Ukuthuthukiswa kwe-Fetal yiyona gama elisetshenziswe lapho ukhuluma ngomjikelezo wezenzakalo eziqala lapho isidoda neqanda zihlangana futhi zivela ekuthuthukisweni okuhlelekile ukwakha umntwana. Ngento ethi "kwenzeka nje" uma owesifazane ekhulelwa, kuyinkimbinkimbi emangalisayo-futhi kumnandi kakhulu ukucabanga ngakho.
Ukubala Ukukhulelwa
Kubalulekile ukwazi ukuthi ukukhulelwa kuthatha amasonto angama-40 kusukela ngosuku lokuqala lokugcina kwakho kuze kube sekuqedeni ukukhulelwa, abasebenzi kanye nokuzalwa. Udokotela wakho uzosebenzisa amasonto ukusiza ukuthola ukuthi ukhona lapho ukhulelwe nokuthi kufanele kwenzekani ngasiphi iphuzu. Lawa maviki abuye aphuluke abe ama- trimesters :
- I-Trimester yokuqala (amaviki 1 kuya ku-13)
- Trimester yesibili (Amaviki 14 kuya ku-27)
- I-Trimestre yesithathu (Amaviki 28+)
Lezi zindlela zokubala zisebenza ngokusemthethweni futhi ezisebenzayo. Izosetshenziswa kuwo wonke amashadi akho wezokwelapha nezinqumo. Ungase ube namanje abantu bebuza ukuthi zingaki izinyanga ezikuwe ekukhulelwe kwakho. Lokhu kumnandi ukubala, kepha ukukhulelwa akungeze kwaze kwaba izinyanga eziyisishiyagalolunye.
Izinyathelo zokuthuthukiswa kwe-Fetal
Uma ukhuluma nabantu abahlola izakhi zofuzo nokuthuthukiswa komntwana, babheka ukukhulelwa ngendlela ehluke kakhulu. Izigaba ezintathu ababukeka ngazo:
- I-Germinal Stage (Amaviki 2 kuya ku-4)
- I-Embryonic Stage (Amaviki 5 kuya ku-9)
- I-Fetal Stage (Amaviki 10+)
I-Germinal Stage (Amaviki 2 kuya ku-4)
Lesi sigaba sokuqala sentuthuko singenye yezinto ezingaziwa kakhulu kubantu abaningi. Lokhu kuqala njengoba iqanda nesidoda zihlangana engxenyeni engaphandle yesithathu yamatayipi okhokho. Uma laba ababili beba munye, imiphumela ye- zygote futhi iqhubeka nohambo lwayo esibelethweni. Kuleli phuzu, umzimba awuqapheli ukukhulelwa okwenzekile. Kungathatha izinsuku eziyisikhombisa noma ngaphezulu ukuhamba ubude bhubhu bese ufaka iqanda elivundisiwe esibelethweni sokulinda.
Isibeletho sakhele i-lining ngokulindela iqanda elivundisiwe. Leli hambo lonke libone ukuhlukaniswa kweseli kusuka esitokisini esisodwa. Ekuqaleni, wonke amaseli afana. Kuze kube yilapho amaseli afinyelela isiteji sesishiyagalombili ukuthi aqale ukuhlukanisa uhlobo lwamaseli azoba. Amaseli angaphakathi aqala ukwakha okuzoba umbungu. Kunezigaba ezintathu:
- I-Ectoderm (isikhumba nesishukela)
- I-Endoderm (isimiso sokuphefumula nokugaya)
- I-Mesoderm (isimiso semisipha nesiguli)
Amangqamuzana angaphandle (trophectoderm) athuthuka e-placenta. Uma i-blastocyst iqala ukufaka esibelethweni, i- griadotropin ye-chorionic (hCG) yabantu ikhishwa, evumela umzimba womama ukuthi ubone ukukhulelwa. Ekugcineni, le hCG izotholakala ngokwanele ukuthi ukuhlolwa kokukhulelwa kuzoba kuhle. Uma sekufakwe ukufakwa kwesitshalo , kuzoshukumisa umzimba ukuba ushintshe imithi yomzimba ukuvimbela umjikelezo wokuya esikhathini ukufika futhi kuze kube yilapho ukukhulelwa sekuphelile.
