Doppler fetus: kuita uye decoding

Nhasi mune chirwere fetus malformations uye chakaipa chokubuda pamuviri zvirwere vari kuramba vachishandisa midziyo ano unobvumira kutarira dambudziko kubva mukati. Ultrasonic midziyo iri zvinowanzoshandiswa nechirwere uye Kuongororwa zvirwere uye mamiriro dzemuviri. Kudzidza kwakadaro zvakasimba okurapa uye akapotsa chinokosha nedanho pakuongorora uye kurapwa. Kuvakadzi vane mimba, kuwedzera dzose zveBhaibheri kugadza fetus Ultrasound pamwe Doppler velocimetry. Zviri muitiro upi zvipatara.

Doppler

Mumazana yose nguva gestation mwana mukadzi yakatarwa chidzidzo Ultrasound muchina. Panguva dzakasiyana zvokukura pamuviri, fetus Doppler iri basa yokutsvakurudza uye kudzivirira zvokukura zvirwere. Doppler - Ultrasound mumwe mhando, izvo kazhinji kuitwa mumwedzi mishoma pamuviri, kazhinji zviri wechitatu trimester.

Kudzidza ropa nechepakati arteries mudumbu, muchibereko chemusikana, kuti placenta kuongorora ropa kuyerera velocity uye mamiriro midziyo mikuru uye achiine rukuvhute arteries, kupa rutsigiro uye kudya kunovaka mudumbu. Kuti aite Kudzidza kwakadaro kunoda rinokosha kamwene. Kazhinji, Doppler Ultrasound rinoitwa pamwe huru kana anogona kupiwa somunhu yoga dzokuwedzera chiremba, kudzidza.

Kudomwa Ultrasound pamwe Doppler

Doppler kuona chaiyo saizi, kuti dhayamita uye nzvimbo huru arteries, kwete chete muchero, asi vo placenta, achiine rukuvhute tambo, mukadzi dumbu, ropa kubuda velocity nemidziyo, uye rinoitawo kuti nenguva kuziva miedzo kuvapo chero hadzina kufambiswa zvakanaka kana kutsakatika kushanda placenta, iyo angava harbinger pakati siyana zvakaoma kunzwisisa zvose panguva yepamuviri uye panguva basa. Naizvozvo, kukosha pakutsvakurudza kwakadaro hakufaniri kurerutswa. Saka, nenguva Doppler fetus inopangidza pamusoro parameters ayo kubvumira nguva kuti vaite chokudzivirira munyu, kuderedza mamiriro uye kudzivirira zvinobvira njodzi.

Zvairatidza kuti Doppler

Doppler sezvo zvokuwedzera kunodiwa kugadza, kana mukadzi ane pamuviri akawana zvinotevera zvirwere:

• Preeclampsia.
• Vane chirwere cheBP mwoyo chirwere.
• cheitsvo.
• Diabetes mellitus.

Uyewo Doppler mudumbu anogona kupiwa panguva yokutanga kuziva miedzo zvokukura zvirwere, vakaremara, kunonoka kukura, oligohydramnios, mukana kukurumidza kuibvisa iri placenta, achiine rukuvhute tambo abnormalities marongerwo kana vachiberekwa chromosomal abnormalities, yakanyanya siyana chomwoyo uye zvichingodaro. D.

Kudzidza uterine tsinga Doppler nzira

Doppler kudzidza uterine tsinga kuti vaongorore mamiriro enyika vascular ezvinhu muchibereko chemusikana, placenta, mezhresnichnogo nzvimbo. Órgãos mezhresnichnogo nzvimbo kunoitika kunyange panguva embryo muchibereko, ingangoita vhiki pashure pamuviri. Kufamba kweropa iri womukadzi dumbu rinoitwa chete chikamu chezvinhu arteries maviri: ovarian uye uterine. Kunyange munguva paumbwe placenta iri pamadziro arteries, vamwe kuchinja kuitika, vakazochinja kutungamirira kukura kwavo uye kuwedzera kufanana kukura placenta. Kuburikidza iyi, ropa riyerere uteroplacental aumbwa kuti apedzise paumbwe placenta ikawanda 10 nguva.

