Kuziva hutachiona mumatanho ekutanga ekugadzirisa intrauterine kunobatsirwa nokuongorora kwekutanga kwemitatu . Ichi chakaoma chekuongororwa kwezvirwere chinangwa chekuongorora kutengesa kwekuwedzera kweprauterine yemwana nekuenzanisa zviratidzo zvepanguva yekuzvitakura. Iyo nzira inogadziriswa uye inoitwa kune vose vanaamai vari mberi.
Nei uchiongorora kuve nepamuviri?
Kuchengetedza panguva yekuzvitakura inomirira nzira, iyo iyo ngozi yekudzikisa kusakanganiswa mumucheche inotangwa. Kuongorora zvirongwa kunobatsira kuziva kusarudzwa kwekugadzirwa kwemararamiro asina kufanira ehu fetus, kusimbisa kusiyana kwekuvandudzwa kwenhengo dzomukati mukati memucheche.
Nzira yacho inopa mazano, asi vakadzi havazomborambi kuita kudaro, vachiziva kukosha kwezvidzidzo zvakadaro. Pano panewo zviratidzo, kuvapo kwechikonzero chinokonzera kutenderwa kwekudzidzira:
- Zera remukadzi rinopfuura makore makumi matatu;
- kutyisa kubvisa pamuviri ;
- kubvisa pamuviri kamwechete muam anamnesis;
- kuvapo kwechromosomal kusagadzikana kwemu fetus muzvisikwa zvakapfuura;
- hutachiwana hutachiwana pamashoko maduku;
- kushandiswa kushandiswa kwezvinodhaka zvinopesana nemashoko mashoma;
- kuvapo kwemitemo yakaipa (kudhakwa, kusvuta zvinodhaka);
- ukama hukama hwepedyo hwababa naamai vemucheche.
Kuchengetedza kwekutanga katatu - chii ichocho?
Kuongorora kwekutanga kwekuita pamuviri ndeyekuongorora kwakakwana muviri weamai. Nekugadzirisa kwayo, vanachiremba vanotevera chinangwa chekuongorora nekutanga uye nekugadziriswa kwekuberekwa kwe fetal kuipa. Panguva imwecheteyo, vanoongorora hutano hwemangwana amai. Kuchengetedza kwekutanga kwetatu kunosanganisira ultrasound uye biochemical blood test kumukadzi ane pamuviri. Kuongororwa kwezviratidzo zveropa kunowanikwa pachikamu chechipiri, pamberi pezvokukanganisa nekufungidzirwa kwehutano zvichienderana nehutachiona hwehutachiona. Nhanho dzinoitwa nguva dzose, maitiro maviri anobvumirwa mune rimwe zuva.
Ultrasound kuongorora 1 trimester
Ultrasound pakuzvitakura inokosha. Nekubatsirwa kwe ultrasound, vanachiremba vanogona kutarisa mudumbu raamai, kuongorora mamiriro ezvinhu ediki, nhengo dzomukati. Mukati yekudzidza kwakadaro, mukutarisa kwekutanga kokutanga, vanachiremba vanocherechedza zviratidzo zveanthropometric, izvo zvinoratidza kuratidza kwakarurama kwema fetus, mutsamba wehukuru hwomuviri wake kusvika panguva yekubata. Apo trimester ichiongororwa, chiremba anonyatsotarisa kune zvidimbu zvinotevera:
- KTP (coccygeal parietal size);
- ukuru hwemusoro we fetal;
- kuenzanisa kwehutachiona hwemhepo;
- hukuru hwemapfupa emakore mazhinji;
- ukuru hwemoyo uye kureba kwemidziyo inoisiya;
- kunzvimbo yepamukati nedzimwe nhengo dzomukati.
Biochemical Screening Trimester
Miedzo yakafanana panguva yekudzivirira vanachiremba vanosarudza mushure mekutambira chigumisiro chakaipa che ultrasound. Akashungurudza hutachiona pahwindo rekuongorora, vanachiremba vanoda kuve nechokwadi chekutarisira kwekufungidzirwa kunofungidzirwa. Zvinofanira kuonekwa kuti chidzidzo chino chinofanira kuitwa pane imwe nguva yekuzvitakura, sezvo mitemo yezvikwangwani zvakananga kubva pachigamba chekuita. Apo biochemical blood test inoteerera zvinotevera zviratidzo:
- HCG ;
- PAPP-A .
Chii chinotarisa kuratidzwa kwekutanga?
Munguva yekuongorora kwekutanga, vanachiremba vanoedza kubvisa zvisingaiti zvechromosomal zvisiri izvo. Izvo zvinopesana hazvizviratidzi pachena nenzira ipi zvayo, kuvapo kwavo hakugadziri mamiriro emukadzi ane pamuviri. Zvisinei, vanogona kuonekwa nehutano hunochinja mukuonekwa kwema fetus uye nekuvapo kwevamwe maridza muropa remai vari mberi. Pakati pezvinogona kuitika zvirwere zvinobatsira kuongorora kuongorora kwekutanga kwetatu:
- Down syndrome - trisomy 21 chromosomes, inowanikwa mumashure ma1 700.
