Imtixaanka shaashadda ee afar-laablaha ah

Tijaabada shaashadda afar-geesoodka ah waa baaritaan dhiig oo la sameeyo inta lagu guda jiro uurka si loo ogaado haddii cunugga uu halis ugu jiro cilladaha dhalashada qaarkood.

Baaritaankaan waxaa badanaa la sameeyaa inta u dhexeysa toddobaadyada 15aad iyo 22aad ee uurka. Waxay ugu saxsan tahay inta u dhexeysa 16 iyo 18 toddobaad.

Muunad dhiig ah ayaa lagaa qaadayaa waxaana loo dirayaa shaybaarka si loo baaro.

Tijaabadu waxay cabirtaa heerarka 4 hormoonno uur leh:

• Alfa-fetoprotein (AFP), waa borotiin uu cunuggu soo saaro
• Gonadotropin chorionic Human (hCG), hormoon laga soo saaray mandheerta
• Unriojugated estriol (uE3), waa nooc ka mid ah hormoonka estrogen ee lagu sameeyo ilmaha caloosha ku jira iyo mandheerta.
• Inhibin A, oo ah hormoon ay sii daayaan mandheerta

Haddii baaristu aysan cabbiraynin heerarka inhibin A, waxaa loo yaqaannaa baaritaanka saddex-geesoodka ah.

Si loo go'aamiyo fursadda uu ilmahaagu ku yeelan karo cillad dhalasho, baaritaanka sidoo kale wuxuu sababi karaa:

• Dadaada
• Asalkaaga asalka ah
• Miisaankaaga
• Da'da uurka ilmahaaga (oo lagu cabiray toddobaadyo laga bilaabo maalinta caadadaadii ugu dambaysay ilaa taariikhda hadda)

Talaabooyin gaar ah looma baahna si loogu diyaariyo imtixaanka. Caadi ayaad cuni kartaa ama cabi kartaa baaritaanka ka hor.

Waxaa laga yaabaa inaad dareento xanuun yar ama qaniinyo markii cirbadda la gelinayo. Waxa kale oo laga yaabaa inaad dareento xoogaa jug ah goobta ka dib markii dhiigga lagaa qaado.

Baadhitaanka waxaa loo sameeyaa si loo ogaado haddii ilmahaagu halis ugu jiro cilado dhalasho oo gaar ah, sida cilladda Down syndrome iyo cilladaha dhalashada ee laf-dhabarka iyo maskaxda (oo loo yaqaan cilladaha tubada neural). Tijaabadani waa tijaabo baaris, sidaa darteed ma baarto dhibaatooyinka.

Haweenka qaarkood waxay halis weyn ugu jiraan inay dhalaan ilmo cilladahan leh, oo ay ka mid yihiin:

• Haweenka ka weyn 35 sano inta ay uurka leeyihiin
• Haweenka qaata insulin si ay u daweeyaan cudurka macaanka
• Haweenka leh taariikh qoys ee cilladaha dhalashada

Heerarka caadiga ah ee AFP, hCG, uE3, iyo inhibin A.

Heerarka qiimaha caadiga ahi way ku kala duwanaan karaan shaybaarada kala duwan. Kala hadal bixiyahaaga daryeelka caafimaadka macnaha natiijooyinkaaga gaarka ah ee baaritaanka.

Natiijada baaritaanka aan caadiga ahayn micnaheedu maahan in ilmahaagu hubaal inuu leeyahay cillad dhalasho. Badanaa, natiijooyinka waxay noqon karaan kuwo aan caadi ahayn haddii ilmahaagu ka weynaado ama ka yar yahay bixiyahaaga uu moodayey.

Haddii aad leedahay natiijo aan caadi ahayn, waxaad yeelan doontaa ultrasound kale si loo hubiyo da'da ilmaha koraya.

