Hōʻike pale Quadruple

ʻO ka hoʻāʻo pale quadruple kahi hōʻike koko i hana ʻia i ka wā hāpai e hoʻoholo ai inā pilikia ka pēpē no kekahi mau hānau hānau.

Hana pinepine ʻia kēia hōʻike ma waena o nā pule he 15 a me ka 22 o ka hāpai keiki. ʻOi ka pololei ma waena o nā pule he 16 a me ka 18.

Lawe ʻia kahi laʻana koko a hoʻouna ʻia i ka hale hana no ka hoʻāʻo ʻana.

ʻO nā ana ka hōʻoia o nā pae o 4 mau hāpai hāpai:

• ʻO Alpha-fetoprotein (AFP), kahi protein i hana ʻia e ka pēpē
• Gonadotropin chorionic kanaka (hCG), kahi hormone i hana ʻia i ka placenta
• Untronjugated estriol (uE3), kahi ʻano o ka hormone estrogen i hana ʻia i loko o ka ʻōpū a me ka placenta
• ʻO Inhibin A, kahi hormone i hoʻokuʻu ʻia e ka placenta

Inā ʻaʻole ana ka hoʻāʻo i nā pae o ka inhibin A, ua kapa ʻia ia he ʻekolu pale hōʻike.

I mea e hoʻoholo ai i ka loaʻa o kāu pēpē i kahi kīnā o ka hānau ʻana, pili pū ka hōʻike i:

• Kou makahiki
• ʻO kāu moʻokūʻauhau
• Kou kaupaona
• ʻO ka hānau hānau o kāu pēpē (ana ʻia i mau pule mai ka lā o kou wā hope loa a hiki i kēia lā)

ʻAʻole pono nā hanana kūikawā e hoʻomākaukau ai no ka hōʻike. Hiki iā ʻoe ke ʻai a inu hoʻi ma mua o ka hoʻāʻo.

Hiki paha iā ʻoe ke ʻeha iki a i ʻole ke kuʻi ke hoʻokomo ʻia o ka nila. Hiki paha iā ʻoe ke hāwele i kahi kani ma ka pūnaewele ma hope o ka huki ʻia ʻana o ke koko.

Hana ʻia ka hoʻāʻo e ʻike inā pilikia paha kāu pēpē no kekahi kīnā o ka hānau ʻana, e like me Down Syndrome a me nā hemahema hānau o ka koluma a me ka lolo (i kapa ʻia he neural tube defect). ʻO kēia hōʻoia kahi hōʻike loiloi, no laila ʻaʻole ia e hōʻike i nā pilikia.

ʻOi aku ka makaʻu o kekahi mau wahine i ka loaʻa ʻana o kahi pēpē me kēia mau kīnā, e like me:

• Nā wahine i ʻoi aku ma mua o 35 mau makahiki i ka wā hāpai
• Nā wahine e lawe ana i ka insulin e mālama i ka maʻi diabetes
• Nā wahine me ka mōʻaukala hānau o nā hānau kīnā

Nā pae maʻamau o AFP, hCG, uE3, a me ka mea kūpaʻa A.

Hiki ke loli iki nā pae waiwai maʻamau i waena o nā hale hana ʻokoʻa. E kamaʻilio me kāu mea mālama ola e pili ana i ke ʻano o kāu mau hopena hōʻike kikoʻī.

ʻO ka hopena o kahi hopena hōʻike maʻamau ʻaʻole ia he kumu hānau kīnā o kāu pēpē. ʻO ka pinepine, hiki i nā hopena ke ʻano ʻē inā ʻelemakule a pēpē paha kāu pēpē ma mua o ka manaʻo o kāu mea hāʻawi.

Inā loaʻa iā ʻoe kahi hopena maikaʻi ʻole, loaʻa iā ʻoe kekahi ultrasound hou e nānā i ka makahiki o ka pēpē e ulu ana.

