Ukuhlolwa kwamakhemikhali - onjani ukuhlaziywa?

umama okhulelwe phakathi nayo yonke inkathi esesibelethweni ingane ukudabula eziningi ezahlukene ukuhlola ukuthi kungakanani abakwaziyo ukuqapha isimo sempilo yowesifazane neyesilo sombungu. Olunye uvivinyo ziyisibopho, kuyilapho abanye sokweluleka ngokwemvelo. Lokho sinjalo kwamakhemikhali ukuhlolwa. Kuyini, lokho kwenziwa futhi yini izifo kungatholakala ngosizo kwalo, singaba esihlokweni.

Uyini Ukuhlolwa kwamakhemikhali phakathi nenkathi yokukhulelwa?

Le ndlela izifundo lokuhlonza yazuza chithi saka umkhuba emtholampilo muva. Ekuqaleni kwathiwa kwenziwe kuphela udokotela ngenjongo ekuhlonzweni of izifo ezithile zofuzo. Kodwa sibonga ukutholakala kanye nempumelelo le ndlela waqala lisetshenziswe ocwaningweni lokuvikela. Manje owesifazane okhulelwe ngaphandle izinkomba yezokwelapha ekhethekile ungakwazi ukuzikhethela kulolu vivinyo.

Ngakho, Ukuhlolwa kwamakhemikhali - kuyini? Lokhu kuhlaziya wegazi emithambo yegazi ukunquma kwezinso chromosomal. Kodwa ukuhlolwa imiphumela kungase kungabi uphethwe esichazayo ngobuciko ngokuphelele usebenzisa le ndlela akunakwenzeka ukuqinisekisa khona izifo chromosomal. It kuchazwa kuphela ematfuba zokugula ezinjalo esimweni ngasinye.

Kute ahumushe kahle imiphumela ukuhlaziywa kwezinto eziphilayo, ngqo phambi igazi kocingo abesifazane abakhulelwe siqondiswe kokuxilongwa ultrasound. Ngokwesibonelo, i-ultrasound udokotela umbungu kwenza izilinganiso, ilinganisela Engcebweni yakhe. Ngeziphambeko kusukela kwezinkambiso esungulwe, kanye namazinga aphezulu imiphumela ukuhlaziywa kwamakhemikhali kwegazi ungakhuluma mayelana nokuba khona kwezinso fetus zofuzo. Phezu ukuthola ezingeni lelisetulu Amathuba kokuba fetus chromosomal iziyaluyalu ochwepheshe ukweluleka alandele izinqubo ezengeziwe zokuxilonga. Ngokwesibonelo, kuleli cala, odokotela bangathatha nika intrauterine impahla ucwaningo ukuze uphethwe wokugcina.

Ngakho, inquma Amathuba khona chromosomal aberrations Ukuhlolwa kwamakhemikhali kuphela. Hlobo luni ukuhlaziywa njengoba kwenziwe, sifunda kamuva kulesi sihloko.

Izinkomba for Ukuhlolwa

Njengoba kushiwo ngenhla, ucwaningo lwenziwa kokubili izinjongo zokuvimbela futhi emtholampilo. Ukuhlolwa okuphoqelekile kuyinto ezimweni ezinjalo:

• Uma umbhangqwana eziseduze;
• owesifazane okhulelwe waphuphunyelwa yinoma iziphi izifo ngokushesha ngaphambi kokukhulelwa futhi ngesikhathi ngokushesha;
• yomlando aphuthelwe isisu, ukuzalwa kwengane isishonile, kwesisu, wazalwa kungakabi isikhathi noma ukuzalwa izingane ukukhubazeka kwezakhi zofuzo;
• umndeni nezihlobo nge izifo chromosomal;
• engu-umama okhulelwe kweminyaka engaphezu kwengu-35;
• imithi abakhulelwe ukuthatha eyenqatshelwe ngesikhathi sokukhulelwa wengane, noma yayivame-X-ray, futhi ray ekushayweni;
• ngaphambi nje kokuba akhulelwe ubaba noma umama kwadingeka ukwelashwa ngemisebe noma x-ray Luhlolo esizayo;
• imiphumela ultrasound abakhulelwe engaqinisekile, futhi kutuswa ukuba afeze kokubeletha Ukuhlolwa kwamakhemikhali (okuyilona elisebenzayo futhi kuyingozi abakhulelwe ukuthi isifundo esinjalo, ukuchaza ngokuningiliziwe udokotela).

