Thawj cov cim qhia ntawm tus menyuam ntxaib thaum ntxov thiab cov yam ntxwv ntawm lub sijhawm cev xeeb tub

2024 Tus sau: Priscilla Miln | [email protected]. Kawg hloov kho: 2024-02-18 01:33

Raws li txoj cai, ntau lub cev xeeb tub tau pom nyob rau hauv cov neeg uas tau ua tiav cov txheej txheem ntawm kev siv tshuaj tua kabmob (IVF), lossis cov muaj hmoo uas twb muaj menyuam ntxaib lossis peb tus menyuam hauv lawv tsev neeg. Yog tias koj npau suav ntau ntawm cov menyuam ntxaib lossis triplets, thiab tsawg kawg yog ib qho ntawm cov xwm txheej no raug coj mus rau hauv tus account, ces koj xav paub txog qhov xwm txheej no sai li sai tau. Nws yog vim li no hnub no peb yuav saib cov tsos mob ntawm tus menyuam ntxaib thaum cev xeeb tub.

Tus kws kho mob yuav tuaj yeem txaus siab rau koj nrog cov xov xwm no tsuas yog tom qab kuaj ultrasound, thiab tom qab ntawd tsis yog thawj zaug, tab sis twb nyob rau peb lub hlis thib ob ntawm cev xeeb tub. Tab sis hauv qhov xwm txheej no, yuav tsum tau saib xyuas kev kho mob tshwj xeeb.

Thiab yog li ntawd, kev xeeb tub ntau yam yog dab tsi thiab dab tsi tshwm sim ntawm cev xeeb tub nrog menyuam ntxaib tuaj yeem pom yav tom ntej leej niam thaum ntxov? Qhov no yog tus kabmob ntawm ob, peb, plaub lossis ntau tus menyuam hauv plab. Cia peb nco ntsoov cov txheeb cais tam sim no: hauv Tebchaws Europe, theem ntawm kev xeeb tub ntau tam sim no tau nce mus rau 1% hauv qabIVF cuam tshuam. Tam sim no, 1 ntawm 89 cev xeeb tub yog ntau yam.

kos npe thaum ntxov

Pib nrog, hauv nqe lus no peb yuav teev cov xwm txheej uas ua rau muaj feem ntau ntawm cov menyuam yug los ib zaug. Cov no suav nrog:

1. Hnub nyoog los ntawm 35 xyoo (qhov no yog qhov tseeb kev tshawb fawb, qhov tseeb yog tias nrog hnub nyoog muaj kev nce hauv cov tshuaj hormones tom qab lub luag haujlwm rau kev loj hlob ntawm qe).
2. Genetic factor (yog tias twb tau muaj cov xwm txheej zoo li no hauv tsev neeg lawm, ces txoj hauv kev los ua niam txiv zoo siab ntawm ob peb tus menyuam ib zaug ntxiv).
3. Kev ua tsis tiav ntawm zes qe menyuam (li ib zaug hauv 200 kev coj khaub ncaws tsis ua haujlwm tshwm sim - qhov loj hlob ntawm 2 qe ib zaug).
4. In vitro fertilization (rau qhov muaj feem ntau ntawm qhov ua tiav ntawm txoj kev, ob peb lub qe fertilized yog cog rau hauv ib tug poj niam ib zaug).
5. Kev txhawb nqa nrog kev pab ntawm qee yam tshuaj (lawv txhim kho kev ua haujlwm ntawm zes qe menyuam, thiab tsim thiab loj hlob ntawm 2 qe ib zaug tshwm sim).
6. Tsis kam lees - tshuaj tiv thaiv qhov ncauj (thaum noj, cov keeb kwm hormonal tsim, raws li thaum cev xeeb tub thiab zes qe menyuam so, thiab tsis kam noj yuav pab txhawb kev ua haujlwm ntawm lub cev).
7. Tsev neeg muaj me nyuam coob (tus me nyuam ntau tus poj niam yug tau me nyuam, txoj kev muaj menyuam ntxaib ntau dua).
8. Cov txiv neej Middle Eastern thiab African feem ntau "ua" menyuam ntxaib (haiv neeg).
9. Ib hnub 21-hnub kev coj khaub ncaws haum rau ntau lub cev xeeb tub.
10. Bicornuate uterus(qhov no pathology ntawm lub cev ua rau tsim ob lub qe ib zaug).