Umjikelezo osukho okwehla esikhathini esivamile yilokho okuzokwenza abesifazane abaningi bathathe ukuhlolwa kokukhulelwa.
I-Embryonic Stage (Amaviki 5 kuya ku-9)
Amaseli manje abhekwa njengembungu. Nakuba manje ngokusuka ngokucacile komuntu, umsunguli usabonakali njengalokho abaningi bethu abakushoyo lapho sicabanga ngomntwana. Isikhathi sokubumbana sibaluleke kakhulu ngoba zonke izinhlelo zomzimba zakhiwa.
Uhlelo olulodwa oluthola izingxoxo eziningi ngalesi sikhathi esibucayi yi- tube ye-neural (okugcina ekugcineni iba yintambo yomgogodla, isimiso sezinzwa, nobuchopho). Lokhu kuqala ukudala izinsuku ezingu-22 ngemuva kokukhulelwe, cishe izinsuku ezingu-36 kusukela ngosuku lokuqala lwenkathi yakho yokugcina. I-Spina bifida ne-anencephaly yizinhlobo ezimbili zeziphambeko ze-neural tube ezingase zenzeke, ikakhulukazi uma kungekho folic acid eyanele emzimbeni. Lesi esinye sezizathu ezinkulu kakhulu zokuthi bonke abafazi abaneminyaka yobudala yokubeletha bathathe amavithamini angakabiphi noma okungenani ama-folic acid . Kungaba nzima ukukhomba ukukhulelwa lokhu ekuqaleni, ikakhulukazi kusukela cishe amaphesenti angu-50 azo zonke ukukhulelwa azihlelwe.
Inhliziyo yomntwana iphinda yakha ngokushesha. Iqala njengomkhumbi wegazi owodwa oqala ukushayela ngeviki lesihlanu lokukhulelwa. Kusasa kakhulu ukuzwa lokhu ngisho nokusebenzisa ubuchwepheshe be-Doppler . Lokhu ngeke kwenzeke kuze kube ngeviki le-10, nakuba i- ultrasound engenaweni yangasese ingathatha ama-pixels amancane aqhuma njengoba isitsha segazi sishaya ngomsebenzi kusukela ekuqaleni kwamasonto ayisithupha kuya kwayisikhombisa. Ukushaya kwenhliziyo kwengane kuyashesha kakhulu kunomuntu omdala, kodwa iqala kancane, ikhuphuka ngokushesha (iqondisa ngasezintweni ezingu-180 ngomzuzu), bese ihlala phakathi no-120 kuya ku-160 ububanzi bokukhulelwa kwesinye isikhathi.
Umzimba uyakha futhi. Uzobona izithombe ngezimbobo noma izindawo ezimnyama eziba amaconsi, amehlo, umlomo, nezindlebe. Uzobona futhi ukufihla kwengalo nomlenze, ukushintsha ngokushesha ukufaka amalunga (ama-elbows namadolo). Uzobona umunwe ohlukanisiwe kanye nemigodi yezinyosi kancane kamuva kule nkathi.
Ngenkathi isinqumo sokuthi umntwana ungowesilisa noma owesilisa yini esinqunyiwe ngokwemvelo, zonke izingane zibukeka ezifanayo kuleli phuzu ngaphandle (nakuba izitho zangaphandle zobulili zikhona, awukwazi ukutshela i-clitoris kusuka epenis).
Lesi sigaba se-embryonic kuphela amasonto amahlanu kuphela. Ekupheleni kwalesi sikhathi, umbungu uzoba nesisindo esifana nesiqeshana sephepha bese uba cishe ubude obusentimitha, kodwa nokho unayo yonke inhlangano yesakhiwo nesakhiwo esidinga impilo yangaphandle.
I-Fetal Stage (Amaviki 10+)
I-term fetus yinto abantu abaningi abayizwile. Leli yigama lobuchwepheshe lomntwana esiteshini sesisu futhi isiLatini "senzalo" noma "izithelo ezandisiwe." Isigaba sesisu sesibonakala singathandeki. Ngenkathi konke kukhona, kunama-nuances amaningi nokulungiswa okuhle kakhulu ukulungiselela ingane yakho yokuphila ngaphandle kwesibeletho.
