Methods o te tātaritanga prenatal: ira, urutomo, kore-urutomo. Tuhinga mo te whakamahi, te hua

tātaritanga prenatal Ko te whakamātautau matatini o te hapūtanga. Ko te whakaaro matua - he ki te tautuhi i ngā pathologies o te tamaiti i te wāhanga o te whanaketanga fetal.

Ko te tikanga tino noa o te tātaritanga prenatal: pupuri ultrasound, te tirotiro o tohu ngā i roto i te toto o te hapu, chorionic villus tīpako, tango i te kiri o te toto uho, amniocentesis.

He aha te mea te tātaritanga prenatal

Ma te faaohipa i ngā tikanga o te tātaritanga prenatal mau kitea i roto i disorders whanaketanga fetal pērā i te syndrome Edwards, syndrome a Down, disorders o te ngakau, me te i roto i te hanganga o te tahi atu abnormalities. Kia whakatau i te hua o te tātaritanga prenatal te whakarau o te tamaiti. I muri i te fariiraa i te raraunga tātaritanga i roto i te mahi tahi ki a Dr. whaea whakatau whanau te tamaiti kei te ranei haukotia te hapūtanga te. kia tukua matapae pai te whakanohonoho kukune. Hoki tātaritanga prenatal pā ki te whakatūnga o te whakamatuatanga matua i whakamātautau ira, kawea nei i roto i roto i te tīmatanga o te hapūtanga, ka rite ki te pai kia rite ki te faaotiraa o te sex fetal. E patua ana enei ratonga katoa i roto i te Center whakapaipai o te tātaritanga prenatal i runga i Prospekt Mira, ahu nei e Ahorangi MV Medvedev. Here taea e koe haere i te whakamātautau prenatal whānui, tae atu ki ultrasound. Whakamahia i te Center mō te hou hangarau 3D, 4D.

Methods o tātaritanga prenatal

tātaritanga prenatal nāianei whakamahi i te whānuitanga o ngā tikanga me ngā hangarau. Ko te whānuitanga me te taumata o te kaha i rerekē ratou. I roto i te whānui, e tahuri iho tātaritanga prenatal ki ngā rōpū nui e rua: urutomo me te kore-urutomo tātaritanga prenatal.

Non-urutomo, ranei rite e huaina ratou, tikanga iti urutomo e kore whakarato hāparapara, me te whētuki o te kukune me te whaea. E tūtohutia ngā tukanga pērā mō ngā wahine hapu katoa, e tika rite kino ratou. tika me whakamātautau ultrasound ngā tango wahi. tikanga urutomo ngā pokanoa (pokanoa) i roto i te tinana o te hapu, te kōhao uterine. e kore e haumaru tino tikanga, na e whakarite ratou ki te tākuta hei parepare whakamutunga, ka i reira te mea he pātai o tiaki te hauora o te tamaiti e parauhia te.

Non-urutomo tātaritanga prenatal

Hoki ngā tikanga kore-urutomo ngā ultrasound me āta prenatal, e taea ki tatou mau te akiaki o te whanaketanga o te kukune. Non-urutomo me te whakaaro he tātaritanga prenatal o āhuatanga serum fetal mō te toto o te whaea.

Ultrasound Ko te tikanga tino noa, e kore e whai te reira i tetahi pānga kino i runga i te wahine, me te hua ano. He metua vahine expectant katoa kia riro tenei ako? He wāhi moot, pea e kore te reira e hiahiatia i roto i te take katoa. Holding ultrasound e whakaturia ana Dr. mō take maha. I roto i te huatū tuatahi, ka taea e koe te whakatau i te maha o hapūtanga, ora ranei te hua ake, he wā pū. I roto i te wha o nga marama ultrasound kua taea whakaatu malformations matotoru congenital o te kukune, wāhi ewe, waikahu. I muri i te 20 wiki kia whakatau i te takoto o te tamaiti i mua nei. Ultrasound taea ki te tautuhi i te ngā kōhikohiko, ki te whakakitea te tātari i te hapu nui Arepa-fetoprotein, a ki te te aamu utuafare i reira e te tahi mau kohakore. E tano ia tapao e kore e taea e tetahi o hua ultrasound kī kotahi rau ōrau o te kukune hauora.

