Mitsara miviri inofarira pamuedzo, kusingagumi kunofadza kubva kungofungidzira kuberekwa kwemazuva ekupedzisira, kushanyira kunozouya kumadzimai ekubvunzurudza kwevakadzi uye nzira dzakawanda dzekuongorora ... Hongu, pasina mubvunzo, kunetseka, asi mukurwa kwemwana ane utano, zvose izvi zvinongororwa zvinodikanwa, uye unofanira kuzvibata ane basa guru, kuitira kuti gare gare raisazova rinorwadza zvinorwadza.
Zvirwere zvisingaperi zvemukadzi, zviratidzo zvayo zvisingaonekwi munyika dzakawanda, zvinogona "kutenderera kumusoro" panguva yekuzvitakura, uye kusava nehutachiona hwehutachiona hwehutachiona hunowanzova chiratidzo chakavanzwa. Ndokusaka vanachiremba vakanyatsorayirwa kuti vaongororwe kutapukirwa pakurongwa kwekuita pamuviri, kunyange kana amai vanotarisira vachinzwa hutano hwakakwana. Mushure mezvose, migumisiro yavo panguva yekuzvitakura yakasiyana - kubva mukuputsa kwekukura kwayo kusvikira pakuguma kwehupombwe kana kuberekwa kwemwana ane maitiro akakura ekurwara. Uye kurapwa kwezvirwere zvemukati munguva yekusununguka kwakaoma nekuda kwekudziviswa kwekusarudzwa kwemishonga inogona kushandiswa nevakadzi vane pamuviri.
Intrauterine (VUI) chirwere chema fetus kana mavairasi anobva kuberekwa, mabhakitiriya, mamwe majekesheni muUtero (kuburikidza ne-placenta, kazhinji-amniotic fluid) kana panguva yekutapukirwa kwechirwere ichi. Muzviitiko zvakawanda, zvinobva kune hutachiona - muviri weamai, zvirwere zvisingagumi zvejenitourinary system (kupera kwechirusix vaginitis, endocervicitis, pyelonephritis, kuputika kwechibereko chekuberekwa, etc.). Panguva imwecheteyo, njodzi yekuwana VUI inowedzera nehutachiona hwehutachiona humwe kana mumwe pathogen panguva yekuzvitakura. Uyewo, nehuwandu hwehuwandu hwehutachiona, zvinokonzerwa nehutachiona hwemukati hungave nzira dzinopesana dzekudzivirira pamuviri: amniocentesis, placentocentesis, kuiswa kwemishonga yakasiyana-siyana kuburikidza nemutsara wembilical, nezvimwe zvakadaro.
Kune zvirwere zvinotungamirira kumatambudziko akakomba, zvinosanganisira zvirwere TORCH-yakaoma:
- toxoplasma (toxoplasma);
- vamwe (zvimwe zvirwere, zvinosanganisira syphilis, chlamydia, inferovirus infection, hepatitis A, B, gonococcal infection, listeriosis, zvichida maserosi, mumapu);
- rubella (rubella);
- cytomegalovirus (cytomegalovirus);
- herpes (herpes)
Ngatimbokurukurai zvakanyanyisa maitiro makuru emishonga inonzi intrauterine inokonzerwa nezvirwere izvi:
- Toxoplasmosis kana izvo zvinonzi "zvirwere zvitsvina" zvinoshamiswa nemaruva emasikirini e toxoplasma, ayo anowedzera munguva yakaoma yehutachiona mumasero evanhu, shiri nemhuka. Utachiona hunowanzoitika nekubatana nehutachiona hwehutachiona hwekatsi, ivhu, nekushandisa nyama yakasvibirira, kusashambwa mishonga nemichero, kashoma - nekuwedzerwa ropa. Nzira yekutapurirwa kwehutachiona inongotarisa chete: kubva kuna amai kuenda kune fetus. Chirwere ichi chinogona kuonekwa nekuongorora ropa uye kunyatsorapwa pakuberekwa nema antibiotic ane spiramycin, iyo inobatsira kuderedza dambudziko rekukura kweVUI mu fetus kusvika 1%.
