Inā ʻoe e hāpai ana i kahi pēpē, he mea maʻamau ke hopohopo nui e pili ana i ka palekana o kāu keiki liʻiliʻi. ʻO ka ʻoiaʻiʻo, ʻo ka ʻike ʻana i kekahi mau mea pili i ke kaiapuni i ka wā hāpai hiki ke hoʻoweliweli i kāu pēpē e ulu ana. I kēia lā, makemake mākou e kamaʻilio e pili ana i kēia mau mea—i ʻike ʻia ma ke ʻano lapaʻau he 'teratogens'.
He aha nā Teratogens?
I ka ʻōlelo maʻalahi, ʻo nā teratogens he mau mea, inā e ʻai ʻia a omo ʻia paha e ʻoe i ka wā hāpai, hiki ke hoʻoulu i nā maʻi hānau (nā kīnā hānau) i kāu embryo a i ʻole fetus e ulu ana. Hiki i kēia ke komo pū me nā lāʻau lapaʻau, nā kemika , kekahi mau maʻi, a i ʻole nā mea ʻawahia . ʻO ka hōʻike ʻana i nā teratogens hiki ke hoʻonui nui i ka pilikia o ka hāʻule ʻana o ka pēpē , ka hānau mua ʻana, a i ʻole ka hānau make.
He aha ka mea e hoʻoholo ai i ke koʻikoʻi o kahi teratogen?
ʻO ka pae o ka pilikia i kau ʻia e kahi teratogen e pili ana i kekahi mau kumu koʻikoʻi:
- ʻO ke ʻano o ka mea, ka lāʻau lapaʻau, a i ʻole ka mea ʻawahia. ʻAʻole like ka hopena o kēlā me kēia mea i ka hāpai ʻana.
- Ka lōʻihi o ka hōʻike ʻana. He hālāwai pōkole wale nō paha, a ua mau anei ka hōʻike ʻana no nā lā a i ʻole nā mahina?
- Ka pae o ka hōʻike ʻia (ka nui). Ua liʻiliʻi a nui paha ka nui?
- Ka makahiki hāpai i ka manawa o ka hōʻike ʻana. He mea nui kēia no ka mea e ulu ana nā ʻōkana like ʻole i nā pae kikoʻī o ka ulu ʻana o kāu pēpē.
- Nā kumu hoʻoilina. ʻO kou ʻano hoʻoilina kū hoʻokahi e hoʻolilo i kāu pēpē i mea maʻalahi a emi iki paha i kekahi mau pilikia.
No laila, ʻo ka pale ʻana i nā teratogens i kou wā hāpai holoʻokoʻa ke ala maikaʻi loa e holomua ai. Eia nō naʻe, e ʻoluʻolu e hoʻomaopopo he mea weliweli loa ka hoʻolaha ʻana i ka wā o nā puka makani koʻikoʻi o ka ulu ʻana o ka fetal.
Pehea ka maʻamau o nā kīnā hānau i hoʻokumu ʻia e nā teratogens?
Ua hōʻike ʻia nā haʻawina e pili pono ana ma kahi o 4% a 5% o nā maʻi hānau āpau i ka hōʻike teratogenic. Eia kekahi, ua hōʻike ʻia kēlā mau hōʻike e hoʻopilikia i ka ulu ʻana o ka noʻonoʻo a me ke kino o ke keiki. He mea kēia e pono ai kou nānā piha a me kou akahele.
He aha kekahi mau hiʻohiʻona maʻamau o nā teratogens?
ʻO nā Teratogens he mau mea i ʻike ʻia e hōʻeha, inā paha ma ke alakaʻi ʻana i nā kīnā hānau, ka nalowale o ka hāpai ʻana, a i ʻole nā pilikia hāpai ʻē aʻe. E ʻimi kākou i nā māhele koʻikoʻi loa.
ʻOna, Paka, a me nā Lāʻau Hoʻonanea
ʻO kēia paha nā ʻano teratogens i kaulana loa.
- ʻOna: Hoʻopilikia nui ka ʻona i ka ʻōnaehana nerve waena o kāu pēpē. ʻO ka inu ʻana i ka ʻona i ka wā hāpai e hoʻonui i ka pilikia o ka Fetal Alcohol Syndrome, hiki ke alakaʻi i nā hiʻohiʻona helehelena ʻē, ka liʻiliʻi o ke poʻo, a me nā pilikia mau loa o ke ʻano a me ke kino.
