Faduwar Cibiya Gabanin Jariri (Umbilical Cord Prolapse): Abin Da Kowane Uwa Ya Kamata Ta Sani

Gabatarwa: Tafiyar Ciki da Abubuwan Da Ba A Zato

Barka da zuwa! Idan kina da ciki ko kuma ke uwa ce mai jiran gado, muna taya ki murna bisa wannan gagarumin mataki na rayuwa. Yin ciki da haihuwa wata tafiya ce mai cike da abubuwan al'ajabi, farin ciki, da kuma wani lokacin 'yan fargaba. Tabbas, kowace uwa tana burin ganin ta haifi jaririnta cikin koshin lafiya ba tare da wata matsala ba. Amma kamar yadda muka sani, aikin likitanci da haihuwa na iya zuwa da wasu kalubale na bazata wadanda ke bukatar kulawar gaggawa. Daya daga cikin wadannan yanayoyi na gaggawa, wanda ko da yake ba a cika samunsa ba amma yana da matukar muhimmanci a san shi, shi ne abin da likitoci ke kira Umbilical Cord Prolapse ko kuma faduwar igiyar cibiya gabanin fitowar jariri.

Wannan makalar an tsara ta ne musamman don yi miki bayani daki-daki, cikin harshe mai sauki da rarrashi, game da menene wannan yanayin, me ke kawo shi, yadda ake gane shi, da kuma abin da likitoci ke yi don tabbatar da lafiyarki da ta jaririnki. Muna so ki kasance da cikakken bayani domin ilimi makami ne, amma ba muna so ki shiga damuwa ba ne, domin wannan matsalar tana faruwa ne da wuya sosai.

Menene Faduwar Igiyar Cibiya (Umbilical Cord Prolapse)?

A yanayi na al'ada, idan lokacin haihuwa ya yi, ruwan da ke kewaye da jariri (amniotic fluid) zai fashe, sannan kan jariri ko wani sashen jikinsa zai fara shiga cikin kogon ƙugu ya nufi hanyar farji, sannan igiyar cibiya ta biyo baya. Amma a yanayin Umbilical Cord Prolapse, igiyar cibiyar jaririn tana lillibowa ko faduwa ta bakin mahaifa (cervix) har ta shiga cikin farji kafin jaririn da kansa ya fito.

Wannan na nufin igiyar cibiyar ta riga jaririn fitowa. Wannan babban kalubale ne saboda idan igiyar cibiyar ta kasance a kasa, duk lokacin da mahaifa ta yi kankancewa (contraction) ko kuma jaririn ya danna kansa kasa, zai matse wannan igiyar cibiyar a tsakanin jikinsa da kashin ƙugun uwa. Wannan matsawa yana da matukar hadari kamar yadda za mu gani a gaba.

Muhimmancin Igiyar Cibiya ga Jariri

Don fahimtar dalilin da ya sa matsewar igiyar cibiya ke da hadari, yana da kyau mu san aikin ta. Igiyar cibiya ita ce hanyar rayuwar jariri (lifeline) lokacin yana cikin ciki. Tana kunshe da jijiyoyin jini guda uku: guda biyu suna daukar jinin da ba shi da iskar gas (deoxygenated blood) daga jariri zuwa mahaifar (placenta), sannan jijiya guda daya tana dauko jini mai cike da iskar shaka (oxygen) da abinci mai gina jiki daga uwa zuwa ga jariri. Haka kuma tana da wani ruwa mai kauri da ke kare wadannan jijiyoyin jini daga matsewa cikin sauki.

Idan aka samu katsewar wannan hanya koda na 'yan mintuna kadan, jariri zai shiga cikin mawuyacin hali na rashin iskar oxygen (hypoxia), wanda hakan ke da tasiri sosai a kan lafiyarsa da rayuwarsa.

Me Ya Sa Wannan Yanayin Ya Zama Na Gaggawa?

Faduwar igiyar cibiya tana daga cikin mafi girman lamuran gaggawa na fannin haihuwa (obstetric emergency). Lokacin da igiyar cibiyar ta fado gabanin jariri, tana fuskantar barazana guda biyu masu girma:

1. Matsewa (Compression): Lokacin da jariri ke kokarin fitowa, zai danna kansa ko wani sashen jikinsa akan igiyar cibiyar da ta fado, inda zai matse ta tsakaninsa da kashin ƙugun mahaifiya. Wannan na hana gudanar jini wanda ke dauke da iskar oxygen zuwa ga jariri. Wannan matsewar tana karuwa sosai lokacin da uwa ke samun naƙuda (contractions).
2. Sanyi da Kankancewar Jijiyoyi (Vasospasm): Idan igiyar cibiyar ta fito waje har iska ko sanyi ya shafe ta, jijiyoyin jinin da ke cikinta suna iya kankancewa da kansu, wanda hakan ma zai rage yawan jinin da ke zuwa ga jaririn.

