Hanyar na prenatal ganewar asali: kwayoyin, cin zali, wadanda ba masu cin zali. Alamomi ga amfani, sakamakon

Prenatal ganewar asali ne wani hadadden jarrabawa ciki. Babban manufar - shi ne su gane daban-daban pathologies daga cikin jariri a matakai na fetal ci gaba.

Mafi na kowa hanyoyin da prenatal ganewar asali: rike duban dan tayi, da abinda ke ciki na daban-daban alamomi a cikin jini na mai ciki, chorionic villus daukan samfur, shan fata na cibiyarki igiyar jini, amniocentesis.

Mene ne prenatal ganewar asali

By ake ji hanyoyi daban-daban na prenatal ganewar asali zahiri gano a fetal ci gaba cuta kamar da Edwards ciwo, Down ta ciwo, cuta na zuciya da kuma a cikin samuwar wasu munanan. Wannan sakamakon na prenatal ganewar asali iya yanke makomar da yaro. Bayan karbar bayanan binciken lafiya tare da haɗin gwiwar Dr. uwa yanke yaro da aka haife ko da daukar ciki da aka katse. M kintace iya bada izinin wani tayin fi. Domin prenatal ganewar asali ya shafi kafa ubanci ta kayyade jarrabawa, wanda yana da za'ayi a farkon matakai na ciki, kazalika da tabbatar da dalilin da fetal jima'i. Duk wadannan ayyuka suna miƙa a cikin babban birnin kasar Center of prenatal ganewar asali a Prospekt Mira, wanda aka karkashin jagorancin Farfesa MV Medvedev. Ga ka iya wuce wani m prenatal jarrabawa, ciki har da duban dan tayi. Amfani a Center for latest 3D fasaha, 4D.

Hanyar na prenatal ganewar asali

Yanzu prenatal bincikowa da amfani da dama hanyoyin da fasahar. Har da matakin na iya aiki da suka yi ya bambanta. A general, prenatal ganewar asali ne zuwa kashi biyu manyan kungiyoyin: cin zali da kuma wadanda ba masu cin zali prenatal ganewar asali.

Non-cin zali, ko kamar yadda aka kira su, kasa cin zali hanyoyin ba su samar m da kuma rauni da tayin da mahaifiyarsa. Irin wannan hanyoyin da ake bada shawarar ga duk mata masu ciki, sun kasance kamar yadda mai hadarin gaske. Na yau da kullum duban dan tayi Nazarin dole ne dole dauki wuri. Masu cin zali dabaru unsa intrusion (tsangwama) a cikin jikin wani ciki, da igiyar ciki rami. Hanyar ba gaba daya lafiya, don haka sanya su zuwa ga likita a matsayin karshe mafaka, idan akwai wata tambaya na tsare da kiwon lafiya na haifa ba.

Non-cin zali prenatal ganewar asali

Ga wadanda ba masu cin zali hanyoyin hada da duban dan tayi da kuma prenatal nunawa, wanda ya yale mu mu tsayar da muhimmancin ci gaba da tayin. Non-cin zali kuma an dauki wani prenatal ganewar asali fetal magani dalilai domin uwar ta jini.

Duban ne ya fi kowa hanya, ba da wani cutarwa effects a kan mace da kuma 'ya'yan da kanta. Shin duk mata masu kamata sami wannan binciken? A moot batu, watakila shi ne ba da ake bukata a kowane hali. Holding duban dan tayi nada Dr. domin dalilai da yawa. A farko trimester, za ka iya sanin ko yawan haihuwa, rayuwa ko 'ya'yan da kanta, a daidai lokaci. A cikin watan huɗu, duban dan tayi iya riga nuna babban nakasar malformations da tayin, mahaifa wuri, ruwar. Bayan 20 makonni iya sanin ko nan gaba jima'i da yaro. Duban dan tayi damar su gane daban-daban anomalies, idan analysis nuna wani ciki high alpha-fetoprotein, kuma idan iyali tarihi akwai wasu lahani. Shi ne ya kamata a lura cewa babu wani daga duban dan tayi sakamakon ba zai iya tabbatar da xari bisa dari na lafiya tayi.