ʻAʻohe nui palekana i ʻike ʻia o ka inu ʻona i ka wā hāpai.
- Uila Paka: ʻO ka puhi paka kekahi mea nui i ka hoʻopaʻa ʻia ʻana o ka ulu ʻana o ka ʻōpū, ka hānau mua ʻana, a me ka hāʻule ʻana o ka naʻau. Hiki iā ia ke hōʻeha hou i nā ʻiʻo māmā palupalu o kāu pēpē a me ka lolo e ulu ana.
- Nā lāʻau lapaʻau leʻaleʻa:ʻO nā lāʻau lapaʻau e like me ka cocaine, methamphetamines, heroin, a me ka marijuana hiki ke alakaʻi i ke kaumaha hānau haʻahaʻa, nā kīnā puʻuwai, a me ka Neonatal Abstinence Syndrome—kahi kūlana kahi e ʻeha ai ka pēpē i nā hōʻailona withdrawal ma hope koke iho o ka hānau ʻana. Eia kekahi, ʻo ka hoʻohana ʻana i nā nila i kaʻana like ʻia e lawe mai i kahi pilikia kiʻekiʻe o nā maʻi i lawe ʻia e ke koko.
Nā lāʻau lapaʻau
Hiki i nā lāʻau lapaʻau i kūʻai ʻia ma ke kūʻai aku a me nā lāʻau lapaʻau i kuhikuhi ʻia ke hana ma ke ʻano he teratogens. He mea nui e kūkākūkā ʻoe me kāu mea mālama ola ma mua o ka lawe ʻana i kekahi lāʻau lapaʻau a mea hoʻohui paha. E heluhelu pono i nā lepili. Inā kānalua ʻoe e pili ana i ka palekana o kahi huahana, e kelepona koke i kāu kauka; ʻoi aku ka palekana o ka pale ʻana i ka hoʻohana ʻana a hiki i ka loaʻa ʻana o ka ʻae loea.
ʻO nā hiʻohiʻona o nā lāʻau lapaʻau teratogenic hiki ke komo pū me:
- Nā lāʻau antiepileptic (AED)
- Nā lāʻau antimicrobial
- Nā Anticoagulants (nā mea hoʻokahe koko)
- Nā lāʻau lapaʻau antithyroid
- ʻO ka Vitamin A nui loa (loaʻa i loko o kekahi mau kirīmi ʻili)
- Nā lāʻau lapaʻau hormonal
Eia kekahi laʻana, inā ʻoe e mālama i kahi maʻi e like me ka maʻi epilepsy, pono paha ʻoe i ka lāʻau lapaʻau e like me ka phenytoin. E kaupaona pono kāu kauka i nā pilikia a me nā pono e hōʻoia i ka palekana o ʻoe a me kāu pēpē i ka wā e mālama ana i kāu mau pono olakino.
Pehea e hoʻokaʻawale ʻia ai nā pilikia o ka lāʻau lapaʻau i ka wā hāpai?
Ua hoʻohana mua ka US FDA i kahi ʻōnaehana i hoʻokumu ʻia i ka leka (A, B, C, D, X) e hoʻokaʻawale i nā pilikia. I ka makahiki 2015, ua pani ʻia kēia e ka Pregnancy and Lactation Labeling Rule (PLLR). Hāʻawi kēia lula i ka ʻike kikoʻī hou aku a waiwai i ka pōʻaiapili e kōkua i nā mea lawelawe olakino e hana i nā hoʻoholo naʻauao no nā poʻe hāpai a me nā poʻe hānai waiū.
ʻO ka hana nui loa, ʻo ia ke hilinaʻi i kāu mea mālama ola e loiloi i ka palekana o kekahi lāʻau lapaʻau e pili ana i kāu ʻike lapaʻau kūikawā.
Nā maʻi a me nā virus
ʻO nā maʻi, nā virus, nā parasites, a me nā maʻi bacteria he mau hoʻoweliweli koʻikoʻi iā ʻoe a me kāu pēpē. Kōkua ka huaʻōlelo pōkole 'TORCH' i nā kauka e hoʻokaʻawale i nā maʻi maʻamau kiʻekiʻe:
- T - Toxoplasmosis (hoʻolaha pinepine ʻia ma o ka hoʻopili ʻana me nā ʻōpala pōpoki)
- O - Nā maʻi ʻē aʻe (e laʻa, Group B Streptococcus, Listeria, Candida, a me nā STI)
- R – Rubella
- C – Cytomegalovirus (CMV)
- H – Ka maʻi Herpes Simplex
- Hoʻokomo pū ʻia ʻo Syphilis i loko o kēia māhele pilikia.
