Ngoxa uncedo lwama-ultrasound ukusuka kwixesha elifutshane nje, ama-moms azayo akakwazi ukubona kuphela umfanekiso ocacileyo kunye nombala weemvumba zawo kwisikrini somlindo (3D ultrasound), kodwa ukulandelelana nokubonakalisa ubuso kunye nokunyakaza ngexesha langempela (4D ultrasound). Kakade ke, umsebenzi we-ultrasound, njengendlela ekhuselekileyo yokuxilongwa, kukhulu kunokuba nje ufunde umama nosana ngaphambi kokunikezelwa. Ngomlingwane, kubalulekile ukucacisa ukukhulelwa kwe-ectopic, ukuvavanya imeko yomntwana, ukuchonga iziphene zayo zophuhliso, ukubeka esweni ukuphunyezwa kweenkqubo eziphazamisayo (amniocentesis, i-chorionic biopsy, cordocentesis) kunye ne-fetometry, enquma ubungakanani bomntwana wesisu nge-ultrasound.
Ukugqithisa i-ultrasound i-screening mandatory - isitshixo sokukhulelwa okuphumelelayo
Ukuze kuhlolwe ukuphuhliswa okuqhelekileyo kokukhulelwa, ukungabikho kokusongela ukuphazamiseka kwayo kunye nokuphambuka okusemandleni, abafazi abakhulelweyo kufuneka baphonononge ii-3-4 kwixesha lokunyuka. Ngokomzekelo, i-ultrasound ye-fetus kwithuba leiveki 10-12 lijolise ekuqingeni inani lamabele, ukuchonga iimeko ezinzulu ezifana ne-Down's syndrome, u-Edwards ngesiseko sokufundwa kwamanqaku ala ma-pathologies angama-chromosomal: ubukhulu bendawo ye-collar indawo (ekwazisa ukukhula kwe-fetal nge-ultrasound 45-83mm ) nobude bamathambo empumlo. Ngenjongo yokuthembeka kwedata efunyenweyo, ngaphezu kwe-ultrasound, ukuhlolwa kwezinto "ze-biochemical" kunokumiselwa. Kwi-ultrasound yokuqala yokugunyaza, imilenze yesisu, isakhiwo sengqondo yaso, intliziyo, isisu, isisu, umlenze kunye nokunyakaza komntwana kuzimisele.
I-ultrasound ye-fetus kwiiveki ezingama-20 ukuya ku-24 ivavanya imeko yepentecenta, i-amniotic fluid kuyo, iyenziwa ekupheliseni ukungalunganga komntwana, kuquka nentliziyo, kunye nokuchonga ngokuchanekileyo ngesondo somntwana. Kwiiveki ezingama-30-32, i-ultrasound ye-fetus iyimfuneko ukuqikelela ubunzima bayo obulinganiselweyo, umgangatho wentambo yomda, ukulinganisa ubukhulu bentloko yomntwana kunye nomnxeba wokuzalwa ngumama.
Ukumiselwa kwexesha elifanelekileyo lokuzalwa - umsebenzi we-fetometry
Kwiseshoni nganye, ixesha elichanekileyo lokunikezelwa liyakunikwa, kodwa eyona nto inolwazi xa isungulwa kwi-trimester yokuqala yokukhulelwa. Ngeli xesha, ubukhulu bomntwana obunqunywe yi-ultrasound ekukhulelweni, njenge-KTP (ubukhulu be-coccyx-parietal) kunye ne-DPR (ububanzi beqanda le-fetal) ngokuqhelekileyo liqhelekileyo, kamva banokuchaphazelwa yimimandla eyahlukeneyo. Ngoko ke, ngokuxeshanye nalezi zikhombisi, inkcazo yexesha lokukhulelwa nokubeletha kwenzeka ngokuhlalutya nokuthelekisa ezinye izikhombisi ze-fetometric kunye nemigangatho yobungakanani be-fetal yi-ultrasound.
Izinto eziphambili ze-fetometry zi:
- I-BDP (ubukhulu biparietal, obunomlinganiselo phakathi kwamathambo exeshana). Kwisifundo, kunokuthi kwenzeke ukuba intloko ye-fetal igxininiswe ekungeneni kwe-pelvis encinci. Kule meko, ngokuqhelekileyo akunakwenzeka ukucacisa i-BDP, ngokubhekiselele kuyo, umgaqo-nkqubo we-ultrasound uza kuba nomcimbi "akunakwenzeka ukucacisa iBDP". Yonke imizamo yokulinganisa ingakhokelela kwiziphoso ekuxilongweni, kwaye ngenxa yeendlela ezingafanelekanga zokuqhuba umsebenzi. Kungathi kwakhona ukuba ubukhulu bentloko buya kunyuswa ngokuthe ngqo (brachycephaly) okanye ixesha elide (dolichocephaly). Izinto ezinjalo, kunye nomlo oqhelekileyo we-ellipsoidal, iintloko ziyimpawu eziqhelekileyo, kodwa zingakhokelela kwimpazamo ekuqaliseni ubudala bexesha lobubele kunye nesisindo somntwana nge-ultrasound. Ukuseka ukuxilongwa ngokuchanekileyo, ingqalelo kufuneka ihlawulwe ekufundeni ezinye izikhombisi ze-fetometry);
- I-LZR (ubukhulu be-occalital size);
- I-OG (ikhanda lomxholo);
- I-OJ (isisu esiswini) ngenye yeendlela eziphambili zokuxilongwa kwexesha lokukhula kwe-intruterine (FGP), njengoko kunceda ukugqiba ubunzima bomntwana nge-ultrasound;
- DLB (ubude bomlenze). Esi sibonakaliso sifanele sisetyenziswe ngenjongo yokugqiba ixesha lokukhulelwa kuphela xa kungenakwenzeka ukufumana i-BDP okanye ngefomu engavumelekanga yentloko, ngelixa kubaluleke kakhulu ekufumaneni i-dysplasia yamathambo;
- DGRK (ububanzi besifuba), njl.
Iingcali zenzululwazi zibonakaliswe ukuba ukusetyenziswa kwangexesha elilodwa izibonakaliso kwenza kube ngokuchanekileyo ngakumbi ukuchonga ixesha lokukhulelwa. Ngexesha elide ukuya kumaveki angama-36, kukulungele ukufunda i-BDP, iDLB kunye ne-OZH, emva kokufanayo -OZ, OG kunye neDLB.
Njengomthetho, isiphetho senziwa ngesiseko setafile ye-ultrasound yemilinganiselo ye-fetal ye-ultrasound, umzekelo othi uboniswe ngezantsi:
Ngenxa yokuba iyunithi nganye inokuqwalaselwa kwiitheyibhile ezahlukeneyo ezinobungakanani be-fetal kwiiveki, iiprotoksi ze-ultrasound zinokungafani kakhulu.
Ukuba ubukhulu bungaphantsi kwexesha lokukhulelwa eliboniswe etafileni, kwaye ukuba ubunzima obuncinane bomntwana bubekwe ngu-ultrasound, ukuxilongwa kwe-HPV kudlalwa. Ukuqinisekiswa kwayo, i-ultrasound eyongeziweyo yenziwa kwi-dynamics, i-cardiotocography kunye ne-dopplerography echazwe. Kwimeko nayiphi na, ukuba iiparameters azihambelani, akufanele ukwesaba ngokukhawuleza, ngenxa yokuba isizathu singabalwa - ixesha lokukhulelwa libekwe ngokungafanelekanga ngenxa yokungalungi ekumiseni umhla wokuvuthwa. Ngokuqhelekileyo le meko ibonakala ngexesha le-curry amenorrhea.