Chidimbu chekuongorora uye kuongorora zvirwere
Kuongororwa kweArt syndrome kunowanzoitwa mune imwe nzira mbiri-kana nguva pfupi mushure mokuberekwa kana panguva yekudzivirira (prenatally). Kunyange zvazvo chirongwa chekuongorora chinogona kuva nekuzvidya mwoyo, kuwana ruzivo rwepamusoro pamusoro pemhando ipi yedziedzo iwe unogona kutarisira uye kuti kuvatsanangurira kunogona kubatsira sei iwe nemumwe wako.
Kuongorora Down Syndrome paKuberekwa
Kunyangwe nekuedzwa kwepabonde, vana vakawanda vane Down syndrome vanoonekwa kuti nguva pfupi mushure mokuberekwa.
Kazhinji kazhinji izvi ndizvo nokuti chiremba anocherechedza kuti mwana ane chimwe chinhu chakasiyana kana chimiro chinowanzoonekwa muArt syndrome.
Somuenzaniso, vacheche vane Down syndrome vanogona kunge vane misoro maduku kupfuura mamwe majaya, madiki anosimudza maziso, imwe mhete yakagadzika, uye muromo muduku une rurimi runoputika. Vanogonawo kuva nekusiyana mumaoko avo netsoka. Vanogona kunge vane chigamba chimwe chete pameso avo (inozivikanwa sechine palmar crease), maoko maduku neminwe medu, uye imwe nzvimbo yakakura pakati peguru uye yechipiri.
Vazhinji vacheche vane Down syndrome vanewo mutsipa wepasi mushure kana hypotonia. Dzimwe nguva, vacheche vane Down syndrome vanoberekwa nezvimwe zviremera zvakakomba kuzvarwa zvakadai sekushaya mwoyo uye kuora kwepamuviri.
Kana chiremba wako achiona kuti mwana wako ane zvimwe zvezvinhu izvi, anogona kunge achinyunyuta kuti mwana wako ane Down syndrome. Chiremba wako achabva agadzirisa kuongorora kwechromosome (inonziwo karyotype ) kusimbisa kuongororwa.
Chidzidzo chechiromosome chiratidzo cheropa chinotarisa makromosomes emwana pasi pe microscope. Vanhu vazhinji vane ma chromosomes makumi mana. Vanhu vane Down syndrome vane nhamba yepamusoro 21 yechromosome ye 47 kromosomes.
Kuongorora Down Syndrome Prenatally
Kunyange zvazvo Down syndrome inowanzoonekwa kuti nguva pfupi mushure mokuberekwa, inowedzera kuongororwa panguva yekuzvitakura (prenatally) zvichibva pamusana pemazuva ekupedzisira anonzi ultrasound (sonogram), chiitiko chisingaenzaniswi chekuberekwa kweropa rwemamai (chirwere chekuberekwa chechibereki) kana kuti amniocentesis kana chorionic villi sampling (CVS) kuedzwa.
Chorionic villi sampling kana CVS chirwere chakaitwa palacenta pakati pevhiki gumi nemasere ekuberekwa.
Izvo zvose ultrasound uye maternal serum kuongororwa zvirongwa zvekuongorora. Kusiyana neizvi, amniocentesis neCVS zvinoonekwa sekuongororwa kwekuongorora. Kuongorora kuongorora hakugoni kukupa zvakasimba kufungidzirwa-zvinongokuudza kana iwe uine ngozi yakawanda yekuva nemwana ane Down syndrome. Kune rumwe rutivi, chirwere chekuongorora chinokupa tsanangudzo yekujekesa.
Kutsvaga kweScsound muDream Syndrome
An ultrasound, uyewo anoziva se sonogram, ndiyo muedzo unoitwa panguva yekudzivirira inoshandisa mazai ane mutsara kuunza mufananidzo kana chifananidzo chemucheche. Dzimwe nguva, asi kwete nguva dzose, vacheche vane Down syndrome vanoratidza zviratidzo zvisiri pachena pane ultrasound inogona kuita kuti chiremba wako afunge kuti fetus ine Down syndrome.
