Kodi zinthu zomwe amawoneka ndi ziti?
Pali mayeso ochepa oyeza kuyesera (magazi) omwe amapezeka panthawi yomwe ali ndi mimba yomwe imatha kulingalira mwayi wanu wokhala ndi mwana ndi matenda a Down syndrome.
Pamene mayeserowa amasiyana pa nthawi yomwe ali ndi mimba, komanso kumvetsetsa (mwayi woti amakupatsani yankho lolondola), onse amayeza zinthu zomwe zimapangidwa ndi mwana kapena feteleza.
Chinthu chachikulu kwambiri poyerekeza ndi seramu poyerekeza ndi kuyezetsa kwa matenda ndikuti palibe vuto loperekera pakati pathu.
Chiyeso Choyesa Kuyesedwa Choyamba: hCG ndi PAPP-A
Pa trimester yoyamba, zinthu ziwiri zotchedwa hCG ndi PAPP-A zimapezeka m'magazi a mayi. Zinthuzi zikhoza kuyesedwa (makamaka pakati pa masabata 10 mpaka 14 a mimba) ndipo amagwiritsidwa ntchito posonyeza mwayi wa mayi wokhala ndi mwana ndi Down syndrome (yomwe ndi trisomy 21).
HCG (Gonadotropin ya Anthu Chorionic)
HCG ndi hormone yopangidwa ndi placenta. Ndipotu, kumayambiriro kwa mimba, ndi mankhwala omwe amawoneka mumsampha wa kunyumba ndi dokotala komanso kuyesedwa kwa mimba.
Mimba yomwe mwanayo ali ndi matenda a syndrome amatha kukhala ndi HCG kuposa ma mimba ena.
PAPP-A (Mapuloteni Ogwirizanitsa Pathupi A)
Azimayi omwe ali ndi magazi ochepa a PAPP-A pa masabata 10 mpaka 14 omwe ali ndi chiberekero amakhala ndi mwayi wochulukira kuti mwana wawo akhale ndi matenda a Down syndrome.
Mawerengero otsika a PAPP-A angasonyezenso chiopsezo chowonjezeka choletsa kukula kwa intrauterine, kubereka msanga, preeclampsia, ndi kubereka.
Zotsatira za Kuthamanga kwa Seramu Woyamba Kuyesedwa kwa Syndrome
Zotsatira za kuyesedwa kwa magazi kwa hCG ndi PAPP-A zimatchedwa "zosayang'ana zowonetsa" kapena "zowoneka bwino" ndipo zimangopatsa mwayi wokhala ndi mwana yemwe ali ndi trisomy 21.
Mwa kuyankhula kwina, kuyezetsa magazi uku sikumadwala matenda a Down syndrome.
Zotsatira Zosayera Zowonetsa
Zotsatira zosawonetsera "zikutanthauza kuti mwayi wanu wokhala ndi mwana ndi Down syndrome ndi wochepa. Ngakhale zili choncho, ndi bwino kukumbukira kuti zotsatira zotsutsa "sizitsimikiziranso kuti palibe vuto lobadwa. Ngati muli ndi zotsatira zowonongeka, simungaperekedwe kuyesa kutsatiridwa ndi matenda a CVS kapena amniocentesis. (Mayeso awa angathe kudziwa matenda a Down, kusiyana ndi kuyesera magazi).
Kumbali ina, mudzapatsidwa mayeso ena a kuyezetsa magazi, omwe amachitidwa mu trimester yachiwiri, yomwe imayeza chinthu chotchedwa AFP. Kuchuluka kwa AFP panopa zowonongeka zofooka za neural tube monga anencephaly ndi spina bifida.
Sungani Zapamwamba Zotsatira
Zotsatira za "Screen" zimatanthauza kuti mwayi wa mwanayo kukhala ndi Down syndrome ndi wapamwamba kusiyana ndi nthawi zonse. Kotero, ndi zotsatira izi, kuyesa kutsatila kuyesa ndi CVS kudzaperekedwa.
Ndikofunika kuzindikira kuti zotsatira zabwino zowonekera sizitanthauza kuti mwana ali ndi vuto lachiromosome. Ndipotu, amayi ambiri omwe ali ndi zotsatira zowonetsa "adzakhala otetezeka" adzakhala ndi ana abwinobwino.
Kuwona kwa Sewero Kukhala Wosangalala ndi Khungu Sitikutsatira Chotsatira
Kuti mudziwe bwino, kuyesedwa kwa seramu sikumakupatsani chidziwitso koma kukupatsani chiwerengero cha mwayi wanu wokhala ndi mwana yemwe ali ndi matenda a Down syndrome.
Pamene kulondola kwa chiyesochi kumasiyanasiyana pang'ono kuchokera ku labu ku labata, kawirikawiri, kuyesa koyambirira kwa seramu kuyesera kwa hcG ndi PAPP-A kudzawona pafupifupi 80 peresenti ya ana omwe ali ndi Down syndrome.
