Nzira pamuviri nechirwere: kuvabereki, invasive, non-invasive. Zvairatidza kuti kushandiswa, migumisiro

Pamuviri chirwere chinhu chisinganzwisisiki kuongorora akazvitakura. Chinangwa chikuru - ndiko kuziva pathologies dzakasiyana-siyana mucheche ari nzendo fetus.

Vakawanda nzira pamuviri nechirwere: wakabata Ultrasound, zviri zvezvinangwa siyana mune ropa pamuviri, chorionic villus zvakabudiswa, achitora ganda achiine rukuvhute tambo ropa, amniocentesis.

Chii pamuviri zvokuongorora

Nokushandisa nzira dzakasiyana-siyana pamuviri nechirwere chaizvoizvo dzakaonekwa mu fetus zvinetso dzakadai Edwards urwere, Down kuti urwere, zvirwere mwoyo uye pakugadzirwa mamwe abnormalities. Kuti migumisiro pamuviri nechirwere angasarudza njodzi mwana. Pashure pokugamuchira chirwere Data vari pamwe chete Dr. mai anoronga mwana azvarwa kana pamuviri iri kuvhiringidzwa. Yakanaka Zvaifungidzirwa angabvumira mudumbu vapore. For pamuviri chirwere unoshandawo pakagadzwa ubaba nokuda kuvabereki kuongororwa, riri kuitwa tanga pamuviri, uyewo kutsunga fetus pabonde. Zvese izvi inopiwa guru Center of pamuviri nechirwere musi Prospekt Mira, izvo inotungamirwa Professor MV Medvedev. Pano unogona kupfuura misoro pamuviri kuongororwa, kusanganisira Ultrasound. Rashandiswa Center kuti ichangobva 3D ano, 4D.

Nzira pamuviri nechirwere

Current pamuviri Diagnostics anoshandisa nzira dzakasiyana-siyana uye michina. Kukura uye padanho vanokwanisa ivo zvakasiyana. Kazhinji, pamuviri chirwere rakakamurwa mapoka maviri guru: invasive uye non-invasive pamuviri kuongorora chirwere.

Non-invasive, kana sezvo dzinonzi, zvishoma invasive nzira regai kupa zvomusejari uye kunotevera ari mudumbu uye amai. Maitiro akadaro varumbidzwa kuvakadzi zvose pamuviri, ivo sezvakanga ngozi. Urongwa Ultrasound bvunzo zvinofanira hazvo kuitika. Invasive nzira dzinosanganisira kupindira (chipingaidzo) mumuviri mumwe pamuviri, iro uterine mhango. Dzinoshandiswa ngozi zvachose, saka ibasa navo chiremba sezvo chokupedzisira, kana paine mubvunzo kuchengetedza utano mwana asati aberekwa.

Non-invasive pamuviri kuongorora chirwere

Vasiri invasive nzira zvinosanganisira Ultrasound uye pamuviri kuongorora, iyo anotibvumira kuchengeta simba pakati kukura mudumbu. Non-invasive uye kunoonekwa sechinhu pamuviri chirwere fetus serum zvinokonzera kuti ropa ramai.

Ultrassom ndicho muitiro, izvozvo hazvina migumisiro inokuvadza pamusoro mukadzi uye michero pacharo. Ko zvose Vanaamai pamuviri vanofanira kugamuchira kudzidza ichi? A moot pfungwa, pamwe haisi kunodiwa ose nyaya. Holding Ultrasound anogadza Dr. kuti zvakawanda. Muzana rokutanga trimester, unogona kuona nhamba pamuviri, kurarama kana michero pacharo, chaiwo izwi. Mumwedzi wechina Ultrasound anogona kare kuratidza chakakomba vachiberekwa malformations ari mudumbu, placenta nzvimbo, Líquido amniótico. Pashure pevhiki 20 kuti kusarudza remangwana bonde mwana. Ultrassom anobvumira kuziva anomalies siyana, kana kuongorora akaratidza pamuviri mukuru Arifa-fetoprotein, uye kana nhoroondo yemhuri pane zvimwe zvikanganiso. Zvinokosha kucherechedza kuti hapana Ultrasound zvabuda zvinogona hazvivimbisi zana muzana ari mudumbu utano.

