Ukubetha esiswini ngexesha lokukhulelwa

usana olusanda kuzalwa ukubetha kwentliziyo

Ukuphulaphula ukubetha kwentliziyo yomntwana yenye yezona zinto zinika umdla ngokukhulelwa. Kodwa baqala nini ukuziva? Owona mzuzu unomdla wovavanyo lokuqala lwe-gynecological ukukwazi mamela ukubetha kwentliziyo yomntwana.

Ugqirha ulalisa ebhedini kwaye i-ultrasound ikubonisa "imbotyi eluhlaza" kwaye nantso, ukubetha kwentliziyo. Yintliziyo yomntana wakho leyo, ibetha ngokukhawuleza. Kodwa, ukususela nini iviwa kwaye ibetha ixesha elingakanani?

Ungaqala ngeyiphi iveki ukuva ukubetha kwentliziyo yomntwana wakho?

Ukubetha kwentliziyo ye-fetal kunokuba Fumana ngeentsuku ezingama-34 (ngaphantsi kweeveki ezi-6) Ukukhulelwa kunye ne-ultrasound ye-transvaginal yefrikhwensi ephezulu kunye nomgangatho olungileyo.

Kwiiveki ezi-6, i Intliziyo Imbumba engekazalwa, ngoku ebetha izihlandlo ezili-110 ngomzuzu, inamagumbi amane angenanto, ngalinye linendawo yokungena nelokuphuma ukuze igazi lingene liphume kuwo. Kwiiveki nje ezimbini, elo nani liya kwanda ukuya kutsho kwi-150-170 beats ngomzuzu.

Ngalo lonke olu lwando, kunokwenzeka ukuba unokuva ukubetha kwentliziyo yomntwana okokuqala malunga ne-9 ukuya kwiiveki ezili-10 zokukhulelwa, nangona usuku oluchanekileyo lunokwahluka. Ngeli xesha iyakubetha malunga ne-170 beats ngomzuzu, isantya esiya kuthi sicothe ukusuka apha ukuya ngaphandle. Ukuyiva, ugqirha okanye umbelekisi uya kubeka isixhobo esiphathwayo se-ultrasound esibizwa ngokuba yiDoppler kwisisu sakho ukukhulisa isandi.

Ukubetha kwentliziyo yosana: ibetha kangakanani

Ukubetha kwentliziyo iqala ukubonakala kwi-ultrasound malunga neeveki ezi-6 zokumitha. Isantya sentliziyo yomntwana kwesi sigaba sikholisa ukuba phakathi kwe-100 kunye ne-120 yeebhithi ngomzuzu (bpm).

Izinga lentliziyo yomntwana oqhelekileyo (FHR) ngokuqhelekileyo liba phakathi kwe-120 kunye ne-160 yeebhithi ngomzuzu (bpm) kwixesha le-intrauterine. Inokulinganiswa nge-ultrasonographical ukusuka malunga neeveki ezi-6, kwaye uluhlu oluqhelekileyo luyahluka ngexesha lokumitha, lukhula malunga ne-170 bpm kwiiveki ezili-10 kwaye emva koko zehla malunga ne-130 bpm ngexesha.

I-Evolution ngokumitha

Nangona i-myocardium iqalisa ukuqhawuka ngesingqi kwiiveki ezi-3 zokukhawulwa (ukusuka kwiiseli ze-myocardial pacemaker ezenzekeleyo kwi-embryonic heart), iqala ukubonakala kwi-ultrasound malunga neeveki ezi-6 zokumitha. Ngoko ke, I-HRF idla ngokuba malunga neebhithi ezili-100-120 ngomzuzu (bpm).

