Ukuthola izifo ezinyangeni zokuqala zokuthuthukiswa kwe-intrauterine kusizwa ngokuhlola i- trimester yokuqala . Lokhu kuyinkimbinkimbi yezinyathelo zokuxilonga kuhloswe ekuhloleni izinga lokuthuthukiswa kwe-intrauterine yengane ngokuqhathanisa izinkomba zesikhathi sokukhulelwa. Inqubo iphoqelekile futhi yenziwa kubo bonke omama esikhathini esizayo.
Kungani ukuhlola ukukhulelwa?
Ukuhlolwa ngesikhathi sokukhulelwa kuyindlela ephoqelekile, lapho ingozi yokuhlakulela okungavamile ebusweni ifakwe. Izinqubo zokuxilonga zisiza ukukhomba ukubonakala okukhona ekuthuthukiseni ukukhubazeka kofuzo lwe-fetus, ukusungula umehluko phakathi kokuthuthukiswa kwezitho zangaphakathi zengane ngesikhathi sokukhulelwa.
Inqubo iyeluleki, kepha abesifazane abenqabe ukwenza kanjalo, bazi ukuthi kubaluleke kangakanani lezi zifundo. Kukhona futhi izinkomba, ubukhona obangela ukuziphatha okugunyazayo kwesifundo:
- unyaka wesifazane uneminyaka engaphezu kwengu-35;
- ukusongelwa kokukhipha isisu ;
- ukukhipha isisu ngokuzenzakalelayo ku-anamnesis;
- ukutholakala kwe-chromosomal engavamile ye-fetus esikhathini sokukhulelwa kwangaphambili;
- izifo ezithintekayo ngamagama amancane;
- ukusetshenziswa okuphoqelelwe kwezidakamizwa eziphikisanayo ngemigomo emifushane;
- Ukuba khona kwemikhuba emibi (utshwala, ukulutha izidakamizwa);
- ubuhlobo obuhlobene eduze nobaba nomama wengane.
Ukuhlolwa kwe-trimester yokuqala - kuyini?
Ukuhlolwa kokuqala kokukhulelwa ukuhlolwa okuphelele komzimba womama. Ngokuqaliswa kwayo, odokotela baphishekela umgomo wokuxilongwa kokuqala kanye nokulungiswa okuqhubekayo kokuthuthukiswa komntwana okungezansi. Ngesikhathi esifanayo, bahlola isimo sempilo kamama ozayo. Ukuhlolwa kwe-trimester yokuqala kuqukethe i-ultrasound kanye nokuhlola kwegazi kwe-biochemical owesifazane okhulelwe. Ukuhlolwa kwezinkomba zegazi kwenziwa esiteji sesibili, lapho kukhona ukuphambuka nokusola kokugula ngenxa yesimo se-ultrasound. Izigaba zenziwa ngokuqhubekayo, izinqubo ezimbili zivunyelwe ngosuku olulodwa.
Ukuhlolwa kwe-Ultrasound kwe-1 trimester
I-Ultrasound ekukhulelweni ibalulekile. Ngosizo lwe-ultrasound, odokotela bakwazi ukuhlola isibeletho somama, bahlole isimo semvelo encane, izitho zangaphakathi. Esikhathini sokutadisha okunjalo, ekuhlolweni kokuqala kwe-trimester, odokotela banakekele izinkomba ze-anthropometric, okuyizinto ezibonisa ukuthuthukiswa okulungile kwe-fetus, ukubhaliswa kobukhulu bomzimba kuze kube sesikhathini sokubeletha. Uma i-trimester ihlolwe, udokotela ukhathalela imingcele elandelayo:
- I-KTP (usayizi weparietal we-coccygeal);
- ubukhulu bekhanda le-fetal;
- ukulinganisa kwe-hemispheres ye-cerebral;
- ubukhulu bamathambo amade amade;
- ubukhulu benhliziyo nobubanzi bezitsha ezisishiya;
- ukwakheka kwesisu nezinye izitho zangaphakathi.
I-Biochemical Screening Trimester
Ukuhlolwa okunjalo ngesikhathi sokukhulelwa odokotela baqokwa emva kokuthola imiphumela emibi ye-ultrasound. Basola ukuthi i-pathology esikrinini sokweqapha, odokotela bafuna ukuqinisekisa ukuthi izinto ezicatshangwayo zihloswe. Kumele kuqashelwe ukuthi lolu cwaningo kufanele lwenziwa kuphela ngesikhathi esithile sokukhulelwa, njengoba izinkomba zezinkomba zixhomeke ngqo esiteji sokukhulelwa. Lapho ukuhlolwa kwegazi lwe-biochemical kugxila ezinkomba ezilandelayo:
- I-HCG ;
- I-PAPP-A .
Yini ukuboniswa kokuqala kokubonisa?
