Omyly pri liečbe oplodnením in vitro | Medicínske právo
              

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Omyly pri liečbe oplodnením in vitro


 | 29.11.2010 | komentárov: 292

Incident zo začiatku novembra tohto roka, ktorý odhalil zámenu genetického materiálu otca pri in vitro oplodnení na prominentnej singapúrskej klinike Thompson Fertility Center, inicioval medzi odborníkmi debatu o predchádzaní omylov pri práci s pohlavnými bunkami odobranými za účelom asistovanej reprodukcie. Omyl bol odhalený niekoľko dní po pôrode dieťaťa, ktorého krvná skupina (typ B) sa nezhodovala s krvnou skupinou otca (typ A) ani matky (typ 0).

Obrazok Celkovo sa predpokladá, že riziko zámeny je nízke vďaka prijatej regulácii, ktorá rešpektuje medzinárodné štandardy.  Odporúčania singapurského Ministerstva zdravotníctva nariaďujú overovanie identity pacietky a identity jej manžela v každom štádiu procedúry. Na identifikáciu sa používajú dva druhy označení. Označenie číslom poistenia a označenie plným znením mena oboch rodičov.  U zahraničných pacientov používajú kliniky označenie menom rodičov a číslo pasu resp. pridelené nemocničné číslo. Správnosť údajov overuje manžel pacientky a zdravotná sestra, ktorá je povinná podpísať protokol o správnosti uvedených údajov. Každá vzorka podlieha kontrole dvoch laboratórnych pracovníkov.
Po odhalení omylu nariadilo singapúrske Ministerstvo zdravotníctva prešetrenie postupu laborantov a dočasne zakázalo vykonávať in vitro oplodnenia na menovanej klinike.  Prieskum viedol k záveru, že v dôsledku zlyhania ľudského faktora došlo k zámene semena dvoch mužov. Embryológ na klinike vyhľadavánej mnohými manželskými dvojicami, pracoval so vzorkami  dvoch párov súčasne.  Ministertvo zdravotníctva prijalo okamžité preventívne opatrenia na predídenie podobným omylom v budúcnosti. Na zabezpečenie identifikácie mužských pohlavných buniek sa od laboratórnych pracovníkov na klinikách vyžaduje, aby pracovali výlučne s jednou vzorkou a používané nástroje (pipety) zničili po každom použití. Dôvodom okamžitého angažovania ministerstva v prešetrení omylu je aj fakt, že uvedený incident výrazne poškodil povesť štátu Singapur ako regionálnej jednotky v poskytovaní zdravotnej starostlivosti.
Pokiaľ ide o identifikáciu ženských pohlavných buniek, v súčasnosti sa črtá možnosť je využiť novú metódu, s ktorou prišli španielski vedci z barcelonskej univerzity. Tí testovali uvedenú metódu na  pohlavných bunkách myší. Ide o metódu implantácie biologicky nezávadných čiarových kódov do ženskej pohlavnej bunky, do oblasti medzi vonkajšou membránou zvanou zona pellucida a bunkovou mebránou. Táto metóda neovplyvňuje rýchlosť vývoja embrya a čiarový kód je odstránený pred implantáciou embrya na stenu maternice.  Technika označovania embryí čiarovým kódom uľahčuje identifikáciu embryí a  zjednodušuje oplodnenie in vitro. Španielska vláda povolila testovanie techniky na ženských pohlavných bunkách s cieľom minimalizovať omyly na klinikách pri využívaní liečby in vitro oplodnením.

Autor: Bc. Zuzana Zoláková

Zdroje:
health.asiaone.com
www.channelnewsasia.com
www.newscientist.com

foto: thepregnancyzone.com









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