Ukuhlolwa okuyinhloko kuboniswe ekukhulelweni

-Delile

• Izivivinyo ezinkulu ekukhulelweni
• 1. Qedela ukubalwa kwegazi
• 2. Uhlobo lwegazi ne-Rh factor
• 3. Ukuzila ushukela
• 4. Ukuhlola ukuthola izifo
• 5. Ukuhlolwa kwesiko lomchamo nomchamo
• 6. I-Ultrasound
• 7. Izivivinyo zabesifazane
• Izivivinyo zokukhulelwa okunobungozi obukhulu

Ukuhlolwa kokukhulelwa kubalulekile kochwepheshe bezokubelethisa ukuqapha ukukhula kwengane nempilo yayo, kanye nempilo yowesifazane, njengoba kuphazamisa ngqo ukukhulelwa. Ngakho-ke, kukho konke ukubonisana, udokotela uhlola isisindo sowesifazane okhulelwe, umfutho wegazi nobubanzi besinqe, futhi akhombise ukusebenza kokunye ukuhlolwa, okufana nokuhlolwa kwegazi, umchamo, ukuhlolwa kwabesifazane kanye ne-ultrasound.

Ngaphezu kwalokho, kwezinye izimo, ikakhulukazi lapho owesifazane eseneminyaka engaphezu kwengama-35 ubudala, udokotela angancoma ezinye izivivinyo, njengoba ukukhulelwa kule minyaka kungaba nezingozi ezihambisana nakho. Ngalesi sizathu, ukuqapha kwenziwa kaningi futhi i-biopsy ye-chorionic villus, i-amniocentesis ne-cordocentesis, isibonelo, ingenziwa.

Imvamisa, kwenziwa izivivinyo eziningi ku-trimester yokuqala yokukhulelwa, njengoba kubalulekile ukuqapha impilo yowesifazane emasontweni okuqala okukhulelwa. Kusukela ku-trimester yesibili yokukhulelwa, kucelwa izivivinyo ezimbalwa, eziqondiswe kakhulu ekubhekeni ukukhula kwengane.

Izivivinyo ezinkulu ekukhulelweni

Ukuhlolwa okukhonjiswe ngesikhathi sokukhulelwa kuhlose ukuhlola impilo yengane nowesifazane okhulelwe nokubheka ukuthi ingane ikhula kanjani. Ngaphezu kwalokho, ngokuhlolwa okucelwe ngudokotela wokubelethisa, kungenzeka ukuthi kutholakale ukuthi ngabe kukhona yini ushintsho oluhlobene nengane noma uma kukhona ubungozi ngesikhathi sokukhulelwa noma ngesikhathi sokubeletha. Izivivinyo ezinkulu ezizokwenziwa ngesikhathi sokukhulelwa yilezi:

1. Qedela ukubalwa kwegazi

Isibalo segazi sihlose ukuhlinzeka ngolwazi ngamangqamuzana egazi sowesifazane, njengamaseli abomvu egazi nama-platelets, ngaphezu kwamaseli omzimba wokuzivikela akhonjwa kulolu vivinyo, ama-leukocyte. Ngakho-ke, kusukela ekubalweni kwegazi, udokotela angabheka ukuthi kukhona yini ukutheleleka okwenzekayo nokuthi uma kukhona izimpawu zokushoda kwegazi, ngokwesibonelo, futhi ukusetshenziswa kwezithasiselo kungakhonjiswa.

2. Uhlobo lwegazi ne-Rh factor

Lokhu kuhlolwa kwegazi kusetshenziselwa ukuhlola iqembu legazi likamama kanye ne-Rh factor, noma ngabe kunegciwane noma cha. Uma umama ene-Rh factor engeyinhle nengane i-Rh factor ayithole njengefa kuyise, lapho igazi lengane lihlangana nelikanina, amasosha omzimba omama azokhiqiza amasosha omzimba alwa nawo, angadala, ekukhulelweni kwesibili, isifo se-hemolytic sengane esanda kuzalwa. Ngakho-ke, kubalulekile ukuthi lokhu kuhlolwa kwenziwe ku-trimester yokuqala yokukhulelwa, ngoba, uma kunesidingo, izinyathelo zokuqapha zingathathwa ukugwema ukuphendulwa komzimba okweqile.

3. Ukuzila ushukela

Ukuzila ukudla kwe-glucose kubalulekile ukubheka ukuthi kunengozi yokuthola isifo sikashukela sokukhulelwa, futhi kubalulekile ukuthi kwenziwe ku-trimester yokuqala neyesibili yokukhulelwa, nokuqapha ukwelashwa nokulawulwa kwesifo sikashukela, isibonelo, uma owesifazane sekuvele ukuthi ukhulelwe.

