Prolaktiin

Teenuseosutaja

Inga Vaasna

Gynecologic oncologist

Arno Uppin

Gynecologic oncologist

Teenuseosutajad

Anu Ansip

Gynaecologist

Ülle Kadastik

Gynaecologist

Liis Kriisa

Gynaecologist

Vaalja Kroon

Gynaecologist

Pille Soplepmann

Gynaecologist

Dr. Andrei Sõritsa

Gynecologist and Fertility Specialist

Dr. Deniss Sõritsa

Gynecologist and Fertility Specialist

Dr. Svetlana Räim

Gynecologist and Fertility Specialist

Dr. Katrin Org

Gynaecologist

Dr. Julia Orsi

Gynaecologist

Aire Sekavin

Gynaecologist

Denis Samarskii

Gynaecologist

Teenuseosutajad

Dr. Andrei Sõritsa

Gynecologist and Fertility Specialist

Dr. Deniss Sõritsa

Gynecologist and Fertility Specialist

Teenuseosutaja

Karin Truu

Midwife

Jekaterina Kalamees viib Elite kliinikus läbi individuaalse lähenemisega perekooli loenguid, mis on mõeldud beebiootel naistele, peredele ja värsketele lapsevanematele.

Ämmaemand Jekaterina Kalamehe ja Elite kliiniku eesmärgiks on pakkuda vajalikku tuge, et lapseootel naine/pere saaks parimal viisil valmistuda vanema rolliks ja sellega toimetulekuks.

Loengutes jagab Jekatrina Kalamees teaduspõhisusele tuginevaid teoreetilisi teadmisi ja praktilisi nõuandeid, mis aitavad kohaneda rasedusega, valmistuda sünnituseks ning beebiga kohtumiseks ja sünnitusjärgse perioodiga toimetulekuks.

Ta jagab nõuandeid toetamaks pere emotsionaalset ja füüsilist heaolu, et pere saaks parimal viisil pereks kasvada ning luua pereliikmete vahel head, hoolivad ja armastavad suhted kõikides eesootavates uue eluga seotud etappides.

Loengute teemad on paindlikud ja neid on võimalik kohandada vastavalt iga naise/paari vajadustele.

Loengus saab naine/pere end mugavalt tunda privaatses ruumis, mis on mõeldud korraga ühele perele. Üks kohtumine kestab 2 akadeemilist tundi ehk 90 minutit.

Selga mugav riietus ning kohtumiseni!

Võimalikud loengute teemad:

RASEDUS:

• muutused naise kehas, kohanemine
• rasedusaegsed vaevused ja nende leevendamine
• sünnituseks ettevalmistumine nii füüsiliselt kui vaimselt
• partneri sünnituseks ettevalmistamine
• kodu kohandamine beebi sünniks

SÜNNITUS:

• sünnituse märgid
• mida haiglasse kaasa võtta
• sünnituse kulg, perioodid, lapse sünd
• aktiivsünnitus ja eneseabi, õpime hingama, lõõgastuma, erinevaid asendeid (praktiline)
• partneri roll sünnitusel, sünnitaja toetamise võimalused (praktiline)
• valuvaigistamise võimalused
• kui kõik ei lähe plaanipäraselt – eriolukorrad sünnitusel

SÜNNITUSJÄRGNE AEG:

• varajane sünnitusjärgne aeg haiglas
• sünnitusjärgne periood kodus, selle erilise aja eripärad, kohanemine
• taastumine, vaimse ja füüsilise tervise toetamine
• võimalikud tugiteenused, mida saab kasuta, kellele mõeldud ja millal? (sünnitusjärgne koduvisiit, füsioteraapia, raseduskriisi nõustamine jmt)
• pereks kasvamine
• sugueluga alustamine sünnitusjärgselt ja rasestumisvastased vahendid

RINNAGA TOITMINE:

