「第三隻眼」
小寶寶的成長由一顆受精卵開始,越變越多顆成為像桑椹般的囊胚,然後變化成像三明治般多層的胚胎,最後再慢慢成型為胎兒。整個過程像西遊記裡孫悟空的七十二變般神奇,卻是每個人類自然的發育過程。孫悟空的千變萬化雖然讓他與二郎神大戰三百回合難分難解,只是最後還是逃不過二郎神的第三隻眼,原形畢露。超音波 就像是婦產科醫師的第三隻眼,將孕期中胎兒與子宮環境的變化,清楚的反映出來。
在懷孕的前幾週,當胎苞還只是0.5公分大小的時候,超音波即可掃瞄出小寶寶的存在;當懷孕三個月時超音波便能觀察到寶寶初為人形的樣子,也能開始做一些測量如唐氏症頸部透明帶的篩檢。 懷孕中期,高層次超音波主要是做器官系統形體上的篩檢,小至0.2 公分的心室中隔缺陷都有可能被找出來。在第三孕期時,超音波會做生產風險的評估或再找出一些寶寶先天性異常的型態。
雖然說超音波不是萬能的,還是有許多疾病與問題無法以超音波發現,如新陳代謝疾病,但對婦產科醫師來說已是不可或缺的工具。
A baby’s journey in life starts with a single fertilised egg, which multiplies to become like a mulberry called morula. Then it becomes a 3-layered structure that will eventually develop different organ systems. The whole process involves innumerable steps of morphological changes. The ability of the embryo to undertake these changes reminds me of the monkey king from the classic Chinese novel “Journey to the West”, who is able to morph into infinite number of objects. However, the rebel monkey king was captured by the Jade Emperor’s nephew because he has a 3rd eye that sees through each the monkey king’s tricks. I think prenatal ultrasound is like the third eye because it sees clearly the many changes an embryo undergoes as it grows.
During the first trimester, an implanted embryo as small as 0.5cm in size may be “seen” by a modern ultrasound. And by 3 months, the risk of Down Syndrome can be calculated based on the measurements done on the already-humanoid embryo. A more sophisticated ultrasound (level II) May be utilised during the second trimester to detect birth defects. For example, a hole as small as 0.2cm may be detected in the heart. During the third trimester, the ultrasound is usually used for obstetrics risk evaluation and/or further screening of any birth defects.
Ultrasound does not detect all prenatal defects because some conditions simply cannot be “seen” on ultrasound, such as inborn error of metabolism. However, the use of ultrasound is an essential tool for all obstetricians.
同時也有1部Youtube影片,追蹤數超過8,140的網紅Mama College,也在其Youtube影片中提到,產前的篩檢項目中,染色體檢查是相當重要的一項,尤其是高齡產婦或是流產高發生群孕婦。 Why do we need Prenatal Screening in the first trimester? 什麼是染色體?What is chromosome? 染色體是儲存人類遺傳訊息「基因」的結構, ...
first trimester down screening 在 Mama College 張嘉兒 Facebook 的最讚貼文
什麼是染色體?你需要什麼產前篩檢? What are we screening for in the first trimester? Understanding Down Syndrome, Edward Syndrome, Patau Syndrome.
first trimester down screening 在 Mama College Youtube 的精選貼文
產前的篩檢項目中,染色體檢查是相當重要的一項,尤其是高齡產婦或是流產高發生群孕婦。
Why do we need Prenatal Screening in the first trimester?
什麼是染色體?What is chromosome?
染色體是儲存人類遺傳訊息「基因」的結構, 正常嬰兒細胞染色體共有23對46條染色體.,分別來自父母雙方.
Chromosomes are a DNA, it dictates who we are, how we look like and our personality. Humans have 23 pairs of chromosomes, one set from each parent.
前22對叫做體染色體, 最後一對為性染色體(sex chromosomes),乃因決定人類性別. 正常男性帶著XY性染色體,女性為XX
Our 23rd pair of chromosomes dictates if we are male are female. XX being female, XY being male.
染色體異常 Chromosomes abnormality
染色體疾病的分類
染色體疾病可分為三大類:即數目異常、結構異常及混合有兩種或兩種以上細胞核型的拼湊型異常。
If there is any mismatch, addition or deletion in any of the 23 pairs chromosomes, mothers may have a miscarriage or infant may be born to have genetic defects, growth retardation or shorter lifespan.
「唐氏綜合症」(T21) 的嬰兒於在第21號染色體多一條所致,故這些嬰兒有47條,影響他們的外觀、身體及智力發展. 大約700人之中有一名會有唐氏綜合症。
Down Syndrome occurs when there is an extra chromosome 21.
除了第21對染色體,第13 「巴陶氏症」和18 「愛德華氏綜合症」對亦常見出現出錯問題,惟對胎兒發展影響更大,此類孩子通常難以生存。
艾德華氏症
艾德華氏症(Edwards syndrome)即三染色體18症,發生率約為每7,000個活產當中會出現一例,女性患者遠多於男性
Edwards Syndrome occurs when there is an extra chromosome 18.
巴陶氏症
巴陶氏症(Patau syndrome)即三染色體13症,
此症的發生率約為每20,000個活產兒會出現一例,由於13號染色體帶有較多的基因數,因此13號三染色體症會造成相當嚴重的傷害,其平均壽命約只有4~6個月,絕大多數的患兒在三歲以前均會夭折。
Patau syndrome occurs when there is an extra 13 chromosome.
透納氏症
透納氏症(Turner's syndrome)又稱為X單染色體症(monosomy X), 這是唯一失去一整個染色體仍能存活的疾病。即使如此,大多數的X單染色體症胎兒在懷孕早期便自然流產或胎死腹中。
Turner's Syndrome occurs when one X chromosome is missing.
篩查測試去計算胎兒染色體綜合症的風險(或機會)
產前的篩檢項目中,染色體檢查是相當重要的一項,尤其是高齡產婦或是流產高發生群孕婦。
Therefore, it is important to have prenatal screening during the 9th-12th weeks of pregnancy.
Please watch the next video to find out what prenatal screening suits you.
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