Ta yaya ne Amurka

Prenatal prenatal ganewar asali a cikin nau'i na duban dan tayi bada shawarar ga duk mata masu ciki a wadannan sharuddan:

• 11-13 makonni na ciki.
• 25-35 makonni na ciki.

Yana azurta ganewar asali na jihar da uwa tasa, da tayin. Transducer ko haska likita sets a farfajiya na ciki na mai ciki, akwai wani intrusion na karar kadawar sauti. Wadannan tãguwar ruwa sun makale haska, kuma ya sanya su a kan lura da allo. A farkon mataki na ciki ne, wani lokacin amfani transvaginal Hanyar. A wannan yanayin, da bincike da aka saka a cikin farji. Wanne sabawa gano nunawa duban dan tayi?
• Haihuwa lahani na hanta, kodan, zuciya, hanjinsu da sauransu.
• Up zuwa 12 makonni na bayyanar cututtuka na Down ta ciwo.
A ci gaba da daukar ciki:
• Ectopic ko masterbatch.
• Yawan 'yan tayi a cikin mahaifa.
• Gestational.
• A iyaye ko breech tayin.
• A fada cikin sharuddan ci gaba.
• A yanayin da bugun zuciya.
• Jinsi yaro.
• Location da kuma yanayin mahaifa.
• A jini ya kwarara a cikin tasoshin.
• A sautin na mahaifa.

Saboda haka, duban dan tayi damar gano wani munanan. Alal misali, hypertonicity na mahaifa iya kai ga barazana da ashara. Bayan gano wannan anomaly, yana yiwuwa su yi dace da matakan kiyaye ciki.

Nunawa na jini

Magani dauka daga cikin mata yayi nazari domin da abun ciki na daban-daban abubuwa:
• AFP (alpha-fetoprotein).
• NE (unconjugated estriol).
• hCG (mutum chorionic gonadotropin).
A halin yanzu Hanyar prenatal nunawa yana da isasshe babban mataki na daidaito. Amma akwai lokacin da wani gwajin ya nuna ko karya tabbatacce ko ƙarya-mummunan sakamako. Sa'an nan likita nada ƙarin hanyoyi na prenatal nunawa, kamar duban dan tayi ko wani bincike Hanyar ne masu cin zali.

Cibiyar na prenatal ganewar asali a Prospekt Mira a Moscow ciyarwa kawai 1.5 hours biochemical nunawa, duban dan tayi, da kuma bayar da prenatal shawara. Bugu da kari ya nunawa na farko trimester, yana yiwuwa ya wuce na biyu trimester biochemical nunawa tare da shawara da kuma duban dan tayi.

A alpha-fetoprotein

Prenatal ganewar asali da kwayoyin cututtuka ta amfani da hanyar na kayyade matakin na alpha-fetoprotein a jini. Wannan nunawa gwajin ya nuna yiwuwar samun haihuwa na wani jariri da wannan Pathology kamar yadda anencephaly, spina bifida, da sauransu. Har ila yau, wani babban kudi na AFP iya nuna ci gaban da dama da 'ya'yan itatuwa, improperly shigar lokaci, da yiwuwar ashara kuma ko da rasa zubar da ciki. A mafi m sakamakon bincike bayar da, idan sanya, a 16-18 ga watan da ya gabata na ciki. Results kafin 14th ko bayan 21 ga watan da ya gabata na sau da yawa erroneous. Wani lokaci reappointed jini kyauta. A wani babban kudi nada Dr. duban dan tayi, shi zai iya dogara sami tabbaci fetal cututtuka. Idan Amurka ba gano dalilin da babban abun ciki na alpha-fetoprotein, amniocentesis da ake sa. Wannan binciken ne mafi daidai kayyade canji a cikin AFP. Idan haƙuri da jini ya karu matakan alpha-fetoprotein, na iya haifar da rikitarwa a lokacin daukar ciki, kamar raya ci gaban da bata lokaci ba, watakila fetal mutuwa, ko placental abruption. Low AFP hada high hCG, kuma a low estriol nuna yiwuwar Down ciwo. A likita daukan la'akari duk sigogi: mace ta shekaru, hormone matakan. Idan an buƙata, sanya ƙarin prenatal hanyoyin.

