Ukuhlolwa kokuqala kokukhulelwa kuyisifundo esijabulisayo somama ozayo. Kuhloswe ukukhomba ukukhubazeka komntwana, ukukhubazeka. Imiphumela yocwaningo ingacutshungulwa udokotela kuphela obona ukukhulelwa.
Kuyini ukuhlolwa kwe-trimester?
Ukuhlolwa kokuqala ukuhlolwa okuphelele kwe-fetus, okubandakanya i-ultrasound nokucwaninga ngegazi ngegazi lomama ozayo. Ukuze ukhulelwe konke lokhu kungenziwa kathathu, isikhathi esingu-1 nge-trimester. Ezimweni eziningi, ukuhlolwa kwe-ultrasound kuphela okudingekayo. Uma udokotela esolwa ukuphulwa, ukuphambene nokujwayelekile, ngaphezu kwalokho, ukuhlola igazi kwegazi kuyolwenziwa.
Ukuze uthole umphumela wenhloso futhi uhumushe kahle idatha, udokotela kumele acabangele izilinganiso eziningana, njengokuphakama, isisindo sowesifazane okhulelwe, ukuba khona kwemikhuba emibi, engathinta imiphumela yocwaningo. Ngalokhu engqondweni, owesifazane okhulelwe akufanele azame ukucacisa ukuhlolwa kokuqala okwenziwe ngesikhathi sokukhulelwa eyedwa.
Kungani ukuhlolwa kokukhulelwa kuyadingeka?
Ukuhlolwa kwe-trimester yokuqala kuvumela izinyathelo zakuqala zokuthuthukiswa kwe-intrauterine ukukhomba ukwehluka okungenzeka ekubunjweni kwezitho zangaphakathi, ukuthola izifo zofuzo. Phakathi kwezinhloso eziyinhloko zokuhlolwa okunzulu okunjalo kowesifazane okhulelwe kungabonakala:
- ukuqedwa kwe- ectopic pregnancy ;
- ukuzimisela kwenani lamantombazane kanye nesisu;
- ukuhlolwa kwemingcele eyisisekelo yobomi be-fetal - ukubalwa kwezinhliziyo, ukulalela imisindo yenhliziyo;
- incazelo yemingcele yomzimba yokuthuthukiswa kwezingane;
- Ukuhlolwa kwe-anatomical ye-fetus (ukutholakala kweziphambeko ekuthuthukiseni);
- Ukuhlolwa kwe-placenta nokuhlonza ukusebenza kwayo.
Ukuhlolwa kokuqala ngesikhathi sokukhulelwa akusinqumi isifo esithile ebusweni, kepha kubonisa kuphela izibonakaliso zalo, amamaki. Imiphumela etholakalayo iyisisekelo sokuphenywa okuqhubekayo, isabelo semfundo eyengeziwe ye-laboratory. Ngemuva kokuthola yonke imininingwane edingekayo yisiphetho esenziwe, ukuxilongwa kwenziwa.
Ukuhlolwa kokuqala kokukhulelwa - isikhathi
Ukuze uthole imiphumela engumgomo evumela ukuhlolwa okulungile kokuthuthukiswa komntwana, ukuhlolwa kufanele kwenziwe ngesikhathi esithile. Imigomo yokuhlolwa kokuqala kokukhulelwa - usuku lokuqala lwesonto le-10 - usuku lwesithupha lwesonto le-13. Izifundo eziningi zenziwa ngeviki le-11-12 lokukhulelwa, okubhekwa njengesikhathi esihle kakhulu.
Njengoba kunikezwe lesi sici, umphumela kanye nenhloso yocwaningo ngokuqondile kuxhomeke ekuqineni kokunqunywa kwegama. Odokotela bayalibala ngolusuku lokugcina esikhathini, usuku lokuqala. Ukuhlinzeka ngolwazi lwezokwelapha ngolwazi olungalungile mayelana nesikhathi sezinyanga zokugcina lugcwele ukungachazwisiswa kolwazi olwamukelwe ngesikhathi sokuhlola.
I-Biochemical Screening Trimester
Lolu hlobo lokuhlolwa kwabesifazane abakhulelwe ku-trimester yokuqala luvame ukubhekwa njengokuhlolwa okuphindwe kabili. Lokhu kungenxa yokuthi phakathi nokuqaliswa kwayo, ukuhlushwa kwegazi kwemingcele emibili kusungulwa: mahhala b-hCG ne-PAPP-A. I-HCG iyi-hormone eqala ukuhlanganiswa emzimbeni womama ozayo lapho kuqala ukukhulelwa. Ukugxila kwayo kwanda nsuku zonke futhi kufinyelela esiphezulu sayo ngeviki lesishiyagalolunye. Emva kwalokhu, kuncipha kancane kancane ku-hCG.
