Kuchengetwa kwevakadzi vane pamuviri kuti vaone chromosomal kusagadzikana kwema fetus, kuonekwa kwepabonde

Dzimwe nguva zvinoratidzika kuti vanaamai vamangwana mwedzi mipfumbamwe chete vanoita izvo zvavanoenda kuna vanachiremba, vanotora miedzo uye vanoita zvidzidzo zvakasiyana-siyana. Uye nei zvakakodzera chete? Kune huwandu hwezvidzidzo zvinoita kuti pave nehutano hwekuva nemwana ane zvirwere zvakadai seArt's syndrome, Edwards syndrome uye zvakanyanya kufambira mberi anomalies, izvo zvinoratidzwa pamatambo ekutanga ekudzivirira. Icho chiri kutarisa kwepabonde. Munguva yedu, kazhinji kacho yakatanga kutarisa vakadzi vane pamuviri kuti vaone chromosomal kusagadzikana kwema fetus, kutariswa kwepabonde.

Chii ichi?

Pakati pevose vanotarisira vanaamai vakamboongororwa, boka revakadzi rinozivikanwa, avo vane misiyano yakasiyana zvakanyanya kubva pane zvakasikwa. Izvi zvinoratidza kuti mumwana wavo wakaberekwa mukana wekuve nehutachiona kana zviremera zvakakwirira pane zvevamwe. Kuongororwa kwepabonde nderekuoma kwezvidzidzo zvinotarirwa kuona hutachiona husina kunaka kana kuti hutachiona hwekukura kwehutano. Iyo yakaoma inosanganisira:

♦ Kuongorora kwehupenyu hwepanyama - kuongorora ropa kunokubvumira kuti uone kuvepo kwezvinhu zvakananga ("markers") muropa iro rinoshanduka mune zvimwe zvirwere, zvakadai seA Down's syndrome, Edwards syndrome, uye neural tube kuputsika. Kuongorora maitiro ezvinyorwa chete ndeyekusimbisa kwezvingaita, asi kwete kuongororwa Naizvozvo, pamwe naye kutsvakurudza kwakawedzerwa kuri kuitwa;

♦ Kuongorora kwe Ultrasound (ultrasound) - kunoitwa mumamiriyoni matatu ekudzivirira uye kunobvumira kutsvaga huwandu hwakaremara hwemaatomical uye kusagadzikana kwekukura kwomwana. Kuongororwa kwepabonde kunosanganisira zvikamu zvakasiyana-siyana, chimwe nechimwe chakakosha, sezvo chinopa ruzivo pamusoro pekusimudzirwa kwomwana uye zvinogona kuitika matambudziko.

Njodzi dzinokonzera kukura kwehutachiwana mumwana asati aberekwa:

♦ Zera remukadzi rinopfuura makore 35:

• kuva nemimba miviri inokonzera pamuviri panguva yekutanga yekuzvitakura;

• kushandiswa musati mambakadzi kana mumatangiro ekutanga ekudzivirira kwemaitiro akawanda ezvokugadzira zvemishonga;

• Kutakurwa naamai vanotevera bhakitiriya, zvirwere zvehutachiwana;

♦ kuvapo mumhuri yemwana ane mazita anogadziriswa Down's syndrome, mamwe zvirwere zvechiromosomal, kuberekwa kunokanganisa;

♦ motokari yemhuri ye chromosomal isina kukodzera;

• zvirwere zvenhaka mumhuri pfupi;

• kusvibiswa kwemhepo kana zvimwe zvinokuvadza kune mumwe wevakaroorana vasati varoora.

Chii chinotsvakurudza kuongorora kwezvinhu zvehupenyu?

• Free subunit yevanhu chorionic hormone (hCG)

• RARP A inotora pamuviri-inosanganisira plasma proteinine A.

HGH hormone inobereka masero embryo shell (chorion). Ndiko kuongororwa kweHCG kuti mimba inogona kutsanangurwa kare pazuva rechipiri-3 mushure mokuberekwa. Nhamba yehomoni ino inowedzera mu 1 trimester uye inosvika pakukwirira kwayo kwemavhiki 10-12. Zvakare, zvishoma nezvishoma zvinoramba zvishoma nezvishoma uye zvinoramba zvichingoitika mukati mehafu yepamuviri. IHCG hormone ine maundi maviri (alpha uye beta). Chimwe chazvo chinoshamisa che beta, chinoshandiswa pakuongorora.

Kana nhamba yeHCG yakakwirira, inogona kutaura nezve:

• Kuwanda kwemashure (zvinodiwa zveHCG zvinowedzera zvichienderana nenhamba yezvibereko);

• Down's syndrome uye zvimwe zvirwere;

♦ Toxicosis;

♦ chirwere cheshuga mumama anouya;

♦ izwi risina kururama rakakonzerwa nepamuviri.