Rashin iskar oxygen ga jariri na iya haifar da mummunan sakamako idan ba a dauki matakin gaggawa ba. Shi ya sa idan aka fuskanci irin wannan matsala, lambobin gaggawa irin su 112 ko 911 ko lambar asibitin gaggawa ta yankinku suna da matukar amfani idan abin ya faru a gida (kodayake a mafi yawan lokuta yana faruwa ne a asibiti).

Ire-Iren Faduwar Igiyar Cibiya

Likitoci sun karkasa faduwar igiyar cibiya zuwa kashi biyu manya:

• Overt Prolapse (Faduwa a bayyane): Wannan shi ne lokacin da igiyar cibiyar ta fito waje ta farji kuma ana iya ganinta ko tabata a fili gabanin jaririn. Wannan shi ne mafi yawa kuma shi ne ya fi saukin ganewa da wuri.
• Occult Prolapse (Faduwa a boye): A wannan yanayin, igiyar cibiyar ba ta fito ta farji ba, amma tana sako-sako ne tare da jaririn. Wato tana kusa da kan jaririn ko kafadarsa amma ba ta gabansa gaba daya. Wannan yana da wuyar ganewa domin ba a iya ganin ta idon basira sai ta hanyar sauyin bugun zuciyar jariri.

Yaya Yawan Afkuwar Wannan Matsala?

Idan kina karanta wannan kuma fargaba ta fara shiga zuciyarki, muna so mu kwantar miki da hankali. Faduwar igiyar cibiya abu ne da ba a cika samunsa ba. Alkaluman bincike daban-daban sun nuna cewa yana faruwa a kusan haihuwa 1 cikin 300, kuma wasu sababbin binciken suna nuna ma cewa ya fi karanci inda ake samun 1 cikin haihuwa 1,000.

Duk da cewa ba kasafai yake faruwa ba, tsananin hatsarin da ke tattare da shi ya sa dukkan ma'aikatan lafiya masu karbar haihuwa suke samun cikakken horo don fuskantarsa a kowane lokaci.

Alamomi Da Yadda Ake Gane Faduwar Igiyar Cibiya

Wani abin lura shi ne cewa, faduwar igiyar cibiya tana faruwa ne a mafi yawan lokuta bayan fashewar ruwan marar uwa (rupture of membranes). Lokacin da ruwan ya fashe da karfi, zai iya kwaso igiyar cibiyar ya fito da ita kasa idan kan jaririn bai toshe hanyar da kyau ba.

Alamomin sun hada da:

• Gani ko Jin Igiyar Cibiya: Idan ruwanki ya fashe sai kika ji ko kika ga wani abu kamar tsumma ko igiya ya fito ta farji, wannan babbar alama ce. Idan hakan ta faru a gida, kada ki yi kokarin mayar da igiyar ciki! Kira lambar gaggawa (misali 112 ko 911) nan take kuma ki je asibiti mafi kusa.
• Sauyin Bugun Zuciyar Jariri: A asibiti, likitoci da ungozomomi suna amfani da na'ura don sauraron bugun zuciyar jariri. Idan igiyar ta matse, bugun zuciyar jaririn zai sauka kasa sosai (Bradycardia) ko kuma ya dinga yin sama da kasa ba bisa ka'ida ba. Wannan ne yakan baiwa likitoci damar gane Occult prolapse ko faduwa a boye.

Kusan fiye da kashi 50% na wannan matsala tana faruwa ne a cikin mintuna 5 da fashewar ruwan jariri, yayin da kashi 70% ke faruwa a cikin sa'a guda.

Menene Ke Janyo Faduwar Igiyar Cibiya? (Causes & Risk Factors)

Babu wata takamaiman hanya guda daya da ke janyo wannan yanayi da za a iya cewa ga shi, amma akwai wasu dalilai masu kara yiwuwar afkuwarsa. Wadannan sune abubuwan da ke baiwa igiyar cibiya damar faduwa kasa kafin jariri:

