So wo ba no sõ dodo kakra wɔ awotwaa mu? Momma yɛnka Fetal Macrosomia ho asɛm!

Sɛ woyɛ ɛna a worehwɛ kwan a, ebia woate sɛ wo duruyɛfo reka sɛ, "Ɛte sɛ nea akokoaa no sõ kakra," anaasɛ "Ɛte sɛ nea akokoaa no mu duru boro so kakra." Anaasɛ ebia woate nka sɛ wo ba no sõ kakra anaa ne mu duru sen nea aka no. Nokwarem no, edin titiriw bi wɔ hɔ a wɔde frɛ eyi wɔ aduruyɛ mu. Ɛnnɛ, yɛbɛka saa tebea yi a wɔfrɛ no "Fetal Macrosomia" ho asɛm. Mma ɛnhaw wo, ɛho hia paa sɛ wuhu eyi.

Dɛn ne nea wɔfrɛ no akokoaa kɛse (Fetal Macrosomia) yi?

Sɛ yɛbɛka no tiawa a, `(Fetal Macrosomia)` kyerɛ sɛ wo ba no mu duru 10% anaa nea ɛboro saa sen sɛnea wɔhwɛ kwan wɔ dapɛn a onyinsɛn no mu. Fa no sɛ, sɛ nkokoaa taa mu duru bɛyɛ kilogram 3 dapɛn yi a, wo ba no betumi ayɛ kilogram 3.3 anaa nea ɛboro saa.

Seesei ebia woresusuw sɛ, "Oo, anka me ba no bɛyɛ kɛse na ɔwɔ apɔwmuden." Ɛyɛ nokware, akokoaa a ɔwɔ apɔwmuden yɛ ɛna biara dae. Nanso, ɛtɔ mmere bi a sɛ akokoaa no sõ dodo a , ebetumi ayɛ den kakra sɛ wobɛwo no sɛnea ɛsɛ, kyerɛ sɛ, wɔ awotwaa mu. Ɛtɔ da bi a, ɛna no awotwaa mu nusu betumi asu, anaasɛ ɛbɛyɛ den sɛ ɔbɛpia akokoaa no afi mu. Sɛ oduruyɛfo no susuw sɛ akokoaa no sõ dodo – kyerɛ sɛ, ɛboro nkaribo 11 (bɛyɛ kilogram 5) anaasɛ bɛboro nkaribo 10 (bɛyɛ kilogram 4.5) sɛ wowɔ asikreyare a – ɛnde ebia ɔkwan a ahobammɔ wom sen biara ne sɛ wɔbɛyɛ oprehyɛn oprehyɛn (C-section).

Sɛ akokoaa no nyin a, ɔhaw bɛn na ebetumi aba bere a wɔawo akokoaa no?

Sɛ worehwɛ akokoaa kɛse kwan a, asiane a ɛwɔ hɔ kakra sɛ wubehyia nsɛnnennen bi bere a worewo no. Momma yɛnhwɛ nea ɛnonom yɛ.

Nsɛnnennen a ebetumi aba ɛna no so

• Wo awo kwan a ɛyɛ ɔbea awotwaa ne beae a atwa ho ahyia (`perineum`) no betumi apira. Esiane sɛ akokoaa no sõ nti, ebia ɔbɛtetew bere a ɔrepue no.
• Ebia mogya bɛtɔ wo asen sɛnea ɛte daa. Ɛtɔ mmere bi mpo a eyi betumi ama mogya atɔ no wɔ awo akyi.
• Hokwan a ɛntaa nsi nso wɔ hɔ sɛ awotwaa no bɛpaapae, na ɛtaa ba ɛnanom a wɔadi kan ayɛ wɔn oprehyɛn oprehyɛn no mu.
• Bere a edi awo mu, titiriw bere a wɔde piapia obi no betumi ayɛ tenten. Eyi betumi abrɛ ɛna no kɛse.
• Ebia wubehu nsakrae wɔ wo ba koma bɔ mu bere a worewo akokoaa no .