Phakathi kwamaviki angu-12 no-14, ungaqala ukuhlukanisa abafana abantombazane ngezitho zangaphandle zobulili, nakuba-ngisho besebenzisa i-ultrasound-kunzima ukuthi kube neqiniso ngokuzimisela ngokocansi kulesi sigaba. Lokhu kungcono kakhulu phakathi kwamasonto angu-18 no-22 ngesikhathi sokukhishwa kwe-fetus anatomy. Ingane yentombazane izozalwa nayo yonke amaqanda ayoke abe nayo empilweni yakhe ngaphakathi kwamaqanda ayo, kuyilapho ingane encane ingenayo isidoda esithombeni sayo.
Kunezinto ongahle uzicabange ngazo ngokukhula njengeminwe yeminwe, izilonda zamehlo, izinwele, namazinyo. Ngisho namazinyo angunaphakade aseqalile ukudala phakathi nalesi sigaba sokukhulelwa. Umzimba ugcwele izinwele ezinhle ezibizwa nge -gogo futhi kukhona ukugqoka esikhumbeni esibizwa ngokuthi i-vernix caseosa.
Emayelana ne- trimester yesithathu , noma amasonto angu-28 kusukela esikhathini sokugcina, isimiso sezinzwa siqala ukusabela okufana neyengane esanda kuzalwa. Ungabona ukuthi ingane yakho ibonakala inesikhathi sokuphumula kanye nomsebenzi ovamile, njengengane esanda kuzalwa. Umntanakho uzokwenza ngisho nokuphefumulela i-amniotic fluid, okuyingxenye ehlanganisa umchamo wesisu.
Ngokuqinisekile umntanakho uzophuma ekubeni yi-gram eyodwa, ubude obulodwa buzoba ngamasentimitha angaba ngu-7 ubude futhi bube ngamasentimitha angaba ngu-20 ubude ubude, kodwa isiteji sesibusiso silingana nokukhula kwesisindo nokuphakama. Izingosi zegciwane zidinga izinguquko eziningi ezihamba kahle. Isibonelo, ubuchopho bomntwana buzokhula ngobukhulu nokuma, kepha akuze kube amasonto wokugcina ukuthi amaphupho ochopho ajule futhi inzuzo yesisindo ebuchosheni ibalulekile. (Lesi esinye sezizathu eziningi zokuthi ukuphela kokukhulelwa kubaluleke kangakanani empilweni nasemphilweni yengane yakho.)
Izinkinga NgeNtuthuko Yomntwana
Kunezinto ezingashintsha inkambo yokuthuthukiswa komntwana wesibalo ezingeni lezakhi zofuzo, kanye nezinkinga ezingokwenyama ezingaphazamisa. Ngezinye izikhathi lezi zinkinga zizovimba inqubo yonke futhi umntwana uzoyeka ukukhula nokukhulelwa kuzophela. Lokhu kungenzeka kakhulu esiteshini segciwane, lapho umama engazi ukuthi ukhulelwe, noma esiteji somoya, lapho angase angazi ukuthi ukhulelwe.
Inkinga yezofuzo noma ngokomzimba ingase ibangele ne-anomaly engabonakali ukufaneleka kwengane, kodwa isacacile. Lokhu kungase kube into efana ne-Down syndrome (i-genetic) noma inyawo lesikhumba (ngokomzimba).
Kunezinto eziningi ezingase zihambe kahle, kodwa ngokubonga abazenzi njalo njalo. Iningi lezingane zibona ukuthuthukiswa kwazo kungabheki ukuzalwa.
I-Genetic Screening
Uma umndeni unomlando wezimpikiswano zezakhi zofuzo noma uma unina engaphezu kweminyaka engamashumi amathathu nanhlanu, kunengqondo ukuthi ukuhlolwa kofuzo kuhlinzekwe ngaphambi noma ngesikhathi sokukhulelwa. Ngaphambi kokukhulelwa, umndeni ungahlolwa izifo zofuzo njengeTay-Sachs , isifo se- sickle cell kanye nabanye. Uma usukhulelwe, ukugxila ekuhloleni ukuhlolwa kuya empeleni kuhlolwe ukukhulelwa okuqondile kanye nomntwana ngenxa yezimo eziphuthumayo.
