Kev muaj menyuam tab tom npaj. Ua ntej yuav xeeb tub, nws raug pom zoo kom ua tiav kev mus ntsib preconceptional thiaj li yuav muab tag nrho cov kev pheej hmoo ntawm nws sab cev xeeb tub thiab cev xeeb tub yam tsis muaj teeb meem. Tsom ntsoov rau qhov tseem ceeb thiab cov ntsiab lus ntawm qhov kev kuaj mob tshwj xeeb rau leej niam yav tom ntej.

Kev kuaj xyuas kev noj qab haus huv ua ntej txoj kev npaj cev xeeb tub tso cai rau koj los tshawb pom cov xwm txheej uas tuaj yeem cuam tshuam rau kev xeeb tub, pib cev xeeb tub noj qab haus huv thiab txheeb xyuas qhov teeb meem uas tuaj yeem ua rau cev xeeb tub. Nyob rau hauv luv luv, nws yog hais txog coj ua ke tag nrho cov mob kom cev xeeb tub thiab rau lub cev xeeb tub no mus raws li zoo raws li tau.

Kev kuaj xyuas ua ntej yog pom zoo los ntawm Haute Autorité de Santé (1) rau txhua tus poj niam uas npaj yuav muaj menyuam. Nws yog ib qho tseem ceeb nyob rau hauv cov kev tshwm sim ntawm ib tug loj obstetric teeb meem thaum lub sij hawm cev xeeb tub yav dhau los los yog ntawm ib tug me nyuam raug kev txom nyem los ntawm ib tug loj pathology. Qhov kev sab laj no tuaj yeem ua nrog tus kws kho mob, kws kho mob poj niam cev xeeb tub lossis tus kws yug menyuam, thiab yuav tsum muaj ua ntej pib "kev sim me nyuam", qhov zoo tshaj plaws nyob rau yav tom ntej txiv.

Qhov kev mus ntsib ua ntej no suav nrog cov khoom sib txawv:

• Un kev ntsuam xyuas (qhov siab, qhov hnyav, ntshav siab, hnub nyoog).

Kev saib xyuas tshwj xeeb yog them rau qhov hnyav vim tias rog dhau tuaj yeem txo qis fertility thiab ua rau muaj kev pheej hmoo ntawm cov teeb meem thaum cev xeeb tub. Ib yam li ntawd, qhov nyias nyias tuaj yeem cuam tshuam rau fertility. Txawm hais tias ua ntej xav txog kev xeeb tub, kev txhawb nqa zaub mov tuaj yeem pom zoo.

• kev kuaj gynecological

Txhawm rau kuaj seb lub tsev menyuam thiab zes qe menyuam puas zoo li qub, palpation ntawm lub mis. Thaum tsis muaj smear tsawg dua 3 xyoos, ib qho smear yog ua ib feem ntawm kev kuaj mob qog noj ntshav (2).

• kawm txog keeb kwm ntawm obstetric

Thaum muaj teeb meem thaum cev xeeb tub yav dhau los (kev mob ntshav siab, ntshav qab zib gestational, kev yug ntxov ntxov, kev loj hlob qeeb hauv utero, fetal malformation, tuag hauv utero, thiab lwm yam), cov kev ntsuas tau tuaj yeem ua kom tsis txhob rov tshwm sim thaum cev xeeb tub yav tom ntej.

• ib qho kev hloov tshiab ntawm keeb kwm kho mob

Thaum muaj mob lossis keeb kwm ntawm kev mob (kab mob plawv, mob vwm, ntshav qab zib mellitus, kub siab, kev nyuaj siab, mob qog noj ntshav, thiab lwm yam), nws yog ib qho tseem ceeb uas yuav tsum tau coj mus rau hauv tus account qhov tshwm sim ntawm tus kab mob ntawm kev xeeb tub thiab cev xeeb tub tab sis kuj rau cov neeg mob. ntawm cev xeeb tub ntawm tus kab mob, nrog rau kev kho mob thiab hloov nws raws li xav tau.

