Kuongorora kwekutanga kwekuzvimba ndiko kudzidza kunonakidza kune amai vari mberi. Chinangwa chekuziva kusvibiswa kwemucheche, kusakanganisika. Migumisiro yekudzidza inogona kuongororwa chete nachiremba uyo anocherechedza pamuviri.
Chii chinonzi kuongorora katatu?
Kutarisa kwekutanga kuongorora kwakakwana kwe fetus, iyo inosanganisira ultrasound uye chidzidzo chezvinyorwa zvehupenyu zvehupenyu hweamai vamangwana. Pamusoro pekuberekwa kwose izvi zvinogona kuitwa katatu, 1 nguva per trimester. Muzviitiko zvakawanda, chete chirongwa chechirongwa che ultrasound chinotarisirwa. Kana chiremba ari kukanganisa kudarika, kukanganisa kubva pane zvisizvo, pamwe nekuwedzera, kuongorora kweropa kunokonzerwa.
Kuti vawane chinangwa chinangwa uye nenzira yakarurama kududzira dhiyabhorosi, chiremba anofanira kufungisisa zvikamu zvakasiyana-siyana, zvakadai sokukwirira, uremu hwevakadzi vane pamuviri, kuvapo kwemitemo yakaipa, iyo inogona kukanganisa migumisiro yekudzidza. Nezvo izvi mupfungwa, mukadzi ane pamuviri haafaniri kuedza kutarisa kuongorora kwekutanga kwakaitwa panguva yekuzvitakura ari oga.
Sei kucherechedza pamuviri kuchidiwa?
Kuongororwa kwekutanga kwetatu kunobvumira matanho ekutanga ekutambisa intrauterine kuti aone kusiyana kwezvinoitika pakuumbwa kwenhengo dzomukati, kuti aone zvirwere zvepachivi. Pakati pezvinangwa zvakakosha zvekuongorora kwakakwana kwemai vane pamuviri kunogona kuonekwa:
- kubviswa kwe ectopic pamuviri ;
- kutsunga kwenhamba yekuberekwa uye chibereko;
- kuongororwa kwemashoko ekutanga ehupenyu hwemuchechi - kuverenga kwekushaya moyo, kuteerera inzwi remwoyo;
- tsanangudzo yemagadzirirwo emuviri wekuchechechecherwa kwechecheche;
- kutomusiyano kuongorora kwe fetus (kuonekwa kwekukanganisa mukuvandudzika);
- Kuongorora kwepa placenta uye kujekesa kusakosha kwayo.
Kuongorora kwekutanga pakubata pamuviri hakugadziri chirwere chimwe mumwana, asi chinongoratidzira zviratidzo zvayo, zviratidzo. Zvibereko zvinowanikwa ndezvikonzero zvekutsvakurudza mberi, kugoverwa kwemamwe mabhuku ekuongorora. Kungoti mushure mokugamuchira ruzivo rwese runodikanwa ndeye kugumisa kwakaitwa, kuongororwa kunoitwa.
Kutanga kuongororwa kwekudzivirira - nguva
Kuti uwane zvinogadziriswa zvinokonzera kuongororwa kwakarurama kwekukura kwekuberekwa, kuongorora kunofanira kuitwa pane imwe nguva. Mitemo yekuongorora kwekutanga kwokudzivirira - zuva rekutanga revhiki yegumi - zuva rechitanhatu revhiki re13. Dzidzo dzakawanda dzinoitwa pavhiki 11-12 yekutakura, iyo inonzi ndiyo nguva yakanakisisa.
Zvichipa izvi, chigumisiro uye chinangwa chekutsvakurudza zvakananga zvichienderana nekururama kwekusarudza kwezwi. Vanachiremba vanozviverenga nezuva rekupedzisira kuenda kumwedzi, zuva rokutanga. Kupa vashandi vezvipatara nemashoko asina kururama pamusoro penguva yemwedzi yekupedzisira yakazara nekusanzwisiswa kwemashoko akawanikwa panguva yekuongorora.
