E kamaʻilio kākou e pili ana i nā neural tube defects (NTDs) e hoʻopilikia ana i ka lolo a me ke kaula spinal o kahi pēpē e ulu ana i loko o ka ʻōpū?

Inā paha ʻoe e hāpai ana i kahi pēpē a i ʻole ua loaʻa mua iā ʻoe ka nūhou maikaʻi, ke noʻonoʻo nei paha ʻoe i nā tausani mea e pili ana i ka mea liʻiliʻi i loko o kou ʻōpū. Pehea ka waiwai o ka ʻike iki ʻana e pili ana i ke olakino o kāu pēpē? No laila, i kēia lā e kamaʻilio mākou e pili ana i kahi mea hiki ke hana i kekahi manawa i ka wā hāpai, akā hiki ke pale ʻia inā ʻike ʻoe ma mua. ʻO ia nā neural tube defects , a i ʻole e like me kā nā kauka e kapa nei iā lākou he "Neural Tube Defects - NTDs". Mai hopohopo, e kamaʻilio maʻalahi mākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha nā neural tube defects (NTDs)? I ka ʻōlelo maʻalahi...

I ka ʻōlelo maʻalahi, ʻo NTD kahi ʻano maʻi hānau . ʻO ia hoʻi, he mau maʻi ia e kū mai ana i ka wā e noho ana ke pēpē i loko o ka ʻōpū. Hoʻopilikia nui lākou i ka lolo o ke pēpē, ke kaula iwi kuamoʻo, a i ʻole ke kaula iwi kuamoʻo (ka ʻōnaehana nerve e holo ana ma o ka iwi kuamoʻo). E hoʻomanaʻo, ʻike pinepine ʻia kēia mau hemahema ma mua o kou ʻike ʻana ua hāpai ʻoe, maʻamau i loko o ka mahina mua o ka hāpai ʻana.

ʻO kēia ka mea maʻamau e hana ʻia. Ke hoʻomaka mua ka ulu ʻana o kahi pēpē i loko o ka ʻōpū, hui pū nā ʻaoʻao ʻelua o ka iwi kuamoʻo o ka pēpē, e hana ana i kahi ʻano like me ka paipu. ʻO kēia ka mea a mākou e kapa nei he neural tube . ʻO kēia neural tube ka mea e ulu aʻe ma hope aku i loko o ka lolo a me ke kaula kuamoʻo o ka pēpē. No laila, inā ʻaʻole pani pono kēia neural tube, inā he hakahaka liʻiliʻi a hemahema paha ma kekahi wahi, a laila hiki mai kēia kūlana i kapa ʻia ʻo NTD. Ua like ia me ke kūkulu ʻana i kahi hale, inā he hakahaka ma kekahi wahi, kahe ka wai mai ka hale.

He aha nā ʻano nui o nā NTD?

Aia kekahi mau ʻano nui o nā kīnā neural tube (NTD). E nānā kākou i kēlā me kēia:

1. Spina Bifida

ʻO kēia ke ʻano maʻamau o ka NTD. ʻO Spina Bifida kahi kūlana i pani ʻole ʻia ai ka neural tube ma kekahi wahi ma ke kuamoʻo i ka wā o ka ulu ʻana o ka fetal. Eia hou, aia kekahi mau ʻano like ʻole:

• ʻO ka Myelomeningocele (Spina Bifida Hāmama):

E noʻonoʻo, i ka wā e hānau ʻia ai kekahi mau pēpē, hiki iā ʻoe ke ʻike i kahi ʻeke piha i ka wai e puka mai ana mai ke kua o ko lākou iwi kuamoʻo. Ua kapa ʻia kēia ʻo `(Myelomeningocele).` I loko o ka ʻeke, aia paha kekahi ʻāpana o ke kaula iwi kuamoʻo o ka pēpē, nā ʻiʻo e uhi ana iā ia `(Meninges)`, nā aʻalolo, a me ke kahe e hoʻopuni ana i ka lolo `(Cerebrospinal Fluid - CSF)`. ʻO kēia ke ʻano koʻikoʻi loa a maʻamau o `(Spina Bifida).`

• ʻO ka Meningocele:

I kēia hihia, ua puka mai paha kahi ʻeke piha i ka wai mai ke kua o ka pēpē. Eia nō naʻe, i kēia hihia, ʻaʻole i hōʻino ʻia ke kaula iwi o ka pēpē, ʻo ia hoʻi, ʻaʻole i loko o ka ʻeke ke kaula iwi.

