Ukuthuthukiswa kwemithi kuye kwasiza ekunciphiseni kakhulu ukufa kwezingane, kodwa ukuthuthukiswa kwanamuhla kungaba ngaphezulu - ukubikezela ukuthi kungenzeka yini izifo ezibi kakhulu. Ngalesi sizathu, ukuhlolwa kusetshenzisiwe, ukuthi kuyini futhi kwenziwa nini, kungcono ukuhlukana ngokuningiliziwe.
Kuyini ukuhlola?
Ngesikhathi sokukhulelwa futhi ngokushesha ngemva kokubeletha, ukuhlolwa kokuhlolwa kuyadingeka ukuhlola izingozi empilweni yomama kanye nosana olusasa. Ukuhlolwa okunjalo kuqhutshwa izikhathi eziningana ukuze kube nezinkomba ezinamandla. Akudingekile ukungabaza ukuthi ukuhlolwa kuyadingeka yini, ukuthi kuyini nokuthi ngabe inqubo ingalimaza ingane, ngoba inconywa yi-WHO. Lokhu kunzima kwezinyathelo ezilula akusizi ngalutho, futhi kungakusindisa ezinkingeni ezinkulu.
Ukuhlolwa kwangaphambi kokubeletha - kuyini?
Ngesikhathi sokubeletha, kuyadingeka ukuthi ulawule inqubo yokwenza umbungu ngesikhathi sokubona ukwephulwa okungenzeka. Ukuhlolwa kwabesifazane abakhulelwe kwenziwa ngenyanga ngayinye yezinyanga ezintathu, inani kanye nezinhlobo zokuhlola zizinquma ngabanye. Udokotela angathumela ukuhlolwa okuphindaphindiwe noma okungeziwe. Lapho ukuhlolwa kuqedile, ukuthi kuyini, nokuthi yiziphi izinqubo zokugunyazwa okumelwe zilungiselelwe, wonke owesifazane kufanele azi. Lokhu kubaluleke kakhulu kulabo abasengozini. Izici ezilandelayo zinqunywe lapha:
- uneminyaka engaphezu kwengu-35;
- kunezingane ezinokukhubazeka kwe-chromosomal;
- okungaphezu kokubili ukuhlukumeza okulandelanayo;
- ukwamukela imithi eyingozi ezinyangeni ezintathu zokuqala;
- umshado phakathi kwezihlobo eziseduze;
- usongo olude lokukhulelwa kwesisu;
- irradiation yabazali ngaphambi kokukhulelwe.
Ukuhlolwa kwe-Neonatal
Le nqubo kufanele yenziwe kuzo zonke izindlu zokubeletha, ukuhlola okunjalo okukhulu kukuvumela ukuba ubone izifo ezibelethwe kanye nezifo. Ukuhlola izingane ezisanda kuzalwa kunika ithuba lokwelapha. Inqubo yenziwa ngezigaba eziningana:
- ukuhlolwa kwegazi okuthathwe esithende somntwana;
- ukuhlolwa kwezwi;
- ucwaningo oluphindaphindiwe;
- Ukuvakashela ochwepheshe abancane uma kwenzeka izinkinga.
Kungani ukuhlolwa?
Inhloso yanoma iyiphi inhlolovo ukukhomba izifo ezikhona noma izingozi zabo. Lapho umntwana ekhulelwe, into yesibili iya kuqala. Lokhu kuyiqiniso ikakhulu uma ukuhlolwa kwesibili kwenziwa ngesikhathi sokukhulelwa, imiphumela yaso ayilungile ngaso sonke isikhathi, ngakho-ke izibonakaliso ze-alamu zidinga ukuhlaziywa ezinye izindlela. Ukungazinaki ngokugcwele lezi zifundo akufanelekile, ngoba ngisho nokufakwa kwangaphakathi ukubeletha noma yikuphi ingane ukuqonda isimo kuzosiza ukulungiselela izinkinga ezikhona.
Ukuhlolwa kwe-Neonatal , kwenziwa ezinsukwini zokuqala zokuphila komntanakho, kunembile kakhulu futhi kusiza ukubona ukutholakala kwesifo. Gwema ukuthi akudingekile, izinkinga eziningi zokuxilongwa kwangaphambili zilawulwa kangcono. Ngisho nezifo ezinzima, amathuba okuthuthukisa isimo asanda kakhulu uma ukutholakala okungajwayelekile kulesi sikhathi.
Ukukhulelwa kokukhulelwa
Ukuthuthukiswa kwe-fetal kuyadingeka ukuthi kuhlolwe njalo, ngakho-ke izivivinyo zenziwa ku-trimester ngayinye:
- Ukuhlola igazi kwe-Ultrasound ne-biochemical.
