Doppler fetus: ukusebenza emagama

Namuhla e sitholakele kombungu futhi ukugeleza yokukhulelwa iziyaluyalu ziya ziba mandla ekusebenziseni imishini yesimanje ivumela ukuthi ukubheka inkinga kusuka ngaphakathi. ama-apharathasi Ultrasonic kuyinto esetshenziswa kabanzi ku ukuxilongwa kanye nokuhlaziywa izifo kanye nezimo zomzimba womuntu. Ukufunda ngezinto ezinjalo ngokuqinile kwezokwelapha futhi cishe esisemqoka inqubo observation kanye nokwelashwa. Kwabesifazane abakhulelwe, ngaphezu izifundo njalo ukhethe ultrasound fetus nge Doppler velocimetry. Kuyinto umkhuba ovamile nganoma yisiphi isikhungo sezokwelapha.

Doppler

Phakathi naso sonke isikhathi sokukhulelwa ingane owesifazane esimisiwe cwaningo ultrasound umshini. Emazingeni ahlukahlukeneko wendlela ukukhulelwa, Doppler fetus inikezwa ucwaningo kanye nokuvimbela izifo zentuthuko. Doppler - ultrasound ingenye kwezinhlobo, ngokuvamile kwenziwa ezinyangeni okugcina enkathi yokukhulelwa, ngokuvamile yokuthathu yesithathu.

Isifundo igazi emaphakathi imithambo umbungu, kwesibeletho, placenta ukuhlola ukugeleza kwegazi velocity isimo izitsha ezinkulu nokuvaleka kwemithambo enkabeni, ukuhlinzeka ukweseka kanye nokudla umbungu. Ukuze afeze isifundo esinjalo kudinga umlomo wombhobho ekhethekile. Ngokuvamile, Doppler ultrasound wenziwa kanye main noma kungenziwa esinikezwa ehlukile, udokotela cwaningo ezengeziwe.

Ukuqokwa ultrasound nge Doppler

Doppler ukucacisa ubukhulu ngqo, ububanzi kanye nendawo kwemithambo yegazi eyinhloko, izithelo hhayi kuphela, kodwa futhi nge placenta, umzanyana, kwesibeletho sowesifazane, igazi ukugeleza velocity e ezitsheni, Kwenza zikwazi ukuthola esifike khona iyiphi semfene noma yokuqothulwa umsebenzi umzanyana, kungaba kuzalwa yezinkinga ezihlukahlukene kokubili ngesikhathi sokukhulelwa futhi ngesikhathi sokubeletha. Ngakho-ke, ukubaluleka ucwaningo olunjalo akufanele ithathwe kancane. Ngakho, Doppler ngesikhathi esifanele okulotshiweyo fetus nemingcele yayo ukuvumela isikhathi ukuba afeze yesondlo ukukhalima, ukudambisa isimo futhi kuvimbele izingozi ezingase zibe khona.

Izimpawu I-Doppler

Doppler njengoba ucwaningo olwengeziwe kufanele akhethe, uma owesifazane okhulelwe wathola lezi zifo ezilandelayo:

• Preeclampsia.
• Abanomfutho wegazi ophakeme nesifo senhliziyo.
• isifo sezinso.
• Ngifundise ngesifo sikashukela.

Futhi Doppler umbungu angabelwa ngesikhathi kusenesikhathi iziyaluyalu zentuthuko, ukukhubazeka azalwa naso, ukubambezeleka zentuthuko, oligohydramnios, kungenzeka nokuvuthwa kwanoma yi-placenta, enkabeni intambo kwezinso e isakhiwo noma azalwa naso chromosomal kwezinso, amafomu ezinzima yesifo senhliziyo kanye nokunye. D.

Ucwaningo lesizalo Umthambo Doppler indlela

Doppler ukutadisha lesizalo Umthambo ukuhlola isimo isimiso semithambo yegazi kwesibeletho, yi-placenta, mezhresnichnogo isikhala. Ukwakhiwa mezhresnichnogo isikhala kwenzeka ngisho ngesikhathi yenzeka embryo yoke, ngemva cishe phakathi neviki elilodwa nje ebamba isisu. Kwegazi wesizalo sowesifazane Kwenziwa iqhaza imithambo emibili: wesibeletho kanye lesizalo. Ngisho ngesikhathi kumiswa placenta ezindongeni kwemithambo yegazi, izinguquko ezithile zenzeka, okuyinto kamuva kuholele ekukhuleni kwabo kanye ukunwetshwa parallel ukukhula umzanyana. Ngokusebenzisa le nqubo, kwakhiwa uteroplacental ukugeleza kwegazi is ukuqedela kumiswa placenta, anda izikhathi 10.

