Ukuphuhliswa kweyeza kuye kwanceda ekunciphiseni kakhulu ukufa kwabantwana, kodwa ukuphuhliswa kwamhlanje kungabaninzi - ukuchaza kwangaphambili ukuba kukho izifo ezinzulu. Kule njongo, ukuhlolisiswa kusetyenziswe, yintoni kwaye yenziwe nini, kungcono ukudibanisa ngakumbi iinkcukacha.
Yintoni ukuhlola?
Ngexesha lokukhulelwa kwaye emva kokubeleka kokukhawuleza, ukuhlolwa kovavanyo kuyadingeka ukuvavanya ingozi kwimpilo yengomama nosana oluzayo. Ezi vavanyo ziqhutywa ngamaxesha amaninzi ukuba zibe nezibonakaliso ezinamandla. Akuyimfuneko ukungathandabuzeki ukuba ukuhlolwa kuyimfuneko, yintoni na kwaye inkqubo ingalimaza umntwana, kuba iyacetyiswa ngu-WHO. Olu bunzima bezinyathelo ezilula aluncedo, kwaye lunokusindisa kwiingxaki ezinzulu.
Ukubonwa kwangaphambi kokubeletha - yintoni na?
Ngexesha lokugaya, kuyadingeka ukuba ulawulwe inkqubo yokwenza imbungu ngexesha lokuba uqaphele ukuphulwa okunokwenzeka. Ukuhlolisiswa kwabasetyhini abakhulelweyo kuqhutyelwa nganye kwinyanga enyanga ezintathu, inani kunye neendidi zeemvavanyo zichonga ngabanye. Udokotela angathumela iimvavanyo eziphindaphindiweyo okanye ezongezelelweyo. Xa ukuhlolwa kwenziwa, yintoni na, kwaye yintoni inkqubo enyanzelisayo kufuneka ilungiselelwe, ngamnye umfazi kufuneka azi. Oku kubaluleke kakhulu kwabo basengozini. Ezi zilandelayo zichazwe apha:
- uneminyaka engama-35 ubudala;
- kukho abantwana abanechromosomal ezingaqhelekanga;
- ezingaphezulu kwezimbini ezilandelelanayo;
- ukumkela amayeza angozi kwiinyanga ezi-3 zokuqala;
- umtshato phakathi kwezihlobo eziseduze;
- usongelo olude lokukhulelwa kwesisu;
- irradiation yabazali ngaphambi kokukhulelwe.
Ukuhlola i-Neonatal
Le nkqubo kufuneka iqhutywe kuwo onke amakhaya okubeleka, ukuhlolwa okuninzi kukuvumela ukuba ubone izifo ezizalwe ngumntwana kunye nezifo. Ukuhlola iintsana ezisanda kuzalwa kunika ithuba lokufumana unyango. Inkqubo yenziwa ngamanqanaba ambalwa:
- ukuhlolwa kwegazi kuthathwe kwisithende somntwana;
- vavanyo lwamazwi;
- uphando oluphindaphindiweyo;
- Ukutyelela iingcali ezincinci xa kukho iingxaki.
Kutheni kuhlolwa?
Injongo yoluphi uphando lubonakalisa izifo ezikhoyo okanye iingozi zabo. Xa umntwana ekhulelwe, into yesibili iya kuqala. Oku kunyanisekileyo xa ukuhlolwa kwesibini kwenziwa ngexesha lokukhulelwa, iziphumo zalo azihlali zichanekile, ngoko iimpawu ze-alamu zidinga ukuhlaziywa ezinye iindlela. Ukungawuthobeli ngokupheleleyo le zifundo akukufanelekanga, kuba kunye nokufakela kwangaphakathi ukuzala nawuphi na umntwana ukuqonda le meko kuza kunceda ukulungiselela ubunzima obunokwenzeka.
Ukuhlolwa kwe-Neonatal , eyenziwa kwiintsuku zokuqala zobomi bomntwana, kunobulungisa ngakumbi kwaye kunceda ukuchonga ubukho besifo. Kuphephe ukuba akuyimfuneko, ezininzi iingxaki zokuxilongwa kwangaphambili zilawulwa kangcono. Ngaphandle kwezifo ezinzima, amathuba okuphucula imeko ayenyuka kakhulu xa ukungaqhelekanga kubonakala kule minyaka.
Ukukhulelwa kokukhulelwa
Ukuphuhliswa kwe-Fetal kuyadingeka ukuba ihlolwe rhoqo, ngoko iimvavanyo zenziwa kwi-trimester nganye:
- Uvavanyo lwegazi lwe-Ultrasound kunye ne-biochemical.