Kuchuluka kwa chidziwitso chimenechi kumawonjezeka ngati mutagwiritsa ntchito mayeserowa mogwirizana ndi mayesero owonetsetsa a ultrasound otchedwa nuchal translucency test, omwe amachitiranso ku trimester yoyamba.
Ngakhale kuyang'aniridwa kwa seramu yoyamba ikupezeka pafupifupi 80 peresenti ya mimba yokhala ndi Down syndrome, "idzaphonya" 20 peresenti (pafupifupi 1 mwa 5) ali ndi pakati pa izi.
Zambiri Zokhudza Nuchal Translucency Ultrasound Screening
Kuwonetsetsa kwa Nuchal ndi njira yapadera yotchedwa ultrasound yomwe inachitidwa mu trimester yoyamba yomwe imayeza kuchuluka kwa madzi kumbuyo kwa khosi la mwana (nuchal translucency).
Izi ndizopadera komanso zovuta kuti mupeze, ndipo ultrasound ikhoza kuchitidwa ndi munthu amene waphunzitsidwa bwino ndi kutsimikiziridwa kuti apeze izi.
Kawirikawiri, muyezo wa pansi pa 3 mm umatengedwa kuti ndi wabwinobwino kapena "kusayima kwasalu" ndipo nyerere ya nuchal ya 3 mm imaonedwa ngati yachilendo kapena yosatsegula.
Kawirikawiri, nuchal translucency measurement ndi wanu woyamba-trimester kufufuza zizindikiro zimagwirizanitsidwa palimodzi pogwiritsa ntchito njira yeniyeni yothetsera machitidwe, ndipo mumapatsidwa zotsatira imodzi yowunikira.
Ngati chithunzi chanu cha nuchal chitasintha, mungatumizidwe kwa otsogolera kuti mukambirane zotsatira zowunikira, zomwe akutanthauza, ndi njira zanu zoyesera monga CVS ndi amniocentesis.
Chiyeso Chiyeso Choyesa Kuyesedwa Kwachitatu: Cell-Free DNA Blood Test
Ndikofunika kuzindikira kuti pali vuto lina loyesa kuyerekezera kwa matenda a Down syndrome omwe amapeza DNA yopanda maselo m'magazi a mayi. Chiyesochi chikhoza kuchitika patangotha masabata 10 atsikana omwe ali ndi kachilombo ka HIV ndipo amapeza 99 peresenti ya amayi omwe ali ndi matenda a Down syndrome.
Zotsatira za mayeserowa ndi pafupifupi 1 mpaka 5 peresenti kapena zowonjezereka za magazi, palibe zotsatira zomwe zingapezeke, ngakhale atayesedwa. Kuwonjezera apo, mayesero ndi okwera mtengo. Izi zati, amayi omwe ali pachiopsezo chachikulu chokhala ndi mwana yemwe ali ndi matenda a Down syndrome amakhala akuyesedwa (mwachitsanzo, akazi omwe ali ndi zaka 35 kapena kuposerapo panthawi yobereka).
Kuphatikiza apo, amayi omwe ali ndi "yesero" yesewero kwa hCG ndi PAPP-A akhoza kusankha kuti ayambe kuyesa DNA popanda majekesiti m'malo mopitirira ndi mayeso owonetsa. Ngati DNA yopanda maselo imayesetsanso bwino, ndiye kuti CVS kapena amniocentesis ikhoza kuchitidwa kuti mudziwe.
Komabe, ngati DNA yopanda selo ilibe vuto, ndiye kuti kuyesa magazi koyambirira (hCG ndi PAPP-A) kumawoneka kuti ndibodza.
Mawu Ochokera
Monga momwe mukuonera, pali njira zingapo zoyambirira zowonetsera zolimbana ndi matenda a Down syndrome kuphatikizapo kuyezetsa magazi kwa hCG ndi PAPP-A, ultrasound, kapena kuphatikiza awiriwo. Kuphatikiza apo, kwa amayi omwe ali ndi chiopsezo chachikulu, palinso kachilombo ka DNA koyesa magazi.
Kusankha njira (ngati ilipo) kuyesera, komanso nthawi (amayi ena amasankha kuyembekezera mpaka pa trimester yachiwiri), ndizofunikira kwa inu nokha ndikusowa kukambirana ndi dokotala wanu nthawi zina komanso nthawi zina mthandizi.
> Zotsatira:
> American College of Obstetrics ndi Gynecologists. (2014). Kuyesera Kuyezetsa Mavuto Obadwa.
> Messerlian GM, Palomaki GE. Down Syndrome: Phunziro lachiwerewere. Wilkins-Huag L, ed. Zaposachedwa. Waltham, MA: UpToDate Inc.
> National Down Syndrome Society. (2012). Kumvetsa Kutulukira kwa Down Syndrome.