an attack of convulsions. Symptoms shortly before an attack of convulsions appear instantly: nausea, flickering of "flies" before the eyes, headache, drowsiness, abdominal pain. This condition of a woman is called preeclampsia, and the seizure itself is called eclampsia. This condition can provoke the development of stroke, heart attack, pulmonary edema, liver and kidney failure. And this happens quite quickly even in a young and seemingly healthy woman. Precisely because the symptoms of preeclampsia are unpredictable, doctors devote a lot of time to the prevention and timely diagnosis of this disease in expectant mothers.

How is the diagnosis made?

If the expectant mother has gained a lot of weight, but no visible edema has appeared, then the doctor can do an MKO or Maclure-Aldrich test. The procedure is simple: a saline solution is injected under the skin and the time it takes for the papule to resolve is recorded. If faster than 35 minutes, then the pregnant woman has hidden edema. Also, many people notice that it is more difficult for them to bend their fingers, and they swell, this is puffiness.

If the doctor revealed only slight swelling of the legs, then it is enough to limit yourself to outpatient treatment, but if swelling of the face and hands is added to this and protein appears in the urine, then you need to go to the hospital. Symptoms of preeclampsia can appear in just a few days. Taking certain drugs can only aggravate the situation, especially diuretic drugs. Many women naively believe that such pills will help remove excess fluid from the body. The fact is that it is not enough in the vessels, because it is in the tissues, which means that diuretics can aggravate the course of preeclampsia.

It is worth recalling that gestosis during pregnancy has risk groups, which include:

• women who have a first pregnancy;
• those who are expecting twins;
• women over the age of 35;
• expectant mothers who have chronic diseases: diabetes mellitus, hypertension, pyelonephritis or vegetative-vascular dystonia.
• ladies who have found sexual infections: ureaplasmosis, chlamydia, mycoplasmosis.

Prevention and treatment of preeclampsia

To avoid preeclampsia, try to eat right, the basis of every growing organism is protein, so try to include fish, cottage cheese, chicken, and eggs in your diet. If doctors have already diagnosed preeclampsia in pregnant women, then the need for protein food increases, because the protein is lost in the urine and goes into the tissues. It is advisable to limit yourself to sweets, try to replace it with fruits and vegetables, preferably rich in fiber.

If you notice a large weight gain, limit your intake of salty foods and liquids. Also, do not forget about an active lifestyle: swimming, hiking or yoga are the best activities for expectant mothers. To avoid swelling, drink a rosehip decoction, bearberry, cranberry juice or kidney tea.

If you have found a mild or moderate degree of preeclampsia, then it is already treated in a hospital, department of pathology. With more severe symptoms, the treatment of preeclampsia is transferred to the intensive care unit. It is necessary to take blood and urine tests, they also do an ultrasound to assess the condition of the fetus. Mandatory consultation of specialists: therapist, neurologist, ophthalmologist. Treatment of preeclampsia mainly consists of infusion therapy to make up for the lack of fluid, at the same time drugs are prescribed that lower blood pressure. The duration of treatment at the hospital depends on the severity of the disease, mostly a week or two. If the treatment of preeclampsia did not give the desired results and it continues to worsen, the pregnant woman is given a caesarean section.

The concern of obstetricians with a large increase in the weight of a pregnant woman is not related to concern about her appearance, but about the health of the mother and baby.

Often to the question: “How much can and should a woman gain weight during pregnancy?” Many answer correctly, about 10-12 kg. But it happens that some add 20 kg or more. Women are indignant: “Why are we constantly weighed in the antenatal clinic, what difference does it make to the doctor, what kind of figure will I have after childbirth? And in general, a woman during pregnancy should eat whatever she wants. And then the baby will not receive the necessary nutrients. So you often have to explain to doctors that pathological weight gain is one of the early symptoms of a serious pathology called preeclampsia.

What is gestosis?

Preeclampsia is a disease that occurs only in pregnant women and usually disappears a few days after childbirth. Preeclampsia affects about a third of expectant mothers. Statistics show how formidable this disease is: for many years it has been firmly among the top three causes of maternal death in Russia.

Preeclampsia begins only after the 16-20th week of pregnancy, and is most often detected in the third trimester (after 28 weeks). It occurs due to changes in the body of a pregnant woman, as a result of which substances are formed in the placenta that can make microholes in the vessels. Through these "holes" from the blood, plasma protein and fluid penetrate into the tissues, so edema is formed. They, at first still invisible to the eye, can be detected when weighing.

"Holes" are also formed in the vessels of the kidneys, so protein enters the urine through them. The more "holes", the more a woman loses protein, the more serious the disease. Therefore, so often the doctor prescribes a general urine test to the expectant mother. This allows you to make a diagnosis and start treatment as early as possible.

Since the fluid has left the vessels, the body has to increase blood pressure in order to pump the remaining fluid through the body. The third symptom of preeclampsia appears - high blood pressure. Due to the thickening of the blood, its coagulability increases, which can lead to the formation of blood clots.

Gestosis is insidious. A woman feels healthy for a very long time. Well, just think, I gained excess weight, they found protein in my urine, for some reason the pressure rose. But the head does not hurt, and the kidneys do not bother either. So everything is ok? And in fact it is not. After all, not only the arms, legs, face swell, but also the placenta (which leads to a lack of oxygen in the fetus), and ultimately the brain (which can lead to seizures).

At the same time, symptoms (headache, nausea, flashing "flies" before the eyes, drowsiness, lethargy, pain in the stomach) appear several hours, and sometimes minutes before an attack of seizures that can take the life of both mother and child.

This condition is called preeclampsia, and the seizure itself is called eclampsia. The danger is that against the background of such a convulsive state, a heart attack, stroke, pulmonary edema, detachment of the placenta and retina, kidney and liver failure develop. And all this very quickly and - in a seemingly healthy and young woman.

That is why doctors of antenatal clinics devote so much time to the prevention and timely diagnosis of gestosis in pregnant women.

Then sit comfortably over the bathtub or basin, and release the first portion of morning urine. Withhold urination, and bring a sterile container to the urethra, in which collect a small amount of urine (sufficient). Empty the rest of the urine into a tub or basin. Thus, the Nechiporenko sample is collected, as is urine for general analysis - the average morning portion.

