Nā Papahana O Ka prenatalʻike,: aaiaoe, invasive, ole-invasive. Nāʻikepili no ka hoʻohana, ka hopena

Prenatalʻike, o ka luna 'ninaninau o ka hāpai keiki. O ka papa kuhikuhi hana - mea e hōʻike likeʻole pathologies o ke keiki ma ka kuʻina o fetal? Acaeoey.

Ka loa e like me ka ano o prenatalʻike,: e hoʻopaʻa nei i ultrasound, kahi o nā hōʻailona i loko o ke koko o ka hapai, chorionic villus mea hōʻikeʻikeʻuʻuku, e lawe ana i ka ili o ka piko koko, amniocentesis.

He aha ka ka prenatalʻike,

Ma ka ana likeʻole ano o prenatalʻike maoli 'akomi i loko o fetal? Acaeoey kāna hana e like me ka Edwards maʻi pale, Down ka maʻi pale, kāna hana o ka naau, a ma ka kahua o nā abnormalities. I ka hopena o prenatalʻike, e hoʻoholo i ka hopena o ke keiki. Ma hope o ka loaa ana i ka PalekanaEND_LINKʻikepili ma keʻano neʻepapa me Dr. makuwahine hoʻoholo i ke keiki ua hānau paha ua keʻakeʻa i ka hāpai keiki. Ano ei ke ae i ka fetus hoʻopulapula. No ka prenatalʻike, Ua pili i ke kukuluia'na o ka paternity ma aaiaoe ninaninau, a ua lawe mai i loko o nā kahua o ka hoʻonaʻauao kakahiaka o ka hāpai keiki, e like me ka manao paa o fetal ke keka. I mau lawelawe i kaumahaia aku ai i loko o ke kapikala Center o prenatalʻike, ma Prospekt Mira, i ua alai ae e Kumu MV Medvedev. Here 'oe ke hele aku i ka hulina prenatal ninaninau, me ultrasound. Hoʻohana 'ia ma ka Center no ka mea hope 3D enehana, 4D.

Nā Papahana O Ka prenatalʻike,

O kēia prenatal lapaʻau 'hoʻohana i keʻano o nā kiʻina hana a me nā' ike loea. I ka loa a me ka nui o ka 'auhau ka mea, ua e lauwili. I mau, prenatalʻike, ua maheleia i nui nā pūʻulu elua: invasive a me ka 'ole-invasive prenatalʻike.

Ole-invasive, a me ka mea, i kapaʻia, emi invasive ano e ole iʻoki lāʻau lapaʻau a me ka trauma o ka fetus, a me ka makuwahine. Oia kaʻina hana i paipai no nā mea a pau hapai wahine, ka mea, e like me pilikia loa. Oaeouee ultrasound examinations e pono lawe wahi. Invasive i kūpono Komo intrusion ( 'ākeʻakeʻa) i loko o ke kino o ka hapai, o ka uterine lua. Nā Papahana mea ole loa palekana, no laila, waihona ia i ke kauka me ka hope e akoakoa ai, ka wā he mea he ninau no ka hoopakele ana i ke ola o ka unborn keiki.

Ole-invasive prenatalʻike,

No ka 'ole-invasive ki ina hana like nā ultrasound a me prenatal loiloi, e leie aku mākou, e malama i keʻano o ka ulu ana o ka fetus. Ole-invasive, a ua manaoia i ka prenatalʻike, o fetal lāʻau lapaʻau kumumea no ke koko o ka makuwahine o ka.

Ultrasound o ka loa e like me ke kaʻina hana no, ka mea, 'aʻole i loaʻa i kekahi palapala' ole ma o ka wahine, a me ka hua iho. He pau expectant makuwahine paha e kau ana i kēia ao? A moot wahi, paha ka mea, ua i koi 'ia i loko o na hihia. E paʻa ana ultrasound e koho i Dr. no na kumu. Ma ka trimester mua, e hiki ke hoʻoholo i ka helu ana o pregnancies, e ola paha ka hua iho, he kūlike loa makahiki. I ka ha o ka malama ultrasound ano hiki loa congenital malformations o ka fetus, placenta wahi, amniotic loli hōʻike. Ma hope o 20 pule paha ho oholo i ka wā e hiki mai ke keka o ke keiki. Ultrasound apono 'e kuhikuhi i ka likeʻole anomalies, ina ka Ikepili hōʻike i ka hapai kiʻekiʻe Alpha-fetoprotein, a ina o ka ohana mōʻaukala loaʻa nō kekahi mau mā. Ua mea waiwai 'ana i kumumanaʻo i kekahi o ka ultrasound hualoaʻa hiki hoʻokahi haneri pakeneka o ke olakino fetus i kumu hoʻomalu.