Tijaabooyin badan iyo la-talin ayaa lagu talin karaa haddii ultrasound-ka uu muujiyo dhibaato. Si kastaba ha noqotee, dadka qaarkiis waxay doortaan inaysan sameynin baaritaanno dheeri ah, sababo shaqsiyeed ama diimeed awgood.Tallaabooyinka soo socda ee suuragalka ah waxaa ka mid ah:

• Amniocentesis, oo hubiya heerka AFP ee dheecaanka amniotic ee ku hareeraysan ilmaha. Baadhitaanka hidda sidaha ayaa lagu samayn karaa dheecaanka amniotic ee laga soo saaray baaritaanka.
• Tijaabooyinka lagu ogaanayo ama meesha looga saarayo cilladaha dhalashada qaarkood (sida Down syndrome).
• La talinta hidaha
• Ultrasound si loo hubiyo maskaxda ilmaha, xudunta lafdhabarta, kilyaha, iyo wadnaha.

Xilliga uurka, heerarka sii kordhaya ee AFP waxaa laga yaabaa inay ugu wacan tahay dhibaatada ilmaha soo koraya, oo ay ka mid yihiin:

• Maqnaanshaha qayb ka mid ah maskaxda iyo qalfoofka (anencephaly)
• Cilad ku jirta mindhicirada ilmaha ama xubnaha kale ee ku dhow (sida duodenal atresia)
• Dhimashada ilmaha caloosha ku jira (badanaa waxay keentaa dhicin)
• Spina bifida (cilladda laf-dhabarka)
• Tetralogy of Fallot (cillad wadnaha)
• Turner syndrome (cillad hidde ah)

Wakaaladda sare ee 'AFP' waxay sidoo kale macnaheedu noqon kartaa inaad sido in ka badan 1 cunug.

Heerarka hoose ee AFP iyo estriol iyo heerarka sare ee hCG iyo inhibin A waxaa sababi kara dhibaato sida:

• Cilladda Down syndrome-ka (trisomy 21)
• Edwards syndrome (trisomy 18)

Shaashadda afar-geesoodka ahi waxay yeelan kartaa natiijooyin been-diid ah iyo been-togan (in kasta oo ay waxyar ka saxsan tahay shaashadda saddex-geesoodka ah). Tijaabooyin badan ayaa loo baahan yahay si loo xaqiijiyo natiijo aan caadi ahayn.

Haddii baaritaanka uusan caadi ahayn, waxaad u baahan kartaa inaad la hadasho la-taliyaha hidda-socodka.

Shaashadda Quad; Baadhitaano badan oo sumadeeyayaal ah; AFP oo lagu daray; Imtixaanka shaashadda saddex-geesoodka ah; AFP hooyada; MSAFP; Shaashadda 4-calaamadeeye; Down syndrome - afar laab; Trisomy 21 - afar laab; Turner syndrome - afar laab; Spina bifida - afar laab; Tetralogy - afar laab; Duodenal atresia - afar laab; La-talinta hidda-wadaha - afar-laab; Alfa-fetoprotein afar laab ah; Gonadotropin chorionic bini'aadamka - afarlaab; hCG - afar laab; Estriol aan la xakamaynin - afargeesle; uE3 - afar laab; Uurka - afar laab; Cilad dhalasho - afar laab; Imtixaanka calaamadaha afarlaha ah; Imtixaanka Quad; Shaashadda sumadeeyaha afar-laablaha ah

• Shaashad afar laab ah

ACOG Practice Bulletin No. 162: Baaritaanka ogaanshaha dhalmada kahor ee cudurada hidaha. Cudurka Gynecol. 2016; 127 (5): e108-e122. PMID: 26938573 pubmed.ncbi.nlm.nih.gov/26938573/.

Driscoll DA, Simpson JL. Baadhitaanka hiddo-wadaha iyo ogaanshaha hidda-socodka dhalmada kahor. Gudaha: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Uurka dhalmada Gabbe: Uurka caadiga ah iyo dhibaatada. 7aad ed. Philadelphia, PA: Elsevier; 2021: cutubka 10.

Wapner RJ, Dugoff L. Ciladda dhalmada kahor ee cudurada ku dhasha. Gudaha: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy iyo Daawada Hooyada-Uur-qaadista ee Resnik: Mabaadi'da iyo Tababarka. 8aad ed. Philadelphia, PA: Elsevier; 2019: cutubka 32.

Williams DE, Pridjian G. Dhalmada. Gudaha: Rakel RE, Rakel DP, eds. Buugga Caafimaadka Qoyska. 9aad. Philadelphia, PA: Elsevier; 2016: cutubka 20.