• ʻO ka Spina Bifida Occulta:

ʻO kēia ke ʻano palupalu loa o ka `(Spina Bifida)`I kēia hihia, aia kahi hakahaka liʻiliʻi ma ka iwi kuamoʻo o ka pēpē, akā ʻaʻohe ʻeke i ʻike ʻia. ʻAʻohe hōʻino i ke kaula kuamoʻo a i ʻole nā ​​​​aʻalolo. ʻO ka hapa nui o ka manawa, ʻaʻole kēia e hoʻopilikia. I kekahi manawa, ʻaʻole paha ʻoe e ʻike he loaʻa iā ʻoe no ke koena o kou ola.

2. ʻAnensefali

He maʻi koʻikoʻi kēia. ʻO Anencephaly kahi maʻi i pani pono ʻole ai ka ʻaoʻao luna o ka neural tube, kahi e ulu ai ka lolo, i ka wā o ka ulu ʻana o ka fetal. ʻO ka hopena, ʻaʻole ulu pono ka iwi poʻo o ka pēpē, ka ʻili, a me ka lolo. Hiki ke nalowale loa kekahi mau ʻāpana o ka lolo a me ke iwi poʻo. ʻIke pinepine ʻia ka ʻiʻo lolo e ulu ana no ka mea ʻaʻohe ʻili a iwi paha e uhi ai. ʻO ka mea kaumaha, ʻo nā pēpē me kēia maʻi e hānau make pinepine ʻia a make paha ma hope koke o ka hānau ʻana.

3. ʻEncephalocele

Hana ʻia kēia ke pani pono ʻole ka ʻōmole neural ma kahi kokoke i ka lolo, e hana ana i kahi puka i loko o ke poʻo. Hiki i ka lolo o ke pēpē a me nā membrane e uhi ana i ka lolo (meninges) ke puka i waho ma o kēia puka, e hana ana i kahi puka e like me ka ʻeke. I kekahi manawa, aia paha he puka liʻiliʻi wale nō ma ka lua ihu a i ʻole ka lae, ʻaʻole i ʻike nui ʻia.

4. ʻIniencephaly

He maʻi koʻikoʻi loa kēia a he mea laha ʻole hoʻi. Hoʻoulu ia i nā kīnā koʻikoʻi o ke kuamoʻo. I ka manawa pinepine, ʻaʻohe loa ka ʻāʻī, a hiki ke kūlou ke poʻo i hope a hiki ke hoʻopili ʻia ke alo o ka pēpē i ka umauma a hiki ke hoʻopili ʻia ka ʻili ma ke kua o ke poʻo. ʻO ka maʻamau, hānau make nā pēpē me kēia maʻi.

ʻO wai ka mea e hoʻopilikia ai kēia mau `(NTDs)`? ​​Pehea ka maʻamau o lākou?

ʻO nā NTD he mau kūlana e kū mai ana i ka wā hānau, ʻo ia hoʻi ke hoʻopilikia nei lākou i ka pēpē e ulu ana . Loaʻa pū lākou i loko o ka mahina mua o ka hāpai ʻana.

ʻOiai ʻaʻole maʻamau loa nā NTD ma kekahi mau ʻāina, he mea nui e makaʻala iā lākou. No ka laʻana, ma ʻAmelika Hui Pū ʻIa, ʻike ʻia kēia ʻano ma kahi o 3,000 mau hāpai ʻana i kēlā me kēia makahiki. I waena o lākou, ʻo Spina Bifida lāua ʻo Anencephaly nā mea maʻamau. ʻOiai he paʻakikī ke loaʻa nā helu helu pololei ma Sri Lanka, he mea nui e hoʻomanaʻo e hiki ke loaʻa kēia mau ʻano i kekahi.