Pehea o ka US

Prenatal prenatalʻike, i loko o ka palapala o ka ultrasound ua paipaiʻia no nā mea a pau hapai wāhine i loko o nā kēia mau hua'ōlelo:

• 11-13 pule o ka hāpai keiki;
• 25-35 pule o ka hāpai keiki.

Ua hoakaka no kaʻike, o ka moku'āina o ka makuwahine, a me ka fetus. Transducer a mīkiniʻimi Kauka e puhi ia ma luna o ka ili o ka abdomen o ka hapai, aohe mea he intrusion o nä hawewe kani. Mau nalu i trapped mīkiniʻimi, a kuu ia ma luna o ke kanaka hoʻoponopono pale. Ma ke kakahiaka nui kahua o ka hāpai keiki ua kekahi manawa hoʻohana transvaginal hana. Ma keia hihia, keʻimi ua hookomoia i loko o ka vagina. A deviations e hōʻike ana loiloi ultrasound?
• Birth mā o ke akepaʻa, puupaa, naau, a me ka naʻau liʻiliʻi'ē aʻe.
• Up no 12 pule o symptoms o Down ka maʻi pale.
Ka hooulu ana o ka hāpai keiki:
• Ectopic ole masterbatch.
• ka helu ana o fetuses i loko o ka opu.
• Gestational.
• ka makua a me breech fetus.
• ka lag i hua'ōlelo o? Acaeoey.
• keʻano o ka Kal.
• hoohanau keiki.
• Location a me ke ano o ke keiki.
• ke koko i loko o nā ipu.
• ka leo o ka uterus.

Penei, ultrasound e leie aku e huai ae i kekahi abnormalities. No ka laʻana, hypertonicity o ka uterus ke alakai i ka make māinoino o ka miscarriage. A ike keia anomaly, e mea hiki ke lawe 'āwīwī ana e malama i ka hāpai keiki.

Loiloi o ke koko

Lāʻau lapaʻau ia mai o nā wāhine hookolokolo aku la ia no kona maʻiʻo o kekahi mau waiwai:
• AFP (Alpha-fetoprotein).
• NE (unconjugated estriol).
• HCG (kanaka chorionic gonadotropin).
O keia hana o prenatal loiloi mai i ka i lawa ke kiekie loa o ka pololei. Akā, he mau manawa, i ka wa i hoao hōʻike a wahahee maikaʻi paha hoopunipuni-io result. A laila, i ke kauka e koho i nā ano o prenatal loiloi, e like me ultrasound a me ka lapaʻau 'ana iaoia mea invasive.

Center o prenatalʻike, ma Prospekt Mira ma Moscow ka hāhai pono 1.5 hola biochemical loiloi, ultrasound, a ua hoakaka prenatal kūkā. Ma waho aʻeo ia loiloi 'i ka trimester mua, he mea hiki i kekahi, i ka lua o ka trimester biochemical loiloi me aʻo a me ka ultrasound.

Ke Alpha-fetoprotein

Prenatalʻike, o ka maʻi aaiaoe ka hoʻohana ano o ka hoomaopopo ana i ka nui o ka Alpha-fetoprotein i loko o ke koko. Kēia loiloi ho'āʻo hōʻike i ka pahiki o ka hanau ana o ke keiki me keia pathology like anencephaly, spina bifida, a me na mea e ae. Nō hoʻi, he uku kiʻekiʻe o AFP e hōʻike i ka ulu ana o kekahi mau hua, improperly hoʻouka kekahi manawa, i ka manawa kūpono o ka miscarriage, a hiki lilo abortion. Ka loa pololei hualoaʻa Ka Ikepili hoʻolako, ina kauʻia ma luna o ka 16-18 la hebedoma o ka hāpai keiki. Nā hualoaʻa ma mua o ka 14th paha ma hope o ka 21 la hebedoma o pinepine erroneous. I kekahi manawa reappointed koko donation. I ka uku kiʻekiʻe e koho i Dr. ultrasound, ka mea hiki reliably loaa e hooiaio ai o fetal ka maʻi. Inā ka US 'aʻole i ho oholo i ka pono o ka maʻiʻo kiʻekiʻe o Alpha-fetoprotein, amniocentesis ua hāʻawi. Kēia like Ua oi pololei e hoʻoholo i ka loli i loko o ka AFP. Inā i ke hoʻomanawanui i ka koko, a mahuahua nui pae o Alpha-fetoprotein, hiki i complications i hāpai keiki, e like me developmental 'ole', paha fetal ka make, a me placental abruption. Low AFP alu kiʻekiʻe hCG, a me ka haʻahaʻa estriol hōʻike i ka manawa kūpono o Down maʻi pale. Ke kauka i loko o ka mooolelo a pau kiko'î: o ka wahine o ka makahiki, hōmona pae. Inā koi 'ia, hoonoho hou prenatal ki ina hana like.