Yini enquma ukuhlaziywa?

Ukuhlolwa kwamakhemikhali Kwenziwa izikhathi ezimbili noma ezintathu kulo lonke ukukhulelwa. Futhi kuye ngokuthi inkathi ngosizo yayo ukuxilonga ezihlukahlukene chromosomal kwezinso ku-fetus:

• Edwards syndrome;
• Patau syndrome;
• Down Syndrome;
• Lange syndrome;
• nokuba khona kwemizwa tube isici.

Izifo ezintathu zokuqala abe negama ezivamile njengoba trisomy. Chaza kusaqalwa anomalies enjalo Ama-chromosomes e uxhumano kusiza odokotela Ukuhlolwa kwamakhemikhali. Siyini ngempela lesi sifo kuka ayingozi? Ephambi kwezinduna trisomy ekucubunguleni kwamakhemikhali igazi laboratory abakhulelwe Kutholwe 22 ngazimbili wama-chromosomes evamile futhi omunye "kathathu." Kuye kwakhiwa lapho zokugula futhi ukuhlukanisa isifo.

Okokuqala senyanga Ukuhlolwa

Ngo umkhuba emtholampilo ngokuvamile ziphendukela ukuhlaziya njengoba 1 yokuthathu Ukuhlolwa kwamakhemikhali. Kuyini, okudingayo nalapho kwenziwe? Ngokokuqala ngqá owesifazane okhulelwe bebhekene umqondo lokuhlolwa isikhathi esingamasonto 11-14. Lokhu inhlolovo kuhlanganisa US, lapho udokotela alinganise Translations nuchal ku-fetus, wathi engu sokukhulelwa futhi Edd.

Ngemva kokuba lona wesifazane ultrasound luhlolo ethunyelwe nodokotela ukuhlolwa igazi. Kulesigaba human chorionic gonadotropin futhi PAPP amaprotheni. Ngokusekelwe imiphumela ochwepheshe kusolakala kahle ukukhula kwengane, kuhlanganise ukuthola kwezinso chromosomal ezifana Down Syndrome.

Futhi ngokuthi "isivivinyo double" Ukuhlolwa kwamakhemikhali 1 yokuthathu. Kuyini lokhu? Ucwaningo olwenziwe ngabe-11-14 amasonto sokukhulelwa usezuze leli gama ngenxa yokuthi ukuthi ukuhlolwa kwegazi ku izinto ezimbili ethize: hCG futhi PAPP amaprotheni.

Amazinga ukusebenza senyanga Ukuhlolwa kuqala

Izinkomba of hCG futhi PAPP kuthonywa izici zangaphandle ezifana isisindo okhulelweyo, isimo sezwe kanye endaweni sezulu lokuhlala, ubude sokukhulelwa kanye nabanye. Ukuze ukuzivumelanisa imithetho eningini labesifazane zalamaqembu.I zakhiwa njengendawo IOM. Kwamakhemikhali Ukuhlolwa kwezinkambiso kubalwa amayunithi ezinjalo. Ukuze abale kubo wathola imiphumela yokuhlolwa kwegazi abakhulelwe yahlukaniswa simiselwe endaweni ethize, inkathi kanye isisindo isigaba abesifazane kuyinsakavukela izinkomba. Ngakho, uma umphumela 0.5-2.5 umama, i-hormone ungaphakathi uhla evamile. Kodwa ngaphezu 2.5 umama libonisa ingozi eliphezulu chromosomal kwezinso.

