Neural tube ku-fetus - it is nokuthi kwakhiwa?

Lapho umama esizayo uthola ukuthi ukhulelwe, ukuphila kwakhe kuthatha incazelo ehlukile ngokuphelele. Manje kudingeka unakekele ngabo hhayi kuphela, kodwa futhi yinhlama ezincane, okuyinto vele uhlala ngaphansi inhliziyo. Into yokuqala ukwenza owesifazane - kuyinto ukubhalisa onguchwepheshe ezinhle, labo abathembile ngesikhathi esifanayo ngaba nokuzethemba inkambo evamile yokukhulelwa.

Yiqiniso, abazali abasebasha okungenani bayathanda ukucabanga ukuthi ingane yabo kungenzeka ukuthuthukisa. Kodwa uma zonke izinkinga Kwatholakala, ungalilahli ithemba. Bonke baneziphiwo yentando yakho e isibhakela futhi benza konke abangakwenza ukuze ingane yazalwa enempilo.

Neural tube ku-fetus - kuyini?

Omama abaningi abalindele ngubani kuphela ufunde izindaba ezinhle mayelana nokukhulelwa, ukusheshe ukufunda zonke izincwadi etholakalayo ngokuzalwa oluzayo. Kulapho iso lawo uthola ulwazi kwi 19-22 usuku owesifazane ebamba usuqalile yakha neural tube ku-fetus. Kuyini lokhu? Phela, umuntu omdala saloluhlobo lwemtimba engekho. Impendulo ilula: neural tube - kuyinto eyinhloko ukuthuthukiswa kohlelo sezinzwa, kuhlanganise nobuchopho nomgogodla. Vula ukugawula sezinzwa - nesigcawu ukwakheka anterior, maphakathi kanye posterior esinyeni.

izifo ezethusayo ukuthi azivumelani ukuphila

Siyaqonda ukuthi omunye izigaba ebaluleke kakhulu ukwazi ngemvelaphi yokuphila okwenzeka ngesikhathi sokukhulelwa - Ukwakheka kwe-neural tube kusukela ozongena ukuthuthukisa asebuchosheni nomgogodla umntwana. Kodwa ngezinye izikhathi kwenzeka ukuthi inqubo ukuvala engxenyeni engenhla ephukile, okuholela ekuthuthukiseni anencephaly (akukho ingqondo ku-fetus). Uma kukhona ukuphazamiseka e kuvalwe phansi kwe-neural tube, kukhona hernia umgogodla. Ngeshwa, zombili lezi zifo azivumelani ukuphila, kodwa kwenzeka kakhulu kuyaqabukela. Izibalo zibonisa ukuthi lesi sifo ushaya oyedwa enkulungwaneni izithelo ayizinkulungwane.

Ngezinye izikhathi kunezimo lapho ucala kutfutfukisa kahle neural tube ku-fetus. Lokho kusho futhi ukuthi kubalulekile ukuba sikhathazeke ngakho?

Yiziphi kwemizwa tube ukukhubazeka?

Zamehlo neural tube - lonke uchungechunge ukukhubazeka ahlukene okungase kwakheke ngokuhamba umbungu. Ngenhlanhla, lezi ngeziphambeko iyivelakancane.

Kubalulekile ukuqonda ukuthi zokugula neural tube umbungu - akusona isifo sanamuhla kubangelwa izimo zamanje yokuphila komuntu. Njengoba lokhu kuqinisekiswa ukuqopha kwezazi, ababenza izifundo ezifanele, zamehlo emgogodleni noma ubuchopho (lokhu kuqinisekisa ukuthuthukiswa okungavamile ugebhezi nomgogodla) etholakale izinsalela umuntu owayephila eminyakeni engu-7,000 edlule.

Ukubhekisela ngowokuqala imisebenzi yesayensi nezokwelapha, ngesisekelo okuyinto singasho, basungula neurosurgery, yaphawula emisebenzini sikaHippocrates. anatomist Italian Morgagni Batista, mhlawumbe, omunye incazelo yokuqala eseduze inikezwe kwemizwa tube zamehlo. Ukwelashwa ngaleso sikhathi, kusobala, lezi zifo awekho ngaphansi, ngoba imithi wayesalokhu ezingeni eliphansi kakhulu ukuthuthukiswa.

Izimbangela lezi zinkinga

Ngeshwa, ngezinye izikhathi kukhona engaphelele neural tube ku-fetus. Hlobo luni zokugula, nokuthi lokho kwabangelwa yini ke? Ake sithole ukuthi kwakungani izizathu ukuphambuka kusuka kuyinsakavukela.

