Kev tshuaj ntsuam plaub fab

Txoj kev ntsuas plaub ntu yog txoj kev kuaj ntshav thaum lub cev xeeb tub los txiav txim seb tus menyuam puas muaj feem yuav ua tsis taus qee yam mob thaum yug los.

Qhov kev kuaj ntshav no feem ntau tau ua thaum 15 thiab 22 lub lim tiam ntawm cev xeeb tub. Nws yog qhov tseeb tshaj plaws ntawm 16th thiab 18th lub lis piam.

Kev kuaj ntshav tawm thiab xa mus rau qhov chaw kuaj ntshav kuaj.

Cov kev ntsuas ntsuas nce qib ntawm 4 cov tshuaj tiv thaiv cev xeeb tub:

• Alpha-fetoprotein (AFP), cov protein tsim los ntawm tus menyuam
• Tib neeg chorionic gonadotropin (hCG), yog cov tshuaj hormones tsim tawm hauv cov me nyuam
• Unconjugated estriol (uE3), ib hom tshuaj los ntawm cov tshuaj estrogen hauv cov menyuam hauv plab thiab cov me nyuam.
• Inhibin A, ib yam tshuaj uas tso tawm los ntawm lub cev

Yog tias qhov ntsuas tsis ntsuas cov qib inhibin A, nws yog hu ua triple screen ntsuas.

Txheeb xyuas qhov muaj feem rau koj tus menyuam muaj mob yug los tsis zoo, qhov kev kuaj no kuj ua rau:

• Koj lub hnub nyoog
• Koj yog haiv neeg tsawg
• Koj lub cev hnyav
• Koj tus menyuam lub hnub nyoog rov qab los (ntsuas hauv cov lis piam txij hnub koj lub sijhawm kawg mus txog hnub tamsis no)

Tsis muaj cov kauj ruam tshwj xeeb uas xav tau los npaj rau kev xeem. Koj tuaj yeem noj lossis haus ib txwm muaj ua ntej kev sim.

Tej zaum koj yuav hnov ​​mob me ntsis lossis plev thaum koob tau ntxig. Koj tuaj yeem hnov ​​zoo ib yam li mob ncus ntawm qhov chaw tom qab kos cov ntshav.

Kev ntsuam xyuas tau ua tiav los xyuas seb koj tus menyuam puas yuav muaj feem ua rau muaj qee qhov kev yug me nyuam, xws li Down syndrome thiab yug cov pob txha caj qaum thiab mob hlwb (hu ua neural tube tsis xws luag). Qhov kev kuaj no yog kev kuaj mob, yog li nws tsis kuaj teeb meem.

Qee tus poj niam muaj feem ntau yuav muaj menyuam nrog cov tsis xws luag, suav nrog:

• Cov pojniam muaj hnub nyoog tshaj 35 xyoos thaum cev xeeb tub
• Cov poj niam siv tshuaj insulin los kho ntshav qab zib
• Cov poj niam muaj tsev neeg muaj keeb kwm muaj keeb kwm tsis zoo

Cov qib ntawm ib txwm muaj ntawm AFP, hCG, uE3, thiab inhibin A.

Cov kab ke tus nqi yuav txawv me ntsis ntawm ntau lub chaw soj nstuam. Tham nrog koj tus kws kho mob txog cov ntsiab lus ntawm koj cov kev kuaj sim.

Txoj kev kuaj ib qho txawv tsis txhais tau tias koj tus menyuam lub hnub yug muaj tsis taus. Feem ntau, cov txiaj ntsig tuaj yeem yog qhov txawv yog tias koj tus menyuam mos lossis laus dua li koj tus kws khomob tau xav.

Yog tias koj muaj qhov tshwm sim tsis zoo, koj yuav muaj lwm zaus kuaj ntsuas hnub nyoog ntawm kev loj hlob ntawm tus menyuam.