Okwesibili senyanga Screening

yokuthathu Esimisiwe kwamakhemikhali Ukuhlolwa 2: kuyini nokuthi kungani udinga ukuba ibhekane ukuzihlola okunjalo? Ukuhlolwa Okwesibili angaqokwa isikhathi amasonto 16-18. Phakathi ucwaningo ezifana olunzulu ultrasound uphethwe, uma kunesidingo, ku-3D-format izobanjelwa, phakathi kwesikhathi lapho udokotela uyosingatha izilinganiso fetus, bayakwazisa ukushaya kwenhliziyo yakhe futhi isikhundla esibelethweni.

Ukuhlolwa kwegazi izobanjelwa ukucacisa hormone amathathu noma amahlanu, ezifana hCG, PAPP, estriol, lactogen esinomhlapho futhi inhibin. Ukuhlaziya okunjalo ubizwa nangokuthi ukuhlolwa kathathu.

Uma kudingeka, umama okhulelwe ingase ithunyelwe ngoba kokubonisana isazi sezakhi zofuzo, ngubani izobheka imiphumela Ukuhlolwa of senyanga yesibili , futhi wenze izincomo.

Screening yokuthathu yesithathu

Screening e yokuthathu yesithathu wenziwa ikakhulukazi udokotela e-32-34 ngesonto th. Phakathi ultrasound luhlolo ngalesi sikhathi udokotela ihlola isimo izibilini ingane, isigijimi sakhe, khona noma ukungabi khona intambo singabanjwa, isimo amanzi amniotic futhi umzanyana. Igazi ihlaziye test kathathu.

Izici ukuhlolwa yokuthathu yesithathu kukhona ezengeziwe ukuhlola ukuthi kungakanani abakwaziyo ngesimo Doppler nakuma-CT. Ukusebenzisa inqubo yokuqala kanye kulinganiselwa ukugeleza kwegazi kunqunywa hypoxia fetus. Eyesibili inquma ukungasebenzi inhliziyo. Lezi zinqubo abazenzi ngendlela efanayo njengoba US, ngokuba ephephile ngokuphelele nengebuhlungu owesifazane okhulelwe nengane yakhe.

Ukulungiselela ukuhlolwa

Udokotela wasikisela ibhekane Ukuhlolwa kwamakhemikhali? Indlela ukuthatha test ukuze uthole imiphumela lesifanele? ukulungiselela Esifanele ukuhlolwa - eqakathekileko ukuthi inquma ukuthembeka imiphumela. Ngokwesibonelo, okungezona ukuhambisana iseluleko yokudla okunempilo e inqubo chemical ukusabela laboratory izokuba mibi mass amafutha, okuyindawo kuyoba nzima ukunquma lutho. Ngakho-ke, usuku olulodwa ngaphambi Ukuhlolwa perinatal kunoma yisiphi isigaba sokukhulelwa ayikwazi ukusetshenziswa kwemikhiqizo elandelayo:

• ukudla okubabayo,
• ngabhema;
• okunamafutha kanye ethosiwe;
• ushokoledi;
• Black itiye eqinile futhi ikhofi;
• ezisawolintshi.

Nikela igazi esiswini esingenalutho.

ukuhlaziywa

Screening kujwayele ukuthatha indawo ngezigaba ezimbili. Eyokuqala ihilela isivivinyo ultrasound. Kuphela ngemuva kokuthola imiphumela ultrasound, kungenzeka ukuba ahambe ukuhlolwa igazi. Ngokuvamile, kwamakhemikhali Ukuhlolwa imiphumela ingatholakala kuphela ngemva kwenkathi ngokwanele eside - kusuka nengxenye amasonto amathathu. Ngo emitholampilo yangasese angase aqhube ukuhlaziywa isikhathi esasizosheshisa - kuze kube ngesonto.

