So ɔfe a edi kan no aka wo ba no ahurututu nso? (Meconium Aspiration Syndrome) Momma yɛnka eyi ho asɛm!

Sɛ́ ɔwofo no, sɛ wuhu sɛ ɛyɛ den ma akokoaa a wɔawo no foforo sɛ ɔbɛhome a, ehu ka wo dɛn? Ɛtɔ mmere bi a, nea ɛde ɔhaw yi ba wɔ akokoaa home mu ne akokoaa no nsu a edi kan a wɔfrɛ no meconium a ɛkɔ akokoaa no ahurututu mu. Ɛnnɛ, yɛbɛka saa tebea yi a wɔfrɛ no `(Meconium Aspiration Syndrome)` ho asɛm.

Dɛn ne meconium? Sɛ ɛkɔ akokoaa no ahurututu mu a, dɛn na ɛba?

Sɛ yɛbɛka no tiawa a, meconium ne wo ba no nsu a edi kan, anaasɛ poo. Ɛnte sɛ poop a wɔtow daa. Ɛyɛ ade a ɛyɛ den, ɛyɛ nnam, ɛyɛ ahabammono tuntum tuntum, a ɛte sɛ tar. Ɛyɛ nneɛma a wo ba no mene bere a ɔwɔ awotwaa mu. Ɛno kyerɛ sɛ ɛyɛ nkokoaa honam ani nkwammoaa, nsu (te sɛ nsu a ɛyɛ nwini), akokoaa ti nhwi a ɛyɛ fɛ (lanugo), bile, ne nneɛma afoforo.

Mpɛn pii no, nkokoaa twa meconium wɔ nnɔnhwerew 48 akyi wɔ awo akyi. Nanso, ɛtɔ da bi a, titiriw sɛ akokoaa no rehyia nhyɛso anaa ɔhaw bi wɔ awotwaa no mu (`(Fetal Distress)`) a, akokoaa no tumi twa saa meconium yi bi ansa na wɔawo no, kyerɛ sɛ, bere a ɔda so ara wɔ awotwaa no mu. Sɛ ɛtwam a, wɔde saa meconium no bɛka awotwaa mu nsu a atwa akokoaa no ho ahyia no ho.

Meconium Aspiration Syndrome (MAS) yɛ tebea a ɛyɛ den ma akokoaa no sɛ ɔbɛhome esiane meconium a ɛne awotwaa mu nsu a ɛhyɛn akokoaa no ahurututu mu nti. Saa nsu a wɔde meconium afra mu yi betumi akɔ akokoaa no ahurututu mu bere a akokoaa no home no, ansa na wɔrewo no anaasɛ bere a wɔrewo no.

Susuw nea ɛba bere a saa meconium a ɛyɛ den a ɛte sɛ tar no hyɛn akokoaa no nsu ne n’ahurututu mu no ho hwɛ.

• Ebetumi asiw akokoaa no mframa kwan .
• Ahurututu betumi asɛe .
• Meconium nso tumi siw ade titiriw bi a wɔfrɛ no ``Surfactant'' a ɛboa ma ahurututu no ma ɛyɛ hyew na ɛyɛ adwuma yiye no dwumadi kwan.

Eyi ma ɛyɛ den yiye ma akokoaa no sɛ ɔbɛhome. Ɛtɔ mmere bi a, tebea yi betumi de nkwa ato asiane mu mpo . Enti, ɛho hia paa sɛ yehu eyi.

Saa tebea yi abu so dɛn?

Sɛ wɔkyekyem pɛpɛɛpɛ a, awo 100 biara mu bɛyɛ 12 kosi 20 benya meconium a wɔde bɛfra awotwaa mu nsu no mu. Yɛfrɛ eyi "amniotic nsu a wɔde meconium ayɛ." Saa tebea yi taa ba nkokoaa a wɔawo wɔn bere nyinaa (adapɛn 40) ne wɔn a wɔawo wɔn akyi (adapɛn 42 akyi) mu.

Nanso biribi a wubetumi asusuw ho ni. Ɛnyɛ nkokoaa a wɔde nsu a meconium ayɛ wɔn ma wɔwo wɔn nyinaa na wonya ``MAS''. Ɔha biara mu kakraa bi pɛ, a ɛwɔ nkokoaa a wɔte saa no mu 2% kosi 10% na wonya saa ``MAS'' tebea yi.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ akokoaa retwe meconium?

