Inhliziyo yesisu iqala ukwehla ngesonto lesihlanu lokukhulelwa, futhi ngeviki lesishiyagalolunye iyisitho esenziwe ngokugcwele, enezakhi ezimbili ze-ventria nama-atria amabili. Ngokwemvelo yesimo senhliziyo, ukusebenza komntwana kuhlonishwa ezinyathelweni zokuqala, kanti engxenyeni yesibili yokukhulelwa izinga lokushaya kwenhliziyo (HR) libonisa isimo se-fetus.
I-heart rate ye-Fetal iyinhlangano evamile
Ku-trimester yokuqala, imvamisa yezinhlungu zomzimba ebusweni ihlale ishintsha. Lokhu kungenxa yokuthi phakathi kwamasonto okuqala okukhulelwa isitho esibalulekile sakhiwa kuphela, futhi ingxenye yesimiso sezinzwa esibhekene nomsebenzi wayo ayikakhuliswa. Ngakho-ke, emasontweni angu-6-8, izinga lokushaywa kwenhliziyo lomsana luyizinyosi ezingu-110-130 ngomzuzu, emasontweni angu-9-10 okujwayelekile kwesilinganiso senhliziyo ezinganeni kushaya izinsimbi ezingu-170-190 ngomzuzu. Kusukela evikini le-11 lokukhulelwa kuze kube yilapho kuzalwa, inhliziyo evamile ye-fetus ingukushaya kwe-140-160 ngomzuzu.
Ukwehlukana emsebenzini wenhliziyo
Ngeshwa, ukukhubazeka emsebenzini wenhliziyo encane kungenzeka kakade ezinkathini zokuqala zokukhulelwa: uma ukushaya kwenhliziyo kungabhalwa emkhatsini we-embryo ubude buka-8 mm, lokhu kungase kube uphawu lokukhulelwa okuqhubekayo. Owesifazane unconywa ukuba ahlole ukuhlolwa kwesibili kwe-ultrasound ngesonto, ngemuva kwalokho utholakala.
Ukwehluka kwesilinganiso senhliziyo evamile (ukwanda kwentengo yenhliziyo kuya kwezingu-200 ngomzuzu noma ukwehla kuya ku-85-100 beats ngomzuzu) ezimweni eziningi kubonisa ukungabi nenjabulo kwengane. I- palpitation esheshayo ye-fetus (tachycardia) ingabonwa kula macala alandelayo:
- i-hypoxia yobusana benani eliphansi (uma owesifazane okhulelwe ehlala isikhathi eside egumbini elithengayo);
- umsebenzi womzimba wengane noma umama;
- ukwandisa ithoni yesibeletho;
- ukukhathazeka ngokomzwelo komama ozayo.
Ukushaya kwenhliziyo okungenangqondo nokubuthakathaka kwe-fetus (bradycardia) kukhuluma ngo:
- hypoxia enkulu ye-intrauterine;
- ukutholakala kokungenakulinganiswa kwe-fetoplacental;
- ukungabi namanzi noma ama-polyhydramnios;
- isethulo sangempela lesisu.
Ukushaya kwenhliziyo kwesibindi kubonisa ukutholakala kokukhubazeka kwenhliziyo noma i-intrauterine hypoxia yengane.
Isilinganiso senhliziyo ye-fetal sinqunywa kanjani?
Kunezindlela eziningana zokunquma nokuhlola umsebenzi womzimba we-fetus: i-auscultation (ukulalela ukushaya kwenhliziyo kwe-fetus ngosizo lwe-stethoscope yesisindo), i-ultrasound, i-cardiotocography (CTG), kanye ne-echocardiography (ECG).
Esikhathini sokuqala sokukhulelwa, umbuzo othi "Iyiphi inhliziyo ebusweni?" Sizosiza i-ultrasound: isebenzisa inzwa engapheliyo, izinqamuzana zenhliziyo zingatholakala ngemva kwamasonto ama-5-6. Okujwayelekile (okuguquguqukayo) okubhalisa ama-ultrasound inhliziyo inhliziyo kusuka emavikini angu-6-7. Ukunquma ukushaya kwenhliziyo emasontweni ahlukene okukhulelwa ku-ultrasound nasezifundweni ezintathu zokuhlola. Emisebenzini yansuku zonke izidakamizwa-izazi zezinzwa zisebenzisa i-stethoscope, ukulalela ngosizo lwakhe umsebenzi wenhliziyo ngodonga lwesisu. Ukuvuthwa kwamathoni enhliziyo kungenzeka kusukela ngesonto lama-20 lokukhulelwa, futhi ngezinye izikhathi - kusukela ngesonto lama-18.
Emasontweni angama-32, izinga lokushaya kwenhliziyo lihlolwe nge-CTG. Le ndlela ikuvumela ukuba urekhode umsebenzi wenhliziyo ye-fetal, ukuchotshozwa kwesibeletho nomsebenzi womntwana wengane. I-CTG evamile iyadingeka uma umama ozayo ehlushwa isifo esinzima se-gestosis, izifo ezingapheli noma ezithathelwanayo, kanye nokungajwayelekile kokuphazamiseka kwe-placental, i-hypotrophy fetal, amanzi aphansi noma ama-polyhydramnios. Ngesikhathi sokubeletha, i-CTG yenzelwa ukukhulelwa ngaphambi kwesikhathi noma ukulibaziseka, ngobuthakathaka bokusebenza noma i-rhodostimulation.
I-ECG ye-fetal iqhutshwa emavikini angu-18-28 futhi kuphela kulezi zinkomba ezilandelayo:
- unyaka womama ungaphezu kuka-38;
- ukubelethwa okukhona kwezingane ezinezifo zenhliziyo ezibelethwe;
- ukukhubazeka kwenhliziyo engumama kumama ozayo;
- i-hypotrophy yesisu;
- ukutholakala kokungajwayelekile emisebenzini yenhliziyo, ezinye izifo kanye nezifo ezingavamile ezitholakala ku-ultrasound of the fetus;
- isifo sikashukela sikhuluma ngabesifazane;
- izifo ezithathelwanayo ngesikhathi sokukhulelwa.
Kulolu cwaningo, kuphela inhliziyo ye-fetus ehlolwe, umsebenzi wayo uhlolwe, kanye nokugeleza kwegazi eminyangweni ehlukene (besebenzisa umbuso weDoppler).