Ngemva kokuvakasha kwangaphambi kokukhulelwa kwekota yokuqala ephawula ukuqala kokulandelela ukukhulelwa, owesifazane okhulelwe uyazuza ngokuvakasha kokulandelela njalo ngenyanga. Inhloso yalokhu kubonisana kwanyanga zonke: ukuqapha ukukhula komntwana, ukubona izinkinga ezingase zibe khona ngesikhathi sokukhulelwa kusenesikhathi futhi kuqinisekiswe inhlalakahle yomama ozozalwa.

E-France, ukuqapha ukukhulelwa kuhlanganisa ama-ultrasounds angu-3, ​​okungaphoqelekile kodwa anikezwa ngokuhlelekile komama abakhulelwe futhi atuswa kakhulu:

• okokuqala okubizwa nge-ultrasound yokuqomisana okufanele kwenziwe phakathi kuka-11 no-13 WA + 6 izinsuku;
• okwesibili okuthiwa yi-morphological ultrasound emavikini angu-22;
• i-ultrasound yesithathu emavikini angu-32.

Ngesikhathi sokubonisana ngaphambi kokubeletha, udokotela wezifo zabesifazane noma umbelethisi uhlola umbiko we-ultrasound futhi kungase kudingeke anikeze ukuhlolwa okwengeziwe noma avumelanise ukulandelwa kokukhulelwa.

Ngemuva kwe-ultrasound yokuqala:

• uma ukulinganiswa kwe-nuchal translucency ku-ultrasound kuhlanganiswe nomthamo wezimpawu ze-serum kanye nobudala bomama kuholela engcupheni ye-trisomy 21 enkulu kune-1/250, i-trophoblast biopsy noma i-amniocentesis izonikezwa umama ukuze 'kusungulwe i-karyotype;
• Uma ukujola kwebhayomethrikhi (isilinganiso sezingxenye ezithile zombungu) kukhombisa ubudala bokukhulelwa obuhlukile kuleso esibalwe ngokuya esikhathini sokugcina, udokotela uzolungisa i-APD (usuku olulindelekile lokubeletha) futhi alungise ikhalenda lokukhulelwa ngokufanele.

Ngemuva kwe-ultrasound yesibili:

• uma kutholakala ukuphazamiseka kwengane noma uma ukungabaza kuqhubeka, udokotela angabeka i-ultrasound yokulandelela noma adlulisele umama ozozala esikhungweni sokuxilonga ngaphambi kokubeletha;
• uma i-ultrasound ibonisa umlomo wesibeletho oguquliwe (oqinisekiswe yi-ultrasound ye-endovaginal), udokotela angathatha izinyathelo ezithile zokuvimbela usongo lokubeletha ngaphambi kwesikhathi: ikhefu lokugula, ukuphumula, noma ngisho nokulaliswa esibhedlela uma kwenzeka ukukhishwa;
• Uma ukukhula kombungu kungagculisi, kuzoyalwa i-ultrasound yokulandelela ukuze kuqashwe ukukhula komntwana.

Ngemuva kwe-ultrasound yesithathu:

• kuye ngezinto ezihlukene ze-ultrasound (i-biometry kanye nokwethulwa komntwana, isilinganiso sesisindo sombungu, indawo ye-placenta) kanye nokuhlolwa komtholampilo kukamama (i-pelvimetry yangaphakathi ngokuhlolwa kwesitho sangasese sowesifazane ukuze kuhlolwe ukwakheka kwe-pelvis ikakhulukazi) , udokotela wezifo zabesifazane noma umbelethisi wenza isibikezelo ngesikhathi sokubeletha. Uma ukubeletha kwesitho sangasese sowesifazane kubonakala kunzima, kuyingozi noma kungenzeki nhlobo (ikakhulukazi i-placenta previa), ukuhlinzwa kokuhlinzwa kungase kuhlelwe;
• uma kusolwa i-foeto-pelvic disproportion (engcupheni yokuthi ingane ingakwazi ukudlula okhalweni) kusolwa, i-pelvimetry izonikezwa ukuthi ihlole ubukhulu be-pelvis yomama;
• uma kwethulwa endlunkulu, kungase kucatshangelwe uhlobo lwe-external maneuver version (VME);
• uma ukukhula kombungu, ikhwalithi yokushintshana kombungu-womama noma inani le-amniotic fluid kungagculisi, kuzolandelwa i-ultrasound.

