Indlela ukunquma fetus RH isici?

Ukukhulelwa kanye nokuzalwa komntwana - inqubo esijabulisayo kodwa futhi sina. Phakathi nenkathi yokukhulelwa, le bezempilo (perinatology, gynecologists) ukuqapha uhlu izinkomba kanye ukuhlola izici eziphawula isimo empilweni kamama kanye umntwana okhulayo. Omunye inkomba sinjalo Rhesus isici umbungu.

Kuyini RH isici

Ngaphansi lo mqondo efihla iprotheni ekhethekile abahlala phezu kobuso amangqamuzana abomvu egazi. Iningi labantu (85%), lokhu namaprotheni, kungani bebizwa RH omuhle. Labo abasele abanga-15% yesizwe sonkana bezwe balobu amaprotheni alikho. Laba bantu abhekwa RH-HIV. Ukukubeka Ngamanye amazwi, RH isici - ingenye izici eziningi immunological wegazi, okuyinto akunamthelela empilweni yomuntu.

Lapho kubalulekile?

Kunezimo lapho uyazi RH yayo unikeza kubalulekile. Okokuqala, kubalulekile uma kwenzeka izimo ezidinga ukumpontshelwa igazi. Okwesibili, ukulungiselela ukuhlinzwa Kuhilela ukuqaphela ngalolu daba. Okwesithathu, kubalulekile ukwazi izithelo RH-accessory ye-uma uhlela ukukhulelwa kanye nengane lokuzalwa. Kulokhu isimo esiyingozi kakhulu yilapho umama okhulelwe RH emibi engapheli yabezindaba umntwana okhulayo has a igazi omuhle. Lapha kunengqondo ukukhuluma mayelana RH ukungqubuzana.

Ingqikithi yalo "ukungqubuzana"

Ake sithi owesifazane enezinwele ka RH-negative igazi noyise esizayo RH-HIV. Amathuba yentuthuko ukungqubuzana kuleli cala Kulinganiselwa njengoba 50 ukufika e-50 Kwanele, ngakho-ke isimo kufanele kube ngaphansi esiqinile Isilawuli ochwepheshe.

Ngaphansi le ndlela ku abazali esizayo ingane ifa kuyise RH omuhle. Ngokusebenzisa placenta igazi amangqamuzana abomvu egazi womntwana Ungangenela egazini likamama, futhi ngeke ukuhunyushwa umzimba njengoba angaphandle, eyozenza isimiso sakhe sokuzivikela ukuze akhiqiza amasosha omzimba ukubhubhisa abomvu egazi ashaye umntwana. Ezimweni ezimbi kakhulu, kwengane, ezisongela ukuphila, ngakho ukuqhuba lihlaziya fetus RH isici - ke anike ingane ithuba azalwe enempilo.

symptomatology

Yini okudingeka ukwazi RH Isici ingane esikhathini esizayo? Zonke izifundo ezidingekayo, umama esizayo noma ngokuphelele ukuqeda kungenzeka ingxabano, futhi lonke uzozala ingane enempilo, noma uyazi ngenkinga futhi bathathe zonke izinyathelo ezidingekile ukuze ubelethe ingane ephile saka.

Nokho, i-umzimba omdala zesifazane zonke izinqubo ezihlobene nale hlobo lwempi, ningathwali yimuphi usongo noma ingozi futhi azinazo izimpawu zokugula. Nakuba ukuba ingane, lesi simo ingase ibe mibi kakhulu.

izimpawu eyethusayo nezinkinga nge RH-accessory ye kwenza kube nokwenzeka ukubona ultrasound umbungu. Kuzoba ebonakalayo, futhi ukugcwala uketshezi ezindaweni lapho kungafanele khona, nokuvuvukala, futhi pose ingane, esingenakubalwa ngokuthi yemvelo (Buddha ukuma).

Ukubuthelela lemiqulu emikhulu uketshezi kwandisa lwesisu wengane, nokumphoqelela ukuncibilikisa imilenze ohlangothini. Lapho ultrasonography nge awokuthi kuzobonakala double ikhanda wesifunda usana, okubonisa khona edema. Hhayi Kulungile usayizi esinomhlapho futhi ububanzi we umthambo umzanyana.

Zonke lezi zimpawu ukhombe ekuthuthukiseni ukungqubuzana umama nengane futhi kufanele kube isifiso sokuthola indlela Rhesus sokusebenzisana yomntwana osakhula esibelethweni.

Ukunquma RH isici wegazi komama wengane

imishini kwezokwelapha Modern kwenza kube nokwenzeka ukuthola Rhesus isici umbungu e senyanga yokuqala sokukhulelwa, ukuqala at amasonto 10.

Ingqikithi indlela kanje. Ngo umama esizayo wenza kocingo wegazi emithambo yegazi. Ivelele kusukela DNA ingane olusakhula esibelethweni. Ngokuqhubekayo, leli DNA uyaphenywa khona therein RhD isakhi sofuzo (RH). Uma e inqubo yocwaningo izingcezu RH isici zitholakala, kuthathwa ngokuthi umuntu olandelayo RH omuhle. Uma izingcezwana ezifana e-DNA ingane alikho - ke kusho ingane ine ungubani RH-HIV.

Ikhishwa ukuzimisela ngesikhathi esifanele Rhesus fetus ivumela isikhathi aqale izinyathelo zokuvimbela, odlulela ukuvela RH ukungqubuzana ukuba ngolunye usuku futhi, ngenxa yalokho, ukunciphisa umonakalo empilweni yengane.