Seesei yenim sɛ sɛ meconium kɔ ahurututu mu a, ebetumi ayɛ asiane. Enti, sɛ wo ba no ahome meconium a, ebia ɔbɛda sɛnkyerɛnne ahorow te sɛ:

• Ɔhome a ɛyɛ den:Ɛte sɛ nea ɛyɛ den ma akokoaa no sɛ ɔbɛhome.
• Koma a ɛbɔ so tew: Akokoaa no koma bɔ brɛoo.
• Honam ani bruu (Cyanosis): Akokoaa no honam ani, titiriw n’ano ne ne nsateaa ano yɛ bruu. Eyi fi nipadua no a ennya mframa pa a ɛdɔɔso.
• Ahome a wɔhome ntɛmntɛm: Ɛtɔ mmere bi a akokoaa no home ntɛmntɛm paa.
• Ahome a wode nnyigyei a ɛyɛ ahurututu yɛ: Wɔyɛ nnyigyei te sɛ "Huh... Huh..." bere a wɔrehome no.
• Koko a ɛkɔ fam: Ɛte sɛ nea koko mu ntokuru no kɔ mu bere a wɔrehome no.
• Nkwa: Akokoaa no te sɛ nea nkwa nnim koraa na onni nkwa.

Sɛ wuhu sɛnkyerɛnne ahorow te sɛ eyinom a, ɛho hia yiye sɛ wobɔ nnuruyɛfo amanneɛ ntɛm ara.

Dɛn nti na eyi rekɔ so? Dɛn nti na ɛte saa?

Ade titiriw nti a meconium hyɛn ahurututu mu ne adwennwen a akokoaa no nya wɔ awotwaa mu anaa bere a ɔrewo no . Nneɛma ahorow nti na adwennwen yi ba. Nhwɛsoɔ:

• Ɔyare mmoawa a wobenya wɔ ɛna anaa akokoaa no mu.
• Oxygen a akokoaa no nya so tew.

Wɔ tebea a ɛhaw adwene a ɛte sɛɛ mu no, akokoaa no home denneennen mpofirim. Sɛnea yɛkura yɛn home mu bere a ehu aka yɛn kɛse no ara pɛ. Saa bere no, nsu a ɛyɛ den no (ne meconium sɛ ɛwɔ hɔ a) kɔ akokoaa no ahurututu mu. Afei meconium a ɛyɛ den no kɔhyɛ ahurututu no mframa kotoku (`(Alveoli)`) mu, na ɛma ɛyɛ den sɛ wɔbɛhome.

Wobɛyɛ dɛn ahu sɛ meconium wɔ nsu no mu?

Mpɛn pii no, nsu a ɛwɔ amniotic mu no mu da hɔ. Nanso sɛ wɔde meconium ka ho a, nsu a efi mu ba bere a nsu no abubu no nya kɔla a ɛyɛ ahabammono-biribiri . Afei nso, nkokoaa a wɔde meconium ahyɛ wɔn mu no honam ani hwɛbea ne wɔn nsateaa nnadewa betumi ayɛ kɔkɔɔ bere a wɔawo wɔn no. Nanso mma ɛnhaw wo, wo nnuruyɛfo ne ayarehwɛfo nim eyi yiye. Wɔrehwɛ nsɛnkyerɛnne a ɛte sɛɛ.

Sɛ akokoaa no mene meconium a, so ɛyɛ ɔhaw?

Eyi nso yɛ ɔhaw a ɛnanom pii wɔ. Ɛyɛ ade a ɛfata sɛ akokoaa bɛmene awotwaa mu nsu bere a ɔwɔ awotwaa mu no. Ɛho hia nso ma akokoaa no nyin. Enti, sɛ wɔde meconium kakra fra amniotic nsu no mu na akokoaa no mene a, ɛrenyɛ ɔhaw kɛse. Nea ɛyɛ hu ne meconium a wɔhome kɔ ahurututu no mu, na ɛnyɛ sɛ wɔbɛmene no.

Ɔkwan bɛn so na nnuruyɛfo hu eyi? Dɛn ne ayaresa ahorow no?

