Ukuhlolwa kwe-Ultrasound
Isikhathi sokuqala i-ultrasound yenziwa ngesikhathi ukwelashwa kokuqala kowesifazane kudokotela. Esikhathini sokuqala (amasonto ama-5-6), umgomo oyinhloko wesifundo ukucacisa ukuthi ukukhulelwa noma ukukhulelwa kwe-ectopic. Esikhathini esilandelayo, i-ultrasound ephoqelelwe yenziwa isikhathi esingamaviki ayishumi kuya kwangu-13. Uma owesifazane ezwa ukuthi ukhulelwe ngalesi sikhathi, ukuhlolwa kwesibili okuhleliwe kuba ngowokuqala ohlwini. Kuqondene nokuhlolwa kwe-ultrasound - isifundo esingabonisa ingozi yezinkinga ezinganeni. Kulesi sigaba, ungathola izifo ezingu-2 zokuzalwa zakwa-chromosomal - I-Down syndrome ne-Edwards syndrome. Phakathi nezinsuku ezingu-7 ezilandelayo, ngokufanayo ngosuku olufanayo, ngokuchaneka kwemiphumela, umama olindelekile kufanele ahlole ukuhlolwa kwezinto eziphilayo, okuthiwa "ukuhlolwa kabili". Ukuze wenze lokhu, kuzodingeka unikele ngegazi kusuka emthanjeni. Uma, ngokusekelwe emiphumeleni yalezi zifundo ezimbili, ingozi enkulu yokukhubazeka kwengane itholakele, udokotela uzokutusa ukuxilongwa ngaphambi kokubeletha (phakathi nale nqubo, i-amniotic fluid noma i-cord blood ithathwa ukuze ihlaziye isethi ye-chromosome futhi icacise ukuxilongwa). Ukuhlolwa kokubili kwe-ultrasound kungenxa yesonto lama-20 kuya ku-22. Imiphumela yayo ifingqa futhi ngemiphumela yokuhlolwa kwezinto eziphilayo (manje kubizwa ngokuthi "ukuhlolwa kathathu": kuvumela ukubona futhi isifo se-chromosomal yesithathu - i-neural tube defect), eyenziwa isikhathi samasonto angu-16 kuya ku-21. I-ultrasound yokugcina ehleliwe yenziwa ngeviki lama-32. Kuhloswe futhi ekutholeni izenzo ezimbi, ezingabonakali ngenxa yokuthi umntwana wayesencane kakhulu. Phakathi ne-ultrasound, odokotela bahlola imingcele ehlukahlukene okumelwe ihambisane nobude bokukhulelwa: ubungakanani besibeletho nosana, ithoni ye-myometrium, izinga lokuvuthwa kwe-placenta, inani le-amniotic fluid. Hlaziya isakhiwo sezitho zangaphakathi zengane, isikhundla sezintambo zomzimba.
Doppler
Le ndlela yokuxilongwa kwe-ultrasound yenza kube lula ukuthola ukuthi ingane isondliwe izakhi eziwanele kanye ne-oxygen evela kumama. Phakathi nokuhlolwa, odokotela bahlola izici zokugeleza kwegazi emthonjeni we-uterine, intambo kanye nomshini we-cerebral womntwana wengane. Njengoba sekuqinisekisiwe, yikuphi ukusheshisa kwegazi okugeleza kulowo mishini, kungaphethelwa ukuthi masinyane kangakanani futhi kunani okungakanani izakhi kanye ne-oksijini eziza kumntwana nokuthi ngabe lezi zibalo zihambisana nesikhathi sokukhulelwa. Ucwaningo luqhutshwa ngezigaba ezimbili. Okokuqala, udokotela ngamunye uhlola umthamo ngamunye we-3 usebenzisa umshini we-ultrasound. Uma isithombe saso sibonakala esibukweni, siphenduka inzwa (Doppler), esilinganisa ijubane lokugeleza kwegazi, ukucindezela kwalo nokumelana komkhumbi. Ukuphazamiseka kwezimpikiswano zegazi kuzokukhombisa ukuthi iziphi izinkinga ezizokwenzeka ngesikhathi sokukhulelwa. Ngakho-ke, uma ingane ingenamsoco okwanele, ingazalwa ngesisindo esincane. Ngokwebufakazi bukadokotela, isibonelo, uma kunezinkinga ngesikhathi sokukhulelwa kwangaphambili, i-Doppler ingenziwa kusukela ngeviki le-13. Ngokujwayelekile futhi lokhu kuhloswe kunqunyelwe bonke abesifazane abakhulelwe esikhathini esivela ku-22 kuya ku-24 ngesonto. Uma udokotela eveza ukuphazamiseka kwegazi, uzobeka isifundo sesibili.