Ngesikhathi sokuhlolwa kokuqala, odokotela bazama ukukhipha okungajwayelekile okungenzeka kwe-chromosomal. Lokhu kuhlukumeza akubonakali ngokwabo nganoma iyiphi indlela, ukutholakala kwabo akuthinti isimo sesifazane okhulelwe. Kodwa-ke, zingabonakala ngokushintsha kwesimilo ekubukeni kwe-fetus nangokuba khona kwamakaki athile egazini lomama ozayo. Phakathi kwama-pathologies angase akwazi ukukhomba ukuhlolwa kwe-trimester yokuqala:
- I-Down syndrome - i- trisomy 21 i- chromosomes, ivela kumacala angu-1 kwangu-700.
- I-pathology ye-neural tube development (encephalocele).
- I-Omphalocele - ngoba le ngxenye yokukhubazeka ibekwe ngaphansi kwesikhumba sodonga lwangaphakathi lwesisu, singene esikhwameni sesisu.
- I-Patau syndrome i-trisomy ku-chromosome 13. Akuvamile, 1 icala lokukhulelwa okungu-10 000. Kuhambisana nokulimala okukhulu ezingxenyeni zangaphakathi. Amaphesenti angama-90% azalwa nalesi sifo ahlongakala ngonyaka wokuqala wokuphila.
- I-Edwards syndrome - i-trisomy ku-chromosome 18. Kwenzeka kumacala angu-1 kwangu-7000. Ngokuvamile kwenzeka kumama asebekhulile (abakhulelwe emva kweminyaka engama-35).
- I-triploidy - ingane itholakala ukuthi ineqoqo lama-chromosomes amathathu, elihambisana nezinkinga eziningi.
- I-Cornelia de Lange syndrome - ebonakala ngokuthuthukiswa kwe-fetus ezinonya eziningi ngokuphuza kwengqondo esikhathini esizayo.
Ukuhlolwa kokuqala kwe-trimester kwenziwa kanjani?
Isikrini sokukhulelwa ku-trimester yokuqala senziwa ngezikhathi eziqinile. Owesifazane utshele kusengaphambili isikhathi salo mcimbi. Ngesikhathi esimisiwe ufika ekubonisaneni futhi kuqala uthola i-ultrasound. Lolu cwaningo lungaba lula ngaphakathi (ngokusebenzisa ubulili) noma isifo sangasese (ngokusebenzisa udonga lwesisu sangaphakathi). Ngokuvamile, inqubo yesiguli ayifani ne-ultrasound evamile. Ngemuva kokuthola imiphumela, uma kucatshangwa ukuthi isifo, ukuvivinya igazi kwegazi kuyasetshenziswa. Le ndaba ithathwe kusukela emthanjeni, ngesisu esingenalutho ekuseni.
Ukuhlolwa kokuqala kokukhulelwa - isikhathi
Ukuze bazilungiselele, ukulungiselela kusengaphambili isifundo, abesifazane bavame ukuthakazelisa odokotela lapho benza ukuhlolwa kwe-trimester yokuqala. Isikhathi salolu cwaningo lukhawulelwe - ukuze uthole imiphumela engumgomo, kufanele kwenziwe ngokuqondile ngezikhathi ezithile zokukhulelwa. Okufanele ukuhlolwa kuyinkathi kusukela ngosuku lokuqala lweviki leshumi lokukhulelwa kuze kube ngumhla ka-6 weviki le-13. Ezimweni eziningi, ukuhlolwa kokuqala kokukhulelwa, izinsuku ezibizwa ngazo ngenhla, zenziwa ngamasonto angu-11-12 ukubeletha. Ngalesi sikhathi, iphutha ekubalweni lincane.
Ilungiselela ukuhlolwa kwe-1-term
Ukuhlola isiqalo sokuqala kwakuyizinhloso, odokotela bagcizelela ukuhambisana nemithetho yokulungiselela isifundo. Endabeni ye-ultrasound, konke kulula: uma kwenziwa nge-sensor transvaginal, ke akukho ukulungiselela okukhethekile okudingekayo; uma ngodonga lwangaphakathi lwesisu - kudingeke ukuba ugcwalise isambiso ngaphambi kwenqubo ye-ultrasound.
Ukulungiselela ukuhlolwa kwegazi nge-biochemical kuyinkimbinkimbi futhi kuhlanganisa:
- Ukuhambisana nokudla: ukuxoshwa ekudleni kwe-citrus, ukudla kwezilwandle, ushokoledi.
- Ukwenqaba izitsha ezithosiwe namafutha.
- Igazi lizinikela emahoreni asekuseni, ngesisu esingenalutho. Ukudla kokugcina kufanele kwenzeke kungakapheli amahora angu-12 ngaphambi kwesikhathi esilinganisiwe sokuhlaziywa.
Imiphumela yokuhlola i-trimester engu-1 - ukucacisa, evamile
Emva kokuhlolwa kwe-trimester yokuqala, ukuchazwa kwemiphumela kwenziwa kuphela udokotela. Ukukhulelwa akukwazi ukuhlola ngokulinganayo amanani atholakalayo, ngisho nalapho eqhathaniswa namazinga okujwayelekile. Ukukhulelwa ngayinye kunezici zayo, ngakho-ke, ukuhlolwa komphumela kufanele kwenziwe ngokucabangela inkambo yokubeletha, isikhathi sayo, isimo somzimba wesifazane, inani lezithelo zokuthela.
