Ndezvipi zvinhu zvavanotarisa?
Kune vashoma vasero testing test (kuongororwa ropa) kunowanikwa panguva yekuzvitakura iyo inogona kuenzanisa mikana yako yekuva nemwana ane Down syndrome.
Kunyange zvazvo miedzo iyi ichisiyana maererano neiyo pawakabata pamuviri, uye kunzwisisika (mukana wavanokupa mhinduro yakarurama), vose vanoyera zvinhu zvinogadzirwa kana ne fetus kana placenta.
Kubatsira kukuru kune serum screening kufananidzwa nekuongororwa kwekuongororwa ndeyokuti hapana ngozi yekusununguka pamuviri kunobatanidzwa navo.
Kutanga Kuongorora Kuongorora Kutatu: hCG uye PAPP-A
Munguva yekutanga kutatu, zvinhu zviviri zvinonzi hCG uye PAPP-A zvinowanikwa muropa raamai. Zvinhu izvi zvinogona kuyerwa (zvinowanikwa pakati pemavhiki gumi kusvika ku14 ekuzvitakura) uye zvinoshandiswa kuratidza mukana wevakadzi wekuva nemwana ane Down syndrome (iyo inonzi trisomy 21).
HCG (Human Chorionic Gonadotropin)
HCG inonzi hormone yakagadzirwa ne placenta. Ichokwadi, pakutanga kwepamuviri, ndicho chinhu chinowanikwa mumusha uye chiremba muhofisi uye kuvhara ropa pamuviri.
Kubata pamuviri umo fetus inonzi Down syndrome inowanzova nehupamhi hweHCG kupfuura dzimwe mimba.
PAPP-A (Kuberekwa-Yakabatana Plasma Protein A)
Vakadzi vane ropa rakadzika pasi pePAPP-A pamasvondo gumi nemasere ekuberekwa vane mukana wakakura wekuti mwana wavo ave neA Down syndrome.
Kuderera kwePAPP-A kunogona kuratidzawo kuwedzera kwekuchengetedzeka kwemukati wekutengesa kuwedzera mukati, kukurumidza kusununguka, preeclampsia, uye kuberekwa.
Migumisiro yekutanga Trimester Serum Kuchengeta Miedzo ye Down Syndrome
Migumisiro yeropa rekuongorora ropa nekuda kweHCG nePAPP-A inonzi se "chisikopo chisingaoneki" kana kuti "chisikopo chinyatso" uye kungopa kupa mukana wekuwana mwana ane trisomy 21.
Mune mamwe mazwi, kuongororwa kweropa rekuongorora ropa hakuzivi kuti Down syndrome.
Kuchengetedza Mhinduro Dzakashata
"Zvisizvo zvisingaoneki" zvinoreva kuti mukana wako wokuva nemwana ane Down syndrome uri pasi. Kunyangwe zvakadaro, zvakakosha kuyeuka kuti "chinyorwa chisingaoneki" chigumisiro hachirevi kuti hakuna matambudziko akaberekwa. Kana iwe uine "chinyorwa chisingaoneki" chikonzero, haungapiwi kutevera-up diagnostic test neCVS kana amniocentesis. (Iyi miedzo inogona kuongorora Down syndrome, kusiyana nekuongorora kuongorora ropa).
Kune rumwe rutivi, iwe uchagoverwa kumwe kuongorora kuongororwa kweropa, kwakaitwa mumutambo wechipiri, iyo inoshandisa chinhu chinonzi AFP. Nhamba ye AFP yemazuva ano zvikwereti zvekuzaruka neural tube zvikanganiso zvakadai seanencephaly uye spina bifida.
Screen Screen Positive Results
"Zviratidzo zvakanaka" zvinoreva kuti mukana wekuberekwa kuva neA Down syndrome wakakwirira kudarika nguva dzose. Saka, nechigumisiro ichi, kutevera-up test diagnostic neCVS ichagoverwa.
Zvakakosha kucherechedza kuti "chinyorwa chinobudirira" chiitiko hachirevi kuti mwana ane chaizvo chromosome isina kufanana. Ichokwadi, vazhinji vakadzi vane "chinyorwa zvakanaka" zvibereko zvichava nevana vane utano hwakanaka.
Kururamisa kweChirwere Chine Mwero uye Chirwere Chisingaiti
Kuti ujekesezve, serum kuongorora kuongororwa hakuiti kuti uongororwe asi inokupa kukosha kwomukana wako wekuva nemwana ane Down syndrome.
Kunyange zvazvo kururamisa kwekuedzwa kunokasiyana-siyana kubva kubasa kuenda kubasa, kazhinji, yekutanga-trimester sero testing test for hcG uye PAPP-A ichaona nezve 80 muzana yevana vane Down syndrome.