Next, the number of erythrocytes, leukocytes and cylinders in the Goryaev chamber is counted, and the result is expressed in units per 1 ml of urine. Normally, in a healthy person, the number of leukocytes does not exceed 2000 per 1 ml, erythrocytes - 1000 per 1 ml, and cylinders - 20 per 1 ml.

An increase in the number of leukocytes, erythrocytes and cylinders in the Nechiporenko test, as a rule, indicates kidney pathology. The reasons for the high content of indicators of the Nechiporenko sample are presented in the table.

• Cystitis (inflammation of the bladder)
• Pyelonephritis
• nephrolithiasis
• Kidney infarction
• Inflammation of the prostate

• Glomerulonephritis (acute and chronic)
• nephrolithiasis
• Tumor pathologies localized in the kidneys and urinary structures

• Glomerulonephritis
• Pyelonephritis
• Kidney poisoning (eg, phosphorus, lead compounds, phenols)
• Kidney amyloidosis
• nephronecrosis
• Anaphylactic shock
• Violation of blood circulation in the tubules of the kidneys with hypertension or thrombosis of the renal artery
• nephronecrosis

Three glass sample

Zimnitsky's test

Rules for collecting urine according to Zimnitsky

Urine collection for the Zimnitsky test is carried out during the day against the background of the usual drinking and food regimens, however, the intake of diuretic drugs should be canceled for this period. To collect urine according to Zimnitsky, prepare 8 clean jars, and sign each with a number (1, 2, 3, etc.) or urination time (9.00, 12.00, etc.). On the day you start collecting the sample, get up at 6:00 am and urinate into the toilet. Then three hours later (at 9:00 am) urinate into jar number 1. Urinate into another jar every three hours, including at night. The last sample is collected at 6:00 the next morning. So you will collect 8 jars of urine at 9:00, 12:00, 15:00, 18:00, 21:00, 24:00, 03:00, 06:00. Take all 8 jars to the laboratory. Do not drain urine into one large container! During the day of collecting the Zimnitsky sample, record the amount of fluid consumed.

Portions of urine at 9.00, 12.00, 15.00 and 18.00 are daytime, and at 21.00, 24.00, 03.00 and 06.00 - night. The normal number of daily portions of urine is ml, and of night portions - ml. The normal relative density of daily portions is, and of night portions -. The difference between the maximum and minimum density values ​​in the samples should not exceed 0.012 - 0.016 units. Normally, the daily volume of urine is 70-75% of the amount of liquid drunk. Daytime diuresis exceeds nighttime, and is at least 2/3 of the daily one.

Equal volumes of night and daytime urine volumes indicate a violation of the concentration ability of the kidneys, that is, renal failure. The same volume of urine in all portions indicates a violation of the adaptive abilities of the kidneys to changing environmental conditions during the day.

Almost the same relative density of all portions of urine is found in renal failure.

An example of a normal Zimnitsky test.

Signs of preeclampsia during pregnancy

Causes of preeclampsia

Reliable reasons leading to the development of preeclampsia are not yet known to modern obstetrics. However, the mechanism of ongoing pathological processes in this condition has already been studied.

Symptoms of preeclampsia: the first signs

The main symptoms of gestosis include:

Diagnostics

Diagnosis for suspected preeclampsia includes a thorough clinical and laboratory examination, namely:

Treatment

Treatment of gestosis depends on its severity. According to the modern classification, preeclampsia is classified into the following types:

Consequences of preeclampsia

Preeclampsia, or preeclampsia, poses a serious danger to both the expectant mother and her unborn baby. The main complications of this pathology for the mother are:

Prevention

Currently, effective measures for the prevention of preeclampsia have not been developed. However, there is a serious randomized trial that proves the advisability of taking acetylsalicylic acid throughout pregnancy in low doses among women at risk. This allows you to significantly reduce the risk of preeclampsia among this category of pregnant women.

Which doctor should I contact for treatment?

If, after reading the article, you assume that you have symptoms characteristic of this disease, then you should seek the advice of a gynecologist.

Gestosis in pregnant women

Preeclampsia

The concern of obstetricians with a large increase in the weight of a pregnant woman is not related to concern about her appearance, but about the health of the mother and baby.

Often to the question: “How much can and should a woman gain weight during pregnancy?” Many answer correctly, approximately kg. But it happens that some add 20 kg or more. Women are indignant: “Why are we constantly weighed in the antenatal clinic, what difference does it make to the doctor, what kind of figure will I have after childbirth? And in general, a woman during pregnancy should eat whatever she wants. And then the baby will not receive the necessary nutrients. So you often have to explain to doctors that pathological weight gain is one of the early symptoms of a serious pathology called preeclampsia.

What is gestosis?

Preeclampsia is a disease that occurs only in pregnant women and usually disappears a few days after childbirth. Preeclampsia affects about a third of expectant mothers. Statistics show how formidable this disease is: for many years it has been firmly among the top three causes of maternal death in Russia.

Preeclampsia begins only after a week of pregnancy, and is most often detected in the third trimester (after 28 weeks). It occurs due to changes in the body of a pregnant woman, as a result of which substances are formed in the placenta that can make microholes in the vessels. Through these "holes" from the blood, plasma protein and fluid penetrate into the tissues, so edema is formed. They, at first still invisible to the eye, can be detected when weighing.

"Holes" are also formed in the vessels of the kidneys, so protein enters the urine through them. The more "holes", the more a woman loses protein, the more serious the disease. Therefore, so often the doctor prescribes a general urine test to the expectant mother. This allows you to make a diagnosis and start treatment as early as possible.

Since the fluid has left the vessels, the body has to increase blood pressure in order to pump the remaining fluid through the body. The third symptom of preeclampsia appears - high blood pressure. Due to the thickening of the blood, its coagulability increases, which can lead to the formation of blood clots.

Gestosis is insidious. A woman feels healthy for a very long time. Well, just think, I gained excess weight, they found protein in my urine, for some reason the pressure rose. But the head does not hurt, and the kidneys do not bother either. So everything is ok? And in fact it is not. After all, not only the arms, legs, face swell, but also the placenta (which leads to a lack of oxygen in the fetus), and ultimately the brain (which can lead to seizures).

At the same time, symptoms (headache, nausea, flashing "flies" before the eyes, drowsiness, lethargy, pain in the stomach) appear several hours, and sometimes minutes before an attack of seizures that can take the life of both mother and child.

