2. Differences depending on local conditions
Dr. Türker Kavas

3. First selfie of our team

4. Medicolegal climate Toxic medicolegal climate
No upper limit for malpractice awards
But there is an upper limit for the compensation by the malpractice insurance
Consequently the main focus of counselling from the doctor’s point of view is based on being on the safe side juristically

5. In public hospitals current practice in Turkey
Doctor’s monthly salary is heavily dependent on the number of examinations she or he made during the past month
Total examination time is usually between 5-10 min, sometimes even shorter
Appointments are made by a central body and the number of daily appoinments are not controlled by the doctor himself

6. Shortness of appropriate personal
In Turkey:
Population: (refugees)
Number of Ob&Gyn: 6163
Number of Medical Geneticists: 150
Number of doctors with continuing certification for NT by FMF (Fetal Medical Foundation): 20

7. Tools Ultrasound equipment Laboratory Old Non calibrated
İnappropriate set-up
Laboratory
Usually non-certified

8. Patient characteristics
Less educated
Giving a sense of probability is often improbable
Ultrasound exam usually is perceived as nothing more than a photo session with the new baby
More violent
There is almost no practicing Ob&Gyn specialist who has never experienced violence at the workplace
Lingually restricted
refugees with very high birth rates

9. Now let’s talk what we do under these circumstances
Usually a written informed consent containing information about:
The aim
The content
The limitations
The alternatives
Possible outcomes and relevant options,
of the screening exam is signed by the patient and her accompanion

10. During the examination
A simple description of 2D examination methodology is given
If we are confident that the findings are normal they are immediately shared with the patient
Abnormal findings are usually explained after the completion of the report

11. This is a joke of the baby. This not a malformation.

12. Normal findings What did we eliminate
%50 of gross anomalies
%85 of Down syndrome babies
Can we do something more sensitive
cfDNA
CVS
Risks concerning the course of pregnancy
Preeclampsia
IUGR
PTD

14. Courtesy of Dr. Fehmi Yazcıoğlu - Perinatologist
Special thanks to
Prof. Dr. Recep Has - Perinatologist

15. Thanks for listening, Bye Bye