Ukuhlolwa kokuqala kokukhulelwa kukufunda okwenzeni umama ozayo. Kujoliswe ekuboniseni ukungasebenzi kwemfesane, ukungaphumeleli. Iziphumo zeso sifundo zinokuthi zihlolwe kuphela ngugqirha obona ukukhulelwa.
Uluphi uvavanyo lwesithathu?
Uvavanyo lokuqala luhlolo olubanzi lwe-fetus, olubandakanya i-ultrasound kunye nesifundo sezinto eziphilayo ngegazi lomama ozayo. Ukukhulelwa konke oku kunokwenziwa kathathu, 1 ixesha kwi-trimester. Kwiimeko ezininzi, ukuhlolwa kwe-ultrasound kuphela okufunekayo. Ukuba ugqirha ugxeka ukuphulwa, ukuphambuka kwimiqathango, ngaphezu koko, uvavanyo lwegazi luya kwenziwa.
Ukuze ufumane umphumo wokukora kwaye uguqule ngokuchanekileyo idatha, ugqirha kufuneka athathe iingqalelo kwiiparitha eziliqela, ezifana nokuphakama, ubunzima bomfazi okhulelweyo, ubukho bemikhwa emibi, enokuchaphazela iziphumo zesifundo. Ngaloo nto engqondweni, owesifazane okhulelweyo akafuneki ukuzama ukucacisa okokuqala ukuhlolwa okwenziwa ngexesha lokukhulelwa kwakhe.
Kutheni kubalulekile ukuhlola ukukhulelwa?
Ukuphonononga kwe-trimester yokuqala kuvumela amaxesha amanyathelo okuphuhliswa kwe-intrauterine ukuchonga ukuphambuka okwenzekayo ekubunjweni kwamalungu angaphakathi, ukufumanisa izifo zofuzo. Phakathi kweenjongo eziphambili zoviwo olunzulu olunokuthi umfazi okhulelweyo unokuqatshelwa:
- ukupheliswa kokukhulelwa kwe- ectopic ;
- ukuzimisela inani lamabele kunye nesisu;
- ukuvavanya iiparameters ezisisiseko zobomi bokutshatyalaliswa - ukubala kweentliziyo, ukuphulaphula izandi zentliziyo;
- inkcazo yemimiselo yenyama yophuhliso lolutsha;
- uviwo lwe-anatomical of the fetus (ukufumanisa iziphene ekuphuhliseni);
- Uviwo lwe-placenta kunye nokuchongwa kokungasebenzi kwayo.
Ukuhlolwa kokuqala ngexesha lokukhulelwa akuyi kugqiba isifo esithile kumntwana, kodwa kubonisa kuphela iimpawu zayo, iimpawu. Iziphumo ezifunyenweyo ziyisiseko sokwenza uphando olongezelelweyo, isabelo seengcali zee-laboratory ezongezelelweyo. Emva kokufumana zonke iinkcukacha eziyimfuneko sisigqibo esenziwe, ukuxilongwa kwenziwa.
Ukuhlolwa kokuqala kokukhulelwa - ixesha
Ukuze ufumane iziphumo eziphambili ezivumela ukuba uvavanyo oluchanekileyo luphuhlise ukukhula, ukucoca kufuneka kwenziwe ngexesha elithile. Imigangatho yokujonga okokuqala ukukhulelwa - usuku lokuqala lweveki ye-10 - umhla wesi-6 weveki ye-13. Uninzi lwezifundo ziqhutywa kwiveki ye-11 ukuya kwe-12 yokukhulelwa, ezibhekwa njengexesha elifanelekileyo.
Njengoko le nto iboniswe, umphumo kunye nenjongo yocwaningo ngokuthe ngqo kuxhomekeke ekuchanekeni kokumiselwa kwekota. Oogqirha babala ngalo mhla wokuya esikhathini, okokuqala ngosuku. Ukubonelela ootitshala bezonyango ngolwazi olungafanelekanga malunga nexesha leenyanga ezidlulileyo kubangelwa ukuchazwa kakuhle kolwazi olufunyenwe ngexesha lokujonga.
I-Biochemical Screening Trimester
Olu hlobo lokuvavanya kwabasetyhini abakhulelweyo kwi-trimester yokuqala badla ngokubizwa ngokuba luvavanyo oluphindwe kabini. Oku kubangelwa kukuba ngexesha lokuphunyezwa kwalo, ukugxininiswa kwigazi lamaparameters amabini kusekwa: i-b-hCG kunye ne-PAPP-A. I-HCG yi-hormone eqala ukuhlanganiswa kumzimba womama ozayo ekuqaleni kokukhulelwa. Ukugxininiswa kwayo kwandisa imihla ngemihla kwaye kufinyelela kwiqondo eliphezulu ngeliveki le-9. Emva koko, kuncipha ukuhamba kancane kweHCG.