I-FHR iye inyuke ngokuqhubekayo kwiiveki ezi-2 ukuya kwezi-3 ezizayo kwaye ibe:

  • ~110 bpm (umyinge) phakathi kweeveki ezi-5 ukuya kwezi-6
  • ~170 bpm kwiiveki ezi-9-10

Oku kulandelwa kukuhla kwe-FHR ethi, ngokomndilili, ibe:

  • ~150 bpm kwiiveki ezili-14
  • ~140 bpm kwiiveki ezili-20
  • ~130 bpm ngekota nganye

Nangona isantya sentliziyo ngokuqhelekileyo siqhelekile kusana olungekazalwa olusempilweni, ukubetha-bethabethana ukuya kutsho kwezili-5 ngomzuzu kunokuvunyelwa.

iinyawo umntwana ebomvu intliziyo kunye sheet

I-pathology ehambelanayo

Isantya sentliziyo esicothayo somntwana sibizwa bradycardia yomntwana kwaye idla ngokuchazwa njenge:

  • FHR <100 bpm phambi kweeveki ezi-6,3 zokumitha, okanye
  • FHR <120 bpm phakathi kwe-6,3 kunye ne-7,0 yeeveki

Ukubetha kwentliziyo yomntwana okhawulezayo kubizwa ngokuba tachycardia yomntwana kwaye idla ngokuchazwa njenge:

  • FHR > 160-180 bpm 5,7
  • Isantya sentliziyo esimalunga ne-170 bpm singahlelwa njenge-borderline fotal tachycardia
  • Ukubetha kwentliziyo yomntwana okhawulezayo nokungaqhelekanga ngokuqhelekileyo kwaziwa ngokuba yi-fetal tachyarrhythmia.

Indlela ukubetha kwentliziyo kuviwa kwaye kujongwe ngayo

Ukubetha kwentliziyo yosana kunokuviwa ngeendlela ezininzi ezahlukeneyo, ngamaxesha athile ( intermittent auscultation ) okanye ngokuqhubekayo ( electronic fetal monitoring (EFM ).

i-auscultation ephakathi

Kulapho ukubetha kwentliziyo yomntwana wakho kumanyelwa ngamaxesha athile ngepinard okanye isixhobo esiphathwayo esiphathwayo se-ultrasound esibizwa ngokuba yiDoptone.. Ukuba usempilweni entle kwaye ukhulelwe ngaphandle kwamagingxigingxi, le yindlela ecetyiswayo yokumamela ukubetha kwentliziyo yosana lwakho ngexesha lokubeleka.

Ababelekisi kunye noogqirha bamamela ukubetha kwentliziyo yosana lwakho umzuzu opheleleyo, rhoqo ngemizuzu eli-15 emva kokubeleka, kwaye nangakumbi njengoko kusondela ukubeleka.

UkuJonga i-EFM eqhubekayo yoMbane 

Iphi ukubetha kwentliziyo yosana lwakho kumanyelwa ngokuqhubekayo kusetyenziswa umatshini ovelisa iprintout ephepheni ebizwa ngokuba yicardiotocograph. (CTG). Umatshini we-EFM usebenza kunye neepads ezimbini (i-transducers), nganye ubukhulu be-coaster, ifakwe kwisisu esinemicu emibini ye-elastic. Enye ibekwe kumphezulu wesisu sakho, ukuze ibe ngasentla kwencam yesibeleko sakho (isibeleko) ukuze ithathe ukuqhawuka kwakho; eyesibini iya kubekwa phezu kwesisu sakho, ngaphezu kwendawo apho ukubetha kwentliziyo yosana lwakho kunokuviwa kakuhle.

Ulwazi olufunyenwe kwii-transducer luguqulwa nge-electronics ngaphakathi komatshini ukuvelisa i-printout kwiphepha legrafu. I-EFM isebenzisa ii-transducers ezimbini zangaphandle yindlela engabonakaliyo. Maxa wambi, ngenxa yezizathu eziya kucaciswa kuwe, ukubetha kwentliziyo yosana kubonwa ngesixhobo sombane esibizwa ngokuba yi-electrode esincinane esibekwe phezu kwentloko yosana size siqhagamshelwe ngocingo olubhityileyo kumatshini, yaye oku bekuya kuthetha ukuba kufuneka ube nentliziyo yangaphakathi. kwilungu lobufazi). uvavanyo ukuba kwenzeke.

indlela yokuphulaphula

Isixhobo esaziwa ngokuba sisandi sengelosi (isandi sengelosi) sisixhobo sasekhaya esibona ukubetha kwentliziyo ye-fetus, uhlobo oluthile lwe-miniaturization ye-detector esetyenziswe ngexesha lokutyelela i-obstetric. Kukho kunye nee-headphones okanye kunye ne-speaker kunye neskrini kwaye kwanele ukuzibeka esiswini ukuze uphulaphule ukubetha kwentliziyo yomntwana.