Kia pehea te ko te US

e tūtohu prenatal tātaritanga prenatal i te puka o te ultrasound mo nga wahine hapu katoa i roto i te ngā e whai ake nei:

• 11-13 wiki o haputanga;
• 25-35 wiki o te hapūtanga.

whakaratohia reira hoki tātaritanga o te kāwanatanga o te whaea me te kukune. Transducer ranei huinga tākuta pūoko i runga i te mata o te puku o te hapu, i reira ko te takahi o ngaru oro. he mea mahanga ēnei ngaru pūoko, a e ratou e ia ki runga ki te mata aroturuki. I te wā wawe o te hapūtanga te ētahi wā whakamahia tikanga transvaginal. I roto i tenei take, kua whakaurua te uiuia ki te tenetene. E ine tāutu āta ultrasound?
• hē fanauraa o te ate, whatukuhu, ngakau, whekau, me ētahi atu.
• Up ki 12 wiki o tohumate o syndrome o Down.
Ko te whanaketanga o te hapūtanga:
• mōwaho masterbatch ranei.
• Ko te tokomaha o fetuses i te kopu.
• Gestational.
• Ko te matua kōaro kukune ranei.
• Ko te takamuri i roto i ngā o te whanaketanga.
• Ko te āhua o te mokowhiti.
• tamaiti Ira.
• Wāhi me te huru o te ewe.
• Ko te rere toto i roto i te oko.
• Ko te āhua o te kōpū.

Ko te kupu, taea ultrasound ki te kitea tetahi abnormalities. Hei tauira, hypertonicity o te kōpū e taea arahi ki te riri o te materoto. Ka kitea tenei Pākatokato, ko reira taea ki te tango i mehua wā ki te tiaki i te hapūtanga.

Āta o te toto

Serum tangohia i te wahine te uiui mo tona ihirangi o ngā matū:
• AFP (alpha-fetoprotein).
• NE (estriol unconjugated).
• HCG (tangata gonadotropin chorionic).
Ko te tikanga hakari o te āta prenatal he tohu makona nui o te tika. Ko reira he wa ka whakaatu i te whakamātautau teka hua pai teka-kino ranei ranei. Na ka whakaturia te tākuta tikanga atu o te āta prenatal, pērā i ultrasound he tikanga tātaritanga he urutomo ranei.

Center o te tātaritanga prenatal i runga i Prospekt Mira i Moscow noho tika 1.5 haora matüora āta, ultrasound, ka whakarato prenatal kōrero. I tua atu ki tātaritanga te huatū tuatahi, he reira taea ki te haere i te rua o huatū āta matüora ki tohutohu me te ultrasound.

Ko te Arepa-fetoprotein

tātaritanga prenatal o mate ira te whakamahi i te tikanga o te whakatau i te taumata o te Arepa-fetoprotein i roto i te toto. heheu tenei whakamātau āta te tūponotanga o te whanau o te tamaiti ki tenei māuiuitanga rite anencephaly, ritua tuaiwi, me ētahi atu. Ano, he auau tiketike o AFP kia tohu i te whanaketanga o te maha hua, tano ore wā tāuta, te taea o materoto me te materoto noa ngaro. E whakarato ana te hua tātari tika te nuinga, ki te whakanohoia i runga i te 16-18 wiki th o te hapūtanga. Hua i mua i te 14 i muri i te wiki 21 th o maha hape ranei. I te tahi taime anō takoha toto. I te auau tiketike e whakaturia ana Dr. ultrasound, ka taea e reliably farii i te reira te haamauraa o mate fetal. Ki te kore e te US whakatau i te take o te ihirangi tiketike o te Arepa-fetoprotein, whakaritea amniocentesis te. Ko atu tika whakatau te huringa i roto i te AFP tenei ako. Ki te nui haere te toto o te manawanui taumata o Arepa-fetoprotein, kia meinga pōauautanga i roto i hapūtanga, pērā i he takaware whanaketanga, pea te mate fetal, ranei abruption placental. Iti hCG tiketike AFP ngā me te estriol iti tohu te taea o Down syndrome. e te tākuta ki pūkete tawhā katoa: tau te wahine o, taumata taiki. Ki te hiahiatia, whakaritea atu tikanga prenatal.