Kana uwandu hweHCG hwakadzika, hunogona kutaura nezve:

• kuvapo kwe ectopic pamuviri;

♦ Kubata pamuviri usina kukudzirwa kana kutyisidzika kwekubvisa pamuviri pakarepo;

♦ kunonoka kukura kwevana remangwana;

♦ kutadza kukwana;

• Kufa kwekufa (mune II-III trimester yekuzvitakura).

Inotaridzwa nehuwandu hwotevera:

MoM - kukosha kwechiratidzo mune serumisi yakakonzerwa nehuwandu hwemukati hwechiratidzo chenguva iyi yekudzivirira. Chimiro ndicho kukosha kwechiratidzo chiri pedyo nekubatana.

Pane zvinhu zvakawanda zvinogona kukanganisa kukosha kwezviratidzo zvakawanikwa:

♦ kurema kwemukadzi ane pamuviri;

♦ Kusvuta;

• kutora mishonga;

• nhoroondo yechirwere cheshuga mellitus mumai anouya;

• pamuviri nekuda kweVIVF.

Nokudaro, paunenge uchiverenga zviitiko, vanachiremba vanoshandisa maMM anodiwa. Kufunga nezvezvinhu zvose uye zvinhu. Nhamba yeMM ranges kubva ku 0.5 kusvika ku2,5. Uye munyaya yekuwanda kwemimba, kusvika ku 3.5 MoM. Zvichienderana nemigumisiro yakawanikwa, zvichave pachena kana amai vari kumangwana vari pangozi yechromosomal pathologies kana kwete. Kana zvakadaro, chiremba achapa mazano ekutsvakurudza mberi. Hazvisiko kuzvidya mwoyo kare kana iwe wakapiwa kuongororwa kwechipiri chetatu - zvinokurudzirwa kuti vakadzi vose vane pamuviri vaongororwe, pasinei nemigumisiro yekutanga kwekuongorora. Mwari anochengetedza rakachengeteka!

II Trimester Ongororo

"Triple test"

Inoitwa kubva kuma16 kusvika kuma20 vhiki yekuzvitakura (nguva yakakwana kubva pamakore 16 kusvika pa18 vhiki).

Kubatanidza kuongorora

• Ultrasound kuongorora (kushandisa data yakawanikwa mumutatu wekutanga);

• Kuchengetedza kwezvinhu zvepanyama;

• kuongorora ropa kune AFP;

Free Estriol;

• chorionic gonadotropin (hCG). Kuongororwa kwechipiri kunosanganisira kuisa njodzi yekuva nemwana ane Down's syndrome, Edwards, neural tube defect nezvimwe zvisipo. Munguva yekuongorora kwechipiri, kuongorora kwehomoni ye placenta uye chiropa che fetus che fetus, iyo inotakurawo ruzivo rwakakosha pamusoro pekusimudzirwa kwomwana. Iko mahomoni e "kuongorora katatu" uye chii chinoratidzwa nekuwedzera kana kuderera muhuwandu hwavo muropa? NeHommone HCG yakatotaurwa pamusoro apa, asi imwe yacho inoda kutsanangurwa.Alfa-fetolrothein (AFP) ipuroteni iripo muropa recheche Matanho ekutanga ekugadzirwa kwemumvuri. Yakagadzirirwa muchiropa uye mukati memakumbo emucheche. Chiito che alpha-fetaprotein chinangwa chekuchengetedza fetus kubva mumuviri wemukirini.

Kuwedzera kwehuwandu hwe AFP kunoratidza kuvepo kwekuvapo:

♦ nhoroondo ye neural tube ye fetus (anencephaly, spina bifida);

♦ Meckel syndrome (chiratidzo-occipital craniocerebral hernia;

♦ esophagus atresia (hutachiona hwekukura kwe fetal, apo inophagus mu fetus inopera, isingafi kusvika mudumbu (mwana haagoni kutora mumuromo) 1 ";

♦ umbilical hernia;

♦ kwete rudo rwemukati rwemadziro emadziro emufusi;

♦ Fetal chiver necrosis nemhaka yehutachiona hwehutachiona.

Kuderedza uwandu hwe AFP inoratidza kuti:

♦ Down's syndrome - trisomy 21 (mushure memavhiki gumi ekuzvitakura);

• Edwards syndrome - trisomy 18;

• kusanzwisiswa kunotsanangurwa kubata pamuviri panguva (yakakura kudarika yekutsvakurudza);

♦ rufu rwemucheche.

• Miitiro yeAAFP muSerum

Free Estriol - iyi hormone inobereka pakutanga placenta, uye gare gare chiropa che fetus. Munzira yakajairika yepamuviri, uwandu hwehomoni iyi hunoramba ichikura.