I-PAPP-A yiprotheyini ye-A-plasma, isakhiwo seprotheni ngokohlobo lwayo. Ngokomxholo wayo emzimbeni, oogqirha bamisela isiseko ekuveliseni ukungaqhelekanga kwe-chromosomal (Down syndrome, syndrome syndrome). Ukongeza, ukungahambelani kwinqanaba le-PAPP-A kunokubonisa oku kulandelayo:
- ukukhula komntwana ;
- hypotrophy;
- pre-eclampsia .
I-ultrasound, i-trimester yokuqala
I-Ultrasound kwi-trimester yokuqala iqhutywe ngaphaya kweeyure ezili-11 kwaye i-lateral 14. Injongo yolu vavanyo kukuba kusekwe imilinganiselo yenyama yokuphuhliswa komntwana, ukuxilongwa kwezinto ezingafaniyo kwisakhiwo. Phakathi kweeramitha eziphambili ezithatyathwe kwi-ultrasound kwi-trimester yokuqala yokukhulelwa:
- I-KTP - ubukhulu be-coccyx-parietal (umgama ukusuka kwithambo leparietal ukuya kwi-coccyx);
- intloko;
- I-BDP - ubukhulu biparietal (umgama phakathi kwama-tubricles parietal);
- I-TVP - ubukhulu bekhola yendawo;
- izinga lentliziyo (izinga lentliziyo);
- ubude begxala, intambo, iphambili kunye nomlenze ophantsi;
- indawo yentliziyo, imitha enkulu yegazi;
- indawo ye-placenta, indawo yesinamathiselo, ubukhulu.
Ukuhlola okokuqala kukulungiselela njani?
Ngaphambi kokuba uthathe iimvavanyo kwi-trimester yokuqala yokukhulelwa, umama okhuselekileyo kufuneka acacise imigaqo yegqirha yokulungiselela. Oku kuya kuphelisa ukufumana isiphumo esingalunganga kunye nesidingo sokuphinda uphumelele uviwo ngenxa yale nto. Ngokuphathelele kwizifundo ezibandakanya ukuhlolwa kokuqala okwenziweyo ngexesha lokukhulelwa, eziphambili ziyi-ultrasound kunye nokuhlolwa kwegazi ngegazi.
Xa ukuhlolwa kokuqala kwenziwa, ukuxilongwa kwe-ultrasound kufakwe kuwo akudingi ukulungiselela okhethekileyo. Yonke into efunekayo eyenziwa ngumfazi okhulelweyo ngaphambi kokuba uphonononge ukusela 1-1.5 ilitha amanzi ngaphandle kwegesi 1-2 iiyure ngaphambi kokuba inkqubo. Emva koko, awukwazi ukuya kwindlu yangasese. I-bladder ezalisiweyo kule meko inceda ukujonga ngokupheleleyo imbilini, isango sayo. Kwimeko yokufundwa kwangaphandle, oku akufunwa.
Ukulungiselela uhlalutyo lwe-biochemical ngokugqithiseleyo. Kwiintsuku ezimbalwa ibhinqa kufuneka ilandele ukutya. Ngomhla wokufunda, ungadli kusasa, nangosuku olungaphambili, uyeke ukuthabatha okungenani iiyure eziyi-8 phambi kovavanyo. Xa ulungiselela ukutya, oogqirha bacetyiswa ukuba basuse:
- tshokoleta;
- zokutya kwezilwanyana;
- izitya ezinamafutha kunye nenyama;
- izithelo ze citrus.
Ukuhlolwa kokuqala kwenziwa njani?
Xa ukuhlolwa kwenziwa, i-trimester yokuqala isele iphelile. Ngaphambi kokuphunyezwa kwalolu bunzima bokuxilonga, ugqirha uxela owesifazane okhulelwe kwangaphambili, umxelela ngemithetho yokulungiselela kunye nemigaqo ethile yokuphunyezwa kwenkqubo nganye. Yona inkqubo yokuxilongwa kwe-ultrasound ayifani neyesiqhelo se-ultrasound. Ngokuqhelekileyo kuqhutyelwa phambili, ukuze uhlolisise kakuhle umntwana. Ngexesha elifanayo, isisombululo esiphezulu sisetyenzisiweyo, esinceda ukuchonga ngesondo somntwana ekuqalekisweni kokuqala.