This condition is called preeclampsia, and the seizure itself is called eclampsia. The danger is that against the background of such a convulsive state, a heart attack, stroke, pulmonary edema, detachment of the placenta and retina, kidney and liver failure develop. And all this very quickly and - in a seemingly healthy and young woman.

That is why doctors of antenatal clinics devote so much time to the prevention and timely diagnosis of gestosis in pregnant women.

We make a diagnosis: gestosis

With a large weight gain and no visible edema, the doctor may suggest that you put the Maclure-Aldrich test (MCO test): inject saline subcutaneously and note the time it takes for the papule to resolve. If faster than 35 minutes, then you have hidden swelling. By the way, if it becomes difficult for you to bend your fingers, they become numb, rings do not fit on them - this is nothing more than swelling of the hands.

If you have only slight swelling of the legs, the doctor will prescribe outpatient treatment. Have your hands and face also swelled, and in addition, protein in the urine has come to light, has the pressure increased? Urgently need to go to the hospital! Sometimes the condition of the expectant mother can worsen in a few days. Do not self-medicate. Sometimes drugs taken by mothers can only aggravate the situation. This is especially true of diuretics (diuretics).

Many women think that in the presence of edema, diuretics will help remove excess fluid from the body. But in fact, there is very little liquid in the vessels, it has gone into the tissues! In this case, taking diuretics dramatically aggravates the course of the disease.

How to identify gestosis?

Weighing a woman, examining her, measuring blood pressure and detecting protein in the urine (in the second half of pregnancy, she is taken before each appearance at the antenatal clinic). True, with gestosis, all three symptoms will not necessarily be present, one or two are much more often observed.

Prevention of gestosis

Who is at risk?

• Women who will become mothers for the first time;
• expecting twins;
• ladies after 35 years;
• mothers with chronic diseases (vegetovascular dystonia, obesity, diabetes mellitus, hypertension or chronic pyelonephritis);
• having sexually transmitted infections (chlamydia, mycoplasmosis, ureaplasmosis).

How can you resist gestosis?

It is clear that a pregnant woman should receive good nutrition. However, many women interpret this truth as follows: "You can eat whatever you want." And even the most persistent and always watching the figure begin to eat everything and in unlimited quantities, sincerely believing that it will be better for the child. But as a result, everything ends with obesity and preeclampsia.

The most important thing that a growing child needs is protein, which is necessary for building the cells of his body. Therefore, the basis of the future mother's diet should be food rich in protein: lean meats (veal, beef and chicken), fish, cottage cheese, eggs.

If preeclampsia has already appeared, the need for protein intake becomes even more important, because, as we have already explained, through the “holes” in the vessels, the protein from the blood goes into the tissues, and is also lost in the urine.

But sweets must be limited - it is advisable not to eat muffins, sweets, ice cream at all. It is better to give preference to fruits, since they are now available all year round. Don't forget about fiber. The feeling of fullness occurs due to the filling of the gastrointestinal tract. Refined foods do not contain enough fiber to fill the stomach but are not absorbed.

Another positive point: fiber is an excellent prevention of constipation. Most of all it is found in vegetables (beets, carrots), fruits and dried fruits, mushrooms (preferably store-bought and not collected in a neighboring forest), seaweed, bran, greens. There are also pharmaceutical preparations, such as microcellulose.

How much weight can a future mother gain?

• Starting from 28 weeks of pregnancy, the expectant mother should gain an average of 350 g, but not more than 500 g per week.
• By the end of pregnancy, weight gain should not exceed 12 kg.
• The exception is women with an initial weight deficit, for example, with a height of 170 cm, weighing 53 kg. Such mothers can add 2-3 kg more than the norm without harm to health.
• Women with initial overweight, on the contrary, should not add more than 10 kg.

Do not get carried away with liquid and salt.

If you gain a lot of weight, you should not lean on pickles, herring and sauerkraut. In this case, the liquid should be limited to 1-1.5 liters per day, including soup and juicy fruits.

Lead an active lifestyle.

Have you noticed that there are fewer obese women of childbearing age? Now childbirth cannot serve as an excuse: “I got fat because I gave birth.” Any woman knows that in order to be in good shape, you only need your own desire, proper balanced nutrition and moderate physical activity. The best types of physical activity for pregnant women are long walks, swimming, Pilates and yoga.

It is believed that the violation of the outflow of urine also contributes to the development of preeclampsia. The fact is that in a standing position, the uterus compresses the ureters, and the outflow of urine is disturbed. To prevent this from happening, doctors recommend that mothers take the knee-elbow position 3-4 times a day for 10 minutes. For convenience, you can put a pillow under your chest and read a book or magazine in this position. This improves the outflow of urine from the kidneys.

For the prevention of edema, kidney tea, rosehip broth, lingonberry leaves, bearberry, cranberry juice are suitable. These drugs have a weak diuretic effect. If you buy a kidney collection at a pharmacy, pay attention to whether it contains half-pala (woolly erva). The fact is that it is able to destroy stones in the kidneys, liver, but at the same time teeth. Therefore, such a collection should be drunk through a straw, and then rinse your mouth.

An alternative to herbal teas can be herbal medicines: kanefron, cystone, cystenal. Many doctors in antenatal clinics prescribe various drugs for the prevention and treatment of edema, such as magnesium preparations (Magne-B6, magnerot), vitamin E and lipoic acid (help prevent the formation of “holes” in the vessels), hofitol (helps the liver inactivate substances that destroy blood vessels ), chimes (not only improves blood circulation in the placenta, but also helps prevent preeclampsia and even ... flu).

In the hospital

Women with edema, mild and moderate preeclampsia are treated in the department of pathology of pregnant women. If preeclampsia is severe, and even more so there are signs of preeclampsia (preconvulsive condition) or the patient has suffered an eclamptic (convulsive) attack, then treatment is carried out in the intensive care unit. The survey plan usually includes:

• blood tests (general, biochemical), coagulogram - determination of coagulability;
• urine tests (general, daily protein loss, Zimnitsky test);
• assessment of the condition of the fetus (ultrasound, cardiotocography and dopplerometry);
• Mandatory consultation of a therapist, ophthalmologist, in severe forms of gestosis - a neurologist.

Treatment consists in the use of infusion therapy (droppers), the purpose of which is to compensate for the lack of fluid in the vascular bed and remove it from the tissues, as well as to compensate for the loss of protein. If the pressure is elevated, suitable antihypertensive drugs are selected.

