ʻO Amniocentesis

ʻO Amniocentesis kahi hōʻike i hiki ke hana ʻia i ka wā o ka hāpai ʻana e nānā no kekahi mau pilikia i ka pēpē ulu. Aia kēia mau pilikia i:

• Hewa hānau
• Nā pilikia genetic
• Maʻi kīnā
• Hoʻonui ulu

Wehe ʻo Amniocentesis i kahi wai liʻiliʻi mai ka ʻeke a puni ka pēpē i ka ʻōpū (uterus). Hana pinepine ʻia ia i ke keʻena o ke kauka a i ʻole ke kikowaena lapaʻau. ʻAʻole pono ʻoe e noho i ka haukapila.

E loaʻa iā ʻoe kahi ultrasound hāpai mua. Kōkua kēia i kāu mea mālama ola ʻike i kahi o ka pēpē i loko o kou ʻōpū.

Kāpala ʻia ka lāʻau numbing ma kahi o kou ʻōpū. I kekahi manawa, hāʻawi ʻia ka lāʻau i ke kī ʻana i ka ʻili ma ka ʻōpū. Hoʻomaʻemaʻe ʻia ka ʻili me kahi wai disinfecting.

Hoʻokomo kāu mea hoʻolako i kahi nila lōʻihi lōʻihi lahilahi ma o kou ʻōpū a i loko o kou ʻōpū. Lawe ʻia kahi wai liʻiliʻi (ma kahi o 4 teaspoons a i ʻole 20 milliliters) mai ka ʻeke e hoʻopuni ana i ka pēpē. I ka hapanui o nā hihia, nānā ʻia ka pēpē e ka ultrasound i ke kaʻina hana.

Hoʻouna ʻia ka wai i kahi keʻena hoʻokolohua. Hoʻokomo ʻia paha ka hoʻāʻo ʻana:

• Nā aʻo genetic
• Ke ana o nā pae alpha-fetoprotein (AFP) (kahi mea i hana ʻia i ke ake o ke keiki e ulu ana)
• Ka moʻomeheu no ka maʻi

ʻO nā hopena o ka hoʻāʻo ʻana i nā genetics ma kahi o 2 mau pule. Hoʻi ʻia nā hopena hōʻike ʻē aʻe i 1 a 3 mau lā.

I kekahi manawa hoʻohana ʻia ka amniocentesis ma hope i ka hāpai ʻana i:

• Kaha maʻi
• E hōʻoia inā hoʻomohala ʻia nā māmā o ka pēpē a mākaukau no ka lawe ʻana
• Wehe i ka nui o ka wai mai a puni ka pēpē inā nui ka wai amniotic (polyhydramnios)

Pono paha e hoʻopiha i kāu ʻōpū no ka ultrasound. E hōʻoia me kāu mea hoʻolako e pili ana i kēia.

Ma mua o ka hoʻāʻo ʻana, lawe ʻia paha ke koko e ʻike i kāu ʻano koko a me ka Rh factor. Loaʻa paha iā ʻoe kahi kī o ka lāʻau i kapa ʻia ʻo Rho (D) Immune Globulin (RhoGAM a me nā mana ʻē aʻe) inā maikaʻi ʻole ʻoe Rh.

Hāʻawi pinepine ʻia ʻo Amniocentesis i nā wahine i hoʻonui i ka makaʻu i ka loaʻa ʻana o kahi keiki me nā kīnā hānau. Hoʻopili kēia i nā wahine i:

• He 35 a ʻoi paha ko lākou wā hānau
• Inā he hōʻike loiloi e hōʻike ana aia paha he kīnā hānau a i ʻole kekahi pilikia ʻē aʻe
• Ua loaʻa nā pēpē me nā kīnā hānau i nā hāpai ʻē aʻe
• Loaʻa i kahi moʻolelo ʻohana o nā maʻi kūlohelohe

Paipai ʻia ka ʻōlelo aʻoaʻo genetic ma mua o ke kaʻina hana. E ʻae kēia iā ʻoe e:

