{"id":9069,"date":"2017-10-31T10:44:44","date_gmt":"2017-10-31T08:44:44","guid":{"rendered":"https:\/\/gynaikologos-komotini.gr\/hamile\/yperichografima-v-epipedou\/"},"modified":"2023-05-02T14:27:18","modified_gmt":"2023-05-02T12:27:18","slug":"ikinci-duzey-ultrason","status":"publish","type":"page","link":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/hamile\/ikinci-duzey-ultrason\/","title":{"rendered":"\u0130kinci d\u00fczey ultrason"},"content":{"rendered":"

\u03a5\u03c0\u03b5\u03c1\u03b7\u03c7\u03bf\u03b3\u03c1\u03ac\u03c6\u03b7\u03bc\u03b1 \u0392\u0384 \u03b5\u03c0\u03b9\u03c0\u03ad\u03b4\u03bf\u03c5<\/h2>\n

\u03a5\u03c0\u03b5\u03c1\u03b7\u03c7\u03bf\u03b3\u03c1\u03ac\u03c6\u03b7\u03bc\u03b1 \u0392\u0384 \u03b5\u03c0\u03b9\u03c0\u03ad\u03b4\u03bf\u03c5<\/h3>\n

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\"anatomiks-anwmalies\"<\/a><\/div><\/div>\n

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Nedir, ne zaman ve kim taraf\u0131ndan yap\u0131l\u0131r?<\/strong><\/h4>\n

\u0130kinci d\u00fczey ultrason, nihai amac\u0131 gebeli\u011fin anne ve fet\u00fcs lehine daha iyi sonu\u00e7lanmas\u0131 olan, do\u011fum \u00f6ncesi bak\u0131m\u0131 iyile\u015ftirecek ve do\u011fum hakk\u0131nda bilgi sa\u011flayacak te\u015fhis bilgilerini do\u011fru bir \u015fekilde toplamay\u0131 ama\u00e7layan, 18-22. gebelik haftalar\u0131 aras\u0131nda yap\u0131lan fet\u00fcs\u00fcn ayr\u0131nt\u0131l\u0131 ultrason muayenesidir. Daha detayl\u0131 olarak, gebelik ya\u015f\u0131 belirlenir, geli\u015fimini kontrol etmek i\u00e7in fet\u00fcs\u00fcn \u00f6l\u00e7\u00fcmleri (biyometri) yap\u0131l\u0131r ve fet\u00fcs\u00fcn do\u011fumsal anomalileri ke\u015ffedilir. Fet\u00fcs\u00fcn maj\u00f6r anatomik anormallikleri<\/strong> (do\u011fumdan sonra cerrahi onar\u0131m gerektiren veya bir dereceye kadar sakatl\u0131\u011fa yol a\u00e7anlar) i\u00e7in testin g\u00fcvenilirli\u011fi %55’tir.<\/strong> Muayene, sertifikaya sahip, d\u00fczenli olarak ultrason yapan, s\u00fcrekli g\u00fcncellenen ve muayene sonunda patolojik bulgular durumunda hastalara dan\u0131\u015fmanl\u0131k yapabilen sonografi uzmanlar\u0131 taraf\u0131ndan ger\u00e7ekle\u015ftirilir. Muayene, ofisimde son teknoloji ultrason taray\u0131c\u0131 Voluson S 10 GE Healthcare BT16\u00a0 ile ger\u00e7ekle\u015ftirilir (Kuzey Yunanistan’da ilk kuruland\u0131r).<\/strong><\/div><\/div>\n

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MERKEZi SiNiR SiSTEMi<\/strong><\/h4>\n

Al\u0131nan ana kesitler transventrik\u00fcler ve transserebellar kesitleridir. Lateral ventrik\u00fcller, septum pellusidum, talamus, serebellum, vermis, beynin 4. ventrik\u00fcl\u00fc gibi beynin \u00e7e\u015fitli anatomik b\u00f6l\u00fcmleri kontrol edilir.
\nGerekli bulundu\u011fu durumlarda beynin ventrik\u00fcllerini ve korpus kallozumu kontrol etmek i\u00e7in sagital ve koronal kesit gibi ek kesitler al\u0131n\u0131r.<\/div>\n