Biochemical Screening Trimester
Iyi ndiyo miedzo yevakadzi vane pamuviri mugore rokutanga vatatu inowanzonzi kuedzwa kaviri. Izvi zvinokonzerwa nekuti panguva yekushandiswa kwayo, kukanganiswa muropa yemiganhu miviri yakasimbiswa: pasina b-hCG uye PAPP-A. HCG inonzi hormone inotanga kuumbwa mumuviri wemai anouya nekutanga kwekuberekwa. Mafungiro ayo anowedzera zuva rega roga uye anosvika pakureba kwawo nevhiki 9. Mushure meizvi, pane kuderera zvishoma nezvishoma muHCG.
PAPP-A ipuroteni yeA-plasma, chirongwa chepuroteni nemaitiro ayo. Maererano nehuwandu hwayo mumuviri, vanachiremba vanogadzirisa zvinokonzerwa nekugadzirwa kwechromosomal kusagadzikana (Down syndrome, Edwards syndrome). Mukuwedzera, kusawirirana kwePAPP-A yezinga kunogona kuratidza zvinotevera:
- kupera kwemucheche ;
- hypotrophy;
- pre-eclampsia .
Ultrasound, first trimester
Ultrasound mumutambo wekutanga unoitwa musati wapfuura masvondo gumi nematanhatu uye inotevera 14. Chinangwa chekutsvakurudza ndechekugadzirisa matanho emhando yekukura kwevana, kuongororwa kwekusaziva mune zvakagadzirwa. Pakati pemitemo mikuru yakatorwa mu-ultrasound mumutambo wekutanga wekuita pamuviri:
- KTP - coccyx-parietal size (kureba kubva parietal bone kusvika ku coccyx);
- musoro circumference;
- BDP - biparietal size (kureba pakati parietal tubercles);
- TVP - ukuru hwekoro nzvimbo;
- muyero we mwoyo (rate ye moyo);
- kureba kwefudzi, chidya, forearm, uye gumbo rezasi;
- nzvimbo yemwoyo, miviri mikuru yeropa;
- nzvimbo yepa placenta, chibatanidza nzvimbo, kuwanda.
Kuongorora kwekutanga ndiko kugadzirira sei?
Usati watora miedzo mukutangira kwekutanga kwekuita pamuviri, amai vakatarisira vanofanira kutsanangura mazano echiremba ekugadzirira ivo. Izvi zvichabvisa kugamuchira kwechikonzero chisina kururama uye chido chekudzokorora zvakare kuongorora nekuda kweizvi. Nezvezvidzidzo zvinosanganisira kuongororwa kwokutanga kunoitwa panguva yekuzvitakura, huru ndeye ultrasound uye biochemical blood test.
Kana kuongorora kwekutanga kuchiitwa, kuongororwa kwe ultrasound kunowanikwa mauri hakudi chero kugadzirira kwakakosha. Zvose zvinoda kuitwa nemukadzi ane pamuviri vasati vapinda muongororo ndeyokunwa 1-1.5 malita emvura pasina gasi 1-2 maawa asati asvika. Mushure meizvozvo, haugone kuenda kuchimbudzi. Chidzara chakazara munyaya ino chinobatsira kuona zvakakwana chibereko, chigadziko chayo. Munyaya yekudzidzira kutapukira, izvi hazvidiwi.
Kugadzirira kushandiswa kwehupenyu hwepanyama kunowedzera. Kwemazuva mashoma mukadzi anofanira kutevera kudya. Pazuva rekudzidza, usadya mangwanani, uye zuva rakapfuura, rega kuitora maawa masere isati yasvika. Paunenge uchigadzirira kubva pakudya, vanachiremba vanonyatsokurudzirwa kubvisa:
- chocolate;
- seafood;
- mafuta namafuta ezviyo;
- citrus fruit.
Kuongorora kwekutanga kwakaitwa sei?
Apo kuongorora kunenge kuchiitwa, yekutanga katatu iko yatopfuura. Pamberi pekushandiswa kwechirwere ichi chakaoma, chiremba anozivisa mukadzi ane pamuviri mberi, anomutaurira nezvemitemo yekugadzirira uye zvakananga zvekushandiswa kwekushandiswa kwega kwega. Icho chaiyo ye ultrasound diagnostic haisi yakasiyana neyakawanda ultrasound. Kazhinji inoitwa kunze kwekutengesa, kuitira kuti uone zviri nani fetus. Panguva imwecheteyo, zvigadzirwa zvepamusoro-shandisheni zvinoshandiswa, izvo zvinobatsira kuziva hutano hwemwana paanotanga kuongorora.
