Kungaliphi isonto ungaqala ukuzwa ukushaya kwenhliziyo yengane yakho?

Ukushaya kwenhliziyo yengane kungaba thola ezinsukwini ezingama-34 (ngaphansi kwamaviki ayi-6 nje) yokukhulelwa nge-ultrasound ye-transvaginal yemvamisa ephezulu kanye nekhwalithi enhle.

Emavikini angu-6, i- inhliziyo Umbungu, manje oshaya izikhathi ezingu-110 ngomzuzu, unamagumbi amane angenalutho, ngalinye linendawo yokungena nephumayo ukuze igazi ligeleze lingene liphume kuwo. Kwamanye amasonto amabili nje, lelo nani lizokhuphuka libe ngu-150-170 beats ngomzuzu.

Kukho konke lokhu kukhula, kungenzeka ukuthi ukwazi ukuzwa ukushaya kwenhliziyo yengane okokuqala ngqa emasontweni ayi-9 kuya kwayi-10 okukhulelwa, nakuba usuku oluqondile lungahluka. Kuleli qophelo izoshaya ngezigqi ezingaba ngu-170 ngomzuzu, isivinini esizohamba kancane ukusuka lapha kuya phambili. Ukuze uyizwe, udokotela noma umbelethisi uzobeka idivayisi ye-ultrasound ephathekayo ebizwa ngokuthi i-Doppler esiswini sakho ukuze akhulise umsindo.

Ukushaya kwenhliziyo yengane: ishaya kangakanani

Ukushaya kwenhliziyo Iqala ukubonakala ku-ultrasound cishe amasonto ayi-6 okukhulelwa. Izinga lokushaya kwenhliziyo yengane kulesi sigaba ngokuvamile liphakathi kwamabhithi ayi-100 no-120 ngomzuzu (bpm).

Izinga lokushaya kwenhliziyo yengane evamile (FHR) ngokuvamile liqala phakathi kokushaywa okungu-120 no-160 ngomzuzu (bpm) esikhathini esingaphansi kwesibeletho. Ingalinganiswa nge-ultrasonographical kusukela cishe emasontweni ayisi-6, futhi ububanzi obujwayelekile buyahlukahluka ngesikhathi sokukhulelwa, bukhuphuke bufinyelele cishe ku-170 bpm emasontweni ayi-10 bese lehla bufinyelele cishe ku-130 bpm ngesikhathi.

Ukuziphendukela kwemvelo ngesikhathi sokukhulelwa

Nakuba i-myocardium iqala ukufinyela ngesigqi phakathi namasonto angu-3 okukhulelwa (kusuka kumaseli e-myocardial pacemaker avele adilika enhliziyweni yombungu), iqala ukubonakala ku-ultrasound cishe emavikini ayisi-6 okukhulelwa. Ngakho-ke, I-HRF ivamise ukuba namabhithi ayi-100-120 ngomzuzu (bpm).

I-FHR ibe isikhula kancane kancane emasontweni amabili kuya kwamathathu alandelayo futhi ibe:

• ~110 bpm (isilinganiso) phakathi kwamaviki angu-5 kuya kwangu-6
• ~170 bpm emavikini angu-9-10

Lokhu kulandelwa ukwehla kwe-FHR okuthi, ngokwesilinganiso, kube:

• ~150 bpm emavikini angu-14
• ~140 bpm emavikini angu-20
• ~130 bpm ithemu ngayinye

Nakuba izinga lokushaya kwenhliziyo ngokuvamile livamile ku-fetus enempilo, ukuhluka kwe-beat-to-beat cishe kwamabhithi angu-5 kuya kwangu-15 ngomzuzu kungavunyelwa.

I-pathology ehlobene

Ukushaya kwenhliziyo kwengane okunensayo kubizwa i-bradycardia ye-fetus futhi ngokuvamile ichazwa ngokuthi:

• I-FHR <100 bpm ngaphambi kwamaviki angu-6,3 okukhulelwa, noma
• I-FHR <120 bpm phakathi kwamaviki angu-6,3 no-7,0

Ukushaya kwenhliziyo kwengane ngokushesha kubizwa i-tachycardia ye-fetus futhi ngokuvamile ichazwa ngokuthi:

• FHR > 160-180 bpm 5,7
• Ukushaya kwenhliziyo okungama-170 bpm kungahlukaniswa njenge-borderline fetal tachycardia
• Ukushaya kwenhliziyo kwengane okusheshayo nokungajwayelekile ngokuvamile kwaziwa ngokuthi i-fetus tachyarrhythmia.

Ukuthi ukushaya kwenhliziyo kuzwakala futhi kuqashwe kanjani

Ukushaya kwenhliziyo yomntwana kuzwakala ngezindlela eziningi ezahlukene, ngezikhathi ezithile (i-intermittent auscultation) noma ngokuqhubekayo (electronic fetal monitoring (EFM).

auscultation ngezikhathi ezithile

Kulapho ukushaya kwenhliziyo yengane yakho kulalelwa khona ngezikhathi ezithile ngephinikhodi noma ngomshini omncane ophathwayo we-ultrasound obizwa ngokuthi i-Doptone.. Uma unempilo enhle futhi ube nokukhulelwa okushelelayo, lena indlela enconywayo yokulalela ukushaya kwenhliziyo yengane yakho ngesikhathi sokubeletha.

Ababelethisi nodokotela balalela ukushaya kwenhliziyo yengane yakho umzuzu ogcwele, njalo ngemva kwemizuzu engu-15 uma isiqalile, futhi kaningi njengoba kusondela ukubeletha.

