twachiya naabhi rakt namunakaran

twachiya naabhi rakt namunakaran (pub), jise cordocentices, bhroon rakt namunakaran, yaa naabhi nus namunakaran bhee kahaa jaataa haye, ack naidaanik aanuvanshik pareekshan haye joe bhroon kii asaamaanyataon kaa pataa lagaane key liye bhroon naabhi seey rakt kii jaanch kartaa haye. bhroon aur maatri rakt kii aapoorti aamtaur parr garbhashay mein ack nus aur dou dhamniyon key saath bhroon seey judee hoti haye. naabhi nus maan seey bhroon koo oxygen yukt rakt pahunchaane key liye jimmedaar haye; naabhi dhamaniyan bhroon seey oxygen kii kamee vaale rakt koo hataane key liye jimmedaar hain. yeh bhroon key ootakon koo thheek seey sugandhit karane kii anumati detaa haye. pub teji seey gunasutra vishleshan kaa ack saadhan pradaan karate hain aur taba upayogi hotaa haye jaba jaankaari koo amneocentasis, choreonic vilas sampling, yaa ultrasound (yaa yadi inn parikshanon key parinam anirnaayak they) key madhyam seey praapt naheen kiya jaa sakata haye; yeh pareekshan jatilata kaa ack mahatvapurna jokhim rakhta haye aur aamtaur parr aanuvanshik dosh key liye uchch jokhim mein nirdhaarit garbhavastha key liye aarakshit hotaa haye. iska upayog pratiraksha thrombocytopanic purpura vaali maataon key saath kiya gayaa haye.
itihas.
pubs bhroon key rakt key namoone kaa ack prakaar haye jise mool roop seey vanshaanugat asaamaanyataon kii upasthiti koo nirdhaarit karane key liye vikasit kiya gayaa thaa. vartamaan mein, yeh ph star, oxygen star, gunasutra sambandhi muddon aur sankramanon sahit kaee asaamaanyataon kaa pataa lagaa sakata haye. 1958 mein, james ell.aiss. yeh maanyata praapt haye kii naabhi rakt gais vishleshan bhroon key poorvavarti hypoxic tanaav kaa sanket dey sakata haye. taba seey yeh vyaapak roop seey sweekaar kiya gayaa haye kii naabhi rakt gais vishleshan shishu key ateet, vartamaan aur sambhavatah bhavishya kii sthiti key baare mein mahatvapurna jaankaari pradaan curr sakata haye. pub 1964 seey shuru hotey hain jaba freda aur adamson ney ack bhroon vaale garbhashay koo hataane kii soochana dee jisamen taral padaarth kaa nirmaan thaa aur joe marr gayaa thaa; haalaanki, yeh pahali prakriyaon mein seey ack thee joe vartamaan dinn key pub key liye vaadaa dikhaati thee. 1972 mein valenti ney parikalpana kii kii bhroon key ootak praapt karane key liye upayog kii jaane vaali prakriya kaa upayog bhroon rakt praapt karane key liye kiya jaa sakata haye, aur 1973 mein, vaha bhroon vaahikaon kaa namuna lene mein saksham thaa; bhroon kii sthiti nirdhaarit karane key saath-saath bhroon rakt praapt karane aur kuchh mamalon mein aadhaan karane key liye 1974 aur 1983 key beach bhroon kii jaanch kaa upayog kiya gayaa thaa aur ise ack prasavpurv pareekshan key roop mein parishkrit kiya gayaa thaa. bhroon kii jaanch ack aisee prakriya haye jisamen bhroon kii kalpana karane key liye maan key pett key madhyam seey ack upkaran daala jaataa haye. pub kaa pahala pralekhit upayog 1983 mein daphos aur sahyogiyon dwara kiya gayaa thaa, jinhone suee key saath ack naabhi nus seey rakt kaa namuna liya aur ack ultrasound key saath isake chaal kii nigrani kii. pub ney bhroon pareekshan key liye ack adhik safal aur cumm khatarnak vikalp prastut kiya haye, jisamen 5-10% kaa garbhpaat kaa khatra thaa.