I-PAPP-A iyiprotheni ye-A-plasma, isakhiwo samaphrotheni ngokwemvelo yaso. Ngokuqukethwe okusemzimbeni, odokotela basungula isimo sokuthuthukiswa kwezimo ezingavamile (i-Down syndrome, i-Edwards syndrome). Ngaphezu kwalokho, ukungahambisani kwezinga le-PAPP-A kungabonisa okulandelayo:
- ukukhula kwe-fetus ;
- i-hypotrophy;
- pre-eclampsia .
I-Ultrasound, i-trimester yokuqala
I-Ultrasound ku-trimester yokuqala iqhutshwa ngaphandle kwamaviki ayisishiyagalolunye ayisishiyagalolunye futhi kamuva 14. Inhloso yocwaningo ukubeka imingcele yemvelo yentuthuko yengane, ukuhlushwa kwe-anomalies kwisakhiwo. Phakathi kwemingcele eyinhloko ethathwa njenge-ultrasound ku-trimester yokuqala yokukhulelwa:
- I-KTP - usayizi we-coccyx-parietal (ibanga ukusuka emathini we-parietal kuya ku-coccyx);
- ikhanda lokuzungeza;
- I-BDP - usayizi we-biparietal (ibanga phakathi kwe-parietal tubercles);
- I-TVP - ubukhulu besikhala sekholomu;
- isilinganiso senhliziyo (isilinganiso senhliziyo);
- ubude behlombe, ithanga, ingxube, nomlenze ophansi;
- indawo yenhliziyo, izitsha ezinkulu zegazi;
- indawo ye-placenta, indawo yokunamathiselwe, ukuqina.
Ukuhlola kokuqala ukuthi ungalungisa kanjani?
Ngaphambi kokuthatha izivivinyo ekuthomeni kokuqala kokukhulelwa, umama olindelekile kufanele acacise izimiso zikadokotela zokuzilungiselela. Lokhu kuzoqeda ukwemukela umphumela ongafanele kanye nesidingo sokuphinda uphinde uphelele ukuhlolwa ngenxa yalokhu. Mayelana nezifundo ezibandakanya ukuhlolwa kokuqala okwenziwe ngesikhathi sokukhulelwa, okuyinhloko yi-ultrasound kanye nokuhlolwa kwegazi kwegazi.
Lapho ukuhlolwa kokuqala sekuphelile, ukuxilongwa kwe-ultrasound kufakwe kuwo akudingi ukulungiselela okukhethekile. Konke okudingeka kwenziwe ngumama okhulelwe ngaphambi kokuba uphenye ukuphuza 1-1.5 amalitha amanzi ngaphandle kwegesi 1-2 amahora ngaphambi kwenkambiso. Emva kwalokho, awukwazi ukuya endlini yangasese. Isikhwama esigcwele kule nkinga kusiza ukubuka ngokuphelele isibeletho, isikhumba salo. Endabeni yokutadisha kwangaphandle, lokhu akudingeki.
Ukulungiselela ukuhlaziywa kwezinto ezinokwemvelo kuphelele. Ezinsukwini ezimbalwa owesifazane udinga ukulandela ukudla. Ngosuku locwaningo, ungadli ekuseni, nangosuku olulandelayo, ayeke ukuthatha okungenani amahora angu-8 ngaphambi kokuhlolwa. Lapho ulungiselela ukudla, odokotela baceliwe kakhulu ukuba basuse:
- ushokoledi;
- izinhlanzi zasolwandle;
- amafutha nama-meat dish;
- izithelo zase-citrus.
Ukuhlolwa kokuqala kwenziwa kanjani?
Lapho ukuhlolwa kwenziwa, i-trimester yokuqala isivele iphelile. Ngaphambi kokuqaliswa kwalesi sinkimbinkimbi sokuxilonga, udokotela utshela owesifazane okhulelwe kusengaphambili, umtshele ngemithetho yokulungiselela kanye nokucaciswa kokuqaliswa kokuphathwa komuntu ngamunye. Yona kanye inqubo ye-diagnosis ye-ultrasound ayifani ne-ultrasound evamile. Ngokuvamile lenziwa ngokungahambisani, ukuze kuhlolwe kangcono le fetus. Ngesikhathi esifanayo, kusetshenziswa imishini yokuxazulula eliphezulu, okusiza ukukhomba ubulili bomntwana ekuhlolweni kokuqala.
