Iimviwo ze-ultrasound
Ngethuba lokuqala i-ultrasound yenziwa ngexesha lokuqala kunyango lomfazi kumgqirha. Kwimigangatho yokuqala (iiveki ezi-5 ukuya ku-6), injongo ephambili yesifundo kukuqinisekisa ukuba ngaba ukhulelwe okanye ukukhulelwa kwe-ectopic. Ngexesha elilandelayo, i-ultrasound iminyanzelo yenziwa ngexesha elide kwiiveki ezi-10 ukuya kuma-13. Ukuba ibhinqa iyakubona ukuba ukhulelwe ngeli xesha, umbuzo wesibini ocwangcisiweyo ube ngowokuqala kumqolo. Ngokuphathelele ukuphonononga kwe-ultrasound - isifundo esinokuthi sichaze umngcipheko weengxaki ezingengomntwana. Kule nqanaba, unokwazi ukufumana izifo ezi-2 zentsholongwane ye-chromosomal - I-Down syndrome kunye ne-Edwards syndrome. Ngexesha leentsuku ezi-7 ezalandelayo, ngokuqinisekileyo ngosuku olufanayo, ukuchaneka kweziphumo, umama okhulileyo kufuneka ahlolisise i-biochemical screening, okuthiwa "ukuvavanya kabini". Ukwenza oku, kuya kufuneka uzinike igazi kwi-vein. Ukuba, ngokusekelwe kwimiphumo yezifundo ezimbini, ingozi enkulu yokukhubazeka kumntwana ifunyenwe, ugqirha uya kuncomela ukuxilongwa kwangaphambi kokubeleka (ngexesha le nkqubo, i-amniotic fluid okanye intambo yegazi ithathwa ukuhlalutya isethi ye-chromosome kwaye icacise ukuxilongwa). Ukuhlolwa kwesekondari yesibini kukuphela kweveki yama-20 ukuya kwe-22. Iziphumo zayo zishwankathelwe kunye neziphumo zokuhlola i-biochemical (eli xesha libizwa ngokuba "uvavanyo oluphindwe kathathu": livumela ukufumanisa i-third chromosomal disorder - i-neural tube defect), eyenziwa ngexesha elide kwiiveki ezi-16 ukuya kuma-21. I-ultrasound ehleliweyo yokugqibela eyenziwa ngeveki ye-32. Kujoliswe kwakhona ekufumaneni imiphumo enokwenzeka, engabonakaliyo ngenxa yokuba umntwana wayesencinane kakhulu. Ngexesha le-ultrasound, oogqirha bavavanya iiparitha ezahlukeneyo ezimele zihambelane nobude bokukhulelwa: ubungakanani besisu kunye nosana, ithoni ye-myometrium, umlinganiselo wokuvuthwa kwe-placenta, inani le-amniotic fluid. Hlaziya isakhiwo sezitho zangaphakathi zentsana, isikhundla sekhanda lomlomo.
Doppler
Le ndlela yokufumanisa i-ultrasound yenza ukuba kube lula ukufumana ukuba umntwana usondliwa ngokwaneleyo izondlo kunye ne-oksijini evela kumama. Ngethuba loviwo, oogqirha bavavanya iimpawu zokuhamba kwegazi kwi-uterine umthamo, intambo kunye nomzobo we-cerebral womntwana. Emva kokuqinisekisa, ngeliphi igalelo legazi elijikelezayo kwiinqanawa, linokugqitywa ngokukhawuleza kunye nokuba kuninzi kangakanani izondlo kunye ne-oksijini eya kumntwana kwaye ukuba ngaba la manani ahambelana nexesha lokukhulelwa. Uphononongo luqhutyelwa kwizigaba ezi-2. Okokuqala, ugqirha ngamnye uhlola nganye yeemibhobho ezintathu usebenzisa umshini we-ultrasound. Xa umfanekiso wayo ubonakala kwisikrini, ujika kwi-sensor (Doppler), olinganisa isantya sokuhamba kwegazi, uxinzelelo lwalo kunye nokuxhatshazwa kwesitya. Ukuphazamiseka kweziphazamiso zegazi kuza kubonisa ukuba zeziphi iingxaki eziza kwenzeka ngexesha lokukhulelwa. Ngoko ke, ukuba umntwana akanako ukondla okwaneleyo, unokuzalwa enesisindo esincinci. Ngokutsho kobugqirha, umzekelo, ukuba kukho iingxaki ngexesha lokukhulelwa kwangaphambili, i-Doppler ingenziwa kwiveki ye-13. Ukusebenza ngokubanzi kwaye ngokuqinisekileyo le mviwo iyalelwe kuwo onke amabhinqa akhulelweyo ngexesha lokusukela nge-22 ukuya kwe-24 iveki. Ukuba ugqirha ubonisa ukuphazamiseka kwegazi, uya kunika isifundo sesibini.