The duration of inpatient treatment depends on the severity of preeclampsia. With edema - about a week, and with mild preeclampsia - up to two. The best treatment for preeclampsia is delivery, since it is pregnancy, or rather, the placenta that causes its development.

Therefore, if treatment is ineffective within 3 days with severe preeclampsia and within 3 hours with preeclampsia (when symptoms appear), a cesarean section is performed for a pregnant woman.

Stanchev's test

why is it being sold?

Stanchev's test - for the diagnosis of preeclampsia

Urine is collected per day. The first morning portion of urine is removed. All subsequent portions of urine allocated during the day, night and morning portion of the next day are collected in one container.

After completing the collection of urine, the contents of the container must be accurately measured, be sure to mix and immediately pour into a small jar. Bring this jar to the laboratory for analysis. You don't have to bring all the urine! In the referral form, indicate the daily volume of urine.

It is important on the day of the study to measure the daily amount of water drunk and the liquid in food products. In the referral form, indicate the amount of fluid you drink.

Urine tests: types and interpretation of results

In addition to the basic clinical analysis of urine, special tests are used that examine in more detail the individual functions of the urinary system and are prescribed in the diagnosis of certain diseases.

The most used today are:

• urinalysis according to Zimnitsky;
• three glass test;
• Sulkovich's test;
• bacteriological examination for sterility;
• Addis-Kakovsky method.

Let's consider these diagnostic methods in more detail.

Zimnitsky test

The study of urine according to Zimnitsky allows you to evaluate the concentration ability of the kidneys. It is used in addition to the clinical analysis of urine.

• acute and chronic renal failure;
• suspicion of existing chronic glomerulonephritis;
• clinical manifestations of chronic pyelonephritis;
• additional diagnosis of diabetes insipidus;
• chronic heart failure and hypertension.

Note: analysis is necessary to assess the activity of the kidneys, and not to make a diagnosis.

Normally, the kidneys excrete urine, which contains high concentrations of toxins and protein metabolism products. These include urea, creatinine, uric acid, glucose isomers, protein substances, and other substances in small amounts. The concentration indicators are units of the relative density of urine.

Purpose of the test: determination of the specific gravity of the elements and compounds in the urine during the daily cycle, since the indicators change at different intervals. Dynamic monitoring of them allows you to draw conclusions about the activity of the kidneys.

Normally, the density of urine is in the range of g / l. The higher the density, the more dissolved organic compounds it contains.

Analysis according to Zimnitsky reveals the daily volume of urine, density at different times of the day, the amount of urine excreted at different time intervals. These data allow us to draw conclusions about the violations of the kidneys.

Relative density is determined in different portions of urine, which are collected every three hours throughout the day.

Method for collecting urine for analysis according to Zimnitsky

• 8 clean glass vessels (jars);
• watch;
• paper and a pen to record the amount of liquid you drink.

The first morning portion is not counted. Then a sampling is made every three hours, a total of 8 times. Each serving is priced separately. The amount of three-hour urine averages from 50 to 300 ml.

1. The first urine collection is carried out from 9.00 to 12.00, then every three hours: until 15.00, 18.00, 21.00, 24.00, 3.00, 6.00, 9.00 (last portion).
2. Jars with contents are placed in stages in the refrigerator for storage.
3. After filling, the jars are delivered to the laboratory.
4. For analysis, a record of the amount of fluid taken is provided.

In one jar, the patient urinates, if necessary, several times in the prescribed time interval. If there were no urges for 3 hours, the jar is left empty. If in 3 hours there was not enough capacity of the “planned” dishes, then fill in an additional one and mark it.

Note: On the eve of delivery, you should not take diuretics. It is also necessary to consult a doctor about the possibility of combining the test with taking other drugs.

Deciphering the results of the Zimnitsky test

The laboratory evaluates the total amount of urine, as well as the individual amount in portions, the density of each portion, as well as daytime diuresis (from 6 am to 6 pm), and nocturnal diuresis (from 6 pm to 6 am)

Normally, daytime diuresis predominates over nighttime. Morning urine density above 1.018 is typical for normal kidney concentration.

Physiological density limits are between 1001 - 1040. Under normal drinking conditions, the density is -.

If the specific gravity of urine does not change throughout the day, a condition called isosthenuria occurs. Significance in the diagnosis of diseases has a variant of hypoisostenuria. With it, the density is reduced to less than g / l. Occurs when the renal tubules are unable to concentrate urine filtrate. Occurs in all types of renal failure. The opposite condition is hyperisostenuria, characterized by a high specific gravity, recorded in case of poisoning with salts of heavy metals, hyperparathyroidism, and diabetes mellitus.

Analysis according to Zimnitsky is able to identify such conditions as:

• Hypostenuria. At a density below 1012 g / l, which is observed in all portions, it can be concluded that the ability of the kidneys to concentrate is impaired. This condition is characteristic of chronic pyelonephritis and glomerulonephritis, renal amyloidosis. It also develops in chronic heart failure accompanied by hypertension, with diabetes insipidus.
• Hyperstenuria. The density of urine is above 1035 g/l. This type of abnormality is characteristic of diabetes mellitus, with blood diseases caused by its destruction (hemolysis, anemia), with gestosis (toxicosis of different stages of pregnancy), and also occurs in some forms of glomerulonephritis.
• Polyuria is a condition in which the volume of urine is more than 1,500-2,000 ml. Also, this deviation can be fixed when more than 80% of the fluid taken per day is excreted in the urine. Polyuria occurs with the development of renal failure, diabetes and diabetes insipidus.

Urine density norms in children

• Nocturia. Occurs when the amount of urine at night prevails over the daytime. This deviation occurs with heart failure. Nocturia can occur with increased drinking regimen. In this case, the density will be reduced. If at least one serving contains a value of 1020 g / l and above, then one should not think about a violation of the concentration function of the kidneys. Normally, the volume of daytime urine is about 65-70%, and night - 30-35%.
• Oliguria. Decrease in daily urine less than 1500 ml. This condition is caused by heart failure, advanced stages of kidney failure.

Three glass sample

The study is used to clarify the location of inflammation in the genitals and bladder. The method is outdated and is used in rare cases when it is impossible to conduct more modern studies.