• tsev neeg keeb kwm kawm

Txhawm rau tshawb nrhiav cov kab mob sib kis (cystic fibrosis, myopathies, hemophilia…). Qee qhov xwm txheej, kev sib tham txog caj ces yuav raug pom zoo txhawm rau txheeb xyuas qhov txaus ntshai rau tus menyuam hauv plab, qhov muaj peev xwm ntawm kev kuaj mob thiab kev kho mob.

• kuaj ntshav

Tsim kom muaj pawg ntshav thiab rhesus.

• kev tshuaj xyuas ntawm txhaj tshuaj

Los ntawm cov ntaub ntawv txhaj tshuaj lossis cov ntaub ntawv kho mob. Kev kuaj ntshav kuj tseem raug coj mus kuaj tshuaj tiv thaiv kab mob sib kis: rubella, kab mob siab B thiab C, toxoplasmosis, syphilis, HIV, kab mob qhua pias. Nyob rau hauv qhov xwm txheej uas tsis yog txhaj tshuaj tiv thaiv kab mob rubella, nws raug nquahu kom txhaj tshuaj tiv thaiv ua ntej kev xeeb tub (3). Rau cov neeg muaj hnub nyoog tshaj 25 xyoo uas tsis tau txais cov tshuaj tiv thaiv kab mob pertussis, kev ntes tuaj yeem ua rau muaj hnub nyoog 39 xyoos; Nws raug pom zoo rau cov niam txiv uas muaj kev npaj niam txiv ua ntej pib xeeb tub (4).

• un kev kuaj hniav kuj tau qhia ua ntej cev xeeb tub.

Thaum lub sij hawm mus ntsib ua ntej no, tus kws kho mob tseem yuav tsom mus rau kev noj cov khoom ntawm nkawm niam txiv txoj kev ua neej txhawm rau txheeb xyuas qhov muaj feem cuam tshuam rau kev xeeb tub thiab cev xeeb tub, thiab tawm tswv yim txhawm rau txwv lawv. . Qhov tseem ceeb:

• txwv tsis pub haus cawv los ntawm lub sijhawm xeeb tub
• txwv tsis pub haus luam yeeb lossis tshuaj
• zam kev noj tshuaj rau tus kheej
• txwv kev raug rau tej yam tshuaj

Thaum tsis muaj kev txhaj tshuaj tiv thaiv kab mob toxoplasmosis, tus poj niam yuav tsum tau ua qee yam kev ceev faj thaum lub sijhawm xeeb tub: ua tib zoo noj nws cov nqaij, tsis txhob noj cov qe nyoos, cov khoom siv mis nyuj nyoos (xws li cheese), nyoos, ntsev los yog haus cov nqaij txias, ntxuav txiv hmab txiv ntoo thiab zaub npaj kom noj nyoos, ntxuav koj txhais tes kom huv si tom qab ua teb, tso siab rau cov kev hloov ntawm tus miv lub litter rau koj tus khub.

Qhov kev mus ntsib ua ntej no yog thaum kawg lub sijhawm rau tus kws kho mob los sau cov tshuaj folate ntxiv (lossis folic acids lossis vitamin B9) vim tias qhov tsis txaus yog cuam tshuam rau tus menyuam hauv plab nrog kev pheej hmoo siab ntawm neural tube kaw abnormalities (AFTN ). Txhawm rau tiv thaiv cov teeb meem loj no, kev siv tshuaj ntxiv tau pom zoo nyob rau theem ntawm 0,4 mg / hnub. Qhov kev noj haus no yuav tsum tau pib sai li sai tau thaum tus poj niam xav xeeb tub thiab txuas ntxiv mus txog 12 lub lis piam ntawm cev xeeb tub. Rau cov poj niam uas muaj keeb kwm ntawm fetuses lossis cov menyuam yug tshiab nrog AFTN lossis cov neeg kho nrog qee yam tshuaj tiv thaiv kab mob (uas tuaj yeem ua rau tsis muaj folate), ntxiv 5 mg / hnub yog pom zoo (4).