No ke aha e loaʻa ai kēia mau neural tube defects (NTDs)?

ʻO kaʻoiaʻiʻo, ʻaʻole hiki i nā kauka a me nā ʻepekema ke ʻōlelo maopopo i ke kumu hoʻokahi o kēia mau NTD. Eia nō naʻe, manaʻoʻiʻo lākou he hui pū ʻia o nā kumu genetic, meaʻai, a me ke kaiapuni .

Ua ʻike ʻia he kumu nui o kēia ka haʻahaʻa o ka pae folic acid i loko o ke kino o ka makuahine, ʻoiai ma mua o ka hāpai ʻana a me nā pule mua o ka hāpai ʻana . He meaʻai koʻikoʻi ka folic acid a i ʻole folate no ka ulu pono ʻana o ka lolo a me ke kaula kuamoʻo o ka pēpē.

He aha nā hōʻailona o nā NTD?

Loaʻa i kēlā me kēia ʻano NTD kona mau hōʻailona kūikawā.

No nā pēpē me kekahi `(NTD)`ʻAʻohe hōʻailona. Eia nō naʻe, hiki i kekahi mau pēpē ke loaʻa nā pilikia koʻikoʻi . E like me ka mea i ʻōlelo ʻia ma mua, make pinepine nā pēpē me ka `(Iniencephaly)` a me ka `(Anencephaly)` i ka wā hānau a i ʻole ma hope koke iho o ka hānau ʻana.

ʻO nā hōʻailona maʻamau o nā NTD:

• Nā pilikia kino - no ka laʻana, ka maʻi lolo (nalowale o nā lālā), ka hiki ʻole ke kaohi i ka mimi a me ka ʻōpala.
• Ka nalowale ʻana o ka ʻike (makapō).
• Ka nalowale o ka lohe (kuli).
• Nā kīnā noʻonoʻo.
• Nā kūlana ʻike ʻole, i kekahi manawa hiki ke make.

Inā manaʻo nā kauka he ``(NTD)'' ko kāu pēpē, e haʻi hou aku lākou iā ʻoe e pili ana i kēia, no ka mea, hiki ke ʻokoʻa kēia mau kūlana mai kekahi pēpē a i kekahi.

Loaʻa i ka makuahine kekahi mau hōʻailona i ka wā hāpai?

ʻAʻole. ʻOiai inā loaʻa i kāu pēpē kahi ``(NTD)'', ʻaʻole ʻoe e ʻike i kekahi mau hōʻailona kikoʻī e pili ana iā ia. ʻIke nā kauka i kēia mau mea ma o nā hoʻokolohua i ka wā hāpai.

Pehea e ʻike ʻia ai kēia mau `(NTDs)`?

ʻO ka maʻamau, ʻike nā kauka i nā NTD ma o nā hoʻokolohua prenatal i ka wā hāpai. He mea nui loa nā scan ultrasound no kēia.

He aha nā hoʻokolohua i hoʻohana ʻia e ʻike ai i nā NTD?

Hoʻohana nā kauka i kēia mau hoʻokolohua e ʻike i nā NTD ma mua o ka hānau ʻana o kahi pēpē:

• Hoʻāʻo Koko: Ma waena o 16 a me 18 mau pule o ka hāpai ʻana, hiki i kāu kauka ke kauoha i kahi hoʻāʻo e ana i kahi protein i kapa ʻia ʻo alpha-fetoprotein (AFP) i loko o kou koko. Inā loaʻa i kāu pēpē kahi NTD, ʻoi aku ke kiʻekiʻe o nā pae koko o ka makuahine o kēia protein ma mua o ka maʻamau (ma kahi o 75% - 80%). Inā kiʻekiʻe kāu mau pae AFP, hiki i kāu kauka ke kauoha i nā hoʻāʻo hou aʻe, e like me ka ultrasound scan.
• ʻO ka Ultrasound Fetal (Prenatal): ʻO ka scan ultrasound i ka wā hāpai ke ala pololei loa e ʻike ai i kekahi mau NTD. Manaʻo pinepine nā kauka i nā scan i ka trimester mua (pule 11-14) a me ka lua o ka trimester (pule 18-22). Nānā kēia mau scan i ka iwi kuamoʻo a me ke poʻo o ka pēpē e ʻike inā he mau hōʻailona o NTD.
• Amniocentesis: Hiki i kēia hoʻāʻo ke nānā i nā NTD a me nā kīnā hānau ʻē aʻe. Pili ia i ka hoʻohana ʻana i kahi nila e lawe i kahi laʻana liʻiliʻi o ka wai amniotic e hoʻopuni ana i ka pēpē. Hana pinepine ʻia kēia ma waena o 15 a me 20 mau pule o ka hāpai ʻana. Eia nō naʻe, aia kekahi mau pilikia e pili ana i kēia hoʻāʻo, no laila e kamaʻilio me kāu kauka e pili ana i ia mea.