Uterine tsinga Doppler anobvumira kuti vaongorore kushanda zononoka tsinga inotungamirwa iyo terminates pamusoro 3rd trimester. Kana matambudziko angamuka panguva pamuviri hariwaniki ose arteries ose vasiri kuchinja, saka havaiti chokuwedzera uye kukura panguva kukura placenta. Nokudaro arteries kuva asingakwanisi nechokwadi zvakakwana kuparadzirwa uye ropa riyerere kuti placenta, izvo zvingaita kuti rufu kana kushayiwa zvokudya, okisijeni. Izviwo, kungaita kuti yokuzviparadzanisa yacho placenta, pamuviri uye kubva kwepamuviri.

Doppler: inopangidza

Panguva Doppler kudzidza pamusoro Ultrasound mudziyo chidzitiro anoratidza graphical cherudo ropa kuyerera velocity ari arteries panguva imwe cardiac kutenderera, izvo vakasiyana systolic uye diastolic. Kuti tinzwisise munguva yemberi, chii mungozi, itai inopangidza:

• Systole - muedzo kunokonzerwa kubva rutapudzo mwoyo tsandanyama.
• Diastole - ndiye kufurirwa kwakaita panguva kuzvivaraidza mwoyo tsandanyama.

Saka, mwoyo mumwe vakarova kuverengwa kuoneka mune systolic uye diastolic BP iri arteries. Nokuti mumwe nomumwe bvunzo midziyo ine mitemo yaro uye maitiro chairwo ropa chokubuda velocity makakombama.

Kuongorora mitemo uye zviratidzo ropa vakashandisa zvinotevera indices:

• Systolic-diastolic reshiyo.
• Kufamba kweropa indekisi.
• nemishonga indekisi.

Systolic-diastolic reshiyo, kurova kwemwoyo indekisi uye kurwisa indekisi vanoratidza mamiriro huru arteries uye yeropa uye ropa riyerere mavari, inova chinangwa kudzidza ichi, sezvo Doppler. Dzemunharaunda uye zvarakasiya kwavari kuratidza rakasiyana-siyana kutyorwa fetus, rinotsanangura zvokurwara chokuita mugumisiro ropa riyerere pamusoro mwana kubereka. Saka, chiremba anogona kuongorora kushanda placenta wayo chinhanho, zvokushandisa zviri okisijeni fetus kuburikidza achiine rukuvhute tambo, uyewo zvichibvira kuremara mu fetus chokuita kweropa zvirwere uye nezvirwere zvomwoyo tsandanyama.

Doppler: mitemo

Kuongorora migumisiro Doppler zveBhaibheri vaishandisa rinokosha tafura tsika. Ivo tsanangurai zvose zvinogamuchirika dzemunharaunda Fetal Doppler nokuda zviratidzi zvitatu:

• Systolic-diastolic reshiyo.
• nemishonga indekisi.
• Kufamba kweropa indekisi.

Zvidzidzo zvakadai zvinofanira kuitwa vakadzi zvose pamuviri, asi zvinonyanya kukosha kuti munhu pangozi uye ane matambudziko wokufambisa ropa, kana nhaka urema.

Doppler fetus uye vascular Ultrasound kudzidza anogadzwa kwenguva vhiki 23 pamuviri. Panguva iyi, muitiro uyu unokosha chaizvo kuti kuongorora boka mukana yematambudziko uye placental malformations, izvo zvingaita kuti kugumiswa pamuviri. Asi ongororo kwakadaro kunogona kuitwa kubvira mavhiki 13 kusvika pakuguma pamuviri. vhiki imwe neimwe ine yayo Doppler indices. zvidzidzo zvose izvi zviri kuitwa kuongorora pfungwa arteries matatu: achiine rukuvhute tsinga, uterine, fetus yeropa.

Chakarurama systolic-diastolic reshiyo, kubvira kwevhiki 20 pamuviri, zvinofanira kuva 2.4 zvichidzika.

indekisi nemishonga rinowanikwa nokuda achiine rukuvhute tsinga, uterine, uye MCA. The ndeyokuva:

• nokuti mai - asingasviki kana kuenzana 0,58;
• nokuti achiine rukuvhute tsinga - idukusa kana kuenzana 0.62;
• indekisi anofanira zvishoma pane kana zvakaenzana 0.77 pakati chepfungwa tsinga ane mudumbu.

