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Dotaz k ultrazvuku a stanovení stáří plodu

Dobrý den, paní doktorko,

opravdu moc Vám děkuji za upřesnění mého dotazu týkající se ultrazvuků a stanovení stáří plodu. Věřím, že jste časově značně vytížená, nicméně jsem se rozhodla, že Vám ještě jednou napíšu.

Pokud by to bylo možné, ráda bych se s Vámi ještě poradila. Bude to znít možná hloupě, omlouvám se... S přítelem jsme se po dvanácti letech společného soužití rozhodli založit rodinu. Toto jsme plánovali velmi důkladně a snažili jsme se na to co nejlépe připravit (jak fyzicky, tak psychicky). Dohodli jsme se, že se o miminko začneme snažit v listopadu 2015. Na konci října jsem však udělala, bohužel pod vlivem alkoholu, fatální chybu, které nesmírně lituji, s dlouholetým společným kamarádem. Bohužel kromě mazlení přes oblečení a orální sex (s ejakulací do úst) k ničemu jinému nedošlo. Toto se stalo 4 DC, kdy mi končila menstruace. Cykly mívám delší, za posledního půl roku pravidelné v rozmezí 30-31 dnů. S přítelelem jsme se začali snažit o miminko 10 DC, dále jsme měli nechráněný pohlavní styk 12 DC, 14 DC, 16 DC a 19 DC. Podařilo se nám hned napoprvé. Bohužel místo radosti od zjištění těhotenství prožívám velké trápení a špatný psychický stav mi i komplikuje průběh těhotenství. Je to již 6 měsíců, co mě napadají myšlenky, zda nemohlo děťátko vzejít z toho orálního sexu...

Já vím, že skrze něj k otěhotnění dojít nemůže, ale v hlavě mi neustále běží myšlenky, že jsem mohla mít nějaké sperma na ruce (i když jsem si je hned poté umyla) a potom se třeba otřít o přirození (například při následném zavádění tamponu na toaletě), nepatrné množství takto přeneseného spermatu se mohlo dostat dovnitř a počkat zde třeba na ovulaci - 6 dní? Paní doktorko, je možné takto otěhotnět?

Těhotenský test mi vyšel pozitivní až cca 5 dní po vynechání menstruace; od začátku těhotenství jsem podstoupila ultrazvukové vyšetření - nejprve nebylo vidět srdíčko a můj gynekolog naznal, že je těhotenství mladší, v 7tt, 10tt a 13 tt (NT+ screening) vycházelo těhotenství vždy o 6 dní mladší. Proto jsem se Vás ptala, zda ultrazvuk pozná přibližné datum početí a stáří plodu. Paní doktorko, můžu se na Vás ještě, prosím Vás - jakožto odborníka na plodnost/neplodnost, obrátit s dotazem, zda je možné, aby shora popisovaným způsobem došlo k početí (v rámci orálního sexu a případného přenosu nepatrného množství spermatu, při menstruaci, při délce mého cyklu, s ohledem na výsledky ultrazvuků). Asi Vám to zní šíleně, ale věřte, že místo šťastného období procházím depresemi a úzkostmi, "zda se nemohlo něco stát". Pokud dopočítám dle UZ a odečtu těch zmíněných 14 dní, vychází početí vždy na 21 DC - mohu se na to spolehnout, nemůže se ultrazvuk ve stanovení stáří splést třeba o 10-12 dní? S přítelem jsme oba drobní, tak jestli není miminko třeba menší z tohoto důvodu a k otěhotnění nemohlo dojít už třeba 4 - 9 DC...

Moc se omlouvám, že Vám ještě píšu, ale musela jsem. Budu velmi, ale velmi vděčná za Vaši odpověď a vysvětlení, pokud si uděláte čas.

Hodně by mi to pomohlo. Ještě jednou Vám moc děkuji, Dagmar

Odpověď:

Vážená paní Hradská,

děkuji Vám za důvěru. Jsem si zcela jistá, že k početí způsobem, který popisujete (orální sex, případné spermie na ruce a otření se o přirození), dojít nemohlo. K početí je třeba poměrně vysoké koncentrace pohyblivých spermií. Představa, že tento výše popsaný případný (vůbec ne jistý) způsob zavedení spermií do pochvy dostačuje k otěhotnění, je, naštěstí pro Vás, zcela mylná. Takto příroda nefunguje. Provedená ultrazvukové měření navíc ukazují na to, že k početí došlo opravdu mnohem později. V počátečních těhotenských týdnech všechny zdravé plody rostou stejně, až zhruba ve druhé části gravidity se růst jednotlivých plodů individuálně odlišuje podle genetických předpokladů, výživy matky a podobně. Proto je také měření v 10. - 12. týdnu nejpřesnější. Prosím, radujte se z Vašeho těhotenství a už nemějte vůbec žádné pochyby.

Mějte se krásně.

Se srdečným pozdravem

MUDr. Lenka Hromadová

vedoucí lékař IVF ambulance

Sanatorium REPROMEDA

Viniční 235

615 00 Brno

tel. +420 533 306 351

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Even though 200,000 vaccines, donated by the European Commission, were flown into the capital, Kinshasa, last week, they are yet to be transported across this vast country - and it could be several weeks before they reach South Kivu.
“We've learned from social media that the vaccine is already available,” Emmanuel Fikiri, a nurse working at the clinic that has been turned into a specialist centre to tackle the virus, told the BBC.
He said this was the first time he had treated patients with mpox and every day he feared catching it and passing it on to his own children - aged seven, five and one.
“You saw how I touched the patients because that's my job as a nurse. So, we're asking the government to help us by first giving us the vaccines.”
The reason it will take time to transport the vaccines is that they need to be stored at a precise temperature - below freezing - to maintain their potency, plus they need to be sent to rural areas of South Kivu, like Kamituga, Kavumu and Lwiro, where the outbreak is rife.
The lack of infrastructure and bad roads mean that helicopters could possibly be used to drop some of the vaccines, which will further drive up costs in a country that is already struggling financially.
At the community clinic, Dr Pacifique Karanzo appeared fatigued and downbeat having been rushed off his feet all morning.
Although he wore a face shield, I could see the sweat running down his face. He said he was saddened to see patients sharing beds.
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