Kev xeeb tub thib ob, hu ua morphological ultrasound, yog ib kauj ruam tseem ceeb hauv kev saib xyuas cev xeeb tub vim tias nws tuaj yeem kuaj pom qhov tshwm sim ntawm tus menyuam hauv plab malformations. Rau cov niam txiv, nws kuj yog ib qho tseem ceeb: qhov nrhiav tau ntawm kev sib deev ntawm tus menyuam.

Qhov thib ob ultrasound tshwm sim nyob rau 5th ntawm cev xeeb tub, nruab nrab ntawm 21 thiab 24 lub lis piam, zoo tshaj plaws ntawm 22 lub lis piam.

Nws tsis yog qhov yuav tsum tau ua tab sis yog ib feem ntawm cov kev ntsuam xyuas uas tau sau tseg thaum cev xeeb tub thiab pom zoo heev.

Rau qhov kev sim no, nws tsis tas yuav tsum yoo mov lossis kom muaj lub zais zis tag nrho. Ntawm qhov tod tes, nws tsis pom zoo kom muab cov qab zib lossis roj rau ntawm lub plab thaum 48 teev ua ntej ultrasound thiaj li tsis cuam tshuam rau cov duab zoo.

Tus kws kho mob coats lub plab ntawm leej niam-rau-ua nrog gelled dej los pab txhawb txoj kev hla ntawm ultrasound. Tom qab ntawd, nws yuav txav qhov kev sojntsuam ntawm lub plab kom tau txais cov duab sib txawv, lossis ntu, ntawm tus menyuam. Qhov thib ob ultrasound no siv sijhawm ntev dua li thawj zaug vim nws txoj kev tshawb fawb tag nrho lub cev ntawm tus menyuam.

Lub hom phiaj tseem ceeb ntawm qhov ultrasound no yog txhawm rau nrhiav qhov txawv txav ntawm morphological. Tus kws kho mob yuav ua tib zoo kawm txhua yam hauv nruab nrog cev los ntawm kev ua ntu ntu uas tso cai rau, ntawm txhua "theem", kom tswj tau qhov muaj thiab cov duab ntawm cov kabmob sib txawv: lub plawv, lub hlwb, cov kabmob sib txawv ntawm lub plab ( plab, zais zis, hnyuv) , tag nrho plaub ceg ceg.

Nws yog thaum lub sij hawm kev ntsuam xyuas no uas fetal malformations yog pom tau yooj yim tshaj plaws. Txawm li cas los xij, txawm hais tias nws muaj txiaj ntsig ntau dua thiab muaj txiaj ntsig, morphological ultrasound tsis yog 100% txhim khu kev qha. Qee zaum nws tshwm sim tias qhov tsis txaus ntseeg ntawm fetal, txawm tias tam sim no nyob rau theem ntawm cev xeeb tub, tsis pom thaum lub sijhawm ultrasound. Qhov no tshwm sim thaum lub malformation tsis yog los yog tsis yooj yim mus siv tau nyob rau hauv daim duab, txoj hauj lwm ntawm tus me nyuam hauv plab npog qhov malformation, los yog thaum yav tom ntej leej niam rog. Subcutaneous adipose cov ntaub so ntswg tuaj yeem cuam tshuam nrog kev hla ntawm ultrasound thiab hloov cov duab zoo.

Thaum lub sij hawm thib ob ultrasound, tus kws kho mob kuj kuaj:

• me nyuam loj hlob siv biometrics (kev ntsuas ntawm biparietal txoj kab uas hla, cranial perimeter, plab perimeter, femoral ntev, transverse plab kab uas hla) cov txiaj ntsig ntawm uas yuav muab piv rau txoj kev loj hlob nkhaus;
• placenta (thickness, qauv, theem ntawm insertion);
• tus nqi ntawm amniotic kua;
• qhov qhib sab hauv ntawm lub ncauj tsev menyuam tshwj xeeb hauv cov xwm txheej ntawm contractions.

Nws kuj tseem yog thaum lub sijhawm ultrasound thib ob uas tshaj tawm ntawm tus menyuam qhov kev sib deev tshwm sim - yog tias cov niam txiv xav paub qhov tseeb - thiab yog tias tus menyuam nyob zoo. Nyob rau theem no ntawm cev xeeb tub, sab nraud genitalia yog tsim thiab pom nyob rau hauv daim duab, tab sis ib txwm muaj ib qho me me ntawm qhov yuam kev, nyob ntawm qhov chaw ntawm tus menyuam hauv particular.

Qee zaum Doppler tau ua thaum lub sijhawm ultrasound. Nrog cov suab sau rau ntawm daim duab, nws pab tswj cov ntshav khiav hauv cov hlab ntsha thiab cov hlab ntsha (uterine arteries, umbilical arteries, cerebral arteries). Nws yog ib qho cuab yeej ntxiv rau kev tswj tus menyuam hauv plab hauv qee qhov xwm txheej txaus ntshai lossis teeb meem kev xeeb tub (1):

• gestational ntshav qab zib;
• ntshav siab;
• kev nyuaj siab fetal;
• kev loj hlob qeeb hauv utero (IUGR);
• ib qho txawv txav ntawm cov kua amniotic (oligoamnios, hydramnios);
• fetal malformation;
• cev xeeb tub monochorial (ntxaib cev xeeb tub nrog ib tug placenta);
• cov kab mob uas twb muaj lawm (hypertension, lupus, nephropathy);
• keeb kwm ntawm obstetric vascular pathologies (IUGR, pre-eclampsia, placental abruption);
• keeb kwm ntawm kev tuag hauv utero.