• imetamiseks ettevalmistumine
• erinevad imetamise asendid, sellega seotud abivahendid
  (praktiline)
• naise toetus imetamise ajal
• erinevad abivahendid (kuidas valida rinnapumpa, rinnanibukaitset jne)
• alternatiivsed toitmise võimalused (näidistega tutvumine)
• võimalikud rinnaga toitmise raskused ja nendega toimetulek
• imetamisnõustamine, kui beebi on sündinud
• rinnaga toitmise lõpetamine

BEEBI:

• esmane hooldus (praktiline)
• beebi vajadused ja nende ära tundmine
• kuidas ma aru saan, et beebil on kõht täis?
• vannitamine (praktiline)
• beebiga õue
• beebi riietamine (praktiline)
• beebi turvalisus
• beebi uni ja päeva rutiin
• beebi arengu toetamine

Teenuseosutaja

Jekaterina Kalamees

Midwife

Panorama™ – Noninvasive prenatal testing (NIPT)

Panorama™ is a blood-based genetic, prenatal screening test of the pregnant person that screens for common chromosomal conditions that affect a baby’s health. Panorama™ uses SNP*-based technology to deliver highly accurate results and unique insights for both singleton and twin pregnancies.

Panorama™ is a screening test, which means that this test does not make a final diagnosis. A high risk result means that your pregnancy has a higher chance of having a specific genetic condition. However, you cannot know for sure if your baby has that condition based upon the screening result alone. All medical decisions should be made after discussion with your healthcare provider regarding diagnostic testing during the pregnancy, like chorionic villus sampling (CVS) or amniocentesis, or testing the baby after birth. *SNP, single nucleotide polymorphism

The Panorama™ difference

The only SNP-based NIPT, designed to inform decisions during pivotal moments of pregnancy care. A differentiated, highly-accurate screening approach evaluates SNPs – the 1% of our DNA that makes us different from one another – to screen for common trisomies, aneuploidies and microdeletions. A sequencing platform of >13K SNPs enables Panorama to deliver a curated prenatal cfDNA screening test that accounts for all ethnicities and population variability.

Validated with clinical rigor

SMART, the largest prospective NIPT study, evaluated the performance of SNP-based NIPT in a real-world population. All results included in the analysis were validated with genetic confirmation. ZERO fetal sex errors in validation studies > 95% positive predictive value (PPV) for trisomy 21 83% clinical sensitivity for 22q11.2 deletions (0.5 Mb+ deletions) > 99% combined sensitivity for trisomies (T21, T18, T13)

Panorama screens for common genetic conditions that are caused by extra or missing chromosomes in the baby’s DNA. Because Panorama uses a unique technology to distinguish between the pregnant person’s and the baby’s DNA, it is the only NIPT that tests for triploidy. Some conditions, such as Down syndrome, are caused by extra copies of a specific chromosome. Others, such as microdeletions, occur when a chromosome is missing a small piece of genetic information.

Conditions Screened For:

Trisomies: *

• Down syndrome/trisomy 21
• Edwards syndrome/trisomy 18
• Patau syndrome/trisomy 13

Sex chromosome aneuploidies: **

• Monosomy X (Turner syndrome)X
• XXY Syndrome (Klinefelter Syndrome)
• Triple X syndrome
• XYY Syndrome (Jacob’s Syndrome)

Microdeletions: **

• 22q11.2 deletion syndrome
• Prader-Willi syndrome †
• Angelman syndrome †
• 1p36 deletion syndrome
• Cri-du-chat syndrome

Triploidy: **

• Only NIPT that tests for triploidy

** Not available for egg-donor or gestational carrier pregnancies or in cases of dizygotic (nonidentical) twins. Triploidy and microdeletions except for 22q11.2 deletions are not available for monozygotic (identical) twins.

† This test has been validated on full region deletions of Prader-Willi syndrome/Angelman syndrome (PWS/AS) only and might be unable to detect smaller deletions. It has not been validated for other molecular mechanisms which could cause PWS/AS such as uniparental disomy (UPD) or methylation.

Microdeletions package can not be ordered for twin pregnancy.
Microdeletions package can not be ordered separately.

