Yintoni le?
Kuzo zonke oomama abaza kuhlolisiswa, iqela labasetyhini lichongiwe, iziphumo zazo zihluke kakhulu kwiimeko eziqhelekileyo. Oku kuphakamisa ukuba emntwaneni wabo ithuba lokuba neyiphi na ipathologies okanye iziphene ziphezulu kunezo zabanye. Ukuhlolwa kokubeleka kubunzima lweengxelo ezijoliswe ekufumaneni ukungaphumeleli kokuphuhliswa okanye ubunzima bomntwana obunzima. Olu bunzima lubandakanya:
♦ Ukuhlolwa kwezinto eziphilayo-ukuhlolwa kwegazi okukuvumela ukuba ufumane ubungqina bezinto ezithile ("abamatshini") egazini eguquka kwiimeko ezithile zentsholongwane, ezifana ne-Down's syndrome, i-Edwards syndrome kunye neempembelelo ze-neural tube. Ukuhlola i-biochemical kuphela yinto eqinisekisiweyo yokuba kungenzeka, kodwa kungekhona ukuxilongwa Ngoko ke, kunye nophando olongezelelweyo lwenziwe;
♦ Ukuhlolwa kwe-Ultrasound (ultrasound) - kwenziwa kwi-trimester nganye yokukhulelwa kwaye kuvumela ukufumanisa ubuninzi beempazamo ze-anatomical kunye nokungaqhelekanga kokuphuhliswa komntwana. Ukuhlolwa kokuqala komntwana kubandakanya izigaba eziliqela, nto ebalulekileyo ebalulekileyo, njengoko inikeza ulwazi malunga nophuhliso lomntwana kunye neengxaki ezinokwenzeka.
Imiba engozini yokuphuhliswa kwezilwanyana kumntwana ongakazalwa:
♦ Ubudala bomfazi bungaphezulu kweminyaka engama-35:
♦ ubuncinane ubuncinane bokukhupha isisu ezimbini kwiindawo zokuqala zokukhulelwa;
♦ sebenzisa ngaphambi kokukhulelwa okanye kwiindawo zokuqala zokukhulelwa kwamanani amalungiselelo e-pharmacological;
♦ iphathwe yi-bacterial mother's future, infections of viral;
♦ ubukho kwintsapho yengane yomntwana ngokuqinisekisayo ukuba i-Down's syndrome, ezinye izifo ze-chromosomal, i-malformations ye-congenital;
♦ Ukuthuthwa kwentsapho ye-chromosomal engafanelekanga;
♦ izifo ezizalwayo kwiintsapho ezisondeleyo;
♦ ukutshatyalaliswa kwemisebe okanye ezinye iziphumo ezinobungozi kumnye wabatshati ngaphambi kokuba ukhulelwe.
Yintoni ephanda ukuhlolwa kwezinto eziphilayo?
• I-subunit yamahhala yehomori ye-chorionic (hCG)
• I-RARP A yiprotheyini ye-plasma echaphazelekayo.
IHGH hormone ivelisa iiseli zebhokhwe le-embryo (i-chorion). Siyabulela kuhlalutyo kwi-hCG ukuba ukukhulelwa kunokuqalwa kakade ngomhla wesi-2-3 emva kokuchumisa. Iqondo le hormone landa kwi-trimester eli-1 kwaye lifikelela kumaqondo angama-10-12. Ukongezelela, iyancipha ngokuthe gqolo kwaye ihlala ihlala rhoqo ngexesha lesibini kwisiqingatha sokukhulelwa. I hormone yeHCG inamacandelo amabini (i-alpha kunye ne-beta). Enye yazo i-beta ekhethekileyo, esetyenziswa ekuxilongeni.
Ukuba izinga leHCG liphakanyisiwe, lingathetha malunga:
• Amathumbu amaninzi (umgangatho weHCG ukwanda ngokumalunga nenani leziqhamo);
• I-Down syndrome kunye nezinye izifo;
♦ I-Toxicosis;
♦ isifo sikashukela kumama ozayo;
♦ Ixesha lokukhulelwa elingakalunganga.
Ukuba izinga leHCG liyancipha, liyakwazi ukuthetha malunga:
♦ kubakho ukukhulelwa kwe-ectopic;
♦ Ukukhulelwa okungapheliyo okanye isongelo sokukhupha isisu;
♦ ukuphuculwa kwexesha elizayo lomntwana;
♦ Ukungenakulungelelaniswa kwamaplanga;
♦ Ukufa komntwana (kwi-II-III ye-trimester yokukhulelwa).