Ngaphezu kwalokho, phakathi kwamaviki angama-24 nama-28 okukhulelwa, udokotela angakhombisa ukusebenza kwesivivinyo se-TOTG, esaziwa nangokuthi ukuhlolwa kokubekezelela i-glucose ngomlomo noma ukuhlolwa kwejika le-glycemic, okuwukuhlolwa okuningiliziwe kokutholakala kwesifo sikashukela . Qonda ukuthi i-TOTG yenziwa kanjani.

4. Ukuhlola ukuthola izifo

Okunye ukutheleleka ngamagciwane, izimuncagazi noma amagciwane kungadluliselwa enganeni ngesikhathi sokubeletha noma kuphazamise ukukhula kwayo, njengoba kwezinye izimo kungawela i-placenta. Ngaphezu kwalokho, uma kwenzeka abesifazane benesifo esingelapheki esithathelwanayo, njenge-HIV, ngokwesibonelo, kubalulekile ukuthi udokotela alibheke njalo igciwane emzimbeni futhi alungise imithamo yemithi, ngokwesibonelo.

Ngakho-ke, ukutheleleka okuyinhloko okufanele kuhlolwe ezivivinyweni ngesikhathi sokukhulelwa yilezi:

• Ugcunsula, okubangelwa amagciwane I-Treponema pallidum, engadluliselwa enganeni ngesikhathi sokukhulelwa noma ngesikhathi sokubeletha, okuholele ekutheni ugcunsula azalwe nawo, ongabonakala ngokungezwa, ukungaboni noma izinkinga zemizwa enganeni. Ukuhlolelwa ugcunsula kwaziwa nge-VDRL futhi kufanele kwenziwe kutrimester yokuqala neyesibili yokukhulelwa, ngaphezu kokuthi kubalulekile ukuthi owesifazane athole ukwelashwa ngendlela efanele ukugwema ukudluliselwa enganeni;
• I-HIV, okungadala iHuman Immunodeficiency Syndrome, ingculaza, futhi okungadluliselwa enganeni ngesikhathi sokubeletha. Ngakho-ke, kubalulekile ukuthi owesifazane atholakale, inani le-virus lihlolwe futhi ukwelashwa kulungiswe.
• URubella, okuyisifo esidalwa amagciwane omndeni I-Rubivirus nokuthi lapho kutholakala ngesikhathi sokukhulelwa kungaholela ekumeni kabi kwengane, ukungezwa, ukushintsha kwamehlo noma i-microcephaly, kubalulekile ukuthi kwenziwe ukuhlolwa ukuze kutholakale igciwane ngesikhathi sokukhulelwa;
• I-Cytomegalovirus, njenge-rubella, ukutheleleka nge-cytomegalovirus kungaba nemiphumela ekukhuleni kwengane, okungenzeka lapho owesifazane engakaqali ukwelashwa futhi igciwane likwazi ukudlulela enganeni nge-placenta noma ngesikhathi sokubeletha. Ngalesi sizathu, kubalulekile ukuthi kwenziwe ukuhlolwa ukukhomba ukutheleleka kwe-cytomegalovirus ngesikhathi sokukhulelwa;
• I-Toxoplasmosis, yisifo esithathelwanayo esidalwa yisimuncagazi esingadala ubungozi obukhulu enganeni lapho ukutheleleka kwenzeka esikhathini sokuqala sokukhulelwa futhi, ngakho-ke, kubalulekile ukuthi owesifazane aqaphele ukugwema ukutheleleka, kanye nokwenza ukuhlolwa ukuqala ukwelashwa nokuvimbela izinkinga. Funda kabanzi mayelana ne-toxoplasmosis ekukhulelweni;
• I-Hepatitis B no-C, okuyizifo ezithathelwanayo ezibangelwa amagciwane angadluliselwa nasenganeni, okungadala ukuzalwa ngaphambi kwesikhathi noma isisindo somntwana esiphansi.

Lezi zivivinyo kufanele zenziwe kwi-trimester yokuqala bese ziphindaphindwa nge-trimester yesibili kanye / noma yesithathu yokukhulelwa, ngokuyalelwa ngudokotela wokubelethisa. Ngaphezu kwalokho, ku-trimester yesithathu yokukhulelwa, phakathi kwesonto lama-35 kanye nelama-37 lokukhulelwa, kubalulekile ukuthi owesifazane ahlolwe i-streptococcus yeqembu B, I-Streptococcus agalactiae, ukuthi ibhaktheriya eliyingxenye ye-microbiota yowesifazane sowesifazane, kodwa kuya ngobungako balo lingaba yingozi enganeni ngesikhathi sokubeletha. Bona ukuthi ukuhlolwa kwenziwa kanjani ukukhomba i-streptococcus yeqembu B.