Ngakho, ezinsukwini 19-20 kokukhula kwayo ngemva kokukhulelwa kumiswa umbungu is plate ngalinye ethize - ifomu lokuqala ukuthuthukiswa kohlelo womuntu sezinzwa. 20-22 ngosuku kufanele uqale interlock, kanjalo zakha neural tube ku-fetus. Iqiniso lokuthi yonke into ihamba ngokohlelo, kuqinisekisa ukungabi khona pathologies ezithile zesimiso sezinzwa ingane ozozalwa. Uma izinsuku 23 kusukela uqala kwemizwa ipuleti ayivaliwe ngokuphelele tube, i-fetus ozokhula emuva izinkinga. Ngalokhu yokucindezeleka okwandayo kungaholela larkspur cerebrospinal ukuthi kubonakala senyanga yokuqala sokukhulelwa.

Enye yezimbangela ezivame kakhulu pathologies enjalo ezibhekwa izifo ezibangelwa amagciwane, emisebeni, okuholela umama esizayo, ogulayo nomdlavuza, kanye yizici zemvelo. Kodwa iningi lalaba ngeziphambeko zenzeka kubantu besifazane abakhulelwe okwathi kwaba kwemizwa tube isici. ingozi High kudala yofuzo.

iziphi izici zangaphandle ezingase zibe imbangela yokuphambana

Yebo, yofuzo yokulimala ezifana kakhulu kwandisa ingozi ivela khona. Kodwa namuhla kuyimbangela ejwayeleke kakhulu odokotela isifo enjalo bakholwe ngemisebe (umama okhulelwe ungathola njalo yokuchayeka emisebeni ye hhayi kuphela ekwelapheni, kodwa ngesikhathi nje kokuhlala kwawo ezindaweni okunobuthi). Zinambuzane, imikhiqizo kaphethiloli nangezinkolelo-ze ezihlukahlukene zokwenziwa umquba nazo yokuthi ucala kutfutfukisa kahle neural tube ku-fetus.

Kuze kube manje, abaningi abawazi, kuyingozi kakhulu ukuphila komuntu ukudla okushintshwe izakhi. Nokho, akubona bonke uyazi ukuthi uma bekhipha umama ukuhlukumeza imikhiqizo efanayo, it kwandisa ingozi yokuba izifo ezibulalayo e ngomntanakhe. Ngisho kubhavu hot, okuyinto ethatha owesifazane ekukhulelweni okuqala avuse isici onjalo.

Unbalanced komama umsoco odokotela okubhekiselwa kuzo nangokuthi nomnyombo kwemizwa tube zamehlo. Owesifazane kufanele luphathwe ukunakekela okukhethekile kanye naye ngesikhathi lonke isikhathi sokukhulelwa. Esimweni lapho ezinye zezici ezingenhla zitholakala ukuphila umama okhulelwe, kufanele kube ukulungele iqiniso lokuthi ukhulelwe luzobandakanya lokuzalwa ephezulu, okuyinto kwemizwa tube isici.

Ingabe kuyiqiniso ukuthi omama isisindo okusezingeni eliphezulu ingozi kwemizwa tube ukukhubazeka liphuma?

Hhayi kudala eyabizwa ngemiphumela yocwaningo ukuthi waqinisekisa iqiniso kwaziwe ukuthi abesifazane abakhuluphele ngesikhathi sokukhulelwa, ingozi kwemizwa tube ukukhubazeka ku-fetus ephezulu izikhathi ezimbili kunaleyo abameleli isisindo encane. Ngokuthakazelisayo, omama esizayo kabani isisindo alanele, lo mkhuba awuzange waphawula.

Lezi kwamiswa ngesisekelo icala imilando California kwabesifazane ababengakaze bethole kwemizwa tube isici ku-fetus. Baphuthunyiswe ku ukuqula icala esikhathini kusuka 1989 kuya ku-1991. Imiphumela yalolu cwaningo lwabonisa ukuthi abesifazane kanye isisindo emzimbeni ngokweqile kwandisa ingozi yokuba lesi sifo ngo-2.1 izikhathi. Kodwa, kuyathakazelisa ukuthi le datha akuphazamisi ukwandisa i-folic acid ukusetshenziswa, izinto ukuntuleka kwazo kubhekwa omunye izimbangela kwemizwa tube kwezinso ku-fetus.

Kwenzakalani izithelo lapho has a kwephula?

Ukuze uqonde ukuthi i-kwemizwa tube isici ku-fetus sebakhiwe, kuyadingeka okungenani Imibandela, ukuqonda ukuthi yini inqubo embryogenesis.

Ngakho, ngesonto lokuqala sokukhulelwa usuphothuliwe kumiswa node-embryonic. Okwesibili - lena inkathi ukwakheka kwezitho Axial ku-fetus, lapho ngentshiseko ekuthuthukiseni extraembryonic ingxenye. Njengoba sekushiwo, ngesonto lesithathu - isikhathi aba khona uma uphonsa neural tube is kusukela ipuleti ekhethekile. Namasonto amathathu okuqala yiwona inkathi neurulation eyinhloko. ukuwa yesibili ku kwesikhathi efanayo amasonto 4-7 kusukela ngomzuzu wokukhulelwa.

