Chimodzi mwa zinthu zosangalatsa komanso zosokoneza kwambiri kwa amayi apakati ndi kusamalidwa padera. Ndipo makamaka mantha amayi omwe akuyembekezeredwa akuyang'ana pa trimester yachiwiri ya mimba. Zomwe zifunikira komanso ngati zili zoyenera kuti tizichita mantha - tidzasanthula m'nkhani yathu.
Ndani ali pangozi?
Malinga ndi zomwe bungwe la World Health Organization likuyang'anira panthawi yoyezetsa ana ku Russia ndi amayi onse apakati. Kafukufuku wovomerezeka amachitidwa kwa amayi omwe ali ndi zifukwa zotsatirazi:
- ali ndi zaka zoposa 35;
- kupezeka m'banja la mwana yemwe ali ndi vuto la chromosomal pathologies;
- ukwati pakati pa achibale;
- mankhwala osokoneza bongo muyeso yoyamba yotsutsana ndi mimba;
- chiopsezo chachikulu cha kutha kwa mimba;
- zolakwika ziwiri kapena zambiri;
- Kutsekemera kwa mmodzi mwa okwatirana asanabadwe.
Kuwunika kwa mimba - nthawi ndi kusanthula
Kawirikawiri kuyang'anitsitsa kwa pathupi poyembekezera kutenga mimba kumachitika kawiri: pa 10-13 ndi masabata 16-19. Cholinga chake ndicho kuzindikira kuti vutoli limakhala loopsya kwambiri.
- Trisomy ya chromosome 21 (Down syndrome);
- trisomy ya chromosome ya 18 (matenda a Edwards);
- Chosowa cha neural tube ya fetus (msana wodwala siwowonjezereka).
Kuwunika kumakhala ndi magawo otsatirawa: ultrasound, test blood, kutanthauzira deta. Gawo lotsiriza ndi lofunika kwambiri: momwe adokotala amadziŵira bwino chikhalidwe cha mwana, sikuti kokha kokha mwanayo akudalira, komanso maganizo a mkazi wokwatira.
Kuwunika kwachiwiri kwa mimba ndi, choyamba, kuyesedwa kuyesedwa katatu, kuyesa magazi, komwe kumatsimikizira kukhalapo kwa zizindikiro zitatu:
- alpha-fetoprotein (AFP);
- chiwerengero cha hCG;
- estriol yaulere (E3).
Malinga ndi mlingo wa zizindikirozi m'magazi a mayi wamtsogolo, amalankhula za chiopsezo chotenga mafupa.
| Chiwawa | AFP | E3 | HCG |
|---|---|---|---|
| Down syndrome (trisomy 21) | Low | Low | Pamwamba |
| Matenda a Edwards (trisomy 18) | Low | Low | Low |
| Ziphuphu zamatope | Pamwamba | Zachibadwa | Zachibadwa |
Kuyezetsa kachiwiri pa nthawi ya mimba kumaphatikizanso kuyeza kwa ultrasound Wophunzira adzafufuza mosamala mwanayo, ziwalo zake, ziwalo zake, kuyesa chikhalidwe cha placenta ndi amniotic fluid. Nthawi yowonetsera kachiwiri ya mimba ya ultrasound ndi biochemical test test sichifanana: ultrasound ndi yophunzitsa pakati pa masabata 20 ndi 24, ndipo nthawi yabwino ya mayeso katatu ndi masabata 16-19.
Tiyeni tione ziwerengerozo
Mwatsoka, sikuti madokotala onse amadziwitsa zotsatira za mayeso atatu kwa amayi amtsogolo. Powonetsera kachiwiri kwa mimba, zizindikiro zotsatirazi ndizofunikira:
- AFP pa masabata khumi ndi asanu ndi limodzi mphambu zisanu ndi zisanu ndi zitatu (19-19) za kugonana - 15-95 U / ml ndi masabata 20-24 - 27-125 U / ml.
- HCG pa sabata lachisanu ndi chitatu mphambu zisanu ndi ziwiri mphambu zisanu ndi ziwiri za mimba - 10000-35000 mU / ml.
- Isriol yaulere pa masabata 17-18 - 6,6-25,0 nmol / l, pa sabata 19-20 - 7,5-28,0 nmol / l komanso pa sabata 21-22 - 12,0-41,0 nmol / l.
Ngati zizindikirozo zili ndi malire, ndiye kuti mwanayo akhoza kukhala wathanzi. Osadandaula ngati chiwerengero cha zotsatira za mayesero chikupita mopitirira malire a chizoloŵezi: mayesero katatu nthawi zambiri "akulakwitsa". Komanso, pali zinthu zingapo zomwe zimakhudza kwambiri zotsatira za kafukufuku wa zamoyo:
- multiple pregnancies;
- IVF;
- kulemera kwake kwa amayi apakati (mwa amayi onse, zizindikiro zawonjezeka, ngati zowonda, zimatsitsa);
- zizoloŵezi zoipa (kusuta panthawi ya mimba);
- matenda a shuga mu amayi apakati;
- Kutanthauzira kosayenera kwa m'badwo wamakono.
Kuwona kuti zikhoza kukhala zovuta kuti mwanayo asatengere. Palibe dokotala yemwe ali ndi ufulu wodzitenga, samangokhala kusokoneza mimba, chifukwa cha kuyang'ana. Zotsatira za maphunzirowa zimangowonjezera pangozi yokhala ndi mwana wokhala ndi zofooka zapachiyambi. Azimayi omwe ali ndi chiopsezo chachikulu amaika mayesero owonjezereka (mwatsatanetsatane wa ultrasound, amniocentesis, cordocentesis).