Enye yezinto ezonwabisayo kunye eziphazamisayo kumabhinqa abakhulelweyo ukuhlolwa kokubeleka. Ngokukodwa ukwesalisa oomama abalindayo bahlola i-trimester yesibini yokukhulelwa. Oko kuyimfuneko kwaye nokuba kuyimfuneko ukuba soyike - siya kuhlalutya kwinqaku lethu.
Ngubani osemngciphekweni?
Kwiingcebiso ze-World Health Organisation ukuhlolwa kokubeleka kwenziwa eRussia ngabo bonke abafazi abakhulelweyo. Uphando olunyanzelisayo luqhutyelwa kubasetyhini abaneengxaki ezilandelayo:
- uneminyaka engama-35 ubudala;
- ubukho kwintsapho yomntwana ene pathologies ye-chromosomal;
- umtshato phakathi kwezihlobo eziseduze;
- iziyobisi kwi-trimester yokuqala echasene nokukhulelwa;
- usongelo olude lokupheliswa kokukhulelwa;
- amathole emibini okanye ngaphezulu;
- irradiation yomnye wabatshati ngaphambi kokuba ukhulelwe.
Ukuhlola ukukhulelwa - ixesha kunye nohlalutyo
Ngokuqhelekileyo ukuhlolwa kokubeletha kokubeletha kwenziwa ngokuphindwe kabini: kwi-10-13 kunye neye-16 ukuya kweeveki. Injongo yalo kukufumanisa i-chromosomal pathologies ezinamandla:
- i-trisomy ye-chromosome yesi-21 (i-Down syndrome);
- i-trisomy ye-chromosome ye-18 (isifo se-Edwards);
- isiphako se-neural tube ye-fetus (intambo yomgca ongapheliyo).
Ukuhlola iquka izigaba ezilandelayo: i-ultrasound, ukuhlolwa kwegazi, ukuchazwa kwedatha. Isigaba sokugqibela sibaluleke kakhulu: ngokugqithiseleyo ukuba ugqirha uvavanya njani imeko ye-fetus, kungekhona nje kuphela ikamva lomntwana lithembeke, kodwa kunye nesimo sengqondo somfazi okhulelweyo.
Isicatshulwa sesibili sokukhulelwa kukuba, okokuqala, oko kuthiwa uvavanyo oluphindwe kathathu, uvavanyo lwegazi lwe-biochemical, olubonisa ukuba kukho izibonakaliso ezintathu:
- i-alpha-fetoprotein (AFP);
- hCG;
- i-estriol yamahhala (E3).
Ngokuxhomekeke kwinqanaba lala manqaku egazini lomama ozayo, bathetha ngomngcipheko wokuphuhlisa i-pathologies yomzimba.
| Ulwaphulo | AFP | E3 | HCG |
|---|---|---|---|
| I-Down syndrome (i-trisomy 21) | Ephantsi | Ephantsi | Ephakamileyo |
| Isifo se-Edwards (i-trisomy 18) | Ephantsi | Ephantsi | Ephantsi |
| Iingxaki zethubhu yamathambo | Ephakamileyo | Eziqhelekileyo | Eziqhelekileyo |
Uvavanyo lwesibini ngexesha lokukhulelwa libandakanya uvavanyo lwe-ultrasound I-Specialist iza kuhlolisisa i-fetus, izitho zalo, izitho zangaphakathi, ukuvavanya imeko ye-placenta kunye ne-amniotic fluid. Isikhathi sesicatshulwa sesibini sokukhulelwa kwe-ultrasound kunye nokuhlolwa kwegazi nge-biochemical akufani: i-ultrasound inolwazi oluninzi phakathi kweeveki ezingama-20 no-24, kunye nexesha elifanelekileyo lokuvavanya kathathu ngamaviki angama-16 ukuya kwe-19.
Masibhale amanani
Ngelishwa, akubona bonke oogqirha abachazela iziphumo zokuvavanywa kathathu kubamama bokamva. Kwi-sibini yesicatshulwa sokukhulelwa, ezi zilandelayo zibonakaliso:
- AFP kwiiveki ezi-15 ukuya ku-19 zesigxina - 15-95 U / ml kunye neveki ezingama-20 ukuya ku-24 ukuya ku-27-125 U / ml.
- I-HCG kwiveki yesi-15-25 yokukhulelwa - 10000-35000 mU / ml.
- I-esriol yamahhala kwiiveki ezingama-18 ukuya kwe-18 ukuya kwi-6 ukuya ku-6 ukuya ku-6 ukuya kwi-1 ukuya kwe-20 ukuya kwe-20 ukuya kwe-20 ukuya kwe-20 ukuya kwe-20 ukuya kwe-22 ukuya kwe-22 ukuya kwe-22 ukuya kwe-22 ukuya kwe- / l.
Ukuba izalathisi ziphantsi kwemida eqhelekileyo, ngoko umntwana uya kuphila ngokupheleleyo. Musa ukukhathazeka ukuba ngaba iinombolo kwiziphumo zeemvavanyo zihamba ngaphaya kwemida yesiqhelo: uvavanyo oluphindwe kathathu ludla "luphutha". Ukongezelela, kukho inani lezinto ezichaphazela kakhulu iziphumo zophando lwezinto eziphilayo:
- ukukhulelwa okubanzi;
- IVF;
- Ubunzima bomfazi okhulelweyo (ngokubamkelekileyo abafazi, ama-indices anyukile, kwimeko yokuxhomekeka, ancitshiswa);
- imikhwa emibi (ukutshaya ngexesha lokukhulelwa);
- isifo sikashukela esikhatywayo kwabasetyhini abakhulelweyo;
- inkcazelo engafanelekanga yeminyaka yobudala.
Ukubona malunga neentsholongwane ezinokubakho komntwana akufanelekanga. Akukho ugqirha unelungelo lokwenza ukuxilongwa, makungabikho nciphisa ukukhulelwa, ngesiseko sokujonga. Iziphumo zezifundo zivumela kuphela ukuvavanya umngcipheko wokuba nomntwana onesiphako sokuzalwa. Abasetyhini abanomngcipheko wokumisela iimvavanyo ezongezelelweyo (i-ultrasound, i-amniocentesis, i-cordocentesis).