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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.
“You will even see that the patients are sleeping on the floor,” he told me, clearly exasperated.
“The only support we have already had is a little medicine for the patients and water. As far as other challenges are concerned, there's still no staff motivation.”

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At a treatment centre in South Kivu province that the BBC visited in the epicentre of the outbreak, they say more patients are arriving every day - especially babies - and there is a shortage of essential equipment.
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Mpox - formerly known as monkeypox - is a highly contagious disease and has killed at least 635 people in DR Congo this year.
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.
“You will even see that the patients are sleeping on the floor,” he told me, clearly exasperated.
“The only support we have already had is a little medicine for the patients and water. As far as other challenges are concerned, there's still no staff motivation.”

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Scientists who discovered mammals can breathe through their anuses receive Ig Nobel prize
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The world still holds many unanswered questions. But thanks to the efforts of the research teams awarded the IG Nobel Prize on Thursday, some of these questions – which you might not even have thought existed – now have answers.

We now know that many mammals can breathe through their anuses, that there isn’t an equal probability that a coin will land on head or tails, that some real plants somehow imitate the shapes of neighboring fake plastic plants, that fake medicine which causes painful side-effects can be more effective than fake medicine without side-effects, and that many of the people famous for reaching lofty old ages lived in places that had bad record-keeping.
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The awards – which have no affiliation to the Nobel Prizes – aim to “celebrate the unusual, honor the imaginative – and spur people’s interest in science, medicine, and technology” by making “people laugh, then think.”

In a two-hour ceremony as quirky as the scientific achievements it was celebrating, audience members were welcomed to their seats by accordion music, before a safety briefing warned them not to “sit on anyone, unless you are a child,” not to “feed, chase or eat ducks” and to throw their paper airplane safely. There were two “paper airplane deluges” during the ceremony in which the audience attempted to throw their creations – safely – at a target in the middle of the stage.
Among those collecting their prizes was a Japanese research team led by Ryo Okabe and Takanori Takebe who discovered that mammals can breathe through their anuses. They say in their paper that this potentially offers an alternative way of getting oxygen into critically ill patients if ventilator and artificial lung supplies run low, like they did during the Covid-19 pandemic.

American psychologist B.F Skinner was posthumously awarded the peace prize for his work attempting to use pigeons to guide the flight path of missiles, while a European-wide research team was awarded the probability prize for conducting 350,757 experiments to demonstrate that a coin tends to land on the same side it started when it is flipped.

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