Kuyadingeka ukuthi ukuhlolwa kwabesifazane abakhulelwe? Screening iyona luhlolo izincomo abesifazane abakhulelwe. Ngakolunye uhlangothi, ngenxa yalesi izifundo lula nokuphepha kungathola zokugula ezibucayi ingane kusaqalwa. Kodwa ngesikhathi esifanayo kunqunywa indlela lesi sifo asilapheki. Ngaphezu kwalokho, imiphumela kuphela ukhombe ingozi iziyaluyalu othuthukisako kungukuthi sitholakale. Lapho ngeziphambeko kutholwa umama okhulelwe is ubhekene nesinqumo esinzima ukuqhubeka ukukhulelwa. Ngakho-ke, isinqumo sokugcina kuphela maduze, abazali zingase zithathe indima ucwaningo anjalo.

okulotshiweyo

Efunda okwakubhalwe kulowo mbhalo Ukuhlolwa kwamakhemikhali kudinga ukutholakala ubuchwepheshe professional. Ukuze ahumushe imiphumela may udokotela kuphela. Kubalulekile ukucabangela bese uqhathanisa izinto ezahlukene ukuqhathanisa amazinga ukuhlola nezici ezithile ukuze nezifo ngenxa yezakhi zofuzo.

Igazi test imele ngaleyo ndlela:

• 1:10 000 kunengozi ongaphakeme lokugula;
• 1: 1000 - nalasemkhatsini;
• 1: 380 - okusezingeni eliphezulu, ezidinga ukucwaninga okwengeziwe.

I okungu ukumela, ngoba icala isibalo sokukhulelwa kungenzeka egunjini lokuhlolwa kwezifo. Lokho Ngokwesibonelo, ngesikhathi ongaphakeme ingozi Amathuba iziyaluyalu chromosomal 1 e-10,000.

nobufakazi

Abakhulelwe ngabomvu ukuhlangana nengane yakhe phezu ultrasound. Kodwa ngesikhathi esifanayo, lokhu kuhlolwa uletha eningi nakho. Ngokuvamile ukusebenza Ukuhlolwa kuthonywa izici zangaphandle, futhi ngesikhathi kabusha Ukuhlola ukuphambuka singakutholi isiqinisekiso yayo. Kodwa ngalesi sikhathi umama okhulelwe ihlangabezana ukwesaba sina okungaziwa futhi ingozi ukuhlonza, okuyinto nomthelela omubi kakhulu ngesimo sempilo nokwakheka kwalo imvuthuluka.

Yingakho iziguli Izibuyekezo izindlela ezintsha zokuxilonga impikiswano. Abanye baya sinokuqiniseka neluhlolo kusenesikhathi ekukhuleni kwengane, nezinye senqabe ku ukubukwa zokuziphatha nezingokomoya.

Izindleko Ukuhlolwa

Esinye sezici ezinomthelela omkhulu ukuze nokunqatshelwa esizayo omama kokubeletha Ukuhlolwa kuyinto izindleko zawo. Kuphela uma isiqondiso ukufundwa nokuziphatha nokuhlolisiswa esibhedlela noma emtholampilo ukuhlaziywa umphakathi kungaba isenzakalo kwesamba.

Uma ukuhlolwa Kwenziwa ngesicelo isilinganiso zokuvimbela noma esibhedlela esizimele, kuzodingeka akhokhe ruble 5000 kuya 9000, kuye emtholampilo asetshenziswe imishini yayo.

Esihlokweni sethu, saxoxa kungani kubalulekile ukuba ibhekane Ukuhlolwa kwamakhemikhali, it is kwenziwe ngayo, ekufunda. Isinqumo yini noma cha kudlule isifundo esinjalo, kubalulekile ukuthatha abakhulelwe kanye nodokotela wakho. Futhi okokugcina, ukhanyisa yalokho omuhle futhi ukulinganisa okuzwakalako ukuhlaziywa izimpendulo wathola.