Enye yezinto ezithakazelisayo nokuphazamisayo kwabesifazane abakhulelwe ukuhlolwa kwangaphambi kokubeletha. Futhi okwesabisa kakhulu omama abalindele ukuhlola i-trimester yesibili yokukhulelwa. Ngalokho okudingekile nokuthi kufanele yini ukwesaba - sizohlaziya esihlokweni sethu.
Ngubani osemngciphekweni?
Ngokwezincomo ze-World Health Organization ukuhlolwa kokubeletha ngaphambi kokubeletha kwenziwa eRussia yibo bonke abesifazane abakhulelwe. Ucwaningo oluphoqelelwe lwenziwe abesifazane abanobunzima bokulandelayo:
- uneminyaka engaphezu kwengu-35;
- ukuhlala emndenini wengane ene-pathologies ye-chromosomal;
- umshado phakathi kwezihlobo eziseduze;
- izidakamizwa ku-trimester yokuqala ziphikisana nokukhulelwa;
- isongo eside sokuqedwa kokukhulelwa;
- ukuhlukunyezwa kwamabili noma ngaphezulu;
- irradiation komunye wabashade ngaphambi kokukhulelwe.
Ukuhlolwa kokukhulelwa - isikhathi nokuhlaziywa
Ngokuvamile ukuhlolwa kokubeletha ngaphambi kokubeletha kwenziwa ngokuphindwe kabili: ngo-10-13 no-16-19 amasonto. Umgomo wayo ukukhomba ukuthi kungenzeka yini ukuthi i-chromosomal pathologies enamandla kakhulu:
- i-trisomy ye-chromosome engama-21 (i-Down syndrome);
- i-trisomy ye-chromosome ye-18 (isifo se-Edwards);
- isici se-neural tube ye-fetus (intambo yomgogodla engeyona ukukhula).
Ukuhlolwa kuhlanganisa izigaba ezilandelayo: i-ultrasound, ukuhlolwa kwegazi, ukuchazwa kwedatha. Isigaba sokugcina sibaluleke kakhulu: ukuthi udokotela uhlola kanjani isimo somntwana, akuyona nje kuphela ikusasa lomntwana elixhomekile, kodwa futhi nesimo sengqondo somama okhulelwe.
Ukuhlolwa kwesibili kokukhulelwa, okokuqala, ukubizwa okuthiwa kathathu, ukuvivinya igazi kwegazi, okukhomba ukuthi kukhona izinkomba ezintathu:
- i-alpha-fetoprotein (AFP);
- inani le-hCG;
- i-estriol yamahhala (E3).
Ngokuya ngezinga lezi zinkomba egazini lomama ozayo, bakhuluma ngengozi yokuthuthukisa i-genetic pathologies.
| Ukuphulwa | AFP | E3 | I-HCG |
|---|---|---|---|
| I-Down syndrome (i-trisomy 21) | Okuphansi | Okuphansi | Phezulu |
| Isifo se-Edwards (i-trisomy 18) | Okuphansi | Okuphansi | Okuphansi |
| Amaphutha amathabhu we-Nerve | Phezulu | Okujwayelekile | Okujwayelekile |
Ukuhlolwa kwesibili ngesikhathi sokukhulelwa kuhlanganisa nokuhlolwa kwe-ultrasound Uchwepheshe uzohlola ngokucophelela ingane, izitho zayo, izitho zangaphakathi, ukuhlola isimo se-placenta ne-amniotic fluid. Isikhathi sokuhlolwa kwesibili sokukhulelwa kwe-ultrasound ne-biochemical test test akufani: i-ultrasound inolwazi oluningi phakathi kwamasonto angu-20 no-24, kanti isikhathi esihle sokuhlolwa kathathu ngamaviki angu-16-19.
Ake sibone izibalo
Ngeshwa, akubona bonke odokotela abachazela imiphumela yokuhlolwa kathathu kubomama abazayo. Ekuhlolweni kwesibili kokukhulelwa, izinkomba ezilandelayo zivamile:
- I-AFP ngamaviki angu-15-19 okubeletha - 15-95 U / ml nasemasontweni angu-20-24 - 27-125 U / ml.
- HCG ngesonto eli-15-25 lokukhulelwa - 10000-35000 mU / ml.
- I-estriol yamahhala emavikini angu-17-18 - 6,6-25,0 i-nmol / l, ngeviki le-19-20 - i-7,5-28,0 i-nmol / l nangesonto eli-21-22 - 12,0-41,0 i-nmol / l.
Uma izinkomba zingaphansi kwemingcele evamile, ingane ingase ibe nempilo ephelele. Ungakhathazeki uma izinombolo emiphumeleni yezivivinyo zihamba ngaphesheya komkhawulo wendabuko: ukuvivinywa kathathu kuvame kakhulu "ukuphutha". Ngaphezu kwalokho, kunezinto eziningi ezithinta kakhulu imiphumela yokucwaninga kwezinto eziphilayo:
- ukukhulelwa okuningi;
- I-IVF;
- isisindo sowesifazane okhulelwe (ngokugcwele abesifazane, ama-indices akhuliswa, uma kunjalo, kuncishisiwe);
- imikhuba emibi (ukubhema ngesikhathi sokukhulelwa);
- isifo sikashukela sinomama abakhulelwe;
- incazelo engalungile yeminyaka yobudala.
Ukuthola ukuthi kungenzeka yini ukuthi ingane yakho ingabhekana ne-fetus akufanelekile. Akekho udokotela onelungelo lokuthola ukuxilongwa, akeke ephazamise ukukhulelwa, ngesisekelo sokuhlola. Imiphumela yezifundo ivumela kuphela ukuhlola ingozi yokuba nengane eneziphene ezibelethayo. Abesifazane abanengozi enkulu yokuqoka izivivinyo ezengeziwe (i-ultrasound eningiliziwe, i-amniocentesis, i-cordocentesis).