ʻO ka ʻōpū i ka wā hāpai

pēpē puʻuwai hou hānau

ʻO ka hoʻolohe ʻana i ka puʻuwai fetal kekahi o nā mea hoihoi loa e pili ana i ka hāpai ʻana. Akā, i ka manawa hea lākou e hoʻomaka ai e manaʻo? ʻO ka manawa hauʻoli loa o ka hoʻokolokolo gynecological mua ka hiki e hoʻolohe i ka puʻuwai o ka pēpē.

Hoʻomoe ke kauka iā ʻoe ma kahi moe a hōʻike ka ultrasound iā ʻoe i kahi "ʻōmaʻomaʻo liʻiliʻi" a laila aia ka puʻuwai. ʻO ia ka puʻuwai o kāu poʻe liʻiliʻi, e paʻi wikiwiki ana. Akā, mai ka manawa hea i lohe ʻia ai a pehea ka lōʻihi o ke kuʻi ʻana?

I ka pule hea e hoʻomaka ai ʻoe e ʻike i ka puʻuwai o kāu pēpē?

Hiki ke kani ka puʻuwai fetal ʻike i nā lā 34 (ma lalo o 6 mau pule) ʻO ka hānau ʻana me kahi ultrasound transvaginal o ke alapine kiʻekiʻe a me ka maikaʻi maikaʻi.

I ka 6 pule, ka puʻuwai ʻO ka embryo, e paʻi ana i kēia manawa he 110 manawa i ka minuke, he ʻehā keʻena kaʻawale, ʻo kēlā me kēia me ka puka a me kahi puka e hiki ai ke kahe ke koko i loko a i waho. I loko o ʻelua pule wale nō, e piʻi ana kēlā helu i ka 150-170 beats i kēlā me kēia minuke.

Me kēia ulu ʻana a pau, hiki paha hiki iā ʻoe ke lohe i ka puʻuwai fetal no ka manawa mua ma kahi o 9 a 10 mau pule o ka hāpai ʻana, ʻoiai ʻokoʻa ka lā pololei. I kēia manawa, e paʻi ana ma kahi o 170 mau beats i kēlā me kēia minuke, ʻo ia ka wikiwiki e hoʻolohi mai ʻaneʻi ma waho. No ka lohe ʻana, e kau ke kauka a i ʻole ka pale keiki i kahi mea kani ultrasound portable i kapa ʻia ʻo Doppler ma kou ʻōpū e hoʻonui ai i ke kani.

ʻO ka puʻuwai fetal: pehea ka nui o ke kani

ʻO ka puʻuwai puʻuwai ʻike mua ʻia ma kahi ultrasound ma kahi o 6 wiki o ka hāpai ʻana. ʻO ka puʻuwai fetal i kēia māhele maʻamau ma waena o 100 a me 120 beats i kēlā me kēia minuke (bpm).

ʻO ka puʻuwai fetal maʻamau (FHR) maʻamau ma waena o 120 a me 160 beats i kēlā me kēia minuke (bpm) i ka wā intrauterine. Hiki ke ana ʻia ma ka ultrasonographically mai kahi o 6 pule, a ʻokoʻa ka laulā maʻamau i ka wā o ka hāpai ʻana, e piʻi aʻe ana ma kahi o 170 bpm i nā pule he 10 a ma hope iho e hoʻemi ana ma kahi o 130 bpm i ke kau.

Evolution ma o ka hapai

ʻOiai e hoʻomaka ana ka myocardium e ʻaelike i loko o 3 mau pule o ka hāpai ʻana (mai nā pūnaʻi pacemaker myocardial depolarized i loko o ka puʻuwai embryonic), ʻike mua ʻia ia ma ka ultrasound ma kahi o 6 mau pule o ka hāpai ʻana. No laila, ʻO ka HRF ma kahi o 100-120 beats i kēlā me kēia minuke (bpm).

Piʻi ka FHR i nā pule he 2 a hiki i 3 a lilo i:

  • ~110 bpm (awelika) i loko o 5 a 6 pule
  • ~170 bpm i 9-10 pule

Ma muli o ka emi ʻana o ka FHR, ma ka awelika, lilo ia:

  • ~150 bpm i 14 pule
  • ~140 bpm i 20 pule
  • ~130 bpm i kēlā me kēia kau

ʻOiai maʻa mau ka puʻuwai i loko o kahi pēpē olakino, hiki ke ʻae ʻia ka hoʻololi ʻana i ka beat-to-beat ma kahi o 5 a 15 mau pahu i kēlā me kēia minuke.