Uvavanyo lwegazi lwegazi, olubandakanya ukuhlolwa kokuqala ngexesha lokukhulelwa, alufani neempendulo zegazi eziqhelekileyo. Izinto eziphathekayo zithathwa kwisisu se-ulnar kusasa ngesisu esingenalutho, sidluliselwe kwiphubhu enyumba, ebhalwe kwaye ithunyelwe kwi-laboratory ukuhlalutya.
Ukuhlolwa kokuqala kokukhulelwa - okuqhelekileyo
Emva kokuba uvavanyo lokuqala luqhutyelwe, ugqirha kuphela kufuneka alinganise iziphumo kunye neziphumo ezifunyenweyo. Uyazi zonke iimpawu zokukhulelwa okuthe ngqo, imeko yomama ozayo, wakhe anamnesis. Ezi zinto ziyakuthi ziqwalaselwe xa ziguqulela iziphumo. Kule meko, oogqirha basoloko benza isilungiso kwiimpawu zomzimba womama, ngoko ukuphambukiswa okuncinane kwimiqathango emiselweyo akuthathwa njengophawu lokuphulwa.
I-ultrasound kwi-trimester yokuqala yokukhulelwa-isisimko
I-short-ultrasound (i-trimester yokuqala yokukhulelwa) ijoliswe ekufumaneni i-pathologies yokukhula komntwana. Ekugqibeleni kwayo ugqirha useka iiparitha zokukhula komzimba wengane, eqhelekileyo ibe nexabiso elilandelayo:
1. IKTR:
- Iiveki ezili-10 zokukhulelwa - 33-41 mm;
- Iiveki ezili-11 - 42-50;
- 12-51-59;
- 13 ukuya ku-62-73.
2. I-TVP:
- Kwiiveki ezi-10 - 1,5-2,2 mm;
- ngo-11 - ukusuka ku-1.6 ukuya ku-2,4;
- kwi-12 - engekho ngaphantsi kwe-1.6 kwaye ingabi ngaphezu kwama-2.5;
- ngo-13 - 1,7-2,7.
3. Intlawulo yenhliziyo (beats ngomzuzu):
- Iiveki ezili-10 - 161-179;
- 11 - ukususela ngo-153 ukuya ku-177;
- 12-150-174;
- 13-47-171.
4. BDP:
- Iiveki ezili-10 - 14 mm;
- 11-17;
- 12 - 20;
- 13 iiveki - 26.
Ukuhlola i-biochemical - imiqondiso yezibonakaliso
Ukuhlolwa kwezinto ezinokwemvelo kwimizi-trimester, ukuchazwa kwento eyenziwa ngugqirha, kunceda ukuchonga i-pathologies yemvelo kwintsana ngexesha elifutshane kakhulu. Izibonakaliso zesiqhelo sesi sifundo zifana nale:
1. hCG (mU / ml):
- Iiveki ezi-10-11 zokukhulelwa - ukusuka kuma-20 000 ukuya kuma-95,000;
- Iiveki eziyi-12 - 20000-90000;
- 13-14 - kungekhona ngaphantsi kwama-15,000 kwaye angabi ngaphezu kwama-60,000.
2. I-RAPP-A (MED / ml):
- Iiveki ezili-10 - 0.45-3.73;
- 11 - 0.78-4.77;
- 12 -1.03-6.02;
- 13 - 1.47-8.55.
Ukuhlolwa kwe-1 trimester - ukuphambuka
Njengoko sele kukhankanywe ngasentla, ukucaciswa kokuqala kokuhlola kufuneka kwenziwe kuphela ngcali. Umama ozayo akufanele aqikelele iziphumo zophando ngeemimiselo. Uvavanyo lufanele lwenziwe ngendlela enzima - oogqirha abanakuze baxilonge ngesiseko sokuhlola kuphela, ukuthelekisa iinkqubo zokuqala zokuhlola izinto. Nangona kunjalo, kunokwenzeka ukwenza iingqiqo malunga nobukho bentsholongwane. IHCG ephakamileyo ibonisa:
- izifo zemizimba - Down syndrome, Edwards , trisomy;
- isifo sikashukela;
- i toxicosis .
Ukunciphisa kwixinaniso yeHCG kwenzeka xa:
- ectopic pathology;
- umngcipheko wokukhipha isisu.