Kubalwa ngolu hlobo lulandelayo:
I-MoM - ixabiso lesalathisi kwi-serum eyahlula ngokubaluleka komlinganiselo wexesha lokukhulelwa. Isiqhelo sixabiso lesalathisi esiseduze nobunye.
Kukho inani lezinto ezinokuchaphazela ukubaluleka kwezikhombisi ezifumanekayo:
♦ ubunzima bomfazi okhulelweyo;
♦ Ukubhema;
♦ ukuthatha imithi;
• imbali yesifo sikashukela esilungileyo kumama ozayo;
• ukukhulelwa ngenxa ye-IVF.
Ngoko ke, xa ubala iingozi, oogqirha basebenzisa ixabiso leMM elichanekileyo. Ukuqwalasela zonke iimpawu kunye nezinto. Umgangatho weeMM ukusuka kwi-0.5 ukuya ku-2.5. Kwimeko yokukhulelwa okubanzi, ukuya kwi-3.5 MoM. Ngokuxhomekeke kwimiphumo efunyenweyo, kuya kucace ukuba ngaba umama ozayo usemngciphekweni we-pathologies ye-chromosomal okanye ayikho. Ukuba kunjalo, ugqirha uya kucebisa uphando olongezelelweyo. Akuyimfuneko ukuxhalabisa kwangaphambili ukuba unikwe i-screening ye-trimester yesibini-kunconywa ukuba bonke abafazi abakhulelweyo bahlolwe, kungakhathaliseki ukuba iziphumo zesigaba sokuqala soviwo. UThixo ukhusela ukhuseleko!
Uvavanyo lweeTrimester II
"Ukuvavanywa kathathu"
Yenziwa kwiveki ye-16 ukuya kwe-20 yokukhulelwa (ixesha elifanelekileyo ukusuka kwi-16 ukuya kweveki le-18).
Ukuhlola okudibeneyo
Ukuhlolwa kwe-ultrasound (usebenzisa idatha efunyenwe kwi-trimester yokuqala);
• Ukuhlola i-biochemical;
• Uvavanyo lwegazi lwe-AFP;
Estriol yamahhala;
• i-chorionic gonadotropin (hCG). Ukukhangela kwesibini kujolise ekuboneni umngcipheko wokuba nomntwana onesifo se-Down, i-Edwards, isiphako se-tube neural and other anomalies. Ngexesha lesibini ukuhlola, ukuhlola ihomoni ye-placenta kunye nesibindi sesisu se-fetus, esineenkcukacha eziyimfuneko malunga nophuhliso lomntwana. Iimodemoni ze "vavanyo kathathu" kwaye yintoni eboniswa ukwanda okanye ukunciphisa kwizinga labo egazini? Ngokumalunga neHHG yeHMG sele ikhankanywe ngasentla, kodwa ezinye ezimbini zifuna iinkcazo.Alfa-fetolrothein (AFP) iprotheni ekhoyo egazini lomntwana Amanyathelo okuqala okuphuhliswa kwamanyamisi. Aphethwe kwintsholongwane kunye nesisu sesisu somntwana. Isenzo se-alpha-fetaprotein sijoliswe ekukhuseleni umntwana kwisistim somzimba somama.
Ukwanda kwinqanaba le-AFP kubonisa ukuba kungenzeka ukuba khona:
♦ Ingxaki ye-neural tube ye-fetus (i-anencephaly, spina bifida);
♦ I-Meckel syndrome (uphawu - i-cipital craniocebral hernia;
♦ I-atrephasia ye-esopha (ukukhubazeka kophuhliso lwe-fetal, xa isisu esikwimfusane siphelile, singabi sifinyelele esiswini (umntwana akanakukudla emlonyeni) 1 ";
♦ i-hernia;
♦ ukungabi nomdla kwindonga yangasese yomzimba yesisu;
♦ I-fetal fover necrosis ngenxa yokusuleleka kwintsholongwane.
Ukunciphisa izinga le-AFP libonisa:
♦ I-Down's syndrome - i-trisomy 21 (emva kweveki ezili-10 zokukhulelwa);
♦ I-Edwards syndrome-trisomy 18;
♦ Ixesha elikhutshelwe ukukhulelwa (ngokungaphezu kokuyimfuneko yophando);
♦ ukufa komntwana.
- Imigangatho ye-AFP kwi-serum
I-estriol yamahhala - le hormone ivelisa kuqala i-placenta, kwaye kamva isibindi sesisu. Kwiimeko eziqhelekileyo zokukhulelwa, izinga le hormone likhula njalo.
Ukwanda kwinqanaba le-estriol kunokuthetha malunga:
♦ Ukukhulelwa kaninzi;
♦ isityalo esikhulu;
♦ Isifo sesibindi, isifo seengtso kumama ozayo.
