Kuongorora, vhiki 12 pamuviri: mutemo inopangidza

Sei kuziva kana kusimukira mudumbu, kana chero kutsaudzira sezvo zvomukati vari vakaumba mafufu? Mhinduro anogona kupa (kana musi vakauya kwenyu pamuviri - vhiki 12) Ultrasound. Avhare kuongorora kukura mudumbu, rinopa Kunyatsoona majini uye chromosomal zvinoitwa mwana nezveramangwana. Izvi zvinoita kuti tikwanise kuziva kuvapo kana kusavapo anomalies.

US akabata 12-vhiki nguva

Chaizvoizvo nzira rinoitwa nenzira mbiri: transvaginally (nomukombiyuta nyinyo achibatsirwa dzinokosha sensors) uye transabdominal (kuburikidza ganda mudumbu). The yokupedzisira zvikuru zvakafanana, uye vokutanga kwete kugadza vakadzi vose vari mudunhu, asi chete vamwe vavo, zvinotevera nyaya:

- kana placenta (chorion kana) kuchamudukupisa chaidzo;

- kana paine remuromo kusaita zvinhu nomazvo, uye zvakafanira kuongorora mashoko dhigirii;

- Kana pane zviratidzo anogumbura cysts uye zvinoshandiswa (kune yakarurama chirwere), kana nodes kuti uterine fibroids iri chaizvo zvakananga riri, asi nzira №2 kwakaratidza mashoko shoma;

- pakuongorora hwomwana mutsipa nzvimbo kana kuyera yakarurama kukura, zvakaoma kubereka nokuti kuti chibereko chakaipa, kana subcutaneous abdominal zvinyama zvikuru gobvu.

A kudzidza iri pasi nzira: mukadzi avete, achipfugama dzenyu; chiremba inoisa munzvimbo nyinyo ultrasonic vachiongorora kuti izvo kuraswa akapfeka kudzivirira kondomu. Kazhinji, zvose anoitwa nokungwarira kukuru, saka mimba asingadi kunzwa marwadzo.

Transabdominal kudzidza zvakaitwa kuitawo. All mhepo pakati Switch uye ganda kumbovadzinga, saka pangava sizvo zvabuda. To napo kuderedza mukana chikanganiso, kushandisa gel chaiyo rinoshandisirwa mudumbu. Zvishoma nezvishoma kufambisa Switch mudumbu, saka kuti iwe unogona kuona miviri mafufu, uyewo dumbu uye placenta mai. Ultrassom achachengetwa zvakakwana ari mudumbu uye haakonzeri iye chinhu kukuvara.

How yokugadzirira US

Kugadzirira kunobva nzira. Kana uri kushandisa transvaginal, Zvinokurudzirwa kushandisa kusvika 1 zuva pamberi kudzidza zvigadzirwa iwayo, izvo zvinogona kukonzera chinovira: chichena, bhinzi, makabheji, pizi. Ura inofanira kudururwa, zvimwe pane magasi kurambidza kuzviongorora dumbu uye azvarwa. Kana wawana manzwiro kuti mudumbu iri inflated, unogona kunwa zvinodhaka "Espumizan", chiri hazvikuvadzi azvarwa.

transabdominal kudzidza asati vakanwa hafu ity mvura kwemaminitsi 30 risati ratanga. Zvakafanira kuti paiva dundira yakazara, izvo tichaongorora mudumbu uye kuongorora mamiriro ake.

Child chiitiko 12-vhiki nguva

Vakawanda zvikuru nadzo vakava mafufu uye zvimwe zvivako duku mberi inotungamirwa kwayo. Avhareji kukura mwana 80 neMM, uye uremu - anenge 20 magiramu. Uyewo, vanachiremba vanoti kudya muchero kwakadaro zvinhu:

- kwemwoyo ucaschenne kupfuura ari wechitatu trimester, uye zvingava anenge 170 anorova paminiti;

- pachiso chomwana asisiri sokunge munhu tadpole, uye anowana kwevanhu unhu;

- unogona kuona maziso, nzeve dzavakadzi ndidzo dzaingoboorwa, shoma vellus bvudzi (ari nzvimbo nevagari vayo uye eyelashes of Education);

- dzakawanda tsandanyama kushanda yakatanga, saka chibereko ichifamba dzose nguva, uye sangano zviri kunyanya kwatangwa uye pachinzvimbo runobva;

- Crumb grimaces uye akakudzvinya maoko kwake nezvibhakera, minwe chinogona kuoneka zvipikiri;

- mwana yakatanga itsvo uye akapotsa akaumba ura, ropa akacherechedza matsvuku masero eropa;

- zvakazara kuumbwa, vose hemispheres uropi, asi "mirayiro" apo dorsal;

- unogona kuona ane mukomana kana musikana, asi nokuti mudumbu haasi nguva dzose nenzira yaunoda naamai uye vanachiremba, zvinokwanisika kuti chikanganiso, saka, kuti kunyatsoenderana munda nenguva 16 fung vhiki.