Cardiotocography
Uphononongo luquka ukuvavanya iipamitha ezi-2 - ubukhulu bentsholongwane yentliziyo yengane kunye nesimo seetoni ze-uterine. Balinganisa i-sensors 2, eziqhotyoshelwe kumama ozayo kwisisu. Isithathu sesesandleni sakhe, cinezela iqhosha rhoqo xa umntwana ehamba. Ingundoqo yendlela: ukuhlalutya utshintsho kwintliziyo yomntwana ekuphenduleni ukunyakaza komzimba wakhe. Injongo kukufumana ukuba i-oxygen eyaneleyo inikezwa kumntwana. Le ndlela isebenza njani? Xa sisuka (sihamba, senza i-gymnastics), sinentliziyo esheshayo. Le nxalenye ibizwa ngokuba yi-reflex cardiac, yenziwa ngeveki yama-30 yokukhulelwa. Ukuba asinayo i-oxygen eyaneleyo, intlawulo yenhliziyo iya kwanda, kwaye inani lezibetho ngomzuzu liza kudlulela kwisiqhelo. Utshintsho olufanayo lunokulandelwa umntwana. Kodwa kwimeko ukuba sele esweleka i-oxygen, umzimba wakhe uya kuziphatha ngendlela eyahlukileyo. Ngokulondoloza amandla, umntwana uya kutshintsha ngaphantsi, kwaye ekuphenduleni ukunyakaza, i-pulse yayo iya kuncipha. Nangona kunjalo, kwiimeko zombini, ukuxilongwa yinto enye: i-fetal hypoxia (ukungabikho kwe-oksijeni), kuphela kwizigaba ezihlukeneyo. Njengomthetho, ngexesha lokukhulelwa, inzwa yesibini, ukuvavanya ithoni yesibindi, ayifumanekanga. Kodwa ngexesha lokunikezelwa, unikela ugqirha ngolwazi olubalulekileyo, kubonisa ukuba kuvela phi ukulwa, kubani amandla kunye nobude babo. Ukuba ababuthathaka, unokufuna ukuvelisa izidakamizwa ukuzinceda. Ngokufanayo, ukubukela utshintsho kwintliziyo yesana, oogqirha banokuqaphela nokukhusela ezinye iingxaki ngexesha. Ngoko ke, ukuba bayaqaphela ukuba umntwana akanalo oksijini okwaneleyo, mhlawumbi akayi kukwazi ukujamelana nokuzalwa kwemvelo, kwaye ke uya kufuneka enze inxalenye yesigxina. I-KTG kufuneka idluliselwe ubuncinane kanye, kwiveki yama-34. Nangona kunjalo, abaninzi ababelekazi bacebisa bonke abafazi ukuba baqhube isifundo ngasinye iintsuku ezili-10 ukuya kwezi-14 ukusuka kwiveki yama-30, ngokukhawuleza xa umntwana ehlaziya i-reflex cardiac. Ekuqaleni umntwana ufumaneka nge-hypoxia, ixesha elide liya kuhlala lonyango. Kwamanye amaziko ogqirha, unokrazula idivaysi ye-ktg kwaye uqhuba isifundo ekhaya, uthumele iziphumo ngevidiyo kumgqirha oza kujonga imeko ngokude.