Ga iyaye masu zuwa, ƙididdige nauyin tayi akan duban dan tayi yana ba ku damar tunanin wannan jaririn da aka dade yana jira dan kadan. Ga ƙungiyar likitocin, wannan bayanan yana da mahimmanci don daidaita tsarin bin ciki, hanyar bayarwa da kuma kula da jariri a lokacin haihuwa.

Ba zai yiwu a auna tayin a cikin mahaifa ba. Saboda haka ta hanyar nazarin halittu, wato ma'aunin tayin akan duban dan tayi, zamu iya samun kimanta nauyin tayin. Ana yin wannan a lokacin duban dan tayi na biyu (kimanin 22 WA) da na ukun duban dan tayi (kimanin 32 WA).

Mai aikin zai auna sassa daban-daban na jikin tayin:

• kewayen cephalic (PC ko HC a Turanci);
• diamita na bi-parietal (BIP);
• kewayen ciki (PA ko AC a Turanci);
• tsawon femur (LF ko FL a Turanci).

Ana shigar da wannan bayanan biometric, wanda aka bayyana a cikin millimeters, sannan a shigar da shi cikin dabarar lissafi don samun kimanta nauyin tayin a cikin gram. Na'urar duban dan tayi tayi tana yin wannan lissafin.

Akwai nau'ikan lissafi kusan ashirin amma a Faransa, na Hadlock ne aka fi amfani dashi. Akwai bambance-bambancen da yawa, tare da sigogi na biometric 3 ko 4:

• Log10 EPF = 1.326 - 0.00326 (AC) (FL) + 0.0107 (HC) + 0.0438 (AC) + 0.158 (FL)
• Log10 EPF = 1.3596 + 0.0064 PC + 0.0424 PA + 0.174 LF + 0.00061 BIP PA - 0.00386 PA LF

Ana nuna sakamakon akan rahoton duban dan tayi tare da ambaton "EPF", don "Kimanin nauyin tayi".

Koyaya, sakamakon da aka samu ya kasance ƙima. Yawancin hanyoyin da aka inganta don nauyin haihuwa na 2 zuwa 500 g, tare da kuskuren kuskure idan aka kwatanta da ainihin nauyin haihuwa daga 4 zuwa 000% (6,4), saboda wani ɓangare na inganci da daidaito na yanke. tsare-tsare. Yawancin karatu sun kuma nuna cewa ga jarirai marasa nauyi (kasa da 10,7 g) ko manyan jarirai (sama da 1 g), gefen kuskure ya fi 2%, tare da dabi'ar wuce gona da iri. na ƙananan nauyin nauyi kuma akasin haka don yin la'akari da manyan jarirai.

An kwatanta sakamakon da ma'aunin kimanta nauyin tayin wanda Kwalejin Faransa na Ƙwararrun tayi (3). Manufar ita ce a tantance 'yan tayin daga al'ada, wanda ke tsakanin 10 ° da 90 ° percentile. Ƙididdiga na nauyin tayin don haka yana ba da damar gano waɗannan iyakar biyu:

• hypotrophy, ko ƙananan nauyi don shekarun haihuwa (PAG), wato nauyin tayin da ke ƙasa da kashi 10 bisa ɗari bisa ga shekarun haihuwa da aka bayar ko nauyi ƙasa da 2 g a lokaci. Wannan PAT na iya zama sakamakon ciwon mahaifa ko tayin ko na uteroplacental anomaly;
• macrosomia, ko “babban jariri”, wato jariri mai nauyin tayin da ya fi kashi 90 cikin 4 na shekarun haihuwa da aka bayar ko ma da nauyin haihuwa sama da XNUMXg. Wannan saka idanu yana da mahimmanci a yanayin ciwon sukari na ciki ko ciwon sukari da ya riga ya kasance.

Wadannan matsananci guda biyu sune yanayi masu haɗari ga jaririn da ba a haifa ba, amma kuma ga uwa a cikin macrosomia (ƙaramar haɗarin cesarean, zubar da jini a lokacin haihuwa musamman).

Ƙididdiga na nauyin tayin shine mahimman bayanai don daidaitawa da bin ƙarshen ciki, ci gaban haihuwa amma kuma yiwuwar kulawar jariri.

Idan a cikin duban dan tayi na uku kiyasin nauyin tayin ya kasance ƙasa da na al'ada, za a yi duban dan tayi a cikin wata na 8 don saka idanu da girma na jariri. A yayin da aka yi barazanar haifuwa da wuri (PAD), za a ƙididdige tsananin yiwuwar haihuwar da wuri bisa ga kalmar amma har ma da nauyin tayin. Idan an kiyasta nauyin haihuwa ya yi ƙasa sosai, ƙungiyar jarirai za ta sanya komai a wurin don kula da jaririn da bai kai ba tun daga haihuwa.

Sakamakon ganewar asali na macrosomia zai kuma canza tsarin kulawa da ciki da haihuwa. Za a yi gwajin duban dan tayi a cikin wata na 8 na ciki don yin sabon kimanta nauyin tayin. Don rage haɗarin dystocia na kafada, raunin plexus na brachial da asphyxia na jarirai, ya karu sosai a cikin macrosomia - ta 5% ga jaririn da ke yin la'akari tsakanin 4 da 000 g da 4% ga jariri fiye da 500 g (30) - shigarwa ko tsara tsarin cesarean ana iya bayarwa. Don haka, bisa ga shawarwarin Haute Autorité de Santé (4):

• idan babu ciwon sukari, macrosomia a cikin kanta ba alama ce ta tsari don sashin cesarean da aka tsara ba;
• ana ba da shawarar sashin cesarean da aka tsara a yayin da aka kiyasta nauyin tayin da ya fi ko daidai da 5 g;
• saboda rashin tabbas na kimanta nauyin tayin, don zato na macrosomia tsakanin 4 g da 500 g, dole ne a tattauna sashin cesarean da aka tsara a kan kowane hali;
• a gaban ciwon sukari, ana ba da shawarar sashin cesarean da aka tsara idan an kiyasta nauyin tayin ya fi ko daidai da 4 g;
• saboda rashin tabbas na ƙididdige nauyin tayin, don zato na macrosomia tsakanin 4 g zuwa 250 g, dole ne a tattauna sashin cesarean da aka tsara akai-akai, tare da la'akari da wasu sharuɗɗan da suka shafi ilimin cututtuka kuma mahallin mahaifa;
• zato na macrosomia ba a cikin kanta ba alama ce ta tsari don sashin cesarean da aka tsara a cikin yanayin mahaifa mai tabo;
• Idan ana zargin macrosomia kuma tarihin dystocia na kafada mai rikitarwa ta hanyar haɓakar plexus na brachial, an ba da shawarar sashin cesarean da aka tsara.

Idan an yi ƙoƙarin yin ƙananan hanyoyi, ƙungiyar masu haihuwa dole ne ta kasance cikakke (ungozoma, likitan obstetrician, anesthesiologist da likitan yara) a lokacin haihuwa an yi la'akari da haɗari a cikin macrosomia.

Idan aka gabatar da breech, ana kuma la'akari da kimanta nauyin tayin lokacin zabar tsakanin ƙoƙari na hanyar farji ko sashin cesarean da aka tsara. Nauyin tayin da aka kiyasta tsakanin gram 2 zuwa 500 wani ɓangare ne na sharuɗɗan yarda don hanyar farji wanda CNGOF (3) ya kafa. Bayan haka, ana iya ba da shawarar cesarean.