Ukuhlolwa kwe-triple marker, okubuye kwaziwe ngokuthi i-triple screen test, ukuhlola igazi kwangaphambi kokubeletha okuthola ubungozi bokungalungi kofuzo ku-fetus. Lokhu kuhlolwa kukala amazinga ezinto ezintathu - i-alpha-fetoprotein (AFP), i-chorionic gonadotropin (hCG) yabantu, kanye ne-estriol engahlanganisiwe (uE3) - egazini lowesifazane okhulelwe.

Kuyini Ukuhlola Umaka Kathathu?

Ukuhlolwa komaka kathathu kubala amathuba okuthi umbungu ube nokungajwayelekile kwe-chromosomal noma iphutha le-neural tube. Ayihloli isifo esiwujuqu. Uma amathuba emaningi, udokotela uncoma ukuhlolwa kokuxilonga ukuze kuqinisekiswe.

• Ukuhlolwa kokuhlolwa okwenziwe phakathi namaviki ayi-15-18 we ukukhulelwa.
• Ihlaziya amazinga egazi amahomoni amathathu - AFP, hCG, estriol.
• Ihlola ubungozi bezinkinga zofuzo njenge-Down's syndrome, i-trisomy 18, noma ukukhubazeka kwemizwa.
• Futhi kubizwa ngokuthi ukuhlolwa kwesikrini kathathu, ukuhlolwa okuphindwe kathathu, ukuhlolwa kwe-AFP plus.

Inhloso Yokuhlola Umaka Kathathu

Uhlolo lukamaka kathathu luhlola ikakhulukazi izindaba ezinkulu zofuzo ku-fetus, njenge:

• I-Down's syndrome - Ibangelwa ikhophi eyengeziwe ye-chromosome 21
• Ukukhubazeka kwe-Neural tube - Lapho i- umgogodla noma ubuchopho buhluleka ukukhula kahle
• I-Edward syndrome (i-Trisomy 18) - I-chromosome eyengeziwe 18
• I-Trisomy 13 (i-Patau syndrome) - I-chromosome eyengeziwe 13

Ukuhlola kubala, ngokusekelwe kumaka egazi likamama, ukuthi ingabe umbungu uwela endaweni enengozi ephezulu noma ephansi yalezi zinkinga ezivamile ze-chromosomal.

Kudingeka Nini Ukuhlola Umaka Kathathu?

Odokotela batusa ukuhlolwa komaka kathathu kwabesifazane abakhulelwe:

• Bangaphezu kweminyaka engama-35 ubudala
• Wayenengane enanoma yikuphi ukukhubazeka kokuzalwa ngaphambilini
• Yiba nomlando womndeni wezinkinga zofuzo
• Yakhelwe kusetshenziswa i-IVF
• Iba nezinkinga zempilo esezivele zikhona njenge sikashukela noma umfutho wegazi ophezulu

Kwenzekani Ngesikhathi Sokuhlolwa Komaka Okuthathu?

• Inani elincane legazi, elizungeze i-5-10 ml likhishwa
• Amazinga e-AFP, i-hCG, ne-estriol ayalinganiswa
• Isofthiwe ibala amathuba okuba sengozini ngokusekelwe kumazinga ehomoni
• Imiphumela ikhombisa amathuba aphezulu noma aphansi ezinkinga zofuzo
• Uma ubungozi obukhulu, kunconywa ukuhlolwa okwengeziwe ukuze kuqinisekiswe ukuxilongwa

Ukuhlolwa kufana nokudonsa igazi okuvamile. Kuboshelwa i-tourniquet, indawo okudonswa kuyo igazi iyahlanzwa, bese umhlengikazi efaka inaliti ukuze kukhishwe igazi ezitsheni ezinamathiselwe. Leli sampula legazi libe selithunyelwa ku- I-laboratory ukuze kuhlaziywe. Akukho ukuphatheka kabi ngokomzimba okubalulekile phakathi noma ngemva kokuhlolwa. 

Ukusetshenziswa Kokuhlola Umaka Kathathu

• Nquma isidingo sokuhlolwa okwengeziwe kokuxilonga ngaphambi kokubeletha
• Yazisa abazali ukuze balungiselele ukukhulelwa nokubeletha okusengozini enkulu
• Nquma ukunakekelwa kwezokwelapha kanye nokungenelela ngesikhathi sokukhulelwa
• Lungiselela abazali ngokomzwelo futhi uhlele izinsiza zengane enezidingo ezikhethekile

Ukuhlolwa kuvumela abazali nodokotela ukuthi bahlale beqaphile futhi benze izinqumo ezinolwazi mayelana nokunakekelwa ngaphambi kokubeletha. Inika abazali amandla okuzihlomisa ukwamukela ingane engase idinge ukwesekwa okwengeziwe kwezokwelapha noma komphakathi.

Inqubo Yokuhlola Umaka Kathathu

Ngaphambi Kwesivivinyo

• Akukho ukulungiselela okukhethekile okudingekayo
• Ingaqhubeka ukudla okuvamile kanye nemisebenzi
• Yazisa udokotela nganoma yimiphi imithi noma izithasiselo

Ngesikhathi Sokuhlolwa

• Igazi likhishwa engalweni njengokuhlola okuvamile
• I-Tourniquet iboshwe engalweni engenhla
• Ukuhlanzwa kwendawo yokufaka inaliti engalweni
• Ukufakwa kwenaliti nokunamathiselwa kwezitsha
• Ukudweba igazi elingu-5 kuye ku-10 ml ezitsheni
• Ukususa i-tourniquet nenaliti
• Ukuhlanza indawo