Kuverenga migumisiro?

Paper nemigumisiro chidzidzo uchawana maoko enyu pamusoro mushure kuongorora (vhiki 12) yakaitwa. Analysis Tsanangudzo achapiwa hereinafter.

Kubva pamwedzi wechitatu zvakanaka inoonekwa nechekare, mumwe mwana kana kwete. Naizvozvo, kana "nhamba zvibereko" mbiru kuchinzi maviri kana kupfuura, zvinoratidza kuti uchava mapatya (vatatu uye zvichingodaro. D.) Ko kare zvinogoneka wo kuwana kana zvibereko odnoyaytsovye (mapatya), kana zviri mapatya (heterozygous).

mupiro

Iri ndiro zita muchero, yaiva pedyo pakuberekwa Canal. Pamasvondo 12, zvinogona chinhu: makumbo, musoro, kana mwana zvachose kuti iri diagonal. mharidzo Final hunoyerwa ne yechi32 vhiki pamuviri. Kana musoro hauna iri kubva muchibereko chemusikana, ari kutora zvose zvinogoneka matanho kuti vagadzirise chinetso ichi.

Kuyera kukura mudumbu (kana fetometry)

Achiongorora zvaive US uye kudiwa vaongorore nzira, asi rinofanira kuita chiremba uyo dzokuMabvazuva kwete chete nhamba, asiwo zvinonyatsorehwa ezvinhu ane pamuviri. mitemo All oboznalsya zvimwe tsamba uye nhamba. Heano zvihombe:

• Bipolar (BPD, BRGP) - chidimbu ichi kureva inonzi biparietal saizi kureva, chinhambwe kubva musoro mumwe .. Parietal mafupa. Kwenguva vhiki 12 Ultrasound vanofanira kuratidza 21 mm BDP.
• Kukura mwana - anenge 8,2 masendimita, uremu haafaniri kuva zvishoma pane 17-19 d
• FML, DlB - nokureba yehudyu. Normal - 7 9 mm.
• Nuchal haafaniri kupfuudza 2.7 mm. Maererano ayo ukuru kunotemwa kana paine zvirwere zvakakomba. Paavhareji, zviri vanenge 1.6 mm.
• The izwi CTE (CRL) kureva coccyx-parietal saizi, kureva kufadza kureba kubva musoro coccyx, ndozvakajairwa - .. 43-73 mm.

Panewo dzimwe abbreviations:

• Hum (AP) - papfudzi kureba.
• AC (OJ) - abdominal sekamufarenzi.
• ABD (J) - dumbu dhayamita.
• PC - kukura mumwoyo.
• OGI - musoro sekamufarenzi.

Nokuti vose parameters izvi 1 kuongorora muna pamuviri kunoita chiremba-sonologu kusarudza sei kuti akure vomwana chivako. Kana iwe wakaita kuyerwa idukusa wokuyera nokuti zvayo vakawanda vanofungidzirwa sezvo vakawira: zvakaenzanirana uye panguva imwe chete kana kuti kwete. Kana usingabvumirani zvishoma chete, saka hapana chikonzero kuti tidzikame. Zvichida zvisiri kunorondedzerwa nguva uye chaizvoizvo ikozvino chete vhiki yechi11. Kana pamwe mwana kukura kwakadaro nemhaka vabereki undersized.

Uyewo, achazoona kuti pane kuremara kukura zvomukati, hakuna kana achiine rukuvhute tambo yakatokura, zvakaita mwoyo mwero (inoenzanirana - kubva 150 kusvika 174 anorova paminiti), kana pane kutsauka ari zvechadenga Líquido amniótico.