Ukuvivinya igazi kwegazi, okufaka ukuhlolwa kokuqala ngesikhathi sokukhulelwa, akufani nalokho okujwayelekile kwesampuli segazi. Lezi zinto zithathwe emthanjeni wesineke ekuseni ekuseni ngesisu esingenalutho, sidluliselwe kumhubhe oyinyumba, okubhalwa futhi uthunyelwe ebhokisithri ukuze kuhlaziywe.
Ukuhlolwa kokuqala kokukhulelwa - okujwayelekile
Ngemuva kokuthi ukuhlolwa kokuqala kwenziwe, udokotela kuphela okufanele aqhathanise imiphumela nemiphumela etholakalayo. Uyazi zonke izici zokukhulelwa okuhlukile, isimo somama ozayo, u-anamnesis wakhe. Lezi zici zicatshangelwa ngempela uma uhumusha imiphumela. Kulolu daba, odokotela benza njalo ukuchitshiyelwa kwezici zomzimba womama, ngakho ukuphambuka okuncane emkhakheni osungulwe akubhekwa njengophawu lokuphulwa.
I-Ultrasound ku-trimester yokuqala yokukhulelwa - okujwayelekile
I-ultrasound encane (i-trimester yokuqala yokukhulelwa) ihloswe ekuhloleni i-pathologies yentuthuko ye-fetal. Ekuqapheliseni kwakhe udokotela usetha imingcele yokuthuthukiswa ngokomzimba wengane, ngokuvamile evame ukuba nalezi zindinganiso ezilandelayo:
I-KTR:
- Amaviki ayishumi okukhulelwa - 33-41 mm;
- Isonto eli-11 - 42-50;
- 12-51-59;
- 13 kuya ku-62-73.
2. I-TVP:
- Emasontweni ayishumi - 1,5-2,2 mm;
- ngo-11 - kusuka ku-1.6 ukuya ku-2,4;
- ngo-12 - hhayi ngaphansi kwama-1.6 futhi angabi ngaphezu kuka-2.5;
- ngo-13 - 1,7-2,7.
Isilinganiso senhliziyo (beats ngomzuzu):
- Amaviki ayishumi - 161-179;
- 11 - kusuka ku-153 kuya ku-177;
- 12-150-174;
- 13-47-171.
4. BDP:
- Amaviki ayishumi - 14 mm;
- 11-17;
- 12 - 20;
- Amaviki angu-13 - 26.
Ukuhlolwa kwamakhemikhali - izinkomba zezikhombisi
Ukuhlolwa kwezinto ezinokwemvelo kwe-trimester, ukucaciswa okwenziwa ngudokotela, kusiza ukuhlonza i-genetic pathologies enganeni ngesikhathi esifushane kakhulu. Izinkomba zendabuko yalolu cwaningo zibukeka kanje:
1. hCG (mU / ml):
- Amaviki angu-10-11 okukhulelwa - kusuka ku-20,000 kuya ku-95,000;
- Amaviki angu-12 - 20000-90000;
- 13-14 - angaphansi kuka-15,000 futhi angaphezu kuka-60,000.
2. I-RAPP-A (MED / ml):
- Amaviki ayishumi - 0.45-3.73;
- 11 - 0.78-4.77;
- 12 -1.03-6.02;
- 13 - 1.47-8.55.
Ukuhlolwa kwe-trimester koku-1 - ukwehluka
Njengoba sekushiwo ngenhla, ukucaciswa kokuhlolwa kokuqala kufanele kwenziwe kuphela ochwepheshe. Umama wesikhathi esizayo akufanele aqhathanise imiphumela yocwaningo ngezimiso. Ukuhlola kumele kwenziwe ngendlela eyinkimbinkimbi - odokotela abakaze baxilongwe ngesisekelo sokuhlola kuphela, uma kuqhathaniswa nemigomo yokuhlolwa kokuqala kweqiniso. Kodwa-ke, kungenzeka ukuba wenze imibono mayelana nokutholakala kwempilo. I-hCG ephakanyisiwe ibonisa:
- izifo zofuzo - Down syndrome, Edwards , trisomy;
- isifo sikashukela mellitus;
- toxicosis .
Ukunciphisa ukuhlushwa kwe-HCG kwenzeka lapho:
- i-ectopic pathology;
- ingozi yokukhipha isisu.