Ma ke ʻano he makuahine e hiki mai ana, ua hana anei kāu kauka i kahi scan a haʻi iā ʻoe, "Ua ʻoi aku ka nui o ke pēpē ma mua o kona nui no ka helu o nā pule āna i hānau ai"? He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe i kahi mea e like me ia. ʻO nā mea e like me, "Auē, aia kekahi mea hewa me kaʻu pēpē? E paʻakikī anei iaʻu ke loaʻa iaʻu ke pēpē?" e hiki mai paha i kou manaʻo. Akā, mai hopohopo. ʻO ka hapa nui o ka manawa, ʻaʻohe mea e hopohopo ai. I kēia lā, e kamaʻilio kākou e pili ana i kēia kūlana i kapa ʻia ʻo 'Large for Gestational Age', a i ʻole LGA no ka pōkole, ma nā huaʻōlelo maʻalahi.
He aha ka 'ʻoi aku ka nui ma mua o ka makahiki hāpai' (LGA)?
I ka ʻōlelo maʻalahi, ʻo LGA ke ʻano o ke kaumaha a i ʻole ka nui o kāu pēpē ua nui loa ia no ka lōʻihi o kou hāpai ʻana, ʻo ia hoʻi, ka helu o nā pule o ke pēpē i loko o ka ʻōpū.
Helu nā kauka i ka makahiki hāpai mai ka lā mua o kou wā hope loa. No laila, ʻokoʻa paha ka lā i ʻōlelo ai kāu kauka ua hāpai ʻoe mai ka lā āu i manaʻo ai ua hāpai ʻoe. Inā ʻaʻole kūlike kou pōʻaiapuni menstrual, hiki i kāu kauka ke hoʻohana i kahi scan ultrasound e hoʻoholo pololei i ka makahiki o ke pēpē. ʻO ka maʻamau, pololei loa nā scan ma waena o 8 a me 18 mau pule.
No laila, inā hana ke kauka i kēia mau helu a lawe i 100 mau pēpē olakino i ka makahiki hāpai like, a aia kāu pēpē i waena o nā 10 kaumaha loa, ua hoʻokaʻawale ʻia kēlā pēpē he LGA.
He aha nā kumu e ulu nui ai kahi pēpē?
Aia kekahi mau kumu e hiki ai i ka nui o kahi pēpē ke hoʻonui penei. ʻAʻole kekahi mau kumu he mea e hopohopo nui ai, akā pono mākou e hopohopo i kekahi.
| Kumu | He wehewehe maʻalahi |
|---|---|
| Ka helu hewa ʻana o ka makahiki hāpai | ʻO kēia ke kumu maʻalahi loa a me ka hopohopo ʻole. Inā ʻaʻole kūpono kou pōʻaiapuni menstrual, ʻaʻole hiki iā ʻoe ke hoʻomanaʻo i ka lā kikoʻī o kou wā hope loa, a i ʻole ʻoe e lawe nei i ka lāʻau lapaʻau hormone, aia paha he ʻokoʻa iki i ka helu ʻana o ka makahiki o ka pēpē. A laila e ʻoi aku ka nui o ka pēpē ma mua o ka helu maoli o nā pule. |
| Loaʻa i ka makuahine ka maʻi diabetes | ʻO kēia ke kumu nui i hānau ʻia ai nā pēpē LGA. ʻO ka maʻi diabetes gestational a i ʻole ka maʻi diabetes i loaʻa ma mua o ka hāpai ʻana e hoʻopilikia i kēia. Ke piʻi aʻe ke kiʻekiʻe o ke kō koko o ka makuahine, loaʻa pū i ka pēpē kēlā kō keu. I ka pane ʻana, hana ke kino o ka pēpē i ka insulin hou aʻe. ʻO kēia insulin keu e hoʻoulu ai i ka pēpē e ulu wikiwiki a hōʻiliʻili i ka momona o ke kino. |
| Ka nui o ke kino o nā mākua | He mea nui nō hoʻi nā mana hoʻoilina ma ʻaneʻi. ʻO nā mākua i lōʻihi, momona, a he kino nui ko lākou, ʻoi aku ka nui o ka loaʻa ʻana o nā pēpē nui. He mea maʻamau loa kēia. |
| Ka piʻi nui ʻana o ke kaumaha i ka wā hāpai | He mea nui e hoʻonui i ke kaumaha i ka wā hāpai. Eia nō naʻe, inā ʻoi aku kou kaumaha ma mua o ka mea e pono ai kou kino, hiki i ke kaumaha keu ke hoʻonui i ka nui o kāu pēpē. E kamaʻilio me kāu kauka e pili ana i ka nui o ke kaumaha e olakino ai. |
He aha nā pilikia e hiki ke kū mai ma muli o ka ulu ʻana o ke pēpē?
ʻAʻole nā pēpē LGA āpau e loaʻa nā pilikia. Akā i kekahi mau hihia, ʻoiai inā nui ka pēpē ma muli o kahi maʻi e like me ka maʻi diabetes, aia paha kekahi mau pilikia. Mai hopohopo, inā ʻike ʻoe i kēia mau mea ma mua, ʻoi aku ka maʻalahi o ka hoʻoponopono ʻana.
