FETAL MEDICINE
Our clinic offers comprehensive and extended screening services to all expectant mothers, relying on our internationally trained experts and on our ultrasound equipment complying with the latest standards. (The examinations are conducted according to the FMF‘s (Fetal Medicine Foundation London) guidelines, which is an international institute auditing and accrediting experts who conduct these exams.)
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1st TRIMESTER EXTENDED SCREENING
The first trimester extended screening allows for the detection of more frequently occurring disorders, affecting the following organs and organ systems:
– missing skull bone – upper jaw bone disorder (orofacial cleft), eye disorders (cyclopia)
– disorders of the brain hemispheres‘developments – neural tube defects, spina bifida
– anomaly in the number or form of arms and feet (e.g. missing limbs, clubfoot)
– anomaly in the form of the chest, open abdominal wall, umbilical hernia, diaphragmatic hernia
– renal pelvis dilatation, anomalies of the bladder
– formal, situational, and size abnormalities of the heart – disorders of the heart chambers and atria, missing septa dividing the chambers – disorders of major blood vessels (stenosis of the aorta or of the pulmonary artery, transposition of the great arteries, etc.) – dysfunctions of the atrioventricular valves – signs of decompensated fetal circulation (e.g. accumulation of pericardial fluid, pleural fluid, abdominal fluid accumulation)
– disorder of the connection of the placenta to the uterine wall (low-lying placenta, hematoma)
– myoma, ovarian cysts
– determination of chorionicity, screening of monochonionic twin pregnancies – management of twin-to-twin transfusion syndrome (TTTS)
– nuchal translucency (NT) – examination of missing fetal nasal bone (NB) – tricuspid insufficiency (TR) – abnormal ductus venosus flow (DV)

2nd TRIMESTER ANATOMIC SCREENING
Thanks to the growth of the fetus, by the second trimester (19th – 20th week), the ultrasound examination allows for the detection of 90% of developmental disorders and nearly 100% of severe heart defects. During the exam, in addition to the examination of the parameters indicating the fetus’ size, we do a 3D exam of the brain and facial bones, and the central nervous system can be examined in detail for the first time. Now spine, limbs – including fingers, chest, lungs, heart and major blood vessels, health of the abdominal wall, and the organs of the abdomen (stomach, bowels, gall bladder, liver, kidneys, bladder), navel and umbilical cord can be thoroughly examined and shown on 40 planes, which we look at during all exams. In addition, we also search for signs of specific abnormalities enhancing the risk of Down syndrome.
Disorders that can be screened for, listed by organ systems (the following list is non-exhaustive):
– morphological variations of the skull – disorders of the cerebral hemispheres, the cerebellum and the water spaces around the brain / e.g. Dandy-Walker malformation, ventriculomegaly, hydrocephalus/
– shape and positional deviations of the eye – abnormalities of the lips, hard palate, differences in the facial profile (wolf throat, rabbit cheeks, nasal bone underdevelopment)
– spinal column and disorders of the formation of the vertebrae (open spine, ossification disorders) – numerical and shape deviations of the arms and legs (e.g. missing limbs, clubfoot)
– abnormalities of the position, shape and size of the heart – heart rhythm disorders – deviations of ventricles and atria, lack of septa between heart cavities – abnormalities of the great arteries (aorta, pulmonary artery, pulmonary veins), e.g. transposition of the great vessels, tetralogy of Fallot, aortic arch abnormalities, etc.) – functional disorders of atrio-ventricular valves – ultrasound signs of circulatory failure (pericardial fluid collection, chest and abdominal fluid)
– umbilical hernia
– small intestinal narrowing/obstruction, intestinal dilatation – calcification of the liver
– underdevelopment/absence of kidneys, cystic degeneration of kidneys – enlargement of the renal pelvis and urethra, abnormalities of the urinary bladder
– placental adhesion disorders (placental placenta lying in front, hemorrhage under the placenta)
– e.g. liver, kidney, adrenal gland, teratomas, etc.

3rd trimester status screening
The third trimester ultrasound examination (28th – 31st week) focuses on the fetus’ growth and development inside the uterus. We will check umbilical and cerebral circulation, in order to check the functioning of the placenta. Considering that the majority of developmental disorders can already be detected during the second trimester ultrasound examination, anomalies detected at this point are generally of lesser significance. However, it can be important to know about them, because they might need to be treated and monitored after birth (smaller heart defects, renal anomalies, etc.)
Genetic consultation
Already during the first semester, mothers-to-be receive genetic consultation if it is advised. During this consultation, we inform about the prevalence of chromosomal abnormalities and about the different genetic examinations that can be done.
Our clinic offers the most up-to-date and modern genetic tests to everybody: the so-called non-invasive prenatal testing, or NIPT which enables to screen certain severe chromosomal disorders (Down, Edwards or Patau syndrome, sex chromosome disorders, and the deletion of smaller parts of certain chromosomes called microdeletion) with an accuracy of 99.5%, without endangering the embryo/fetus. Hence this testing does not bear any risk of miscarriage. The testing is based on the examination of the cell-free DNA of the embryo/fetus circulating in the mother’s blood (more precisely, DNA from the placenta cells). Non-invasive prenatal testing can be done at any time between the 9th and the 20th week with the same efficacy. It is advised, though, to choose the earliest date possible. The test results can be expected to be ready within 8-12 working days.

DR. LÁSZLÓ MOLNÁR
Head physician for obstetrician gynaecologist,
accrediteted specielist and sonography
Dr. László Molnár, our clinic’s genetics specialist with more than 15 years of experience, welcomes you to Villa Medicina!
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