Ukuthuthukiswa kombungu kungathinteka ngenxa yokukhubazeka okuhlukahlukene kwe-chromosomal, okungaholela ezinkingeni eziningi ku-fetus. Lokhu okudidayo kungase kubangele amaphutha esakhiwo kuma-chromosome, inani elingafanele lezinto zofuzo eziqukethwe ku-chromosome ethile, noma ukungalingani kwenani lama-chromosome. Ukukhubazeka kokuzalwa, izifo ze-chromosomal, ngisho nokuphuphunyelwa yizisu kungase kubangele ukuba khona kwalokhu kukhubazeka. Ukusetshenziswa komaka kabili noma ukuhlola okukabili kusiza ukukhomba lokho kuphazamiseka kwengane, okuthi uma kuyekwa kungabonwa, kubangele ukukhubazeka ngemva kokubeletha enganeni.

Kuyini Ukuhlolwa Kwemaka Okukabili?

Ukuhlolwa kwe-double marker, okubuye kwaziwe ngokuthi i-Maternal serum screening, ukuhlolwa kokuhlola okujulile okuyingxenye enkulu. uhlelo lokuhlola lwe-trimester yokuqala. Ukuhlolwa komaka okukabili kuwukuhlola okubikezelayo, okusho ukuthi imiphumela yakhona ikhombisa amathuba okungavamile kwe-chromosomal. Ukuhlola omaka okukabili ekukhulelweni kubheka amazinga egazi omaka ababili abahlukene: I-Beta-hCG (i-beta-human chorionic gonadotropin) ne-PAPP-A (Iphrotheni Ye-Plasma A ehlobene Nokukhulelwa). 

Amazinga aphakeme e-beta-hCG avame ukuhlotshaniswa nengozi eyengeziwe yokuphazamiseka kwe-chromosome. Ukuze kutholakale noma yikuphi ukudidayo kusenesikhathi futhi kuvinjwe izinkinga ezimbalwa zezempilo zengane engakazalwa, odokotela ngokuvamile bakhuthaza iziguli ukuthi zenze lokhu kuhlolwa ku-trimester yokuqala.

Inhloso yokuhlolwa kwe-Double Marker

Ukuhlolwa komaka okuphindwe kabili kuwukuhlola okubaluleke kakhulu kokuthola ukuba khona kohlobo oluthile lokungajwayelekile kwe-chromosome ngesikhathi sokukhulelwa, okusiza ukugwema izinkinga ezimbalwa zempilo zangemva kokubeletha. Lokhu kuhlola kusiza ekutholweni kokudidayo kwe-chromosomal ku-fetus ekhulayo. Ngokuvamile, umbungu wesifazane wakhiwe ngamapheya angu-22 e-XX Chromosomes, kuyilapho umbungu wesilisa ngokuvamile unamapheya angu-22 e-XY chromosomes. Nokho, ezimweni ezingavamile, i-chromosome engavamile ingase ibe khona kuwo wonke noma kwamanye amangqamuzana omzimba, okuholela esimweni sofuzo esaziwa ngokuthi i-trisomy. 

Ezimweni ezinjalo, ingane ingase ibe namakhophi amathathu e-chromosome engavamile esikhundleni samabili. Lokhu kungaholela ekukhuleni kokukhubazeka, izenzakalo ezibambezelekile noma ukuhlakanipha okungajwayelekile enganeni engakazalwa. Ngakho-ke ukunquma ukuthi ingabe kukhona yini okungavamile kwe-chromosomal kusetshenziswa isivivinyo somaka kabili sokukhulelwa kungaba wusizo kubo bobabili umama nengane engakazalwa.

Kwenzekani ngesikhathi sokuhlolwa kwe-Double Marker?

Ukuhlolwa komaka kabili kuhlanganisa isampula yegazi nokuhlolwa kwe-ultrasound okuhlaziya izimpawu ezimbili: i-beta hCG yamahhala kanye nephrotheni ye-plasma ehlobene nokukhulelwa A (PAPP-A). I-beta-hCG yamahhala iyihomoni ekhiqizwa yi- i-placenta kwabesifazane abakhulelwe, futhi inani eliphakeme lale hormone lixhunyaniswa nengozi eyengeziwe ye-Trisomy-18 ne-Down syndrome. I-PAPP-A, ngakolunye uhlangothi, iyiphrotheni ye-plasma ebalulekile ekusebenzeni komzimba. Ukuba ne-Down syndrome kungenzeka kakhulu uma kunamazinga aphansi amaprotheni e-plasma. Okutholakele kokuhlolwa komaka okukabili kuhlukaniswa ngokuthi Okuhle, okunobungozi obukhulu, nokubi.