Ngaphezu kwama-ultrasounds amathathu okuthi, ngenxa ye-biometrics, avumele ukukhula kombungu ukuba kuqashelwe, udokotela wezifo zabesifazane noma umbelethisi unethuluzi elilula kakhulu lokulandela lokhu kukhula ngesikhathi sokubonisana kwanyanga zonke ngaphambi kokubeletha: ukukalwa kokuphakama kwesibeletho. Lesi senzo sihlanganisa ukulinganisa, kusetshenziswa iteyiphu yokuthunga, ibanga phakathi konqenqema olungaphezulu lwe-pubic symphysis (i-pubic bone) kanye nesikhwama sesizalo (ingxenye ephakeme kakhulu yesibeletho). Njengoba isibeletho sikhula ngokulingana nengane, lesi silinganiso sinika inkomba enhle yokukhula komntwana kanye nenani le-amniotic fluid. Udokotela wenza lesi senzo ekuboniseni ngakunye kokubeletha kusukela ngomhla wesi-4 wokukhulelwa.

Ngesikhathi sokubonisana ngaphambi kokubeletha, udokotela wezifo zabesifazane noma umbelethisi uhlola imibuzo embalwa ngempilo yakho - ngokomzimba kodwa nangokwengqondo. Futhi ungangabazi ukwabelana ngezifo zakho ezihlukahlukene zokukhulelwa (isicanucanu, ukuhlanza, i-acid reflux, ubuhlungu beqolo, ukuphazamiseka kokulala, ama-hemorrhoids, njll.) kodwa nanoma yikuphi ukukhathazeka nokukhathazeka.

Kuye ngalo mbuzo, udokotela uzokunikeza izeluleko ezihlukahlukene zokuhlanzeka nokudla ukuze uvimbele izifo zokukhulelwa futhi, uma kunesidingo, uzonikeza ukwelashwa okulungiselelwe ukukhulelwa.

Uma kwenzeka ukucindezeleka kwengqondo, angakuqondisa ekubonisaneni nodokotela wezengqondo, endaweni yakho yokuzalwa njengesibonelo.

Uzobhekisisa nendlela ophila ngayo - indlela odla ngayo, ukubhema, izimo zokusebenza nezokuthutha, njll. - futhi uzohlinzeka ngezeluleko zokuzivikela ngokufanele, futhi uma kunesidingo uzokwakha ukunakekelwa okuthile.

Ngesikhathi sokuhlolwa komtholampilo, ngokuhlelekile ekuboniseni ngakunye kokubeletha, udokotela uhlola izici ezihlukahlukene ukuze aqinisekise impilo yakho enhle:

• ukuthatha umfutho wegazi, ukuthola umfutho wegazi ophakeme;
• isisindo;
• ukushaya kwesisu kanye nokuhlolwa kwesitho sangasese sowesifazane.

Uyasiqaphela futhi isimo sakho esivamile futhi ubuza nganoma yiziphi izimpawu ezingavamile: ukuphazamiseka kokuchama okungase kubonise ukuthi unegciwane lomgudu womchamo, ukukhishwa okungavamile kwesitho sangasese sowesifazane okungase kube uphawu lokutheleleka esithweni sangasese, imfiva, ukopha, njll.

Yiqiniso, lapho kukhona izimpawu ezinjalo eziyisixwayiso, kufanele uthintane ngaphandle kokulibala ngaphandle kokulandelela kwanyanga zonke.

Lokhu kuhlolwa komtholampilo, okuhlotshaniswa nokuhlolwa okuhlukahlukene kwezinto eziphilayo okunqunywe ngesikhathi sokukhulelwa kanye nezikrini ze-ultrasound, futhi kuhloswe ukuthola izinkinga ezithile ze-fetus kanye nezokubeletha ngokushesha ngangokunokwenzeka:

• isifo sikashukela sokukhulelwa;
• i-hypertension noma i-pre-eclampsia;
• ikhekhe kusengaphambili;
• ukubambezeleka kokukhula kwesibeletho (IUGR);
• ukuzalwa ngaphambi kwesikhathi (PAD) okusongelwa;
• i-cholestasis yokukhulelwa;
• ukungahambisani kwe-Rhesus;
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