Ib qho ntawm kev lom zem tshaj plaws thiab cuam tshuam rau cov poj niam cev xeeb tub yog qhov kuaj xyuas kev xeeb tub. Thiab qhov tseem ceeb txaus ntshai rau leej niam leej txiv yog kuaj xyuas tus me nyuam thib ob ntawm cev xeeb tub. Yuav ua li cas nws xav tau thiab seb nws yog tsim nyog nws ntshai - peb yuav soj ntsuam nyob rau hauv peb tsab xov xwm.
Leej twg muaj feem yuav muaj teeb meem?
Ntawm qhov kev pom zoo ntawm lub koom haum World Health Organization kev kuaj thaum xeeb tub tau ua tiav nyob rau hauv Russia los ntawm tag nrho cov poj niam cev xeeb tub. Yuav tsum tshawb xyuas cov poj niam uas muaj cov teeb meem nram no:
- hnub nyoog tshaj 35 xyoo;
- muaj nyob hauv tsev neeg ntawm ib tug me nyuam nrog chromosomal pathologies;
- kev sib yuav ntawm cov txheeb ze ze;
- tshuaj hauv thawj peb lub hlis tom qab tsis pub muaj menyuam hauv plab;
- lub sij hawm ntev heev ntawm txoj kev xeeb tub;
- ob lossis ntau tshaj xiam oob qhab;
- irradiation ntawm ib tus txij nkawm ua ntej conception.
Kev kuaj ntshav rau kev xeeb tub - sijhawm thiab kev tshuaj xyuas
Feem ntau kev kuaj poj niam cev xeeb tub yog kuaj ob zaug: thaum 10-13 thiab 16-19 lub lis piam. Nws lub hom phiaj yog txhawm rau txheeb xyuas tau cov mob chromosomal heev:
- trisomy ntawm 21st chromosome (Hlav Syndrome);
- trisomy ntawm 18th chromosome (Edwards kab mob);
- defect ntawm neural tube ntawm fetus (spinal qaum tsis-proliferation).
Kev ntsuam xyuas muaj cov theem nram qab no: ultrasound, blood test, txhais cov ntaub ntawv. Qib kawg yog qhov tseem ceeb heev: tus kws kho mob ntsuas tus xeeb ceem li cas, tsis yog ntawm tus me nyuam lub neej yav tom ntej, tab sis kuj yog lub hlwb hauv lub cev xeeb tub ntawm tus poj niam cev xeeb tub.
Qhov kev kuaj thib ob ntawm kev xeeb tub yog, ua ntej tshaj plaws, qhov kev ntsuam xyuas triple, kev kuaj ntshav biochemical, uas pom tias muaj peb yam ntsuas:
- alpha-fetoprotein (AFP);
- tag nrho hCG;
- dawb estriol (E3).
Nyob ntawm seb cov kev ntsuas no nyob rau hauv cov ntshav ntawm leej niam yav tom ntej, lawv tham txog kev pheej hmoo ntawm kev tsim cov kab mob genetic pathologies.
| Ua txhaum | AFP | E3 | HCG |
|---|---|---|---|
| Down syndrome (trisomy 21) | Tsawg | Tsawg | Siab |
| Edwards tus kab mob (trisomy 18) | Tsawg | Tsawg | Tsawg |
| Qhov hlab ntsha tub pob txha tsis xws | Siab | Qhov qub | Qhov qub |
Qhov kev kuaj thib ob thaum lub sijhawm cev xeeb tub kuj muaj kev soj ntsuam hauv ultrasound uas yuav ua tib zoo kuaj xyuas tus menyuam hauv plab, nws cov pob txha, cov hauv nruab nrog cev, ntsuas qhov mob ntawm lub tsho me nyuam thiab cov kua amniotic. Lub sij hawm ntawm kev kuaj thib ob rau kev xeeb tub rau kev kuaj ntshav ultrasound thiab kuaj biochemical tsis sib dhos: Ultrasound yog feem ntau qhia ntawm 20 thiab 24 lub lis piam, thiab lub sij hawm siv rau kev kuaj ntshav kuaj yog 16-19 lub lis piam.
Cia peb xam cov nuj nqis
Hmoov tsis zoo, tsis yog txhua tus kws kho mob ua kom tiav cov kev ntsuas ntawm txoj kev kuaj zaum peb mus rau cov niam tsev yav tom ntej. Hauv kev soj ntsuam zaum thib ob rau kev xeeb tub, cov yeeb yam nram qab no yog cov cai:
- AFP nyob rau ntawm 15-19 lub lim piam ntawm gestation - 15-95 U / ml thiab nyob rau ntawm 20-24 lub lis piam - 27-125 U / ml.
- HCG nyob rau lub lim tiam 15-25 ntawm kev xeeb tub - 10000-35000 mU / ml.
- Dawb estriol ntawm 17-18 lub lim piam - 6,6-25,0 nmol / l, ntawm 19-20 lub lim tiam - 7,5-28,0 nmol / l thiab thaum 21-22 lub lis piam - 12,0-41,0 nmol / l.
Yog tias cov ntsuas no nyob rau hauv cov kev txwv, ces tus me nyuam yuav muaj kev noj qab haus huv tag nrho. Tsis txhob txhawj yog tias cov naj npawb hauv cov qhab nias ntawm cov kev ntsuam xyuas mus dhau ntawm cov kev txwv: qhov kev ntsuam xyuas triple feem ntau yog "yuam kev". Tsis tas li ntawd, muaj ntau ntau yam uas cuam tshuam rau cov ntsiab lus ntawm cov kev tshawb fawb biochemical:
- ntau tus cev xeeb tub;
- IVF;
- qhov hnyav ntawm tus poj niam cev xeeb tub (nyob rau hauv cov poj niam, cov cim qis dua, thaum cov neeg tsis muaj zog, lawv txo qis);
- tus cwj pwm phem (haus luam yeeb thaum cev xeeb tub);
- ntshav qab zib mellitus rau cov poj niam cev xeeb tub;
- tsis muaj tseeb txhais ntawm lub hnub nyoog gestational.
Kev paub txog cov pathologies ntawm fetus yog tsis tsim nyog nws. Tsis pub ib tus kws kho mob muaj txoj cai los ua tus mob, cia li cuam tshuam rau kev xeeb tub, ntawm kev kuaj xyuas. Cov txiaj ntsig ntawm cov kev tshawb fawb cia tsuas yog los ntsuas qhov kev pheej hmoo ntawm muaj ib tug me nyuam uas muaj tus kab mob hauv qhov teeb meem. Cov pojniam uas muaj feem yuav ua haujlwm ntxiv (kuaj ultrasound, amniocentesis, cordocentesis).