Odokotela bakhuthaza abesifazane abaneminyaka engaphezu kwengama-35 kanye nalabo abanomlando wokukhubazeka kokuzalwa emndenini ukuthi bathole lokhu kuhlolwa ngoba maningi amathuba okuba babe nokungajwayelekile kwe-chromosome, okungase kubangele ukukhubazeka kwe-chromosomal enganeni esakhulayo.

Inqubo yokuhlolwa kwe-Double Marker

Ngesikhathi sokuhlolwa kwegazi okumaka kabili, okokuqala, kuzokwenziwa i-ultrasound. Khona-ke, kuzokwenziwa ukuhlolwa kwegazi ukuze kutholwe amazinga amakaki amabili: I-Beta-hCG Yamahhala (BHB) ne-PAPP-A Yamahhala (PAPP-A). Ukuphatha lokhu kuhlolwa kuqondile, njengoba kudinga kuphela isampula yegazi kowesifazane okhulelwe.

Izinyathelo ezengeziwe zifaka:

• Ukusebenzisa isirinji ukuqoqa isampula yegazi emithanjeni.
• Ukufaka ibhande lokunwebeka ezingalweni kubangela ukuthi imithambo yegazi ivuvuke.
• Uma imithambo ibonakala, sebenzisa isibulala-magciwane esikhethekile ukuze uhlanze indawo ehlosiwe.
• Faka ngokucophelela inaliti, engase ibangele ukuzwa kwe-pinprick njengoba ingena emthanjeni wegazi. Ngaphambi kokuhlolwa, amasampula ayaqoqwa, agcinwe, futhi acutshungulwe.

Lena inqubo eqondile evamise ukuthatha imizuzu emihlanu ukuya kweyishumi kuphela ukuqeda. Ngakho-ke, kuyatuseka ukuhlela ukuhlolwa kwe-Dual Marker ukuze uphathe kangcono isimo.

Ukusetshenziswa kokuhlolwa kwe-Double Marker

Ukuze kutholwe ukuthi ingabe ingane inakho yini okungavamile ku-chromosomal, kusetshenziswa ukuhlola omaka kabili. Ukuhlolwa kubalulekile ukuze kutholakale noma yiziphi izinkinga zemizwa, njenge-Down syndrome noma i-Edwards syndrome, ku-fetus. Ukuhlolwa kwe-Double Marker, okuvame ukwaziwa ngokuthi Ukuhlolwa Kwegazi Lomama, kunconywa kakhulu phakathi nekota yokuqala yokukhulelwa. Kungolunye lwezivivinyo zokuhlolwa komama ezibaluleke kakhulu ezenziwa ngesikhathi sokukhulelwa. Ukusetshenziswa kokuhlolwa kwe-double marker ikakhulukazi ukuthola izimo ezifana ne-Down syndrome, eyaziwa nangokuthi i-trisomies 21, 18, kanye ne-13, engaholela ekutheni izinselele ezingokomzimba nezingokwengqondo ngengane engakazalwa.

Uzilungiselela Kanjani Ukuhlolwa Kwemaka Ekabili?

Asikho isidingo sokulungiselela ukuhlolwa okukhethekile; ilula impela. Kodwa-ke, kubalulekile ukuthi iziguli zazise udokotela wazo ngemithi yazo yamanje kanye nanoma yikuphi ukungezwani komzimba okungenzeka zibe nakho. Kuye ngalolu lwazi, bangase belulekwe ukuthi bayiyeke okwesikhashana imithi ethile ngaphambi kokuhlolwa. Lokhu kuhlolwa akukuzili futhi kungenziwa nganoma yisiphi isikhathi sosuku.

Amanani Emiphumela Yokuhlola Umaka Ekabili

Umbiko wokuhlola omaka kabili unganquma ukuthi ingabe ingane isengozini ephansi, ingcuphe emaphakathi, noma engcupheni enkulu yokuthola ukungavamile kwe-chromosomal. Umphumela ojwayelekile kungaba umphumela wobungozi obuncane noma umphumela ongemuhle wesikrini. Umaki ophindwe kabili wokuhlolwa awunayo kubonisa ukuthi amathuba okuthi ingane ibe nokungajwayelekile kwe-chromosomal mancane kakhulu. Ukuhlolwa kwezimpawu eziphindwe kabili kubonisa ubungozi obumaphakathi noma obuphezulu, okungase kudinge ukuhlolwa okwengeziwe, okufana nokuhlolwa kokubeletha okungeyona invasive (NIPT), ukuze kuqinisekiswe ukuxilongwa.

