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Ethical aspects of prenatal diagnosis
ŠIROKÁ, Barbora
The thesis deals with the applications of ethical principles in prenatal diagnosis. The introduction is devoted to the phenomenon of life and its aspects. The professional medical part characterises the preimplantation and prenatal diagnosis and methods used during the care of pregnant. The ethical part of the thesis describes the origin, the approaches and concepts of bioethics. Further it defines each of bioethical principles which are based on bioethics. At the end of the third chapter various aspects and problems of medical ethics are shown. The aim of the last chapter of this thesis is the ethical reflection in which the different diagnostic methods are examined in terms of bioethical principles. It´s followed by analyzing the current situation ethics of prenatal diagnosis in the Czech Republic. Comparison of different opinions from professionals in this field is interesting and surprising. The fourth chapter is concluded with specific case studies of pregnant women. Conclusions include evaluation and comparison of available information and express my own view on the issue.
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Prenatal diagnosis by imaging methods
VLČEK, Martin
The bachelor degree thesis focuses on imaging methods in prenatal diagnostics. The theoretical part informs the readers about the current situation in this field, including invasive and noninvasive examination methods. The theoretical part is concluded with a chapter on prenatal detection of heart disease by means of screening examination of pregnant women. The objective of the thesis was to highlight the activities of a radiological assistant, to describe his/her activities during the use of various modalities and possibilities in diagnostics of congenital heart diseases, both prenatally and perinatally. One hypothesis was formulated, concerning the activity of a radiological assistant in diagnostics of congenital heart diseases during the prenatal period. The quantitative research was designed based on the number of examined fetuses and newborns in the teaching hospital (Fakultní nemocnice) in Motol and in the Center of Medical Genetics (Centrum lékařské genetiky s.r.o.) in České Budějovice in the course of 1 year. In 59 fetuses examined with magnetic resonance the following 3 congenital heart diseases were detected most frequently: 7 cases of agenesis of corpus callosum, 6 cases of ventriculomegalia and 7 cases of congenital cystic adenomatoid lung malformation. None of the examined mothers was diagnosed with placenta defects or pathological changes on the fetus heart. The formulated hypothesis has been confirmed. At present, congenital heart diseases are not routinely prenatally examined by means of magnetic resonance due to the too robust technology and insufficient quality of the imaging. The prominent role is still being played by ultrasonic examinations performed by gynecologists and obstetricians. The thesis and the research results may be used by cardiologists, gynecologists, obstetricians, as well as radiologists.
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"The importance of screening examination methods in prenatal diagnosis from a midwife{\crq}s perspective"
PROCHÁZKOVÁ, Klára
The subject of this bachelor thesis is to create a well-arranged and comprehensible review of the current status and possibilities of the prenatal diagnosis, as it nowadays represents an integral part of almost all pregnancies and many pregnant women decide whether to undergo a prenatal diagnosis and which method of the prenatal diagnosis should be employed in order to achieve a maximum guarantee that they will not give birth to a child with a defect. This thesis has a total of six aims. To find out if the midwives are informed about possibilities of screening examinations in the pregnancy, whether they proceed in compliance with the recommendations of the Society for Gynaecology and Obstetrics during these examinations, whether the pregnant women according to the midwives understand the meaning of the screening examinations, whether the pregnant women according to the midwives are interested in performance of screening examinations in pregnancy and whether the pregnant women are interested in optional, above standard examinations that are not fully covered from the health insurance. In order to ascertain these aims, a total of six hypotheses were postulated on the grounds of which an anonymous questionnaire was created that was focused on evaluation of the theoretical knowledge of the midwives about possibilities of screening examinations in pregnancy and on evaluations of pregnant women{\crq}s interest in these examinations based on the opinions of the midwives. The questionnaire contained a total of 26 questions. The cohort of respondents consisted of the midwives working with pregnant women in 79 selected gynaecological-obstetric outpatient departments in Prague where the research was carried out. A total of 146 questionnaires were distributed, the rate of return of which was 66%. The interpretation of the results is based on the total of 94 respondents. The first hypothesis was based on a presumption that the midwives are informed about possibilities of the screening examinations in pregnancy. This presumption was confirmed as the opinions of the respondents were in 66% in accordance with this hypothesis. In the hypothesis 2, there was a presumption that in the field of the screening examinations, the midwives do not proceed according to the recommendations of the Society for Gynaecology and Obstetrics. This hypothesis was not confirmed as nearly all midwives claimed to proceed in compliance with these recommendations. In the third hypothesis, there was a presumption that according to the midwives, the pregnant women do not know the meaning of the screening examinations in pregnancy. This hypothesis was not confirmed as the average of 86% midwives gave a positive answer at this point. The fourth hypothesis was based on a presumption that midwives positively evaluate the importance of the screening examinations in pregnancy. This hypothesis was confirmed as the average of 92% of responders evaluated the importance of these examinations positively. In the fifth hypothesis, there was a presumption that the pregnant women are according to the midwives interested in performance of screening examination in pregnancy. This hypothesis was confirmed as the average of 95% of respondents gave opinions that were in accordance with this hypothesis. The last hypothesis was based on a presumption that the pregnant women are not interested in the optional, above standard examinations that are not fully covered from the health insurance. This hypothesis was not confirmed as the average of 51% of respondents reported the pregnant women to be interested in these examinations. This thesis and the results of the research part should help the midwives and other medical staff to increase the awareness on screening examination methods of the prenatal diagnosis.
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