Kuwedzera kwehuwandu hweEliriol kunogona kutaura nezve:

♦ Kubata pamuviri;

• chibereko chikuru;

♦ chirwere cheropa, chirwere chepfungwa mumai anouya.

Kupera muzinga reestriol kunogona kuratidza:

• fetoplacental insufficiency;

♦ Down's syndrome;

♦ Anencephaly we fetus;

• kutyisidzirwa kwekusununguka nguva isati yasvika;

♦ Adrenal hypoplasia ye fetus;

♦ utachiona hwemukati. Maitiro eestriol mu serum.

Ultrasound III Trimester Kuongorora

Inobviswa kubva pamakore makumi matatu nemakumi matatu kusvika pamakumi matatu evhiki ekuberekwa (nguva yakanakisisa inobva pamakumi matatu nemakumi matatu nemaawa matatu). Iyo ultrasound inoongorora mamiriro uye nzvimbo ye placenta, inotarisa kuwanda kweamniotic fluid uye nzvimbo ye fetus mubereki. Maererano nezviratidzo, chiremba anokwanisa kupa zvidzidzo zvakare - dopplerometry uye cardiotocography. Doppler - tsvakurudzo iyi inoitwa kubva pamasvondo makumi maviri nemaviri ekuberekwa, asi kazhinji vanachiremba vanorayira mushure mevhiki ye30.

Zviratidzo zvekuita:

• fetoplacental insufficiency;

• kusakwanika kuwedzerwa kwehupamhi hwehumi hwe uterine fundus;

♦ Kudzingiswa kwembambo yembilical;

♦ gestosis, nezvimwewo.

Doppler inzira inonzi ultrasound iyo inopa ruzivo pamusoro pehutachipa ropa. Kuwedzerwa kweropa kunopinda mumidziyo yechibereko, muromo wembilical, katikati yecherebral arteri uye aorta ye fetus inotsvakurudzwa uye inofananidzwa nemitengo yenguva ino. Maererano nemigumisiro, mhedziso inofungidzirwa pamusoro pekuti ingave fetus ropa inowanikwa here, kana pane kushayikwa kweokisijeni nemuviri. Kana zvichidikanwa, zvinodhaka zvinorayirwa kuti zvivandudzire ropa rinobva kune placenta. Cardiotocography (CTG) inzira yekurekora fetal heart rate uye kushanduka kwayo mukupindura kwezvipembenene zveuite. Inokurudzirwa kupedza kubva pamusika wevhiki 32 wekudzivirira. Iyi nzira haina zvinyorwa. CTG inoitwa pamwe nekubatsirwa kwe sensor ultrasonic, iyo yakagadzirirwa pamimba yemukadzi ane pamuviri (kazhinji anoshandiswa kunze, iyo inonzi yakananga CTG). Nguva ye CTG (kubva pamaminitsi makumi mana kusvika makumi matanhatu) inobva pane zvikamu zvebasa uye zororo rekuberekwa. CTG inogona kushandiswa kuongorora mamiriro emwana uye panguva yekuzvitakura, uye munguva yekuzvarwa kwayo pachayo.

Zviratidzo zveTCTG:

♦ chirwere cheshuga mumama anouya;

• Kubata neHan factor;

♦ Kuona antiphospholipid antibodies panguva yekuzvitakura;

♦ kunonoka pakukura kwekukura.

Chiremba anorayira kuongorora uye (kana zvichidiwa) anorayira kuongorora zvakare, asi haafaniri kutora chisarudzo chemukadzi. Vanaamai vakawanda munguva yemberi vanoramba kurongedza zvidzidzo, vachikakavadzana kuti vachazoberekera mune chero zviitiko, pasinei nemigumisiro yekudzidza. Kana iwe ukapinda munhamba yavo uye usingadi kuongorora, ipapo iyi ndiyo yako yakarurama, uye hapana munhu anogona kukumanikidza. Basa rechiremba nderokutsanangura kuti sei kuongorora kwepabonde kuchiitwa, izvo zvinowanikwa zvinogona kuitwa sechigumisiro chekutsvakurudza kunoramba kuripo, uye kana zviitiko zvisingakanganisi nzira (chorionic biopsy, amniocentesis, cordocentesis), taura nezvengozi dzinogona kuitika. Pashure pezvose, njodzi yokubvisa pamuviri mushure mekuongorora kwakadaro inenge 2%. Chiremba anofanirawo kukunyevera pamusoro peizvi. Zvinosuruvarisa, vanachiremba havasi nguva dzose vaine nguva yekutsanangura muchidimbu zvibereko zvekuongorora. Tinovimba kuti munyaya ino takakwanisa kujekesa zvimwe zvikamu zvekudzidza uku kwakakosha.