• Matsayin Jariri Ba Dai-dai Ba (Breech or Transverse Presentation): A al'ada jariri ya kamata ya kasance kansa na kasa sosai (cephalic presentation) wanda hakan ke toshe kofar mahaifa tare da hana igiyar cibiya zuyawa kasa. Amma idan jariri yana zuwa da gindi ko kafa (breech) ko kuma ya kwanta a karkace (transverse), akwai sarari da yawa da igiyar cibiya za ta iya faduwa.
• Yawan Ruwan Jariri (Polyhydramnios): Idan mace tana da ruwan jariri mai yawan gaske, lokacin da ruwan zai fashe, yana fitowa da wani irin karfi kamar ambaliya, wanda zai iya janyo igiyar cibiya ta taho tare da shi.
• Yawan Haihuwa Ko Juna Biyu na 'Yan Biyu (Multiple Pregnancies): Kasancewar jarirai fiye da daya a ciki yana canza tsarin kwanciyarsu, wanda hakan kan baiwa igiyar cibiyar damar zuyawa kasa.
• Fashewar Ruwa Da Wuri (Premature Rupture of Membranes): Idan ruwan marar ya fashe kafin jariri ya yi nauyi ko ya gangaro kasa sosai a cikin kashin ƙugu, igiyar cibiya tana iya gangarowa.
• Kankantar Jariri (Low Birth Weight) ko Ciki da Bai Isa Haihuwa Ba (Prematurity): Jariri karami ba zai toshe hanyar fita gaba daya ba, don haka ya bar sarari ga igiyar cibiya.
• Tsawon Igiyar Cibiya: Idan igiyar cibiyar jaririn tana da tsayi fiye da kima, tana da saukin lulluɓowa kasa.
• Haihuwa Fiye Da Biyar (Multiparity): Mace da ta haihu sau da yawa, mahaifarta da tsokokin kashin ƙugunta sun ɗan fi sakewa, wanda zai sa jariri bai cika kafuwa da wuri ba.
• Katsalandan Na Asibiti: A wasu lokuta da ba a cika samunsu ba, idan likita yana kokarin fasa ruwan marar domin ya sanya naƙuda (amniotomy) ko kuma yana amfani da wasu kayan aiki don fadada bakin mahaifa, igiyar cibiya tana iya samun hanyar faduwa, musamman idan jaririn bai sakko kasa sosai ba.

Yiwuwar Mummunan Sakamako (Complications)

Dole ne a fadi gaskiya cewa, faduwar igiyar cibiya lamari ne mai matukar hatsari ga rayuwar jariri idan ba a dauki mataki a lokacin da ya dace ba. Mafi yawan hatsarin ya ta'allaka ne akan rashin samun iskar oxygen. Wadannan sune abubuwan da ka iya faruwa idan aka samu tsaiko:

• Hypoxia: Karancin iskar oxygen a cikin jinin jariri.
• Hypoxic-ischemic encephalopathy (HIE) / Asphyxia: Wannan wani mummunan lalacewar kwayoyin halittar kwakwalwa ne da ke faruwa idan jariri ya dade bai sami iskar oxygen ba. Yana iya haifar da shanyewar jiki.
• Cerebral Palsy: Wata nakasa ce ta dindindin a kwakwalwa wadda ke shafar motsin jiki da sarrafa tsokoki, wanda hakan kan faru saboda jinkirin samun iskar oxygen yayin haihuwa.
• Mutuwar Jariri a Ciki Ko Yayin Haihuwa (Stillbirth): Wannan ne babban bakin cikin da ke faruwa idan igiyar ta matse gaba daya na tsawon lokaci kuma ba a gudanar da tiyata cikin gaggawa ba.

Kar ki manta: Wadannan munanan abubuwan suna faruwa ne kawai idan an samu dogon tsaiko. Idan kina asibiti, likitoci a shirye suke koyaushe don dakile su.

Yadda Likitoci Ke Karbar Wannan Yanayi Na Gaggawa (Treatment and Management)

Da zarar likita ko ungozoma ya gano cewa igiyar cibiya ta fado, asibiti zai shiga wani yanayi na daukar matakin gaggawa ba tare da bata wani lokaci ba. Manufar farko ita ce cire matsi daga kan igiyar cibiya sannan na biyu shi ne fidda jariri da gaggawa.

Ga yadda ake gudanar da tsarin ceto:

1. Sauke Matsi Akan Igiyar Cibiya: Da zarar an fahimci lamarin, likita ko ungozoma zai sanya hannunsa a cikin farjin uwar ya dago kan jariri ko sashen jikinsa don hana shi ci gaba da matse igiyar cibiyar. Wannan likitan ba zai cire hannunsa ba har sai an fidda jaririn! Tabbas, wannan tsari na iya zama mai ban tsoro kuma ba dadi ga uwar, amma shi ne abin da zai ceci rayuwar jaririnta.
2. Canza Yanayin Kwanciyar Uwa: Za a buƙaci uwar ta sauya yanayin kwanciyarta. Ana iya sa ta ta kwanta akan guiwawinta yayin da kirjinta ke karkashin kasa (knee-chest position), ko kuma a sa ta ta kwanta sannan a daga kugu da kafafunta sama. Wannan yana sa nauyin jaririn ya koma baya, wanda ke taimakawa wajen rage matsi a kan igiyar.
3. Dakatar Da Naƙuda (Tocolysis): Ana iya yi wa uwa allura don dakatar da kankancewar mahaifa na wani dan lokaci don rage ci gaba da tura jaririn kasa.
4. Tiyata Ta Gaggawa (Emergency C-Section): Mafi yawan lokuta, hanya mafi aminci kuma mafi sauri don tseratar da jariri ita ce ta hanyar tiyata (Cesarean Section). Za a garzaya da uwar zuwa dakin tiyata ba tare da wani jinkiri ba don fidda jaririn. Wani lokaci, idan bakin mahaifa a bude yake sosai (10cm) sannan kuma an tabbatar da jaririn ya taho kusa da fita kuma kansa yana kasa sosai, likita na iya amfani da na'urorin taimakawa wajen ciro shi (Vacuum or Forceps) don hanzarta haihuwa ta farji. Amma tiyata ce aka fi yi don kiyayewa.