hCG

Chorionic gonadotropin mutum ko (hCG) a ciki a farkon matakai don kimanta mafi muhimmanci Manuniya. Plus wannan bincike - farkon matakai na definition, ko da duban dan tayi ne ba m. Bayan hadi, kwai yana da wani 6-8 ranar fara nuna hCG.
HCG matsayin glycoprotein hada da alpha da beta subunits. Alpha m tare da pituitary hormones (FSH, TSH, LH). kuma beta - shi ne na musamman. Wannan shi ne dalilin da ya sa gwajin ga beta subunit (beta-hCG) da ake amfani a daidai samu sakamakon. The m bincike gwajin tube aka yi amfani, wanda ba ya amfani da wani takamaiman hCG gwajin (a cikin fitsari). A jini beta hCG daidai gane asali ciki riga at 2 makonni na hadi. A taro na hCG a fitsari bincike ore 1-2 kwanaki daga baya fiye da a cikin jini. A fitsari hCG matakan a 2 sau kasa.

Dalilai da shafi cikin hCG

Ma'ana hCG ciki a farkon matakai, shi wajibi ne don la'akari da wasu daga cikin abubuwan da influencing da sakamakon bincike.
Karuwa da hCG a lokacin daukar ciki:
• Non-sharadi zargin da hakikanin rai.
• Mahara ciki (kara a sakamakon a gwargwado ga yawan 'ya'yan itace).
• Early toxicosis.
• Preeclampsia.
• Major malformations.
• Acceptance na progestogens.
• Ciwon mellitus.
Ragewan da matakin na hCG - nonconformity lokaci, musamman jinkirin ginawa-hCG yawa mafi girma daga 50% na kullum:
• Non-sharadi zargin da hakikanin rai (mafi sau da yawa saboda sababbu sake zagayowar).
• barazanar zubar da ciki (da matakin an rage ta fiye da 50%).
• rasa zubar da ciki.
• perenashivanie.
• Ectopic ciki.
• kullum placental insufficiency.
• A mutuwar wani tayi a 2-3 trimester.

masu cin zali hanyoyin

Idan likita ya yanke shawarar cewa ga ganewa na hereditary cututtuka, cuta a cikin ci gaban da cin zali prenatal ganewar asali ya kamata a yi amfani da, ana iya amfani da daya daga cikin wadannan hanyoyin:
• cordocentesis.
• Chorionic villus daukan samfur (nazarin abun da ke ciki na sel cewa siffofin da Mahaifa).
• Amniocentesis (amniocentesis).
• Platsentotsentez (gano mummunan sakamakon bayan kamuwa da cuta).

A amfani masu cin zali hanyoyin - azumi da kuma tabbatar da cikakken sakamakon binciken. Amfani a farkon daukar ciki. Saboda haka, idan akwai wani tuhuma da munanan a fetal ci gaba, prenatal ganewar asali hereditary cututtuka take kaiwa zuwa cikakken karshe. Iyaye da likitoci iya a lokacin yanke shawara su bar 'ya'yan itace, ko kuma karbi wani ciki. Idan iyaye, duk da Pathology, har yanzu yanke shawara su ci gaba da jariri, da likitoci da lokaci zuwa yadda ya kamata su gudanar da daidaita da juna biyu da kuma ko da yi wa tayin a cikin mahaifa. Idan yanke shawara a kan zubar da ciki aka yarda, to, a farkon matakai, a lokacin da gano sabawa, da jiki da kuma wajen tunani, wannan hanya ce mafi sauki da jure.