Asiane a ewo akokoaa no so - titire no mmati mu dystocia

Sɛ akokoaa no yɛ kɛse a, asiane ahorow bi nso wɔ hɔ. Eyinom mu nea ɛhaw adwene kɛse ne tebea bi a wɔfrɛ no `(Shoulder Dystocia)`.Sɛ yɛbɛka no tiawa a, eyi ne bere a akokoaa no mmati kɔhyɛ ɛna no awotwaa mu bere a akokoaa no ti afi awotwaa mu aba no. Bere a eyi betumi asi wɔ awo biara mu no, ɛda adi sɛ ɛba nkokoaa akɛse so.

Mmati mu Dystocia yɛ tebea a egye ntɛmpɛ ankasa. Nanso mma ɛnhaw wo, wo duruyɛfo ne awogyefo no wɔ nhyehyɛe bi wɔ nea wɔbɛyɛ sɛ biribi a ɛte sɛɛ si a. Wɔbɛhwɛ wo wɔ w’awo bere nyinaa mu.

Saa tebea yi (Shoulder Dystocia) betumi ama nneɛma a edidi so yi ato akokoaa a wɔawo no foforo:

• Ebia akokoaa no dompe mu abubu , titiriw ne kɔn mu dompe.
• Brachial Plexus a Ɛpira . Eyi yɛ ntini ahorow a ɛde nsɛnkyerɛnne kɔ akokoaa no nsa mu no sɛe. Eyi betumi ama abasa no ayɛ mmerɛw.
• Ɛntaa mma koraa sɛ amemene no betumi asɛe.

Asiane ahorow yi betumi atra hɔ wɔ awo akyi mpo ama nkokoaa a wɔn mfe akɔ anim.

Nkokoaa a wɔwo wɔn akɛse no taa nya akwahosan ho haw ahorow bi wɔ awo akyi:

• Mogya mu nkwammoaa kɔkɔɔ dodow a ɛkɔ soro wɔ mogya no mu. Eyi betumi ama asiane a ɛwɔ hɔ sɛ akokoaa no benya jaundice no ayɛ kɛse.
• Asikre a ɛwɔ mogya mu a ɛba fam (hypoglycemia).
• Ɔhome Ho Ɔhaw ahorow.

Dɛn ne nsɛnkyerɛnne a ɛkyerɛ sɛ akokoaa no yɛ kɛse?

Nokwarem no, ɛyɛ den sɛ wubehu wo ba no kɛse pɔtee kosi sɛ wɔbɛwo no. Ɛkame ayɛ sɛ sɛnkyerɛnne ahorow pii a wuhu bere a wonyinsɛn no yɛ pɛ, ɛmfa ho sɛnea wo ba no nyin no. Ɛno kyerɛ sɛ nneɛma te sɛ yafunu kɛse ne ɔbrɛ abu so wɔ nyinsɛn a ɛfata mu. Nanso, nneɛma bi wɔ hɔ a ebia wo duruyɛfo besusuw sɛ wo ba no yɛ kɛse bere a ɔreyɛ wo nhwehwɛmu no.

Dɛn nti na akokoaa no nyin kɛse saa wɔ awotwaa no mu? Dɛn ne nea enti a ɛte saa?

Ebia wo duruyɛfo besusuw sɛ wo ba no anya macrosomia esiane nneɛma yi nti:

• Sɛ wo ``Fundal Height'', kyerɛ sɛ, awotwaa no tenten (yafunu no tenten susuw), korɔn sen sɛnea wɔhwɛɛ kwan. Ebia wobɛkae sɛ oduruyɛfo no susuw eyi wɔ nhwehwɛmu biara mu.
• Sɛ wo mu duru yɛɛ kɛse dodo bere a na wonyinsɛn no a. Yɛn nyinaa nim sɛ mu duru a ɛkɔ soro ba bere a nyinsɛn mu, nanso ɛho hia sɛ yɛma ɛkɔ so yɛ nea ɛfata.
• Sɛ wowɔ asikreyare, anaasɛ wo nyaa asikreyare bere a na wonyinsɛn (gestational diabetes). Eyi ne ade titiriw a ɛde nkokoaa akɛse ba.
• Sɛ woawo akokoaa kɛse dedaw a.
• Sɛ da a ɛsɛ sɛ wowo no twam a, wo ba no bɛyɛ kɛse kakra bere a nna no kɔ so no.
• Sɛ w’ankasa wowoo wo sɛ akokoaa kɛse a, ɛtɔ mmere bi a ebetumi ayɛ awosu mu ade.