Zvimwe zvezviratidzo izvi zvisinganzwisisi zvinosanganisira kuderera kwehukadzi urefu (pfupa mumakumbo), kuwedzera kweganda mushure mehuro (kunonzi nuchal translucency), kana kusavapo kwemapfupa emapfupa. Izvi ndizvo zvinowanzozonzi se "vanyoro zvishoma" nekuti hapana chimwe chezvinhu izvi zvinokonzerwa ne ultrasound zvichaita kuti fetus isangane nezvinetso pachavo. Zvisinei, vanogona kuita kuti chiremba anyeke kuti fetus ine Down syndrome. Zvimwe zviratidzo zvakakomba zvinogona kuonekwawo pa-ultrasound zvinosanganisira mwoyo kusakwana uye mumatumbo.
Zvisinei, Down syndrome haigoni kuongororwa zvichienderana nehutachiona hwekutsvaga. Izvi zvinongoratidzira kuti kune ngozi yakawanda yokuti mwana mucheche angave ane Down syndrome. Kubva pane izvi zvinowedzera njodzi, chiremba wako achakurudzira kuti uone amniocentesis kana CVS kuti uone kuongorora. Zviri kwauri kuti usarudze kana usiri kuedza iyi.
Zvakakosha kucherechedza kuti vazhinji vana vakaberekwa neArt syndrome vanoratidzira kusakanganiswa kwe ultrasound. Kakawanda vanhu vanonyengedzwa nekunyengedzwa nesarudzo yakagadziriswa nokuti vanozvitenda zvinoreva kuti hakuna matambudziko nemwana. Zvinosuruvarisa, izvi hazvisi zvechokwadi.
Kuva nechirwere chechirwere chechirwere chakakosha uye kune chimwe chinhu chinokurudzira, asi hachisi chivimbo chekuti zvinhu zvose zvakakwana.
Maternal Serum Screening Tests mu Kuongorora Down Syndrome
Kuongororwa kweropa (kwakaitwa pamamai) kazhinji kunonzi "quadruple screen" kunogona kuitwa pakati pe15 ne20 yevhiki yekuzvitakura. Chiwande chechina chinotarisa zvinhu zvina muropa raamai:
- Alpha-fetoprotein (AFP)
- Unconjugated estriol
- Human chorionic gonadotropin (hCG)
- Inhibin A
AFP inobudiswa mu yolk sac uye fetal chiropa, estriol inobudiswa ne fetus uye placenta, hCG inobudiswa mukati memakate, uye inhibin A inogadzirwa ne-placenta uye mazai. Apo mwana mucheche ane Down syndrome, mazamu ezvinhu izvi muropa raamai muropa anogona kunge akasiyana kubva pakuzvarwa.
Iko-screen yechina inodaro-sezvinoreva zita rayo-kungoongorora kuongorora. Haikwanisi kutaura pachena kana mwana wako ane Down syndrome, asi anogona kukuudza kana ngozi yako yakakwirira. Kana kuongorora kwako kuve kwakanaka, zvinongoreva kuti njodzi yekuwana mwana ane Down syndrome yakakwirira kupfuura vamwe vakadzi vezera rako. Asi kunyange nekunzvera kuongorora kuongorora, vakadzi vakawanda vachave nevana vasina Down syndrome. Mukutaurirana, chinyorwa chechina chinotyisa chinoreva kuti mukana we Down syndrome uri pasi asi kwete zero. Hazvivimbisi mwana asina Down syndrome.
Chiyero chechina chinosanganiswa nezera remukadzi chinogona kuona 75 kubva muzana yezvokuita pamuviri zvakabatwa neTrisomy 21 kuvakadzi vasati vasvika makore makumi matatu nemakumi matatu uye vanodarika makumi mapfumbamwe nematatu ekuberekwa kwevakadzi vane makore makumi matatu nemashanu kana kupfuura.