Kuverenga mhedziso Ultrasound pamuviri vangasangana okuti akadai "polyhydramnios" uye "oligohydramnios". Chii uye kana zvakakodzera kuti chinhu chokutya? Hapana chakaipa aya mashoko ikoko. Ndiyo imwe chete kutsunga pamusoro uwandu mvura iyo mudumbu floats: kana paine kupfuura zvakafanira, wakaiswa polyhydramnios, kana shoma - oligohydramnios. Kazhinji, izvi zvinoratidza mamwe dzevanhu: intrauterine chirwere (IUI), kusagadzikana itsvo, musimboti tsinga. Onawo kana mvura zvakawanda zvinonyanya kuzivikanwa. Kana hongu, zvino ndiyo Pointer pachena utachiona.

The chikuru Kutonga kana anoona zvarakasiya kubva ndozvakajairwa - kuti tisatya, asi kuenda nyanzvi.

Kana pane anogona kuva zvarakasiya kubva placenta?

Ultrassom rinoratidza apo vakakoshesa "mwana chigaro" sezvo akakura, kana pane chirwere, uye zvakawanda. Yakanaka kuita ndiko kuisa rwemberi parusvingo dumbu. Asi placenta anogona "namatirai" uye kuti mberi, uye kusvikira pasi. Panguva iyoyo rirege bindepinde muromo chomukati pamusoro dumbu. Ichi chirwere anonzi chorionic kana chakagadzirwa placenta previa. Panyaya iyi, kana mamiriro ezvinhu richachinja, uye kana kwete, basa rimwe caesarean chikamu pakukurukura. Kana shaya havasi zvakakwana yakavharwa, kunonzi asina kukwana previa; kuberekwa panguva iyoyo kuitwa senguva dzose.

Kana placenta "chavasina" pedyo mbudo (asingasviki 70 mm), hurukuro yakaderera. Sezvo zvingava nengozi ropa, Zvinokurudzirwa pamuviri sekwaserera nzira. Zvadaro kuchengeta kana placenta kumusoro kumukazve. Kana mavhiki 32-36 ichi zvaitika, hazvizovi kutyisidzira, uye mukadzi ichabudisa nenzira inozivikanwa.

The kukura ari placenta ino izwi akaenzana 0. "lobular" placenta - ndiwo mwero Kukura wechipiri, uye mamiriro ezvinhu akadaro zvakafanira kuti chiremba. The deposits calcium munyu dzinonzi calcifications. The ndeyokuva, kana ivo varipo vari placenta rokutanga mwero vakura.

Kana paine rufu zvimwe chikamu "mwana chigaro," ichi anonzi myocardial placenta. Muchiitiko chino, yaida kuti chiremba kuziva chikonzero uye taurira kurapwa, nekuti kana zvichaitika, uye ipapo, mwana vasina okisijeni yakakwana uye zvinodiwa kuti ayo kukura zvinhu.

Cervix: nehurumende mamiriro

On the 12 fung vhiki chiyero remuromo saizi, izvo zvinofanira kuva asingasviki 30 mm. The kwenguva zviri, nani. Kana iye ane pfupi chaizvo, asingasviki 20 neMM, ari pamuviri iri muchipatara, uye anogona kushandiswa kurapwa kuvhiyiwa. uterine miromo dzakavharika, zvose kwokunze uye dzakawanda.

Myometrium (tsandanyama kana ezvinhu) inoratidza kuti pane ngozi yokubva pamuviri yakakura. Kana nechirwere zvinoratidza kuti iyi pane hypertonicity pakati dumbu, mukadzi aibatwa. Kunyanya kutyisa zvinhu zvakadai se "fossilization" dumbu, "kusunda-muedzo" iri lumbar nharaunda.

How kuona nguva Ultrasound

Kushandisa anokosha tafura CTE dzaona gestational zera. Kungava kuti yakadai chawo yakavakwa kupinda Ultrasound muchina chirongwa. Enzanisa mashoko - a dzaona kubva wokupedzisira kumwedzi uye Ultrasound wakabudiswa. Kana musiyano iri diki (imwe kana mbiri vhiki), imi kuwana chaiyo munguva inotaurwa nokuda obstetrician. Kana mamwe mismatches (anopfuura 2 weeks), kusakoshesa izwi yakajeka Ultrasound.

Pamuviri kuongorora: chii uye sei

Iva kunyanya kungwarira kana pamuviri - 12 mavhiki. Ultrassom kuongorora - zvose yezvidzidzo izvi zvakagadzirirwa kuti vaongorore kukura mudumbu. In Ultrasound wokutanga ichi, uye ipapo akarayira avhare (zvichienderana vaita). Kuipedzera kana:

- Vakadzi pamuviri makore 35 uye vakwegura.