Shin Za A Iya Rigakafin Faduwar Igiyar Cibiya?

Hanya mafi kyau ta takaita hatsarin wannan lamari ita ce sanin gaskiya: Babu wata hanya ko dabara da mace mai ciki za ta iya yi a gida ko a kanta don hana faduwar igiyar cibiya. Wannan matsala ce da ke faruwa daga tsarin jiki da kwanciyar jariri wanda ba ya karkashin ikon kowa. Haka kuma, yana da wuya a iya hasashen cewa hakan zai faru kafin lokacin naƙuda.

Amma, abin da za ki iya yi shi ne:

• Bin shawarwarin asibiti musamman idan an gaya miki cewa jaririnki yana kwance ta kafa (breech) ko ruwanki yayi yawa.
• Garzayawa asibiti cikin gaggawa da zarar ruwan mararki ya fashe. Idan kuma kika ji kamar wani abu ya biyo bayan ruwan, ko kika lura da rage motsin jariri daban da yadda kika saba, kar ki dakata koda da minti daya, sami mota ko ambulan zuwa asibiti mafi kusa sannan ki tabbatar kin shaida musu abin da ke faruwa ta lambar 112 ko 911 a kan hanya.

Rayuwar Jariri Bayan Wannan Hadari (Survival and Prognosis)

Labari mai dadi shine, a wannan zamanin da muke ciki na ci gaban kimiya da fasahar lafiya, yawan jariran da ke tsira da rayukansu ba tare da wata matsala ba yana da yawa matuka, muddin abin ya faru a asibiti. Alkaluma sun nuna cewa idan faduwar igiyar cibiya ta faru a asibiti karkashin kulawar likitoci, yawan jariran da ke mutuwa bai wuce kashi 3% ba (kodayake wasu nazarin sun nuna ya kai 7%). Gaba daya kashi 93-97% na jariran suna samun lafiya.

Matsalar tafi muni ne idan wannan yanayin ya faru a wajen asibiti, kamar a gida ko akan hanya. An kiyasta cewa hatsarin rasa ran jariri yana karuwa har sau 20 idan lamarin ya faru ba a kusa da asibiti ba. Wannan dalili ne mai karfi da ke nuna muhimmancin tsara gurin haihuwa da wuri da kuma zuwa asibiti da zaran alamun naƙuda ko fashewar ruwa sun nuna.

Matsalar Kwayar Halittar Hankali Da Goyon Baya

Saniyar cewa kin fuskanci yanayin gaggawa yayin haihuwa zai iya sanya ki cikin matsanancin rawar jiki, damuwa da tsoro (trauma). Yana da kyau mahaifiya ta fahimci cewa wannan abin bai faru saboda wani laifi da ta yi ba. Babu wani abu da kika ci, kika sha ko kika yi da ya kawo wannan yanayi.

Bayan an tsallake rijiya da baya, yana da matukar muhimmanci a tattauna da likitoci, masu ba da shawara kan lamurran kwakwalwa da iyali don samun damar bayyana bacin rai da fargabar da aka ji yayin abin ya faru. Kasancewar kin wuce wannan yanayin cikin nasara wani babban abin godiya ne.

Kammalawa

Tafiyar ciki da haihuwa tana cike da abubuwan da ba za mu iya hangowa gaba daya ba, amma samun bayanan da suka dace kan lamurra irin su faduwar igiyar cibiya (Umbilical Cord Prolapse) yana sa mu kasance a shirye don daukar matakan da suka dace. Wannan yanayi na jinkirin oxygen ne kuma yana bukatar hanzari. Ba za a iya riga-kafin sa ba, amma tsananin mayar da hankali da gaggawar sanar da likitoci lokacin da ruwan mara ya fashe shi ne babban makamin magance shi.

Muna yi miki fatan samun ragowar lokacin ciki mai dadi, da haihuwa cikin koshin lafiya, da kuma jariri mai albarka da koshin lafiya wanda zai sanya murmushi a fuskarki. Kar ki bari wannan bayani ya tsorata ki, a maimakon haka ya zama wani makami na ilimi a gare ki.

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