hCG

Chorionic gonadotropin kanaka 'ole (hCG) ma ka hāpai keiki i loko o ke kakahiaka kuʻina e loiloi i nā nā hoailona loa nui. Hua hoʻohui keia Ka Ikepili - na kuʻina kakahiaka nui o ka ho'ākāka 'ana, a hiki i ka wā ultrasound mea ole informative. Ma hope o fertilization, ke hua mai i ka 6-8 lā hoʻomaka e paka hCG.
HCG like me ka glycoprotein haku o Alpha a me ka Hoʻokolohua subunits. Alpha'ālike me ka pituitary hormones (FSH, TSH, LH); a me ka Hoʻokolohua - Ua kū hoʻokahi. Ia mea ke kumu o ka hoao ana no ka Hoʻokolohua subunit (Hoʻokolohua-hCG) ua hoʻohana 'ia no ka pololei loaaʻi i ka hopena. Ke kokololio PalekanaEND_LINK ho'āʻo holehole mai ai i hoʻohana ', a aole i pili i kekahi mau' HCG ho'āʻo (ma ka mimi). I ke koko Hoʻokolohua hCG pololei diagnose hāpai keiki mua ma 2 pule o ka fertilization. I ka lehulehu o hCG ma ka mimi PalekanaEND_LINK oʻoʻana 1-2 lā hope ma mua i loko o ke koko. Ka mimi hCG pae i loko o 2 manawa emi.

Makaʻu ka heluna o ka HCG

Wā hCG hāpai keiki i loko o ke kakahiaka kahua o ka hoʻonaʻauao, ka mea i pono, e lawe i ka mooolelo kekahi o nā kumumea i alakaʻi ai i ka hopena o ke Ka Ikepili.
Mahuahua ana o hCG i hāpai keiki:
• 'ole-kaʻaeʻana oleloia a me ka maoli ola.
• mau hāpai keiki (mahuahua ma ka hopena i like me ka helu o ka hua).
• I toxicosis.
• Preeclampsia.
• Mele malformations.
• ae o progestogens.
• mimikō mellitus.
Ua hakumakuma ka nui o ka HCG - nonconformity manawa, loa lohi hana-hCG nā hoʻohui like oi aku mamua o 50% o ke kūmau.
• 'ole-kaʻaeʻana oleloia a me ka maoli ola (oi pinepine no ka ole pōʻaiapuni).
• hooweliweli abortion (ua hoemiia kaʻilikai ma ka nui ma mua o 50%).
• lilo abortion.
• perenashivanie.
• Ectopic hāpai keiki.
• maʻi placental insufficiency.
• ka make ana o ka fetus i loko o 2-3 trimester.

invasive ki ina hana like

Inā ke kauka ua hoʻoholo 'ia no ka ka loaʻaʻana o hereditary maʻi, kāna hana i loko o ka ulu ana o ka invasive prenatalʻike, E e hoopili, ka mea hiki ke hoʻohana' ia kekahi o nā kēia mau kaʻina hana:
• cordocentesis.
• Chorionic villus mea hōʻikeʻikeʻuʻuku (study o ka haku mele 'ana o ke keena i lilo' ke keiki).
• Amniocentesis (amniocentesis).
• Platsentotsentez (hōʻike 'io hopena ma hope o ka maʻiʻaʻai).

Ka pono invasive ano - hookeai, a ai ka 'hopena hemolele. Hoʻohana 'ia i loko o kakahiaka hāpai keiki. No laila, ina he mea kekahi e hoʻohuoiʻia o abnormalities ma fetal kūpono 'ana, prenatalʻike, o hereditary maʻi hiki aku ai i ka pololei hopena a. I nā mākua a me nā kumu i loko o ka wā e i ka olelo hooholo, e haalele i ka hua a me ka 'ōlelo i ka hāpai keiki. Inā na makua, ma naʻe o ka pathology, nō olelo, e malama i ka bebe, na kauka i manawa e pono hoʻomaka a hoʻomaʻa i ka hāpai keiki, a hana i ka fetus i loko o ka opu ahiahi. Inā i ka olelo hooholo ma abortion i mahaloia, laila, i loko o ke kakahiaka nui kuʻina, i ka wa a ka 'akomi i haiahū kūmau, nā kāohi a me mentally, keia hana ua nui maʻalahi tolerated.