- Asati kuti, vana vakaberekwa vakafa.

- Kuongorora yapfuura muchero intrauterine chirwere chakanga dzakaonekwa.

- isu mwana azvarwa, vakawana imwe chromosomal abnormality.

- It chakasimbiswa kuti anomalies vakadaro vane hama nevabereki vose.

Chete inokosha nzvimbo kubereka achivhara (vhiki 12). How kuzviita? Unganidzai zvose miedzo: Ultrasound, ropa, kwokunze mashoko. Assessment kudzidza anoita geneticist, uye pfungwa iri akawanda pedyo pakora uye nenhamba: akasununguka Beta-hCG uye PAPP-A. Kazhinji, zvezvinangwa aya vakadzidza zvakanaka-yakasimbiswa mubatanidzwa. Kana pane mumwe wavo yachinja, hazvirevi kuti mudumbu ane zvimwe zvokurwara.

Saka kana firimu pa vhiki 12 pamuviri, kushandisa hunhu zvezvinangwa izvi. It syvorochnye mapurotini. Kana vane kutsaudzira, ipapo mwana uchava nemagene abnormalities. Free β-hCG - munhu subunit pamusoro chorionic (chorion - utachiona ichi) munhu gonadotrophin uye PAPP-A - ari pamuviri-akabatanidza mapuroteni A. Kuti kudzidza zviratidzo izvi akashandisa Elisa munhu akaidza (enzayemu kwakabatana immunosorbent munhu akaidza).

HCG zvinoita kwetunhu steroid mahormone (ari placenta yellow muviri). Vanachiremba vakaona kuti zviri hCG inodzivirira mudumbu kubva kurambwa. Exploring padanho, unogona zvaizoitika mberi nzira pamuviri. Maererano zvokurapa uwandu, hCG inowedzera zvishoma nezvishoma kusvikira vhiki rechi10 uye ipapo inoramba anenge chete pamwero (kubvira 5000 kusvika 50000 Iu / L) kusvika 33 vhiki, uye ipapo anogona kumuka zvishoma.

1 kuongorora zviri pamuviri iri 10 fung iri vhiki rechi13 izwi. Kuverenga zvose ngozi, tora yakawanda date: US zuva CTE uye NMV (nuchal translucency).

Analyses izvi zvinokosha chaizvo zviri kuziva huripo abnormalities ari okutodza. Zvisinei, kana uchapupu akamutsa zvishoma, usanetseka uye kuita zvechimbichimbi mhedziso. Unongofanira kuva kuzoitawo geneticist, vachakuudza zvokuita inotevera. Panewo mukana kuti kururama iverengwe Ultrasound. Kuongorora ane 12-vhiki pamuviri zvinogona kudzokororwa - kujekesa, kana chiremba vanonyorera invasive nechirwere, izvo zvakarurama kuona majini iine mwana. Zvichienderana chii nguva, kuti kana chorionic villus zvakabudiswa kana amniocentesis.

Kana kunyange 1 kuongorora kwakaratidza yakaderera chaizvo mukana chromosomal abnormalities ari mudumbu, hazvina zvakakodzera kusiya kuongorora, iyo paruchaitika 4-5 mwedzi pamuviri. Uyezve hCG uye AFP, kuona pachiyero vakasununguka estriol (bvunzo katatu).

Kuti tizive parameters β-hCG uye PAPP-A, kupa ropa kuongorora. Mavhiki 12 - ane nguva yakakwana kuti vakwanise kuona pamberi nokukanganisika kuongorora (kana kusava) abnormalities mu okutodza.

Mhedziso ongororo

Zvichienderana migumisiro nemiedzo ropa zvinoratidza sei nenhamba akasiyana chakaipa nazvo. Saka, kuongorora ane 12-vhiki pamuviri kungaratidza zvinotevera:

- Down Syndrome.

- Hapana muchero, uye 2 (3, etc ...). muchero More - zvakawanda kwevari kemikari.

- toxicosis.

- sizvo yakatarwa nguva pamuviri. Nokuti mumwe vhiki kwomwana unoenderana parameter kuti anosarudza chaiyo makore azvarwa.

- muHupo chirwere cheshuga ari mai.