Lesizalo Umthambo Doppler ivumela ukuhlola ukusebenza Kuvunguza Umthambo kumiswa okuyinto evala kuya phezulu senyanga 3rd. Uma kuphakama izinkinga ezingase zivele ngesikhathi sokukhulelwa ingekho yonke imithambo izinguquko bokuphila, ngakho ayinwebeki futhi ikhule ngesikhathi ukukhula umzanyana. Ngaleyo ndlela imithambo babe ayikwazanga ukuqinisekisa ngokwanele kwegazi nokugeleza kwegazi eliya yi-placenta, okungase kuholele ekubeni uthunyelelwe ukufa noma ukuntula izakhi, umoya-mpilo. Lokhu kungaholela lamabutho yomzanyana yisisu futhi yisisu.

Doppler: okulotshiweyo

Phakathi nesifundo Doppler kudivayisi ultrasound Isibuko ebonisa elwa sokuqhafaza ukugeleza kwegazi velocity e imithambo ngesikhathi ngasinye umjikelezo inhliziyo, okuyinto zingafani systolic futhi diastolic. Ukuze uqonde esikhathini esizayo, yini sengozini, ukwenza okulotshiweyo:

• Systole - ingcindezi evela nokwehlisa imisipha yenhliziyo.
• Diastole - kuyinto ingcindezi elakhiwe phakathi ukuphumula imisipha yenhliziyo.

Ngakho, inhliziyo ngomunye beat ukufundwa avele systolic futhi diastolic blood pressure ku imithambo. Ngayinye izitsha test has imithetho yayo siqu futhi izici igazi ejwayelekile ukugeleza Isivinini Curves.

Ukuze ahlole amazinga kanye nezinkomba wegazi wasebenzisa indices ezilandelayo:

• Systole-diastolic isilinganiso.
• Pulse Inkomba.
• Ukumelana Inkomba.

Systole-diastolic isilinganiso, inkomba ishayela nokumelana Inkomba kubonise isimo imithambo main futhi le-aorta nokugeleza kwegazi kuzo, okuyinto inhloso yalolu cwaningo, njengoba Doppler. Izinkambiso kanye ngeziphambeko kuzo ezibonisa izinhlobo ezahlukene ukwephulwa wokukhula kwengane esiswini, ukuchaza zokugula ezihambisana ne umphumela ukugeleza kwegazi ku ingane esindayo. Ngakho, lo dokotela ungakwazi ukuhlola ukusebenza placenta kanye nokusebenza yayo, izimpahla i-oksijini ukuze umbungu uhlale ngokusebenzisa umzanyana, kanye ukukhubazeka kungenzeka ekuthuthukisweni kwe-fetus ezihambisana iziyaluyalu nezifo imisipha yenhliziyo kwegazi.

Doppler: imithetho

Ukuze ukuhlola imiphumela Doppler izifundo esetshenziswa itafula ekhethekile yamanani. Bengachaza zonke izindinganiso ezamukelekayo Doppler kwengane izinkomba ezintathu:

• Systole-diastolic isilinganiso.
• Ukumelana Inkomba.
• Pulse Inkomba.

Ukufunda ngezinto ezinjalo kufanele kwenziwe bonke abesifazane abakhulelwe, kodwa kubaluleke ngokukhethekile ukuba ubani isengozini futhi has izinkinga nge kwegazi, noma ukukhubazeka sitholwa njengefa.

Doppler fetus semithambo ultrasound cwaningo uqokelwa isikhathi esingamasonto 23 okukhulelwa. Ngalesi sikhathi, le nqubo lubalulekile kakhulu iqembu ukuhlolwa ingozi yezinkinga kombungu esinomhlapho, okungase kuholele ekubeni uthunyelelwe ukukhipha izisu. Kodwa izifundo ezinjalo kungaba kwenziwe kusukela emasontweni 13 kuya ekubeletheni. Isonto ngalinye has siqu Doppler indices yayo. Zonke lezi zifundo abazenzi ukuhlola imithambo ezintathu eziyinhloko: Umthambo enkabeni, lesizalo, aorta fetus.

Inkomba systolic-diastolic isilinganiso, kusukela Emasontweni onke okukhulelwa 20, kufanele kube 2.4 noma ngaphansi.