- Ultrasound. Igazi lingahlolwa ukuba ukukhulelwa kokuqala kwakunanyanzelwanga. Ukwaziswa kobuchule bubububuxoki kule nqanaba, ngoko ke, izigqibo ezigqibeleleyo kwisiseko asizenzi.
- Ultrasound. Ekufumaneni ukungaqhelekanga okuphuculweyo, i-Doppler kunye ne-cardiography ingasetyenziselwa ukungezelela.
Ukuhlolwa kwezinto eziphilayo
Kulo sifundo, igazi legazini liyathathwa, elifunyenweyo kusasa kwisisu esingenanto. Ekubeni bavavanya kwi-trimester yokuqala, isiphumo saso sibonisa iingxaki ezinokwenzeka, kwaye asiba isigwebo. Uvavanyo luyenziwe kubakishi ababini:
- In-hCG - inceda ukugcina nokuqhubeka nokukhulelwa.
- I-RARR-A - inoxanduva lokuphendula ngokumkhusela komzimba womfazi, umsebenzi kunye nokwakhiwa kwepentecenta.
Umxholo okongezelelweyo we-B-hCG unokuthetha ngawo:
- toxicosis ngaphambi kwesikhathi;
- I-Down's syndrome kunye nezinye iinguqu ze-chromosomal;
- ukukhutshwa kwexesha lokukhulelwa ngokungalunganga;
- iswekile sesifo sikashukela;
- buninzi .
Umxube ophantsi we-B-hCG ubonisa:
- ukukhulelwa kwe-ectopic;
- ukungenakunyaka;
- Isifo se Edwards ;
- umngcipheko wokukhulelwa kwesisu.
Ukuphambuka kwe-PAPP-A kubonisa ukuba kungenzeka:
- utshintsho lwe chromosomal;
- ukukhipha isisu;
- ukuvimbela ukukhulelwa;
- syndromes monogenic.
Ukucima i-ultrasound
Iimvavanyo ze-ultrasound zilungiswe kwinqanaba ngalinye lesigxina, iziphumo zokuhlola zivumelekile ukuba zibone ukubunjwa kwezinto ezingaqhelekanga ekubunjweni komntwana. Ukuchazwa ngokuchanekileyo koko ubonayo, udinga isifundo esiphakamileyo kumgqirha, ngoko ke, xa kukho ukungathandabuzeki, kungcono ukujonga isigqibo ngenye ugqirha. Kwi-trimester yokuqala, amanqaku alandelayo ahlolwa:
- Ubunzima bekhola yendawo - ngakumbi xa ikhudlwana, iphakamileyo amathuba okuba ne-pathology.
- Ubude bethambo lesangasenokubonisa ukuguqulwa kwe-chromosomal, kodwa kufuneka kuqinisekiswe ziziphumo zeemvavanyo ezisele.
Kwi-trimester yesibini, isifundo senziwa kuphela kwisisu esiswini, senziwa ngeenjongo ezininzi:
- Ukuvavanya kwe-fetus anatomy yokufumanisa izifo eziphuhlisayo.
- Ulungelelaniso lwezinga lophuhliso kunye nexesha lokukhulelwa.
- Ukucacisa ukuveliswa komntwana .
Kwi-trimester yesithathu, ingqalelo eninzi ihlawulwa kwiimeko ezinzima zokukhusela kunye nokukhawuleza kokukhula kokukhula komntwana, kuba ekupheleni kwexesha elingaphelanga libonakala libalahleko, eziphambili zifunyenwe ngaphambili. Ngethuba lokufunda, ugqirha ujonge:
- ubukhulu be-trunk kunye nentloko (kufuneka ukucwangcisa ubunzima bomntwana);
- inkqubo ye-genitourinary;
- ingqondo;
- izitho kwisisu;
- umqolo;
- umhlathi, i-orbit kunye nasolabial;
- indlela yokuziphatha;
- urhulumente wezitho zokuzala zomama.
Ukuhlola ukukhulelwa - ixesha
Kubalulekile ukuba umama wesikhathi esizayo angazi nje ukuba yintoni "ukuphonononga", kodwa ukumela imida yexesha layo. Iimvavanyo zixhomekeke kakhulu kwixesha lokukhulelwa, ukuba le ngongoma iyalahlwa, ngoko kunokwenzeka ukuba kuncitshiswe ngokukhawuleza ukuphumelela kokufundwa okanye ukufumana iinkcukacha zobuxoki.