ʻO nā maʻi ʻē aʻe a me nā virus e hiki ke hoʻopilikia i nā pilikia:
- ʻO ka maʻi puʻupuʻu a me ka shingles
- ʻO ka maʻi Hepatitis B, Hepatitis C, a me nā maʻi hepatitis viral ʻē aʻe
- HIV
- Maʻi ʻelima
Nā mea ʻawahia o ke kaiapuni, nā kemika, a me nā kumu kino
Hiki i kekahi mau kemika a me nā mea ʻawahia o ke kaiapuni ke hana i nā kīnā hānau kino, me nā pilikia e like me Spina Bifida, Cleft Palate, a i ʻole nā pilikia neurological. ʻO nā hiʻohiʻona o ia mau hōʻike ʻino e like me:
- ʻO ka ʻike ʻia ʻana i ka radiation (e laʻa me nā kukuna X) a i ʻole nā lāʻau lapaʻau maʻi kanesa (Chemotherapy)
- ʻO nā ʻauʻau wela, nā sauna, a i ʻole nā kumu wela ʻē aʻe e hoʻokiʻekiʻe i ka mahana o kou kino
- Mercury (loaʻa i loko o kekahi mau ʻano iʻa)
- Ke kēpau (loaʻa pinepine i ka pena a me nā paipu o nā hale kahiko)
- Nā kemika weliweli a i ʻole nā metala kaumaha i loaʻa ma nā wahi hana a i ʻole nā wahi hana
Nā Kūlana Lapaʻau Mau Loa
Hiki i kekahi mau maʻi mau loa āu e loaʻa ai ke hoʻonui i ka pilikia o nā kīnā hānau no kāu pēpē. ʻO nā laʻana e komo pū me ka Diabetes Mellitus, nā maʻi thyroid, a me nā maʻi autoimmune e like me Lupus a i ʻole Rheumatoid Arthritis. I kēia mau hihia, ʻo ka hoʻonui ʻia o ka pilikia o ka hōʻike ʻana i nā teratogens pinepine mai nā lāʻau lapaʻau i hoʻohana ʻia e mālama i kēia mau kūlana a i ʻole mai nā kūlana i mālama pono ʻole ʻia.
He mea nui e kūkākūkā i kekahi mau kūlana olakino mua āu i loaʻa ai a me nā lāʻau lapaʻau āu e lawe nei me kāu kauka. Pono paha ʻoe e hoʻololi i ka hoʻolālā hoʻokele no kou kūlana maʻi mau i kou wā hāpai.
I ka manawa hea ka mea weliweli loa i ka wā hāpai i ka hoʻopili ʻana i nā teratogens?
He mea ʻino ka ʻike ʻana i nā teratogens i kēlā me kēia pae o ka hāpai ʻana. Eia nō naʻe, ʻoi aku ka kiʻekiʻe o ka pilikia i nā pule ʻewalu mua o ka hāpai ʻana. ʻO kēia no ka mea, i loko o kēia manawa, ke ulu ikaika nei nā ʻāpana a me nā ʻōnaehana o kāu pēpē, e hoʻolilo ana i ka fetus i mea maʻalahi loa i nā hopena ʻino o nā teratogens. Hōʻike ka noiʻi hiki i nā teratogens ke hoʻopilikia i kahi pēpē i ʻelua pule ma hope o ka hāpai ʻana.
Eia kekahi laʻana, loaʻa nā Neural Tube Defects (NTDs) ma mua o ka pule ʻelima o ka hāpai ʻana. ʻO ka neural tube ke kumu no ka lolo a me ka iwi kuamoʻo. Loaʻa nā NTDs inā ʻaʻole pani pono ka neural tube, hiki ke alakaʻi i nā ʻano kīnā hānau like ʻole.
He aha nā ʻano kīnā hānau i hoʻokumu ʻia e nā teratogens?