chorionic villus daukan samfur

Chorionic villus daukan samfur ya shafi bincike na microscopic barbashi chorionic villi - nan gaba placental Kwayoyin. Wannan barbashi ne m genes da tayin, wanda damar zuwa faye hali chromosomal abun da ke ciki, domin sanin da kwayoyin kiwon lafiya na jaririn. A analysis aka yi a da ake zargi da cututtuka dangantawa da chromosomal kurakurai a ganewa (Edwards ciwo, Down ta ciwo, Patau et al.), Ko a hadarin tasowa wani m cuta na cystic fibrosis, sickle cell anemia, chorea Gentigtona. Result chorionic villus Samfur bayyana 3.800 haifa ba cututtuka. Amma irin wannan aibi, a lahani na na tsarin jijiya tube, wannan hanya ba za a iya gano. Wannan Pathology da aka gano kawai a lokacin da amniocentesis ko cordocentesis hanyoyin.
A lokacin analysis chorion kauri ya kamata ba kasa da 1 cm, da ya dace da 7-8 makonni na ciki. Kwanan nan, da hanya da aka yi a 10-12 makonni, shi ne mafi aminci ga tayin. Amma ba daga baya fiye da 13th mako.

yin hanyoyin

Hanyar huda (transcervically ko transabdominally) zaba likitoci. Yana dogara gare inda sarrafa gwada chorion igiyar ciki ganuwar. A cikin wani hali, a biopsy aka yi karkashin iko na duban dan tayi.

The mace tana kwance a kan baya. A zaba wuri domin huda dole gida m sakamako. Huda na ciki bango, myometrial bango an yi haka da cewa allura daina kai hare hare a hada a layi daya chorion. A Amurka sarrafawa motsi da allura. Sirinji samar yadudduka chorionic villus daukan samfur, da allura da aka cire. Lokacin da transcervical hanya, a mace a kan kujera kamar wata al'ada jarrabawa. Express zafi ba ji. A cervix da farji ganuwar suna gyarawa da musamman filaya. Damar da aka bayar a catheter kamar yadda ya kai gare shi da chorionic nama shiga sirinji da kuma abu ne dauka domin bincike.

amniocentesis

prenatal bincike dabaru hada fi na kowa - pathological Hanyar kayyade fetal - amniocentesis. An shawarar 15-17 mako. A gudanar da jihar iko da tayin duban dan tayi. Doctor ta hanyar da na ciki bango abun da ake sakawa a allura a cikin ruwar, tsotsa wani adadin na bincike da kuma da allura cire. Shirya na 1-3 makonni. Amniocentesis ne kadan kawo hadari ga ci gaban da ciki. A 1-2% na mata iya samun yayyo na ruwa, shi yana tsayawa ba tare da magani. Maras wata-wata zubar da ciki zai iya kawai faruwa a cikin 0.5% na lokuta. Allura tayin lalace, za ka iya yi da hanya har ma a lokuta da mahara biyu a ciki.

kwayoyin dabaru

Dot gwajin - shi ne sabuwar lafiya kayyade Hanyar in fetal bincike ya nuna Patau ciwo, Edwards, Down, Turner, Klinefelter. A gwajin da aka gudanar kan data samu daga cikin uwa tasa ta jini. The manufa shi ne cewa halitta mutuwa da dama placental Kwayoyin a cikin jini rafi uwa 5% fetal DNA. Wannan ya sa ya yiwu don gane asali babbar trisomies (dot gwajin).

Ta yaya ne hanya? Daukan jini daga jijiyar na mace mai ciki, fetal DNA da aka saki. A sakamakon haka ne ba a cikin kwanaki goma. A gwajin da aka za'ayi a wani mataki na ciki daga 10 makonni. The daidaito daga cikin bayanai 99,7%.