Sei US

Pamuviri pamuviri chirwere muchimiro Ultrasound inokurudzirwa kuvakadzi zvose pamuviri unotevera:

• Mavhiki 11-13 akazvitakura;
• Mavhiki 25-35 akazvitakura.

It akagovera chirwere mamiriro amai azvarwa. Transducer kana Switch chiremba anogadza pamusoro pemvura mudumbu ane pamuviri, pane kupindira kuti ruzha. Mafungu izvi anobatwa Switch, uye anoisa navo Monitor chidzitiro. Panguva yokutanga padariro pamuviri pacho rinoshandiswa transvaginal nzira. Panyaya iyi, kuti vachiongorora akaiswa mukati nyinyo. Ndezvipi zvarakasiya rinozivisa kuongorora Ultrasound?
• Birth kuremara chiropa, itsvo, mwoyo, ura nevamwe.
• Up kuti vhiki 12 zviratidzo Down kuti syndrome.
Kukura pamuviri:
• Ectopic kana masterbatch.
• Uwandu fetuses mudumbu.
• Gestational.
• Mubereki kana breech mudumbu.
• The lag tichitarisa kukura.
• The hunhu kwemwoyo.
• Gender mwana.
• Location uye mamiriro ezvinhu placenta.
• The ropa riyerere nenhumbi.
• The mataurire dumbu.

Saka, Ultrasound anobvumira kuziva chero abnormalities. Somuenzaniso, hypertonicity pamusoro dumbu kunogona kukonzera ngozi nokupfupfudzika. Akaziva anomaly ichi, zvinokwanisika kuti kutora tichiwana matanho chokuchengetedza pamuviri.

Kuongorora ropa

Serum akatorwa kubva vakadzi akaongororwa ayo zviri chepfu zvakasiyana siyana:
• AFP (Alpha-fetoprotein).
• NE (unconjugated estriol).
• HCG (human chorionic gonadotropin).
The nzira aripo pamuviri kuongorora ane zvakakwana anokudzwa zvakarurama. Asi pane nguva apo munhu bvunzo anoratidza kana nhema akanaka kana nhema negative mugumisiro. Ipapo chiremba anogadza mamwe nzira pamuviri kuongorora, zvakadai Ultrasound kana yokuongororwa nzira iri invasive.

Nzvimbo pamuviri nechirwere musi Prospekt Mira muMoscow anopedza maawa 1,5 chete nokukanganisika kuongorora, Ultrasound, uye anopa pamuviri kubvunza. Kuwedzera avhare pamusoro trimester wokutanga, zvinokwanisika zvakaitika rechipiri trimester nokukanganisika kuongorora pamwe mazano uye Ultrasound.

Arifa-fetoprotein

Pamuviri chirwere yokugara zvirwere kushandisa nzira dzokuziva padanho Arifa-fetoprotein muropa. Izvi rinovharidzira bvunzo inoratidza ndingangokuvara kuzvarwa mwana pamwe zvokurwara ichi sezvo anencephaly, chinonzi spina bifida, uye vamwe. Uyewo, yakakwirira mwero AFP zvingaratidza pave nemichero anoverengeka, zvisina kukodzera ndakagadza nguva, mukana nokupfupfudzika uye kunyange kurashikirwa pamuviri. The yakarurama kwazvo zvabuda ongororo inopa, kana akaisa pamusoro 16-18 fung vhiki akazvitakura. Results pamberi wa14 kana mushure 21 fung vhiki kazhinji yakakanganiswa. Dzimwe nguva kuzosarudzwazve kuti ave mubati ropa kuzozvidzorerwa. At refu zvazvingava anogadza Dr. Ultrasound, unogona yakavimbika kutambira simbiso fetus zvirwere. Kana US asingadi kuona mhaka mukuru zviri Arifa-fetoprotein, amniocentesis iri ratakapiwa. kudzidza Iri zvakarurama anosarudza kuchinja muna AFP. Kana ropa murwere vakawedzera kwevari Arifa-fetoprotein, zvingakonzera matambudziko panguva pamuviri, zvakadai kunonoka kukura, zvichida rufu fetus, kana placental abruption. Low AFP aibatanidza mukuru hCG uye pasi estriol anoratidza mukana Down syndrome. Chiremba inorangarira parameters zvose: mukadzi zera, mahomoni. Kana waida, ngaagadze mamwe pamuviri nzira.