Who should have Panorama™ prenatal screen?

The Panorama™ prenatal screen is designed for women of any age and ethnicity who are at least 9 weeks pregnant. It cannot currently be used by women carrying three or more babies (triplets and above), women who have used an egg donor or surrogate carrying more than one baby (twins or triplets), or those who have received a bone marrow transplant.

What are the benefits of having the Panorama™ prenatal screen?

As early as 9 weeks into your pregnancy, a simple blood draw can tell you if your baby is at higher risk for having Down syndrome and other common genetic conditions, as well as the sex of your baby. Noninvasive and highly accurate, Panorama™ identifies more than 99% of pregnancies affected with Down syndrome and has the lowest reported false positive rate of any prenatal screening test for the commonly screened chromosomal abnormalities: trisomy 21, trisomy 18, and trisomy 13.

Screening for egg donor pregnancies

Conditions screened in egg donor pregnancies:

• Trisomy 21 (also known as Down syndrome)
• Trisomy 18 (also known as Edwards syndrome)
• Trisomy 13 (also known as Patau syndrome)

Why it is important to know whether the twins are identical or not?

This information helps your healthcare provider to determine the appropriate amount of follow-up and what specialists may be necessary for your pregnancy. Identical twins may share a placenta. A shared placenta can increase the chance for unequal growth and a severe condition called twin-twin transfusion syndrome (TTTS). There is no risk of TTTS for fraternal twins.

Panorama can provide risk evaluation for more conditions than any other non-ivasive prenatal test for twins:

Down syndrome, Edwards syndrome, and Patau syndrome Turner syndrome, a genetic disorder that occurs in girls that is associated with heart defects, learning difficulties, and infertility 22q11.2 deletion syndrome, a genetic disorder that occurs in boys and girls that is associated with learning differences, heart defects, and other birth defects* *Risk evaluation available for pregnancies determined by Panorama to involve identical twins/p>

For twin pregnancies, only Panorama can provide:

• Zygosity information
• Individual fetal fractions for dizygotic twins
• Fetal sex for each twin
• Monosomy X risk for monozygotic twins

Panorama helps clinicians identify higher risk for conditions that affect more than 1 in 45 twin pregnancies.

What Does the OSCAR Test Show?

The OSCAR test (One-Stop Clinic for Assessment of Risk) is a first-trimester combined screening performed between the 12th and 13th weeks of pregnancy.

It assesses the risk of chromosomal abnormalities such as Down syndrome, Edwards syndrome, and Patau syndrome. If a high risk is detected, it helps guide further steps such as non-invasive prenatal testing (NIPT) (e.g., Panorama or Nifty) or invasive diagnostic procedures.

In addition to chromosomal risk, the OSCAR test also evaluates the risk of preeclampsia, fetal growth restriction, and preterm birth.

Why Is This Important?

An extended assessment for preeclampsia and other pregnancy complications offers valuable information for both the expectant mother and the physician — such as whether the pregnancy falls into a higher-risk group for fetal growth issues. This allows for early planning of additional monitoring or treatments during pregnancy.

What Does the OSCAR Test Include?

The OSCAR test consists of:

• Fetal ultrasound
• Maternal blood hormone analysis
• Maternal blood pressure measurement

During the ultrasound, specific markers characteristic of chromosomal syndromes are measured and combined with maternal blood hormone levels (fb-hCG, PAPP-A, and PLGF). Using these results along with your medical history, a personalized risk assessment is calculated.

The Full OSCAR Screening Covers:

• Visualization of fetal heartbeat
• Determining the placenta’s position
• Estimating the amount of amniotic fluid
• Visualization of fetal limbs and movement
• Assessment of fetal anatomy, including heart and spine
• Measurements required to assess the risk of:
• Down, Edwards, and Patau syndromes
• Preeclampsia, fetal growth restriction, and preterm birth

Results are available within 1–2 business days.

Who Should Consider the OSCAR Test?

