Amniocentesis

Amniocentesis ke teko e ka etsoang nakong ea bokhachane ho batla mathata a itseng ho lesea le ntseng le hola. Mathata ana a kenyelletsa:

• Liphoso tsa pelehi
• Mathata a lefutso
• Tšoaetso
• Nts'etsopele ea matšoafo

Amniocentesis e tlosa mokelikeli o monyane ka mokotleng o potileng lesea le ka popelong. Hangata ho etsoa ofising ea ngaka kapa setsing sa bongaka. Ha ho hlokahale hore u lule sepetlele.

U tla ba le bokhachane ba ultrasound pele. Sena se thusa mofani oa hao oa tlhokomelo ea bophelo ho bona moo ngoana a leng ka popelong ea hau.

Moriana oa manonyeletso o tšeloa karolong ea mpa ea hau. Ka linako tse ling, moriana o fanoa ka ho thunngoa letlalong ka mpeng. Letlalo le hloekisoa ka mokelikeli o thibelang likokoana-hloko.

Mofani oa hau o kenya nale e telele e tšesaane ka mpeng le ka popelong ea hau. Mokelikeli o monyane (likhabapo tse ka bang 4 kapa limililitara tse 20) o ntšoa ka mokotleng o potileng lesea. Maemong a mangata, lesea le shebeloa ke ultrasound nakong ea ts'ebetso.

Mokelikeli o romeloa laboratoring. Teko e ka kenyelletsa:

• Lithuto tsa liphatsa tsa lefutso
• Tekanyo ea litekanyo tsa alpha-fetoprotein (AFP) (ntho e hlahisoang sebeteng sa lesea le ntseng le hola)
• Setso bakeng sa tšoaetso

Liphetho tsa liteko tsa liphatsa tsa lefutso hangata li nka libeke tse ka bang 2. Liphetho tse ling tsa liteko li khutla matsatsing a 1 ho isa ho a 3.

Ka linako tse ling amniocentesis e boetse e sebelisoa hamorao nakong ea bokhachane ho:

• Hlahloba tšoaetso
• Hlahloba hore na matšoafo a ngoana a se a holile ebile a loketse ho pepa
• Tlosa mokelikeli o feteletseng ho tsoa ho lesea haeba ho na le amniotic fluid e ngata haholo (polyhydramnios)

Sesepa sa hau se ka hloka ho tlala bakeng sa ultrasound. Botsa mofani oa hau ka sena.

Pele ho tlhahlobo, mali a ka nkuoa ho fumana mofuta oa mali a hau le Rh factor. U ka fumana sethunya sa moriana se bitsoang Rho (D) Immune Globulin (RhoGAM le lihlahisoa tse ling) haeba u le Rh negative.

Hangata Amniocentesis e fuoa basali ba kotsing e kholo ea ho ba le ngoana ea nang le bokooa ba tsoalo. Sena se kenyelletsa basali ba:

• E tla ba lilemo li 35 kapa ho feta ha ba tsoala
• Ho bile le tlhahlobo ea tlhahlobo e bonts'ang hore ho ka ba le bothata ba tsoalo kapa bothata bo bong
• Ke bile le masea a nang le bokooa nakong ea bokhachane bo bong
• Ho ba le nalane ea lelapa ea mathata a liphatsa tsa lefutso

Tlhabollo ea lefutso e khothaletsoa pele ho ts'ebetso. Sena se tla o lumella ho:

• Ithute ka liteko tse ling tsa bakhachane
• Etsa qeto e nang le tsebo mabapi le likhetho tsa tlhahlobo ea bakhachane

Teko ena:

• Ke tlhahlobo ea tlhahlobo, eseng tlhahlobo ea tlhahlobo
• E nepahetse haholo bakeng sa ho fumana Down syndrome
• Hangata e etsoa lipakeng tsa libeke tse 15 ho isa ho tse 20, empa e ka etsoa nako efe kapa efe lipakeng tsa libeke tse 15 ho isa ho tse 40

Amniocentesis e ka sebelisoa ho fumana mathata a fapaneng a liphatsa tsa lefutso le li-chromosome ho lesea, ho kenyelletsa:

• Anencephaly (ha lesea le haelloa ke karolo e kholo ea boko)
• Down syndrome
• Mathata a tloaelehileng a ts'oaetso a fetisoang ke malapa
• Mathata a mang a lefutso, joalo ka trisomy 18
• Matšoao a amniotic fluid

Sephetho se tloaelehileng se bolela:

• Ha ho mathata a liphatsa tsa lefutso kapa a chromosome a fumanoeng ho lesea la hau.
• Maemo a Bilirubin le alpha-fetoprotein a bonahala a tloaelehile.
• Ha ho matšoao a tšoaetso a fumanoeng.

Tlhokomeliso: Amniocentesis hangata ke teko e nepahetseng ka ho fetesisa bakeng sa maemo a liphatsa tsa lefutso le ho senyeha ha maikutlo, leha e le ntho e sa tloaelehang, lesea le kanna la ba le liphatsa tsa lefutso kapa mefuta e meng ea bofokoli ba tsoalo, leha liphetho tsa amniocentesis li tloaelehile.

Sephetho se sa tloaelehang se ka bolela hore lesea la hau le na le:

• Bothata ba liphatsa tsa lefutso kapa chromosome, joalo ka Down syndrome
• Liphoso tsa tsoalo tse amanang le mokokotlo kapa boko, joalo ka mokokotlo oa mokokotlo

Bua le mofani oa hau ka moelelo oa sephetho sa hau sa liteko. Botsa mofani oa hau:

• Boemo kapa bofokoli bo ka phekoloa joang nakong ea bokhachane kapa kamora 'moho
• Ke litlhoko life tse khethehileng tseo ngoana oa hau a ka bang le tsona kamora ho hlaha
• Ke likhetho life tse ling tseo u nang le tsona mabapi le ho boloka kapa ho emisa ho ima

Likotsi ha li na thuso, empa li ka kenyelletsa:

• Tšoaetso kapa kotsi ho lesea
• Ho nyopa
• Ho dutla ha lero la amniotic
• Ho tsoa mali ka bosaling

Setso - mokelikeli oa amniotic; Setso - lisele tsa amniotic; Alpha-fetoprotein - likoli

• Amniocentesis
• Amniocentesis
• Amniocentesis - letoto la lihlooho tse

Driscoll DA, Simpson JL, Holzgreve W, Otano L. Tlhahlobo ea liphatsa tsa lefutso le tlhahlobo ea liphatsa tsa lefutso tsa bakhachane. Ka: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Likokoana-hloko: Bokhachane bo tloaelehileng le ba bothata. La 7th. Philadelphia, PA: Elsevier; 2017: khaolo ea 10.

Patterson DA, Andazola JJ. Amniocentesis. Ka: Fowler GC, li-eds. Mekhoa ea Pfenninger le Fowler ea Tlhokomelo ea Mathomo. La 4 ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 144.

Wapner RJ, Dugoff L. Tlhahlobo ea bakhachane ea mathata a tlhaho. Ka: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, li-eds. Creasy le Resnik's Maternal-Fetal Medicine: Melao-motheo le Tloaelo. La 8th. Philadelphia, PA: Elsevier; 2019: khaolo ea 32.