chorionic villus mea hōʻikeʻikeʻuʻuku

Chorionic villus mea hōʻikeʻikeʻuʻuku komo ai Ka Ikepili o microscopic (particles) o chorionic villi - i ka wā e hiki mai placental keena. Kēia huna He'ālike nā'ōewe o ka fetus, e leie aku e emi iho i ka chromosomal haku mele 'ana, e hooholo i ka aaiaoe ola o ke keiki. Ka Ikepili ua hana i loko o kēia maʻi pili me ka chromosomal hewa ma ka hapai ana (Edwards maʻi pale, Down ka maʻi pale, Patau listen'ōlelo.), A ma ka pilikia o ka ulu i ka maʻi hiki o cystic fibrosis, pahikakiwi ke kelepona hele anaemia, chorea Gentigtona. Hopena chorionic villus mea hōʻikeʻikeʻuʻuku hōʻike 3.800 unborn keiki maʻi. Akā, ua he kina, he hewa o ka neural Tube, keia iaoia hiki ole ke 'akomi i. Kēia pathology ua 'akomi i wale ka wā amniocentesis a cordocentesis kaulike.
I ka manawa o ke Ka Ikepili chorion mānoanoa e e ole e emi malalo o 1 knm, e hoʻopili like me 7-8 pule o ka hāpai keiki. Nei, ua hana i ke kaʻina hana ma 10-12 pule, ia mea i pakele no ka fetus. Akā,ʻaʻole hope ma mua o ka hebedoma 13th.

ae hana i na kaʻina hana

Ano O puncture (transcervically paha transabdominally) i koho surgeons. Ua hilinaʻi nui ma luna o kahi IIeEeAIEUIeXAIIUE kŘpa a chorion uterine pā. Ma kekahi hihia, he biopsy ua hana ma lalo o ka mana o ke ultrasound.

Ka wahine e moe ana ma luna o kona kua. Ke koho wahi no ka puncture pono kūloko anesthetic kanawai. Puncture ka abdominal pa, ua i myometrial pa no laila, i ke kui kele ma wahi komo pū laua chorion. Ma US e hoʻomalu aku holo o ke kuikele. 'Ohe hua mai la fabrics chorionic villus mea hōʻikeʻikeʻuʻuku, ke kui kele ma ua wehe. I ka transcervical hana, he wahine ma luna o ka moe e like me ka maʻamau ninaninau. Expressʻeha ua i ikeia. Ua paa ke cervix a vaginal paia me ka kūikawā pliers. Ka hookipaia a ua hoakaka ia ke catheter me ka mea hiki i ka chorionic'aʻaʻa pili ana 'ohe, a ua laweʻia ka mea no Ka Ikepili.

amniocentesis

prenatal PalekanaEND_LINK i kūpono loaʻa i ka loa, he pono ole - pathological iaoia o ka hoomaopopo ana fetal - amniocentesis. ? Aeiiaiaiaaia 15-17 hebedoma. I alakaʻi i ka moku'āina hooponopono ana o ka fetus ultrasound. Kauka ma ka abdominal pā inserts he kuikele i loko o ka amniotic loli, e hānai i ka kekahi nui o Ka Ikepili a me ke kui kele ma wehe. Hoomakaukau mai o 1-3 pule. Amniocentesis mea he wahi pilikia no ka hooulu ana o ka hāpai keiki. I ka 1-2% o na wahine i ka mahina kulu o ka loli, e mahana me ka lapaau. Noho'na makaainana i ulu abortion hiki wale ana i ka 0.5% o ka hihia. Needle fetus ua poino, e hiki ke hana i ke kaʻina hana, a hiki i ka hihia o ka mau hāpai keiki.

aaiaoe 'ana i kūpono

Kiko ho'āʻo - o ka Hou Loa palekana aaiaoe hana i loko o fetal noiʻi hōʻike Patau maʻi pale, Edwards, Hilal, Turner, Klinefelter. Ke hōʻike me ka mākaʻi ma ke kumu o nāʻikepili loaa mai ke koko o ka makuwahine. I ka rula o ia i ka make maoli ana o ka helu o placental aeee i loko o ke koko kahawai o ka makuwahine 5% fetal DNA. Kēia i mea e hiki ai e diagnose nui trisomies (kiko ho'āʻo).

Pehea o ke kaʻina hana? I ke koko, mai kekahi aa koko o ka wahine hapai, fetal DNA ua hookuu. Ua hāʻawiʻia ka hopena i loko o 'umi mau lā. Ka hōʻike ua lawe mai i kekahi kahua o ka hāpai keiki mai ka 10 pule. I ka pololei o ka 'ike 99,7%.