ʻO ka ultrasound hāpai ʻelua, i kapa ʻia ʻo ultrasound morphological, he hana koʻikoʻi i ka nānā ʻana i ka hāpai ʻana no ka mea hiki iā ia ke ʻike i nā hemahema o ka fetal. No nā mākua, he mea koʻikoʻi nō ia: ʻo ka ʻike ʻana i ke kāne o ke pēpē.

Hana ʻia ka ultrasound ʻelua ma ka lā 5 o ka hāpai ʻana, ma waena o 21 a me 24 mau pule, ʻoi aku ka maikaʻi ma 22 pule.

ʻAʻole koi ʻia akā he ʻāpana ia o nā hoʻokolohua i kuhikuhi ʻia i ka wā o ka mālama ʻana i ka hāpai ʻana a ua manaʻo nui ʻia.

No kēia ho'āʻo, ʻaʻole pono ka hoʻokē ʻai ʻana a i ʻole ka piha ʻana o ka ʻōpū. Ma ka ʻaoʻao ʻē aʻe, ʻaʻole ʻōlelo ʻia e kau i ka ʻaila a i ʻole ka aila ma ka ʻōpū i nā hola 48 ma mua o ka ultrasound i ʻole e hoʻopilikia i ka maikaʻi o ke kiʻi.

Hoʻopili ka mea hoʻomaʻamaʻa i ka ʻōpū o ka makuahine me ka wai gel i mea e maʻalahi ai ka hele ʻana o ka ultrasound. A laila, e hoʻoneʻe ʻo ia i ka ʻāʻī ma ka ʻōpū i mea e loaʻa ai nā kiʻi like ʻole, a i ʻole nā ​​ʻāpana, o ke pēpē. ʻOi aku ka lōʻihi o kēia ultrasound ʻelua ma mua o ka mea mua no ka mea ʻo ia ke aʻo ʻana i ke anatomy piha o ka pēpē.

ʻO ka pahuhopu nui o kēia ultrasound ka ʻimi ʻana i nā abnormalities morphological. E aʻo maʻamau ka mea hoʻomaʻamaʻa i kēlā me kēia okana ma ka hana ʻana i nā ʻāpana transverse e hiki ai, ma kēlā me kēia "pae", ke hoʻomalu i ke alo a me ke ʻano o nā ʻano like ʻole: ka puʻuwai, ka lolo, nā ʻāpana ʻokoʻa o ka ʻōpū (ka ʻōpū, ka ʻōpū, ka ʻōpū) , na lala eha.

ʻO ia ka wā o kēia hoʻokolokolo ʻana e ʻike maʻalahi ʻia nā hemahema o ka fetal. Eia naʻe, ʻoiai ʻoi aku ka maikaʻi a ʻoi aku ka maʻalahi, ʻaʻole 100% hilinaʻi ka morphological ultrasound. I kekahi manawa, ʻaʻole ʻike ʻia kahi anomaly fetal, ʻoiai i kēia wā o ka hāpai ʻana, i ka wā o kēia ultrasound. Hana ʻia kēia i ka wā ʻaʻole hiki ke ʻike ʻia ka hemahema i ke kiʻi, ʻo ke kūlana o ka pēpē e uhi i ka hemahema, a i ʻole ke kaumaha o ka makuahine e hiki mai ana. Hiki i ka ʻiʻo adipose subcutaneous ke hoʻopilikia i ka hele ʻana o ka ultrasound a hoʻololi i ka maikaʻi o ke kiʻi.

I loko o kēia ultrasound ʻelua, nānā pū ke kauka:

• ka ulu ʻana o ka pēpē me ka hoʻohana ʻana i ka biometrics (ana ana i ke anawaena biparietal, cranial perimeter, abdominal perimeter, femoral long, transverse abdominal diameter) e hoʻohālikelike ʻia nā hopena i kahi pihi ulu;
• ka placenta (ka mānoanoa, ka hale, ka pae o ka hoʻokomo);
• ka nui o ka wai amniotic;
• ʻo ka wehe ʻana i loko o ka ʻāʻī i ka wā o ka hoʻopaʻa ʻana.

ʻO ia hoʻi i loko o kēia ultrasound ʻelua e hoʻolaha ʻia ai ka moekolohe o ka pēpē - inā makemake nā mākua e ʻike maoli - a inā maikaʻi ke kūlana o ka pēpē. I kēia wā o ka hāpai ʻana, ua hoʻokumu ʻia ka genitalia o waho a ʻike ʻia i ke kiʻi, akā aia mau kahi hapa liʻiliʻi o ka hewa, e pili ana i ke kūlana o ke pēpē.

Hana ʻia kahi Doppler i kekahi manawa i kēia ultrasound. Me nā leo i kākau ʻia ma ka pakuhi, kōkua ia i ka mālama ʻana i ke kahe ʻana o ke koko i loko o nā kīʻaha like ʻole a me nā aʻa (nā ʻaʻaʻa ʻōpū, nā ʻaʻa umbilical, nā aʻa cerebral). He mea hoʻohui ia no ka hoʻomalu ʻana i ka ulu ʻana o ka fetal i kekahi mau kūlana pilikia a i ʻole nā ​​pilikia obstetric (1):

• ka maʻi diabetes gestational;
• hypertension;
• pilikia o ke keiki;
• ka ulu ulu ʻana i utero (IUGR);
• kahi ʻano ʻino o ka wai amniotic (oligoamnios, hydramnios);
• malformation o ke keiki;
• ʻO ka hāpai ʻana o ka monochorial (ka hānau ʻelua me ka placenta hoʻokahi);
• nā maʻi ma mua o ka makuahine (hypertension, lupus, nephropathy);
• he moʻolelo o nā maʻi maʻi vascular obstetric (IUGR, pre-eclampsia, placental abruption);
• he moʻolelo o ka make ma ka ʻōpū.

