{"id":2510,"date":"2026-02-26T10:08:02","date_gmt":"2026-02-26T10:08:02","guid":{"rendered":"https:\/\/www.iforbes.cz\/?p=2510"},"modified":"2026-02-26T10:08:02","modified_gmt":"2026-02-26T10:08:02","slug":"vyznam-prenatalni-pece-v-gynekologii-roste","status":"publish","type":"post","link":"https:\/\/www.iforbes.cz\/index.php\/2026\/02\/26\/vyznam-prenatalni-pece-v-gynekologii-roste\/","title":{"rendered":"V\u00fdznam prenat\u00e1ln\u00ed p\u00e9\u010de v gynekologii roste"},"content":{"rendered":"\n

T\u011bhotenstv\u00ed dnes nen\u00ed jen obdob\u00edm o\u010dek\u00e1v\u00e1n\u00ed, ale i pe\u010dliv\u00e9ho sledov\u00e1n\u00ed v\u00fdvoje d\u00edt\u011bte. Modern\u00ed prenat\u00e1ln\u00ed p\u00e9\u010de dok\u00e1\u017ee v\u011bt\u0161in\u011b rodi\u010d\u016f zajistit p\u0159edev\u0161\u00edm klid a uji\u0161t\u011bn\u00ed, \u017ee v\u0161e prob\u00edh\u00e1, jak m\u00e1. N\u011bkdy v\u0161ak rutinn\u00ed vy\u0161et\u0159en\u00ed vyvol\u00e1 pochybnost \u2013 a\u0165 u\u017e jde o z\u00e1va\u017en\u00fd n\u00e1lez nebo zm\u011bnu, kterou b\u011b\u017en\u00fd gynekolog nedok\u00e1\u017ee spolehliv\u011b posoudit a je pot\u0159eba druh\u00fd n\u00e1zor. Pr\u00e1v\u011b tehdy p\u0159ich\u00e1z\u00ed na \u0159adu superkonzili\u00e1rn\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed, specializovan\u00fd ultrazvuk prov\u00e1d\u011bn\u00fd zku\u0161en\u00fdm odborn\u00edkem, kter\u00fd se na v\u00fdvoj plodu d\u00edv\u00e1 opravdu do detailu.<\/strong><\/p>\n\n\n\n

T\u011bhotenstv\u00ed pod lupou<\/strong><\/p>\n\n\n\n

Superkonzili\u00e1rn\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed nen\u00ed b\u011b\u017enou kontrolou, kterou absolvuje ka\u017ed\u00e1 t\u011bhotn\u00e1 \u017eena. Indikuje se tehdy, pokud obvodn\u00ed gynekolog vyslov\u00ed podez\u0159en\u00ed na mo\u017enou odchylku od norm\u00e1ln\u00edho v\u00fdvoje nebo p\u0159\u00edmo najde patologii. Smyslem nen\u00ed rodi\u010de vyd\u011bsit, ale z\u00edskat p\u0159esn\u011bj\u0161\u00ed odpov\u011bdi.<\/p>\n\n\n\n

\u201eJedn\u00e1 se o p\u0159ibli\u017en\u011b p\u016flhodinov\u00e9 ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed, p\u0159i kter\u00e9m je plod systematicky vy\u0161et\u0159en doslova od hlavy k pat\u011b. Krom\u011b z\u0159ejm\u00fdch vad p\u00e1tr\u00e1me i po takzvan\u00fdch minor markerech \u2013 drobn\u00fdch znac\u00edch, kter\u00e9 mohou tak\u00e9 napov\u011bd\u011bt, zda je vhodn\u00e9 pokra\u010dovat v dal\u0161\u00edm vy\u0161et\u0159ov\u00e1n\u00ed, obvykle vy\u0161et\u0159en\u00ed chromozom\u00e1ln\u00ed v\u00fdbavy plodu,\u201c<\/em> vysv\u011btluje MUDr. Zuzana Kokrdov\u00e1, Ph.D., vedouc\u00ed gynekolo\u017eka z centra prenat\u00e1ln\u00ed p\u00e9\u010de a genetiky PRENET.<\/p>\n\n\n\n