Izixhobo zokubona ukubetha kwentliziyo yosana zikhuselekile kwaye zithembekile, ukuba nje zinophawu lokuvunywa kokungeniswa kumazwe aseYurophu (uphawu lweCE), oluqinisekisa umgangatho wazo. Kwaye zikhuselekile kumntwana ongekazalwa.

Ingcebiso kukusebenzisa ukusuka kwi-12-14 iveki yokukhulelwa ukuya kwiveki ye-20.
abazali baphulaphule ukubetha kwentliziyo yomntwana

ukubetha kwentliziyo yosana olungaqhelekanga

Isingqi sentliziyo esempilweni sifuna ulungelelwaniso olucokisekileyo ukumpompa igazi ngokufanelekileyo kuwo wonke umzimba. Esi singqisho silawulwa yimpembelelo yombane evumela ukuzaliswa okuhambelanayo kunye nokukhupha amagumbi amane entliziyo. Iimeko ezininzi zinokubangela ukuba iimpembelelo zombane ezilawula intliziyo zibe zingaqhelekanga.ngokukhawuleza kakhulu (tachycardia) okanye ucotha kakhulu (bradycardia).

I-Fetal heart arrhythmia, okanye ukubetha kwentliziyo engaqhelekanga, sisizathu esiqhelekileyo sokuthunyelwa kwi-cardiologist yomntwana. Kwiimeko ezininzi, ukubetha kwentliziyo okucothayo kakhulu okanye ngokukhawuleza kakhulu kokwexeshana. Kwezi meko, iqela lakho liya kubeka iliso ngokusondeleyo ukukhulelwa kwakho. Ngaphantsi kwe-2% ye-fetal heartbeat irregularity ibonisa i-arrhythmias ye-cardiac yokwenene.

Kwiiveki ezili-16 zokukhulelwa, intliziyo yosana kwakheka ngokupheleleyo kwaye ibetha ngesantya esiphakathi kwe-110 kunye ne-160 yeebhithi ngomzuzu (bpm).

I-Fetal cardiac arrhythmias ihlala ihlelwa njengenye yezi zilandelayo:

  • IBradicardia: izinga lokubetha kwentliziyo ngaphantsi kwe-100 bpm
  • ibhloko yentliziyo yokuzalwa
  • ukufinyela kwe-atrial kwangaphambi kwexesha (PAC)
  • tachycardia supraventricular o yi-atrial flutter: izinga lokubetha kwentliziyo ngaphezu kwe-180 bpm

Iimpawu kunye nezizathu

Imeko idla ngokuqatshelwa xa ugqirha emamele ukubetha kwentliziyo yomntwana malunga neeveki ezili-10-12 zokukhulelwa. Nangona kunjalo, isigqi esingaqhelekanga sinokungaqali phambi kokukhulelwa. Umama ngokuqhelekileyo akanazo iimpawu kwaye akaqapheli naluphi na utshintsho kwintshukumo yomntwana.

Isizathu sokuba uninzi lwe-arrhythmias lungaziwa, kodwa ezinye iimeko zinokuthi zibangelwa ukungalingani kwe-electrolyte, ukuvuvukala, amayeza, okanye imeko yofuzo. Iimeko ezinzulu ze-arrhythmia zinokubangelwa sisiphene sentliziyo, njenge-congenital heart block, okanye yimeko efunyenwe njengefa eyaziwa ngokuba yi-QT syndrome ende.

Uvavanyo kunye nokuxilongwa

Ukuba kukrokrelwa i-arrhythmia, iimvavanyo ezongezelelweyo ziya ku-odolwa, kubandakanywa ne-echocardiogram yomntwana. Olu vavanyo luya kunceda i-feetal cardiologist ukuxilonga ukuba i-arrhythmia yomntwana wakho ibangelwa yingxaki ngesakhiwo sentliziyo.


Umxholo wenqaku uyabambelela kwimigaqo yethu imigaqo yokuziphatha yokuhlela. Ukuxela impazamo cofa apha.

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