Apo kuongororwa kwepamuviri (ultrasound, amniocentesis) kunoratidza kuti mwana ane chirwere chakakomba kana kuti kupfuurira kwepamuviri kunoisa upenyu hwomukadzi ane pamuviri pangozi, nyanzvi yezvokurapa inopa vaviri vacho kubvisa pamuviri (kana kuti kubvisa pamuviri nenzira yekurapa) . Iyo IMG inotariswa zvakanyanya uye inotongwa nechinyorwa L2213-1 chePublic Health Code (1). Nokudaro, maererano nemutemo, “Kubvisa pamuviri nokuzvidira kunogona, chero nguva ipi zvayo, kuitwa kana vanachiremba vaviri nhengo dzeboka remarudzi akasiyana-siyana vakabvuma, pashure pokunge boka iri rapa zano raro rokurayira, kana kuti kupfuurira kwemimba kunoisa mungozi zvikuru. hutano hwemukadzi, kureva kuti kune mukana wakasimba wekuti mwana asati aberekwa achatambura kubva kune imwe mamiriro ehumwe simba rinozivikanwa seisingarapike panguva yekuongororwa. “

Mutemo hausi nokudaro rondedzero yezvirwere kana kukanganisa uko IMG inotenderwa, asi mamiriro ekubvunzurudza eboka remultidisciplinary iro richaunzwa kuti riongorore chikumbiro cheIMG uye kupa chibvumirano chayo.

Kana iyo IMG yakakumbirwa kune hutano hwaamai-ku-va, timu inofanirwa kuunza pamwe vashoma vanhu vana vanosanganisira:

• gynecologist-obstetrician nhengo ye multidisciplinary prenatal diagnosis centre
• chiremba akasarudzwa nemukadzi ane pamuviri
• mushandi wezvemagariro evanhu kana psychologist
• nyanzvi mune mamiriro ane mukadzi

Kana IMG ichikumbirwa kune hutano hwemwana, chikumbiro chinoongororwa neboka remultidisciplinary prenatal diagnosis centre (CPDPN). Mukadzi ane pamuviri anogona kukumbira kuti chiremba waanosarudza atore chikamu mukubvunza.

Muzviitiko zvose, sarudzo yekubvisa pamuviri kana kuti kwete inosara nemukadzi ane pamuviri, uyo anofanira kunge akamboudzwa nezvese data.

Nhasi, kashoma kuti IMG iitwe nekuda kwehutano hwemukadzi ane pamuviri. Maererano nemushumo weMultidisciplinary Centers for Prenatal Diagnosis 2012 (2), 272 IMG yakaitwa nokuda kwezvikonzero zveamai vachipokana ne7134 nokuda kwezvikonzero zve fetal. Zvinangwa zve fetal zvinosanganisira zvirwere zvemajini, chromosomal abnormalities, malformation syndromes uye utachiona hunogona kudzivirira kurarama kwemwana kana kukonzera kufa pakuzvarwa kana mumakore ake ekutanga. Dzimwe nguva kurarama kwomwana hakusi pangozi asi anenge ari mutakuri wehurema hwakakomba hwomuviri kana kuti hwepfungwa. Izvi zvinonyanya kuitika munyaya ye trisomy 21. Maererano nemushumo weCNDPN, zvikanganiso kana malformation syndromes uye chromosomal zviratidzo zviri pamavambo anopfuura 80% eIMGs. Pakazara, ingangoita 2/3 yezvitupa zveIMG zvezvikonzero zve fetal inoitwa pamberi pe22 WA, kureva panguva iyo iyo fetus isingaite, inoratidza iwoyu chirevo.

Zvichienderana nezvenguva yekuzvitakura uye hutano hwaamai-va-kuve, iyo IMG inoitwa kana nekurapa kana nzira yekuvhiya.

Nzira yekurapa inoitika mumatanho maviri:

• kutora anti-progestogen kuchavhara chiito cheprogesterone, hormone inokosha pakuchengetedza pamuviri
• Maawa 48 gare gare, kutungamirirwa kweprostaglandin kuchaita kuti zvikwanise kukonzera kubereka kuburikidza nekuita kuti uterine contractions iwedzere uye kuwedzera kwemuromo wechibereko. Kurapa-kubvisa marwadzo nekupinza kana epidural analgesia inoitwa zvakarongeka. "Fetus" inobva yabuda zvayo.

Nzira yezviridzwa inosanganisira classical cesarean chikamu. Yakachengeterwa mamiriro ekukurumidzira kana kupesana nekushandiswa kweiyo nzira yekurapa. Kusununguka kwomuzvarirwo zvirokwazvo kune ropafadzo nguva dzose kuitira kuchengetedza bviro yenhumbu dzinotevera, nokunzvenga vanga raKesaria rinonetesa chibereko.

Muzviitiko zvese izvi, chigadzirwa chefeticide chinobaiwa pamberi peIMG kuitira kuti moyo we "fetus" umire uye kudzivirira kushushikana kwe "fetus".

Kuongororwa kwePlacenta ne "fetus" kunopihwa mushure meIMG kutsvaga kana kusimbisa zvikonzero zvekusagadzikana kwe "fetus", asi sarudzo yekuti vozviita here kana kusazviita inogara iri kuvabereki.

Kuongororwa kwepfungwa kunopihwa zvakarongeka kuna amai nevaviri kuti vapfuure nedambudziko iri rekufirwa.

Kana ikanyatsoperekedzwa, kuberekwa kwemukadzi inhanho yakakosha muchiitiko chekufirwa uku. Kunyanya kuziva nezvekuchengetwa kwepfungwa kwevakaroorana ava vari kuburikidza nekufirwa, mamwe mapoka emadzimai anotopa tsika inopoteredza kuberekwa. Vabereki vanogona zvakare, kana vachida, kutanga chirongwa chekuzvarwa kana kuronga mariro emwana. Masangano anowanzoratidza kuva tsigiro inokosha munguva dzino dzakaoma.