Ɔkwan bɛn so na nnuruyɛfo hu sɛ akokoaa yɛ kɛse anaa?

Sɛ wo duruyɛfo susuw sɛ wo ba no sõ a, ebia ɔbɛkra sɛ wɔnyɛ ultrasound scan mfa nhwɛ sɛnea akokoaa no mu duru te ne nsu dodow a ɛwɔ akokoaa no mu (amniotic fluid) a atwa akokoaa no ho ahyia. Wunim nea ultrasound yɛ. Ɛde nnyigyei asorɔkye a ano yɛ den di dwuma de wo ba no mfonini anaa video mena.

So yentumi mfa ultrasound kɛkɛ nhu pɛpɛɛpɛ?

Asɛmmisa pa. Ultrasound ntumi nkyerɛ wo ba no mu duru pɛpɛɛpɛ . Ɛma wunya adwene a ɛyɛ den nkutoo, a wɔde 10% ka ho anaasɛ wɔayi afi mu . Sɛ nhwɛso no, sɛ scan no ka sɛ akokoaa no mu duru bɛyɛ kilo 4 a, ɛno yɛ "asɛm a eye sen biara" ara kwa. Ná akokoaa no mu duru betumi ayɛ kilogram 3.6 kosi 4.4 ankasa.

Afei nso, ultrasound ntumi nkyerɛ sɛ ebia biribi te sɛ mmati mu dystocia a yɛadi kan aka ho asɛm no bɛba anaa. Enti, oduruyɛfo no bɛka nsɛm a efi ultrasound no mu, wo nyinsɛn ho abakɔsɛm (sɛnea woawo nkokoaa bere bi a atwam, w’akwahosan tebea horow), ne nhwehwɛmu ahorow a woyɛ no abom de ahu bere ne ɔkwan a eye sen biara a ahobammɔ wom a wobɛfa so awo akokoaa no.

Dɛn bio na oduruyɛfo no rehwehwɛ?

Sɛ wubesi gyinae sɛ ebia wuhia ultrasound scan a, oduruyɛfo no bɛyɛ nea edidi so yi nso:

• Wo ``Fundal Height`` a wobɛsusu. Eyi ne kwan a efi wo awotwaa no atifi kɔ ``Pubic Bone`` a ɛwɔ wo yafunu ase no.
• Wo yafunu a wobɛbɔ. Oduruyɛfo no bɛbɔ mmɔden sɛ obenya akokoaa no kɛse ho adwene denam wo yafunu no mmeae bi a ɔbɛhwɛ so.

Sɛ nhwehwɛmu ahorow yi kyerɛ sɛ akokoaa no sõ a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu foforo (te sɛ Biophysical Profile anaa Nostress Test) na ama wɔahwɛ akokoaa no akwahosan bio.

Sɛ akokoaa no yɛ kɛse a, ayaresa bɛn na wobetumi ayɛ?

Macrosomia a wobɛsa no fa akwahosan tebea biara a ɛda adi a ebia wowɔ , te sɛ asikreyare anaa kɛseyɛ mmoroso a wubedi ho dwuma ho titiriw . Ɛsɛ sɛ wo ne wo duruyɛfo bom di tebea biara a ebetumi aka wo nyinsɛn anaa awo ho dwuma.

Mpɛn pii no, aduan pa a wubedi, apɔw-mu-teɛteɛ, ne asikreyare a wobɛma ayɛ yiye (sɛ ɛho hia a wobɛnom insulin) ne nneɛma a ɛho hia sen biara a wubetumi ayɛ.