- Pathology ye neural tube development (encephalocele).
- Omphalocele - nokuda kwechikamu ichi chezvirwere chemukati chemuviri chinoiswa pasi peganda rekunze kwemuviri pamadziro, kusvika muchechi yake.
- The Patau syndrome is trisomy pa chromosome 13. Hazviwanzoiti, 1 kamu-10 000 pamuviri. Icho chiri pamwe chete nekukuvara kwakanyanya kune nhengo dzomukati. Vana makumi mapfumbamwe kubva muzana vakaberekerwa nehutano hunofa mukati megore rokutanga rehupenyu.
- Edwards syndrome - trisomy pa chromosome 18. Izvo zvinoitika mumatambudziko anokwana 1 000. Kazhinji inowanikwa mumadzimai akwegura (ane pamuviri mushure memakore makumi matatu).
- Triploidy - mucheche anoonekwa kuti ane chromosomes yechitatu, iyo inowirirana nematambudziko akawanda.
- Cornelia de Lange syndrome - inoratidzwa nekuvandudzwa kwema fetus zvakashata zvakanyanya nekukurumidza kwekutadza mupfungwa munguva yemberi.
Iko kuongorora kwekutanga kwetatu kwakaitwa sei?
Kuongorora kuve nepamuviri mumutambo wekutanga kunowanikwa muzvikamu zvakasimba nguva. Mukadzi akaudzwa nguva isati yaitika. Penguva yakatemwa anouya kumubvunzurudzo uye kutanga anotarisa ultrasound. Ichi chidzidzo chinogona kupfurikidza (kuburikidza nemudzimai) kana chepabonde (kuburikidza nekunze kwemuviri kumadziro). Nenzira yakawanda, chirongwa chemu murwere hachisi chakasiyana nechekare ultrasound. Mushure mokugamuchira migumisiro, kana chirwere chinenge chichifungidzirwa, chirwere chekuongorora ropa chinoshandiswa. Nyaya yacho inotorwa kubva mumhino, pane isina chinhu mudumbu mangwanani.
Kutanga kuongororwa kwekudzivirira - nguva
Kuzvigadzirisa pachavo, kugadzirira mberi kwekudzidza, vakadzi vanowanzofarira vanachiremba pavanoita kuongorora kwekutanga kwevatatu. Nguva yekuongororwa uku haigoneki - kuitira kuti uwane zvinogadziriswa, inofanira kuitika zvakanyanyisa mune dzimwe nguva dzehupamuviri. Izvo zvakakosha zvekuongororwa ndezvenguva kubva pazuva rokutanga revhiki yegumi yekuzvitora kusvika musi wechitanhatu wevhiki yegumi nembiri. Muzviitiko zvakawanda, kuongorora kwekutanga kwekuita pamuviri, iyo mazuva ayo anonzi pamusoro apa, inoitwa kumavhiki gumi nemasere kusvika ku12 gestation. Panguva ino, kukanganisa muhuwandu hakusi kudarika.
Kugadzirira kwenguva 1 yekuongorora
Kuchengetedza chetatu yekutanga kwaiva nechinangwa, vanachiremba vanomiririra pakuteerera nemitemo yekugadzirira kwekudzidza. Munyaya ye ultrasound, zvinhu zvose zvakajeka: kana zvichiitwa neinzwi rinoputika, saka hapana kugadzirira kunokosha kunodiwa; kana kuburikidza nemadziro emadziro emukati - inofanirwa kuzadza mukanda pamberi pemaitiro e ultrasound.
Kugadzirira kweropa rekuongorora ropa kunonyanya kuoma uye rinosanganisira:
- Kuteerera nekudya: kusabviswa kubva pakudya kweviritsi, hove yegungwa, chocolate.
- Kuramba kwezinga rakabikwa uye mafuta.
- Ropa rinopa mambakwedza maawa, pane dumbu risina chinhu. Kudya kwekupedzisira kunofanirwa kuitika mushure memaawa gumi nemaviri isati yasvika nguva yakatarwa yekuongorora.
Migumisiro yekuongorora 1 trimester - decoding, norm
Mushure mekuongororwa kwekutanga kwekutatu, tsanangudzo yemigumisiro inoitwa chete nachiremba. Mucheche haakwanisi kuongorora zvakajeka mararamiro akawanikwa, kunyange kana achivaenzanisa nemitengo yezvinodiwa. Mimba yoga yoga ine maitiro ayo, saka, kuongororwa kwechigumisiro kunofanira kuitwa nekufungisisa nguva yekuita gumbo, nguva yaro, nyika yemukadzikadzi, nhamba yekutakura michero.