Ukumelana Inkomba ibalwa ukuze Umthambo enkabeni, lesizalo, futhi MCA. Kuyinsakavukela kuyinto:

• umama - esingaphansi noma ilingane 0.58;
• I-Umthambo enkabeni - kuncane noma elilingana 0,62;
• Inkomba kumelwe ibe ngaphansi noma ilingane 0,77 phakathi Umthambo cerebral fetus.

Engxenyeni yokukhulelwa wesibili, lezi zibalo cishe zinjalo. Futhi ekupheleni kwesikhathi esesibelethweni izinkomba isilinganiso systolic-diastolic akufanele idlule amayunithi ezimbili.

Ibonisa amagugu

Doppler 3 senyanga igazi fetus ukugeleza izifundo futhi kunomthelela ekuhlonzweni, zokuvimbela injongo esingamahlalakhona esinomhlapho, ekwelapheni preeclampsia nezinguquko nobuntu ukugeleza kwegazi ezitsheni lesizalo. Ekuboneni ukwehla kusho amagugu diastolic, isilinganiso systolic-diastolic kuyathuthuka kakhulu, futhi ngenxa yalokhu omunye Inkomba, kubalwa ngesisekelo yalo, nako kuyanda.

Lapho Doppler e semester yokukhulelwa ukunakekelwa okukhethekile lesibili nelesithathu ikhokhelwa ochwepheshe Umthambo enkabeni. I ijika ukufunda we Umthambo lemcoka enkabeni intambo igazi kuthatha ezibalulekile ngemva kwesonto yeshumi yokukhulelwa. Kulesi isici diastolic blood flow ayikwazi ukutholwa amasonto 14. Ngo-fetus chromosomal angahlangani esesikhundleni uhlamvu amasonto 10-13 sokukhulelwa ngokuvamile eqoshiwe reverse ukugeleza diastolic.

Ngo ayinzima ekhulelwayo eliphakeme systolic-diastolic isilinganiso ingeqi amayunithi ezintathu phezu ijika ukubonisa egazini. Ukuze zokugula fetus libhekene kwehle ukuqeda Isivinini diastolic kuze ukunyamalala ngokuphelele.

Ngu enyangeni yesihlanu sokukhulelwa futhi phambili izinkomba ezibaluleke kakhulu zokuxilonga babe ucwaningo isithelo ukugeleza kwegazi. Ihlola ngokuyinhloko le-aorta ne maphakathi Umthambo palsy. Amanani ala notshwala igazi ube imibundu okusezingeni eliphezulu izinguquko ingcindezi systolic ku-aorta, ngokuvamile obuhambisana nokuthanda ukwehla ukusebenza diastolic. I ezincane zingabantu, ayanda ingozi pathologies. Isimo ezingezinhle kakhulu kuyinto zero ukubaluleka ingxenye diastolic.

Ukuze kungenzeka cerebral Umthambo izinguquko phakathi ngeziguli ukugeleza kwegazi ephelezelwa, kunalokho, ukwanda ingxenye diastolic, okuyinto yena, siwukubonakaliswa hyperperfusion palsy futhi ikhombisa ukuthuthukiswa hypoxia fetus.

Ekuhloleni igazi flow emithambo yegazi imbobo iphakama systolic hlala iningi endaweni ezithakazelisayo we ijika futhi ezishaywayo ngaphandle okushintshako ngezikhathi yehlela avele ingxenye diastolic esikhathi esifushane. Ngakho, yonke ijika kuyinto kakhulu mfaniswano ngaphandle iphakama abukhali abazinikezele. Uma ezikhonjiswe iziqongo eziphakeme ingxenye systolic, noma ukunyamalala ingcindezi diastolic, kungase kukhombise chromosomal zokugula fetus, kanye okuvela hypoxia fetus.

Ukunemba ultrasound Doppler indlela imayelana 70%. Indlela ephumelela kakhulu isifundo esiphathelene utero-esinomhlapho ne-fetus ube-esinomhlapho ukugeleza kwegazi, okuyinto cishe sasiyikhulu namashumi amaphesenti angaba ukuxilonga kwempilo.

Ukuhlolwa imiphumela yocwaningo

Ngokwe indices ezahlukene iziyaluyalu igazi izinkomba ihlukaniswe ngamazinga ahlukene:

• 1 degree - lokhu kuliphazamise uteroplacental ukugeleza kwegazi ngesikhathi njalo izithelo esinomhlapho igazi noma esinomhlapho ukwephulwa izithelo uteroplacental unmodified.
• 2 degree - kungcono ushintsho yesikhathi esisodwa futhi ukuphazamiseka kuzo zombili izinhlobo igazi kwemali, kukhombisa ukuthi ungayifinyeleli iyiphi amagugu ezibucayi, kodwa nendawo ukuba.
• Ibanga 3 - kuyinto ukutholakala ukwephulwa baluleke izithelo-esinomhlapho ukugeleza kwegazi, kungakhathaliseki izinguquko noma ukwephula ngisho ezincane utero-esinomhlapho ukugeleza kwegazi.

