Izinsuku ukuhlolwa lesibili ekukhulelweni. ucwaningo olunzulu abesifazane abakhulelwe

Eminyakeni engaba ngu-25-30 edlule ezweni lethu ayikho le nto ezifana ucwaningo olunzulu kwabesifazane abakhulelwe. In the ukungabikho ultrasound ukufundwa kwenziwe kanye lonke gama noma cha nhlobo kwamiswa.

imithi yesimanje inokubukeka ohlukile nokugcinwa sokukhulelwa, futhi ngokuhambisana namazinga omhlaba omama batusa kakhulu ukudlula Ukuhlolwa lokuqala nelesibili. Ultrasound kusiza ukuhlola ukuthuthukiswa umbungu.

"Inkathi Yokuchuma"

yokuthathu Okwesibili abaningi abawubiza ngokuthi "isikhathi osemqoka", okuyinto Uthatha th 14 kuya 27 th ngesonto. i-hormone amazinga egazini kancane kancane, umzimba uyobe ukuzivumelanisa noshintsho. ukugula Morning, isicanucanu futhi ukukhathala kakhulu ukulahlekelwa phansi, kanye nabesifazane abakhulelwe uzizwe yokwanda ubungqabavu.

Njalo ngemva kwamasonto amabili umama okhulelwe uhambela udokotela ngubani uqaphe ushintsho wegazi kanye nesisindo umzimba, kanye nabaqaphi ukubukeka edema. Qiniseka ukuthi bangayeki ukuhlolwa kwegazi kanye nomchamo.

Endaweni ehlukile, i Udokotela Wabesifazane liyakhuluma ngokuphela isikhathi sesibili Ukuhlolwa ekukhulelweni. Ngokuvamile abesifazane banovalo kulezi izifundo, kodwa ngisho okungenzeka ukwehluleka iphutha. imithetho Screening nazo ngokufingqiwe lokhu kubuyekezwa.

ukuhlolwa kuqala

Ababili abaphuma uhlelo locwaningo kokubeletha uvele Russia muva. Ukuhlolisisa esibanzi okuhloswe ngaso ukuba sisheshe kwezinso zenani elikhulu eziyifa kanye azalwa naso ku-fetus.

Esigabeni sokuqala kwenziwe isikhathi esingamasonto 10-14. Imiphumela 1 Ukuhlolwa uvumele ukukhiqiza ukuphila kwabo engozini ngoba kombungu ezithile azalwa naso futhi chromosomal kwezinso. It wenziwa usebenzisa ultrasound kanye nokuhlaziywa igazi ku PAPP-A no β-hCG. Ngaphezu kwalokho, udokotela angase akunikeze chorionic villus amasampuli izimpawu ezilandelayo:

- ukwandisa fetus Translations nuchal (3 mm);

- yobudala abesifazane kusukela engu-35 ubudala;

- chromosome kwezinso emkhayeni.

ukuhlolwa yesibili

Izinsuku ukuhlolwa lesibili ekukhulelweni - amasonto 17-19. Ngo senyanga yesibili umama okhulelwe uyophinde ube ultrasound kungakanani abakwaziyo kanye nokuhlola ukuhlolwa igazi, okuyinto evame ukubizwa ngokuthi ukuhlolwa kathathu.

I-World Health Organization itusa ukuba ukuhlolwa yesibili kubo bonke abakhulelwe kanye nakanjani labo basengozini:

- yobudala engaphezu kwengu-35;

- izisu ezimbili, nokuningi;

- eyamukelayo contraindicated izidakamizwa abakhulelwe senyanga yokuqala;

- ukushadana kwezihlobo eziseduze;

- eside usongo ukukhipha izisu;

- zokugula umbungu ku ultrasound lokuqala;

- isifo esithathelanayo acute (senyanga yesibili).

Screening akudingi ukuqeqeshwa okukhethekile. Kubalulekile ukukhumbula ukuthi uhlole igazi hormone eside ngangokunokwenzeka ngemva kwesonto lamashumi amabili.