Cov qauv ntawm cev xeeb tub yog cov kabmob ntawm 1 fetus. Tab sis kev coj tus kheej ntawm ntau tus me nyuam tsim ib lub nra ntxiv rau ntawm tus poj niam lub cev. Vim li no, txhua tus niam uas muaj kev cia siab yuav tsum paub cov cim ntawm tus menyuam ntxaib thaum ntxov. Cov no suav nrog cov hauv qab no:

• genetics (nco ntsoov tias kev yug dua tshiab ntawm ntxaib lossis triplets yog ua tau hauv ib tiam);
• ntawm kev sim ua los ntawm cov poj niam hauv tsev, kab thib ob yuav pom tseeb thiab tuab, qhia tias qib hCG siab;
• tsaug zog heev;
• mob toxicosis;
• yuav tsim pob txuv, uas tuaj yeem ua tau vim qhov ntau ntawm cov tshuaj hormones;
• plab loj hlob sai;
• ntxov thiab nquag txav.

Kev pom zoo ntawm kev xeeb tub ntau yam

Cov tsos mob saum toj no ntawm tus menyuam ntxaib, uas niam nws tus kheej tuaj yeem nco ntsoov txawm tias ua ntej mus ntsib kws kho mob gynecologist, tsis yog ib qho yooj yim zam los ntawm tus poj niam. Yog tias koj pom cov cim no, thov ceeb toom rau koj tus kws kho mob txog nws.

Ntawm no yog cov cim qhia tias tus kws kho mob gynecologist tuaj yeem pom thaum cev xeeb tub ntau:

• kab rov tav furrow cais menyuam;
• tob tob ntawm uterine fundus;
• kuaj pom 4 qhov loj ntawm palpation ntawm lub plab (ob lub taub hau thiab ob lub plab);
• Ultrasound ntawm 12 lub lis piam cev xeeb tub;
• phonoelectrocardiography (muaj kev ntaus ob lub siab ib zaug);
• thaum mloog tau sau tseglub plawv dhia hauv qhov chaw sib txawv;
• AFP kuaj hauv peb lub hlis thib ob ntawm cev xeeb tub tsis yog qhov zoo xwb, tab sis siab dua (kuaj rau kev kuaj pom qhov txawv txav ntawm tus menyuam hauv plab).

Nyob

Saum toj no, peb tau txheeb xyuas ntau cov cim qhia ntawm tus menyuam ntxaib thaum ntxov uas tus niam uas xav tau nws tus kheej tuaj yeem ntes tau, tam sim no cia peb tham txog lawv kom meej ntxiv. Cia peb pib nrog kev qaug zog ntxiv. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias cov niam uas muaj menyuam ntxaib, triplets, thiab lwm yam kev pw tsaug zog ntawm kev mus (sab, sawv, pw). Qhov no tuaj yeem pom txawm tias nyob rau theem thaum lawv tsis paub txog lawv cev xeeb tub (uas yog, txij li thawj hnub ntawm fertilization).

Thaum cev xeeb tub, qaug zog, qaug zog thiab tsaug zog, tshwj xeeb tshaj yog nyob rau thawj peb lub hlis twg, yog qhov qub, tab sis nrog ntau lub cev xeeb tub, lawv txhais tau ob npaug.

Yog ib tug poj niam twb xav ntau dua nws thawj tus menyuam lawm, nws yuav yooj yim hnov qhov txawv, tab sis tus poj niam primiparous yeej tsis to taub nws tus mob. Nws yooj yim npaum li cas kom paub cov menyuam ntxaib ntawm qhov kos npe no? Yog tias koj muaj ib tus hluas nkauj cev xeeb tub, qaug zog yog pom ntawm nws, tab sis nws tseem flutters, nyiam lub neej thiab lwm yam, thiab rau koj mus ua hauj lwm yog ib tug tiag tiag feat, ces feem ntau koj yuav xav tau menyuam ntxaib. Txawm li cas los xij, nws tsim nyog tsis suav nrog ntau yam ntxiv uas ua rau qaug zog hnyav:

• kev nyuaj siab;
• khoom noj phem;
• ua haujlwm hnyav thiab lwm yam.

mob khaub thuas

Lwm lub cim ntawm tus menyuam ntxaib yog mob thaum sawv ntxov. Thov nco ntsoov tias qhov no yuav tsis tas yuav xeev siab lossis ntuav nrog kev ua pauj, nws tsuas yog qhov kev tawg uas dhau los ntawm nruab nrab hnub.