Kubalulekile ukuqonda umehluko phakathi kokuhlola ingane yakho kanye nokuhlolwa kwangempela kofuzo. Ukuhlola kungabonisa ingozi wena noma ingane yakho enayo yokuba nesifo ikakhulukazi. Lokhu kuvame ukuqhathaniswa nobungozi obuningi bomuntu osemuva nomlando wakho. Ngakho isikrini esihle sizobonisa ukuthi ukuhlolwa kwakho kwembula ukuthi wena noma ingane yakho ingozi enkulu kunokulinganisa ubudala nobudala bakho.
Uma unekrini elihle, noma ngegazi noma nge-ultrasound, kufanele unikezwe ukuhlolwa kofuzo. Njengoba lezi zivivinyo zinengozi encane kodwa yangempela yokukhulelwa, akukhuthazwa ukuba wonke umuntu asebenzise lezi zivivinyo. Lezi ezimbili ezivame kakhulu yi- chorionic villus sampling (CVS) ne-amniocentesis. Uzosebenza nodokotela wakho, umeluleki wezakhi zofuzo, nabanye ukuhlola inqubo.
Impilo Yokukhulelwa
Impilo yokukhulelwa iyoxhomekeka empilweni yomama nomlingani ngezinga elithile. Lokhu kuhlanganisa impilo yezinyanga ezimbili eziholela ekukhulelwe. Lesi esinye sezizathu zokuvakashelwa kokuqala kwezempilo nokuhlelwa kokuphila kokubeletha kubalulekile, njengoba kunconywa yiCenter for Disease Control and Prevention (CDC).
Ukunakekelwa ngaphambi kokubeletha kuqala uma ukukhulelwa kuqinisekiswa futhi kuzoqhubeka nokuqedwa kokukhulelwa. Lokhu kuhlanganisa ukunakekelwa kokuvimbela, ukuhlolwa, nokuphathwa kwezinkinga kanye nezinkinga ezingenzeka uma ziphakama.
Kubalulekile ukwazi ukuthi kunezinto ezithinta imvelo ezithandwayo ukuthi awunakho ukulawula. Ezinye zihambisana nempilo yakho. Isibonelo, uma ubhekene ne-diethylstilbestrol (DES) -ifomu ye-estrogen enqunyelwe abesifazane besuka ku-1930 kuya ku-1970-njengengane engumntwana, ungase ube nenengozi enkulu yokuthola izifo ezithile ze-uterine noma ukukhulelwa kwesisu. Akukho lutho ongakwenza ukuze uthuthukise izingozi ze-DES exposure yakho. Kodwa-ke, ungahlola ukuthi kungenzeka yini izingozi zamakhemikhali nezemvelo emsebenzini; udokotela noma umbelethisi wakho angakusiza ekuqondiseni ukuthi yini ozoyibuza mayelana.
> Imithombo:
> I-American College yezidakamizwa namaGynecologists (ACOG). Ukuthuthukiswa kokubeletha: Indlela ingane yakho ekhula ngayo ngesikhathi sokukhulelwa. FAQ156, Juni 2015.
> Izinkinga zokuziphatha ezivivinyweni zofuzo. I-ACOG Committee Opinion No. 410. Ikhomishana yaseMelika yasezimbangi kanye namaGynecologists. I-Obstet Gynecol 2008; 111: 1495-502.
> I-Moos MK. Kusukela ku-Concept Ukuzijwayeza: Ukuzindla Ngaphambi Kwempilo Ye-Agenda. Umbhalo Wezempilo Yabesifazane; Mashi 2010; 19 (3): 561-7.
> Ngaphambi kokuqala Ukunakekelwa kwezempilo kanye nempilo: Ukuqukethwe komtholampilo kokunakekelwa kwangaphambi kwesikhathi. Journal American of Obstetrics and Gynecology; Disemba 2008; I-Vol 199, No. 6, k. S257-S396-Ukwengeza B.
> Robbins, CL, Zapata, LB, Farr, SL. Izinkomba Zempilo Zengqalasizinda Zengqalasizinda - Ukukhulelwa Kwendlela Yokuqapha Ukuhlolwa Kwemingcipheko kanye Nokusebenza Kwengozi Yokuhlola Isingeniso, 2009. MMWR 2014; 63 (Cha. SS-3).