Ukuhlola kuhlanganisa izindlela zokucwaninga eziphephile nezilula ezisetshenziselwa ukuhlola okuningi.
Ukuhlolwa kokuqala kokukhulelwa kuhloswe ekuboneni i-pathologies ehlukahlukene emntwaneni. Iqhutshwa emavikini angu-10-14 okukhulelwa futhi ihlanganisa i-ultrasound (i-ultrasound) kanye nokuhlolwa kwegazi (ukuhlolwa kwesimo semvelo). Odokotela abaningi batusa ukuhlola bonke abesifazane abakhulelwe ngaphandle kokunye.
Ukuhlolwa kwezinto ezinokwemvelo kwe-trimester yokuqala yokukhulelwa
Ukuhlolwa kwezinto ezinokwemvelo kuyimigomo egazini lezimpawu ezishintsha ku-pathologies. Kwabesifazane abakhulelwe, ukuhlolwa kwamakhemikhali kubalulekile ikakhulukazi, ngoba kuhloswe ukuthola ukukhubazeka kwe-chromosomal ebusweni (njenge-Down syndrome, i-Edwards syndrome), futhi nokuthola ukukhubazeka kobuchopho nomgogodla. Imelela ukuhlolwa kwegazi ku-hCG (i-chorionic gonadotropin yabantu) naku-RAPP-A (i-plasma-A ephazamisekile ekhulelwe). Ngesikhathi esifanayo, hhayi kuphela izinkomba ezibhekwayo, kodwa futhi ukuphambuka kwabo kusukela isilinganiso isilinganiso esungulwe isikhathi esinikeziwe. Uma i-RAPP-A inciphise, lokhu kungabonisa ukukhubazeka kwengane, kanye ne-Down syndrome noma i-Edwards syndromes. I-hCG ephakanyisiwe ingabonisa isifo se-chromosomal noma ukukhulelwa okuningi. Uma izinhlayiya ze-HCG ziphansi kunejwayelekile, lokhu kungabonisa ukuthi isifo se-placental, isongo sokukhulelwa kwesisu, ukutholakala kwe-ectopic noma ukukhulelwa okungathuthuki. Kodwa-ke, ukwenza ucwaningo lwezinto eziphilayo kuphela akukwenzeki ukuthi kutholakale ukuxilongwa. Imiphumela yakhe ikhuluma kuphela ngengozi yokuthuthukisa izifo futhi unike udokotela isizathu sokunikeza izifundo ezengeziwe.
I-Ultrasound yingxenye ebalulekile yokuhlola oku-1 kokukhulelwa
Ukuhlolwa kwe-ultrasound, thola:
- ukulungisa kwezitho zangaphakathi zengane;
- isikhundla esilungile sokuphatha kanye nemilenze;
- Ukuxhumana ngobukhulu bomzimba ngokwemigomo yokukhulelwa;
- isakhiwo nendawo ye-placenta.
Futhi futhi:
- ukukala ukugeleza kwegazi nokusebenza kwenhliziyo;
- Linganisa indawo yekollar (indawo entanyeni phakathi kwezicubu ezithambile nesikhumba). Ukulinganisa kubaluleke kakhulu, ngoba amanzi angakwazi ukuqoqa kule ndawo, futhi ngaphezu kwezindinganiso ezingaphezu kwendabuko (okujwayelekile kuya kufika ku-3 mm) kubonisa ukwehluka kokuthuthukiswa;
- ukuskena nokukala ithambo lesisindo. Ngesikhathi samaviki angu-11, kubonakala ku-98% wezingane futhi ngeke kubonakale ku-70% wezingane ezine-Down syndrome.
Lapho ukuhlolwa kwe-trimester yokuqala yokukhulelwa, amathuba okuthola i-Down syndrome ne-Edwards syndrome iphezulu futhi i-60%, futhi kanye nemiphumela ye-ultrasound ikhuphuka ibe ngu-85%.
Kubalulekile ukuqaphela ukuthi imiphumela yokuhlolwa kokuqala ngesikhathi sokukhulelwa ingathonywa yizici ezilandelayo:
- Ukukhulelwa okuphindaphindiwe (ama-indices akhulisiwe, nokuhlolwa kwesimo semvelo kungenzi lutho);
- isisindo sowesifazane (ngesisindo esikhulu, izinkomba zivame ukwanda);
- imikhuba emibi;
- Izifo zomama (isibonelo, umkhuhlane ngesikhathi sokuhlolwa noma izifo ezingelapheki);
- ukuthatha imithi;
- ukubeka isikhathi esinqunyiwe (amazinga ancike esikhathini sokukhulelwa).
Lezi zici kudingeka zicatshangelwe uma kucatshangelwa imiphumela yokuhlolwa kokuqala kwabesifazane abakhulelwe. Ngokwehlukana okuncane okujwayelekile, odokotela batusa ukuhlolwa kwe-trimester yesibili. Futhi ngengozi enkulu yokugulisa, njengomthetho, i-ultrasound ephindaphindiwe, ukuhlolwa okwengeziwe (ucwaningo lwe-chorionic villus noma ucwaningo lwe-amniotic fluid) lunqunywe. Akuyona into engafanele ukubonisana ne-geneticist.