aadhunik chikitsa aur naee takneekon key vikas key saath, pub kaa upayog aksar naheen kiya jaataa haye sivaay isake kii jaba bhroon aur sandigdh asaamaanyataon key sambandh mein teji seey nidan aur nirnay liye jaane chaahiye. pub koo mukhya roop seey sthit sankaran (machhali) mein pratideepti dwara pratisthaapit kiya gayaa haye joe gunasutra asaamaanyataon kii adhik vistrit jaanch haye.
prakriya.
yadi bhroon vyavharya haye, tou prakriya key kaaran honey vaali jatilataon key kaaran aapaatkaaleen cesarian section aavashyak honey kii sthiti mein prakriya koo ack operation room key paas kiya jaataa haye. vartamaan mein, vyavaharyata kii koee nishchit ayu naheen haye kyonki yeh garbh key baahar jeevit rahane kii bhroon kii kshamata parr nirbhar kartaa haye, joe samay seey pahale janm key mamalon mein, navjat avastha key madhyam seey bhroon koo jeevit rakhane key liye aavashyak chikitsa dekhbhal aur praudyogiki taka pahunch parr nirbhar curr sakata haye. bhroon kii vyavaharyata aamtaur parr garbhavastha key lagbhag 24 seey 25 saptah mein hoti haye. jaba bhroon 24-34 saptah kii umr key beach hotaa haye, tou fefadon kii paripakvata koo uttejit karane key liye prakriya seey lagbhag 24 ghante pahale rogi koo ack glucocorticoid diyaa jaataa haye. bhroon kii sthiti koo dekhane key liye prakriya seey pahale ack ultrasound kiya jaataa haye aur suee kaa margadarshan karane mein madad karane key liye prakriya key dauran iska upayog kiya jaa sakata haye. bhroon key rakt key khilaf tulanaa key liye maan kaa rakt kheencha jaataa haye, aur aavashyakta key anusaar davaaon kii aapoorti karane key liye maan mein antahshira pahunch sthaapit kii jaati haye. intramniotic sankraman key jokhim koo cumm karane key liye, prakriya seey lagbhag 1 minut pahale antahshira pahunch key madhyam seey antibiotic davaaon kii aapoorti kii jaati haye. yadi bhroon kii gati prakriya kii safalata key liye ack jokhim haye, tou bhroon koo ack bhroon lakvagrast dawa kaa upayog karke lakvagrast kiya jaa sakata haye.
20 yaa 22 gaze vaali reedh kii suee kaa upayog aamtaur parr pub mein kiya jaataa haye aur ise ack anticoagulant key saath taiyar kiya jaa sakata haye, joe thakka banane key jokhim koo cumm karane mein madad kartaa haye. prakriya key dauran, pahala kadam naabhi key apekshaakrit sthir khand kaa pataa lagaana haye. ack vishisht namuna sthal vaha hoga jahan naabhi kaa khand naal key sabse karib hotaa haye. haalaanki, iss sthaan parr maatri rakt sandushan kaa khatra haye. yadi naal poorvavarti sthiti mein haye tou rakt kaa namuna adhik aasaani seey praapt kiya jaa sakata haye. haalaanki, yadi naal peechhe kii sthiti mein haye, tou bhroon naabhi kii seedhi pahunch koo avaruddh curr sakata haye. ack baar jaba naabhi kii nully taka pahunch jaataa haye aur suee kii sahee sthiti kii pushti hoe jaati haye, tou bhroon kaa rakt kheencha jaataa haye. sabhi aavashyak namoone lene key baad suee koo hataa diyaa jaataa haye. raktasraav kii prakriya key baad puncher kii jagah kii nigrani kii jaati haye. yadi bhroon vyavharya haye, tou bhroon key hriday gati kii nigrani ack seey dou ghante key liye kii jaati haye.