The analysis is carried out in the morning, before eating and drinking. Before urine collection, a toilet of the external genitourinary organs without the use of detergents is necessary. The day before, three clean jars are prepared with markings (1,2,3). Urine is collected sequentially in three vessels: in the first (1) - an insignificant part, in the second (2) - the main one, and in the third (3) - the remainder.

The collected material is immediately delivered to the laboratory, where it is examined under a microscope to determine the content of erythrocytes and leukocytes.

Deciphering the analysis of a three-glass sample

Detection of leukocytes and (or) erythrocytes:

• in 1 portion - it is typical for the presence of inflammation in the urethra;
• in 2 servings - for inflammation in the bladder;
• in 3 servings - for the inflammatory process in the bladder, prostate gland, kidneys;
• in all portions - characteristic of inflammation of the kidneys or mixed pathology.

Sulkovich's test

Using this research method, the content of calcium in the urine is determined. The indicator of the content of this mineral is important in the additional diagnosis of rickets. Also, this analysis can be used to control and correct the dose of vitamin D consumed by the child.

The test is carried out by introducing Sulkovich's reagent containing oxalic acid into the urine of a patient, as a result of which a cloudy precipitate forms when interacting with calcium.

Sulkovich urinalysis method

Urine is collected in a dry and clean dish. Before collecting urine, a thorough toilet of the genitals is carried out. A small amount of urine is released in a trickle into the toilet, the rest is collected in a jar.

On the eve of the test, you should not take mineral water, milk, herbs, alcoholic drinks, coffee, otherwise the test may give distorted results. Within 3 days before the test, it is required to limit the consumption of foods rich in calcium (nuts, legumes, etc.).

Deciphering the result of the Sulkovich test

According to the degree of turbidity, the result is evaluated in points (from 0 to 4):

1. 0 points - clear urine - no calcium in the urine - hypocalcemia.
2. 1-2 points - slight turbidity - normal result.
3. 3-4 points - severe turbidity - hypercalcemia.

In some laboratories, the result is evaluated with pluses.

The sample has an inaccurate result, and, if necessary, is supplemented by a biochemical blood test.

The study is prescribed for suspected development of thyroid diseases (hypo-hyperthyroidism), vitamin D abuse, to detect tumors that produce calcium.

Bacteriological examination of urine for sterility

The examination is carried out to assess the degree of purity of urine, as well as to detect a specific type of pathogen. The same method can determine the sensitivity of microbes to antibiotics.

Urine, flowing through the internal mucous membranes of the urethra, washes away the mucus and microorganisms that are on them. Bacteriological examination allows you to establish the presence of the pathogen and its quantity.

For the study, 5-7 ml of morning urine, collected only on an empty stomach, after the toilet of the perineum, is necessary. The second portion is used.

Urine is placed in vessels with nutrient media, and after a while the grown colonies of microorganisms are evaluated.

Deciphering the bacteriological analysis of urine for sterility

The result is evaluated according to the following data:

1. The number of detected colonial microorganisms up to 1000 corresponds to the presence of normal flora.
2. From 1000 to - there is an opportunistic flora that can cause an inflammatory process.
3. More - in the urine of pathogenic microorganisms, there is an acute inflammatory process.

In the case of the growth of a colony consisting of different elements, the infection is considered chronic. In difficult cases, additional identification of the pathogen is carried out by re-sowing on special nutrient media. However, this addition lengthens the time of diagnosis, but at the same time specifies the type of antibiotic used.

These methods are simple, available for use in any medical institution, and have proven themselves well when examining a large number of people.

Addis-Kakovsky method

Allows you to diagnose kidney infections by counting red blood cells, white blood cells and cylinders in the urine.

• renal polycystosis;
• glomerulonephritis;
• kidney stones;
• chronic renal failure.

In practice, a simplified method of this analysis is used, the collection of which takes 10 hours. In the evening, a liter clean jar is prepared, the last urination is offered to the patient at 22.00. You should not go to the toilet at night, otherwise the results of the analysis will be distorted. In the morning, the toilet of the genitals is carried out, and at 8.00 the bladder is emptied into the prepared dishes, the collected material is immediately delivered to the laboratory.

Interpretation of the results of urinalysis according to the Addis-Kakovsky method

Evaluation of results in the norm:

• leukocytes up to 2 million;
• erythrocytes up to 1 million;
• cylinders up to 20 thousand.

An increase in these indicators indicates the presence of a pathological process.

The described methods at the present stage have been completely or partially replaced by new methods, but still have not lost their relevance due to their simplicity, accessibility and low cost. At the same time, they remain informative and accurate.

Plisov Vladimir, medical commentator

urinalysis according to stanchev

Herpes on the lips.

Antibodies to the herpes virus ig G detected

Comments

Wow, I just got a doctor’s note, I also gained a lot of weight this time - +2.1 kg in 12 days! I also have all the tests in the norm, there are no edema, the doctor drew my attention to this, they say, watch your weight, walk more, but did not send me anywhere.

I just looked at my last urine test, there is a protein of 0.033%. they write that this is a type of variant of the norm, but there was a large load on the kidneys. Maybe that's why she sends it? in all previous analyzes, the protein is negative everywhere.

It is quite possible that my protein was at zero all the time, I also looked now)

At first they send me to lose weight, to drive the water, but you can refuse the maternity hospital if all the tests are normal, I saved myself from edema with herbs during my first pregnancy, unless of course they were on your diet and cottage cheese, buckwheat, boiled chicken only white meat, analysis did not give this one (

13 more articles on the topic: What you need to know about early toxicosis

6 more articles on the topic: What drugs can and cannot be pregnant

What is preeclampsia in pregnancy. Symptoms, signs, consequences

Preeclampsia is a serious complication of late pregnancy, which is why it is also called late "toxicosis". With gestosis, the work of the kidneys, blood vessels and brain of the expectant mother worsens. Its most characteristic signs are an increase in blood pressure and the appearance of protein in urine tests.

An increase in pressure may be imperceptible, but is more often manifested by headache, nausea, blurred vision. Protein in the urine indicates a violation of the kidneys and is often accompanied by edema.

In severe cases, preeclampsia can lead to seizures, placental abruption, developmental delay and death of the baby.

In 90% of cases, preeclampsia begins after 34 weeks, most often in pregnant women with their first baby. An earlier start (from 20 weeks) is a sign of a severe course. The closer to the expected date of birth, gestosis began, the better its prognosis.