Ua ʻike ʻia nā Teratogens e hoʻoulu i nā kīnā hānau he nui. ʻO kekahi o nā pilikia i ʻike pinepine ʻia:
- Nā pilikia o ka lolo a i ʻole ke kaula kuamoʻo, e like me Anencephaly (kahi i nalowale ai nā ʻāpana o ka lolo a i ʻole ke poʻo)
- Nā ʻano kino a i ʻole ke ʻano o ke kino, e like me nā lālā i nalowale a i ʻole nā ʻāpana kino i hoʻoponopono ʻole ʻia
- Lehelehe māwae a me ka lehelehe
- Ka pilikia o ka noʻonoʻo a i ʻole nā pilikia o ka ʻōnaehana nerve
- Nā pilikia cardiovascular a i ʻole nā hemahema o ka puʻuwai
Pehea e pale aku ai i nā teratogens i ka wā hāpai?
ʻO ke ala maikaʻi loa e pale aku ai i nā teratogens, ʻo ia ka hoʻolālā ʻana i kou hāpai ʻana ma mua inā hiki. ʻO ka hoʻolālā ʻana e hiki ai iā ʻoe ke loaʻa ka mana ma luna o nā maʻi maʻi a hana i nā hoʻololi ola e pono ai, e like me ka haʻalele ʻana i ka puhipaka.
Eia naʻe, ʻaʻole hiki ke hana mau ʻia kēia. Ke hāpai ʻoe, aia kekahi mau hana hiki iā ʻoe ke hana e hōʻemi i ka pilikia o ka hōʻike ʻana i ka teratogen:
- E kūkākūkā i kekahi lāʻau lapaʻau āu e lawe nei me kāu kauka.
- E pale loa i nā sikaleka, ka waiʻona, a me nā lāʻau lapaʻau leʻaleʻa.
- Mai lawe i nā mea hoʻohui, nā lāʻau lapaʻau ma luna o ke kūʻai aku, a i ʻole nā lāʻau lapaʻau me ka ʻole o ka nīnau mua ʻana i kāu kauka.
- E pale i ka hoʻomaʻemaʻe ʻana i nā pahu ʻōpala e pale aku ai i ka ʻike ʻia ʻana e kekahi mau parasites.
- E pale i nā ʻauʻau wela, nā sauna, a me nā mea āpau e hoʻokiʻekiʻe ai i ka mahana o kou kino.
- E pale i ka ʻai ʻana i nā iʻa kiʻekiʻe i ka mercury, e like me ka tuna a me ka iʻa pahi kaua.
- E kamaʻilio me kou luna a i ʻole ka 'Oihana Kumuwaiwai Kanaka e pili ana i nā kemika weliweli i loaʻa ma kāu wahi hana.
He mea nui e kamaʻilio pololei a ākea me kāu kauka hānau keiki i kou wā hāpai. ʻO kēia ka ʻoiaʻiʻo e pili ana i ka hoʻohana ʻana i ka waiʻona a i ʻole ka lāʻau lapaʻau. Aia lākou ma laila e kōkua i ka hōʻoia ʻana i ka palekana a me ke olakino o kou hāpai ʻana. Mai kānalua e nīnau i kāu kauka ma mua o ka hoʻomaka ʻana i kekahi lāʻau lapaʻau a mea hoʻohui paha. ʻO ke akahele loa i ka wā hāpai ka ala maikaʻi loa.
Nā manaʻo hope loa e hoʻomanaʻo ai
ʻO ka pale ʻana i kāu pēpē mai nā teratogens i ka wā hāpai e kōkua i ka pale ʻana i nā kīnā hānau. ʻO ka hana mua, ʻo ia ka noho ʻike e pili ana i ke ʻano o ka hiki ʻana o kekahi mau mea ʻino i kāu pēpē a me ka hopena maikaʻi ʻole i ko lākou ulu ʻana. ʻO ka pale ʻana i nā teratogens e kōkua i ka hōʻoia ʻana i ka hāpai olakino a hāʻawi i kāu pēpē i ka hoʻomaka maikaʻi loa i ke ola.
E kamaʻilio ākea me kāu kauka e pili ana i nā lāʻau lapaʻau āu e lawe ai, kekahi inu ʻona, a me kou wahi hana a noho paha. Hiki iā lākou ke pane i kāu mau nīnau e pili ana i nā mea e hiki ai ke hoʻoulu i nā kīnā hānau a pehea e pale pono ai iā ʻoe iho a me kāu pēpē.