Sɛ wo nsuo bubu na wohu meconium wɔ wo amniotic nsuo mu a, nnuruyɛfoɔ bɛhwɛ wo ba no yie paa sɛ ɛbɛhunu ``MAS'' ho nsɛnkyerɛnneɛ wɔ awoɔ akyi. Sɛnea yɛadi kan aka no, ɛnyɛ nkokoaa nyinaa na wonya saa tebea yi esiane meconium nti.

Nneɛma atitiriw a wɔde hu yare no ne:

• Akokoaa no tebea a wɔbɛhwɛ so: Wɔhwɛ sɛnea akokoaa no home, ne nipadua kɔla, ne ne dwumadi.
• Koko a Wotie: Wɔde afiri a wɔde tie asɛm tie akokoaa no koko de hwɛ sɛ nnyigyei biara a ɛyɛ soronko wɔ hɔ anaa.
• Koko so X-ray: .Eyi betumi ahu pefee sɛ meconium akɔhyɛ ahurututu no mu anaasɛ nsu aboaboa ano.
• Mogya mu Mframa Ho Nhwehwɛmu: Saa nhwehwɛmu yi boa ma wohu oxygen ne carbon dioxide dodow a ɛwɔ akokoaa no mogya mu ne baabi a ɔhome mu haw kodu.

Ɔkwan bɛn so na ayaresa no te?

Ayaresa no gyina meconium dodow a akokoaa no awe, sɛnea ɛyɛ den, ne sɛnea ɛyɛ den ma akokoaa no sɛ ɔbɛhome so.

• Sɛ akokoaa no su yiye wɔ awo mu na ɔyɛ nnam paa a, mpɛn pii no ɛho nhia sɛ wɔde ayaresa soronko ma.
• Suctioning: Eyi ne ade a edi kan a ɛsɛ sɛ woyɛ. Wɔde bulb syringe ketewaa bi yi meconium fi akokoaa no ano, ne hwene, ne ne menewam. Ɛtɔ da bi a, wɔde afiri ketewaa bi nso hyɛ akokoaa no mframa afiri (trachea) mu de yi meconium biara a abata ho no fi hɔ.
• Oxygen a wɔde ma: Sɛ ɛda so ara yɛ den ma akokoaa no sɛ ɔbɛhome a, ma oxygen denam oxygen akataso a wode bɛhyɛ n’anim no so.

Ebia ɛho behia sɛ wɔde nkokoaa binom a wɔwɔ MAS a emu yɛ den no kɔ Neonatal Intensive Care Unit (NICU) ma wɔhwɛ wɔn titiriw. Eyinom bi ne:

• Sɛ wode bɛka afiri a ɛma mframa bɔ ho: Sɛ ɛyɛ den ma akokoaa no sɛ n’ankasa bɛhome a, saa afiri yi boa.
• Surfactant Therapy: Wɔde aduru bi a wɔfrɛ no surfactant ma na aboa ahurututu no ma abue.
• Nnuru a ekum ɔyare mmoawa: Sɛ ɔyare bi wɔ ahurututu mu a, wɔde ma sɛ wɔmfa nsa.
• ECMO (Extracorporeal Membrane Oxygenation): Eyi yɛ ayaresa titiriw a wɔde di dwuma wɔ tebea horow a emu yɛ den yiye mu. Wɔma akokoaa no koma ne n’ahurututu home, na wɔde afiri bi de mframa pa gu mogya no mu.
• Radiant Warmer: Ɛboa ma wɔhwɛ akokoaa nipadua mu hyew so.
• CPAP (Continuous Positive Airway Pressure) afiri: Ɛboa ma akokoaa no ahurututu bue.

Kae sɛ, wɔyɛ saa ayaresa yi nyinaa na ama wo ba no ho atɔ no ntɛm. Nnuruyɛfo ne ayarehwɛfo no bɛma wo ba no hwɛ a eye sen biara.

So wobetumi asiw meconium a wɔtwetwe no ano? Dɛn ne nneɛma a ɛde asiane ba?

Sɛ yɛbɛka nokware a, ɔkwan biara nni hɔ a wɔbɛfa so asiw meconium aspiration ano koraa wɔ akokoaa mu. Efisɛ ɛyɛ biribi a ɛne akokoaa no adwennwen na ɛba. Nanso, nnuruyɛfo hwɛ yiye bere nyinaa sɛ ebia meconium wɔ awotwaa mu nsu no mu ne sɛ ebia akokoaa no wɔ ``Fetal Distress'' mu anaa. Sɛ wohu tebea yi ntɛm a, wobetumi asiw meconium aspiration a emu yɛ den ano na wɔafi ase sa yare ntɛm.