nā wāwae pēpē ʻulaʻula puʻuwai a me ka pepa

Pilikia pili

Ua kapa ʻia ka puʻuwai lohi o ka fetal Fetal bradycardia a ua wehewehe pinepine ia penei:

  • FHR <100 bpm ma mua o 6,3 pule o ka hāpai ʻana, a i ʻole
  • FHR <120 bpm ma waena o 6,3 a me 7,0 pule

Kapa ʻia ka puʻuwai fetal wikiwiki ʻo ka tachycardia hānai a ua wehewehe pinepine ia penei:

  • FHR > 160-180 bpm 5,7
  • Hiki ke helu ʻia ka puʻuwai o ka puʻuwai ma kahi o 170 bpm ma ke ʻano he borderline fetal tachycardia
  • ʻO ka wikiwiki a me ka maʻamau o ka puʻuwai fetal ka mea maʻamau i kapa ʻia he fetal tachyarrhythmia.

Pehea ka lohe ʻana a me ka nānā ʻana o ka puʻuwai

Hiki ke lohe ʻia ka puʻuwai o ka pēpē ma nā ʻano like ʻole, i nā manawa maʻamau (intermittent auscultation) a i ʻole mau (electronic fetal monitoring (EFM).

auscultation intermittent

ʻO ia kahi e hoʻolohe ʻia ai ka puʻuwai o kāu pēpē i nā manawa maʻamau me kahi pinard a i ʻole kahi mea uila liʻiliʻi liʻiliʻi i kapa ʻia ʻo Doptone.. Inā maikaʻi kou olakino a maʻemaʻe kou hāpai ʻana, ʻo ia ke ala i ʻōlelo ʻia e hoʻolohe ai i ka puʻuwai o kāu pēpē i ka wā hana.

Hoʻolohe nā palekeiki a me nā kauka i ka puʻuwai o kāu pēpē no hoʻokahi minute piha, i kēlā me kēia 15 mau minuke i ka wā i hoʻokumu ʻia ai ka hana, a laila pinepine pinepine i ka wā e kokoke mai ana ka hānau ʻana.

Ka nānā 'ana i ka Fetal Fetal (EFM) 

Aia ma hea Hoʻolohe mau ʻia ka puʻuwai o kāu pēpē me ka hoʻohana ʻana i kahi mīkini e hana i kahi paʻi ma ka pepa i kapa ʻia he cardiotocograph. (CTG). Hana ka mīkini EFM me ʻelua mau pads (transducers), kēlā me kēia me ka nui o kahi coaster, i hoʻopili ʻia i ka ʻōpū me ʻelua mau kaula elastic. Hoʻonoho ʻia kekahi ma ka piko o kou ʻōpū, no laila aia ma luna o ka piko o kou ʻōpū (uterus) e kiʻi ai i kou ʻōpū; ʻo ka lua e kau ʻia ma kou ʻōpū, ma luna aʻe o kahi e lohe maikaʻi ʻia ai ka puʻuwai o kāu pēpē.

Hoʻololi ʻia ka ʻike i loaʻa mai nā transducers e ka uila i loko o ka mīkini e hana i kahi paʻi ma ka pepa kiʻi. ʻO ka EFM me ka hoʻohana ʻana i nā transducers waho ʻelua he ala non-invasive. I kekahi manawa, no nā kumu e wehewehe ʻia ai iā ʻoe, ʻike ʻia ka puʻuwai o ka pēpē e kahi electrode liʻiliʻi i kau ʻia ma ke poʻo o ka pēpē a hoʻopili ʻia e kahi uwea lahilahi i ka mīkini, a ʻo ia ke ʻano he puʻupuʻu kūloko. ( vaginal). e ho'āʻo i kēlā mea.

pehea e hoolohe ai

ʻO ka mea i kapa ʻia ʻo ka leo ʻānela (kani ʻānela) he mea hana hale ia e ʻike ai i ka puʻuwai o ka ʻōpū, kahi ʻano miniaturization o ka mea ʻike i hoʻohana ʻia i ka wā o ka obstetric visit. Aia lākou me nā headphone a i ʻole me ka leo a me ka pale a lawa ia e kau ai ma ka ʻōpū e hoʻolohe ai i ka puʻuwai o ka pēpē.

He mea palekana a hilinaʻi nā mea ʻike puʻuwai Fetal, ʻoiai lākou e lawe i ka hōʻailona o ka ʻae ʻia no ka lawe ʻana mai i ʻEulopa (ka hōʻailona CE), e hōʻoiaʻiʻo ana i ko lākou maikaʻi. A palekana nō hoʻi lākou no ka pēpē.