The OSCAR test is suitable for all pregnant women, but is especially recommended for those with:

• Age over 35 years
• IVF pregnancy
• Previous child with a chromosomal abnormality
• Previous child with a heart defect
• Diabetes
• High blood pressure
• Obesity (BMI over 30)
• Previous preeclampsia or fetal growth restriction
• History of stillbirth
• Recurrent miscarriages

Preeclampsia – Affects 5–8% of Pregnancies

Several factors can increase the risk of developing preeclampsia:

• First pregnancy
• Maternal age over 40
• Carrying multiples (e.g., twins)
• Family history of preeclampsia (mother or sister)
• Preeclampsia in a previous pregnancy
• Pre-existing high blood pressure
• Pre-existing autoimmune diseases
• Pre-existing diabetes
• Gestational diabetes (diabetes diagnosed during pregnancy)
• Obesity
• IVF pregnancy

Preterm Birth

Preterm birth is defined as the onset of regular uterine contractions before 37 weeks of pregnancy, accompanied by changes in the cervix (e.g., dilation).

Babies born prematurely often face serious health complications and may require specialized monitoring and medical care.

Nifty

NIPT is a non-invasive test that detects genetic conditions such as Down, Edwards, and Patau syndrome, from as early as week 10 of pregnancy.

Trusted

More than 10,000,000 pregnant women all over the world have already done the NIPT by GenePlanet test.

Secure

Samples are analysed in GenePlanet’s own laboratory in Europe, which ensures the highest level of quality and data security.

Simple

The test requires a small blood sample (10 ml), taken from pregnant woman’s arm. It is available from week 10 of pregnancy.

Accurate

Proven > 99% detection rate for most common trisomies based on a study of nearly 147,000 pregnancies.

Nifty Standard

Most common trisomies:

• Down syndrome/trisomy 21
• Edwards syndrome/trisomy 18
• Patau syndrome/trisomy 13

Sex chromosome aneuploidies:

• Turner syndrome/monosomy X
• Klinefelter syndrome/XXY
• Triple X syndrome/XXX
• Jacobs syndrome/XYY

Gender information

Nifty Plus

Most common trisomies:

• Down syndrome/trisomy 21
• Edwards syndrome/trisomy 18
• Patau syndrome/trisomy 13

Additional trisomies:

• Trisomy 9
• Trisomy 16
• Trisomy 22

Sex chromosome aneuploidies:

• Turner syndrome/monosomy X
• Klinefelter syndrome/XXY
• Triple X syndrome/XXX
• Jacobs syndrome/XYY

Gender information

Deletion and duplication syndromes – 60 syndromes

Nifty Pro

Most common trisomies:

• Down syndrome/trisomy 21
• Edwards syndrome/trisomy 18
• Patau syndrome/trisomy 13

Additional trisomies:

• Trisomy 9
• Trisomy 16
• Trisomy 22

Sex chromosome aneuploidies:

• Turner syndrome/monosomy X
• Klinefelter syndrome/XXY
• Triple X syndrome/XXX
• Jacobs syndrome/XYY

Gender information

Deletion and duplication syndromes – 92 syndromes

Täpsem ja põhjalikum info lapseootel naistele

NIFTY Pro pakett sisaldab 92 deletsiooni ja duplikatsiooni sündroomi ning pakub lapseootel naistele varasemast veelgi rohkem ja põhjalikumat infot. Deletsiooni/duplikatsiooni sündroomid ei ole olemasolevale paneelile (Plus) lihtsalt lisatud, vaid pigem valitud välja põhinedes mitmele kriteeriumile (nagu näiteks haiguse tõsidus ja kliiniline tähtsus). Selle tulemusena on mõned sündroomid, mida nt Plus pakett sisaldab, Pro paketist välja jäetud.

Valideerimisuuring kromosoomikoopiate variantide arvu kindlaks tegemiseks väikese ulatusega kogu genoomi sekveneerimise abil on läbi viidud.