Inani elivamile le-hCG ku-Double Marker Test kwabesifazane abakhulelwe lisukela ku-25700 kuya ku-288000 mIU/ml kuwo wonke amaqembu eminyaka. I-PAPP-A i-dual marker test ibanga elijwayelekile kwabesifazane abakhulelwe i-1 MoM (inqwaba ye-median) kuwo wonke amaqembu eminyaka yobudala kwabesifazane.

Imiphumela yokuhlolwa yomaka kabili ivamise ukuhlukaniswa ngezigaba ezimbili ezihlukene:

Yiziphi Izinzuzo zokuhlolwa kwe-Double Marker?

Ukuhlolwa kwegazi okumbaxambili kunezinzuzo ezimbalwa kubazali, okuhlanganisa:

• Ukuhlolwa kwe-double marker akunikezeli abazali kuphela ulwazi abaludingayo ukuze benze izinqumo zokukhulelwa benolwazi kodwa futhi kuthola ukukhubazeka ku-fetus ekhulayo.
• I-Double Marker Test ayihlaseli, ayifaki ingozi kubo bobabili umama okhulelwe kanye nengane engakazalwa. Eqinisweni, kuyindlela elula yokuthola izinto ezingavamile ze-chromosome ku-fetus ngesikhathi sokukhulelwa.
• Le nqubo isiza ukukhomba izici eziyingozi ezihlobene nokukhulelwa futhi ihlole ukuthi ukukhulelwa kungase kube yingozi yini empilweni kamama.
• Izindleko zokuhlola omaka ababili nazo ziyathengeka. Kuyindlela engabizi kakhulu yokuthola ukungahambi kahle kwe-chromosomal ngesikhathi sokukhulelwa futhi ifinyeleleka eqenjini elibanzi labesifazane okungenzeka bangakwazi ukufinyelela ekuhlolweni okumba eqolo.
• Abanye besifazane bathola ukuthi ukwazi imiphumela ye-Double Marker Test kubanikeza ukuthula kwengqondo futhi kubasiza ukuba balungiselele ukuzalwa kwengane yabo.

Isiphetho

Kuyalulekwa kakhulu ukuthi wenze ukuhlolwa kwe-double marker ukuze kutholwe ukungahambi kahle ekuqaleni kokukhulelwa. Nakuba kungaphoqelekile, umbiko wokuhlola omaka okabili unganikeza ulwazi olwengeziwe olusiza ekuthuthukisweni nasekulawuleni ukukhulelwa.

Imibuzo Evame Ukubuzwa

1. Inembe kangakanani i-Double Marker Test? 

Izimpendulo. Ukuhlolwa kokumaka kabili ekukhulelweni akukona ukuxilonga kodwa kunokubikezela. Ayinikezi ngokuhlaziywa kwesayensi okuqinisekile kodwa ikhombisa amathuba okudidayo kwe-chromosomal.

2. Ingabe Ukuhlolwa Kwe-Double Marker kuyimpoqo? 

Izimpendulo. Ukuhlolwa komaka kabili akuphoqelekile kodwa kunconywa kakhulu, ikakhulukazi komama abakhulelwe abaneminyaka engaphezu kuka-35 engozini enkulu yezinkinga ze-chromosomal.

3. Ukuhlolwa kwe-Double Marker kuthatha isikhathi esingakanani? 

Izimpendulo. Ukuhlolwa kokumaka okukabili ngokuvamile kuthatha imizuzu emihlanu ukuya kweyishumi ngenxa yobulula bako.

4. Ingabe bukhona ubungozi obuhlobene ne-Double Marker Test? 

Izimpendulo. Ukuhlolwa komaka kabili akunazo izingozi. Lokhu kuhlolwa kwegazi kuwumkhuba futhi akuhlaseli.

Izikhombo:
https://www.healthline.com/health/pregnancy/double-marker-test#what-it-is
https://www.metropolisindia.com/blog/disease/double-marker-pregnancy-test/
https://redcliffelabs.com/myhealth/lab-test/pregnancy-test/double-marker-test-during-pregnancy/