Wo duruyɛfo no ne wo bɛka asiane ahorow a ɛwɔ awo a wɔde fa ɔbea awotwaa mu mu ho asɛm. Wɔ tebea horow bi mu no, wobetumi akamfo akyerɛ sɛ wɔnyɛ C-section na ama asiane a ɛwɔ hɔ sɛ ɔhaw ahorow bɛba no so atew. Nanso ɛho hia sɛ wuhu eyi: Wɔnkyerɛe sɛ awo a wɔwo ntɛm (i.e., awo a wɔyɛ ho nhyehyɛe ansa na adapɛn 39 adu) no brɛ nsɛnnennen ase. Enti, ɛnsɛ sɛ wɔwo no ntɛm gye sɛ aduruyɛ mu ntease foforo bi wɔ hɔ a enti akokoaa no kɛse te.

So ɛho hia sɛ wɔyɛ oprehyɛn (C-section) sɛ akokoaa no sõ a?

Ɛnyɛ nea ɛho hia ankasa. Ɛnyɛ akokoaa kɛse biara na ebehia sɛ wɔyɛ no C-section. Nanso, nea edidi so yi na ɛda adi sɛ ɛho behia sɛ wɔyɛ C-section:

• Sɛ woadi kan awo akokoaa a ɔwɔ `(Shoulder Dystocia)` a.
• Sɛ wowɔ asikreyare na wɔhwɛ kwan sɛ wo ba no mu duru bɛboro nkaribo 10 (bɛyɛ kilogram 4.5).
• Wunni asikreyare, nanso wubu akontaa sɛ wo ba no mu duru boro nkaribo 11 (bɛyɛ kilogram 5).

Wo duruyɛfo na osi gyinae ahorow yi bere a ɔne wo akasa awie na egyina wo tebea no so.

So akwan bi wɔ hɔ a wɔbɛfa so asiw akokoaa no kwan sɛ onnyin saa?

Sɛ yɛbɛka nokware a, `(Fetal Macrosomia)` taa yɛ den sɛ wobedi kan ahyɛ nkɔm pɛpɛɛpɛ. Ɛyɛ bere a wɔawo akokoaa no na wɔkari no akyi nkutoo na yebetumi aka no pen sɛ, "Oo, akokoaa no yɛ kɛse." Wobetumi awo nkokoaa binom akɛse asen sɛnea ɛte daa a asiane biara nni ho mpo.

Nanso, akwahosan pa a wobɛkɔ so ayɛ ne nyinsɛn a ɛfata betumi aboa ma asiane yi so atew akodu baabi:

• Kɔ ayaresabea ahorow a wɔyɛ no daa ansa na wɔawo. Wo duruyɛfo a wobɛkɔ akɔsra wo daa no bɛma wo ne wo duruyɛfo no ahwɛ sɛnea wo ba no nyin yiye. Ɛyɛ hokwan pa nso sɛ wubebisa nsɛm biara a ebia wowɔ.
• Ma w’adwene nsi wo mu duru so. Sɛnea ɛho hia sɛ wuhu wo mu duru ansa na woanyinsɛn no, saa ara na ɛho hia nso sɛ wuhu sɛnea wo mu duru yɛ kɛse bere a wonyinsɛn no. Ɛyɛ papa sɛ yɛde yɛn adwene besi nnuan a ɛwɔ yɛn man yi mu no bi so kakra (e.g., esiam nnuan, nnɔkɔnnɔkɔwade).
• Sɛ wowɔ asikreyare a, yɛ nneɛma a ɛho hia na ama woadi so. Asikreyare a na ɛwɔ hɔ dedaw (Diabetes Mellitus) ne nyinsɛn mu asikreyare (Asikreyare a ɛba bere a wɔyem) nyinaa yɛ nneɛma atitiriw a ɛde asiane kɛse ba awotwaa mu macrosomia mu.

Akwahosan ho haw bɛn na nkokoaa a wɔwo wɔn akɛse betumi anya daakye?