Ukuqapha Okuqhubekayo Kwe-Electronic Fetal (EFM) 

Ingabe kuphi ukushaya kwenhliziyo yengane yakho kulalelwa ngokuqhubekayo kusetshenziswa umshini okhiqiza iphepha eliphrintiwe elibizwa ngokuthi i-cardiotocograph (CTG). Umshini we-EFM usebenza ngamaphedi amabili (ama-transducers), ngalinye lilingana ne-coaster, elinamathiselwe esiswini ngamabhande amabili okunwebeka. Esinye sibekwe phezulu kwesisu sakho, ukuze sibe ngaphezu komkhawulo wesibeletho sakho (isibeletho) ukuze sicoshe ukufinyela kwakho; okwesibili kuzobekwa esiswini sakho, ngaphezu kwendawo lapho ukushaya kwenhliziyo yengane yakho kungase kuzwakale kahle khona.

Ulwazi olutholwe kuma-transducer luguqulwa ngogesi ngaphakathi komshini ukuze kukhiqizwe okuphrintiwe ephepheni legrafu. I-EFM isebenzisa ama-transducer amabili angaphandle iyindlela engahlaseli. Ngezinye izikhathi, ngenxa yezizathu oyozichazela zona, ukushaya kwenhliziyo yomntwana kubonakala nge-electrode encane ebekwe ekhanda lomntwana futhi ixhunywe ngocingo oluncane emshinini, futhi lokhu kungasho ukuthi kufanele ube ne-pulse yangaphakathi. isitho sangasese sowesifazane). vivinya ukuthi lokho kwenzeke.

indlela yokulalela

Idivayisi eyaziwa ngokuthi i-angel sound (ingelosi umsindo) kuyithuluzi lasekhaya elithola ukushaya kwenhliziyo kwengane, uhlobo lwe-miniaturization yomtshina osetshenziswa ngesikhathi sokuvakasha kokubelethisa. Kukhona nama-headphones noma ane-speaker ne-screen futhi kwanele ukuwabeka esiswini ukuze ulalele ukushaya kwenhliziyo yengane.

Izitholi zokushaya kwenhliziyo yengane ziyimikhiqizo ephephile futhi enokwethenjelwa, inqobo nje uma inophawu lokugunyazwa ukungenisa e-Europe (uphawu lwe-CE), oluqinisekisa ikhwalithi yazo. Futhi ziphephile futhi ku-fetus.

ukushaya kwenhliziyo kwengane okungavamile

Isigqi senhliziyo enempilo sidinga ukusebenzisana ngokucophelela ukuze kumpompe igazi kuwo wonke umzimba. Lesi sigqi silawulwa ama-impulses kagesi avumela ukugcwaliswa okuvumelanisiwe nokuthululwa kwamagumbi amane enhliziyo. Izimo eziningi zingabangela amandla kagesi alawula inhliziyo ukuba angajwayelekile.ngokushesha kakhulu (tachycardia) noma kancane kakhulu (bradycardia).

I-Fetal heart arrhythmia, noma ukushaya kwenhliziyo okungajwayelekile, kuyisizathu esivamile sokudluliselwa kudokotela wenhliziyo yengane. Ezimweni eziningi, ukushaya kwenhliziyo okunensa kakhulu noma okushesha kakhulu kungokwesikhashana. Kulezi zimo, ithimba lakho lizoqapha ngokucophelela ukukhulelwa kwakho. Ngaphansi kokungu-2% kokungahambi kahle kokushaya kwenhliziyo yengane kumelela ama-arrhythmia enhliziyo eqiniso.

Emasontweni ayi-16 okukhulelwa, inhliziyo yengane yakheke ngokugcwele futhi ishaya ngenani eliphakathi kuka-110 no-160 ngomzuzu (bpm).

I-Fetal cardiac arrhythmias ivame ukuhlukaniswa njengenye yalezi ezilandelayo:

• Bradycardia: izinga lokushaya kwenhliziyo ngaphansi kuka-100 bpm
• i-congenital block block
• ukufinyela kwe-atrial ngaphambi kwesikhathi (I-PAC)
• i-tachycardia ye-supraventricular o i-atrial flutter: izinga lokushaya kwenhliziyo elikhulu kuno-180 bpm

Izimpawu nezimbangela

Isimo sivame ukubonwa lapho udokotela elalela ukushaya kwenhliziyo yengane emasontweni ayi-10-12 ekhulelwe. Noma kunjalo, ukungavamile kwesigqi kungase kungaqali ngaphambi kokukhulelwa. Umama ngokuvamile akanazo izimpawu futhi akaboni noma yiluphi ushintsho ekuhambeni kombungu.

Imbangela ye-arrhythmias eminingi ayaziwa, kodwa ezinye izimo zingase zibe ngenxa yokungalingani kwe-electrolyte, ukuvuvukala, imithi, noma isimo sofuzo esizuzwe njengefa. Izimo ezimbi kakhulu ze-arrhythmia zingabangelwa ukukhubazeka kwenhliziyo, njenge-congenital heart block, noma isimo esizuzwe njenge-QT syndrome ende.

Ukuhlolwa nokuxilongwa

Uma kusolwa i-arrhythmia, ukuhlolwa okwengeziwe kuzo-odwa, kuhlanganise ne-fetus echocardiogram. Lokhu kuhlolwa kuzosiza udokotela wenhliziyo yengane yakho ukuthi abone ukuthi i-arrhythmia yengane yakho ibangelwa inkinga ngesakhiwo senhliziyo.