Unlike early toxicosis, which is considered “normal” by many doctors, preeclampsia disrupts the course of pregnancy and must be treated. In severe preeclampsia that threaten the development of the baby, it is often necessary to resort to stimulation of preterm labor or caesarean section.

Tendency to gestosis

Preeclampsia of varying degrees occurs on average in 10-15% of expectant mothers, much more often it appears in the first pregnancy. The timing of its onset is from 20 weeks and up to several days after childbirth. With multiple pregnancies, preeclampsia can begin earlier (from 16 weeks) and is more severe.

In the second pregnancy, the likelihood of meeting with late toxicosis falls. The easier the first preeclampsia proceeded, and the closer its beginning was to the term of delivery, the less likely it is to repeat. Those mothers who started earlier and had a difficult course, especially if they had to do a caesarean section because of this, are more likely to meet with preeclampsia again.

When the likelihood of gestosis is greater:

• In the first pregnancy;
• If you already had chronic diseases before pregnancy: kidney problems, high blood pressure or overweight. In this case, preeclampsia is called “combined”, in contrast to “pure” preeclampsia, which develops against the background of complete health;
• Pregnancy with twins and triplets;
• Heredity, that is, parents or sisters suffered from preeclampsia;
• Age less than 20 and over 35 years.

If preeclampsia was not in the first pregnancy, it is very unlikely that it will be in the second.

Causes of gestosis during pregnancy

Although scientists have not fully established the causes of preeclampsia, it is known that the placenta plays a major role in its development. When there is insufficient blood supply to the uterus (for example, when the uterine arteries are narrowed) or the placenta itself is pathological, it triggers a mechanism for raising pressure to increase blood flow.

The rise in pressure is achieved due to the narrowing of the vessels of the mother's body, but this leads to a deterioration in the blood supply to her vital organs - the kidneys and brain. They receive less blood, and their performance deteriorates.

With edema, water exits the bloodstream into the tissues, which makes the blood thicker and increases the formation of blood clots. Blood clots can clog small vessels and worsen blood flow even more, and thick blood increases pressure. There is a vicious circle.

Signs of preeclampsia

There are three main signs of preeclampsia, which usually appear together or in pairs: edema, protein in the urine, and increased blood pressure.

The appearance of protein in the urine (proteinuria).

The first and main criterion that indicates kidney damage. Almost never preeclampsia happens without proteinuria, and the stronger it is, the worse. Although the identification of this sign alone does not yet speak of gestosis.

Normally, protein in the urine should be absent.

Small amounts, in the region of 0.033 g / l, in combination with leukocytes, may be a sign of inflammation of the kidneys (pyelonephritis).

0.8 g / l and more rather speak of preeclampsia.

Proteinuria in combination with an increase in pressure over 140/90 always speaks of preeclampsia.

Urine analysis should be taken before each visit to the doctor in the antenatal clinic. If it seems to you that the urine has become cloudy, dark in color or covered with foam, take the test without waiting for the appointed day.

An increase in blood pressure greater than 140/90 mm Hg. Art.

This is the second main sign of preeclampsia, which may go unnoticed, or may be manifested by headache, nausea, flies before the eyes, dizziness.

The combination of high blood pressure with protein in the urine is called preeclampsia, and speaks of the initial stage of brain damage to the expectant mother. This is why blood pressure must be measured at every visit to the doctor.

In severe cases, untreated high blood pressure can lead to severe damage to the nervous system: loss of consciousness, seizures (eclampsia), and bleeding in the brain (stroke). Such a danger arises when the upper numbers of blood pressure exceed 160, and the lower 110 millimeters of mercury.

Often found during normal pregnancy, and in themselves are not a sign of preeclampsia, but only in combination with proteinuria or high blood pressure. Moreover, preeclampsia without edema (“dry”) is more difficult.

If you have swelling, it is easy to determine if you do a simple test. With your thumb, press on the inner surface of the lower leg in the region of the bone and hold for a few seconds. If a hole remains at the site of pressure, then there is swelling. Similarly, you can conduct this test on any other part of the body.

Another sure sign of edema is that slippers or shoes have become small, the wedding ring cannot be removed from the finger. In some cases, there are hidden edema. They can be identified by too much weight gain compared to the norm.

Examination for suspected preeclampsia

• Analysis of urine. Allows you to identify protein, ketone bodies, leukocytes, bacteria and other elements. This makes it possible to distinguish kidney damage in preeclampsia from pyelonephritis or other diseases.
• Blood analysis. Such indicators as hemoglobin play a role (a slight decrease at the end of pregnancy is the norm), hematocrit (blood thickening), platelets, the level of liver enzymes (indicates liver damage in severe preeclampsia).
• Ultrasound of the uterus and fetus with dopplerometry. Allows you to assess the development of the baby and recognize his delay in time. Evaluation of blood flow in the uterine arteries using Doppler allows you to give an approximate prognosis for the development of the disease: the worse the blood flow, the greater the likelihood of preeclampsia.
• Fetal CTG. It is done after the 28th week of pregnancy, at an earlier date it is not significant. Shows the mobility of the baby, the work of his heart and, therefore, the presence or absence of hypoxia (oxygen starvation).

Accurate Diagnosis

All of these symptoms are characteristic not only for preeclampsia, and they must be distinguished from signs of other diseases, especially if the expectant mother had them before pregnancy. Therefore, only a doctor can make an accurate diagnosis of gestosis.

Late toxicosis (gestosis), edema during pregnancy.

The course of a real pregnancy before curation

The date of the beginning of the last menstruation is May 23, 2012, the date of the first movement is 18 weeks. Date of the first appearance in the antenatal clinic - 1.07.12. She visited the LCD regularly: up to 28 weeks - 1 time in 4 weeks, 1 time in 2 weeks from 29 weeks.

During the first trimester of pregnancy: exacerbation of chronic pyelonephritis at 8, 11 and 15 weeks. As well as gestosis of the first half of pregnancy, without complications

During the second trimester: no complications.

During the third trimester: no complications.

The first ultrasound was at 11 weeks pregnant. Conclusion: according to fetometry 1 fetus, correspond to 11 weeks.

Second ultrasound at 18 weeks pregnant. Conclusion: according to fetometry, the fetus corresponds to weeks.

Third screening at 33 weeks gestation. Conclusion: according to fetometry, the fetus corresponds to 33 weeks.

Blood group II, Rh +.

