Miedzo ye Ultrasound
Nenguva yokutanga ultrasound inowanikwa panguva yekurapa kwemukadzi kune chiremba. Muchikamu chekutanga (vhiki 5-6), chinangwa chikuru chekudzidza ndechekuziva kana chiri pamuviri kana ectopic pamuviri. Nguva inotevera, inomanikidzirwa ultrasound inoitwa kwemaawa gumi kusvika ku13. Kana mukadzi akawana kuti ane pamuviri panguva ino, ipapo chipiri chekugadzirisa chinangwa chinova chekutanga mumutsara. Izvo pamusoro pekuongorora-ultrasound - chidzidzo chinogona kuisa njodzi yekusawirirana mumwana. Panguva ino, unogona kuziva 2 congenital chromosomal zvirwere - Down syndrome uye Edwards syndrome. Mumazuva manomwe anotevera, zvakajeka zuva rimwechete, kuitira kukwana kwemigumisiro, amai vakatarisira vanofanira kuongorora maitiro ezvinyorwa, izvo zvinonzi "kuongorora kaviri". Kuti uite izvi, iwe uchada kugovera ropa kubva mumutsipa. Kana, zvichibva pamigumisiro yezvidzidzo zviviri izvi, dambudziko guru rekukanganisa mumwana rinoonekwa, chiremba achakurudzira kuongorora chirwere chisati chaitika (panguva iyi, amniotic fluid kana cord ropa inotorwa kuongorora chromosome yakagadziriswa uye kujekesa kuongororwa). Chipiri chekuongorora kwechirongwa chetachiona ndeyekupera kwevhiki 20-22. Zvigumisiro zvaro zvinowanikwa muchidimbu nemigumisiro yezvinyorwa zvehupenyu (ikozvino inonzi "kuongorora katatu": inobvumira kuonawo chechitatu chromosomal disorder - neural tube defect), iyo inoitwa kwemaawa masere kusvika ku21. Iyo yekupedzisira yakagadzirirwa ultrasound inoitwa pavhiki 32. Inotarisirwawo nekuona maitiro akaipa, asingaoneki nekuda kwekuti mwana akanga achiri muduku. Munguva ye ultrasound, vanachiremba vanoongorora maitiro akasiyana-siyana anofanirwa kufanana nekureba kwehutumbi: ukuru hwechibereko nechecheche, inzwi re myometrium, chiyero chekutsvaga kwepentecenta, chiyero che amniotic fluid. Ongorora sangano remukati memwana, chinzvimbo chemubilical cord.
Doppler
Iyi nzira ye ultrasound diagnostics inoita kuti zvive nyore kuziva kana mwana wacho anodyiswa zvakakwana zvinokonzera uye oksijeni kubva kuna amai. Panguva yekuongororwa, vanachiremba vanoongorora zviitiko zvekuyerera kweropa muutteriti, tambo uye pakati peperesi yeropa yemwana. Sezvo wakaziva, pamhepo ipi inokurumidza ichiyerera nemidziyo, inogona kupedzerwa nekukurumidza uye mune zviyero zvakadini masikirwo uye okisijeni zvinouya kumucheche uye kana zviyero izvi zvinoenderana nemutambo wekuita pamuviri. Kudzidza kunoitwa muzvikamu zviviri. Kutanga, chiremba wega wega anoongorora imwe neimwe yemarriyuta matatu achishandisa mishoni ye ultrasound. Kana chifananidzo chacho chichioneka pachikona, chinoshandura pa sensor (Doppler), iyo inoyera kuwedzerwa kweropa, kupikisa uye kushorwa kwemudziyo. Kuongororwa kwehutano hwekubuda ropa kucharatidza kuti chii chinetso chichaitika panguva yekuzvitakura. Saka, kana mwana asina zvokudya zvakakwana, anogona kuberekwa ane uremu hushoma. Maererano nekupupurira kwechiremba, somuenzaniso, kana pane zvipingamupinyi munguva yepamuviri yepakutanga, Doppler inogona kuitwa kubva pavhiki 13. Muitiro wakazara uye pasina mubvunzo kuongororwa kunorayirirwa kumudzimai wese ane pamuviri munguva inobva kubva kuma22 kusvika kuma24. Kana chiremba achiratidza dambudziko rekuyerera kweropa, iye achapa chidzidzo chechipiri.
Cardiotocography
Chidzidzo chacho chinosanganisira kuongorora 2 zvidimbu - huwandu hwomwoyo hwecheche yemwana uye hutachiona hweutterine. Vanoyera 2 masero, ayo anonamatira kumangwana amai vari mudumbu. Yechechitatu iri muruoko rwake, kuvhara bhodhi nguva dzose kana mwana achifamba. Icho chinonyanya kukosha: nzira yekuongorora kuchinja kwekushaya moyo kwemu mwana mukupindura kutenderera kwomuviri wake. Chinangwa ndechokuwana kana oxygen yakakwana inopiwa kumwana. Iyi nzira inoshanda sei? Apo patinenge tichifamba (tinomhanyira, tinoita gymnastics), tine kukurumidza kwemoyo. Ichi chinonzi chinonzi reflex cardiac, inoumbwa nevhiki ye30 yekuzvitakura. Kana tisingakwanisi okisijeni yakakwana, mutemo we mwoyo unowedzera, uye nhamba yezvirosi paminiti ichapfuura yakazara. Kuchinja kwakadaro kunogona kuteverwa kumwana. Asi munyaya yacho kana akareba asingashayi okisijeni, muviri wake uchaita zvakasiyana. Nokuponesa simba, mwana acharamba achifamba zvishoma, uye pakupindura kufamba, kupisa kwake kunononoka. Zvisinei, mumatambudziko acho ose, kuongororwa ndomumwe: fetal hypoxia (kusakwana kwe okisijeni), kungosiyana nezvidimbu. Semitemo, panguva yekuzvitakura, yechipiri senzwi, kuongorora inzwi rechibereko, hachiwanzoshandiswa. Asi panguva yekuzvarwa, anopa chiremba anokosha ruzivo, kuratidza kuti hondo dzinowanzoitika sei, chii icho simba ravo uye nguva. Kana ivo vasina simba, munogona kuisa madhiragi kuti muwedzere. Mukufananidza, kutarisa kuchinja mumoyo wemwana, vanachiremba vanokwanisa kuona nekudzivirira mamwe matambudziko munguva. Saka, kana vakaona kuti mwana haana oxygen yakakwana, zvichida haazokwanisi kurwisa kuberekwa kwezvisikwa, uye ipapo achazoita chikamu chekudzivirira. KTG inofanira kupfuudzwa kamwe chete, pavhiki ye 34. Zvisinei, vananyamukuta vakawanda vanokurudzira vakadzi vose kuti vaite chidzidzo ichi mazuva gumi nemasere kubva pamakumi matatu evhiki, pakarepo mwana paanotanga reflex yemoyo. Pakutanga mwana wacho anowanikwa ane hypoxia, nguva yakawanda icharamba ichirapa. Mune zvimwe zvipatara, unogona kukwereta ktg device uye unofambisa chidzidzo pamba, kutumira mhinduro kuburikidza nevhidhiyo kune chiremba uyo achaongorora mamiriro acho kure.