Control de patológías durante el embarazo: Técnicas de Screening

14-10-2013

Técnicas de  se basan en diferentes modelos matemáticos que nos aproximan al riesgo de padecer en un embarazo determinadas patologías. No existen ninguna prueba que sea capaz de diagnosticar  el 100% de casos  como tampoco ninguna que tenga el 0% de falsos positivos diagnosticados, por lo tanto cuando nos indiquen un riesgo determinado siempre se recomienda la realización de Técnicas de Diagnóstico. Específicamente para el diagnóstico de cromosomopatías tenemos:

  • Test combinado del Primer Trimestre: Específicamente diseñado para seleccionar embarazadas con riesgo (screening) de trisomías 21,18 y 13, presenta aproximadamente una tasa de detección del 90% y un falso positivo del 5% o dicho de otra forma, no detecta al menos 1 de cada 10 Sd de Down y a 1 de cada 20 embarazadas  las selecciona falsamente para amniocentesis. Se trata de un modelo matemático que incluye 3 parámetros:
  1. La edad materna.
  2. Analítica de sangre materna (entre la 9 y las 12 semanas de gestación): que detecta la Papp-a y la Bhcg libre.
  3. Ecografía fetal (entre la 11 y la 14 semanas de gestación): Fundamentalmente determinación de la Traslucencia nucal a la que se puede incluir la determinación de marcadores secundarios como el Hueso Nasal, la Regurgitación tricuspídea y el Ductus venoso.
  • Determinación de DNA fetal en sangre materna:
    Esta prueba tiene como finalidad ayudar a determinar el riesgo de presencia de aneuploidía fetal de los cromosomas 21, 18, 13 y cromosomas sexuales X e Y en embarazos únicos  y gemelares de dos fetos con al menos 10 semanas de gestación. No está diseñada para ser utilizada en gestaciones de más de 2 fetos, en mosaicismo, trisomía parcial o traslocaciones.
    Mediante un análisis de sangre materno es capaz de detectar aproximadamente un 99% de las trisomías 21, un 98% de las trisomías 18 y un 89% de las trisomías 13 con un falso positivo del 0,1%, 0,1% y 0,4% respectivamente.
    El análisis se puede realizar a partir de las 10 semanas de gestación, se remite para su procesamiento a Estados Unidos  presentando resultados en el 95% de las muestras en un tiempo de  aproximadamente 2 semanas.

Estas pruebas le ofrecen un gran control del proceso de gestación, así como una seguridad en los resultados de las pruebas. En el Centro Ginecológico Elcano encontrará un equipo de especialistas dirigido por los Doctores Javier Peña Irala, Olga Ramón Martínez, Fernando Mozo de Rosales y Marta Castillo Martínez cuyo consejo les será muy útil si opta por este tipo de pruebas.

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