Kana uchitarisa zviratidzo zvekufambiswa kwemwana, zvakagadzirwa ne ultrasound, vanachiremba vanocherechedza zvinotevera:
- KTR - hukuru hwemucheche kubva korona kusvika kumuswe;
- kureba kwomuviri - ukuru hwemuviri wemwana kubva kumusoro kusvika kune zvitsitsinho;
- musoro circumference;
- BDP (biparietal size) - kureba pakati peusiya hillocks;
- TVP - ukuru hwekoro nzvimbo;
- Mutengo we mwoyo - moyo wekuda mwana.
Paunenge uchitarisa maitiro ezvinyorwa zvepanyama panguva yekuzvitakura, teerera kune zviratidzo zviviri zvikuru:
- β-hCG-chorionic gonadotropin;
- PAPP-A inonzi protein-A, inobatanidzwa nepamuviri.
Nzira dzekuongororwa kwe 1 trimester - kukodha ye ultrasound, tafura
Muchiitiko chimwe nechimwe, vanachiremba, pavanongorora mitsva yekuongorora kwe ultrasound kwekutanga kwema trimester, vanoita kururamisa kune mumwe munhu unhu hwekukura kwe fetus. Zvichipa izvi, vanachiremba vanobvuma kupotsa zvishoma kwezviratidzo kubva pamitemo yakagadzirwa. Mukuwedzera, migumisiro yezviongorori inogonawo kukanganiswa neimwe chimwe chinhu-kukanganisa mukuverenga nguva yakashandiswa nechiremba chiremba. Kutakura kuongorora kwekutanga kwekuita pamuviri, maitiro ayo anopiwa mutafura iri pasi apa, vanachiremba vanotanga kutsanangurira nguva chaiyo yekubata.
Kuchengetedza kwekutanga kwekutatu-kujekesa migumisiro yeropa
Sezvakataurwa pamusoro apa, kuongorora ropa remukadzi ane pamuviri kunoshandiswa kune apo chirwere chinowanikwa kana kana pane kusafungirwa kwayo ne ultrasound. Muchiitiko ichi, vanachiremba vanocherechedza zvinotevera zviratidzo:
- β-hCG -chorionic gonadotropin, chinhu chinonzi hormonal chinogadzirwa necharion. Nekubatsira kwake kuongorora kuberekwa mukutanga kwekutanga. Zvisinei, ndiye chiratidzo chinokosha che 1 trimester chete. Zuva rimwe nerimwe huwandu hweHCG hunowedzera, hunoti huwandu hwemavhiki gumi nemasere kusvika ku12.
- PAPP-A inonzi protein-A, inobatanidzwa nepamuviri. Iyi proteiniti yakagadzirwa inobudiswa ne-placenta, inokonzerwa nekugadzirwa kwayo kwakakwana nekushanda. Mushure mokuongorora maitiro ezvinyorwa zvemagetsi ekutanga kwetatu, migumisiro inotaridzirwa nachiremba uyo ari kutarisa mukadzi ane pamuviri. Izvo zvinokosha zvezvikwereti izvi panguva yekuzvitakura zvinopiwa mumatafura ari pasi apa.
Kuita zvepabonde kwemwana paunotanga kuongorora
Kuchengetedzwa kwepabonde kwe1 trimester hakubvumi kuti zvive nechokwadi chekuita zvepabonde revana remangwana. Zvichipa izvi, vanachiremba havanyanyi kukoshesa ichi chiratidzo. Zvisinei, pakukumbira kwaamai pachavo, nyanzvi pane imwe nzvimbo yakakwana yemucheche anogona kuita zvaanofunga pamusoro pepabonde re fetus. Mukuita, haisi nguva dzose yakabatana nechokwadi uye inowanzokanganisa, saka kana kuongorora kwekutanga kuchiitwa iyi parameter haina kuverengwa.
Zvinonyanya kuongororwa zvigadzirwa zvekutanga chetatu
Chigumisiro chakaipa chekuongororwa kwekutanga chetatu ndicho chikonzero chekuongorora zvakare. Zvisinei, inoitwa pashure penguva, pa2 uye, kana zvichidikanwa, mumatatu matatu. Muzviitiko zvisingawanzove, nemigumisiro yakaipa kubva kuongororo dzakawanda, vanachiremba vanogona kusimbisa pakuita kusakosha kuongororwa. Ikozvino nemigumisiro yeiyi inotsvakurudza chisarudzo chekuwedzerwa kwekuita pamuviri kana kukanganisa kwayo kunoitwa. Pakati peizvi nzira yekuongorora:
- chorionic villus biopsy;
- cordocentesis (cord blood analysis);
- amniocentesis (kudzidza amniotic fluid).