hCG

Chorionic gonadotropin munhu kana (hCG) mu nhumbu muna tanga kuongorora inokosha zviratidzo. Plus ichi kuongorora - vokutanga zvokukura tsanangudzo, kunyange kana Ultrasound hakusi anodzidzisa. Mushure fertilization, zai ane 6-8 zuva anotanga kubudisa hCG.
HCG somunhu glycoprotein rinoumbwa Arufa Beta subunits. Alpha akafanana ne pituitary mahormone (FSH, TSH, LH); uye Beta - yakasiyana nedzimwe. Ndokusaka bvunzo kuti Beta subunit (Beta-hCG) rinoshandiswa kuti zvakarurama kuwana mugumisiro. Kufambira chirwere bvunzo rinoparadza anoshandiswa chisingazivi kushandisa chairo HCG bvunzo (mu weti). Ropa Beta hCG zvakarurama rokuongorora pamuviri kare panguva 2 weeks wekusangana. Kuwanda hCG mu weti chirwere dzinokura mazuva 1-2 papera pane muropa. The weti hCG yomuropa muna 2 nguva shoma.

Zvinhu kukanganisa HCG

Kutsanangura hCG pamuviri mukuvamba mumatanho, zvinokosha kufungawo zvimwe zvinhu kufurira pamusana kuongorora.
Zvakawanikwa hCG panguva pamuviri:
• Non-abvume mhosva uye upenyu chaihwo.
• Multiple pamuviri (kuwedzera nemhaka zvakaenzanirana nokuwanda muchero).
• Early toxicosis.
• Preeclampsia.
• malformations Major.
• Kubvuma progestogens.
• Chirwere mellitus.
Achideredza padanho HCG - nonconformity nguva, zvikuru kunonoka akavaka-hCG kuwanda kupfuura 50% of ndozvakajairwa:
• Non-abvume mhosva uye upenyu chaihwo (kakawanda pamusana kwemashifiti kutenderera).
• pangozi pamuviri (padanho ipfupi neinopfuura 50%).
• kurashikirwa pamuviri.
• perenashivanie.
• Ectopic pamuviri.
• Chirwere placental insufficiency.
• Kufa fetus muna 2-3 trimester.

invasive nzira

Kana chiremba afunga kuti nokuda kuziva miedzo nhaka zvirwere, zvirwere kukura invasive pamuviri nechirwere anofanira kutevedzerwa, rinogona kushandiswa rimwe maitiro anotevera:
• cordocentesis.
• Chorionic villus zvakabudiswa (kudzidza murwiyo masero anoumba placenta).
• Amniocentesis (amniocentesis).
• Platsentotsentez (vanozivikanwa zvakaipa pashure utachiona).

Kunakisa invasive nzira - kutsanya uye achisimbisa mugumisiro akakwana. Akashandiswa mangwanani pamuviri. Saka, kana paine fungidziro ose abnormalities mu fetus, pamuviri chirwere kubva enhaka zvirwere kunotungamirira mhedziso yakarurama. Vabereki uye vanachiremba vanogona munguva chisarudzo kusiya muchero kana kubvisa pamuviri. Kana vabereki, pasinei zvokurwara, achiri kusarudza kuchengeta mwana, vanachiremba vane nguva zvakanaka kuitisa uye kuchinja pamuviri uye kunyange kubata fetus mudumbu. Kana sarudzo iri pamuviri unogamuchirwa, ipapo tanga, kana kuona kutsauka, mumuviri uye mupfungwa, nzira iri nyore kuregerera.