I kekahi manawa, hiki ke ʻike ʻia kekahi mau NTD ma hope o ka hānau ʻana o ke pēpē ma o nā hoʻokolohua kiʻi e like me MRI (Magnetic Resonance Imaging) a i ʻole CT (Computed Tomography) scans.

He aha nā lāʻau lapaʻau no nā NTD?

No nā kūlana e like me `(Spina Bifida)` a me `(Encephalocele), aia kekahi mau koho lapaʻau ma muli o ke koʻikoʻi o ke kūlana.

ʻO ka mea pōʻino, ʻaʻohe lāʻau lapaʻau no Anencephaly a me Iniencephaly. Make pinepine kēlā mau pēpē i ka wā hānau a i ʻole ma hope koke iho o ka hānau ʻana.

Lapaʻau no ka Spina Bifida a me ka Encephalocele

ʻO ke ʻano o ka mālama ʻana no nā kūlana ʻelua e pili ana i ke koʻikoʻi o ke kūlana a inā he mau pilikia ʻē aʻe ko ka pēpē. ʻO ke ʻoki kino ke ʻano nui no nā mea ʻelua.

ʻO ka maʻamau, mālama ʻia ka encephalocele ma ke ʻoki kino, kahi e hoʻihoʻi ʻia ai ka ʻāpana o ka lolo i puka mai ka iwi poʻo o ke pēpē, me nā membrane e hoʻopuni ana iā ia, i loko o ka iwi poʻo, e pani ana i ka puka i loko o ka iwi poʻo.

ʻO Myelomeningocele, ke ʻano maʻamau o ka spina bifida, e mālama pinepine ʻia me ke ʻoki ʻana e hoʻoponopono i ka puka ma ka iwi kuamoʻo o ka pēpē. Hiki ke hana ʻia kēia ʻoki ma mua o ka hānau ʻana o ka pēpē (ʻoki ʻana o ka pēpē) a i ʻole ma hope koke iho o ka hānau ʻana (ʻoki ʻana ma hope o ka hānau ʻana) .

Pono paha kēia mau kūlana ʻelua i ka mālama lōʻihi , ma muli o ke kūlana o ke keiki. I ka hala ʻana o ka manawa, pono paha ke ʻoki kino hou aʻe, a i ʻole nā ​​​​pilikia e like me ka hydrocephalus, ʻo ia hoʻi ka hōʻiliʻili ʻana o ka wai keu a puni ka lolo, pono paha e mālama ʻia.

He aha nā kumu pilikia no ka hoʻomohala ʻana i kahi NTD?

Hiki i kekahi wahine ke hānau keiki me ka ``(NTD)``. Eia nō naʻe, hiki i kekahi mau kumu ke hoʻonui i kēia pilikia. E nānā kākou i ke ʻano o lākou:

• Ka hemahema o ka Folate (folic acid): He mea nui loa kēia. ʻO ka Folate kahi ʻano huaora B-9. He mea nui ia no ka ulu olakino o ka pēpē. Inā ʻaʻole lawa ka folic acid ma mua o ka hāpai ʻana a i nā mahina mua o ka hāpai ʻana, ʻoi aku ka nui o ka manawa e loaʻa ai kahi NTD e like me Spina Bifida.