hCG

Chorionic gonadotropin tangata ranei (hCG) i roto i te hapū i roto i te tīmatanga o te wāhanga ki te arotake i te tohu tino nui. Plus tenei tātaritanga - te tīmatanga o te whakamāramatanga, ara, no te kahore te mea mōhiohio ultrasound. I muri i te kikiritanga, kua te hua tīmata te ra 6-8 ki te hua hCG.
HCG rite te glycoprotein tito o te ārepa me te peta subunits. Arepa ōrite ki hormones rapae o (FSH, TSH, LH); me te peta - he ahurei. Ko te aha whakamahia te whakamātautau mo te subunit beta (beta-hCG) te ki tika whiwhi i te hua. Kei te whakamahia e te tere takai whakamātautau tātaritanga, e kore nei e te tono i te whakamātautau HCG motuhake (i roto i te mimi). Ko te hCG toto peta tika tātari hapūtanga kua i 2 wiki o te kikiritanga. Ko te kukū o hCG i mimi tātaritanga tupulaki 1-2 ra i muri atu i roto i te toto. Ko te mimi taumata hCG i roto i te 2 nga wa iti.

Āhuatanga e pa ana i te HCG

Tautuhi hCG hapūtanga i te tīmatanga o nga wāhanga, he mea e tika ana ki te tango ki te pūkete etahi o nga āhuatanga e awe ana i te hua o te tātari.
Hua o hCG i roto i hapūtanga:
• Non-hanganga ture e kiia ana me te ora tūturu.
• hapūtanga maha (ake i roto i te hua i roto i te rahi ki te maha o te hua).
• toxicosis Early.
• Preeclampsia.
• malformations Major.
• Whakaae o progestogens.
• Mate huka mellitus.
E tukupu ana i te taumata o te HCG - wā nonconformity, tino puhoi nohanga hanga-hCG nui atu i te 50% o te täkupu:
• Non-hanganga ture e kiia ana me te ora tūturu (atu maha no o huringa hikuwaru).
• materoto whakatuma (heke te taumata e neke atu i te 50%).
• ngaro materoto.
• perenashivanie.
• hapū i te pūkano.
• ti'a'tu te iti hoki placental.
• Ko te mate o te kukune i te 2-3 huatū.

tikanga urutomo

Ki te whakatau te tākuta e mo te rapunga o mate tuku, kia tono disorders i roto i te whanaketanga o te tātaritanga prenatal urutomo, taea te whakamahi i te reira tetahi o nga ngā tukanga e whai ake nei:
• cordocentesis.
• Chorionic villus tīpako (ako o te hanganga o ngā pūtau e ngā te ewe).
• Amniocentesis (amniocentesis).
• Platsentotsentez (tāutuhia nunu'a tōraro i muri i te mate).

Ko te painga tikanga urutomo - nohopuku me te kī i te hua tino. Whakamahia i roto i te hapū wawe. Na, ki te mea i reira he tetahi māharahara o abnormalities i te whanaketanga fetal, te tātaritanga prenatal o mate tuku arata'i ki fakamulituku tika. kia i roto i te wa hanga ngā mātua me ngā tākuta i te whakatau ki te waiho i te hua ranei whakamutu i te hapūtanga. Ki te mau metua, i roto i te noa'tu o te māuiuitanga, tonu whakatau ki te pupuri i te tamaiti, te taote i te wā ki te whakahaere tika, ka whakarite i te hapūtanga me te ara hamani te kukune i roto i te kopu. Ki te te whakatau i runga i materoto whakaae te, na roto i te tīmatanga tonu, ka te ine kitea, e rua tinana, a hinengaro, kei te nui māmā nohotahi tenei tukanga.