Ukuncipha kwinqanaba le-estriol kunokubonisa:
♦ Ukungafezeki komntwana;
♦ I-Down's syndrome;
♦ Ukukhathazeka komntwana;
♦ isongelo lokunikezelwa kwangethuba;
♦ I-Adrenal hypoplasia ye-fetus;
♦ usulelo lwe-intrauterine. Iimiselo ze-estriol kwi-serum.
Ukuqhathaniswa kwe-Ultrasound III Trimester
Iqhutywayo ukusuka kwi-30 ukuya kwe-34 iveki yokukhulelwa (ixesha elifanelekileyo livela kwi-32 ukuya kweye-33 yeveki). I-ultrasound ihlola imeko kunye nendawo yendawo ye-placenta, inquma inani le-amniotic fluid kunye nendawo yomntwana ebuswini. Ngokwezibonakaliso, ugqirha unokunika izifundo ezongezelelweyo - i-dopplerometry ne-cardiotocography. I-Doppler - olu uphando lwenziwe ukususela kwiveki yama-24 yokukhulelwa, kodwa amaninzi amaninzi awagulisa oogqirha emva kweveki yama-30.
Izimpawu zokuphumeza:
♦ Ukungafezeki komntwana;
♦ Ukwanda okwaneleyo ekuphakameni kokuma kwe-uterine fundus;
♦ Ukudibanisa kwintambo yomlomo;
♦ gestosis, njl
I-Doppler yindlela ye-ultrasound enika ulwazi malunga nokunikezelwa kwegazi lomntwana. Isantya sokujikeleza kwegazi kwiinqanawa zesisu, intambo yesibindi, intsimbi yesibhedlele yesibhakabhaka kunye ne-aorta ye-fetus iphandwa kwaye ifaniswe namazinga ale xesha. Ngokweziphumo, izigqibo zithatyathwa malunga nokuba i-fetus blood supply is aqhelekileyo, nokuba kukho ukungabikho kwe-oxygen kunye nezondlo. Ukuba kuyimfuneko, iziyobisi zimiselwe ukuphucula igazi le-placenta. I-Cardiotocography (CTG) yindlela yokurekhoda izinga lentliziyo ye-fetal kunye neenguqu zalo ekuphenduleni iziphambano ze-uterine. Kucetyiswa ukuba uchithe kwiiveki ezingama-32 zokukhulelwa. Le ndlela ayinakuphikiswa. I-CTG yenziwa ngoncedo lwe-ultrasonic sensor, echanekileyo kwisisu esisetyhini esithwele (esetyenziswa rhoqo ngaphandle, oko kuthiwa yi-CTG engathanga ngqo). Ubungakanani be-CTG (ukusuka kwi-40 ukuya kweyimizuzu engama-60) kuxhomekeke kwizigaba zomsebenzi kunye nokuhlala komntwana. I-CTG ingasetyenziselwa ukubeka iliso kwimeko yengane kwaye ngexesha lokukhulelwa, kwaye ngexesha lokuzalwa ngokwaso.
Iimpawu ze-CTG:
♦ isifo sikashukela kumama ozayo;
♦ ukukhulelwa nge-Rh factor;
♦ ukufumanisa iintsholongwane ze-antiphospholipid ngexesha lokukhulelwa;
♦ Ukulibaziseka ekukhuleni komntwana.
Ugqirha uqondisa ekuhlolweni kwaye (ukuba kunyanzelekile) uncoma uviwo olongezelelweyo, kodwa akufanele achukumise isigqibo somfazi. Oomama abaninzi bokomva baqale ukwenqaba ukuphonononga izifundo, bethetha ukuba baya kuzala nayiphi na imeko, kungakhathaliseki ukuba zeziphumo zezifundo. Ukuba ungena kwinani labo kwaye ungafuni ukwenza ukukhangela, ke oku kukunene kwakho, kwaye akukho mntu unokukunyanzela. Indima yogqirha kukucacisa ukuba kutheni ukuhlolwa kwenkqubo yokubeletha kwangaphambili, yintoni ekufunyaniswa ngayo ngenxa yoluphando oluqhubekayo, kunye neendlela zokuxilonga ezingavumelekanga (i-chorionic biopsy, amniocentesis, cordocentesis), xelela ngemingcipheko engenzeka. Emva koko, ingozi yokukhipha isisu emva kweemviwo ezinjalo malunga ne-2%. Ugqirha kufuneka kwakhona akuxwayise ngale nto. Ngelishwa, oogqirha abanalo ixesha lokuchaza ngokucacileyo iziphumo zokuhlola. Siyathemba ukuba kweli nqaku siye sakwazi ukucacisa ezinye iinkalo zale sifundo esibalulekileyo.