- Kuti zvive nehutachiona hwehutachiona hunokonzerwa nehutachiona hwehutachiona , pachikwata chekuita pamuviri kuronga zvinodiwa kupfuudza kuongorora kwehupo hwehutachiona huripo hwechirwere ichi. Kuvhara pamuviri panguva yekuzvitakura, kunyanya mumatatu ekutanga, kune ngozi zvikuru nekuda kwekushayikwa kwehutano hwakanaka uye kukanganisa kwakanyanya kwekuzvarwa kwemafuro emucheche. Ngozi yekuparara nekufa kwekufa kunowedzera kusvika kanomwe. Kupindira kwehutachiwana kumucheche, kusanganisira nhengo dzaro, kunoitwa mutsika panguva yechikamu chakaoma chechirwere chaamai. Muedzo wakanaka wekubatsira rubella musati wechirwere unogona kuratidza hutachiona hwechirwere ichi nekuda kwekuwedzerwa kwehuduku (maererano nehuwandu, anenge 90% yevana vanotambura nerubella vasingagadziri) kana vachirangwa munguva ino.
- Cytomegalovirus (CMV) ndiyo inokonzera causative agent ye intrauterine cytomegalovirus, inogona kukonzera kukanganiswa kwezviviri zvemukati nehuropi hwomukomana. Dambudziko rekudzidzira IVF uye chimiro chemucheche yakakanganiswa kunobva pakuvapo kwezvirwere mumamai uye nguva yehutachiwana hwehutachi. Pakutanga utachiona hwemamai, hutachiwana hwehutachiona hwema fetus huri makumi matatu. Nokudaro, vakadzi vasina zvirwere zvemagetsi ku CMV, vanokurudzirwa mwedzi mumwe nomumwe kutarisa zvirwere zvemakondomu kumakondomu eVMV uye zvirwere zvekuita zvirwere, kunyanya panguva yekudzivirira mumazamu-munguva yechando. CMV inogona kuwanika mumvura yose yemuviri, maererano neiyi, inogona kutapukirwa nemhepo ine simba uye zvepabonde, kuburikidza nekupfuura kuburikidza nezera rekuberekwa uye kunyange nekuyamwisa. Ndokusaka mukana wepamusoro wehutachiona hunowira mugore rokutanga roupenyu hwomwana. Munhu anogona kuva mutakuri we CMV pasina kuratidzwa kwezviratidzo zvakasiyana zvechirwere (clinical picture inofanana neBARAL ARD), asi panguva imwechete iyo inotangira chirwere, mumatambudziko mazhinji nekuderera kwehutachiona huse.
- Intrauterine herpetic utachiona hunokonzerwa nehutachiona hwe hepes simplex, iyo yakapararira uye CMV. Herpes yemhando yekutanga inowanikwa munenge ma100% evanhu vakuru, asi mu 95% emhosva, inokonzera kutonhora. Kuvharirwa kwema fetus kunogona kuitika nehutachiona kubva mumuviri wemukati kana kuburikidza neropa, iyo inokanganisa placenta, fetus, yakazara nekuumbwa kwepenital. Zvinogona kufa rufu rwechi fetus panguva chero ipi zvayo yekubatsira, kana kupfuura nomugero wekubereka kunogamuchira utachiona hunenge 1% yezvibereko. Mukana wekutapukirwa kwechecheche mubereki herpes (herpes yechipiri rudzi) muchikamu chakaoma kana kana chiitiko chekuwedzera kwechirwere chacho chisingaverengeki 40%. Mishonga inonyanya kutakura pamuviri inogona kutungamirira kudiwa yekubvisa pamuviri, pane imwe nguva, uye nguva dzose, nekutarisa kwekusimudza fetus uye mamiriro ayo, maitiro e-ultrasound-based angangodaro kurapwa nemishonga inorwisa (acyclovir) uye kuisa zvirwere zvemishonga. Mukana wekukundwa kwemazino emukadzi, chikamu chekudya chinokurudzirwa. Utachiona hweHerpetic muzvitsva zvinogona kuonekwa nemaronda epakati peganda kana maziso (ophthalmoherpes).
Diagnostics yeVUI
Kupiwa latency (latency) yezviratidzo zveVUI, kuonekwa kwekuvapo kwezvipatara zvemukati kwakaoma, asi zvinogoneka kuburikidza nemubatsiro wezviitiko zvinotevera zvekuongorora.
DNA tsvakurudzo inoshandisa nzira yePCR (polymer-chain reaction) - inoshandiswa pakuonekwa kwezvirwere zvezvirwere zvepabonde (STDs). Nheyo dzekudzidza iri kutora kubva kumadzimai edzimba. Mhedzisiro ndeye ruzivo pamusoro pemutakuri kana kuti kuvapo kwechirwere chinotapukira. Kujekesa kuongororwa, zvichienderana nehuwandu hwepathogen, zvidzidzo zvinowanikwa zvinogona kuitwa nenzira yeBacteriological tsika uye kuongorora ropa. Kuongororwa kweropa ye intrauterine utachiona neE ELISA (enzyme immunoassay)