Objective research

The general condition of the pregnant woman is satisfactory, the position is active, consciousness is clear. Pulse 80 bpm per minute, blood pressure on both hands 110/60 mm Hg, respiratory rate 21 per minute, body temperature 36.6 C. Height 168 cm, weight 73 kg. The physique is normosthenic. There are no curvature of the spine. No bone or joint deformities were found. Integuments of physiological color, without areas of pigmentation and depigmentation. Turgor and elasticity of the skin are not changed. Hair on the female type. Subcutaneous fat is moderately developed. The navel is flattened. Auscultation revealed vesicular breathing, no wheezing. Auscultation of I and II tones of normal volume, clear, no noise. The stool is normal - decorated, urination is painless.

Special obstetric study

The belly is oval. Abdominal circumference cm. The height of the fundus of the uterus above the womb is 38 cm. The dimensions of the pelvis: distantia spinarum - 28 cm, distantia cristarum - 32 cm, distantia trochanterica - 36 cm, conjugata externa - 22 cm. Michaelis rhombus: vertical size 13 cm, horizontal 11 see Rhombus has the correct shape - the pelvis is normal. Solovyov's index - 15 cm, which indicates the normal thickness of the bones.

External obstetric studies using Leopold-Levitsky methods.

First reception: in the bottom of the uterus, the pelvic end of the fetus is determined, WDM 38 cm.

The second reception - the longitudinal position of the fetus, the first position of the fetus, the front view of the fetus is determined.

The third technique is head diligence.

The fetal heartbeat is heard on the right below the umbilicus. The fetal heartbeat is clear, rhythmic, the number of beats is 145 per minute. The estimated weight of the fetus according to ultrasound is 3600 gr.

Gestosis during pregnancy

The concept of "gestosis"

If a pregnant woman has greatly gained weight, obstetricians are not worried about her appearance, but about the health of the expectant mother and her baby. Preeclampsia during pregnancy is a serious disease, in order to recognize it in the early stages, doctors weigh expectant mothers at each examination. Of course, this causes numerous indignations, one asks, what difference does it make to a doctor, I add a yakilogram (this is the norm) or 20, is my figure? So doctors have to explain that pathological weight gain is one of the symptoms of a serious pathology of preeclampsia in pregnant women.

This disease is insidious, occurs only in expectant mothers. Almost a third of expectant mothers suffer from preeclampsia, it is difficult to detect in the early stages and poses a threat to the mother and fetus. The first signs of preeclampsia can be seen only from the 20th week, most often many doctors begin to notice changes only in the third trimester, from the 28th week. The reason that preeclampsia occurs in pregnant women is a change in the body of the expectant mother, substances are produced in the placenta that are capable of making small holes in the vessels, it is through them that fluid and plasma penetrate from the blood into the tissue, which leads to swelling. The more holes are formed in the vessels, the more the woman loses protein, and, accordingly, the disease is aggravated. Doctors often prescribe a general urine test to understand if there is a protein there and, based on this, determine whether preeclampsia occurs during pregnancy or not.

Symptoms of preeclampsia in pregnancy

Since the fluid disappears from the vessels, the body increases blood pressure in order to quickly pump the rest of the fluid through the body, it is not for nothing that the symptoms of preeclampsia do not exclude high blood pressure. The blood thickens, its clotting decreases, which can cause blood clots.

The insidiousness of gestosis of pregnant women lies in the fact that a woman feels healthy for a long time. Well, just think, protein in the analyzes and excess weight - is this an indicator? After all, the kidneys do not bother, and the head does not hurt, swelling is not visible. But puffiness can manifest itself not only on the arms and legs, but also in the placenta, which means that the fetus simply does not have enough oxygen, in the future this will manifest itself as an attack of convulsions. Symptoms shortly before an attack of convulsions appear instantly: nausea, flickering of "flies" before the eyes, headache, drowsiness, abdominal pain. This condition of a woman is called preeclampsia, and the seizure itself is called eclampsia. This condition can provoke the development of stroke, heart attack, pulmonary edema, liver and kidney failure. And this happens quite quickly even in a young and seemingly healthy woman. Precisely because the symptoms of preeclampsia are unpredictable, doctors devote a lot of time to the prevention and timely diagnosis of this disease in expectant mothers.

How is the diagnosis made?

If the expectant mother has gained a lot of weight, but no visible edema has appeared, then the doctor can do an MKO or Maclure-Aldrich test.

If the doctor revealed only slight swelling of the legs, then it is enough to limit yourself to outpatient treatment, but if swelling of the face and hands is added to this and protein appears in the urine, then you need to go to the hospital. Symptoms of preeclampsia can appear in just a few days. Taking certain drugs can only aggravate the situation, especially diuretic drugs. Many women naively believe that such pills will help remove excess fluid from the body. The fact is that it is not enough in the vessels, because it is in the tissues, which means that diuretics can aggravate the course of preeclampsia.

It is worth recalling that preeclampsia during pregnancy has risk groups, which include:

• women who have a first pregnancy;
• those who are expecting twins;
• women over the age of 35;
• expectant mothers who have chronic diseases: diabetes mellitus, hypertension, pyelonephritis or vegetative-vascular dystonia.
• ladies who have found sexual infections: ureaplasmosis, chlamydia, mycoplasmosis.

Prevention and treatment of preeclampsia

To avoid preeclampsia, try to eat right, the basis of every growing organism is protein, so try to include fish, cottage cheese, chicken, and eggs in your diet. If doctors have already diagnosed preeclampsia in pregnant women, then the need for protein food increases, because the protein is lost in the urine and goes into the tissues. It is advisable to limit yourself to sweets, try to replace it with fruits and vegetables, preferably rich in fiber.

If you notice a large weight gain, limit your intake of salty foods and liquids. Also, do not forget about an active lifestyle: swimming, hiking or yoga are the best activities for expectant mothers. To avoid swelling, drink a rosehip decoction, bearberry, cranberry juice or kidney tea.

If you have found a mild or moderate degree of preeclampsia, then it is already treated in a hospital, department of pathology. With more severe symptoms, the treatment of preeclampsia is transferred to the intensive care unit. It is necessary to take blood and urine tests, they also do an ultrasound to assess the condition of the fetus. Mandatory consultation of specialists: therapist, neurologist, ophthalmologist. Treatment of preeclampsia mainly consists of infusion therapy to make up for the lack of fluid, at the same time drugs are prescribed that lower blood pressure. The duration of treatment at the hospital depends on the severity of the disease, mostly a week or two. If the treatment of preeclampsia did not give the desired results and it continues to worsen, the pregnant woman is given a caesarean section.