Nā pilikia i ka wā hānau
Ma muli o ka nui o ka pēpē, he mea paʻakikī paha iā ia ke puka maʻalahi i waho o ke kahawai hānau.
- Ka Hana Lōʻihi : Hiki i ka hana lōʻihi ke hōʻemi i ka nui o ka oxygen i loaʻa i ka pēpē. Hiki iā ia ke hoʻonui i ka pilikia o nā maʻi a me ke komo ʻana o ka ʻōpala mua o ka pēpē (meconium) i ke alaloa.
- Hānau paʻakikī: Pono paha ʻoe e hoʻohana i nā mea hana e like me nā forceps a i ʻole ka vacuum e hānau ai i ka pēpē. Pono paha ʻoe e hana i kahi ʻoki liʻiliʻi (episiotomy) kokoke i ka vagina.
- Nā ʻeha hānau: I nā hihia kakaikahi, hiki ke loaʻa kahi iwi ʻāʻī i haki a i ʻole nā aʻalolo lima i hōʻino ʻia ma muli o ka pēpē e pana ana i waho.
- No ka ʻoki ʻoki cesarean `(ʻO ka hoʻonui ʻia o ka pilikia o ka hānau ʻana ma ke ʻano cesarean : Pono paha kahi ʻoki cesarean ulia pōpilikia inā ʻaʻole hiki ke hānau maʻamau ʻia ka pēpē. Loaʻa kēia i nā pilikia e like me ke kahe koko nui a me ka manawa hoʻōla lōʻihi.
Nā pilikia e kū mai ana ma hope o ka hānau ʻana o ke keiki
He kiʻekiʻe loa kēia pilikia ke loaʻa ka maʻi diabetes i ka makuahine a hānau ʻia kahi pēpē LGA.
ʻO ke kō koko haʻahaʻa i loko o ka pēpē (Hypoglycemia): E hoʻomaopopo pono i kēia. I loko o ka ʻōpū, hana ke kino o ka pēpē i ka insulin hou aʻe e kū ai i ka nui o ke kō e puka mai ana mai ka makuahine. Akā ma hope o ka hānau ʻana, ʻoiai ua pau ke kō e puka mai ana mai ka makuahine, loaʻa nō i ke kino o ka pēpē ka insulin keu i hana ʻia. Ma muli o kēia, hiki i ka pae kō koko o ka pēpē ke hāʻule koke i lalo loa. Kāhea mākou i kēia he hypoglycemia . ʻO ia ke kumu e nānā ai nā kauka a me nā kahu maʻi i ke pae kō o kahi pēpē LGA i kona wā e hānau ai.
Eia kekahi, ʻo nā pēpē LGA i hānau ʻia e nā makuahine maʻi diabetes e loaʻa iki ka pilikia o ka pilikia hanu, ka momona, a me ka maʻi diabetes type II ma hope aku o ke ola.
He aha kāu e hana ai inā makaʻu ʻoe no kēia?
ʻO ka mea maikaʻi loa a koʻikoʻi loa hiki iā ʻoe ke hana, ʻo ia ke kamaʻilio ākea e pili ana i kēia me kāu kauka . E hoʻolohe i kāu mau makaʻu a me nā nīnau a pau.
Hiki iā ʻoe a me kāu kauka ke hana pū e hoʻolālā i kāu hānau ʻana a kūkākūkā i ka mea e hana ai inā he pilikia. Inā loaʻa iā ʻoe ka maʻi diabetes gestational, hiki iā ʻoe ke kōkua i ka hoʻomalu ʻana i ka ulu ʻana o kāu pēpē ma ka hahai ʻana i nā ʻōlelo aʻoaʻo a kāu kauka, ka ʻai, a me ka lāʻau lapaʻau.
E hoʻomanaʻo, mai manaʻo he haunaele nā mea āpau no ka mea he LGA ʻoe. Ma ka hoʻomaopopo mua ʻia a me ka hana ʻana i nā hana e pono ai, hiki iā ʻoe ke hānau i kahi pēpē olakino a nani hoʻi.
Leka Lawe-Home
- ʻO ke ʻano o ka 'Nui no ka Makahiki Hānau' (LGA) ʻo ia hoʻi, ʻoi aku ka nui o ka pēpē ma mua o ka helu o nā pule i loko o ka ʻōpū. ʻAʻole kēia he mea e hopohopo mau ai.
- ʻO ke kumu nui e hoʻopilikia nei i kēia, ʻo ia ka maʻi diabetes o ka makuahine (i ka wā hāpai a ma mua paha). Hiki i ka nui o ke kino o nā mākua a me ka piʻi ʻana o ke kaumaha o ka makuahine ke pāʻani i kahi kuleana.
- Hiki i ka LGA ke alakaʻi i nā pilikia i ka wā hānau a me kahi pilikia o ke kō koko haʻahaʻa (hypoglycemia) i loko o ka pēpē ma hope o ka hānau ʻana.
- ʻO ka mea maikaʻi loa āu e hiki ai ke hana, ʻo ia ke kamaʻilio ākea e pili ana i kēia me kāu kauka, e hahai i kāna ʻōlelo aʻo, a e mālama pono i nā maʻi e like me ka maʻi diabetes.
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