Le nqubo ubhekwa non-koda futhi alamukeli usongo ukuphila nempilo kukamama kanye nengane. Nokho, kuze kube muva nje, ukwazi RH isici umbungu kungaba kuphela ngokutadisha we villi placenta noma egazi losana umntwana utero. Lezi zinhlobo izinqubo (amniocentesis, cordocentesis) kubhekwa koda futhi izimo zezokwelapha kuphela esiqinile kungabangela ukumiswa kwabo.

amniocentesis

Uma kuba khona isidingo ukuze uthole ukuthi iqondeni isimo ingane njengoba kukhona umbuzo kahle, ngendlela ukucacisa fetus RH isici, ochwepheshe banganikeza amniocentesis, okuyinto wokubhoboza of ulwelwesi ngenhloso ukuthatha amniotic fluid ucwaningo kokuqukethwe bilirubin kuzo. Lesi sibalo ephawula ngokunembile isimo umntwana.

Nokho, abesifazane kufanele uqaphele ukuthi le nqubo kuyingozi ngempela. Kukhona njalo ithuba zokugula -amniotic fluid. Futhi kungenzeka ukuvuza uketshezi ngaphandle ulwelwesi, nesenzakalo ebangela ukopha. Ukunqunywa Rhesus isici umbungu ngu amniocentesis kungabangela abruption esinomhlapho ekuseni.

Inqubo ingasatshenziswa ezimweni lapho amasosha ama-RH isici samanje kakade egazini likamama futhi okuqukethwe kwabo (titer) kuyinto 1:16 futhi lona wesifazane seluvele ingane nge isifo hemolytic ngayo lapho usana (HDN) ngefomu ezinzima.

cordocentesis

Ngazi kanjani le RH isici umbungu lokusebenzisa leli su? Iphuzu eliyinhloko ukuthi wenza wokubhoboza, amasampula egazi Kwenziwa ucwaningo e umzanyana. With ukusetshenziswa le ndlela ka bilirubin ezingeni isethwe ngokunembile ngaphezu amniocentesis. Igazi umntwana futhi kusetshenziswa le ndlela.

Cordocentesis futhi kuyingozi ngempela futhi kungabangela zonke yezinkinga ejwayelekile amniocentesis. Ngaphezu kwalokho, ukwakheka hematoma e umzanyana, okungase kuphazamise izingxoxo ezivamile izinto phakathi kukamama kanye nengane.

Icacisa fetus isici Rhesus ngokusebezisa cordocentesis ngokuvamile zinikezwa lapho okuqukethwe masosha omzimba Ingxenye 1:32, phambi kwezingane abaphethwe ukungezwani-hlobo ikhanda noma wafa emiphumeleni RH ingxabano.

Ingabe kungenzeka ukwelapha ukungqubuzana Rhesus kwabesifazane abakhulelwe

Ukwelashwa Yiqiniso, kungenzeka. Nokho, indlela ephumelela kakhulu, enikeza yi eziphumelela kakhulu ingane igazi. Inqubo phakathi ochwepheshe kubhekwa okuyingozi kakhulu, kodwa kakhulu ngcono isimo indoda esizayo, futhi ngezinga eliphezulu okungenzeka yenza kube lula ukugwema ukubeletha singakafiki isikhathi.

Ngaphambili kwakukhona ezinye izindlela ethandwa yokwelashwa, okuyinto nokho akasinikanga umphumela okubeka obala zokwelapha kanye kubhekwa amancane noma ingaphumeleli ngokuphelele. izindlela ezinjalo zihlanganisa grafts isikhumba kusukela umama esizayo umyeni wakhe, plasmapheresis, njll

Kunoma yikuphi, uma RH isici umbungu futhi unina wenza sikwazi ukwenza sitholakele Rhesus ukungqubuzana, le iphila kunazo inketho kokuphothula sokukhulelwa futhi ukuzalwa komntwana okunempilo ukuze uthole ngaphansi kokuqondisa ochwepheshe bezokwelapha, futhi ukugcwaliseka kwazo zonke iziqondiso zazo.

Rhesus ukungqubuzana futhi ukulethwa

Lapho umbuzo kanjani ukucacisa fetus RH isici, kwalungiswa, futhi kukhona isethi ingxabano, kubalulekile lapho sokukhulelwa iyisici isikhathi umzimba kamama. Ochwepheshe bathi ngokushesha lokhu kwenzeka, aba maningi izinkinga kanye nezinkinga zokukhulelwa luyoqhubeka.

Isizathu salokhu wukuthi umphumela RH ukungqubuzana aqoqana ngokuhamba kwesikhathi. Ngakho-ke, iningi amacala, ukukhulelwa, ochwepheshe batusa ukuqedela kuhlelwe preterm lokuzalwa.

Odokotela zonke izindlela ezitholakalayo ukuqapha isimo ingane futhi ngesisekelo ulwazi wathola unqume ukuthi ukuqhubeka ukukhulelwa noma umntwana azalwe phambili kancane ephephile isikhathi kuyadingeka. nokubeletha Yemvelo ezimweni ezinjalo kungenzeka kuphela uma kwenzeka ukuthi ingane lisesimweni egculisayo futhi azikho ezinye izinkinga. Ngo inqubo yokuthuthukisa amakhono zabasebenzi odokotela softwe izici esibalulekile isimo ingane futhi uma kukhona izici ukuthi izinkinga eziphathelene nokubeletha, isinqumo ukubamba ingxenye cesarean. Ukuze le nkinga ngokukhethekile le ndlela kubhekwa ukulethwa mnene kakhulu.