No laila, inā ʻoe e hoʻolālā ana e hāpai, a i ʻole ua hāpai mua ʻoe, he mea nui loa ia e lawe i nā huaora prenatal i kuhikuhi ʻia e kāu kauka. Manaʻo nui ʻia e lawe i ka liʻiliʻi he 400 micrograms (mcg) o ka folic acid i kēlā me kēia lā. He manaʻo maikaʻi nō hoʻi e ʻai i nā meaʻai waiwai i ka folate (e like me ka spinach, pears).

• Moʻolelo ʻohana o nā kīnā neural tube: ʻO kahi makuahine i loaʻa kahi pēpē me kahi NTD ma mua, he 2% a 3% ka piʻi ʻana o ka pilikia o ka loaʻa ʻana o kahi pēpē ʻē aʻe me ke kīnā like. Inā makemake ʻoe e ʻike hou aku e pili ana i kēia, he manaʻo maikaʻi e ʻike i kahi kākāʻōlelo genetic.
• ʻO kekahi mau lāʻau antiseizure: Hiki i kēia mau lāʻau ke hoʻonui i ka pilikia o NTDs inā lawe ʻia i ka wā hāpai. Inā ʻoe e lawe ana i ka lāʻau no ka maʻi epilepsy, e kamaʻilio me kāu kauka ma mua o kou hāpai ʻana e aʻo pehea e hoʻopilikia ai ka lāʻau i kāu hāpai ʻana.
• Maʻi diabetes:ʻOi aku ka nui o ka pilikia o nā makuahine hāpai me ka maʻi diabetes i kāohi pono ʻole ʻia e loaʻa kahi pēpē me ka "(NTD)".
• Momona: ʻOi aku ke kiʻekiʻe o kēia pilikia no nā makuahine momona ma mua o ka hāpai ʻana.
• Hoʻonui ʻia ka mahana o ke kino i ka wā hāpai mua: Inā piʻi ka mahana o kou kino (hyperthermia) i nā pule mua o ka hāpai ʻana, inā paha ma muli o ke kuni mau a i ʻole ka hoʻohana ʻana i ka sauna a i ʻole ka ʻauʻau wela, aia kahi pilikia liʻiliʻi o ka hoʻomohala ʻana i nā NTD.
• Ka hoʻohana ʻana i ka opioid i ka wā hāpai mua: ʻO nā opioids kahi ʻano lāʻau hoʻopau ʻeha hiki ke hoʻopili nui. Inā ʻoe e hoʻohana iā lākou i nā mahina ʻelua mua o ka hāpai ʻana, ʻoi aku ka nui o kou loaʻa ʻana o kahi pēpē me ka NTD. Inā hāpai ʻoe a ke lawe nei i kekahi lāʻau lapaʻau e loaʻa paha nā opioids, e haʻi koke i kāu kauka.

Hiki i kahi pēpē me ka `(NTD)` ke ola?

ʻAe, hiki i nā pēpē me kekahi mau kīnā neural tube e like me `(Spina Bifida)` a me `(Encephalocele)` ke ola. Eia naʻe, e like me ka mea i ʻōlelo ʻia ma mua, make pinepine nā pēpē me `(Anencephaly)` a me `(Iniencephaly)` i ka wā hānau a i ʻole ma hope koke iho o ka hānau ʻana.

ʻO nā pēpē me ka `(Spina Bifida),` ʻoiai ʻo `(Myelomeningocele)` a i ʻole `(Encephalocele),` ua ʻoi aku ka nui o ka pilikia o ka hōʻino ʻia ʻana o ke aʻalolo. Hiki i kēia ke alakaʻi i nā kūlana e like me ka maʻi lolo. ʻO ka hōʻino ʻia ʻana o ke aʻalolo a me ka nalowale o ka hana i loaʻa i ka wā hānau he mau loa ia. Eia nō naʻe, aia kekahi mau lāʻau lapaʻau e hiki ke kōkua i ka pale ʻana i ka hōʻino hou aʻe a me nā pilikia.