I kēia wā o ka hāpai ʻana, aia ka pēpē ma kahi o 25 knm mai ke poʻo a i ka manamana wāwae, ʻo ka hapalua o kona nui hānau. He 500 gr wale nō kona kaumaha. ʻO kona mau wāwae he 4 knm (2).

He nui kona lumi e neʻe ai, ʻoiai inā ʻaʻole ʻike mau ka makuahine i kēia mau neʻe. ʻAʻole hiki iā ia ke ʻike akā paʻa loa ʻo ia i ka hoʻopā ʻana. Moe ʻo ia ma kahi o 20 mau hola i ka lā.

Hōʻike maopopo ʻia kona mau wāwae, nā lima, a me kona mau lima me nā manamana lima maikaʻi. Ma ka moʻolelo, puka mai ke ʻano o kona ihu. Ua like ka nui o kona puʻuwai me ka ʻoliva, a i loko o laila aia nā ʻāpana ʻehā e like me ke aʻaʻa pulmonary a me ke aorta.

ʻIke mākou i nā vertebrae a pau ma ke kiʻi, e hana i kahi ʻano kū. ʻAʻohe ona lauoho i kēia manawa, akā he maʻalahi i lalo.

No nā mākua, ʻo kēia ka lua o ka ultrasound ka mea ʻoluʻolu loa: ua lawa ka pēpē i hiki iā mākou ke ʻike maopopo i kona mau maka, kona mau lima, kona mau wāwae, akā liʻiliʻi naʻe e ʻike piha ʻia ma ka pale a ʻae i kahi ʻike o kēia mea liʻiliʻi. ua hoʻokumu maikaʻi ʻia.

Ke hoʻohuoi ʻia kahi ʻano ʻino ʻole, e hāʻawi ʻia ka makuahine i kahi kikowaena antenatal diagnostic center a / a i kahi sonographer kuhikuhi. Hana ʻia nā hoʻokolohua ʻē aʻe no ka hōʻoia ʻana i ka anomaly a hoʻomaʻemaʻe i ka maʻi: amniocentesis, MRI, ultrasound cardiac, MRI a i ʻole fetal scan, ʻoki koko fetal, hoʻāʻo koko no nā kāne, etc.

I kekahi manawa ʻaʻole hōʻoia nā hoʻokolohua i ka anomali. Hoʻomaka ka nānā ʻana i ka hāpai ʻana.

Ke ʻike ʻia ʻaʻole koʻikoʻi ka anomaly, e hoʻonohonoho ʻia kahi hana maʻamau no ke koena o ka hāpai ʻana. Inā hiki ke mālama ʻia ka anomaly, ʻoi aku ka maʻi, mai ka hānau ʻana a i nā mahina mua o ke ola, e hoʻonohonoho ʻia nā mea āpau e hoʻokō i kēia mālama.

Ke hōʻoia ʻia ka maʻi prenatal e loaʻa ana ka pēpē i "kahi maʻi o ka ʻumekaumaha i ʻike ʻia ʻaʻole hiki ke hoʻōla ʻia i ka manawa o ka maʻi" e like me nā kikokikona, ʻae ke kānāwai (3) i nā mea maʻi e noi i ka hoʻopau lāʻau o ka hāpai ʻana (IMG) a i ʻole " therapeutic abortion” i kēlā me kēia manawa o ka hāpai ʻana. ʻO nā hale kikoʻī i ʻae ʻia e ka Biomedicine Agency, nā Multidisciplinary Centers for Prenatal Diagnosis (CPDPN), ke kuleana no ka hōʻoia ʻana i ke koʻikoʻi a me ka hiki ʻole o kekahi mau pathologies fetal a no laila e ʻae iā IMG. ʻO kēia nā maʻi genetic, chromosomal abnormalities, malformation syndromes a i ʻole anomaly koʻikoʻi loa (o ka lolo, ka puʻuwai, ka ʻole o nā puʻupaʻa) hiki ʻole ke hana i ka wā hānau a hiki ke alakaʻi i ka make o ke pēpē i ka hānau ʻana a i kona mau makahiki ʻōpio. , ka ma'i e hiki ke pale i ke ola o ka bebe a i ole e make ai i kona hanau ana a i kona mau makahiki mua paha, ka ma'i ma'i e alaka'i ai i ke kino kīnā ko'iko'i a i 'ole ka na'au.

I loko o kēia ultrasound ʻelua, hiki ke ʻike ʻia nā pilikia hāpai ʻē aʻe:

• ka hoʻopaneʻe ʻana o ka ulu ʻana o ka ʻōpū (IUGR). A laila e hana ʻia ka nānā ʻana i ka ulu mau a me ka ultrasound Doppler;
• he mea ʻino i hoʻokomo ʻia i ka placental, e like me ka placenta previa. E nānā ka ultrasound i ka ulu ʻana o ka placenta.