Txog toxicosis, nws tsim nyog nco ntsoov tias txhua yam kab mob yog tus kheej. Qee leej niam zoo siab ntawm tus menyuam ntxaib thiab triplets tau zoo thaum cev xeeb tub. Thiab cov neeg uas xav tau ib tug me nyuam yuav muaj kev tsis xis nyob heev vim yog mob toxicosis hnyav. Yog tias koj hnov zoo - qhov no tseem tsis tau yog qhov qhia tias koj nqa ib tus menyuam hauv plab xwb.

Tsis txhob hnov qab txog poj niam txoj kev xav, uas hnyav heev thaum cev xeeb tub. Cov niam txiv uas xav tau tuaj yeem xav txog nws tus kheej tias nws muaj pes tsawg tus menyuam thiab lawv yog poj niam txiv neej.

kev

Lwm qhov cim ntawm kev xeeb tub ntxaib yog kev txav mus los thaum ntxov. Raws li txoj cai, tus niam thawj zaug xav tias nws tus menyuam txav mus li cas thaum lub lim tiam thib kaum cuaj. Yog tias koj nyob hauv koj lub cev xeeb tub thib ob lossis ntau dua, koj tuaj yeem hnov qhov tshee thaum ntxov li kaum rau lub lim tiam.

Ntau zaus, cov poj niam uas xav tau ob lossis ntau dua cov menyuam yaus muaj kev txav ua ntej thiab khaus ntau dua. Tsis tas li ntawd, nrog ntau lub cev xeeb tub, muaj qhov sib txawv ntawm qhov loj ntawm lub tsev menyuam thiab qhov ncua sij hawm ntawm kev coj khaub ncaws. Twb tau nyob rau hnub tom qab, tus kws kho mob, los ntawm palpation thiab mloog lub plab, yuav tuaj yeem txiav txim siab tus menyuam mos. Ua tib zoo saib xyuas qhov tseeb tias kev txav mus los thaum cev xeeb tub ntau yam tsis txawv ntawm cov niam uas xav tias thaum nqa ib tus menyuam.

hcg

Thaum koj kuaj cev xeeb tub, nws yog tib neeg chorionic gonadotropin uas ceeb toom koj txog qhov xwm txheej "nyiam". Tom qab koj tau sau npe nrog tus kws kho mob gynecologist (pib hnub thib kaum ntawm hnub yug), tus kws kho mob tas li, thoob plaws hauv lub cev xeeb tub, saib xyuas qib ntawm cov tshuaj no. Ib qho ntawm cov cim qhia ntawm tus menyuam ntxaib yog qib hCG siab.

Ntxiv rau, cov niam uas xav tias menyuam ntxaib nce txog tsib kilograms hnyav dua li cov poj niam cev xeeb tub nrog ib tus menyuam. Txawm li cas los xij, nco ntsoov tias qhov no tsis yog tib yam cuam tshuam rau qhov hnyav nce. Ua tib zoo saib xyuas koj cov zaub mov, nyob rau hauv txoj hauj lwm no nws yog qhov zoo dua tsis txhob overeat. Noj tsawg, tab sis ntau zaus, thiab nco ntsoov saib koj cov zaub mov, vim tam sim no kev noj qab haus huv ntawm tus menyuam kuj nyob ntawm nws.

hnub nyoog gestational

Lwm qhov cim qhia ntawm tus menyuam ntxaib thaum cev xeeb tub yog lub hnub nyoog gestational siab. Nws yog dab tsi? Thaum koj mus ntsib koj tus kws kho mob gynecologist, nws yuav ntsuas qhov kev ncua deb ntawm sab saum toj ntawm lub tsev menyuam thiab sab saum toj ntawm pubis. Qhov no yog qhov tsim nyog los txiav txim siab lub hnub nyoog gestational ntawm tus menyuam.

Yog tias koj cev xeeb tub ntau, ces lub tsev menyuam nthuav dav ntxiv, yog li ntawd, tus nqi nce. Tab sis, nws tsim nyog nco ntsoov tias qhov no tsis yog vim li cas rau qhov tshwm sim no. Yog vim li cas thiaj tseem ceeb mus ntsib koj tus kws kho mob tsis tu ncua.

AFP

Yuav ua li cas ntxiv koj tuaj yeem paub txog kev xeeb tub ntau yam tsis muaj ultrasound? Cov cim ntawm cov menyuam ntxaib peb kuajmuaj ntau ntau nyob rau hauv tsab xov xwm, tab sis AFP xeem mus unnoticed. Nws yog ua los xyuas qhov kev yug me nyuam tsis xws luag. Tsis txhob ntshai yog tias qhov tshwm sim siab txaus lossis qhov zoo, qhov no feem ntau tshwm sim nrog ntau lub cev xeeb tub. Yuav tsum tau ultrasound kom paub meej qhov tshwm sim.