\"kentriko-nevriko-sistima\"<\/a><\/div><\/div>\n

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\"iperixografima-v-epipedou-proswpo3\"<\/a><\/div>\n

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Y\u00dcZ<\/strong><\/h4>\n

Al\u0131n, g\u00f6z \u00e7ukurlar\u0131, dudaklar ve kulaklar sabit olarak 12 hafta sonra bulunur. Sagital, enine ve koronal kesitler anatominin de\u011ferlendirilmesinde a\u00e7\u0131klay\u0131c\u0131d\u0131r. Orta sagital kesit bize fet\u00fcs\u00fcn profilini verirken, kafatas\u0131na de\u011fen parasagital kesitler kulaklar\u0131 g\u00f6sterir. Bununla birlikte, t\u00fcm anatomiyi bulmak i\u00e7in en \u00f6nemlileri koronal kesitlerdir.<\/div><\/div>\n

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AKC\u0130\u011eERLER<\/strong><\/h4>\n

Akci\u011ferlerin muayenesi i\u00e7in 4 bo\u015flu\u011fun kesiti yeterlidir. Bu kesitte akci\u011ferler homojen bir \u015fekilde ekojenikken, 18-23. hafta ultrasonografisinde bu kesitin merkezinin 1\/3’\u00fc kalp taraf\u0131ndan, geri kalan k\u0131sm\u0131 ise akci\u011ferler taraf\u0131ndan \u00f6rt\u00fcl\u00fcd\u00fcr. Bu kesit ile g\u00f6\u011f\u00fcs bo\u015flu\u011funun \u00e7evresini de \u00f6l\u00e7ebiliriz. Fetal g\u00f6vdenin sagital kesiti, g\u00f6\u011f\u00fcs bo\u015flu\u011funu kar\u0131n bo\u015flu\u011fundan ay\u0131ran septumun tan\u0131mlanmas\u0131n\u0131 sa\u011flar.<\/div>\n

\"pneumones\"<\/a><\/div><\/div>\n

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\"kardia\"<\/a><\/div>\n

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KALP<\/strong><\/h4>\n

Al\u0131nan ana kesitler, kalbin lezyonlar\u0131n\u0131n %60’\u0131n\u0131n saptand\u0131\u011f\u0131 kalbin 4 bo\u015flu\u011funun kesiti, aort ve pulmoner arterin \u00e7\u0131k\u0131\u015f kesiti ve b\u00fcy\u00fck damarlar\u0131n ve ba\u011flant\u0131lar\u0131n\u0131n derinlemesine incelendi\u011fi 3 damar kesitleridir. \u015e\u00fcphe bar\u0131nd\u0131ran durumlarda, ek kesitler al\u0131n\u0131r veya fet\u00fcs\u00fcn \u00f6zel fetal-kardiyolojik-ultrason muayenesi istenir.<\/div><\/div>\n

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\u0130SKELET<\/strong><\/h4>\n

Uzuvlar tomurcuk halinde ilk kez 8. haftada, femur ve humerus ise 9. haftada ortaya \u00e7\u0131kar. 10. haftadan itibaren tibia\/fibula ve radius\/ulna, 11. haftadan itibaren ise ayak parmaklar\u0131 ve el parmaklar\u0131 ortaya \u00e7\u0131kar. T\u00fcm kemikler 11. haftadan itibaren bulunur. V\u00fccut hareketleri 9. haftadan itibaren ve uzuvlar\u0131n hareketleri 11. haftadan itibaren g\u00f6r\u00fclmeye ba\u015flar. Humerus, radius\/ulna, femur ve tibia\/fibula uzunluklar\u0131 benzerdir ve do\u011frusal olarak artar. 18-23 haftal\u0131k ultrason taramas\u0131nda her bir uzuvun \u00fc\u00e7 par\u00e7as\u0131 tan\u0131nmal\u0131 ancak sadece femur \u00f6l\u00e7\u00fclmelidir.<\/div>\n

\"skeletos\"<\/a><\/div><\/div>\n

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\"prosthio-koiliako-toixwma\"<\/a><\/div>\n