- Ectopic pamuviri.

- High ngozi yokubva pamuviri yakakura.

Pane mitemo mabasa?

Chokwadi hapana! Dzidza navo zvaunokwanisa nokuita zvidzidzo zvakadai Ultrasound, achivhara (vhiki 12). wokuyera It zvichazivikanwa pashure pokudzidza date chiremba. Zvisinei, pane srednemeditsinskie zviratidzo zvakajeka kuti vhiki imwe neimwe pamuviri. Somuenzaniso, β-hCG musi 11-12 vhiki kunofanira kubva 200,000 kusvika 90,000 Iu / Rine mamiririta.

Zvisinei, zvinofanira kurangarirwa kuti kuongorora ane 12-vhiki pamuviri anopa Zvechokwadi, mukuru kwazvo, asi zvakadaro hauna Izvi vakakwana, nokuti mukadzi wose ane chaiyo muviri yavo, nhoroondo anofanira kutorwa nachiremba wako. Kana mudumbu haasi oga, ipapo zvakaoma rokuongorora. Tarisa mifananidzo. Kana dzinopfuura imwe nehafu kana kaviri, izvozvo zvinogona vakagumisa kuti 2 kana kupfuura tuvana. Mumwe nomumwe zvezvibereko warwo chorion uye zvakasiyana kemikari kugadzirwa. Naizvozvo, mukuru kuita kwakadaro, uye amai ramangwana akadana Ultrasound kusimbisa vakawanda pamuviri.

Kamwe firimu (vhiki 12), mureza tsika iyoyo muchinjikwa zvazvakaipira pamwe Data vakawana kuti kuverenga kana zvokurwara iri. Vanachiremba inoshandiswa chinangwa ichi rinokosha chinhu, rinonzi Amai. It rinowanikwa nevanhu nzira yemaitiro: uwandu kemikari, iyo yakatogadzirwa kwakavakirwa migumisiro kuongorora, rakakamurwa hCG (ichi anoenderana kwomuzvarirwo pamuviri). Zvinofanira kuwana mumwe (zviri Zvakanakisa). Zvakanaka kare pamusoro migumisiro zvidzidzo zvose kutongwa kana kuti zvinosanganisira boka mai ngozi pamwe chromosomal abnormalities kana kwete. Zvinokosha kucherechedza kuti kunyange kana kamwe kamwe zvakaitika, hazvina chokupedzisira mutongo, asi chete mumwe fungidziro. Naizvozvo, dzimwe zviratidzo zvakafanana uye chete ipapo chero mhedziso. Kudzokorora yose achivhara ane 12-vhiki pamuviri: Ultrasound, mahormone, RTA anogona kutora kudzidza wechipiri rechipiri trimester.

PAPP-A puroteni anokonzera zvirwere ari pamuviri, uye zvinobatsira kuti placenta kushanda. Sezvo zvikumbaridzo vari zvakajeka nemiganhu kunotsanangurwa, ayo kutsauka zvikuru kunaka. .. yose ndeyokuti kuti vakadaro "akasvetuka" nhamba kutaura chete ane zvichibvira nokupfupfudzika, asiwo pamusoro zvakadaro zvinotyisa abnormalities akaita chirwere cheDown syndrome, De Lange urwere, etc. anonzi kwomuzvarirwo nhamba dzinotevera: kubva 11 ndipo kusvika 12 ndipo vhiki - 0,7 kusvika 4,76; kubva 12 fung kusvikira vhiki rechi13 - 1,03- 6,01.

Reviews yezvidzidzo

Vakadzi vaiita kuongorora (vhiki 12), zvakasiyana kutaura nezvazvo. Mumwe zvisiri kuzivikanwa zvepabonde mwana. Pane tsanangudzo - izwi iri diki, zvichiita pakupedzisira kutaura ndiani achaberekwa: musikana kana mukomana, chete panguva 16 fung vhiki. Kutaura pamusoro zvakasiyana mutengo. Vamwe vanhu vanopfuura nemiedzo for free, vamwe vanobhadhara kubvira 1000 kusvika 3000 rubles.

Zvisinei, vanaamai vakawanda vanoti Ultrasound kuongororwa, uye kukubatsira kunzwisisa sei mwana wako. Sezvo nzira idzi ikozvino zvaida, rinogona chirwere uye kurapwa nguva kutanga kuva chirwere kuti mwana akaberekwa utano.