Duban dan tayi na ciki na biyu, wanda ake kira morphological ultrasound, wani muhimmin mataki ne na lura da ciki saboda yana iya gano yiwuwar lalacewar tayin. Ga iyaye, yana da mahimmanci: na gano jima'i na jariri.

Duban dan tayi na biyu yana faruwa ne a ranar 5 ga ciki, tsakanin makonni 21 zuwa 24, wanda ya dace yana da makonni 22.

Ba dole ba ne amma yana cikin tsarin gwaje-gwajen da aka tsara yayin bin ciki kuma ana ba da shawarar sosai.

Don wannan gwajin, ba lallai ba ne a yi azumi ko a sami cikakkiyar mafitsara. A gefe guda kuma, ba a ba da shawarar sanya kirim ko mai a cikin ciki ba a cikin sa'o'i 48 da ke gaba da duban dan tayi don kada ya shafi ingancin hoton.

Ma'aikacin suturar ciki na mahaifiyar da za ta kasance tare da ruwan gelled don sauƙaƙe hanyar duban dan tayi. Sa'an nan, zai motsa binciken a cikin ciki don samun hotuna daban-daban, ko sassan, na jaririn. Wannan duban dan tayi na biyu yana dadewa kadan fiye da na farko domin yana nazarin cikakken yanayin jikin jaririn.

Babban makasudin wannan duban dan tayi shine a nemo abubuwan da ba a saba gani ba. Mai aikin zai yi nazarin kowace gabo ta hanyar yin sassa daban-daban waɗanda ke ba da izinin, a kowane “matakin”, don sarrafa kasancewar da siffar gabobin daban-daban: zuciya, ƙwaƙwalwa, gabobin ciki (ciki, mafitsara, hanji) , gaba dayansu hudu.

A lokacin wannan binciken ne aka fi gano nakasuwar tayin cikin sauƙi. Duk da haka, ko da yake yana da ƙarin inganci da ƙwarewa, duban dan tayi ba abin dogara 100% ba. Wani lokaci yakan faru cewa anomaly tayi, ko da yake a wannan matakin na ciki, ba a gano shi ba yayin wannan duban dan tayi. Wannan yana faruwa a lokacin da rashin lafiyar jiki ba ko kuma da wuya a iya samuwa a cikin hoton, matsayi na tayin yana rufe rashin lafiyar jiki, ko kuma lokacin da mahaifiyar gaba ta kasance mai kiba. Maganin adipose na subcutaneous na iya haƙiƙa yana tsoma baki tare da wucewar duban dan tayi kuma ya canza ingancin hoton.

Yayin wannan duban dan tayi na biyu, ma'aikacin kuma yana duba:

• girma baby ta amfani da kwayoyin halitta (ma'auni na diamita na biparietal, cranial perimeter, kewayen ciki, tsawon femoral, diamita na ciki mai juyayi) sakamakon wanda za a kwatanta shi da ci gaba mai girma;
• mahaifa (kauri, tsari, matakin sakawa);
• adadin ruwan amniotic;
• budewar ciki na mahaifa musamman a yayin da ake ciki.

Har ila yau, a cikin wannan duban dan tayi na biyu ne sanarwar jima'i na jariri ya faru - idan iyaye suna so su sani ba shakka - da kuma idan jaririn yana da kyau. A wannan mataki na ciki, an kafa al'aurar waje kuma ana iya gane su a cikin hoton, amma akwai ƙananan kuskuren kuskure, dangane da matsayi na jariri musamman.

Wani lokaci ana yin Doppler yayin wannan duban dan tayi. Tare da sautunan da aka rubuta akan jadawali, yana taimakawa wajen sarrafa jini a cikin tasoshin jini daban-daban da arteries (jiyoyin mahaifa, arteries na umbilical, arteries na cerebral). Kayan aiki ne na ƙarin don sarrafa girman tayin a wasu yanayi masu haɗari ko rikice-rikice na haihuwa (1):

• ciwon sukari na gestational;
• hauhawar jini;
• ciwon tayi;
• jinkirin girma a cikin utero (IUGR);
• rashin daidaituwa na ruwan amniotic (oligoamnios, hydramnios);
• rashin lafiyar tayin;
• ciki monochorial (cikin tagwaye tare da mahaifa guda ɗaya);
• cututtuka na mahaifa da suka rigaya (hawan jini, lupus, nephropathy);
• tarihin cututtukan cututtukan mahaifa (IUGR, pre-eclampsia, zubar da ciki);
• tarihin mutuwa a cikin mahaifa.