Izimpawu I-Doppler aphoyintimenti

Doppler kwengane ingasatshenziswa kanye noma kabili phakathi ukukhulelwa njengoba inqubo isimiso. Ngezinye izikhathi ezinqunyiwe kaningi. Lokhu kwenzeka uma kukhona ubungozi noma pathologies umbungu noma isimo edingekayo kwesibeletho futhi umzanyana. Kukhona uhlu izinkomba okuyiwona nje kudingeka siqiniseke futhi Doppler ukugeleza izifundo:

• Uma iminyaka yobudala kamama mkhulu kunezinhliziyo 35 noma ngaphansi kuka-20 eminyakeni (noma ukukhulelwa ngasekupheleni ekuseni).
• Polyhydramnios futhi oligohydramnios.
• On ngaphambili cwaningo ekhiqizwa ultrasound umshini wembula intambo singabanjwa.
• ukuthuthukiswa kwengane lags ngemuva kwezinkambiso aqine.
• Umama waphawula ezinzima isifo esingelapheki.
• Lapho ukukhulelwa odlule yaphela ngo ukuphuphuma kwesisu noma ukukhubazeka izingane zizalwe zinokukhubazeka okungathi ezinzima noma zishonile.
• Uma kukhona ukuba izinsolo kombungu.
• Lapho nokukhulelwa izingane eziningi ngasikhathi.
• Uma umama has a negative RH isici, okungase kuholele ekungasebenzini kwenqatshwa umbungu nge kwegazi ompofu.
• Ngezinye abanelisi CTG nemingcele.
• Uma kwadingeka indawo ikhulelwe ukuhlukumezeka besisu.

Uma kukhona usongo kokuthi wake waphazamiseka okungazelelwe yokukhulelwa, qiniseka izifundo aphoyintimenti Doppler ukucacisa izimbangela besaba izimo ezinjalo. Kulokhu, lo wesifazane olala esibhedlela usuku, lapho icala lokuqala ihlolwa phezu ultrasound Doppler futhi alashwe i-hormone ukuze silondoloze ukukhulelwa eside, lapho kungenzeka ukuqhuba ukulethwa iphephile ingozi omncane.

Survey Ukulungiselela

Ukuze balungele lo izifundo Doppler e efiselekayo ukhulelwa kwamahora ambalwa ngaphambi kokuba ngivakashe ehhovisi US ukuba badle bese abe nomkhawulo amanzi. Ukuze kuqale ucwaningo badinga ukuba alale embhedeni eduze umshini emhlane waso, okwembula ngesikhathi esifanayo esiswini kusukela esifubeni kuya imbilapho. Uma uyikha phezulu le esiswini we abakhulelwe isicelo esisodwa noma ngaphezulu amaconsi ijeli ekhethekile conductive kusiza Ukungena isignali ultrasonic futhi ngaphezulu inzwa ekhethekile, okuyizinto ezibangela ngokushelela phezu esiswini.

Doppler kwengane kungaba kwenziwe njengoba izingubo omnyama nomhlophe, futhi ngezinye umbala samanje lapho ultrasound Uchwepheshe uzobona Curves ezilele ezibonisa umfutho futhi ulinganisele sokusuka kuwo noma ukugeleza kwegazi e imithambo. Ukulandela, udokotela uzobangenisa idatha etholwe ngesikhathi kuhlolwa, bese ubhala ukuba umbhalo, bese uyonika isiphelo sesimiso Doppler ultrasound ezandleni emtholile lona wesifazane okhulelwe.

Doppler izinkomba fetus nokuchazwa kwayo iyoba usizo kuhle ukuba Udokotela Wabesifazane ekuphathweni kwabesifazane abakhulelwe belungiselela ukulethwa nokulawula yezinkinga ephephile. Ukuqapha izibilini umbungu esebenzisa Doppler izifundo lula kakhulu futhi ubelokhu iminyaka eminingi kufakazela ukusebenza kahle yayo futhi nokwethenjelwa. Inani elandayo oluye lwenziwa eminyakeni yamuva, ukusekela ukuhlolwa ukuphepha kanye ultrasound ubuchwepheshe, esinciphisa kungenzeka ezithi ukubhema kulimaza impilo kokubili umama okhulelwe kanye usana olungakazalwa.