Nyob rau theem no ntawm cev xeeb tub, tus me nyuam yog li 25 cm ntawm lub taub hau mus rau ntiv taw, ib nrab ntawm nws qhov loj me. Nws hnyav tsuas yog 500 g. Nws ob txhais taw yog kwv yees li 4 cm (2).

Nws tseem muaj chaw txav ntau heev, txawm tias tus niam-rau-tus yuav tsis hnov ​​​​cov kev txav no. Nws tsis tuaj yeem pom tab sis nws yog qhov rhiab heev rau kov. Nws pw txog 20 teev ib hnub twg.

Nws ob txhais ceg, nws txhais caj npab qhia meej meej, thiab txawm tias nws txhais tes nrog cov ntiv tes zoo. Hauv profile, cov duab ntawm nws lub qhov ntswg tshwm. Nws lub plawv yog qhov loj ntawm cov txiv ntseej, thiab nyob rau hauv nws tag nrho plaub qhov chaw yog tam sim no raws li pulmonary hlab ntsha thiab aorta.

Peb pom yuav luag tag nrho cov vertebrae uas nyob rau hauv daim duab, tsim ib hom nres. Nws tseem tsis tau muaj plaub hau, tab sis ib qho yooj yim cia.

Rau cov niam txiv, qhov thib ob ultrasound no feem ntau yog qhov qab tshaj plaws: tus menyuam loj txaus kom peb pom nws lub ntsej muag, nws txhais tes, ob txhais ceg, tab sis tseem me me kom pom tag nrho ntawm qhov screen thiab tso cai rau cov ntsiab lus ntawm qhov me me. twb tsim tau zoo lawm.

Thaum lub morphological abnormality yog xav tias yuav, leej niam-rau-tau raug xa mus rau qhov chaw kuaj mob antenatal thiab / los yog ib tug siv sonographer. Lwm yam kev ntsuam xyuas yog ua kom paub meej tias qhov tsis zoo thiab kho qhov kev kuaj mob: amniocentesis, MRI, mob plawv ultrasound, MRI lossis fetal scan, fetal blood puncture, kuaj ntshav rau ob niam txiv, thiab lwm yam.

Qee zaum kev ntsuam xyuas tsis paub meej tias qhov tsis zoo. Kev saib xyuas cev xeeb tub ces rov pib dua li qub.

Thaum kuaj pom qhov tsis txaus ntseeg tsawg dua, kev soj ntsuam tshwj xeeb yuav raug teeb tsa rau qhov seem ntawm cev xeeb tub. Yog tias qhov anomaly tuaj yeem kho tau, tshwj xeeb yog phais, txij thaum yug los lossis thawj lub hlis ntawm lub neej, txhua yam yuav raug teeb tsa los siv qhov kev saib xyuas no.

Thaum qhov kev kuaj mob ua ntej yug menyuam tau lees paub tias tus menyuam raug mob los ntawm "ib qho xwm txheej ntawm lub ntiajteb txawj nqus pom tau tias kho tsis tau thaum lub sijhawm kuaj mob" raws li cov ntawv, txoj cai (3) tso cai rau cov neeg mob thov kev kho mob tsis pub cev xeeb tub (IMG) lossis " kev rho menyuam tawm” nyob rau txhua lub sijhawm ntawm cev xeeb tub. Cov qauv tshwj xeeb tau pom zoo los ntawm Lub Chaw Haujlwm Biomedicine, Multidisciplinary Centers for Prenatal Diagnosis (CPDPN), yog lub luag haujlwm rau kev lees paub qhov hnyav thiab qhov tsis zoo ntawm qee yam kab mob hauv plab thiab yog li tso cai rau IMG. Cov no yog cov kab mob caj ces, chromosomal abnormalities, malformation syndromes los yog loj heev anomaly (ntawm lub paj hlwb, lub plawv, tsis muaj lub raum) inoperable thaum yug los thiab uas yuav ua rau tuag ntawm tus me nyuam thaum yug los los yog thaum ntxov xyoo. , kab mob uas tuaj yeem tiv thaiv kev ciaj sia ntawm tus menyuam lossis ua rau nws tuag thaum yug los lossis thawj xyoo, pathology ua rau muaj kev tsis taus ntawm lub cev lossis kev txawj ntse.

Thaum lub sij hawm thib ob ultrasound no, lwm yam teeb meem ntawm cev xeeb tub tuaj yeem kuaj pom:

• Intrauterine loj hlob retardation (IUGR). Kev saib xyuas kev loj hlob tsis tu ncua thiab doppler ultrasound yuav ua tiav;
• placental insertion abnormality, xws li placenta praevia. Ib qho ultrasound yuav saib xyuas qhov evolution ntawm placenta.