Asiane ahorow bi wɔ hɔ a ebetumi ama obi anya meconium aspiration syndrome:

• Nyinsɛn a ɛba bere akyi:Ɛno kyerɛ sɛ wɔbɛtrɛw nyinsɛn no mu asen adapɛn 42.
• Ɛna no wɔ asikreyare anaa mogya mmoroso.
• Awo a ɛkyɛ anaasɛ ɛyɛ den.
• Oxygen dodow a ɛso tew wɔ akokoaa no mu bere a ɔyem no.
• Awotwaa no Nnyin Anohyeto (FGR).

Nnuruyɛfo de wɔn adwene si nkokoaa a ɛnanom a wɔwɔ asiane ahorow yi awo wɔn so kɛse.

Dɛn ne nsɛnnennen a ebetumi aba? Bere tenten ahe na egye ansa na asa?

MAS ho nsɛnnennen a ɛtra hɔ kyɛ no ntaa mma na mpɛn pii no wobetumi adi ho dwuma na wɔasa no yare wɔ nna kakraa bi mu.

Nanso, nkokoaa a wɔwɔ ``MAS'' no betumi ayɛ asiane kɛse kakra sɛ wobenya saa tebea horow yi sen nkokoaa afoforo:

• Ahurututu mu yare ( ahurututu mu yare) .
• Akisikuru
• Abofra a Wɔawo No Foforo Ahurututu Mu Ntini Mu Nkɔso (PPHN) .
• Ahurututu no a ɛhwe ase `(Pneumothorax)`
• Oxygen a enni nipadua mu `(Hypoxia)`

Nanso kae sɛ ɛnyɛ akokoaa biara a ɔmene meconium na onya `(MAS)`, na ɛnyɛ akokoaa biara a ɔwɔ `(MAS)` na onya saa nsɛnnennen yi. Sɛ wohu na wɔsa no ntɛm a, eyi yɛ tebea a wotumi sa no kɛse.

Nkokoaa dodow no ara ho tɔ wɔn wɔ meconium a wɔtwe wɔn ho no mu wɔ nnɔnhwerew kakraa bi mu. Wɔ tebea horow a emu yɛ den kɛse mu no, ebia ebehia sɛ akokoaa no tra NICU nna anaa adapɛn pii, anaasɛ ebia ebehia sɛ ɔde ne ho to oxygen a wɔde ka ho so.

Nea ɛsɛ sɛ yɛma ɛtra yɛn adwenem (Take-Home Message) .

Meconium Aspiration Syndrome yɛ tebea a emu yɛ den, nanso wotumi sa, a ebetumi aba wɔ mmofra a wɔawo wɔn foforo mu. Wo duruyɛfo bɛhwɛ wo ba no awotwaa mu nsu mu sɛ ebia meconium wɔ hɔ bere a wɔawo no. Sɛ wo ba no da ahoyeraw ho sɛnkyerɛnne biara adi a, ɔbɛyɛ biribi ntɛm ara de ayi meconium no afi ne hwene ne n’ano.

Ade a ɛho hia sen biara ne sɛ wubehu tebea yi ntɛm na woasa no ntɛm. Saa kwan no so no, hokwan a ɛwɔ hɔ sɛ nsɛnnennen bɛba no sua koraa. Nkokoaa dodow no ara ho tɔ wɔn koraa wɔ nna kakraa bi mu, na nsunsuanso bɔne a ɛtra hɔ kyɛ no ntaa mma.

Afei nso, kae sɛ ɛnyɛ nkokoaa a wɔwɔ meconium wɔ wɔn awotwaa mu nsu mu nyinaa na wobenya meconium aspiration syndrome. Enti mma wo ho nnyɛ wo hu a ɛho nhia. Gye w’aduruyɛfo kuw no di. Wɔbɛma wo ne wo ba no hwɛ a eye sen biara.

` Meconium, Meconium Aspiration Syndrome, Abofra a Wɔawo No Foforo, Akokoaa a Ɔhome, Akokoaa Fefe a Edi Kan, Ahurututu mu Nyarewa, Meconium Aspiration Syndrome, Akokoaa a Wɔawo No Foforo a Ɔhome Ho Ɔhaw, Amniotic Fluid, Fetal Distress