Vy\u0161et\u0159en\u00ed m\u016f\u017ee prov\u00e1d\u011bt pouze l\u00e9ka\u0159 \u2013 gynekolog-porodn\u00edk \u2013 kter\u00fd je dr\u017eitelem certifik\u00e1tu Spole\u010dnosti pro ultrazvuk v porodnictv\u00ed a gynekologii. Certifikaci odborn\u00edk z\u00edsk\u00e1 a\u017e po p\u0159edlo\u017een\u00ed dokumentace k v\u00fdvojov\u00fdm vad\u00e1m, kter\u00e9 s\u00e1m p\u0159i vy\u0161et\u0159en\u00edch rozpoznal a odborn\u011b popsal. Toto osv\u011bd\u010den\u00ed se nav\u00edc pravideln\u011b obnovuje, v\u017edy po p\u011bti letech. V praxi toti\u017e rozhoduj\u00ed zku\u0161enosti, kvalitn\u00ed p\u0159\u00edstrojov\u00e9 vybaven\u00ed i schopnost ultrazvuk spr\u00e1vn\u011b nastavit. U n\u011bkter\u00fdch vz\u00e1cn\u00fdch genetick\u00fdch syndrom\u016f jsou odchylky od norm\u00e1lu jen velmi nen\u00e1padn\u00e9, a proto je lze snadno p\u0159ehl\u00e9dnout.<\/p>\n\n\n\n

\u010cas hraje roli<\/strong><\/p>\n\n\n\n

Superkonzili\u00e1rn\u00ed vy\u0161et\u0159en\u00ed je mo\u017en\u00e9 prov\u00e1d\u011bt kdykoli b\u011bhem t\u011bhotenstv\u00ed, nej\u010dast\u011bji se s n\u00edm v\u0161ak setk\u00e1me v jeho prvn\u00ed polovin\u011b. St\u00e1le v\u011bt\u0161\u00ed pozornost se soust\u0159ed\u00ed hlavn\u011b na obdob\u00ed kolem 13. t\u00fddne, kdy se prov\u00e1d\u00ed i tzv. prvotrimestr\u00e1ln\u00ed screening. Ten je na rozd\u00edl od superkonzili\u00e1rn\u00edho ultrazvuku v \u010cesk\u00e9 republice hrazen zdravotn\u00ed poji\u0161\u0165ovnou v\u0161em t\u011bhotn\u00fdm bez rozd\u00edlu. \u201eZ\u00e1sadn\u00ed je nevynechat prvotrimestr\u00e1ln\u00ed screening a zaj\u00edmat se o jeho kvalitu. Ne v\u0161echna pracovi\u0161t\u011b postupuj\u00ed podle stejn\u00e9ho protokolu (rozd\u00edl spo\u010d\u00edv\u00e1 v tom, co dan\u00fd protokol pova\u017euje za nutn\u00e9 zobrazit). D\u00e1le se pracovi\u0161t\u011b li\u0161\u00ed v p\u0159\u00edstrojov\u00e9m vybaven\u00ed. Podrobn\u00e9 posouzen\u00ed anatomie plodu podle jasn\u011b dan\u00e9ho protokolu a zku\u0161enost vy\u0161et\u0159uj\u00edc\u00edho l\u00e9ka\u0159e jsou kl\u00ed\u010dov\u00e9,\u201c<\/em> upozor\u0148uje MUDr. Kokrdov\u00e1.<\/p>\n\n\n\n

Obrovsk\u00fd pokrok v ultrazvukov\u00e9 technice dnes umo\u017e\u0148uje u\u017e v t\u00e9to ran\u00e9 f\u00e1zi t\u011bhotenstv\u00ed velmi detailn\u00ed zobrazen\u00ed. Vysoce specializovan\u00e1 pracovi\u0161t\u011b maj\u00ed proto ambice odhalit p\u0159ibli\u017en\u011b 50\u201360 % v\u0161ech v\u00fdvojov\u00fdch vad, kter\u00e9 je mo\u017en\u00e9 rozpoznat a\u017e do konce gravidity. Je p\u0159itom dobr\u00e9 p\u0159ipomenout, \u017ee v tomto t\u00fddnu m\u011b\u0159\u00ed vy\u0161et\u0159ovan\u00fd plod od hlavi\u010dky k zade\u010dku p\u0159ibli\u017en\u011b 70 mm.<\/p>\n\n\n\n

