Dr. Tamar Borkowski Tillman – ד״ר תמר בורקובסקי

Dr. Tamar Borkowski Tillman is a senior Ob-Gyn, specializing in Fetal medicine and ultrasound.

Dr. Borkowski Tillman had a Fellowship in Fetal Medicine Foundation in London UK, under the direction of Prof. Kypros Nicolaides.

She specialises in performing ultrasound examinations such as anomaly scans, targeted scans (neurosonography and other conditions), nuchal translucency, twins pregnancies, doppler US, 3D & 4D US and more.

Dr. Borkowski Tillman is a MD graduate of the Sackler faculty of Medicine, Tel Aviv University.

She completed an internship in Ob-Gyn at Beilinson Hospital in 2008 and a certificate studies in Ob-Gyn ultrasound at the School of advanced Studies in Sackler faculty of Medicine, Tel Aviv University.

Dr. Borkowski Tillman is a senior consultant in the Ob-Gyn ultrasound unit at Beilinson Hospital.

:Ultrasound scans in pregnancy

Nuchal translucency scan

Nuchal translucency (NT) is the sonographic appearance of a collection of fluid under the skin behind the fetal neck in the first-trimester of pregnancy. In fetuses with chromosomal abnormalities, cardiac defects and many genetic syndromes the NT thickness is increased. The combination of NT and maternal serum free β-hCG and PAPP-A improves the detection to 90%. (FMF UK)

Nuchal translucency scan is done between 11 to 13.6 weeks.

Ultrasound anatomy scan

This is a detailed ultrasound anatomy scan, also called the anomaly scan. It evaluates anatomic structures of the fetus and the placenta. This scan is an important component of routine prenatal care.

Early anomaly scan is done between 14 to 16 weeks of pregnancy. The exam reviews the structure and size of the various organs and systems (skull, brain, face, heart, limbs, spine, abdomen, etc.), the location of the placenta and the amount of amniotic fluid.
Second trimester (late) anomaly scan is carried out between 21 and 24 weeks pregnant. It is a detailed examination of the fetus in the second trimester.
Third trimester anomaly scan is performed in the advanced stage of pregnancy usually between week 30 and week 32. It is usually focused on the structure of the brain, skeleton and kidneys, the urinary and intestinal system of the fetus, and findings that can only be detected at this point of pregnancy.
Scans that are aimed at a particular system or a defined clinical condition, such as suspected malformations, pregnancies with suspected CMV infection, suspected fetal growth, fetal doppler.

Amniocentesis

Amniocentesis is an invasive testing designed to diagnose chromosomal disorders and genetic diseases during pregnancy. It is usually done from week 17 to week 22 + 6. However, there are special cases where there is a medical instruction to perform amniocentesis in later weeks, and even during the third trimester of pregnancy.

Amniotic fluid is a clear fluid that fills the amniotic sac that surrounds the fetus and protects it inside the uterus. Amniotic fluid is mainly made from the urine of the fetus, but it also contains cells from an embryonic source. These are mainly skin cells that fall into the water, and other cells from the fetal respiratory, digestive and urinary systems.

In amniocentesis, a thin needle is inserted through the abdominal wall of the mother into the uterus and a sample of amniotic fluid is aspirated. The test is performed under ultrasound guidance, to ensure that the needle does not damage the fetus itself or the placental sac.

Using a laboratory test of amniotic fluid, several types of tests can be performed:

Genetic testing such us CMA, karyotype, EXOM or specific hereditary diseases in families where there is a known hereditary disease.

Special tests – for example to diagnose fetal infection with a virus or parasite such as CMV. These tests are performed only in cases where a clear medical instruction has been established.

It is important to know that it is not possible to test all genetic syndromes through amniocentesis. And also, that some of the congenital malformations are not due to a genetic problem, so amniocentesis does not help in their diagnosis.