Izvi zvinowedzera kuwedzera kana iwe ukashandisa izvi kuedza pamwe chete nekuongorora kwe ultrasound kunonzi nuchal translucency test, iyo inoitwawo mumutatu wekutanga.
Apo chekutanga-trimester serum screening inoona inenge 80 muzana yezvokudzivirira neArt syndrome, "ichishaya" 20 muzana (inenge 1 mu5) kutakura nemamiriro aya.
Zvimwe Pamusoro peNuchal Translucency Ultrasound Screening
Nuchal translucency screening ndeyeiyo ultrasound yakagadzirwa yakaitwa mumutambo wekutanga wokuyera iyo inoyera huwandu hwehutachiona hunotevera musana wemutsipa (nuchal translucency).
Ichi chiyero chakakosha uye chakaoma kuwana, uye iyo ultrasound inogona kungoitwa chete nemumwe munhu akambodzidziswa zvakananga uye anovimbiswa pakuwana chiyero ichi.
Nenzira yakawanda, chiyero pasi pe3 mm chinonzi chakanaka kana kuti "chisingaoneki" uye nuchal translucency measurement yapamusoro 3 mm inofungidzirwa sechinhu chisina kujairika kana chekuyera.
Kazhinji kacho, nuchal translucency measurement uye yako yekutanga-trimester sarudzo yekuongorora maitiro inosanganiswa pamwechete uchishandisa sargorithm chaiyo kana kuti rondedzero, uye iwe unopiwa imwe sarudzo yekuongorora.
Kana nuchal yako yekuongorora kuongorora yakakosha, iwe uchatumidzwa kune mazano ekuongorora maitiro, izvo zvinorevei, uye maitiro ako ekuongorora kutsvaga seCVS uye amniocentesis.
Chimwe Chimwe Chekutanga Chekuedza Kuongorora Kuongorora: Cell-Free DNA Blood Test
Zvakakosha kucherechedza kuti kune imwe yekutanga-trimester kuongorora kuongorora kweArt syndrome iyo inoona DNA isina musero muropa raamai. Uyu muedzo unogona kuitwa mushure memavhiki gumi ekuberekwa uye unowana kusvika 99 muzana yezvokuita pamuviri wakabatwa neArt syndrome.
Iko kukanganiswa kwemuedzo kuri munenge kusvika ku5 kubva muzana kubva muzana kubva kuzana kubva kuzana kubva kuzana kubva kuzana kubva kuzana kubva muzana kana kuwedzerwa kwezvidzidzo zveropa, hapana mhinduro inogona kuwanikwa, kunyange mushure mokunge muedzo uchidzokidzwa. Mukuwedzera, kuedza kunodhura. Izvozvo zvakati, vakadzi vari pangozi yakakura yokuva nevana vane Down syndrome vanowanzoedzwa (somuenzaniso, vakadzi vane makore 35 kana kupfuura panguva yekuberekwa).
Mukuwedzera, vakadzi vane "screen screen" yeHCG nePAPP-A vanogona kusarudza kupinda musero-isina DNA test kunze kwekuenderera mberi nechirwere chekuongorora. Kana iyo DNA isina-sero ichienzanisa zvakanaka, ipapo CVS kana amniocentesis inogona kuitwa kuti iongororwe.
Kune rumwe rutivi, kana DNA isina musero yakaongororwa haina kunaka, saka kuongorora kwepakutanga kweropa (iyo hCG uye PAPP-A) inowanzoonekwa inhema.
Shoko Rinobva
Sezvaunogona kuona, kune huwandu hwekutanga-trimester dzakasiyana siyana zvekuongorora maitiro eArt syndrome kusanganisira kuongorora ropa kweHCG uye PAPP-A, ultrasound, kana kusanganiswa kwemaviri. Mukuwedzera, kune vakadzi vane ngozi yakawanda, kunewo musero usina DNA.
Kusarudza iyo (kana iripo) nzira yekuongorora, pamwe chete nenguva (vamwe vakadzi vanosarudza kumirira kusvikira wechipiri chetatu), zvakakunakira iwe sarudzo yako pachako uye inoda kukurukurirana kwakanyanya nachiremba wako uye pane dzimwe nguva mazano emagetsi.
> Sources:
> American College of Obstetrics uye Gynecologists. (2014). Kuongorora Kuedzwa Kwekuberekwa Kwekuzvarwa.
> Messerlian GM, Palomaki GE. Down Syndrome: Kubva Prenatal Screening. Wilkins-Huag L, ed. Kusvika pari zvino. Waltham, MA: UpToDate Inc.
> National Down Syndrome Society. (2012). Kunzwisisa Kuongororwa kweA Down Syndrome.