Nokuti yechipiri yezana pamuviri, nhamba idzi anenge kuchinja. Uye pakazopera nguva gestation zviratidzi ose systolic-diastolic reshiyo haafaniri kupfuudza muzvikamu zviviri.

kuratidza tsika

Doppler 3 trimester fetus ropa kuyerera zvidzidzo uye inoita kuti mangwanani nechirwere, dziviriro chinangwa placental insufficiency, Mabatirwo preeclampsia chete mamirire kuchinja ropa riyerere munzira uterine midziyo. Kuona kuderera Zvichakadaro diastolic tsika, systolic-diastolic reshiyo anochinja zvikuru, uye maererano, mumwe indekisi, dzaona pachishandiswa yaro, ari kuwedzera.

Kana Doppler ari kwetemu pamuviri vainyatsotarisirwa wechipiri uye yechitatu inobhadharwa Nyanzvi achiine rukuvhute tsinga. The achidzidza munyonga ari nechepakati tsinga rimwe achiine rukuvhute tambo ropa anotora zvinokosha pashure wechigumi vhiki pamuviri. In ichi chinhu ropa kuyerera diastolic haigoni kuonekwa kwemavhiki anosvika 14. In fetus chromosomal abnormality chine hunhu pa vhiki 10-13 gestation unowanzovapo akanyorwa diastolic chokubuda neizvi.

In nyore pamuviri zvazvingava systolic-diastolic reshiyo hakuiti kupfuudza zviyero zvitatu pamusoro munyonga kuratidza muropa. For fetus zvokurwara dzinoratidzwa ungaderedza kuguma diastolic velocity kusvikira yakakwana kunyangarika.

By rechishanu mwedzi pamuviri uye mberi chinokosha chirwere zviratidzi vane kutsvakurudza chibereko ropa kuyerera. Rinoongorora chikuru yeropa uye pakati chepfungwa tsinga. Tsika idzi ropa Rwako vane yakakwirira zvikumbaridzo systolic vachimanikidzwa kuchinja yeropa, kazhinji achiperekedzwa vasanyanye diastolic unongotaura. The maduku ndivo, dzakanga mukana pathologies. Chinonyanya vanoshorwa mamiriro chinhu razero ukoshi diastolic zvinoriumba.

Nokuti pakati chepfungwa tsinga zvekuchipatara kuchinja ropa riyerere angaperekedzwa nekusiyana, nokuwedzera diastolic zvinoriumba, izvo zvinozoita chinoratidza chepfungwa hyperperfusion uye chinoratidza kukura fetus hypoxia.

Kudzidza ropa riyerere ari venous mutsinga dzinofamba nemukaka systolic nenhongonya yepasisa zhinji nzvimbo kufarira zviri munyonga uye vari chomumba pasina chimbichimbi kuchinja nguva nenguva dips kuoneka mune diastolic chezvinonhuwira pfupi refu. Saka, zvose munyonga uri substantially dzakafanana pasina vakazvitsaurira unopinza twi. Kana runotaurwa yakakwirira nhongonya pakati rokuti systolic, kana kunyangarika ari diastolic kumanikidzwa, izvozvo zvingaratidza kuti ane chromosomal fetus zvokurwara, uyewo panowanikwa fetus hypoxia.

Kururama Ultrasound Doppler nzira inenge 70%. Inonyatsobudirira kudzidza utero-placental uye fetus-placental ropa aibuda, riri inenge zana muzana kunogona rokuongorora zvinetso zvakasiyana-siyana.

Kunyatsoongorora dzokudzidza zvabuda

Maererano akasiyana indices ropa zvirwere zviratidzi rakakamurwa madhigirii dzakasiyana:

• 1 dhigirii - ichi kunetswa mune uteroplacental ropa riyerere panguva dzose muchero placental ropa kana placental kutyora zvibereko unmodified uteroplacental.
• 2 dhigirii - chinhu chimwe-nguva shanduko uye kuvhiringidza mune zvose mhando Rwako ropa, zviratidzo kuti urege kusvika chero dzinonetsa tsika, asi vane nzvimbo kuva.
• Grade 3 - ndiye Kuwanikwa dzinonetsa kutyorwa maererano nezvibereko-placental ropa kuyerera, pasinei nokuchinja kana kunyange zviduku kutyorwa utero-placental ropa riyerere.