chorionic villus zvakabudiswa

Chorionic villus zvakabudiswa kunosanganisira kuongorora nemaziso tudonhwe chorionic villi - yemberi placental masero. PARTICIPLE Izvi dzakafanana majini ari mudumbu, izvo zvinoita kuti munguva chromosomal nziyo, kuona majini hutano mwana. The kuongorora rinoitwa mu vanofungidzirwa zvirwere chokuita chromosomal zvikanganiso pakunambwa (Edwards urwere, Down kuti urwere, Patau, et unto.), Kana pangozi yokuita isingarapiki chirwere cystic fibrosis, nembezo sero kupererwa neropa, chorea Gentigtona. Result chorionic villus zvakabudiswa kunoratidza 3,800 vasati vaberekwa zvirwere mwana. Asi chakaremara yakadaro, zvakakanganisika pakati Neural chubhu, nzira iyi haigoni kuonekwa. zvokurwara Izvi dzakaonekwa chete kana amniocentesis kana cordocentesis maitirwe ezvinhu.
Panguva ongororo chorion ukobvu Hachifaniri asingasviki 1 masendimita, unoenderana vhiki 7-8 akazvitakura. Munguva ichangopfuura, muitiro rinoitwa vhiki 10-12, zviri nani kuti azvarwa. Asi kwete pava paya vhiki rechi13.

achiita maitiro

Nzira ponji (transcervically kana transabdominally) akasarudzwa vanovhiya. It kunotsamira apo vemunyika nekaupenyu chorion uterine masvingo. Chero zvazvingava, pane biopsy rinoitwa kudzorwa Ultrasound.

Mukadzi avete shure kwake. Nzvimbo yakasarudzwa nokuti ponji zvakafanira emo rufimbi maturo. Kuponjesa abdominal rusvingo, rusvingo myometrial unoitwa kuti tsono mumuhara yaisanganisira yakafanana chorion. On US kudzorwa kwebasa tsono. Syringe aigadzira micheka chorionic villus zvakabudiswa, tsono chinobviswa. Kana transcervical nzira, mumwe mukadzi pamubhedha chakafanana hwandaiva kuzviongorora. Express kurwadziwa haina akanzwa. The cervix uye kusangana nekutsi kwemukadzi masvingo wakaiswa chaizvo pingisi. Access Inoshandiswawo anobudisa mushonga zvishoma nezvishoma sezvo wasvika chorionic zvinyama anobatana sirinji uye zvinhu rakundwa kuti ongororo.

amniocentesis

pamuviri chirwere nzira dzinosanganisira vanhuwo zvikuru - pathological nzira dzokuziva fetus - amniocentesis. Zvinokurudzirwa 15-17 vhiki. In kuitisa mamiriro kudzora azvarwa Ultrasound. Doctor kuburikidza abdominal rusvingo inoisa tsono munzvimbo Líquido fluid sucks imwe yakawanda kuongorora uye tsono kubviswa. Kugadzirira vhiki 1-3. Amniocentesis Zvishoma ngozi kukura pamuviri. Muna 1-2% yevakadzi vanogona leakage pamusoro fluid izvozvo anomira pasina kurapwa. Vaingoerekana pamuviri zvinogona chete kuitika muna 0.5% nyaya. Tsono mudumbu wakaremara, unogona kuita nzira kunyange vanenge vakawanda pamuviri.

nemagene unyanzvi

Tira bvunzo - ndiwo Newest yakachengeteka nzira majini mune fetus tsvakurudzo inoratidza Patau urwere, Edwards, Down, Turner, Klinefelter. The bvunzo iri kuitwa pachishandiswa mashoko vakawana kubva muropa ramai. The musimboti ndechokuti zvepanyama rufu nhamba masero placental kupinda ropa karwizi mai 5% fetus DNA. Izvi zvinoita rokuongorora trisomies kukuru (tira bvunzo).

Sei muitiro? Kunoda ropa kubva tsinga mukadzi pamuviri, fetus DNA asunungurwa. Mugumisiro anopiwa mukati memazuva gumi. The bvunzo rinoitwa chero kunenge pamuviri kubva kwevhiki 10. Rakarurama ruzivo 99,7%.