Thov nco ntsoov tias cov menyuam ntxaib tsis yog ib txwm pom ntawm thawj zaug ultrasound. Txawm hais tias muaj ntau qhov xwm txheej thaum muaj ntau yam kev xeeb tub tau kuaj pom ntxov li lub lim tiam thib rau. Thaum lub lim tiam 22, nws yog qhov muaj feem ntau tias tus kws kho mob yuav pom ntau tus menyuam mos ntawm kev kuaj ultrasound. Qhov yuam kev ntawm lub sijhawm no tsuas yog tshwm sim yog leej niam xav tau tsib lossis ntau tus menyuam.

Kev pheej hmoo ntawm kev xeeb tub ntau yam

Peb tau tshuaj xyuas kom meej thawj cov tsos mob ntawm tus menyuam ntxaib uas leej niam tuaj yeem pom nws tus kheej yam tsis tau sab laj nrog kws tshaj lij. Tam sim no cia peb mus rau lo lus nug ntawm yog vim li cas, tshwj xeeb tshaj yog muaj ntau lub cev xeeb tub, nws yog ib qho tseem ceeb mus ntsib koj tus kws kho mob tsis tu ncua?

Risks ncaj qha nyob ntawm kev sib txuas ntawm daim nyias nyias, placenta thiab ntxaib. Txhua qhov kev xeeb tub thib peb yog monochorionic (cov me nyuam muaj ib qho placenta). Ntawm lawv:

• ntau tshaj 30% - dichorionic-diamniotic (ob txoj hlua caj dab, qhov sib faib tuab ntawm cov menyuam mos);
• ntau tshaj 60% - monochorionic-diamniotic (thin septum);
• 2% - monochorionic-monoamniotic (cov hnab amniotic thiab placenta).

Hauv thawj kis, qhov kev pheej hmoo tsawg tsawg yog tias thawj tus menyuam muaj kev nthuav qhia cephalic. Cov ntaub ntawv no tsis xav tau kev saib xyuas tshwj xeeb. NtawmMonochorionic-diamniotic cev xeeb tub nrog cov menyuam ntxaib muaj txoj hauv kev los tsim feto-fetal transfusion syndrome. Niam raug pom zoo kom mus kuaj xyuas ob zaug hauv ib hlis. Qhov nyuaj tshaj plaws thiab txaus ntshai yog qhov thib peb. Ntawm no, cov me nyuam yaus khiav txoj kev pheej hmoo loj hlob ua ke nrog lub cev (Siamese ntxaib) los yog kev sib txuas ntawm cov hlab ntsha. Yuav tsum tau kuaj ultrasound ntau zaus, thiab yuav tsum tau kuaj xyuas qhov chaw caesarean.

Txoj kev xeeb tub

Yog koj mloog tus kws kho mob cov lus pom zoo, ces koj yuav siv sij hawm no tsis muaj kev zoo siab dua cov poj niam uas xav tau ib tug menyuam. Txij li thaum lub sij hawm cev xeeb tub ntau, ob lub load tam sim ntawd poob rau ntawm niam lub cev, cov kws kho mob muab rau koj ntau dua.

Thaum koj xav tias yuav muaj ob lossis ntau tus menyuam mos, muaj feem ntau ntawm kev nchuav menyuam lossis ua kua dej amniotic ua ntej. Qhov no yog qhov tseeb tshwj xeeb hauv lub hlis tsis ntev los no. Tsis txhob overexert koj tus kheej, tsis txhob ua lub cev hnyav. Rau qee qhov, kev pw tsaug zog lossis pw hauv tsev kho mob tau pom zoo.

Raws li txoj cai, menyuam ntxaib yug ntxov (ntawm 36 lossis 38 lub lis piam). Lawv qhov hnyav tsawg dua li ntawm lwm cov menyuam yaus, txawm li cas los xij, lawv txawv ntawm qhov muaj peev xwm hloov tau. Qhov hnyav thiab qhov ncig ntawm lub plab yuav loj dua me ntsis rau cov poj niam xav tau ib tug menyuam.

Nco ntsoov saib koj cov zaub mov, sab laj nrog koj tus kws kho mob txog kev noj cov vitamins thiab minerals complexes. Nrog ntau lub cev xeeb tub, lub cev tuaj yeem tso tawm sai sai.