A wannan mataki na ciki, jariri yana da kusan 25 cm daga kai zuwa ƙafa, rabin girman haihuwarsa. Yana auna kawai 500 gr. Ƙafafunsa sun kai kusan 4 cm (2).

Har yanzu yana da daki da yawa don motsawa, koda kuwa mahaifiyar mai jiran gado ba koyaushe tana jin waɗannan motsin ba. Ba ya iya gani amma yana da matukar damuwa da taba. Yana kwana kusan awa 20 a rana.

Ƙafafunta, hannayenta sun bayyana a fili, har ma da hannayenta da kyawawan yatsunsu. A cikin bayanin martaba, siffar hancinsa yana fitowa. Zuciyarsa tana da girman zaitun, kuma a cikinsa dukkan sassan hudu suna nan kamar jijiya na huhu da aorta.

Muna ganin kusan dukkanin vertebrae wanda a cikin hoton, ya zama nau'i na tsayawa. Ba shi da gashi tukuna, amma sauƙaƙan ƙasa.

Ga iyaye, wannan duban dan tayi na biyu sau da yawa ya fi dadi: jaririn yana da girma don mu iya ganin fuskarsa, hannayensa, kafafunsa, amma har yanzu ƙananan isa ya bayyana a cikakke akan allon kuma ya ba da damar bayyani na wannan kadan. kasancewar an riga an tsara shi sosai.

Lokacin da ake zargin rashin daidaituwar dabi'ar halittar jiki, ana mayar da mahaifiyar da za ta kasance zuwa cibiyar tantancewar haihuwa da / ko mai daukar hoto. Ana yin wasu gwaje-gwaje don tabbatar da rashin lafiya da kuma tsaftace ganewar asali: amniocentesis, MRI, cardiac ultrasound, MRI ko fetal scan, huda jinin tayi, gwajin jini ga ma'aurata, da dai sauransu.

Wasu lokuta gwaje-gwaje ba su tabbatar da anomaly. Sa'an nan a ci gaba da lura da ciki a kullum.

Lokacin da cutar da aka gano ba ta da tsanani, za a kafa takamaiman bi-bi-da-bi don ragowar ciki. Idan ana iya magance matsalar rashin lafiya, musamman ta tiyata, tun daga haihuwa ko kuma a farkon watannin rayuwa, za a shirya komai don aiwatar da wannan kulawa.

Lokacin da ganewar asali na haihuwa ya tabbatar da cewa jaririn yana fama da "wani yanayi na musamman wanda aka gane ba zai iya warkewa ba a lokacin ganewar asali" bisa ga matani, doka (3) ta ba da izini ga marasa lafiya su nemi izinin dakatar da ciki (IMG) ko " zubar da ciki na warkewa” a kowane lokaci na ciki. Takamaiman tsarin da Hukumar Biomedicine ta amince da su, Cibiyar Kula da Cututtuka ta Multidisciplinary for Prenatal Diagnosis (CPDPN), suna da alhakin tabbatar da tsanani da rashin lafiyar wasu cututtukan mahaifa kuma don haka ba da izini ga IMG. Waɗannan su ne cututtuka na kwayoyin halitta, nakasawar chromosomal, rashin lafiyar jiki ko rashin lafiya mai tsanani (na kwakwalwa, zuciya, rashin koda) wanda ba zai iya aiki ba lokacin haihuwa kuma yana iya haifar da mutuwar jariri a lokacin haihuwa ko a farkon shekarunsa. , kamuwa da cuta wanda zai iya hana rayuwar jariri ko kuma ya haifar da mutuwarsa a lokacin haihuwa ko a cikin shekarunsa na farko, cututtukan cututtuka da ke haifar da mummunar nakasa ta jiki ko ta hankali.

A lokacin wannan duban dan tayi na biyu, ana iya gano wasu matsalolin ciki:

• Ciwon girma na intrauterine (IUGR). Sa'an nan kuma za a yi saka idanu na girma na yau da kullum da kuma duban dan tayi na Doppler;
• rashin daidaituwar shigar mahaifa, kamar placenta praevia. Na'urar duban dan tayi zai saka idanu akan juyin halittar mahaifa.