Kakade kule nkathi yesikhathi kungaba ukuhlukumeza, okusho ukuthi umgogodla dizrafii. Pathology neural tube, okuyinto ludlulele izenzo ezimbi lumbosacral emgogodleni saleso senzakalo esizayo, kungenzeka kuphela ngesikhathi neurulation yesibili. Manje kuba sobala ukuthi ukuthuthukiswa okungavamile neural tube ku-fetus iqala emavikini ekucala yokukhulelwa, yingakho yokwelapha lezi zifo zenzeka ngendlela ekuvimbeleni ukukhumuzeka zinokukhubazeka okungathi sína. Ngakho, ukwelashwa kufanele kuqale ngaphambi kokukhulelwa futhi uqhubeke ngesikhathi emavikini ekucala esesibelethweni.

Ngo ukuthuthukiswa kwemizwa tube ukukhubazeka inezimpawu yayo

Njenganoma yimuphi isifo noma sokuphazamiseka akhule kahle, ekwakhekeni kwemizwa tube isici i-fetus iyakwazi izimpawu lalo.

Izimpawu umgogodla dizrafii kwezokwelapha zanamuhla uyazicabangela imiqondo elandelako:

• Afihliwe emgogodleni emfantwini: isici onjalo uvame etholakala endaweni lumbosacral. Kuyingozi ngoba izimpawu zokwelashwa akekho lapho. Lokhu zokugula kutholakala ngokuphelele ngengozi, isibonelo, ngemva esimweni emgogodleni. Sekube akukho izinguquko eziphawulekayo kwesikhumba, ngezinye izikhathi kunezindlela amnyama noma talc. Lokhu emfantwini ezifihliwe into njengoba ezimbi umnsalo avaliwe omunye amathambo. Isifo esifanayo kunemiphumela bajabula, okuhlanganisa ebusuku incontinence, ukuhlukumeza abalulekile isimo lesifanele, ubuthakathaka imisipha yemilenze, ubuhlungu esifundeni lumbar, ngisho ukusonteka zezinyawo. Yingakho kubalulekile ukubona ukuthi kukhona kumiswa lesifanele neural tube ku-fetus.
• Cystic eqhekeza evulekile: basuke obizwa hernias kweqiniso umgogodla. Bangase bathathe ngesimo protrusion olulinganiselwe Mater laseDura. Okuqukethwe hernias esinjalo oludakayo okungukuthi cerebrospinal fluid. Le nqubo sina isifo lungaboniswa amathambo ezimbili noma ezintathu. Abantu abaningi azalelwa nge isici onjalo, wahlala kahle ukuphila isikhathi eside ngenjabulo. Ukuhlinzwa ezimweni ezinjalo, odokotela batusa ukusebenzisa kuphela uma kukhona ukukhula wangempela hernia umgogodla. Uma isici ithambo enjalo ithumba 3-5 amathambo, isiguli kuzodingeka nakho ukuba buthakathaka kwezicubu incontinence. Kodwa, ngeshwa, lesi sifo ezivamile esiqukethe 6-8 amathambo. Isikhumba ku umbhunu mncane kakhulu, futhi esikhanyayo ngokusebenzisa nolwelwesi pia ishidi. Lokhu kungolunye uhlobo kakhulu yokungafaneleki, okuvame iphela esakeni ikhefu hernia futhi outflow ka cerebrospinal fluid.
• Ngu kungamboza ububi obedlulele kubhekwe emfantwini emgogodleni nezicubu elithambile, okuyinto kuhambisana ukwakheka ezilimele emgogodleni. isici okunjalo ngempilo cishe ayihambelani.

Abathandwayo Kuyaphawuleka ukuthi indawo hernias anjalo angu-90% amacala ewela esifundeni lumbar, futhi kakhulu kuyaqabukela ebonwe esifundeni thoracic noma wesibeletho. Lesi simo kuchaza ukuthi uma isici kwenzeka ku-fetus, ukukhulelwa ngokuvamile akhishwa isisu nokuguqulwa (yisisu). Imibungu okunjalo bayabulawa ngenxa nje yokuthi ukwakhiwa kwabo okwengeziwe cishe kungenakwenzeka.

Indlela ukuxilonga enesici, noma kwemizwa tube kwezinso?

Bona kwemizwa tube isici e-US kuphela le yokuthathu yesithathu yokukhulelwa. Kodwa kungakenzeki lokho, kukhona inala amathuba ukuthola zokugula efanayo.