5. Ukuhlolwa kwesiko lomchamo nomchamo

I-Urinalysis, eyaziwa nangokuthi i-EAS, kubalulekile ukukhomba ukutheleleka komgudu womchamo, okuvame ukwenzeka ngesikhathi sokukhulelwa. Ngaphezu kwe-EAS, udokotela ubuye akhombise ukuthi kwenziwa isiko lomchamo, ikakhulukazi uma owesifazane ebika izimpawu zokutheleleka, njengoba kulokhu kuhlolwa kungenzeka ukukhomba ukuthi iyiphi i-microorganism ebhekene nokutheleleka, ngakho-ke, kungenzeka udokotela ukukhombisa ukwelashwa okungcono kakhulu.

6. I-Ultrasound

Ukusebenza kwe-ultrasound kubaluleke kakhulu ngesikhathi sokukhulelwa, njengoba kuvumela udokotela nowesifazane ukuthi babheke ukukhula kwengane. Ngakho-ke, kungenziwa i-ultrasound ukukhomba ubukhona bombungu, isikhathi sokukhulelwa nokusiza ukunquma usuku lokuzalwa, ukushaya kwenhliziyo kwengane, isikhundla, ukukhula nokukhula kwengane.

Isincomo ukuthi i-ultrasound yenziwe kuwo wonke ama-trimesters okukhulelwa, ngokusho kokuqondiswa kukadokotela wokubelethisa. Ngaphezu kwe-ultrasound ejwayelekile, ukuhlolwa kwe-morphological ultrasound kungenziwa futhi, okuvumela ubuso bomntwana ukuthi bubonwe nezifo zikhonjwe. Thola ukuthi kwenziwa kanjani ukuhlolwa kwe-morphological ultrasound.

7. Izivivinyo zabesifazane

Ngaphezu kwezivivinyo ezivame ukukhonjiswa ngudokotela, izivivinyo zabesifazane zinganconywa futhi ukuze kuhlolwe isifunda esisondelene. Kunganconywa futhi ukuthi kwenziwe ukuhlolwa kokuvikela, okwaziwa nangokuthi yiPap smear, okuhlose ukubheka ukuba khona kwezinguquko emlomo wesibeletho ezingakhombisa umdlavuza, isibonelo. Ngakho-ke, ukusebenza kwalezi zivivinyo kubalulekile ukuvimbela izinkinga kwabesifazane.

Izivivinyo zokukhulelwa okunobungozi obukhulu

Uma udokotela ethola ukuthi ukukhulelwa okubeka engcupheni enkulu, angaveza ukuthi kwenziwa izivivinyo eziningi ukuze kuhlolwe izinga lobungozi futhi, ngaleyo ndlela, akhombise izinyathelo ezinganciphisa ubungozi bokukhulelwa kanye nezinkinga ezikhona kumama futhi okomntwana. Ukukhulelwa okuyingozi kakhulu kuvame kakhulu kwabesifazane abaneminyaka engaphezu kwengama-35 ubudala, okunamathuba amakhulu okukhulelwa kwesisu noma izinkinga.

Lokhu kungenxa yokuthi amaqanda angaba nezinguquko ezithile ezandisa ubungozi bengane enesifo esithile sofuzo, njengeDown's Syndrome. Kodwa-ke, akubona bonke abesifazane abakhulelwe ngemuva kweminyaka engama-35 abanezinkinga ngesikhathi sokukhulelwa, sokubeletha noma sokubeletha, ingozi iba nkulu phakathi kwabesifazane abakhuluphele, abanesifo sikashukela noma ababhemayo.

Ezinye zezivivinyo ezingakhonjiswa udokotela yilezi:

• Iphrofayili ye-Fetal biochemical, esebenza ukusiza ekutholeni izifo zofuzo enganeni;
• I-Corial villus biopsy kanye / noma i-karyotype yesisu, esebenza ukuhlonza izifo zofuzo;
• I-echocardiogram ye-Fetal ne-electrocardiogram, ehlola ukusebenza kwenhliziyo yengane futhi evame ukukhonjiswa lapho kutholakala ukungajwayelekile kwenhliziyo enganeni ngokuhlolwa kwangaphambilini;
• I-MAP, ekhonjiswa abesifazane abane-hypertension, ukubheka ubungozi be-pre-eclampsia;
• I-Amniocentesis, esebenza ukuthola izifo zofuzo, njenge-Down syndrome kanye nezifo, njenge-toxoplasmosis, rubella, cytomegalovirus. Kumele yenziwe phakathi kwesonto le-15 nele-18 lokukhulelwa;
• UCordocentesis, eyaziwa nangokuthi isampula yegazi lombungu, isebenza ukuthola noma ikuphi ukushoda kwe-chromosomal enganeni noma okusolakala ukuthi kungcoliswe i-rubella kanye ne-toxoplasmosis sekwedlule isikhathi sokukhulelwa;

Ukusebenza kwalezi zivivinyo kubalulekile ngoba kuyasiza ukuthola izinguquko ezibalulekile ezingelashwa ukuze zingathinti ukukhula kombungu. Kodwa-ke, naphezu kwakho konke ukuhlolwa, kunezifo kanye nama-syndromes atholakala kuphela ngemuva kokuzalwa kwengane.