Imivimbo emibili ehlonishwayo ekuvivinyweni, injabulo engenamkhawulo ngokucabanga komama wesikhathi esizayo, ukuvakashelwa okuzayo kokubonisana kwabesifazane kanye nezinkomba eziningi zokuhlaziywa ... Yebo, ngokungangabazeki, okweqisayo, kodwa emzabalazweni wengane enempilo, zonke lezi zinqubo zidingekile, futhi kudingeka uziphathe enezibopho eziphezulu, ukuze kamuva kungeke kube buhlungu buhlungu.
Izifo ezingapheli zowesifazane, izimpawu zazo ezingabonakali esimweni esivamile, zingakwazi "ukuhamba phezulu" ngesikhathi sokukhulelwa, futhi ukungahambi kahle kokutheleleka kwe-intrauterine kuyingozi kuphela uphawu olufihlekile. Yingakho odokotela belulekwa kakhulu ngesikhathi sokukhulelwa ukukhulelwa ukuhlolwa, ngisho noma umama okhulelwe ephilile ngokuphelele. Phela, imiphumela yabo ngesikhathi sokukhulelwa ihluke - ukuphulwa kokuthuthukiswa kwayo kuze kube sekupheleni kokukhulelwa noma ukuzalwa kwengane enezinhlobo ezinzima zokwelapha. Futhi ukwelashwa kwezifo ze-intrauterine ngesikhathi sokukhulelwa kuyinkimbinkimbi ngenxa yokuvinjelwa kokusetshenziswa kwezidakamizwa ezisetshenziswayo ngabesifazane abakhulelwe.
Ukutheleleka kwe-intrauterine (VUI) ukutheleleka kwe-fetus noma ama-virus asanda kuzalwa, amabhaktheriya, nezinye izinambuzane ezincane e-utero (ngokusebenzisa i-placenta, kancane kancane-amniotic fluid) noma ngesikhathi sokungena nge-canal yokuzalwa enegciwane. Ezimweni eziningi, umthombo wokutheleleka - umzimba womama, izifo zawo ezingapheli zesistimu ye-genitourinary (ukuguguleka komzimba we-cervix vaginitis, endocervicitis, i-pyelonephritis, ukuvuvukala kwe-appendages ye-uterine, njll). Ngesikhathi esifanayo, ingozi yokuthuthukisa i-VUI iyanda ngokutheleleka okuyisisekelo ngenye ye-pathogen ngesikhathi sokukhulelwa. Futhi, ngezinga eliphansi lokungatholakali, izimbangela zokutheleleka kwe-intrauterine zingase zibe izindlela eziphazamisayo zezifundo zokukhulelwa: amniocentesis, placentocentesis, ukwethulwa kwemithi ehlukahlukene ngokusebenzisa intambo yomzimba, nokunye okunjalo.
Kulezi zinambuzane eziholela ezinkingeni ezimbi kakhulu, zifaka ukutheleleka kwe-TORCH-complex:
- i-toxoplasma (i-toxoplasma);
- ezinye (ezinye izifo, ezibandakanya isifo samagciwane, i-chlamydia, ukutheleleka kwe-enterovirus, i-hepatitis A, B, ukutheleleka kwe-gonococcal, i-listeriosis, isisombululo esingaba khona, izimpumputhe);
- i-rubella (rubella);
- i-cytomegalovirus (i-cytomegalovirus);
- i-herpes (herpes).
Ake sihlole ngokuningiliziwe izinhlobo eziyinhloko zezifo ezibangelwa yi-intrauterine ezibangelwa yizifo eziphilayo:
- I-Toxoplasmosis noma okuthiwa "izifo zesandla ezingcolile" ijabule yi-parasite ye-toxoplasma, ephindaphinda esikhathini esiyinkimbinkimbi sokutheleleka emaqenjini abantu, izinyoni nezilwane. Ukutheleleka kaningi kubangelwa ukuthintana namagciwane wegciwane lesandulela ngculazi, inhlabathi, nokusetshenziswa kwenyama eluhlaza, imifino engahlanjululwa nezithelo, kaningi kakhulu - ngokumpompela igazi. Imodi yokudluliselwa kwegciwane lesandulela ngculazi iyingxenye eyodwa kuphela: kusuka kumama kuya ekuzalweni. Lesi sifo se-parasitic singatholwa ukuhlaziywa kwegazi kanye nokuphathwa okhethekile ngesikhathi sokukhulelwa nge-antibiotic equkethe i-spiramycin, esiza ukunciphisa ingozi yokuthuthukiswa kwe-VUI emfusus kuya ku-1%.