Ngemuva kweTest

• Isampula yegazi lithunyelwe elebhu ukuze lihlaziywe
• Amazinga okuhlola we-AFP, hCG, estriol 
• Ukubalwa kwezikolo ezinobungozi kusetshenziswa isofthiwe
• Udokotela azise abazali ngemiphumela
• Ukuhlola okwengeziwe uma ubungozi obukhulu bubonisiwe

Lungiselela Ukuhlolwa Kwemaka Ezintathu

Njengoba kuhilela ukudonsa igazi kuphela, akukho ukulungiswa okuqondile okudingekayo. Kodwa, ngokujwayelekile:

• Yidla ukudla okunomsoco okunomsoco
• Qhubeka nanoma yimiphi imithi ebekiwe
• Gwema ukubhema, utshwala nezidakamizwa
• Yazisa udokotela ngezinkinga zempilo ezingapheli
• Yabelana okwedlule izinkinga zokukhulelwa, uma ikhona
• Bhala phansi imibuzo ongase ube nayo mayelana nokuhlolwa

Ukuphumula ngokwanele nokudla kuthuthukisa inhlalakahle yakho futhi kusekela ukukhula okufanele kombungu.

Isho ukuthini Imiphumela Yokuhlola Umaka Kathathu (uma iphansi futhi ingaphezulu kwamazinga avamile)?

Ibanga elijwayelekile:

• I-AFP: <2.5 MoM (ama-median amaningi)
• I-hCG: 0.5 - 2.5 MoM
• I-Estradiol: >0.25 MoM

Umphumela Wokuhlola Omuhle:

• Amazinga aphezulu e-AFP akhombisa ithuba elikhulu lokuvuleka kwe-neural tube defect njenge-spina bifida. 
• I-AFP ephansi ikhomba engcupheni ye-Down's syndrome.
• I-hCG ephakeme ingasho amathuba amakhulu e-Down's syndrome, i-triploidy, nokukhulelwa kwamawele.
• I-estradiol ephansi ibonisa ingozi ephezulu ye-Down's syndrome kanye ne-Edwards syndrome trisomy 18.

Umphumela Wokuhlola Omubi:

• Amazinga e-AFP, hCG kanye ne-estradiol ngaphakathi kwebanga elivamile abonisa ubungozi obuphansi bokungajwayelekile kofuzo. 
• Nokho, ingane enempilo ayiqinisekisiwe.

Umaka Ophindwe Kabili kanye Nomaka Kathathu: Uyini umehluko?

Nawu umehluko phakathi komaka okabili kanye nokuhlolwa kukamaka okuthathu: 

• Ukuhlolwa kokumaka kabili - i-AFP ne-hCG kuphela
• Ukuhlolwa kokumaka okuthathu - i-AFP, i-hCG ne-estradiol

Ukuhlolwa komaka kathathu kunwebeka kakhulu njengoba kuhlaziya ihomoni eyodwa eyengeziwe. Lokhu kunikeza ukunemba okukhulu ekunqumeni ubungozi bokuphazamiseka kofuzo. Inamazinga aphansi amanga amahle kanye namazinga aphezulu okutholwa.

Isiphetho

Ukuhlolwa komaka kathathu kuvumela abesifazane abakhulelwe ukuthi bahlole amathuba okuthi ingane yabo ibe nokudidayo okukhulu kwe-chromosomal noma izinkinga ze-neural tube. Ngaphansi kokuqondisa kochwepheshe, ukuhlolwa kunikeza abazali amandla okuthuthukisa imiphumela yezempilo ngokungenelela okufika ngesikhathi. Nakuba kungekho ukuhlolwa kokubeletha okunembile ngokuphelele, isikrini esiphindwe kathathu sinikeza imininingwane ebalulekile yokunakekelwa kwangaphambi kokubeletha okunakekile futhi okumatasa.

Ama-FAQ:

1. Liyini izinga elijwayelekile lesiko lomchamo?

Izimpendulo: Izinga le-AFP phakathi kuka-0.5-2.5 MoM libhekwa njengejwayelekile. Ngaphezulu kuka-2.5 MoM ukhombisa ubungozi obuphezulu, ngakho-ke kufanele uvakashele udokotela wakho.

2. Kwenzekani uma ukuhlolwa kuka-triple marker ku-positive?

Impendulo: Ukuhlolwa okuqondile kusho ingozi enkulu yezindaba zofuzo. Ukuhlolwa okwengeziwe kokuhlola okuhlaselayo kuyadingeka ukuze kuqinisekiswe ukuphazamiseka kwe-chromosomal. I-Amniocentesis kanye ne-chorionic villus sampling yizivivinyo zokuqinisekisa ngaphambi kokubeletha.

3. Kwenzekani uma ukuhlolwa kuka-triple marker kungenayo?

Impendulo: Umphumela ongemuhle uphakamisa amathuba aphansi okuphazamiseka. Kodwa, akuqinisekisi ukuthi ngeke kube khona ukuphazamiseka. Ukuhlola okuphindaphindiwe kungase kudingeke uma udokotela esola izinkinga ezingase zibe khona. 

4. Yisiphi isikhathi esingcono kakhulu sokwenza ukuhlolwa okuthathu?

Izimpendulo: Isikhathi esifanele sokuhlolwa komaka kathathu siphakathi kwamaviki ayi-15 kuya kwangu-20 okukhulelwa. Lokhu kuvumela ama-hormone ukuba akhuphukele emazingeni alinganisekayo egazini. Ukuhlola kusenesikhathi kunganikeza imiphumela engathembekile enemiphumela eminingi engamanga. Amahomoni akhuphuka phakathi kwamaviki 15-18, okwenza kube iwindi lokuhlola elilungile.