Why do a DOT test during pregnancy and what are the reviews about it?

Any pregnant woman wants to be sure that her baby is perfectly healthy. Women who have reason to doubt it are especially in need of such assurance. You can find out the truth by agreeing to amniocentesis, chorion biopsy, and cordocentesis. However, these procedures can be life-threatening for the child. Today there is a safer alternative - the DOT test.

What it is?

The DOT test is a non-invasive prenatal DNA diagnostic method. It is designed to determine the sex of the child, as well as possible chromosomal pathologies, such as Down syndrome and a number of other anomalies. For research, blood taken from a vein of a pregnant woman is used. There are no punctures of the fetal bladder and the associated risks of losing the baby.

The essence of the method is based on understanding the processes that take place in the body of the expectant mother during pregnancy. So, due to the natural death of some cells of the placenta, part of the blood cells of the fetus enters the mother's blood. By the 10th week of pregnancy, the amount of such freely circulating extracellular DNA of the baby in maternal blood approaches 10% of the total amount of maternal blood.

Starting from this period, you can do a DOT test. Fetal DNA is isolated from a blood sample taken from a woman's vein. His study provides a detailed answer to the question of whether the baby is healthy. The test shows whether the crumbs in the mother's womb have pathologies such as:

• Down syndrome;
• Edwards syndrome;
• Patau syndrome;
• Klinetfelter's syndrome;
• Turner syndrome.

All these anomalies are considered total, and often fatal for the baby, because they are not compatible with life. The exception is Down's syndrome: "sunny" kids are viable. But not every family is ready to accept and raise such a child. That is why there is a need for a DOT test.

Is the analysis accurate?

The veracity of the DOT test is quite high. So, he defines the syndromes of Edwards, Patau and Down almost unmistakably: by 99.7%. Turner and Klinefelter syndromes - with a probability of up to 90%. The sex of the child is determined within a week with a probability of over 99%. With the same accuracy, the blood type and Rh factor of the baby are determined, which makes it possible to assess the risks of developing an Rh conflict if a woman has Rh-negative blood.

An error is excluded if the material for the study is collected correctly and the study itself is carried out in accordance with all strict criteria.

Indications

The test can be performed on any woman of her choice. A prerequisite is a singleton pregnancy. If a woman is carrying twins or triplets, the accuracy of the DNA test results in this case cannot be vouched for. But this is general information, and direct indications for the DOT test are:

• the mother's age is over 35 years (with age, the likelihood of chromosomal abnormalities increases);
• increased or high risks based on the results of universal screenings that are carried out for pregnant women in the first and second trimester of pregnancy;
• the probability of giving birth to an unhealthy child due to unfavorable heredity, if there have already been cases of the birth of such babies in the family;
• miscarriages or missed pregnancies in history;
• consanguineous marriage or pregnancy resulting from incest.

The test can also be carried out during pregnancy that occurred with the help of assisted reproductive technologies (IVF), as well as during surrogate motherhood.

Contraindications

The test is not carried out if more than one fetus grows in the womb of a woman, as well as with concomitant oncological diseases of the expectant mother. Also, the test will not give a reliable result if the expectant mother has had a blood transfusion over the past six months.

How the test is done

The DOT test is carried out in three simple steps. On the appointed day, the woman needs to come to the clinic and take a regular blood test. Further, the baby's DNA is extracted from it by genomic sequencing and examined. The final stage is the interpretation of the data and the registration of the probability of risk for each of the determined chromosomal diseases. It is this conclusion that is given to a pregnant woman.

How long does the study take?

Like all non-invasive prenatal tests (NIPT), the DOT test is not done quickly. It usually takes 10 to 12 days to get results. In some cases, specialists may need a little more time. It all depends on the workload of the laboratory and the order of research in this medical institution.

Sometimes, within the allotted time, specialists fail to isolate the DNA of the fetus. The woman is invited to donate blood again for a new study.

Pros and cons

The undoubted advantage of the DOT test is that the result can be obtained much earlier than with other diagnostic methods. If you do a test at the 11th week of pregnancy, then after ten days the result will be known. The first screening, for comparison, is only carried out between 11 and 13 weeks, and its results will also have to wait. In addition, the accuracy of the DOT test is incomparably higher, because screening diagnostics is the most common probability calculation and nothing more.

Early informing leaves the pregnant woman with a choice: you can have time to terminate the pregnancy if she makes such a decision (of her own free will, this can be done up to twelve weeks of pregnancy). If the test is done at a later date, then the woman will have to receive confirmation of the result from non-invasive diagnostics by passing an invasive one, because such tests are not yet a basis for doctors to issue a referral for termination of pregnancy for medical reasons.

To get such a referral, you still need to do a chorionic biopsy or amniocentesis. This is precisely the relative minus of the method.

On the other hand, the woman has no doubts. If the DOT test showed Down syndrome in a child and the woman does not want to give birth to such a baby, then she will go for invasive diagnostics without unnecessary fear. The accuracy of the test is high, but a negative DOT test means that there is no need for an invasive diagnosis, everything is fine with the baby, even if the results of the screening study were disappointing. The results of the DOT test are difficult to interpret in two ways or ambiguously. The conclusion indicates the name of the disease and the actual risk of its presence in percent. Normally, the results should be negative, and the risks should be low.

Forcing a woman to terminate a pregnancy if the child is sick, no one has the right. She may decide to leave the baby, and then the doctors will continue to manage the pregnancy, provide all the necessary medical and advisory support.

Another tangible disadvantage of the DOT test is that so far such diagnostics are not widely used. Such analyzes are carried out only in medical genetic centers, specialized clinics. These are not in every small town, and therefore the woman will have to find the nearest clinic and go there to take the test.

The number of diseases determined by the DOT test is significantly lower than the number of pathologies that can be detected during invasive diagnostics. Therefore, in the contract with the clinic, the woman will definitely be shown a clause stating that good results do not guarantee the birth of a healthy child.

How much does it cost?

In different regions of Russia, the price may differ. It all depends on the medical institution. On average, the cost of a DOT test as of the beginning of 2018 is 29 thousand rubles. The most affordable prices are offered by network clinics "Genoanalystika", "UltraMed".