Zvairatidza kuti Doppler kugadzwa

Fetus Doppler anogona kupiwa kamwe kana kaviri paaiita nhumbu sezvo purogiramu muitiro. Dzimwe nguva iri ushandiswe kakawanda. Izvi zvinoitika kana paine ngozi kana pathologies ari mudumbu kana inodiwa ezvinhu dumbu uye placenta. Pane mazita zvairatidza kuti izvo chete vanofanira kuva nechokwadi uye Doppler kuerera zvidzidzo:

• Kana zera raamai ndiwo makore kupfuura 35 kana asingasviki 20 (mangwanani kana kunonoka pamuviri).
• Polyhydramnios uye oligohydramnios.
• On yapfuura kudzidza ikabereka Ultrasound muchina kwakaratidza tambo yakatokura.
• Fetus lags shure hwakagadzwa dzemunharaunda.
• Mai vakacherechedza zvikuru chirwere.
• Kana yapfuura pamuviri yakaguma muna kupfupfudzika kana vana vaine kwazvo vakaremara kana wakaberekwa.
• Kana paine kuva kunyumwira kuti malformations.
• Kana pamuviri pevana vakawanda.
• Kana amai ane kunaka kusapindirana kweropa chinhu, izvo zvinogona kuguma kuramba ari mudumbu pamwe murombo kutenderera.
• At kusingagutsi CTG parameters.
• Kudai waiva nzvimbo pamuviri abdominal kunotevera.

Kana paine kutyiswa pakarepo chidzivaidzo pamuviri, iva nechokwadi kugadzwa Doppler zvidzidzo kuona zvinokonzera kutya kwakadaro. Panyaya iyi, mukadzi akarara rimwe zuva muchipatara, apo nyaya yokutanga riri amutsvaka pamusoro Doppler Ultrasound uye anogamuchira kemikari kurapa kuitira kuchengetedza pamuviri kuti izwi, kuti izvo zvinoita kuitisa wakachengeteka hurukuro shoma ngozi.

Survey Preparation

Kugadzirira Doppler dzepamusha pamuviri zvinokosha kuti vaviri maawa pamberi kushanya US hofisi kutora zvokudya uye zvino chete mvura. Nokuti kutanga kudzidza vanofanira pasi pamubhedha pedyo muchina kumusana kwayo, kuratidza panguva dumbu kubva chipfuva kusvika muhudyu. Pamusoro pemvura mudumbu ane pamuviri vakashandisa mumwe kana kupfuura mumate ane conductive gel chinokosha chinobatsira kupinda ari ultrasonic chiratidzo uye seari chaiyo Switch, izvo kutungamirira zvakanaka pamusoro pechiso mudumbu.

Fetus Doppler anogona kuitwa sechinhu outfits-chena dema-uye, uye panguva ino ruvara umo Ultrasound nyanzvi achaona makakombama ane nhongonya kuti anoratidza kusimba uye mwero zvokutsauka kubva kana ropa riyerere munzira arteries. Zvichitevera kuongororwa, chiremba achaita kuuya nemashoko vakawana panguva kuongororwa, uye nyora navo inopangidza, uye ipapo achapa kwemamiriro Doppler Ultrasound mumaoko mukadzi pamuviri.

Doppler fetus zviratidzo uye avo kududzirwa ichava rubatsiro rakanaka obstetrician-gayinakorojisiti mu basa nevakadzi pamuviri kugadzirira njodzi kukurukura uye masimba matambudziko. Monitoring zvomukati ari mudumbu achishandisa Doppler zvidzidzo zviri itsanangudzo zvikuru uye kwave nemakore akawanda tanakidzwa ayo kunyatsoshanda uye rakavimbika. A kuwedzera nhamba yezvidzidzo ichiitwa mumakore achangopfuura, kutsigira yakachengeteka rokuongorora pamwe Ultrasound michina, kubvisa mukana kukuvadza utano zvose pamuviri uye mwana.