- Ukuze uvimbele izifo ezibangelwa yi- intrauterine ezibangelwa igciwane le-rubella , esigabeni sokuhlela ukukhulelwa kuyadingeka ukudlulisa ukuhlaziywa kokutholakala kokuzivikela okuqhubekayo kulesi sifo. Ukutheleleka ngesikhathi sokukhulelwa, ikakhulukazi ku-trimester yokuqala, kuyingozi kakhulu ngenxa yokuntula ukwelashwa okuphumelelayo kanye namathuba aphezulu okuba nengane yokuzalwa enganeni. Ingozi yokukhulelwa kwesisu nokufa komntwana kukhula kuze kube izikhathi ezine. Ukungena kwegciwane kumntwana, kufaka phakathi izitho zalo, kwenziwa ngokuphindaphindiwe ngesikhathi sesisindo sesifo somama. Umphumela omuhle wokuhlolwa we-rubella ngaphambi kokukhulelwa kungabonisa ukuthi unesifo esithathelwanayo lesi sifo ngenxa yokudluliselwa kwakhe ebuntwaneni (ngokusho kwezibalo, izingane ezingaba ngu-90% zihlushwa i-rubella ngokungenakulinganiswa) noma zigonywe ngalesi sikhathi.
- I-Cytomegalovirus (i-CMV) i-agent causative ye-intrauterine cytomegalovirus ukutheleleka, okungabangela izifo zezingaphakathi zangaphakathi nobuchopho bomntwana. Ingozi yokuthuthukisa i-IVF kanye nesimo se-fetus ethintekile ixhomeke ekubeni khona kwama-antibodies kumama nesikhathi sokutheleleka kwe-fetus. Ekuthelelekeni okuyinhloko komama, amathuba okutheleleka kwe-fetus angama-30%. Ngakho-ke, abesifazane abangenawo ama-antibodies ku-CMV, kunconywa ukuqapha kwamasosha omzimba wanyangazonke kuya ezinkomba ze-CMV nokutheleleka komsebenzi, ikakhulukazi ngesikhathi sokukhulelwa ngesikhathi sekwindla nobusika. I-CMV ingatholakala kuzo zonke izikhukhula zomzimba, ngokuphathelene nalokhu, ingatheleleka ngezindlela ezingenasidlangalaleni nangokwezocansi, ngokudlula ku-canal yokuzalwa ngisho nokuncelisa. Yingakho amathuba amakhulu okutheleleka awela ngonyaka wokuqala wokuphila kwengane. Umuntu angaba ngumthwali we-CMV ngaphandle kokubonakaliswa kwezibonakaliso ezithile zesifo (isithombe somtholampilo sifana ne-banal ARD), kodwa ngesikhathi esifanayo sibe umthombo wokutheleleka, ezimweni eziningi ngokunciphisa umzimba wonke.
- Ukutheleleka kwe-herpetic herpetic kubangelwa igciwane le-herpes simplex, elibanzi kanye ne-CMV. I-Herpes yohlobo lokuqala ivela kubantu abangaba ngu-100%, kanti ngamacala angu-95%, kubangelwa ukushisa. Ukwelashwa kwe-fetus kungabanjwa ngokutheleleka kusuka embelethweni noma ngegazi, okuthinta i-placenta, i-fetus, iqukethe ukubunjwa kwezinkinga zokuzalwa ezinganeni. Kungenzeka ukufa kwe-fetus nganoma yisiphi isikhathi sokuthuthukiswa, lapho kudlula umkhuhlane wokuzalwa kuthola ukutheleleka okungaba ngu-1% wezithelo. Ingozi yokutheleleka komntwana osanda kuzalwa ngo-herpes ngokobulili (uhlobo lwe-herpes lwesigaba sesibili) esigabeni esibucayi noma uma kwenzeka ukwanda kwesimo sakhe esingapheli kungama-40%. Ukutheleleka okuyinhloko ekukhulelweni kokuqala kungabangela isidingo sokukhipha isisu, ngosuku olulandelayo, ngokuqapha okuqhubekayo kokuthuthukiswa kwe-fetal nesimo sayo, izindlela ezisekelwe nge-ultrasound zingase zibe ukwelashwa kokwelapha nge-antiviral (acyclovir) kanye nezidakamizwa zokuzivikela. Uma kwenzeka ukunqotshwa kwe-herpes yofuzo, isigaba sokudla sinconywa. Ukutheleleka kwamagciwane ezinsana kungabonakaliswa izilonda zendawo yesikhumba noma amehlo (ophthalmoherpes).
Ukuhlonza kwe-VUI
Njengoba kunikezwe i-latency (latency) yezimpawu ze-VUI, ukutholakala kokutholakala kwezifo zangaphakathi kwe-intrauterine kunzima, kodwa kunokwenzeka ngokusiza kwamasu alandelayo okuxilonga.
Ucwaningo lwe-DNA usebenzisa indlela ye-PCR (ukusabela kwe-polymer chain) - esetshenziselwa ukutholakala kwezifo zezifo ezithathelwana ngocansi (STDs). Isisekelo saleso sifundo sibheka ezithombeni zobulili. Umphumela uba ngolwazi mayelana nomthwali wezinto zokuphatha noma ukutholakala kwesifo esithathelwanayo. Ukuze kucaciswe ukuxilongwa, kuye ngokuthi uhlobo oluthile lwe-pathogen, izifundo ezingeziwe zingenziwa ngendlela ye-bacteriological culture kanye nokuhlaziywa kwegazi. Ukuhlaziywa kwegazi ngokutheleleka kwe-intrauterine nge-ELISA (enzyme immunoassay)