Okokuqala, njengoba sekushiwo, kubalulekile ukwenza uphethwe wokulungiselela, okuyinto Kunconywa esikhathini bekuhlela sokukhulelwa esizayo. Kufanele vakashela Udokotela Wabesifazane, Urologist nofuzo. Uma kungenzeka, kufanele iphumelele ekuhlolweni ezibonisa ezingeni ingozi yokuba ingane zinokukhubazeka neural tube. Ngaphezu kwalokho, kuhle ukufunda nezincwadi eziningi. Lokhu kuzosiza ukuba aqonde ukuthi yini neural tube umbungu, kanye kungenzeka ukufunda zonke izincomo lochwepheshe, okuyinto kuyoba usizo esikhathini esizayo.

Ngemva nje ebamba isisu, ngeke akwenze ngaphandle kokuhlola yenyanga i obelethisayo. Senyanga yesibili yokukhulelwa ngaso sonke isikhathi kufanele kuhambisane njalo kwegazi omama esizayo. Kuyinto kakade ukuba bafeze kokuxilongwa ultrasound umbungu. Ungabi namahloni ukubuza onguchwepheshe ngesimo ingane, ikakhulukazi uma niyiqembu besifazane babe sengozini enkulu yokufa kwemizwa tube kwezinso.

Ngo yokuthathu yesithathu, isivele kungenzeka ukubona by ultrasound malformation azalwa naso we-fetus, esiqubukile ngenxa yokuthi neural tube okungalungile. Izithombe umbungu esibelethweni ukuze uqinisekise uphethwe, ungase futhi abonise omunye uchwepheshe.

Uma omunye izigaba ukwakheka kwemizwa tube isici iye yaqinisekisa, kuba nesizathu esizwakalayo ukukhulisa indaba isisu. Nokho, okokuqala kudingeka wazi ukuthi degree of ukwephulwa, ngenxa yokuthi ezinye izinhlobo zawo zingaba nkulu ngempela ukuphila okuvamile. Namuhla malformation neural tube, okuyinto lubonakaliswa ekuthuthukiseni malformation fetus ezingelapheka ukungenela kuhlinzwa. ukuhlola engeziwe liyadingeka emva owabeke kokutshelwa ngokukhubazeka kwengane, ngoba isisu - kuba ophumayo zokugcina.

Ukwelashwa nokuvikelwa kwemizwa tube ukukhubazeka

Ukwelashwa nokuvikelwa izinkinga zibe ngenxa yokuthi olwaludiliziwe ukwakheka kwe-neural tube, ungaqala ngokushesha emva kokuzalwa. Ngokushesha nje lapho odokotela kuzosusa wonke ezisongela impilo ingane, okungukuthi, ukubuyisela kwezimila okuvele lokushisa lomzimba hlola indawo kuzalwa, umbhunu ngokushesha kufanele luphathwe izibulali-magciwane bayigubungele nge amathawula oyinyumba. Ngemva ingxoxo nabazali, uma uvumelana ukuhlinzwa, ukuzalwa idluliswe emnyangweni neurosurgical, lapho bonke ucwaningo oludingekile, ngoba ngaphandle kwabo, ukusebenza ngeke iphumelele.

Uma kukhona usongo uqhekeko umbhunu, asike izidumbu zabantu Kwenziwa ngokushesha. Uma kungenjalo, ungase ulinde kuze kube yilapho ingane ikhule. isinqumo esinjalo ulungisiswa yokuthi izikhala - kuyinto "esangweni evulekile" nganoma yisiphi uhlobo izifo. Ngokuvamile, ngemva kokuba kususwe hernias zenzeka ukuvuvukala suppurative. Ngokwezibalo, cishe 78% eziguli osemusha yezinkinga efanayo. Kufanele kuqashelwe ukuthi ngezinsuku ezimbalwa nje ngemva kokuhlinzwa impilo in nezingane benganhlanhlathi. Nokho, 5% izingane zisekhona engozini.

Futhi kubaluleke yokuthi uma ubambe ukusebenza efanayo esikhathini kuzalwa, ungakwazi ukubuyisa ngokugcwele ubuqotho Mater laseDura. Okungukuthi, ingane ukuthuthukisa ngemva kokuhlinzwa kuyinto eyamukeleka ngokuphelele, futhi ngeke ulindele ukuphila okuvamile egcwele. Kufanele kuqondwe ukuthi uphenyo lokuqala eyenziwa ngaphambi ukusebenza ngokushesha okukhulu. Ingabe kuphela ukuhlolwa ezidingekayo ukuze ugcine umntwana futhi ayikuvumeli ukuba ngisale ukukhubazeka esaphila. Kubalulekile ukuba sikuthathe njengokungathi sína futhi inkathi nasezinkingeni ezilandela ngemva kokuhlinzwa. Ukuze nokuvuselelwa kwenzeke kalula futhi ngaphandle yezinkinga, zonke izincomo udokotela ekwelapheni kufanele kulandelwe ngokucophelela.