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\u00d6N KARIN DUVARI<\/strong><\/h4>\n

\u00d6n kar\u0131n duvar\u0131n\u0131n normal geli\u015fimi 4 ektodermal k\u0131vr\u0131m\u0131n (sefalik, kaudal, 2 lateral) kayna\u015fmas\u0131na ba\u011fl\u0131d\u0131r. 8-10 haftada t\u00fcm embriyolar, g\u00f6bek kordonu taban\u0131nda hiperekojenik bir kitle olarak g\u00f6r\u00fcnen, ancak 10-12 haftal\u0131k d\u00f6nemde karn\u0131n i\u00e7ine d\u00f6nen normal orta ba\u011f\u0131rsak f\u0131t\u0131\u011f\u0131n\u0131 g\u00f6sterir. Bu i\u015flem 11+5 haftada tamamlan\u0131r, b\u00f6ylece enine kesitlerde bak\u0131ld\u0131\u011f\u0131nda karn\u0131n normal anatomisi art\u0131k g\u00f6r\u00fcn\u00fcr hale gelir. B\u00f6ylece, g\u00f6bek kordonunun kar\u0131na giri\u015fi g\u00f6r\u00fcn\u00fcr, ancak pelvis i\u00e7indeki mesane de tasvir edilir, b\u00f6ylece mesane ve kloakan\u0131n ekstrofisi hari\u00e7 tutulur.<\/div><\/div>\n

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S\u0130ND\u0130R\u0130M S\u0130STEM\u0130<\/strong><\/h4>\n

Mide ultrason ile 9. haftadan itibaren sol \u00fcst kar\u0131nda ekojenik kistik b\u00f6lge olarak g\u00f6r\u00fcl\u00fcr.
\nBa\u011f\u0131rsak normal olarak, mekonyumun kolon k\u0131vr\u0131mlar\u0131n\u0131 doldurdu\u011fu 3. trimestere kadar t\u00fcm k\u0131s\u0131mlar\u0131nda e\u015fit derecede ekojeniktir. Karaci\u011fer, \u00fcst kar\u0131n b\u00f6lgesinde, kendisine daha fazla oksijen verilmesi nedeniyle sol lobun sa\u011fdan daha b\u00fcy\u00fck olmas\u0131yla ay\u0131rt edilir. Safra kesesi umblikal venin intrahepatik k\u0131sm\u0131n\u0131n sa\u011f\u0131nda ve alt\u0131nda oval bir kistik olu\u015fumdur. Dalak, midenin arkas\u0131nda ve solunda \u00e7apraz olarak bulunur. Kar\u0131n \u00e7evresi mide, karaci\u011fer ve portal venin b\u00f6l\u00fcnmesi seviyesinde \u00f6l\u00e7\u00fclmelidir. Eksenel g\u00f6r\u00fcn\u00fcmde, omurgan\u0131n solunda aort ve sa\u011f\u0131nda inferior vena kava yer al\u0131rken, aortun solunda mide yer al\u0131r.<\/div>\n

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\u00dcR\u0130NER S\u0130STEM<\/strong><\/h4>\n

