Mothandizidwa ndi ultrasound kuchokera pa nthawi yatsopano, amayi amtsogolo sangathe kuona chithunzi choyera ndi mtundu wa zinyenyeswazi pawindo la pulogalamuyo (3D ultrasound), komanso amawonetsa nkhope ndi maonekedwe ake mu nthawi yeniyeni (4D ultrasound). Zoonadi, ntchito ya ultrasound, monga njira yabwino yodziwira, ndi yaikulu kwambiri kuposa kungodziwa mayi ndi mwanayo asanabadwe. Pakatikatikati mwa mimba, m'pofunikira kudziwa ectopic mimba, kuyesa mkhalidwe wa mwanayo, kuzindikira zolakwika zake, kuyang'ana kukhazikitsidwa kwa njira zowonongeka (amniocentesis, chorionic biopsy, cordocentesis) ndi fetometry, yomwe imayesa kukula kwa mwana wosabadwa ndi ultrasound.
Kupititsa kuvomerezedwa kwa ultrasound screenings - chinsinsi cha mimba yabwino
Pofuna kudziwa kuti kukula kwa mimba kumakhala kosavuta, kusakhala koopseza kwa kusokonezeka kwake komanso zomwe zingasokonezeke, amayi apakati ayenera kuyang'aniridwa ndi ultrasound nthawi 3-4 pa nthawi yogonana. Mwachitsanzo, mazira a fetus kwa milungu khumi ndi khumi ndi khumi ndi khumi (10-12) amawunikira kuti adziwe chiwerengero cha fetus, kutulukira malingaliro aakulu monga Down's syndrome, Edwards pogwiritsa ntchito kufufuza kwa chromosomal pathologies: makulidwe a collar space (chidziwitso cha kukula kwa fetus ndi ultrasound 45-83mm ) ndi kutalika kwa mafupa a mphuno. Cholinga cha kudalirika kwa deta yolandiridwa, kuphatikizapo ultrasound, kuyerekezera kwa "biochemical" kungathenso kulangizidwa. Muyeso yoyamba ya ultrasound, miyendo ya fetus, maonekedwe a ubongo, mtima, m'mimba, chikhodzodzo, msana ndi kayendedwe ka mwanayo zatsimikiziridwa.
Kachilombo ka fetus pamasabata makumi awiri ndi awiri ndi awiri (20-24) akuyang'ana momwe chiwalo cha placenta chimayambira, amniotic madzi mmenemo, amachitidwa kuti athetse malingaliro a fetus, kuphatikizapo mu mtima, ndi kuzindikira molondola kugonana kwa mwanayo. Pakadutsa masabata 30-32, kamwana kameneka kamakhala kofunikira kuti muzindikire kukula kwake, chikhalidwe cha umbilical, kuti muyese kukula kwa mutu wa mwana ndi kanjira ya mayi.
Kutsimikiza kwa nthawi yeniyeni ya kubadwa - ntchito ya fetometry
Pa gawo lirilonse, nthawi yeniyeni yobereka imatsimikiziridwa, koma zomwe zimaphunzitsidwa kwambiri ndizomwe zimakhazikitsidwa m'miyezi itatu yoyamba ya mimba. Panthawi imeneyi, kukula kwa fetus kumatsimikiziridwa ndi ultrasound mu mimba, monga KTP (coccyx-parietal size) ndi DPR (madigiri a fetal fetus) kawirikawiri amakhala ofanana, kenako amatha kutsogoleredwa ndi zinthu zosiyanasiyana. Choncho, panthawi imodzimodziyo ndi zizindikirozi, tanthauzo la nthawi ya mimba ndi kubereka kumachitika poyesa ndikuyerekeza zizindikiro zina za fetometric ndi zizindikiro za kukula kwa fetus ndi ultrasound.
Zachigawo zazikulu za fetometry ndi izi:
- BDP (biparietal kukula, yomwe ndi kukula pakati pa mafupa a m'nyengo). Pa phunzirolo, zikhoza kuchitika kuti mutu wa fetal umayikidwa pakhomo la pakhosi. Pankhaniyi, nthawi zambiri sizingatheke kuti pakhale BDP, mothandizidwa ndi yomwe, protocol ya ultrasound idzakhala ndi "chinthu chosatheka kuti muzindikire BDP". Kuyesera konse kungayambitse zolakwika, komanso chifukwa cha njira zolakwika zogwirira ntchito. Zingakhalenso kuti miyeso ya mutu idzawonjezeka mozungulira (brachycephaly) kapena longitudinally (dolichocephaly). Zozizwitsa zoterezi, pamodzi ndi mawonekedwe a ellipsoidal, mitu ndizosiyana, koma zingapangitse zolakwitsa pozindikira zaka zowonongeka ndi kukula kwa fetus ndi ultrasound. Pofuna kupeza chithandizo choyenera, chidwi chiyenera kulipidwa powerenga zizindikiro zina za fetometry);
- LZR (kukula koyambirira-occipital);
- OG (mutu wachizungulire);
- OJ (m'mimba ya m'mimba) ndi imodzi mwa njira zofunika kwambiri zogwiritsira ntchito intrauterine kukula msanga (FGP), chifukwa zimathandiza kudziwa kukula kwa feteleza ndi ultrasound;
- DLB (ntchafu kutalika). Chizindikiro ichi chiyenera kugwiritsidwa ntchito pofuna kudziŵitsa nthawi yokhala ndi mimba kokha ngati sikutheka kupeza BDP kapena ndi mawonekedwe osalimba a mutu, pamene ndi chinthu chofunikira kwambiri pakuzindikira chigoba cha dysplasia;
- DGRK (m'mimba mwake), ndi zina zotero.
Sayansi imatsimikiziridwa kuti kugwiritsa ntchito kamodzi kokha zizindikiro kumapangitsa kuti zikhale zolondola kwambiri kuti mudziwe nthawi yomwe ali ndi mimba. Pakati pa masabata 36, ndi bwino kuti muwerenge anthu a BDP, DLB ndi OZH, mutatha chimodzimodzi - OZ, OG ndi DLB.
Monga lamulo, mapetowa amapangidwa pa maziko a tebulo la ultrasound la fetal miyeso ya ultrasound, chitsanzo cha zomwe zafotokozedwa pansipa:
Chifukwa chakuti gawo lirilonse lingakonzedwe pa matebulo osiyana ndi kukula kwa fetasi kwa masabata, ma protocol angapangitse kusiyana kwakukulu.
Ngati kukula kuli kochepa kusiyana ndi nthawi yomwe mayi ali ndi mimba, ndipo ngati kamwana kakang'ono kameneka katsimikiziridwa ndi ultrasound, matenda a HPV amakhala opangidwa. Kwa kutsimikizira kwake, zowonjezereka za ultrasound zimagwiritsidwa ntchito mwamphamvu, cardiotocography ndi dopplerography. Mulimonsemo, ngati magawowa sakugwirizana, musamachite mantha nthawi yomweyo, chifukwa chifukwa chingakhale banal - nthawi yoyembekezera imakhala yosalongosoka chifukwa chosadziwika pozindikira tsiku la ovulation. Kawirikawiri izi zimakhala zochitika panthawi yamakondomu.