Kuongorora kunosanganisira nzira dzakachengeteka dzekutsvakurudza dzinoshandiswa pakuongorora kuwanda.
Chirongwa chekutanga chekuita pamuviri chinangwa chekuziva zvirwere zvakasiyana-siyana mumucheche. Inoitwa pamasvondo gumi nemasere ekuberekwa uye inosanganisira ultrasound (ultrasound) uye kuongorora ropa (biochemical screening). Vanachiremba vazhinji vanokurudzira kuongorora vose vakadzi vane pamuviri vasina chavanoita.
Kuchengetedza kwezvinhu zvepanyama kwekutanga kwekutanga kwekuita pamuviri
Kuchengetedza kwepanyama kwechimiro ndiko kutsunga muropa revaridzi vanochinja mumatambudziko. Kune vakadzi vane pamuviri, kunyanya kuongorora maitiro ezvinyorwa kunokosha zvikuru, sezvo inotarisirwa kuongorora chromosomal kusagadzikana mumucheche (zvakadai seA Down syndrome, Edwards syndrome), uyewo pakuona kusagadzikana kwouropi nemutsipa wesipinha. Inomirira kuongorora ropa kweHCG (munhu chorionic gonadotropin) uye paRAPP-A (purogiramu-inosanganiswa neprotini-A plasma). Panguva imwecheteyo, kwete chete zviratidzo zvinoshandiswa zvinotorwa, asiwo kuparadzana kwavo kubva kuhuwandu hunokosha hwakagadzirirwa kwenguva yakatarwa. Kana RAPP-A yakaderedzwa, izvi zvinogona kuratidza kushanduka kwemabere, uye zvakare syndrome kana Edwards syndromes. Yakawanda hCG inogona kuratidza chromosomal disorder kana kutora mimba yakawanda. Kana zvikwangwani zveHCG zvakadarika pane zvakajairika, izvi zvinogona kuratidza hutachiona hwehutachiona, hutambudzi hwekusiya pamuviri, kuvapo kwe ectopic kana kuti kutora pamuviri usina kusimbiswa. Zvisinei, kuita zvinongororwa kwehupenyu hwehupenyu hakuiti kuti zvive nyore kugadzirisa kuongororwa. Zvigumisiro zvake zvinongotaura chete nezvehutano hwekudzivirira hutano uye kupa chiremba chikonzero chokugovera zvidzidzo zvakare.
Ultrasound chikamu chinokosha chekuongorora 1 kwekuita pamuviri
Nokuda kwekushandiswa kwechirongwa chekudzidzira, tsanangura:
- Kururamisa kwemukati mhengo dzomwana;
- nzvimbo yakarurama yezvibatanidza nemakumbo;
- Kukurukurirana kwehukuru hwomuviri kumashoko ekuzvitakura;
- chimiro uye nzvimbo ye placenta.
Uye zvakare:
- kuyera ropa nekuyerera uye mwoyo basa;
- Enzanisa nzvimbo yemirasi (iyo mitsipa iri pakati pezvinyoro zvinyoro uye ganda). Chiyero chakakosha zvikuru, sezvo mvura inogona kuunganidzirwa munharaunda ino, uye kudarika mararamiro ari pamusoro pemaitiro (zvinowanzoita kusvika kusvika 3 mm) inoratidza kusiyaniswa kwekukura;
- kuongorora uye kuyera pfupa remhino. Panguva yevhiki gumi nemana, inoonekwa muna 98% yevana uye haigone kuonekwa mu 70% yevana vane Down syndrome.
Apo kuongororwa kwekutanga kokutanga kwekuita pamuviri, mikana yekuziva Down syndrome uye Edwards syndrome yakanyanya kwazvo uye iri 60%, uye pamwechete nemigumisiro ye ultrasound inowedzera kusvika 85%.
Zvakakosha kucherechedza kuti migumisiro yekuongorora kwekutanga panguva yekuzvitakura kunogona kuchinjwa nezvinhu zvinotevera:
- Kubata mitezo yakawanda (iyo makisikiti inowedzera, uye kuongorora maitiro ezvinyorwa hazviiti chero pfungwa);
- kuyerwa kwemukadzi (ane kuyerwa kukuru, zviratidzo zvinowanzowedzerwa);
- miitiro yakaipa;
- zvirwere zvomukadzi (somuenzaniso, kutonhora panguva yekuedzwa kana zvirwere zvisingaperi);
- kutora mishonga;
- zvisina kukodzera kugadzirisa matanho (mazana anoenderana nenguva yehutachiwana).
Izvi zvinofanirwa kuongororwa paunofunga nezvemigumisiro yekutanga kuongororwa kwevakadzi vane pamuviri. Nekusavhiringidza kuduku kubva kuchimiro, vanachiremba vanokurudzira kuongorora kwechipiri chetatu. Uye nehuwandu hwehutachiona hwekutapukisa, semutemo, kudzokorora ultrasound, kuongororwa kwakawedzerwa (chorionic villus sampling kana kuti amniotic fluid tsvakurudzo) inorayirwa. Hazvina kufanira kutarisana neine geneticist.