B\u00f6brekler ve adrenal bezler, mide seviyesinin alt\u0131nda her iki tarafta da omurgan\u0131n \u00f6n\u00fcnde yer al\u0131r ve 9. haftadan itibaren, ancak her durumda 12. haftadan itibaren g\u00f6r\u00fclebilir. Ekojeniteleri 9. haftada y\u00fcksektir, ancak gebelik ya\u015f\u0131yla birlikte azal\u0131r. Karn\u0131n boyuna ve enine kesitleri b\u00f6brekleri inceler. Daha detayl\u0131 olarak, boyuna kesitte eliptik bir g\u00f6r\u00fcnt\u00fcye sahipken, enine kesitte ovaldirler. Karaci\u011fer ve ba\u011f\u0131rsak k\u0131vr\u0131mlar\u0131ndan biraz daha hipoekoiktirler. 20. haftada kortikal k\u0131s\u0131m med\u00fcller k\u0131s\u0131mdan daha ekojenik olan kaps\u00fcl benzeri hiperekoik bir b\u00f6lgeye sahiptirler. Gebelik ya\u015f\u0131n\u0131n ilerlemesi ile birlikte, dokular\u0131n etraf\u0131nda s\u0131n\u0131rlar\u0131 artt\u0131ran ve onlar\u0131 \u00e7evredeki organlardan daha belirgin hale getiren ya\u011f birikir, 26-28 haftalarda renal kaliksler ve arkuat arterler g\u00f6r\u00fclebilir. B\u00f6breklerin uzunlu\u011fu ve \u00e7evresi ya\u015fla birlikte artar, ancak b\u00f6brek \u00e7evresinin kar\u0131n \u00e7evresine oran\u0131 gebelik boyunca yakla\u015f\u0131k olarak %30’a e\u015fit olarak sabit kal\u0131r. B\u00f6bre\u011fin \u00f6n-arka \u00e7ap\u0131 <5mm 15-19 hafta, <6mm 20-29 hafta, <8 mm 30-40 hafta. Periferik obstr\u00fcksiyon veya reg\u00fcrjitasyon olmad\u0131\u011f\u0131nda normal \u00fcreterler nadiren g\u00f6r\u00fcl\u00fcr. Mesane %80 oranla 11. haftadan itibaren g\u00f6r\u00fclebilir ve 13. haftada oran %90’\u0131n \u00fczerindedir.<\/div><\/div>\n

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Plasenta, serviks, g\u00f6bek kordonu<\/strong><\/h4>\n

Plasentan\u0131n pozisyonu, g\u00f6bek kordonunun konumu, i\u00e7erdi\u011fi damar say\u0131s\u0131, herhangi bir dolanma ve d\u00fc\u011f\u00fcm olup olmad\u0131\u011f\u0131 kontrol edilir ve son olarak rahim a\u011fz\u0131n\u0131n uzunlu\u011fu \u00f6l\u00e7\u00fcl\u00fcr ve herhangi bir dilatasyon olup olmad\u0131\u011f\u0131na bak\u0131l\u0131r.<\/p>\n

\"plakountas-omfalios-lwros\"<\/a><\/p>\n

<\/div>\n","protected":false},"excerpt":{"rendered":"

\u03a5\u03c0\u03b5\u03c1\u03b7\u03c7\u03bf\u03b3\u03c1\u03ac\u03c6\u03b7\u03bc\u03b1 \u0392\u0384 \u03b5\u03c0\u03b9\u03c0\u03ad\u03b4\u03bf\u03c5 \u03a5\u03c0\u03b5\u03c1\u03b7\u03c7\u03bf\u03b3\u03c1\u03ac\u03c6\u03b7\u03bc\u03b1 \u0392\u0384 \u03b5\u03c0\u03b9\u03c0\u03ad\u03b4\u03bf\u03c5   Nedir, ne zaman ve kim taraf\u0131ndan yap\u0131l\u0131r? \u0130kinci d\u00fczey ultrason, nihai amac\u0131 gebeli\u011fin anne ve fet\u00fcs lehine daha iyi sonu\u00e7lanmas\u0131 olan, do\u011fum \u00f6ncesi bak\u0131m\u0131 iyile\u015ftirecek ve do\u011fum hakk\u0131nda bilgi sa\u011flayacak te\u015fhis bilgilerini do\u011fru bir \u015fekilde toplamay\u0131 ama\u00e7layan, 18-22. gebelik haftalar\u0131 aras\u0131nda yap\u0131lan fet\u00fcs\u00fcn ayr\u0131nt\u0131l\u0131 ultrason muayenesidir. Daha detayl\u0131…<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":9039,"menu_order":7,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/wp-json\/wp\/v2\/pages\/9069"}],"collection":[{"href":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/wp-json\/wp\/v2\/comments?post=9069"}],"version-history":[{"count":0,"href":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/wp-json\/wp\/v2\/pages\/9069\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/wp-json\/wp\/v2\/pages\/9039"}],"wp:attachment":[{"href":"https:\/\/gynaikologos-komotini-old.xo-websites4.gr\/tr\/wp-json\/wp\/v2\/media?parent=9069"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}