Deletsioonide/duplikatsioonide tuvastamise tundlikkus on järgmine:

• 88.89% kui del/dup suurus on suurem kui 10 M aluspaari
• 72.73% kui del/dup on väiksem kui 10 Mbp

The man should abstain from ejaculation for 3–5 days before providing a semen sample for analysis. This helps to give a clearer picture of his sperm production and fertilization capacity (sperm count and motility).

What Can Be Quickly Assessed in Semen During Analysis?

• Sperm count (concentration): The number of spermatozoa per milliliter of semen.
• Sperm motility and movement categories: This includes fast-progressive, slow-progressive, non-progressive (moving in place), and immotile sperm.
• Sperm morphology: General appearance and structure, including the percentage of normal forms, as well as defects in the head, acrosome, midpiece, tail, and multiple anomalies per sperm (teratozoospermia index).
• Semen volume, color, smell, and pH value (acidity/alkalinity): These parameters provide insight into the function of the male reproductive glands and the condition of the reproductive tract.
• Sperm agglutination: The clumping of sperm and the extent of it, which in some cases may interfere with natural fertilization.
• Sperm membrane integrity: Evaluated using a hypo-osmotic swelling test, where sperm with intact membranes show tail curling, while those with damaged (e.g., dead) membranes remain straight.
• Vital staining for immotile sperm: When a large portion of sperm is non-motile, special staining can determine the proportion of live versus dead sperm. In some cases, immotility may be caused by structural anomalies in the tail or midpiece—often of genetic origin. In assisted reproduction (e.g., ICSI), it is possible to fertilize eggs successfully using live but immotile sperm.

There are 2 different categories for sperm analysis – basic semen analysis and comprehensive semen analysis.

The main difference between the two is, that in basic analysis there are analysed different sperm parameters only from ejaculate, but in comprehensive analysis there are coming in the sperm different functional tests – membrane integrity, presence of antisperm antibodies on the membrane of sperm cells, also morphology and motility after fractionating semen by swim-up method, which selects only motile sperm cells from the ejaculate likewise it happens also by natural conception.

Semen analysis is performed by our biologist Andre Taimalu.

Pregnancy Planning Package Includes the Following Tests:

For Women

• Blood pressure measurement
• Body Mass Index (BMI) calculation
• Vaginal and cervical swabs for infections (gonorrhea and chlamydia PCR method, bacteriological analysis, PAP smear, non-specific inflammation markers, detection of clue cells)
• Urine analysis
• Blood tests (fasting required – no food or drink beforehand!) – complete blood count, blood sugar, blood group and Rh factor, APCR, TSH (thyroid-stimulating hormone), Prolactin (PROL), testosterone, ASAT, ALAT (liver enzymes), anti-HIV, HBsAg, HBcAb, anti-HCV, Treponema pallidum antibodies (T. Pallidum Ab), Ca125.
• Ultrasound examination

For Men

• Blood pressure measurement
• Body Mass Index (BMI) calculation
• General semen analysis and inflammation screening in semen Important: Abstain from intercourse for 3–5 days before giving the sample.
• Urine analysis
• Gonorrhea and chlamydia screening from urine (PCR method)
• Blood tests (fasting required – no food or drink beforehand!) – complete blood count, blood sugar, blood group and Rh factor, TSH (thyroid-stimulating hormone), ASAT, ALAT (liver enzymes), anti-HIV, HBsAg, HBcAb, anti-HCV, Treponema pallidum antibodies (T. Pallidum Ab).

Service Providers

Women can undergo the pregnancy planning examination on any weekday between 8:30 AM and 11:00 AM by booking an appointment with Dr Svetlana Räim, Dr Andrei Sõritsa, or Dr Deniss Sõritsa. Men can have a pregnancy planning test done every working day from 10:00 to 13:00 by registering with biologist Andre Taimalu at 740 9930.

Dr. Andrei Sõritsa

Gynecologist and Fertility Specialist

Dr. Deniss Sõritsa

Gynecologist and Fertility Specialist

You will be informed of the results by phone within one week.