US kwezinkambiso

Lapho efeza ochwepheshe cwaningo zokuxilonga ukulinganisa:

1. Isakhiwo fetus isimo izitho zangaphakathi.
2. Ubude wesibeletho (kuyinsakavukela - 36-40 mm).
3. Ikhwalithi nenani amniotic fluid (izinga - 1-1.5 amalitha).
4. Isimo placenta (kuyinsakavukela - ukuvuthwa 0).

Njengoba umntwana ke, unikeze isibonelo sokuthi isikhathi esingamasonto 18:

1. Isisindo - 160-215, the
2. Ukuphakama - 20-22 cm.
3. Usayizi isilinganiso ikhanda fetus - 3,8-5,5 cm.
4. usayizi cerebellar - 1.5-1.9 cm.
5. I ububanzi we inhliziyo - 1.5-2 cm.
6. I ububanzi we humerus - 1,9-3,1 cm.
7. I ububanzi kunawo wonke - 1.8-3.2 cm.
8. ubukhulu besisu - 3,1-4,9 cm.

Tholakele US imithetho ukuvumela udokotela ukwenza isiphetho ngabantu ngeziphambeko kungenzeka ekuthuthukiseni bese unquma ucwaningo olwengeziwe.

ukuhlolwa kathathu

Njengoba sishilo kakade, isikhathi Ukuhlolwa yesibili ngesikhathi sokukhulelwa amiswa ngokuhambisana UBANI izincomo. Through ukuhlolwa kathathu ochwepheshe ukuchaza amazinga amathathu izimpawu of hCG, estriol mahhala futhi alpha-fetoprotein.

Igazi ukuhlaziywa is mhlawumbe eyenziwa phakathi kwesonto lesikhombisa sokukhulelwa. Screening, kodwa amamethrikhi kunalokho isuselwe, icubungula isimiso esikhethekile. Umphumela kuphela eyaziwa kungakapheli amasonto amabili.

Uhlaziyo kudinga ukulungiselela kancane. Odokotela ukweluleka usuku ngaphambi kokuya lab Gwema izithelo ezisawolintshi, kwasolwandle, ushokoledi kanye cocoa, kanye okunamafutha kanye nokudla okuthosiwe. Kumele udle okungenani amahora angu-4-6. isiphuzo Esamukeleka 150 ml amanzi ethafeni amahora amane.

hCG

Ake sihlolisise ngesikhathi izimpawu ukuthi avele isivivinyo kathathu. Kutfutfukiswa hCG ekhiqizwa chorion fetus. Amanani Ephakeme zingase zibonise ukuthi amaningi sokukhulelwa, toxemia noma isifo sikashukela kwabesifazane abakhulelwe. Lihambisana amazinga aphansi nezinye hormone ezimbili, odokotela basikisela ingozi Down Syndrome.

Amanani aphansi hCG uvumele ukuze sifinyelele iziphetho ngokuthi ukukhula komntwana ethunjini noma cha asathuthuka, sesatshiswa isisu noma ukufa fetus, kanye ezingamahlalakhona esingamahlalakhona esinomhlapho. It kwandisa ingozi Edwards syndrome.

AFP

AFP - iprotheni plasma, ekuqaleni akhiqizwa-yolk sac, futhi kamuva pheshana emathunjini bese isibindi fetus. Izinga eliphansi AFP kusikisela-Down syndrome noma ukugula Edwards, ukuthola placenta ongaphakeme, isifo sikashukela umama okhulelwe.

Uprated-hormone okuthiwa i ezingeni kungase eyobonisa ingozi ukulimala kobuchopho, kwezinso, atresia duodenal, kwemizwa tube zikhubazeke futhi zibe anterior udonga besisu. Ngaphezu kwalokho, ukwanda amanani kungenzeka endabeni RH ukungqubuzana, amanzi aphansi, usongo ukukhipha izisu, kanye ukufa kwengane.

estriol khulula

I synthesis hormone esibindini umbungu kanye umzanyana. Ngokuhamba evamile yokukhulelwa estriol Ileveli kokukhulumela phezulu, okuyinto enomthelela ukulungiswa amabele ngoba lactation futhi sithuthukise ukugeleza kwegazi izitsha lesizalo. Nokho, ehlome ukwanda noma ukwehla yayo ezingeni ingabangela ukukhathazeka.