V\u010dasn\u00e1 diagnostika nav\u00edc z\u00e1sadn\u011b ovliv\u0148uje dal\u0161\u00ed postup. Pokud je potvrzena v\u00fdvojov\u00e1 vada, obvykle n\u00e1sleduje invazivn\u00ed vy\u0161et\u0159en\u00ed \u2013 nap\u0159\u00edklad odb\u011br tk\u00e1n\u011b z placenty nebo plodov\u00e9 vody \u2013 kter\u00e9 umo\u017en\u00ed ov\u011b\u0159it chromozom\u00e1ln\u00ed v\u00fdbavu plodu. Tyto informace pak pom\u00e1haj\u00ed rodi\u010d\u016fm i l\u00e9ka\u0159\u016fm rozhodnout o dal\u0161\u00edm postupu.<\/p>\n\n\n\n

Co v\u0161e vy\u0161et\u0159en\u00ed odhal\u00ed?<\/strong><\/p>\n\n\n\n

Existuje obrovsk\u00e9 mno\u017estv\u00ed vrozen\u00fdch v\u00fdvojov\u00fdch vad. Vada m\u016f\u017ee b\u00fdt omezena na jeden v\u00fdvojov\u00fd syst\u00e9m nebo se mohou vady kombinovat. Nej\u010dast\u011bji se jedn\u00e1 o vrozen\u00e9 vady srdce nebo centr\u00e1ln\u00edho nervov\u00e9ho syst\u00e9mu. Pr\u00e1v\u011b zde nastupuje specialista, kter\u00fd je schopen posoudit z\u00e1va\u017enost dan\u00e9 vady a nast\u00ednit mo\u017en\u00e1 \u0159e\u0161en\u00ed. Nebo v komplikovan\u011bj\u0161\u00edch p\u0159\u00edpadech m\u016f\u017ee vyslovit podez\u0159en\u00ed na p\u0159\u00edtomnost genetick\u00e9ho syndromu, a to z drobn\u00fdch odchylek od norm\u00e1lu. I ty se toti\u017e mohou kombinovat. U syndrom\u016f s \u010detnost\u00ed nap\u0159\u00edklad 1 na 50 000 a\u017e 100 000 porod\u016f je soust\u0159ed\u011bnost a kvalita zobrazen\u00ed z\u00e1sadn\u00ed. Jen tak je mo\u017en\u00e9 v\u0161imnout si detailu, kter\u00fd napov\u00ed a povede ke spr\u00e1vn\u00e9 diagn\u00f3ze.<\/p>\n\n\n\n

Superkonzili\u00e1rn\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed pak odpov\u00ed na ot\u00e1zku, zda d\u00edt\u011b trp\u00ed vrozenou v\u00fdvojovou vadou, jak je v\u00e1\u017en\u00e1, zda je po porodu operovateln\u00e1 a jak\u00e9 jsou vyhl\u00eddky na dal\u0161\u00ed norm\u00e1ln\u00ed psychomotorick\u00fd v\u00fdvoj.<\/p>\n\n\n\n