Mukupera kwema1990, kutanga-trimester kuongorora miedzo yeA Downs Syndrome (uye mamwe maitiro echromosomal) zvakagadzirwa. Iyi miedzo inosanganisira kuenzanisa nuchal translucency ne ultrasound uye kuongororwa kweropa mbiri: munhu chorionic gonadotropin uye pamuviri-inobatanidzwa plasma proteine A (PAPPA). Migumisiro yechiratidzo iyi inosanganiswa nezera remukadzi yekutsvaga njodzi yekupedzisira yechromosomal, kusanganisira trisomy 21.
Amniocentesis muKutsvaga Down Syndrome
Kana kuongorora kuongorora ropa kana kuti ultrasound kunoratidza ngozi yakawedzerwa, kana iwe uri pamusoro pemakore makumi matatu, iwe uchagoverwa amniocentesis. An amniocentesis chiratidzo chinowanzoitwa pakati pemasvondo gumi nemashanu nemakumi maviri ekuberekwa. Inosanganisira kushandisa nhovo yakapinza yakaiswa kuburikidza nemimba yako (kwete nemudumbu mako), kuwana mamwe amniotic fluid akapoteredza fetus. Izvi zvinonzi amniotic fluid zvine mamwe emasero eganda re fetus. Aya masero eganda anogona kushandiswa kuwana fetal karyotype-mufananidzo wemakromosomes emu fetus. Kana iyo fetus inowanikwa kuva nhamba yepamusoro yechromosome, ipapo kuongororwa kwe Down syndrome kunoitwa.
CVS mukutsvaga Down Syndrome
Chorionic villi sampling kana CVS inzira inowanikwa pamasvondo anenge 11 kusvika ku13 ekudzivirira. Mune nzira iyi, nete shoma kana catheter inowanikwa muparcenta kuwana mamwe masero. Iyo placenta inotorwa kubva kumasero akafanana anoumba fetus, saka nokutarisa masero epa placenta, iwe uri kutarisa masero emucheche. Aya masero anobva atumirwa kubasa rekuongorora chromosome. Kana karyotype inoratidza kuti fetus ine nhamba yepamusoro yechromosome, ipapo fetus ichava neA Down syndrome.
Amniocentesis uye CVS inoshandiswa kuongororwa panguva yekuzvitakura-zviri kwauri kuti uone kana zvikomborero zvekuziva nezvekromosomes yako ye fetus inopfuura mungozi yekuita. Nzira mbiri idzi dzine pangozi duku yekuparara. Dambudziko iri rishoma kuti 1 muzana ye amniocentesis uye anenge 1 kusvika 2 muzana yeCVS. Vamwe vakadzi vanosarudza CVS kuAmniocentesis nokuti vanoda kuwana ruzivo rwakapfuura mukudzivirira kwavo, uye vamwe vanoda amniocentesis nekuda kwedambudziko guru rekusununguka pamuviri. Iwe chete iwe unogona kusarudza zvakakunakira iwe.
> Sources:
> American Pregnancy Association. (2016). Quad Screen Test.
> National Institute of Child Health and Human Development (NICHD). Down Syndrome: Chimiro Chinhu.
> Simpson JL. Nzira dzisingazivikanwi dzekuongorora chirwere chepabonde: chero ramangwana rakasara? Best Pract Res Clin Obstet Gynaecol . 2012 Oct; 26 (5): 625-38.
> Smith M, Visootsak J. Noninvasive kuongorora mashandisi eArt syndrome: a review. Int J Womens Health . 2013; 5: 125-31.
> Zolotor AJ, Carlough MC. Kuvandudza paPrenatal Care. Ndiye Chiremba weNzara . 2014 Feb 1; 89 (3): 199-208.