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He aha ka prenatal diagnostic?
Loaʻa i nā wāhine hāpai a pau ke nānā ʻana i ka prenatal (nā ultrasounds ʻekolu + ka hoʻāʻo koko ʻelua o ka trimester). Inā hōʻike ka hōʻike ʻana aia kahi pilikia o ka malformation a i ʻole nā mea kūpono ʻole no ka pēpē, e hana hou ʻia ka noiʻi ma o ka hana ʻana i kahi maʻi prenatal. Hiki iā ia ke ʻike a hoʻokaʻawale paha i ka hele ʻana o kahi anomaly fetal a i ʻole kahi maʻi. Ma muli o nā hopena, manaʻo ʻia kahi wānana e hiki ke alakaʻi i ka hoʻopau lāʻau o ka hāpai ʻana a i ʻole ka hana ʻana i ka pēpē i ka hānau ʻana.
ʻO wai ka mea hiki ke pōmaikaʻi mai ka maʻi prenatal?
ʻO nā wāhine a pau e pili ana i ka hānau keiki me ke kīnā.
I kēia hihia, hāʻawi mua ʻia lākou i kahi kūkākūkā olakino no ka ʻōlelo aʻoaʻo genetic. I loko o kēia nīnauele, wehewehe mākou i nā mākua i ka wā e hiki mai ana i nā pilikia o nā hoʻokolohua diagnostic a me ka hopena o ka malformation i ke ola o ka pēpē.
Prenatal diagnostic: he aha nā pilikia?
Loaʻa nā ʻano hana like ʻole, me nā ʻano hana non-invasive (me ka pilikia ʻole i ka makuahine a me ka pēpē e like me ke ultrasound) a me nā ʻano invasive (amniocentesis, no ka laʻana). Hiki i kēia mau mea ke hoʻoulu a i ʻole nā maʻi a no laila ʻaʻole ia he mea liʻiliʻi. Hana ʻia ia mau mea inā loaʻa nā hōʻailona ikaika o ka pōʻino o ka fetal.
Ua uku hou ʻia ka maʻi prenatal?
Hoʻihoʻi hou ʻia ka DPN i ka wā i kauoha ʻia i ka lāʻau lapaʻau. No laila, inā he 25 kou mau makahiki a makemake ʻoe e hana i ka amniocentesis no ka makaʻu wale i ka hānau ʻana i kahi keiki me Down's Syndrome, ʻaʻole hiki iā ʻoe ke koi i ka uku no ka amniocentesis, no ka laʻana.
ʻO ka hōʻailona prenatal no nā hemahema kino
'Ohanahana. Ma waho aʻe o nā ultrasounds screening ʻekolu, aia nā mea i kapa ʻia ʻo "reference" sharp ultrasounds e hiki ai ke ʻimi i ka hele ʻana o nā mea ʻino morphological: limb, cardiac or renal malformations. Ua hoʻoholo ʻia he 60% o ka hoʻopau lāʻau o ka hāpai ʻana ma hope o kēia hoʻokolokolo.
ʻO ka hōʻailona prenatal no nā ʻano ʻino
Amniocentesis. Hana ʻia ma waena o ka pule 15 a me 19 o ka hāpai ʻana, hiki i ka amniocentesis ke hōʻiliʻili i ka wai amniotic me kahi nila maikaʻi, ma lalo o ka mana ultrasound. No laila hiki iā mākou ke ʻimi i nā abnormalities chromosomal akā nā kūlana hoʻoilina. He hoʻokolohua ʻenehana a hiki i ka 1% ka hopena o ka hoʻopau ʻana i ka hāpai ʻana. Mālama ʻia ia no nā wahine ma luna o 38 mau makahiki a i ʻole i manaʻo ʻia he pilikia ko lākou hāpai ʻana (moʻolelo ʻohana, nānā hopohopo, no ka laʻana). ʻO ia ka ʻenehana diagnostic i hoʻohana nui ʻia: 10% o nā wahine ma Farani e hoʻohana nei.
ʻO ka biopsy de trophoblast. Hoʻokomo ʻia kahi paipu lahilahi ma loko o ka pūpū a i kahi e loaʻa ai ka chorionic villi o ka trophoblast (ka placenta e hiki mai ana). Hāʻawi kēia i ke komo i ka DNA o ke keiki e ʻike ai i nā mea ʻino chromosomal. Hana ʻia kēia hoʻokolohua ma waena o ka pule 10 a me 11 o ka hāpai ʻana a ʻo ka pilikia o ka hāʻule ʻana ma waena o 1 a me 2%.
ʻO ka hoʻāʻo koko makuahine. ʻO kēia ke ʻimi ʻana i nā pūpū fetal i loaʻa i nā mea liʻiliʻi i ke koko o ka makuahine. Me kēia mau pūnaewele, hiki iā mākou ke hoʻokumu i kahi "karyotype" (genetic map) o ka pēpē e ʻike i kahi ʻano ʻino chromosomal. ʻO kēia ʻenehana, hoʻokolohua mau, hiki i ka wā e hiki mai ana ke hoʻololi i ka amniocentesis no ka mea ʻaʻohe pilikia no ka pēpē.
Cordocentesis. ʻO kēia ka lawe ʻana i ke koko mai ka ʻaʻa umbilical o ke kaula. Mahalo i ka cordocentesis, ua ʻike ʻia kekahi mau maʻi, ʻo ia hoʻi o ka ʻili, hemoglobin, rubella a i ʻole toxoplasmosis. Hana ʻia kēia laʻana mai ka pule 21 o ka hāpai ʻana. Eia nō naʻe, nui ka pilikia o ka nalo ʻana o ka fetal a hiki i nā kauka ke hana i ka amniocentesis.