Lapho uhlola izinkomba zokuthuthukiswa komuntu ngamunye, etholakala yi-ultrasound, odokotela banakekele imingcele elandelayo:
- I-KTR - ubukhulu be-fetus kusuka komqhele kuya kumsila;
- ubude bomzimba - ubukhulu bomzimba wengane kusukela phezulu kuya ezithende;
- ikhanda lokuzungeza;
- I-BDP (ubukhulu biparietal) - ibanga phakathi kwe-hillocks emnyama;
- I-TVP - ubukhulu besikhala sekholomu;
- Isilinganiso senhliziyo - izinga lenhliziyo lomntwana.
Lapho uhlola ukuhlolwa kwamakhemikhali ngesikhathi sokukhulelwa, qaphela izinkomba ezimbili eziyinhloko:
- i-β-hCG-gonadotropin ye-chorionic;
- I-PAPP-A iyi-protein-A, ehambisana nokukhulelwa.
Izindlela zokuhlola i-trimester engu-1 - ukucacisa i-ultrasound, itafula
Esimweni ngasinye ngabanye, odokotela, lapho behlola imiphumela ye-ultrasound ukuhlolwa kwe-trimester yokuqala, yenza ukulungiswa kwezici zomuntu ngamunye zokuthuthukiswa komntwana. Njengoba kunikezwe leli qiniso, odokotela bayavuma ukuphambukiswa okuncane kwezinkomba kusuka emithethweni esungulwe. Ngaphezu kwalokho, imiphumela yezifundo nayo ingathinteka kwesinye isici - iphutha ekubaleni isikhathi esichithwa yi-obstetrician. Ukukhipha ukuhlolwa kokuqala kokukhulelwa, izimiso zazo ezinikezwa etafuleni elingezansi, odokotela kuqala baqaphele isikhathi esiqondile sokukhulelwa.
Ukuhlolwa kwe-trimester yokuqala - ukumisa imiphumela yegazi
Njengoba kuphawuliwe ngenhla, ukutadisha igazi kowesifazane okhulelwe kusetshenziselwa lapho kutholakala ukuthi i-pathology iyatholakala noma uma kukhona ukusola nge-ultrasound. Kulokhu, odokotela banakekele izinkomba ezilandelayo:
- I-β-hCG- gonadotropin ye-chirionic, i-hormonal substance eyenziwe yi-chorion. Ngosizo lwakhe ukuxilonga ukukhulelwa ngezigaba zakuqala. Kodwa-ke, uyinkomba ebalulekile ye-trimester eyodwa kuphela. Nsuku zonke ukuhlushwa kwe-hCG kwanda, kufinyelela emasontweni angu-11 kuya ku-12 ukuya kwesikhashana.
- I-PAPP-A iyi-protein-A, ehambisana nokukhulelwa. Le nhlanganisela yamaprotheni ikhiqizwa yi-placenta, enesibopho sokuthuthukiswa kwayo kanye nokusebenza kwayo. Ngemuva kokuhlolwa kwezinto eziphilayo ze-trimester yokuqala, imiphumela igxiliwe udokotela obuka owesifazane okhulelwe. Amanani alezi zikhombisi ngesikhathi sokukhulelwa anikezwa kumatafula angezansi.
Ubulili bomntwana ekuhlolweni kokuqala
Ukuhlolwa kwangaphambi kokubeletha kwe-1 trimester akuvumeli ukucacisa ngokuthembekile ubulili bezingane ezizayo. Njengoba kunikezwe leli qiniso, odokotela abathinti ukubaluleka kule nkhomba. Kodwa-ke, ngesicelo sikaMama uqobo lwakhe, isazi esendaweni ekahle ye-fetus singenza izinhloso zakhe ngokuphathelene nobulili bomntwana. Ngokwenza njalo, azihambisani ngaso sonke isikhathi namaqiniso futhi ngokuvamile aphutha, ngakho-ke uma ukuhlolwa kokuqala kwenziwa le parameter ayicatshangelwa.
Imiphumela yokuhlola engalungile ye-trimester yokuqala
Umphumela ombi wokuhlola i-trimester yokuqala yisizathu sokuhlola kabusha. Nokho, kwenziwa ngemuva kwesikhathi, ngo-2 futhi, uma kunesidingo, ku-3 trimesters. Ezimweni ezingavamile, lapho kunezimo ezimbi ezivela ezifundweni eziningana, odokotela bangabambelela ekwenzeni ukuhlolwa okuphazamisayo. Kakade ngemiphumela yalezi zicwaninga isinqumo sokwandiswa kokukhulelwa noma ukuphazamiseka kwayo kwenziwa. Phakathi kwalezi zindlela zokuxilonga:
- i-chorionic villus biopsy;
- i-cordocentesis (ukuhlaziywa kwegazi lomthambo);
- amniocentesis (isifundo se-amniotic fluid).