rakt key namoone praapt karane key baad, unhein rakt key thakke banane seey rokane key liye anticoagulant yukt tubes mein rakhaa jaataa haye. yadi rakt kaa namuna naal key paas kii jagah parr praapt kiya gayaa thaa, tou yeh sunishchit karane key liye kii rakt parr naidaanik pareekshan kiye jaane seey pahale bhroon aur maatri rakt kaa koee mishran naheen huaa haye, bhroon rakt pushti pareekshan kiya jaanaa chaahiye. bhroon kii laal rakt koshikaaen (aar. bee. see.) aamtaur parr maatri aar. bee. see. seey badee hoti hain, aur aar. bee. see. kii ausat matra, ausat corpuscular volume (aim. see. vee.), yeh nirdhaarit karane key liye upayog kii jaane vaali vidhiyon mein seey ack haye kii bhroon kaa rakt dooshit huaa haye yaa naheen. ack anya vidhi, maanav choreonic gonadotropin (aich. see. jee.) nirdhaaran, maatri rakt kaa pataa lagaa sakata haye kyonki maatri rakt mein aich. see. jee. kaa star uchch hotaa haye. haemoglobin kshaariya vikriteekaran pareekshan (upayukt pareekshan) maatri rakt kii upasthiti kaa pataa lagaa sakata haye, joe kshaariya abhikarmak mein namuna jodane parr laal seey bhoore rung mein rung parivartan dwara ingit kiya jaataa haye. rakt typing seey maatri rakt kaa bhee pataa chalata haye, kyonki aaee antigen kewal vayaskon mein hotaa haye. clehower-betke pareekshan acid mein haemoglobin key utsarjan kii nigrani karke garbhavastha kii teesari timahi seey pahale maatri rakt kii bahut cumm matra kaa pataa lagaa sakata haye kyonki vayask aur bhroon haemoglobin acid mein alag-alag roop seey nikalate hain. anta mein, ack shwet rakt koshika ginati namoone mein maatri rakt kaa pataa lagaa sakati haye, kyonki bhroon kii shwet rakt koshikaaen mukhya roop seey leukocytes hoti hain, jabaki maatri shwet rakt koshikaaen jyaadaatar neutrophil hoti hain. yadi amneotic drav namoone mein ghusata haye, tou namoone mein aar. bee. see., shwet rakt koshikaon aur platelets kii matra mein kamee aaegi. saath hii, namoone mein amneotic drav key anuroop pattern dikhaai denge.
sambandhit jokhim.
sabse aam jatilata puncher site kaa raktasraav yaa raktasraav haye aur vishesh roop seey khatarnak hoe sakata haye jaba bhroon 21 saptah seey cumm umr kaa hoe. yadi bhroon mein koee dosh haye joe usake platelets koo prabhaavit kartaa haye tou raktasraav kaa khatra adhik hotaa haye. aamtaur parr aise mamalon mein raktasraav key jokhim koo cumm karane key liye daataa platelets kaa aadhaan kiya jaataa haye. yadi raktasraav gambhir haye, tou tatkaal prasav ack vikalp haye jaba taka kii bhroon jeevit rahane key liye paryaapt purana haye, yaa bhroon key rakt kii matra kii bahaali parr vichaar kiya jaa sakata haye. ack anya sambhaavit jatilata cord hematoma haye, jisamen koee vishisht lakshan naheen hotey hain lekin achaanak bradycardia seey sanket diyaa jaa sakata haye. yadi hematoma niyantran mein haye, tou sthir honey taka bhroon kii nigrani kii jaati haye. yadi bhroon asthir rahata haye, tou prasav kiya jaa sakata haye. bhroon kaa raktasraav ack aur jatilata haye joe taba hoti haye jaba bhroon kaa rakt maatri rakt mein mill jaataa haye. ack chhota bhroon raktasraav maatri pratijan mein vriddhi kaa kaaran bunn sakata haye, jabaki ack badaa bhroon raktasraav bhroon anaemia aur mrityu kaa kaaran bunn sakata haye. bhroon bradycardia, cumm hriday gati, ack aur jatilata haye joe hoe sakati haye. bhroon bradycardia key adhikansh mamle paanch minut key bheetar swayam hull hoe jaate hain. sankraman kii jatilata kii ghatana darr cumm hoti haye, aur sankraman key jokhim key khilaf nivaarak upaayon koo lagu kiya jaataa haye, jaise kii antibiotic kaa upayog aur asseptic takneek. haalaanki, aich. aaee. vee. jaise virus kaa urdhvaadhar sancharan hoe sakata haye. bhroon kii haani bhee hoe sakati haye, vishesh roop seey bhroon kii asaamaanyataon, prachaalak trutiyon, placental penetration aur bhroon kii vyavaharyata sahit kaee jokhim karakon kii upasthiti mein.