Nhwehwɛmu ada no adi sɛ nkokoaa a wɔwo wɔn akɛse no wɔ asiane kɛse mu sɛ wobenya nea edidi so yi daakye:

• Asikre dodow a ɛba fam wɔ mogya mu (`Hypoglycemia`) wɔ mmofraase.
• Kɛse mmoroso wɔ mmofraase.
• Metabolic syndrome yɛ tebea horow kuw bi a ɛma asiane a ɛwɔ hɔ sɛ obi benya nyarewa te sɛ komayare, akisikuru, ne asikreyare no yɛ kɛse.

Nanso kae sɛ, sɛ nnompe abubu anaa ntini asɛe wɔ awo mu mpo a, nkokoaa dodow no ara ho tɔ wɔn koraa fi saa apirakuru no mu.

``Fetal Macrosomia`` yɛ tebea a ebetumi de nsɛnnennen a emu yɛ den aba bere a wɔrewo no. Ɛwom sɛ nneɛma pii na ɛde eyi ba de, nanso asikreyare a wontumi nni so ne kɛseyɛ mmoroso ne ade titiriw abien a ɛde ba.Wubetumi atew asiane a ɛwɔ hɔ sɛ wobɛwo akokoaa kɛse no so denam tebea horow yi a wubedi ho dwuma yiye no so. Nneɛma te sɛ apɔw-mu-teɛteɛ daa ne aduan pa a wubedi betumi aboa wo ma woanyinsɛn yiye na atew asiane a ɛwɔ hɔ sɛ wubenya nsɛnnennen no so. Nsuro sɛ wubebisa wo duruyɛfo ɔkwan pa a wobɛfa so ahwɛ wo ne wo ba no ho asɛm. Ɛwom sɛ ``Fetal Macrosomia'' betumi ayɛ aniberesɛm de, nanso wɔwo nkokoaa akɛse dodow no ara a wɔwɔ apɔwmuden.

Enti, nneɛma bɛn na ɛho hia paa a ɛsɛ sɛ yɛkae fi eyi mu?

Okay, enti momma yɛnbɔ nneɛma a yɛaka ho asɛm a ɛsɛ sɛ wode sie w’adwene mu no bi mua:

• ``Fetal Macrosomia`` kyerɛ sɛ akokoaa no mu duru yɛ kɛse sen sɛnea wɔhwɛ kwan wɔ awotwaa no mu.
• Nea ɛde eyi ba titiriw ne asikreyare a ɛna no nya (titiriw nea wontumi nni so) ne ne mu duru a ɛkɔ soro dodo bere a wanyinsɛn no.
• Sɛ akokoaa no nyin a, ɛna no ne akokoaa no nyinaa betumi anya nsɛnnennen bi bere a wɔrewo no. ``Shoulder Dystocia`` yɛ tebea a emu yɛ den a ebetumi ato akokoaa no.
• Nnuruyɛfo nam ultrasound scan ne nhwehwɛmu afoforo so nya akokoaa no kɛse ho adwene.
• Ɛnyɛ akokoaa kɛse biara na ɛsɛ sɛ wɔyɛ no C-section, nanso wɔ tebea horow bi mu no, ɛno ne ɔkwan a ahobammɔ wom sen biara.
• Wobetumi atew asiane yi so denam asetra pa a wɔbɛbɔ, aduan a ɛkari pɛ a wobedi, ne tebea horow te sɛ asikreyare a wobedi so no so.
• Mma ɛnhaw wo, wɔwo nkokoaa akɛse dodow no ara a wɔwɔ apɔwmuden. Wo ne wo duruyɛfo nsusuw biribiara ho na di n’akwankyerɛ akyi.

Sɛ wowɔ nsɛmmisa foforo bi fa eyi ho a, hwɛ hu sɛ wubebisa wo duruyɛfo. Wɔn na wobetumi de afotu a eye sen biara ama wo.

` Fetal Macrosomia, Akokoaa Kɛse, Nyinsɛn, Awo, Oprehyɛn a Wɔyɛ no Oprehyɛn, Asikreyare, Mmati mu Dystocia