- I-Ultrasound. Igazi lingabuye lihlolwe uma ukuhlolwa kokuqala kokukhulelwa kunganakwa. Ukungazi kahle ngale ndlela kuphazamiseka ngalesi sigaba, ngakho-ke, iziphetho zokugcina ngesisekelo asikwazi.
- I-Ultrasound. Ekutholeni ukungahleleki okuthuthukayo, i-Doppler ne-cardiography ingasetshenziswa ngaphezu kwalokho.
Ukuhlolwa kwe-Biochemical
Ukuze kufundwe, igazi eliyingozi liyathathwa, elitholakala ekuseni ngesisu esingenalutho. Njengoba bahlola ukuqala kwe-trimester, umphumela wayo ubonisa izinkinga ezibonakalayo, futhi awube isinqumo. Ukuhlolwa kwenziwa ngamakaki amabili:
- In-hCG - kusiza ukugcina nokuqhubeka nokukhulelwa.
- I-RARR-A - ibhekene nokuphendula komzimba komzimba wesifazane, umsebenzi nokubunjwa kwe-placenta.
Okuqukethwe okwandisiwe kwe-B-hCG kungakhuluma nge:
- toxicosis ngaphambi kwesikhathi;
- I-Down's syndrome nezinye izinguquko ze-chromosomal;
- igama lokukhulelwa elingakalungi;
- isifo sikashukela sikashukela sikashukela;
- ukuphindaphindiwe .
Ukuhlushwa okuphansi kwe-B-hCG kubonisa:
- ukukhulelwa kwe-ectopic;
- ukungakwazi kahle kwamapayipi;
- I-Edwards syndrome ;
- ingozi yokukhulelwa kwesisu.
Ukuphambuka kwe-PAPP-A inkomba kubonisa ukuthi kungenzeka:
- izinguquko ze-chromosomal;
- ukukhipha isisu okuzenzekelayo;
- ukuvimbela ukukhulelwa;
- syndromes monogenic.
Ukuhlolwa kwe-Ultrasound
Izivivinyo ze-Ultrasound zihlelwe esigabeni ngasinye sokubeletha, imiphumela yokuhlola ivumela ukubona ukwakheka kokungajwayelekile ekubunjweni kwe-fetus. Ukuze uthole incazelo eqondile yalokho okubonayo, udinga isitifiketi esiphakeme kudokotela, ngakho-ke uma kwenzeka ungabaza, kungcono ukuhlola isiphetho nomunye udokotela. Esikhathini sesithathu sokuqala, amaphuzu alandelayo ahlolwa:
- Ubuningi besikhala sekhanda - uma lukhulu kakhulu, lukhuphuka amathuba okuba ne-pathology.
- Ubude besithambo sangasese bungabonisa ukuguquguquka kwe-chromosomal, kodwa kufanele kuqinisekiswe ngemiphumela yezivivinyo ezisele.
Ku-trimester yesibili, isifundo senziwa kuphela ngesisu esiswini, senziwa ngezinhloso eziningana:
- Ukuhlolwa kwe-anatomy ye-fetus yokuthola izinkinga zokuthuthukiswa.
- Ukuhlanganiswa kwezinga lokuthuthukiswa kanye nesikhathi sokukhulelwa.
- Ukucacisa ukunikezwa kwe-fetus .
Ku-trimester yesithathu, ukunakwa okwengeziwe kunakhokhwa ezinkingeni ezingase zibe nzima nokukhulelwa kokukhula komntwana, ngoba esikhathini esinjalo sekwephuzile kungabonakali ukukhubazeka, okubalulekile kutholakala ngaphambili. Phakathi nesifundo, udokotela ubheka:
- ubukhulu be-trunk nekhanda (okudingekayo ukuhlela isisindo somntwana);
- uhlelo lwe-genitourinary;
- ubuchopho;
- izitho esiswini;
- umgogodla;
- umhlathi, i-orbit kanye nasolabial;
- ukuphendula okuziphatha;
- isimo sezitho zokubeletha zomama.
Ukuhlolwa kokukhulelwa - isikhathi
Kubalulekile ukuba umama wesikhathi esizayo angazi nje ukuthi lokhu "ukuhlolwa" kuyini, kodwa ukumela imingcele yesikhathi. Izivivinyo zixhomeke kakhulu esikhathini sokukhulelwa, uma leli phuzu lishaywa indiva, kungenzeka ukuthi kunciphise ngokuphawulekayo ukuphumelela kwesifundo noma ukuthola idatha yamanga.
