Izwi rokuti "tsika yekuparara kwepabonde" mumakumbo anovhiringidza inowanzoshandiswa kurondedzera mamiriro ayo maviri kana mamwe maitiro ekuvhiringidzika akanganiswa mumutsara. Panguva imwecheteyo, kukanganisa kunogona kuitika zvose munguva pfupi uye mu 2-3 trimester. Ngationei nezvechirwere ichi mune zvakawanda, ticharondedzera zvikonzero.
Tsika yekuparara kwekudzivirira pamuviri - zvinokonzera
Kuongororwa kworudzi urwu rwechiremba kunoratidzira kakawanda apo chirongwa chekubereka mwana chinokanganisa panguva imwechete 2 kana kupfuura dzimwe nguva mumutsara. Apo kuongororwa kwekuparara kwepasi, zvikonzero zvaro zvakasiyana, vanachiremba vanoita kuongororwa kwakazara kwechiitiko chemuviri wevakadzi vane pamuviri. Maererano nekucherechedza nezvezvokurapa, urwere urwu hunomuka semugumisiro we:
- Chromosomal kusakanganisika. Inenge 60% yezviitiko zvose zvekugumburwa kwegore rekuita kwechikwata kune chikonzero ichi. Pakati pezvinowanzokanganisa trisomy ndeye 18, 22, 14, 15, chromosomes. Izvi zvirwere zvinowanzokonzera kubuda kwepabonde pavhiki 12.
- Kuzvidzivirira kwemitemo. Zvinowanikwa mu80% yevakadzi vane chirwere ichi kunove nekugadzirwa kwe interferon-gamma mukupindura kune fetal antigens iripo. Zvakakosha kuziva kuti kudengenyeka kwepamusoro kunowedzera huwandu hwezvirwere zvinokonzera mavhopupu embryo muropa rega reamai.
- Kunetseka mamiriro ezvinhu. Mumamiriro ezvinhu akadaro, kubudiswa kwezvinhu izvo zviri chikamu chemuviri wezvirwere zvekuzvidzivirira mumuviri kunoratidzwa. Kunyange zvakadaro, pane kuderedza kwemidziyo yeropa yepentecenta, iyo inoita kuti fetus.
- Hormonal disorders. Kune mhando dzakawanda dzisina kushandiswa kweHommonal system iyo inotungamirira kukuvhiringidzika: kuwedzerwa kufanana kwevarume vebonde, hyperprolactinaemia, kuvhiringidzika kwetachiona gland.
- Matambudziko eAnatomic ezvo nhengo dzomuviri. Maererano nehuwandu hwemashoko, kusagadzikana mukugadzirwa kwehutano kunotungamirira kukurudzirwa kwemasimba mune 12% yematambudziko.
- Zvirwere zvinotapukira zvinotapukira muhutano hwekubereka. Pakati pezvirwere zvinotapukira zvinokonzera kukanganisa kwechibvumirano chero nguva: mycoplasmosis , chlamydia, ureaplasmosis.
- Migumisiro yezvinhu zvekunze (ngozi dzebasa, doro rinoshandiswa, nicotine).
Usingadi kutora pamuviri
Kuparara kwepabonde panguva yepakutanga kunowanzonyorwa kune vakadzi vechidiki vane mamiriro ekudzivirira emasimoni. Mukuwedzera, zviitiko zvinotevera zvinotungamirira kukanganisa kwegadziriro yekubata panguva yekutanga kwayo:
- chromosomal kusagadzikana mu fetus;
- mhando dzakakura dze toxicosis ;
- kusagadzikana mune chimiro chemuviri wekubereka (kuisa mukati mushure mekugadzirisa kubata pamuviri hakugoneki nekuda kwechirwere chemuviri weutter).
