Teko ea skrini e nne

Teko ea skrine ea makhetlo a mane ke tlhahlobo ea mali e etsoang nakong ea bokhachane ho fumana hore na ngoana o kotsing ea ho ba le bofokoli bo itseng ba tlhaho.

Teko ena hangata e etsoa lipakeng tsa libeke tsa 15 le 22 tsa bokhachane. E nepahetse haholo lipakeng tsa libeke tsa 16 le 18.

Ho nkuoa sampole ea mali ebe e romeloa labong ho ea hlahlojoa.

Mehato ea liteko e na le lihormone tse 4 tsa bokhachane:

• Alpha-fetoprotein (AFP), protheine e hlahisoang ke lesea
• Chorionic gonadotropin (hCG), hormone e hlahisoang ka placenta
• Unconjugated estriol (uE3), mofuta oa hormone estrogen e hlahisoang ka popelong le phakeng
• Inhibin A, hormone e lokolloang ke placenta

Haeba tlhahlobo e sa lekanyetse litekanyetso tsa inhibin A, e bitsoa tlhahlobo ea skrine e meraro.

Ho fumana monyetla oa hore ngoana oa hau a be le bothata ba tsoalo, tlhahlobo e boetse e bakoa ke:

• Lilemo tsa hau
• Morabe oa hau
• Boima ba hau
• Nako ea bokhachane ea ngoana oa hau (e lekantsoe ka libeke ho tloha ka letsatsi la ho qetela ho fihlela ka letsatsi la hona joale)

Ha ho mehato e ikhethileng e hlokahalang ho itokisetsa tlhahlobo. O ka ja kapa oa noa ka mokhoa o tloaelehileng pele ho tlhahlobo.

U ka utloa bohloko bo bonyenyane kapa motsu ha nale e kentsoe. U kanna oa utloa ho phatloha hampe setšeng kamora hore mali a huloe.

Teko e etsoa ho fumana hore na ngoana oa hau a ka ba kotsing ea bofokoli bo itseng ba tsoalo, joalo ka Down syndrome le bofokoli ba tlhaho ea mokokotlo le boko (bo bitsoang neural tube defects). Teko ena ke tlhahlobo ea tlhahlobo, ka hona ha e fumane mathata.

Basali ba bang ba kotsing e kholo ea ho ba le ngoana ea nang le liphoso tsena, ho kenyelletsa:

• Basali ba ka holimo ho lilemo tse 35 nakong ea bokhachane
• Basali ba noang insulin ho alafa lefu la tsoekere
• Basali ba nang le nalane ea lelapa ea bokooa ba tsoalo

Maemo a tloaelehileng a AFP, hCG, uE3, le inhibin A.

Mekhahlelo e tloaelehileng ea boleng e ka fapana hanyane hara lilaboratori tse fapaneng. Bua le mofani oa tlhokomelo ea bophelo mabapi le moelelo oa sephetho sa hau sa liteko.

Sephetho se sa tloaelehang sa liteko ha se bolele hore ngoana oa hau o na le bothata ba tsoalo. Hangata, liphello li ka ba tse sa tloaelehang haeba ngoana oa hao a le moholo kapa a le monyenyane ho feta mofani oa hau a nahane.

Haeba u na le sephetho se sa tloaelehang, u tla ba le ultrasound e 'ngoe ho lekola lilemo tsa ngoana ea ntseng a hola.

Litlhahlobo tse ling le tlhabollo li ka khothaletsoa haeba ultrasound e bontša bothata. Leha ho le joalo, batho ba bang ba khetha ho se hlole ba etsoa liteko tse ling, ka mabaka a botho kapa a bolumeli.Mehato e latelang e ka kenyelletsa:

• Amniocentesis, e lekolang boemo ba AFP ka mokelikeli oa amniotic o potileng lesea. Ho etsa liteko tsa lefutso ho ka etsoa ka amniotic fluid e tlositsoeng bakeng sa tlhahlobo.
• Liteko tsa ho fumana kapa ho thibela likoli tse ling tsa tsoalo (joalo ka Down syndrome).
• Tlhabollo ea lefutso.
• Ultrasound ho lekola boko ba ngoana, lesapo la mokokotlo, liphio le pelo.

Nakong ea bokhachane, maemo a eketsehileng a AFP a ka ba teng ka lebaka la bothata ba lesea le ntseng le hola, ho kenyelletsa:

• Ho ba sieo ha karolo ea boko le lehata (anencephaly)
• Ho holofala mala a lesea kapa litho tse ling tse haufi (joalo ka duodenal atresia)
• Lefu la ngoana ka mpeng (hangata le fella ka ho senyeheloa ke mpa)
• Spina bifida (sekoli sa mokokotlo)
• Tetralogy ea Bohata (bofokoli ba pelo)
• Turner syndrome (bofokoli ba lefutso)

High AFP e ka boela ea bolela hore o jere lesea le fetang le le leng.

Maemo a tlase a AFP le estriol le a phahameng a hCG le inhibin A a ka ba teng ka lebaka la bothata bo kang:

• Down syndrome (trisomy 21)
• Lefu la Edwards (trisomy 18)

Sesepa se mane se ka ba le liphetho tse fosahetseng le tse fosahetseng (leha e nepahetse hanyane ho feta skrine e meraro). Ho hlokahala liteko tse ling ho netefatsa sephetho se sa tloaelehang.

Haeba tlhahlobo e sa tloaeleha, o kanna oa hloka ho bua le moeletsi oa liphatsa tsa lefutso.

Sesepa sa Quad; Ho lekola makhetlo a mangata; AFP mmoho; Teko ea skrine habeli; Mme oa AFP; MSAFP; Skrine ea 4-marker; Down syndrome - makhetlo a mane; Trisomy 21 - makhetlo a mane; Turner syndrome - makhetlo a mane; Mokokotlo oa bifida - makhetlo a mane; Tetralogy - makhetlo a mane; Duodenal atresia - makhetlo a mane; Tlhabollo ea liphatsa tsa lefutso - makhetlo a mane; Alpha-fetoprotein makhetlo a mane; Chorionic gonadotropin - makhetlo a mane; hCG - makhetlo a mane; Estriol e sa sebetsanang - makhetlo a mane; uE3 - makhetlo a mane; Ho ima - makhetlo a mane; Sekoli sa tsoalo - makhetlo a mane; Teko ea lesupa le mane; Teko ea Quad; Sesepa sa lesupa le mane

• Sesepa se mane

Tloaelo ea ACOG Bulletin No. 162: Ho etsa tlhahlobo ea bakhachane bakeng sa mathata a lefutso. Gynecol e thibelang. 2016; 127 (5): e108-e122. PMID: 26938573 e fetotsoe.ncbi.nlm.nih.gov/26938573/.

Driscoll DA, Simpson JL. Ho hlahloba liphatsa tsa lefutso le tlhahlobo ea liphatsa tsa lefutso tsa bakhachane. Ka: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Li-Obstetrics tsa Gabbe: Bokhachane bo Tloaelehileng le Bothata. La 7th. Philadelphia, PA: Elsevier; 2021: khaolo ea 10.

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.

Williams DE, Pridjian G. Lithibela. Ka: Rakel RE, Rakel DP, bahlophisi. Buka ea bongaka ea Meriana ea Lelapa. La 9th. Philadelphia, PA: Elsevier; 2016: khaolo ea 20.