Pokud je n\u00e1lez z\u00e1va\u017en\u00fd, p\u0159ipou\u0161t\u00ed \u010desk\u00e1 legislativa ukon\u010den\u00ed t\u011bhotenstv\u00ed do 24. t\u00fddne. Tento postup je rodi\u010d\u016fm nab\u00eddnut, zda se pro n\u011bj rozhodnou, je pln\u011b na jejich uv\u00e1\u017een\u00ed.  V\u010dasn\u00e9 odhalen\u00ed vrozen\u00e9 v\u00fdvojov\u00e9 vady umo\u017e\u0148uje del\u0161\u00ed \u010das na konzultaci a podrobn\u011bj\u0161\u00ed vy\u0161et\u0159en\u00ed (n\u011bkter\u00e1 laboratorn\u00ed vy\u0161et\u0159en\u00ed trvaj\u00ed a\u017e 3 t\u00fddny). Jen tak je mo\u017en\u00e9 co nejl\u00e9pe odhadnout stav d\u00edt\u011bte po narozen\u00ed. Jsou ale situace, kdy to nen\u00ed mo\u017en\u00e9 a v\u017edy z\u016fstane nejistota. N\u011bkter\u00e9 syndromy i vady mohou m\u00edt toti\u017e rozd\u00edln\u00e9 klinick\u00e9 projevy. V tomto psychicky n\u00e1ro\u010dn\u00e9m obdob\u00ed mohou rodi\u010de vyu\u017e\u00edt pomoci interven\u010dn\u00edch psycholog\u016f.<\/p>\n\n\n\n

Informace m\u00edsto nejistoty<\/strong><\/p>\n\n\n\n

A\u010dkoli samotn\u00e9 doporu\u010den\u00ed na specializovan\u00e9 vy\u0161et\u0159en\u00ed m\u016f\u017ee b\u00fdt pro rodi\u010de stresuj\u00edc\u00ed, jeho p\u0159\u00ednos je z\u00e1sadn\u00ed. \u201eV mnoha p\u0159\u00edpadech p\u0159inese p\u0159edev\u0161\u00edm uklidn\u011bn\u00ed \u2013 potvrzen\u00ed, \u017ee se plod vyv\u00edj\u00ed bez v\u00fdznamn\u00fdch probl\u00e9m\u016f. A pokud se riziko potvrd\u00ed, d\u00e1v\u00e1 rodi\u010d\u016fm mo\u017enost p\u0159ipravit se, vyhledat dal\u0161\u00ed odborn\u00edky nebo u\u010dinit informovan\u00e9 rozhodnut\u00ed,\u201c <\/em>dopl\u0148uje MUDr. Kokrdov\u00e1.<\/p>\n\n\n\n

Superkonzili\u00e1rn\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed tak p\u0159edstavuje dnes u\u017e samoz\u0159ejm\u00fd n\u00e1stroj modern\u00ed prenat\u00e1ln\u00ed p\u00e9\u010de. Umo\u017e\u0148uje j\u00edt za hranice b\u011b\u017en\u00e9ho screeningu, pod\u00edvat se na v\u00fdvoj d\u00edt\u011bte opravdu detailn\u011b a nab\u00eddnout rodi\u010d\u016fm to nejd\u016fle\u017eit\u011bj\u0161\u00ed \u2013 p\u0159esn\u00e9 informace v okam\u017eiku, kdy na nich nejv\u00edc z\u00e1le\u017e\u00ed.<\/p>\n\n\n\n

Foto: Prenet<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

T\u011bhotenstv\u00ed dnes nen\u00ed jen obdob\u00edm o\u010dek\u00e1v\u00e1n\u00ed, ale i pe\u010dliv\u00e9ho sledov\u00e1n\u00ed v\u00fdvoje d\u00edt\u011bte. Modern\u00ed prenat\u00e1ln\u00ed p\u00e9\u010de dok\u00e1\u017ee v\u011bt\u0161in\u011b rodi\u010d\u016f zajistit p\u0159edev\u0161\u00edm<\/p>\n","protected":false},"author":1,"featured_media":2511,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"colormag_page_container_layout":"default_layout","colormag_page_sidebar_layout":"default_layout"},"categories":[53],"tags":[569,571,570,573,572],"_links":{"self":[{"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/posts\/2510"}],"collection":[{"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/comments?post=2510"}],"version-history":[{"count":1,"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/posts\/2510\/revisions"}],"predecessor-version":[{"id":2512,"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/posts\/2510\/revisions\/2512"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/media\/2511"}],"wp:attachment":[{"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/media?parent=2510"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/categories?post=2510"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.iforbes.cz\/index.php\/wp-json\/wp\/v2\/tags?post=2510"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}