- I-trimester yokuqala - ngoba izivivinyo zithunyelwa emavikini angu-11-14, kodwa ochwepheshe bakholelwa ukuthi isikhathi esihle kakhulu isikhathi samasonto angu-12-13.
- I-trimester yesibili - igama elihle lokuhlola ukukhulelwa ngalesi sigaba ngamasonto angu-16-20.
- Ucwaningo lwesithathu lwezintathu luqhutshwa emavikini angu-30-34, isikhathi esihle kakhulu amasonto angu 32-34.
Ukuxilongwa kwengane esanda kuzalwa
Ngemuva kokunakekelwa okwedlulele ngesikhathi sokubeletha, abesifazane abafuni njalo ukuqonda ukuthi ukuhlola ukuhlolwa kosana kuyini. Abanye bathembele emizweni yabo, bekhohlwa ukuthi kungenzeka ukubonakaliswa kwezifo kamuva. Ukuhlaziywa okulula ezinsukwini zakuqala zokuphila kwengane kungabonisa izinkinga ezinkulu futhi kunikeze ithuba lokuthuthukisa. Ukuhlolwa kwengane kwenziwa ezinyathelweni eziningana, ukunikeza abazali ulwazi oluyisisekelo mayelana nempilo yakhe.
Ukuhlolwa kwezinsana ngezifo ezifa
Isivivinyo sokuqala esivame ukubizwa ngokuthi "ukuhlolwa kwesithende", ngoba kusuka lapha igazi kuthathwa ukucwaninga. Uma izimpawu ezifunayo zitholakala, kuhlolwa okungeziwe. Ukuhlolwa, izimo zazo ezivame ukukhuliswa ngezifo ezintsha, kunconywa zonke izingane, uma zingabanjwanga ekhaya lokubeletha, abazali kufanele bazifake ngokwabo. Ngenxa yocwaningo, izinkinga ezilandelayo zefa zingatholakala.
- I-Phenylketonuria - izimpawu zivela ngemva kwezinyanga ezingu-6, imiphumela ingaba ukuphazamiseka kwengqondo. Uma kutholakala ngesikhathi, kungenzeka ukuvimbela intuthuko ngokuthola ukwelashwa.
- I-fibrosis ye-cystic - ukwephulwa komsebenzi wokuphefumula nokugaya ngenxa yokungahambi kahle kwezingqungquthela zokuvimba kwangaphandle. Ukudla kanye nama-enzyme we-pancreas asetshenziselwa ukujwayela isimo.
- I-Galactosemia - ayigcini i-carbohydrate yobisi, eholela ezilonda zesibindi, isimiso sezinzwa, amehlo. Ezinyangeni zokuqala zokuphila ngokuvamile kuba imbangela yokufa, izingane ezisinda ngaphandle kokwelashwa zihlala zikhubazekile.
- I-Adrenogenital syndrome - idinga usizo olusheshayo, ngaphandle kokuba ingozi yokufa iphezulu.
Ukuhlolwa kokulalela
Ukuthola ukuphazamiseka kokuzwa ezinganeni ezisanda kuzalwa, indlela yokukhishwa kwe-otoacoustic isetshenziswa, ibonisa ngisho nokunciphisa kancane ukuzwela kwalesi sitho. Ukuhlolwa okuvelayo kubonisa ulwazi mayelana nesidingo sokuqhubeka nomntwana. Ucwaningo lufakazela ukuthi izidakamizwa ezingaphezu kuka-3-4 zokulahlekelwa kokuzwa ezinyangeni ezingu-6 zisiza ukugwema ukulibaleka ekukhulumeni nasekuthuthukiseni ulimi lwezingane. Uma izinsiza zokuzwa zisetshenziselwa emuva kwesikhathi, khona-ke kuyoba khona emuva. Ngenxa yalesi sizathu, ukutadisha kunconywa ngendima ephoqelekile.
Ukuhlolwa kwezingane ezisanda kuzalwa nge-Neonatal - izinsuku
Ukusebenza kahle kwezinga eliphezulu kuhluke kuphela ekuhlolweni, isikhathi esifike ngaso. Ukuhlolwa kwegazi kwenziwa ngehora lesine ekuseni (ngaphambi kwezinsana - ku-7) amahora amathathu emva kokudla. Imiphumela iyaziwa zingakapheli izinsuku ezingu-10 emva kokuzalwa. Uma kutholakala izinkinga, kuzotholakala ukuhlolwa okuqhubekayo. Isivivinyo sokuzwa senziwa ngemuva kwezinsuku ezingu-4 zokuphila, amaphutha angaphambilini angenzeka. Uma umphumela omubi utholakala, ukuhlolwa kuphindiwe ngemva kwamasonto angu-4-6.