• E aʻo e pili ana i nā hōʻike prenatal ʻē aʻe
• E hoʻoholo hoʻoholo e pili ana i nā koho no ka hōʻoia prenatal

Kēia hōʻike:

• He hōʻoia diagnostic ia, ʻaʻole ia he hōʻike kānana
• Kūpono loa ia no ka diagnose Down Syndrome
• Hana pinepine ʻia ma waena o 15 a 20 mau pule, akā hiki ke hana ʻia i kēlā me kēia manawa ma waena o 15 a 40 mau pule

Hiki ke hoʻohana ʻia ka Amniocentesis e hōʻoia i nā pilikia ʻokoʻa a me nā chromosome i loko o ka pēpē, e like me:

• Anencephaly (ke nalowale nei ka pēpē i kahi hapa nui o ka lolo)
• Down syndrome
• Nā maʻi metabolic kakaikahi i hoʻoili ʻia i loko o nā ʻohana
• ʻO nā pilikia ʻē aʻe, e like me trisomy 18
• Nā maʻi i loko o ka wai amniotic

ʻO kahi hopena maʻamau:

• ʻAʻole i loaʻa kahi pilikia a me nā pilikia chromosome i kāu pēpē.
• ʻIke ʻia nā pae Bilirubin a me alpha-fetoprotein maʻamau.
• ʻAʻole i loaʻa nā hōʻailona o ka maʻi.

Kahakaha: ʻO ka amniocentesis maʻamau ka hōʻoia pololei loa no nā kūlana kūlohelohe a me nā malformation, ʻoiai he kakaikahi, loaʻa paha i kahi pēpē ke ʻano a me nā ʻano hānau ʻē aʻe, ʻoiai inā he maʻamau nā hopena amniocentesis.

Ma muli o ka hopena o ka hopena o kāu pēpē:

• ʻO kahi pilikia a kine a chromosome paha, e like me Down Syndrome
• Nā kīnā hānau e pili ana i ka iwi kuamoʻo a i ʻole ka lolo, e like me spina bifida

E kamaʻilio i kāu mea hāʻawi e pili ana i ke ʻano o kāu mau hopena hōʻike. E noi i kāu mea hāʻawi:

• Pehea e mālama ʻia ai ke ʻano a i ʻole kīnā paha i ka wā ma hope o kou hāpai ʻana
• He aha nā mea kūikawā e pono ai kāu keiki ma hope o ka hānau ʻana
• He aha nā koho ʻē aʻe āu e pili ana i ka mālama ʻana a hoʻopau ʻana i kāu hāpai ʻana

Heʻuʻuku nā pilikia, akā hiki ke hoʻopili ʻia:

• ʻO ka maʻi a ʻeha paha i ka pēpē
• Hāʻule hāʻule
• Ke kulu ʻana o ka wai amniotic
• Kahe koko ʻana

Moʻomeheu - amniotic fluid; Ka moʻomeheu - nā hunaʻi amniotic; Alpha-fetoprotein - amniocentesis

• ʻO Amniocentesis
• ʻO Amniocentesis
• Amniocentesis - moʻo

ʻO Driscoll DA, Simpson JL, Holzgreve W, Otano L. Ke kānana genetic a me ka ʻike genen prenatal. I: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Nā Obstetrics: Nā Pregnancies Maʻamau a me nā pilikia. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 10.

Patterson DA, Andazola JJ. ʻO Amniocentesis. I: Fowler GC, nā ʻaoʻao. ʻO Pfenninger a me Fowler's Procedures no ka mālama mua. ʻEhā ed. Piladelapia, PA: Elsevier; 2020: chap 144.

ʻO Wapner RJ, Dugoff L. Palapala Prenatal o nā maʻi kūlohelohe. I: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. ʻO Medicine a Maternal-Fetal a Creasy a me Resnik: Nā Manaʻo a me ka Hoʻomeheu. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 32.