Cov kev ntsuam xyuas ntau ntxiv thiab kev pab tswv yim yuav pom zoo yog tias qhov ntsuas kab mob ultrasound pom ib qho teeb meem. Txawm li cas los xij, qee tus neeg xaiv tsis muaj kev sim ua ntxiv, rau tus kheej lossis kev ntseeg.Cov kauj ruam tom ntej muaj xws li:

• Amniocentesis, uas kuaj txog qib AFP hauv cov kua dej amniotic puag ncig tus menyuam. Kev kuaj caj ces tuaj yeem ua tiav ntawm cov kua dej amniotic tawm rau txoj kev ntsuas.
• Kev ntsuam xyuas txhawm rau kuaj pom lossis tswj qee yam kev mob yug (xws li Down syndrome).
• Kev qhuab ntuas raws caj ces.
• Ultrasound los tshawb xyuas tus menyuam lub hlwb, tus txha nraub qaum, raum, thiab lub plawv.

Thaum cev xeeb tub, nce qib ntawm AFP yuav yog vim muaj teeb meem nrog tus me nyuam hauv plab, xws li:

• Qhaj ntawm ib feem ntawm lub hlwb thiab pob txha taub hau (anencephaly)
• Muaj mob rau hauv tus menyuam lub plab lossis lwm yam kabmob (xws li duodenal atresia)
• Kev tuag ntawm tus menyuam hauv plab (feem ntau ua rau nchuav menyuam)
• Spina bifida (txha caj qaum)
• Tetralogy ntawm Fallot (mob plawv)
• Turner syndrome (caj ces tsis xws luag)

Daim siab AFP tseem tuaj yeem txhais tau tias koj tau nqa ntau tshaj 1 tus menyuam.

Qib qis ntawm AFP thiab estriol thiab theem siab ntawm hCG thiab inhibin A yuav yog vim muaj teeb meem xws li:

• Mob syndrome (trisomy 21)
• Cov Mob Edwards (trisomy 18)

Lub vijtsam plaub muaj peev xwm muaj qhov cuav tsis raug thiab qhov tsis raug (txawm tias nws yog qhov tseeb me ntsis dua lub vijtsam triple). Xav tau kev ntsuam xyuas ntxiv los txhawm rau paub meej qhov txiaj ntsig tsis meej.

Yog tias ntsuas pom tsis meej, koj yuav tsum tham nrog kws sab laj tswv yim.

Quad npo; Ntau hom cim ntsuas; AFP ntxiv; Triple screen xeem; AFP niam; MSAFP; 4-cim vijtsam; Down mob siab - quadruple; Trisomy 21 - plaub npaug; Turner syndrome - plaub npaug; Spina bifida - plaub npaug; Tetralogy - plaub npaug; Duodenal atresia - plaub npaug; Kev pab tswv yim rau caj ces - plaub ceg; Alpha-fetoprotein plaub npaug; Tib neeg chorionic gonadotropin - plaub npaug; hCG - plaub npaug; Unconjugated estriol - plaub npaug; uE3 - plaubru; Cev xeeb tub - plaub npaug; Qhov tsis zoo thaum yug los - plaub npaug; Quadruple npav ntsuas; Quad kuaj; Quadruple npav screen

• Quadruple npo

ACOG Kev Ua Daim Ntawv No Tsis Yog 162: Kev kuaj mob ua ntej rau kev tsis taus ntawm caj ces. Obstet GynecolCov. 2016; 127 (5): e108-e122. PMID: 26938573 pubmed.ncbi.nlm.nih.gov/26938573/.

Driscoll DA, Simpson JL. Kev kuaj raws caj ces thiab kev kuaj cev xeeb tub. Hauv: Landon MB, Galan HL, Jauniaux ERM, li al, eds. Gabbe's Obtetrics: Li Qub thiab Teeb Meem Ua Xeeb TubCov. 7 tus ed. Philadelphia, PA: Elsevier; 2021: chap 10.

Wapner RJ, Dugoff L. Kev paub txog kev xeeb tub ntawm kev mob plab hnyuv tawm tuaj. Hauv: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Nyiaj RM, eds. Kev Tsim Nyog thiab Resnik Cov Tshuaj Tiv Thaiv Leej Niam: Cov Ntsiab Cai thiab Kev UaCov. 8 tus ed. Philadelphia, PA: Elsevier; 2019: chap 32.

Williams DE, Pridjian G. Obstetrics. Hauv: Rakel RE, Rakel DP, eds. Phau Ntawv Qhia Txog Tshuaj Tsev NeegCov. 9le ed. Philadelphia, PA: Elsevier; 2016: chap 20.