I-Cardiotocography
Ucwaningo lubandakanya ukuhlola imingcele emibili - izinga lokushaya kwenhliziyo yengane kanye nesimo sohlobo lwe-uterine. Balinganisa izinzwa ezimbili, ezinamathela kumama ozayo esiswini. Owesithathu usezandleni zakhe, ucindezele inkinobho njalo lapho umntwana ehamba. Okuyinhloko yendlela: ukuhlaziya ushintsho ekushaya kwenhliziyo kwengane ekuphenduleni ukunyakaza komzimba wakhe. Umgomo uwukuthola ukuthi i-oxygen eyanele inikezwa ingane. Le ndlela isebenza kanjani? Uma sithutha (sigijima, senza ama-gymnastics), sinokushaya kwenhliziyo ngokushesha. Lo mkhuba ubizwa ngokuthi i-reflex yenhliziyo, yenziwa isonto lama-30 lokukhulelwa. Uma singenayo umoya okwanele, izinga lokushaya kwenhliziyo liyokhula, futhi inani lezinyosi ngomzuzu lizodlulela kujwayelekile. Izinguquko ezifanayo zingalandelwa ingane. Kodwa uma kwenzeka isikhathi eside engenakho i-oxygen, umzimba wakhe uzoziphatha ngendlela ehlukile. Ngokulondoloza amandla, umntwana uzohamba kancane, futhi ekuphenduleni ukunyakaza, ukushayela kwakhe kuzophuza. Kodwa-ke, kuzo zombili izimo, ukuxilongwa kuyinto eyodwa: hypoalia fetal (ukuntuleka oksijeni), kuphela ngezinga elihlukahlukene. Njengomthetho, ngesikhathi sokukhulelwa, inzwa yesibili, ukuhlola ithoni yesibeletho, akuvamile ukusetshenziswa. Kodwa ngesikhathi sokubeletha, unikeza udokotela ulwazi olubalulekile, ekhombisa ukuthi zikhona izikhathi eziningi zokulwa, yiziphi amandla nezikhathi zabo. Uma bebuthakathaka, kungase kudingeke ukuthi uqalise izidakamizwa zokuzikhulisa. Ngokufanayo, ukubuka izinguquko ezinhliziyweni zezingane, odokotela bangabona futhi bavimbele ezinye izinkinga ngesikhathi. Ngakho-ke, uma beqaphela ukuthi ingane ayinayo i-oxygen eyanele, mhlawumbe ngeke ikwazi ukulwa nokuzalwa kwemvelo, khona-ke kuyodingeka ukuthi yenze ingxenye ye-cearean. I-KTG kumele idluliswe okungenani kanye, ngeviki lama-34. Kodwa-ke, ababelethisi abaningi banxusa bonke abesifazane ukuba baqhube lolu cwaningo njalo izinsuku ezingu-10 kuya kwezingu-14 kusukela ngesonto lama-30, ngokushesha nje lapho umntwana eqala ukucabanga komzimba. Ngaphambili ingane ithola ukuthi ikhona ne-hypoxia, isikhathi esiningi sizohlala ukwelashwa. Kwezinye izikhungo zezokwelapha, ungakwazi ukuqasha idivayisi ktg futhi uqhube isifundo ekhaya, ukuthumela imiphumela ngevidiyo kudokotela ozoqapha isimo kude.