- I-trimester yokuqala -kuba iimviwo zithunyelwa kwiiveki ezili-11 ukuya kwe-14, kodwa iingcali zikholelwa ukuba ixesha elifanelekileyo lixesha eli-12 ukuya kweeveki.
- I-trimester yesibini - ixesha elifanelekileyo lokujonga ukukhulelwa kweli nqanaba liiveki ezingama-16 ukuya kwe-20.
- Izifundo eziyesithathu zintathu ziqhutyelwa kwiiveki ezingama-30-34, ixesha elifanelekileyo lingama-32-34 iiveki.
Ukuxilongwa kwintsana
Emva kokugqithisa unyango ngexesha lobuncinci, abafazi abahlali befuna ukuqonda okokuvavanywa kwintsana. Abanye bathembela kwiimvakalelo zabo, belibala malunga nokubonakala kwezifo emva koko. Uhlalutyo olulula kwiintsuku zokuqala zobomi bentsana lunokuveza iingxaki ezinzulu kwaye zinike ithuba lokuphucula. Ukuhlolisiswa komntwana kwenziwa kwiinqanaba eziliqela, ukunika abazali ulwazi olusisiseko ngempilo yakhe.
Ukuhlola iintsana kwiintsholongwane
Uvavanyo lokuqala oluyimfuneko ludla ngokuba luthi "ukuhlolwa kwesithende", kuba apha ukusuka apha igazi lithathwa kuphando. Ukuba iimpawu ezifunwayo zifunyenwe, iimvavanyo ezongezelelweyo zenziwa. Ukuhlolwa, iimiqathango zazo zivame ukukhuliswa ngezifo ezitsha, kucetyiswa kubo bonke abantwana, ukuba bengabanjwanga kwikhaya lokubeleka, abazali kufuneka bazisebenzise ngokwabo. Ngenxa yolu vavanyo, iingxaki ezilandelayo ziza kugqitywa.
- I-Phenylketonuria - iimpawu zivela emva kweenyanga ezili-6, imiphumo ingabangela ukuphazamiseka kwengqondo. Ukuba ifunyenwe ngexesha, kunokwenzeka ukukhusela ukuphuhliswa ngonyango lokutya.
- I-cystic fibrosis - ukuphulwa komsebenzi wokuphefumla kunye nokugaya ngenxa yokungahambi kakuhle kwezigulane zangaphandle. Ukutya kunye ne-enzyme yepascreas zisetyenziselwa ukumisela imeko.
- I-Galactosemia - ayigcini i-carbohydrate yobisi, ekhokelela kwizilonda zesibindi, inkqubo yesantya, amehlo. Kwiinyanga zokuqala zobomi kaninzi kuba yimbangela yokufa, abantwana abasinda ngaphandle kokonyango bayakhubazeka.
- I-Adrenogenital syndrome - idinga uncedo olukhawulezileyo, ngaphandle kokuba umngcipheko wokufa uphakeme.
Ukuhlola i-Audiological
Ukufumanisa ukuphazamiseka kokuvalelwa kwiintsana ezisanda kuzalwa, indlela yokuchithwa kwe-otoacoustic isetyenzisiweyo, ibonisa nokuba kuncipha okuncinci kuluvo lwalo lungu. Ukuphononongwa kwenkcazelo kubonisa ulwazi malunga nesidingo sokuqhubeka nomsebenzi nomntwana. Izifundo zibonisa ukuba i-prosthetics kwi-3-4 degree yelahleko yokuvalelwa kwiinyanga ezili-6 inceda ukuphepha ukulibaziseka kwintetho nokuphuhliswa kolwimi kwabantwana. Ukuba izixhobo zengxoxo zisetyenziswe kamva, ngoko kuya kubakho umva. Ngenxa yesi sizathu, isifundo siyanconywa kumhlathi onyanzelekileyo.
Ukuhlolwa kwesantya kwintsana - iintsuku
Ubuchule obuphezulu buhluke kuphela ekuhlolweni, ixesha lokudibana nalo. Ukuhlolwa kwegazi kwenziwa ngomhla we-4 kusasa (kwiintsana zokuqala - kwi-7) emva kweeyure ezintathu emva kokutya. Iziphumo ziyaziwa zingadlulanga iintsuku ezili-10 emva kokuzalwa. Ukuba kukho iingxaki, kuya kufuneka iimvavanyo ezingaphezulu. Uvavanyo lokuvavanywa lwenziwa emva kweentsuku ezi-4 zobomi, iimpazamo zangaphambili ziyakwenzeka. Ukuba umphumo ombi ufunyenwe, uvavanyo luphindaphindiwe emva kweiveki ezi-4-6.