Encishisiwe ukusebenza estriol abonisa ingozi kwesisu, ukuntuleka kwegazi emzimbeni wengane, imisiwe ukuthuthukiswa ngokomzimba noma izifo intrauterine. Kukhona amathuba Down Syndrome, esinomhlapho noma esingamahlalakhona adrenal. Ukudla okungafanele nemithi elwa namagciwane ingase futhi iholele ukwehla elibukhali amagugu.

Uprated estriol ezingeni kungenzeka kuwuphawu nokukhulelwa izingane eziningi ngasikhathi noma isifo sesibindi. Ngaphezu kwalokho, ochwepheshe ngenkathi ephawulekayo ukunciphisa i-hormone ukubikezela preterm lokuzalwa.

mayelana imiphumela

Ngakho, ngokuqinile isikhathi ukuhlolwa lesibili ngesikhathi sokukhulelwa futhi imiphumela ukuhlaziywa ivumela ukwenza iziphetho kwangaphambilini mayelana nokuba khona noma ukungabi khona izifo zofuzo.

Nokho, kukhona izinto ezingaba nomthelela yokuhlola kathathu. Ngokwesibonelo, IVF, ukukhulelwa amaningi, definition engalungile sokukhulelwa ngifundise ngesifo sikashukela, kanye nenye i-(nobe kungazuzi) isisindo abesifazane.

Kukholakala ukuthi uma kukhona nemingcele ultrasound futhi kwegazi ngaphakathi kwemikhawulo evamile, khona-ke ingane kungenzeka uvumelane. Isimo obuhlukile iyona isisekelo kucatshangwa ingozi pathologies eziningi, kodwa ngesisekelo ukuhlolwa noma Udokotela Wabesifazane akusho ukuxilonga. Kulokhu, udokotela ekwelapheni uncoma okwengeziwe nolunye uvivinyo (amniocentesis, uchwepheshe ultrasound futhi cordocentesis), kusuka lapho abazali banelungelo lokwenqaba ukuya.

izifo kunokwenzeka

Kusukela ekuqaleni kuka-14 kuze kube sekupheleni kwesonto lama-27 kuyinto senyanga yesibili. Screening abesifazane abakhulelwe kuphakamisa ukukhathazeka, ngoba imiphumela yocwaningo kungaba engozini. Ayikho osizini mkhulu kuno ukugula kwengane, ngisho engakazalwa.

Izifo ukuthi odokotela basikisela imiphumela yokuhlola kathathu:

1. Down Syndrome. Kubonakala ngokushesha ngemva umuntu ekhulelwa, lapho iqanda noma Isidoda chromosome eyengeziwe. Ngakho, esikhundleni chromosome 46 umbungu 47 Kumiswa (ngokweqile - imizuzu 21 pair). Amathuba Down syndrome 1-1.5%. Ukubikezela isifo kusengaphambili akunakwenzeka, kodwa ngokwezinga elincane ku ukubukeka kwayo kuthinta yobudala kamama.
2. Edwards 'syndrome. Kukhona esifana-Down syndrome, kodwa le-chromosome eyengeziwe kuyinto umbhangqwana 18th. Singazalwa ngasikhathi izingane eside zifane ngaphambi kwesikhathi: ababuthakathaka, kubuhlungu futhi incane kakhulu, zinokukhubazeka eziningi zomzimba izingxenye kanye izitho zangaphakathi. Izingane sifo Edwards kuyaqabukela ephile iminyaka kuze kube usuku lokuzalwa lokuqala. Amathuba isifo - 1 ku 5000 izinsana.
3. Neural tube isici. Ngosuku lama-20 okukhulelwa, neural tube - lokuqala ngesimo ipuleti. Ngemva kwezinsuku ezimbalwa ama-ke kufanele ukoma up ibe tube. Le nqubo ithatha ngokushesha impela, futhi ukulungisa inkinga kusaqalwa akunakwenzeka. Neural tube is ngokuphelele angilali noma niguquke kamuva, ngenxa yalokhu, ingane umbhunu futhi ngine-spina bifida.

Izinsuku ukuhlolwa yokukhulelwa wesibili akhethiwe ukuze ukuthola lezi zamehlo.