ʻOi aku paha nā ho'āʻo a me nā ʻōlelo aʻoaʻo paha e koi ʻia inā hōʻike ka ultrasound i kahi pilikia. Eia nō naʻe, koho kekahi poʻe ʻaʻole e hana hou i nā hoʻokolohua hou, no nā kumu pilikino a hoʻomana paha.Nā ʻanuʻu aʻe e hiki mai ana:

• Amniocentesis, ka mea e hōʻoia i ka pae o ka AFP i ka wai amniotic e hoʻopuni ana i ka pēpē. Hiki ke hana i nā hoʻāʻo genetic ma ka wai amniotic i hoʻoneʻe ʻia no ka hoʻāʻo.
• ʻO nā hoʻāʻo e ʻike a hōʻole paha i kekahi mau kīnā hānau (e like me Down Syndrome).
• ʻLelo aʻoaʻo genetic.
• ʻO Ultrasound e nānā i ka lolo o ka pēpē, nā ʻalalā, nā puʻupaʻa, a me ka puʻuwai.

I ka wā hāpai, hoʻonui ʻia nā pae o ka AFP ma muli o kahi pilikia me ka pēpē e ulu ana, e like me:

• Ka loaʻa ʻole o kahi ʻāpana o ka lolo a me ka iwi poʻo (anencephaly)
• Kīnā ʻole i loko o ka ʻōpū o ka pēpē a i ʻole nā ​​mea pili ʻē aʻe (e like me duodenal atresia)
• Ka make ʻana o ke pēpē i loko o ka ʻōpū (ʻo ka hopena maʻamau i ka hānau hānau ʻole)
• Spina bifida (maʻi kīnā)
• ʻO Tetralogy o Fallot (maʻi kīnā ʻole)
• Turner syndrome (maʻi kīnā)

Hiki i ke kiʻekiʻe AFP ke manaʻo e hāpai ana ʻoe ma mua o 1 pēpē.

ʻO nā haʻahaʻa haʻahaʻa o ka AFP a me ka estriol a me nā kiʻekiʻe o ka hCG a me ka inhibin A ma muli o kahi pilikia e like me:

• Down syndrome (trisomy 21)
• Edwards maʻi pale (trisomy 18)

Hiki i ka pale quadruple ke loaʻa nā hopena maikaʻi ʻole a maikaʻi ʻole (ʻoiai ʻoi aku ka pololei ma mua o ka pākolu pale). Pono nā ho'āʻo hou e hōʻoia i kahi hopena maikaʻi ʻole.

Inā kūpono ʻole ka hoʻāʻo, pono ʻoe e kamaʻilio me ke kākāʻōlelo.

Pākuʻi Quad; Ke kānana māka lehulehu; AFP hoʻohui; Hōʻike pale Triple; AFP makuahine; MSAFP; Pale 4-marker; Down Syndrome - quadruple; Trisomy 21 - quadruple; Turner Syndrome - quadruple; Spina bifida - quadruple; Tetralogy - quadruple; Duodenal atresia - quadruple; ʻLelo aʻoaʻo genetic - quadruple; Quadruple ʻo Alpha-fetoprotein; Gonadotropin chorionic kanaka - quadruple; hCG - quadruple; Unconjugated estriol - quadruple; uE3 - quadruple; Hāpai keiki - quadruple; Hānau hānau - quadruple; Hōʻike hoʻāʻo Quadruple; Hōʻike Quad; Pākuʻi māka Quadruple

• Pākuʻi Quadruple

ʻO ka Bulletin Hoʻolālā ACOG Helu 162: ʻO ka hōʻoia diagnostic Prenatal no nā maʻi maʻi. ʻO Obstet Gynecol. 2016; 127 (5): e108-e122. PMID: 26938573 pubmed.ncbi.nlm.nih.gov/26938573/.

ʻO Driscoll DA, Simpson JL. ʻO ka kānana genetic a me ka hōʻoia genetical prenatal. I: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Nā Kāpena Gabbe: Nā Pregnancies Maʻamau a me nā Pilikia. ʻEpekema 7 Piladelapia, PA: Elsevier; 2021: chap 10.

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.

ʻO Williams DE, Pridjian G. Obstetrics. I: Rakel RE, Rakel DP, eds. Puke aʻo o ka lāʻau lapaʻau ʻohana. 9th ed. Piladelapia, PA: Elsevier; 2016: chap 20.