ʻO ka ʻōlelo aʻo e hoʻohana ia mai ka pule 12-14th o ka hāpai ʻana a hiki i ka pule 20th.
makua e hoʻolohe ana i ke aloha o ka puʻuwai o ka pēpē

puʻuwai hānai ʻano ʻē

ʻO ka puʻuwai o ka puʻuwai olakino e pono ai ka hoʻonohonoho pono ʻana e hoʻopaʻa pono i ke koko a puni ke kino. Hoʻomalu ʻia kēia puʻupuʻu e nā manaʻo uila e ʻae i ka hoʻopiha ʻana a me ka hoʻokuʻu ʻana o nā keʻena ʻehā o ka puʻuwai. Hiki i nā kūlana he nui ke hana i nā manaʻo uila e hoʻomalu i ka naʻau i ka maʻamau.wikiwiki loa (tachycardia) a lohi loa (bradycardia).

ʻO ka arrhythmia o ka naʻau fetal, a i ʻole ka puʻuwai puʻuwai ʻole, he kumu maʻamau ia no ka hāʻawi ʻana aku i kahi cardiologist fetal. I ka hapanui o nā hihia, he manawa pōkole ka puʻuwai puʻuwai lohi a wikiwiki paha. I kēia mau hihia, e nānā pono kāu hui i kou hāpai ʻana. ʻOi aku ma mua o 2% o nā hemahema o ka puʻuwai fetal e hōʻike ana i nā arrhythmias cardiac maoli.

I nā pule he 16 o ka hāpai ʻana, ua hoʻokumu piha ʻia ka puʻuwai fetal a paʻa i ka wikiwiki ma waena o 110 a me 160 beats i kēlā me kēia minuke (bpm).

Hoʻokaʻawale pinepine ʻia nā arrhythmias cardiac fetal e like me kekahi o kēia:

  • Bradycardia: ka puuwai ma lalo o 100 bpm
  • poloka naʻau hānau
  • ka ʻoki ʻana o ka atrial mua (PAC)
  • supraventricular tachycardia ʻO ka puʻuwai atrial: ʻoi aku ka nui o ka puʻuwai ma mua o 180 bpm

Nā hōʻailona a me nā kumu

ʻIke mua ʻia ke ʻano i ka wā e hoʻolohe ai ke kauka i ka puʻuwai fetal ma kahi o 10-12 pule o ka hāpai ʻana. Eia naʻe, ʻAʻole hiki ke hoʻomaka ka ʻino o ka puʻuwai ma mua o ka hāpai ʻana. ʻAʻohe hōʻailona maʻamau ka makuahine a ʻaʻole ʻike i ka loli o ka neʻe ʻana o ka fetal.

ʻAʻole ʻike ʻia ke kumu o ka hapa nui o nā arrhythmias, akā ʻo kekahi mau hihia ma muli o ka electrolyte imbalance, mumū, nā lāʻau lapaʻau, a i ʻole kahi maʻi genetic hoʻoilina. ʻO nā hihia koʻikoʻi o ka arrhythmia hiki ke hoʻokumu ʻia e kahi kīnā o ka naʻau, e like me ka poloka naʻau congenital, a i ʻole ma kahi maʻi hoʻoilina i kapa ʻia ʻo long QT syndrome.

Ho'āʻo a hōʻoia

Inā manaʻo ʻia ka arrhythmia, e kauoha ʻia nā hoʻokolohua hou, me ka echocardiogram fetal. E kōkua ana kēia ho'āʻo ʻana i kāu cardiologist fetal e ʻike inā loaʻa ka arrhythmia o kāu pēpē ma muli o ka pilikia me ke ʻano o ka puʻuwai.


Hoʻopili ka ʻike o ka ʻatikala i kā mākou kumumanaʻo o ka hoʻoponopono hoʻoponopono. E hōʻike i kahi kaomi hemahema ʻaneʻi.

E lilo i mea mua e wehewehe

E waiho i kāu manaʻo

Kāu leka uila aae? E,ʻaʻole e paʻiʻia. i hāliu aku i koi 'ia kula *

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  1. He kuleana no ka ʻikepili: Miguel Ángel Gatón
  2. Ke kumu o ka ʻikepili: kaohi SPAM, hoʻokele ʻōlelo.
  3. Legitimation: Kou ʻae
  4. Ka kamaʻilio ʻana o ka ʻikepili: ʻaʻole e hōʻike ʻia ka ʻikepili i nā ʻaoʻao ʻekolu koe ka mana o ke kānāwai.
  5. Pūnaewele mālama: Pūnaewele i mālama ʻia e Occentus Networks (EU)
  6. Nā Kuleana: I kēlā me kēia manawa hiki iā ʻoe ke palena, hoʻōla a kāpae i kāu ʻike.