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The Constitutional Court said on Thursday that termination of pregnancy due to fetal defects is inconsistent with the Polish constitution. Does such a judgment mean that prenatal testing ceases to make any sense? We asked specialists about it.
- Obstetricians emphasize that prenatal examinations are not only about deciding whether to keep a child, but also about verifying potential diseases that can be treated when the child is born.
- These types of tests are giving babies who would only live a few days or weeks after giving birth, say gynecologists and obstetricians.
- Prenatal diagnosis allows, for example, to assess the risk of premature birth, which is one of the worst things that can happen to a pregnant woman – says Dr. Krzysztof Janowiec
- Dr. Krzysztof Kucharski explains that the detection of abnormalities in the development of pregnancy is a time for the patient to prepare for a possible illness of the child.
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– Prenatal diagnosis is used to assess the state of development of the fetus until the child is born – says Dr. Krzysztof Janowiec, obstetrician-gynecologist who performs this type of examination at the Superior Medical Center in Krakow. – Thanks to it, we also assess risk factors that may affect the course of pregnancy. I mean the occurrence of, for example, pre-eclampsia, eclampsia and premature birth which are very dangerous for a woman. These are also very serious risk factors for babies, because premature birth is one of the worst things that can happen to a pregnant woman. Of course, it all depends on what stage of pregnancy it occurs, but if it is early, it can be a sentence for the baby.
Prenatal tests allow to assess the child’s structure
Another aspect of prenatal diagnosis is the assessment of the occurrence of a severe genetic defect in a child. The research is focused primarily on the disadvantages of the so-called chromosomal aberrations, i.e. defects linked to sex chromosomes. After 11 weeks of pregnancy, doctors can determine the risk of a baby having a severe genetic condition, such as Down syndrome, Patau’s syndrome, or Edwards syndrome, and other chromosomal abnormalities that are much less frequent.
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– We often underestimate the fact that thanks to prenatal examinations it is possible to assess the structure of a child’s organs – adds Dr. Janowiec. – Even in the first trimester of pregnancy, the doctor is often able to estimate how the child’s organs develop and to spot any abnormalities that require careful evaluation in the second trimester of pregnancy. Knowing them well in advance, you can direct further diagnostics.
– I have not read the judgment, but it seems to me that it does not concern prenatal diagnostics at all – says Dr. Krzysztof Kucharski, gynecologist-obstetrician from the Damian Medical Center. – Non-invasive prenatal diagnosis includes ultrasound and morphological tests. On their basis, the doctor can assess the genetic and developmental defects of the child. Doing these tests is important to everyone. Doctors can plan how to proceed with the pregnancy and what treatment is best given after the birth. On the other hand, the patient has time to prepare for a possible illness of the child. Prenatal diagnosis is subject to the standards of the National Health Fund, which are established by the Ministry of Health and updated on an ongoing basis.
It gives children with heart defects a chance to live a normal life
Prenatal testing has an established place in medicine. We cannot give up on them and there is a lot of evidence for that. A properly built child, without genetic defects, may experience some organ abnormality, and if we introduce appropriate therapy, we give him a chance for a normal life. This is especially true for defects in the heart and urinary system, as they usually require surgery very shortly after birth.
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– When there is a serious suspicion of an irreversible defect in a child, it must always be confirmed – explains Dr. Janowiec. – It is a myth that we only recognize a child’s genetic defect on the basis of ultrasound. Each doubt is verified by a team of experts and by amniocentesis, a test involving the collection of amniotic fluid and its genetic analysis. The result is 100% certain.
Prenatal diagnosis carried out according to the latest FMF (Fetal Medicine Foundation) standards is complete because it allows for an early assessment of the patient’s risk scale at a sufficiently early stage, i.e. in the 11-14th week of pregnancy. However, in the second stage, in the 18-20th week of pregnancy, the child should be assessed. If the doctor detects any abnormalities, he has time to perform invasive diagnostics, if necessary.
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