antahshleshm nus bhroon rakt namunakaran pub key vikalp key roop mein kiya jaa sakata haye. isamen bhroon key pett mein naabhi key antahshira bhaag mein suee daali jaati haye. pub kii tulanaa mein iss vikalp key laabh yeh hain kii bhroon key rakt key sandushan kii sambhavana bahut cumm haye, bhroon raktasraav kaa khatra cumm hoe jaataa haye, namuna sthal seey raktasraav kaa khatra cumm hoe jaataa haye, aur namuna sthal taka pahunch aasaan haye, chaahe naal kii sthiti kuchh bhee hoe. bhroon thrombocytopania key uchch jokhim vaali garbhavasthaon mein, site raktasraav key bahut cumm jokhim key kaaran rakt key namoonon kii yeh pasandida vidhi haye.
sanket aur matbhed.
 pub ack naidaanik pareekshan naheen haye joe harr garbhavastha mein ingit kiya jaataa haye. haalaanki, yeh garbhavastha key mamalon mein sujhaaya jaataa haye jisamen rakt gais kaa star aur ph ack sthiti key nidan mein sahaayata karega, jaise kii anaemia, yaa prasav yojana, yadi garbhavastha kii samaapti parr vichaar kiya jaa rhaa haye yaa vishesh yojanaaen banaai jaani chaahiye. naabhi kii nully seey honey vaali rakt gais kaa vishleshan naidaanik prabandhan mein sahaayata curr sakata haye aur lagbhag 80 pratishat avasaadgrast navjat shishuon mein janm dumm ghutane key nidan koo samaapt curr sakata haye. bhroon key rakt mein cumm oxygen aur maan key rakt mein uchch star key sanyojan mein bhroon key vikas kii gambhir samasyaaen bhee pub key upayog kaa sanket detee hain. bhroon key ootak perfusion aur chayapachaya parr adhik vistrit tippaniyon aur jaankaari key saath, vikas parr behtar bhavishyavaniyan kii jaa sakati hain. garbhavastha key liye jisamen aanuvanshik asaamaanyataaen maujood hoe sakati hain, pub kaa upayog ack caryotype kaa nirmaan karane key liye kiya jaa sakata haye, aamtaur parr 48 ghanton key bheetar, aur aniyamit gunasutra pattern kaa pataa lagaaya jaa sakata haye. cariotype aanuvanshik dosh kii gambhirta kii vistrit tasveer dene key saath-saath vikasatmak bhavishya kii bhavishyavani karane key liye monosomy, trisomy, yaa gunasutron key gayab hisson kii pushti yaa pataa lagaane mein saksham hain. aggar bhroon seey laal rakt koshikaon koo anuchit tareeke seey todane kii ummeed kii jaati haye, aur hydrops bhroon key unmoolan mein, bhroon key cumm seey cumm 2 hisson mein taral padaarth kaa nirmaan hotaa haye, tou judwa bachchon key mamalon mein bhee pubs kaa sanket diyaa jaataa haye, jisamen amneotic drav kaa sanchay hotaa haye aur kaafee alag vriddhi darr (cumm seey cumm 10 pratishat) hoti haye. bhroon key sankraman kaa sandeh, jaise kii rubela aur toxoplasmosis, saath hii bhroon koo dawa yaa rakt aadhaan kii aapoorti karane kii aavashyakta pub key upayog key liye sanket hain.