Hiki i kekahi mau pēpē me ka "Spina Bifida" ke ola me ka ʻole o nā pilikia a i ʻole nā ​​​​pilikia liʻiliʻi loa.

Pehea e mālama ai i kaʻu pēpē me kahi `(NTD)`?

He mea nui e hoʻomanaʻo i kēia: ʻAʻole like nā pēpē a pau me nā NTD. ʻOi aku ka hopena o nā pēpē me Spina Bifida a me Encephalocele i nā ʻano like ʻole. He mea hiki ʻole ke wānana pololei pehea e hopena ai kāu pēpē. ʻO ka mea maikaʻi loa hiki iā ʻoe ke hana, ʻo ke kamaʻilio me kāu kauka e pili ana i ke kūlana o kāu pēpē a loaʻa ka ʻōlelo aʻo mai iā lākou.

I ka ulu ʻana o kāu keiki, pono paha iā ia ke kōkua o kahi hui o nā kauka e hāʻawi i nā mālama like ʻole a lākou e pono ai. He mea nui loa ia e kākoʻo i kāu keiki a hōʻoia e loaʻa iā lākou ka mālama olakino maikaʻi loa.

Āhea wau e ʻike ai i ke kauka e pili ana i nā NTD?

Inā hānau ʻia kāu keiki me kahi NTD, pono lākou e ʻike i ke kauka a i ʻole ka hui lapaʻau i nā manawa a pau e mālama iā lākou no ke koena o ko lākou ola.

Inā ʻoe e lawe nei i ka lāʻau lapaʻau no ka maʻi epilepsy a i ʻole opioids, e kamaʻilio me kāu kauka ma mua o kou hāpai ʻana e ʻike pehea e hoʻopilikia ai ka lāʻau lapaʻau i kou hāpai ʻana a me ka hiki ke loaʻa kahi pēpē me kahi NTD.

He mea maʻamau ka makaʻu a me ka haʻalulu ke ʻike ʻoe he ``(NTD)`' ko kāu pēpē. Akā e hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi. Nui nā kumuwaiwai e hiki ke kōkua iā ʻoe a me kou ʻohana. He mea nui e kamaʻilio me ke kauka i ʻike i nā ``(NTDs)'' e aʻo pehea e pili ai kāu pēpē a pehea e hoʻomākaukau ai no ia.

ʻO ka mea hope loa, nā mea e pono ai mākou e hoʻomanaʻo (Leka Lawe-Home)

Ke lana nei koʻu manaʻo ua hāʻawi kēia kūkākūkā iā ʻoe i kekahi ʻike e pili ana i nā "Neural Tube Defects - NTDs". ʻO ka mea nui loa, ʻo ia ka ʻike ʻana i kēia mau mea ma mua.

• ʻO nā NTD (nā kīnā ulu e kū mai ana i loko o ka lolo a me ke kaula kuamoʻo o ka pēpē i nā pule mua o ka hāpai ʻana.
• He meaʻai koʻikoʻi loa ka waikawa Folic no ka pale ʻana i kēia mau kūlana. ʻO ka lawe ʻana i ka waikawa folic i kēlā me kēia lā mai ka manawa āu e hoʻolālā ai e hāpai a i nā mahina mua o ka hāpai ʻana hiki ke hōʻemi nui i ka pilikia o NTDs.
• Hiki ke ʻike ʻia nā NTD ma o nā kiʻi ultrasound i ka wā hāpai.
• ʻOiai kekahi mau NTD he mau lāʻau lapaʻau, e like me ke ʻoki ʻana, ʻaʻohe lāʻau lapaʻau o kekahi mau maʻi koʻikoʻi.
• Inā he mau nīnau a hopohopo paha kāu e pili ana i nā NTD, e kamaʻilio me kāu kauka.

Lana ko mākou manaʻo he mea kōkua kēia ʻike iā ʻoe. E loaʻa iā ʻoe ka ikaika e loaʻa ai kahi pēpē olakino!

ʻO ke kīnā o ka ʻōnaehana neural, NTD, Spina Bifida, Anencephaly, Folic Acid, Hāpai keiki, Nā kīnā hānau, Nā kīnā o ka ʻōnaehana neural