tīpako villus chorionic

Chorionic villus tīpako tā tātari o matūriki mōkitokito o te Villi chorionic - te pūtau placental heke mai. Tenei matūriki Ko ira ōrite o te kukune, e taea ana ki te tohu i te hanganga pūira, ki te whakatau i te hauora iranga o te tamaiti. whakamana te tātaritanga i roto i mate whakapae e pā ana ki hapa pūira i haputanga (Edwards syndrome, syndrome a Down, Patau et al.), ranei i mōrea o te whakawhanake i te mate mahu o Simi, anemia pūtau toronaihi, chorea Gentigtona. Hua chorionic villus tīpako heheu 3,800 mate tamaiti e parauhia te. Ko te koha taua, he koha o te ngongo neural, e kore e taea te kitea tenei tikanga. kitea ana tēnei māuiuitanga te amniocentesis cordocentesis ranei anake ka ngā tukanga.
I te wa o te tātari chorion matotoru kia kore iti iho i te 1 cm, e hāngai ana ki 7-8 wiki o te hapūtanga. Tata nei, whakamana te hātepe kei te i 10-12 wiki, he reira haumaru hoki te kukune. Otiia e kore e i muri atu i te wiki 13.

te raveraa i ngā tukanga

Tikanga poka (transcervically transabdominally ranei) tīpakohia tākuta. Tei te reira ki runga ki te wahi paetata taiepa uterine āhua chorion. I roto i tetahi take, whakamana te unuhanga i raro i te mana o te ultrasound.

Kei te takoto te wahine i runga i tona hoki. Ko te wahi i whiriwhiria mo te pānga whakarehu rohe poka tika. Poka te taiepa puku, i hanga taiepa myometrial te kia i ngā te takotoranga ngira chorion whakarara. I US kaupapa whakahaere o te ngira. Pūwero papanga whakaputaina chorionic villus tīpako, nekehia atu te ngira te. A, no te tikanga transcervical, he wahine i runga i te moenga, ano he whakamātautau tonu. e kore te mamae Express ite. Kua whakaritea nga taiepa waha, me te tara ki kūmau motuhake. whakaratohia Access te he pū tōngāmimi rite tae reira te kiko chorionic hono pūwero me tangohia te rauemi e mo te tātari.

amniocentesis

tikanga tātaritanga prenatal ngā te tino noa - tikanga pathological o te whakatau fetal - amniocentesis. Kei te 15-17 wiki tūtohutia ana. I roto i te whakahaere i te mana kāwanatanga o te ultrasound kukune. Doctor roto i te taiepa puku kōkuhu he ngira ki te waikahu, ngotea te nui etahi o te tātari me te ngira nekehia. Teuteu o 1-3 wiki. Ko te iti mōrearea mo te whanaketanga o te hapū Amniocentesis. I roto i te 1-2% o kia wheako leakage o wai wahine, mutu reira kahore maimoatanga. Ka taea e anake materoto noa puta i roto i 0.5% o te wā. Kei te pakaru kukune ngira, ka taea e koe te mahi i te tukanga tae noa i roto i te wā o te hapūtanga maha.

tikanga ira

DOT whakamātautau - ko te tikanga ira haumaru hōu i roto i te rangahau fetal heheu Patau syndrome, Edwards, Down, Turner, Klinefelter. whakahaere ana te whakamātautau kei i runga i te pūtake o ngā raraunga whiwhi i te toto o te whaea. Ko te parau tumu Ko e te mate maori o te maha o ngā pūtau placental ki te awa toto o te whaea 5% DNA fetal. hanga tenei reira taea ki te whakatau trisomies nui (DOT whakamātautau).

Kia pehea te Ko te tukanga? E toto i te rua o te wahine hapu, tukua DNA fetal te. hoatu te hua kei roto i nga ra kotahi tekau. kawea te whakamātautau i roto i tetahi wā o te hapūtanga i te 10 wiki. Ko te tika o te mōhiohio 99.7%.