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Tamizaje genético, una prueba para descatar anomalías en el feto

Tamizaje genético, una prueba para descatar anomalías en el feto

En Colombia, este examen no lo cubre la EPS.

Tamizaje genético, una prueba para descatar anomalías en el feto
Por: Mónica Toro
13 de Julio de 2012
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Los padres desean que sus hijos siempre tengan la mejor salud, en especial cuando se encuentran ellos en desarrollo dentro del vientre materno. Por tanto, las ecografías, los exámenes de sangre y el cumplimiento a todos los controles prenatales son fundamentales para lograr este objetivo.Existe un examen especial que se le puede practicar a la madre  y al feto durante el primer o segundo trimestre de gestación, conocido como prueba de tamizaje genética. El ginecobstetra Fabio Quijano y el obstetra perinatólogo Jorge Orjuela explican:¿Qué es?El tamizaje genético es una prueba de detección precoz que ayuda a establecer si el bebé viene con problemas de tipo cromosómico. Permite detectar aproximadamente el 90 por ciento de anomalías cromosómicas en el bebé. Para esto se lleva a cabo una prueba de sangre a la mamá y una ecografía.  ¿Cuándo se realizan?La prueba de sangre se lleva a cabo entre las semanas 11 y 12. Y la primera ecografía entre las semanas 11 y 14 de embarazo (idealmente semana 12). Allí el experto toma las medidas en la nuca y en el hueso para descartar el síndrome de Down ( los niños con estesíndrome tienen nariz pequeña y poco desarrollada).¿Solo se realiza en esas semanas?Sí, porque son tiempos que obedecen al comportamiento biológico de los marcadores que se miden, los cuales aparecen en un momento del embarazo y luego desaparecen.¿Qué enfermedades detecta?Varias alteraciones cromosómicas, entre ellas la más común, el síndrome de Down. Aparte de los síndromes de Patau, de Edwards y de Turner.¿Cómo se detectan?La tasa de detección de anomalías cromosómicas con el tamizaje completo, o sea combinando una medición de hormonas (por medio de la prueba de sangre) más la ecografía, es de aproximadamente el 95 por ciento. Todos esos resultados se unen, y un software especial calcula el riesgo del feto de alguna de estas enfermedades. Si se detecta alguna anomalía, se le ofrece a los padres un estudio invasivo, ya sea una amniocentesis o una biopsia de vellosidad coriónica.¿Y en qué consiste la amniocentesis?Se practica una punción del saco gestacional (embarazo) para obtener una muestra del líquido amniótico. De allí se aíslan células fetales que flotan en el líquido, se cultivan para aumentar el número de estas y, luego, se les practica un estudio genético (cariotipo), para definir si el feto es o no portador de una enfermedad cromosómica. Se realiza a partir de la semana 16 y podría traer consecuencias, como la pérdida del embarazo.¿Y la biopsia de vellosidad coriónica?Se realiza una punción transabdominal sobre el útero, con la idea de obtener una muestra de vellosidades coriales, las cuales van a formar más adelante la placenta. Esto permite hacer un estudio genético del feto, el cual puede arrojar resultados más rápidamente que la amniocentesis. Se practica entre las semanas 10 y 13 de gestación.¿Todas las mujeres pueden acceder a este tamizaje genético?En Colombia, el POS cubre un ultrasonido en el primer trimestre, donde lamentablemente no está establecida la obligatoriedad del médico de buscar los marcadores ecográficos de anomalías genéticas. Las pacientes que deseen acceder a este test (pruebas en sangre más ultrasonido) deben hacerlo de forma privada y el costo es de unos 500 mil pesos. Además, son muy pocos los médicos colombianos expertos en esta área. Se requiere entrenamiento, y no todas las clínicas tienen disponibilidad económica ni profesional para esto.

 

 

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