A biochemical blood test, iyo inosanganisira kuongorora kwekutanga panguva yekuzvitakura, haisi yakasiyana neyonguva yakawanda yeropa. Nyaya yacho inotorwa kubva mumashure emvura mumangwanani musina chinhu chisina chinhu, ichiendeswa kune imwe nyoka, iyo yakanyorwa uye inotumirwa ku laboratori kuti iongororwe.
Kuongorora kwekutanga kwekuita pamuviri - inowanzo
Mushure mekuongorora kwekutanga kwave kuchiitwa, chiremba chete anofanira kufananidza mhinduro nemigumisiro yakawanikwa. Iye anoziva nezvezvinhu zvose zvehutumbi hwakadaro, mamiriro emumai anouya, iye anamnesis. Izvi zvinhu zvinofanirwa kuongororwa pazvinenge zvichitsanangura zvigumisiro. Muchiitiko ichi, vanachiremba vanogara vachigadzirisa humwe humwe hutsika hwemuviri waamai, naizvozvo kupotsa zvishoma kubva pachimiro chakasarudzwa hakusi kuonekwa sechiratidzo chekuputsa.
Ultrasound in the first trimester of pregnancy - the norm
Iyo shoma shorty (yekutanga katatu yekudzivirira) inotarisirwa kuongorora hutano hwekukura kwe fetal. Pakuziva kwayo chiremba anogadzirisa zviyero zvekugadzirwa kwemuviri wemwana, izvo zvinowanzova nezviyero zvinotevera:
1. KTR:
- Vhiki gumi dzekutakura - 33-41 mm;
- 11 vhiki - 42-50;
- 12-51-59;
- 13 kusvika 62-73.
2. TVP:
- Pamasvondo gumi - 1,5-2,2 mm;
- mu11 - kubva pa6 kusvika ku4;
- muna 12 - kwete pasi pe 1.6 uye kwete kupfuura 2.5;
- muna 13 - 1,7-2,7.
3. Nhamba ye mwoyo (bhiza paminiti):
- Vhiki gumi - 161-179;
- 11 - kubva 153 kusvika 177;
- 12-150-174;
- 13-47-171.
4. BDP:
- Vhiki gumi-14 mm;
- 11-17;
- 12 - 20;
- 13 masvondo - 26.
Kuchengetedza kwezvinhu zvepanyama - mitemo yezviratidzo
Kuchengetedza kwechimiro chechimiro chemutatu, kududzirwa kwezviri kuitwa nechiremba, kunobatsira kuziva zvirwere zvepabonde mumwana kwenguva pfupi. Zviratidzo zvechimiro chechidzidzo ichi chinoratidzika seizvi:
1. hCG (mU / ml):
- Mavhiki 10-11 ekudzivirira - kubva pa20,000 kusvika ku95,000;
- Vhiki 12 - 20000-90000;
- 13-14 - kwete pasi pe15,000 uye kwete kupfuura 60 000.
2. RAPP-A (MED / ml):
- Vhiki gumi-0.45-3.73;
- 11 - 0.78-4.77;
- 12 -1.03-6.02;
- 13 - 1.47-8.55.
1st trimeter screening - deviations
Sezvatotaurwa pamusoro apa, kujekeswa kwekuongorora kwekutanga kunofanira kuitwa chete neyanyanzvi. Amai anouya havafanire kuenzanisa migumisiro yekutsvakurudza nemitemo. Kuongororwa kunofanira kuitwa nenzira yakaoma - vanachiremba havazombotaridzi pachikonzero chekuongororwa chete, kuenzanisa nheyo dzekuongorora kwekutanga kwechokwadi. Zvisinei, zvinokwanisika kuita pfungwa dzekuvapo kwehutano. Yakawanda hCG inoratidza:
- Matambudziko ezvechirwere - Down syndrome, Edwards , trisomy;
- chirwere cheshuga mellitus;
- toxicosis .
Kuderedza muHCG maitiro kunowanikwa apo:
- ectopic pathology;
- ngozi yekubvisa pamuviri.