Kusada kwekuita pamuviri pamhedziso
Kutsigira kwehurumende, kugadziriswa kwematanho pamatanho ekupedzisira, kunokonzera kukura kwechimwe chinhu chisingaoneki mu 2 uye 3rd trimester. Zvisinei, hazvigoni kubvisa zvachose zvakadaro. Pakunonoka kwemazuva ekupedzisira, kubuda kwepabonde kunowedzera, zvikonzero zvingangodaro zvinotevera:
- kushaya kukwana - kusagadzikana kwemaitiro ekugadzirisa uye kukura kwenzvimbo yemwana, kushanda kwayo;
- kusagutsikana kwechibereko chemuviri • kuzarurwa kwechirwere chechibereki kunowanzokonzera kubvisa pamuviri kwepabonde uye kuberekwa nguva isati yaitika;
- zvipembenene zve genitourinary sphere
- gestosis - chiitiko chakafambidzana nekubudirira kwekududzwa kwedema, kuwedzera kweropa.
Kuongororwa kwekuenda kwepamuviri
Kuongororwa kwe "chimiro chekuperevedza" kunogadzirwa nachiremba zvichienderana nemigumisiro yekuongorora kwakazara. Kuongororwa kwekuputsa uku kunosanganisira:
- kubvunzurudza kwezvenyanzvi;
- Ultrasound kana MRI yezviputi;
- endoscopy ye uterine cavity;
- kuongororwa kweropa kwemazinga ehomoni (TSH, FSH, progesterone, LH);
- kuongororwa ropa kwe cytomegalovirus, herpes;
- Smears kubva kuUrethra nemukadzi;
- endometrial biopsy;
- kuongororwa ropa kune miviri yeAntispermal;
- kuongororwa pamusoro pekugara nhaka kune trombo.
Tsika yekuparara kwekudzivirira pamuviri - kurapwa
Paunenge uchitarisa "kutadza kusununguka", chirwere chinotanga mushure mokunge chikonzero chemu murwere chave chichizivikanwa. Chirongwa chekurapa zvakananga chinoenderana nechikonzero chakakonzera chirwere. Nzira yekurapa inogadzirwa nachiremba mumwe nomumwe zvichienderana nemigumisiro yeongororo. Kazhinji nzira yekurapa yakareba, ine zvikamu zvakasiyana-siyana.
Saka, kana mukadzi ane sarudzo dzemukati muchirwere chinokonzera kubuda kwepamuviri kwehupamuviri hwakatanga, kurapwa kunosanganisira kupindira kwekuvhiya kuti ubvise. Nekushaya simba kwechindori chemuviri munharaunda yemudzinza, vanachiremba vanomisa mapurisa akasiyana-siyana anodzivirira muromo wechibereko kubva pakuzarura, kudzivirira kuberekwa kusati kwapera. Saka zvinobvira kudzivisa zvinetso, kuchengetedza fetus.
Nekuchinja kwehomoni, chikonzero chekurapa chirwere chakadaro sekugara kwepamuviri kwekuita pamuviri ndiyo nzira yemishonga inorwisa mabhakitiriya. Progesterone kusagutsikana kunowanzokonzera kukura kwekubvisa pamuviri. Muchiitiko chekusaremara kwemajini kunokonzera kukanganisa kuberekwa pasinei neshoko, nzira chete yekubuda nayo ndeye IVF uchishandisa mupiro ejaculate kana mazai.
Kubata kusina kutsanangurwa - kutarisa kwemazuva ano dambudziko
Genotyping hemostasis nekugara kwepamuviri isiri nzira yekufambisa yekuongorora chirwere, nekuratidza thrombophilia. Nechirwere ichi, kune chirevo chekugadziriswa kwemukati maitiro eropa clots. Somugumisiro, kusvibiswa kweropa kunoderera. Kazhinji chirwere chacho chinotora. Mukuwedzera kune hutano hwakadaro sechiitiko chekusununguka kwemaitiro, chirwere chepachivi chinokonzera chirwere chinogona kukonzera:
- intrauterine kukura kunonoka;
- placental insufficiency;
- kucherekera toxicosis.