isaki aakramak prakriti key kaaran, bhroon aur maan kii suraksha sunishchit karane key liye pub key virodhabhas, prakriya seey naa gujarane key karanon koo dhyaan mein rakhaa jaanaa chaahiye. garbhavastha key pahale 18 hafton key dauran, naabhi nus jisamen seey rakt kaa namuna liya jaataa haye, bahut sthir naheen hoti haye, jisase atyadhik raktasraav hoe sakata haye; isaliye, 18 saptah kii umr seey cumm umr key kissy bhee bhroon mein pub koo pratibandhit kiya jaataa haye. jabaki rakt gais kaa star aur ph maan maataa-pitaa aur chikitsa peshevaron koo bhroon kii sthiti kaa ack snapshot dene mein saksham hain, inn bhrunon kii nigrani cumm aakramak prakriyaon aur upkaranon, jaise kii ultrasound, cardiotocography, yaa maatri rakt parikshanon key saath kii jaa sakati haye. hepatitis bee seey prabhaavit maataon koo pub mein jaane kii salah naheen dee jaati haye. inn mamalon mein, bhroon koo maan seey hepatitis virus key anubandh kaa khatra badh jaataa haye. haalaanki, iss jokhim key saath prakriya kii aavashyakta parr bhee vichaar kiya jaanaa chaahiye. bhroon key sankuchan key badhate jokhim key kaaran maanav pratiraksha kamee virus (aich. aaee. vee.) key liye sakaratmak pareekshan karane vaali maataon mein pub naheen kiye jaane chaahiye. yadi bhroon aich. aaee. vee. seey sankramit haye yaa naheen, yeh nirdhaarit karane key liye pub kaa upayog kiya jaa rhaa haye tou yeh pratikool naheen hoe sakata haye.
ekal naabhi dhamani key saath bhroon.
bhroon key lagbhag 1 pratishat naabhi kshetra mein sabse prachalit dosh ack naabhi dhamani haye. jaba ack ekal naabhi dhamani paaee jaati haye, tou kissy bhee anya vikasatmak asamanyata kaa pataa lagaane key liye ack vistrit ultrasound sahit adhik pareekshan kiye jaate hain joe ekal dhamani, aanuvanshik vichalan, yaa anya karanon kaa parinam hoe sakate hain. bhroon key vikas sambandhi asaamaanyataaen aur ack asamanya caryotype kii chinta pub kaa sanket detee haye; haalaanki, ekal naabhi dhamani vaale bhrunon mein adhik jokhim hoe sakata haye. inn mamalon mein, dou dhamniyon key kaam koo karane key liye ack ekal naabhi dhamani kii aavashyakta hoti haye, isaliye inn maangon koo puuraa karane key liye ise aksar apane aakar kaa dedh gunaa taka failaaya jaataa haye. pub key dauran ack ekal naabhi dhamani koo puncher karane key ack pralekhit mamle key parinamswarup aniyamit sudhaar key saath bhroon kii hriday gati mein kamee aaee; haalaanki, yeh nishkarsh nikaalana mushkil haye kii yeye lakshan kewal punchard naabhi dhamani kaa parinam they kyonki inn bhrunon mein aksar pahale seey maujood dosh aur asaamaanyataaen hoti hain. jabaki ultrasound aur rung pravaah maanchitran kaa upayog naabhi dhamani seey bachane key liye kiya jaa sakata haye aur naabhi nus seey namuna liya jaa sakata haye, failaav ekal naabhi dhamani koo chhidra karane mein aasaan banaata haye. naabhi dhamani mein rakt pravaah lagbhag 20 saptah seey samanya matra seey doguna dekhaa jaataa haye isaliye pub key dauran ack chhidrit naabhi dhamani kaa prabhaav adhik gambhir hotaa haye.

