Omuguwa gw’omu nnabaana gw’omwana wo gwesibye ku mabbali g’enseke? (Marginal Cord Insertion) Ka twogere ku nsonga eno!

Ba maama bangi buli kiseera beeraliikirivu olw’obulamu bw’omwana waabwe ng’ali lubuto, oba akula bulungi, nedda? Kale, oluusi omusawo wo bw'akola ultrasound scan n'agamba ekintu nga, "Waliwo enjawulo entono mu nnabaana y'omwana, si wakati mu nnabaana, wabula yeesibye ku mabbali," kya bulijjo okuwulira omulundi gumu ng'otya katono n'okweraliikirira. Ekyo kye tuyita embeera nga eno ``Marginal Cord Insertion''. Kale, ka twogere ku nsonga eno mu bulambulukufu leero, mu ngeri gy’osobola okutegeera? Waliwo eky'okutya, era ka tuzuule ddala ekigenda mu maaso mu kino.

Omanyi Marginal Cord Insertion kye ki?

Mu ngeri ennyangu, `(Marginal Cord Insertion)` nkyukakyuka ntono mu ngeri omuguwa gw'omwana `(Umbilical Cord)` gye guyungibwa ku `(Placenta)` ng'ali lubuto. Omanyi, `(Umbilical Cord)` eringa omuguwa gw'obulamu ogugatta maama n'omwana. Omwana afuna ebiriisa byonna ne omukka gwa oxygen bye yeetaaga okuva ku maama ng’ayita mu musuwa guno ogw’omu nnabaana. Omuguwa guno ogw’omu nnabaana guyungibwa ku kitundu eky’enjawulo ekiyitibwa `(Placenta)`, ekikula ng’oli lubuto lwokka.

Mu budde obwabulijjo, omuguwa gw’omu nnabaana gulina okusibirwa wakati mu nnabaana, oba okumpi ennyo nalyo. Kino kiri bwe kityo kubanga ebiriisa bisobola okukulukuta obulungi okuva ku maama okutuuka mu nnabaana n’okuva awo okutuuka ku mwana awatali kulemesa kwonna. Eyo y’engeri esinga okuba ey’obukuumi.

Naye mu mbeera ya `(Marginal Cord Insertion)`, omuguwa guno ogw’omu nnabaana tegukwatagana na makkati ga nnabaana, wabula gukwatagana ku mabbali oba ku mabbali g’enseke (nga milimita 20 okuva wano). Okubeera omutuufu, okuyungibwa kuno kuli sentimita bbiri oba wansi okuva ku mabbali g’ekikuta. Okuyungibwa okw’ekika kino bwe kukolebwa ku mabbali, oluusi (si bulijjo) olugendo lw’emmere okuva mu nnabaana okutuuka ku mwana luyinza okubeera mpola katono. Ekyo bwe kibaawo, okukula kw’omwana kuyinza okukendeera katono. Kino tukiyita `(IUGR - Okuziyiza okukula mu nnabaana)`. Ate era oluusi omutima gw’omwana guyinza okukendeera ng’azaala.

Wabula ekisinga obukulu wano kwe kuba nti embuto ezisinga ezirina `(Marginal Cord Insertion)` ziggwa mu kuzaala nga mulamu bulungi nga tewali buzibu bwonna. Kale, kirungi obutasattira mangu ddala, nedda?

Embeera eno ya bulijjo etya?

Embeera eno eyitibwa ``Marginal Cord Insertion'', esinga kubeera mu mbuto ezizaala abaana abawera, gamba ng'abalongo oba abaana abasatu, okusinga mu mbuto ez'omuntu omu. Bubaawo mu mbuto eziri wakati wa 2% ne 25%. Omuwendo guno guba wansi mu lubuto olumu ate nga gusinga mu lubuto oluwera.

Bubonero ki obuyinza okukuyamba okumanya oba olina Marginal Cord Insertion?

Wano waliwo ensonga enkulu. Ebiseera ebisinga, maama alina ``Marginal Cord Insertion'' tafuna bubonero bwonna obwenjawulo.Oyinza obutalaba njawulo yonna. Omusawo wo ajja kutera okulaba okuyungibwa kuno okutali kwa bulijjo mu nnabaana mu kiseera ky’okukebera eddoboozi erya bulijjo ng’oli lubuto.

Lwaki kino (Marginal Cord Insertion) kibaawo? Biki ebivaako?

Abanoonyereza n’okutuusa kati tebamanyi bulungi kivaako Marginal Cord Insertion. Kyokka, waliwo ensonga ezilowoozebwa nti zongera obulabe bw’okuyingiza omuguwa ogw’ekika kino. Nga bwe twagambye emabegako, kisinga kubeera mu mbuto ezirina abalongo abawera (nga abalongo). Okugatta ku ekyo, waliwo ensonga endala eziwerako eziyinza okuvaako:

• Okukozesa ebiragalalagala oba omwenge ng’oli lubuto.
• Okubeera n’embeera y’obujjanjabi etali ya bulijjo nga ssukaali.
• Emyaka gya maama giri emyaka 35 n’okudda waggulu ( advanced maternal age ).
• Guno kwe kuzaalibwa kwo okusooka (`Nulliparity`).
• Okuba nga okozesezza IUD (Intrauterine Device) nga tannafuna lubuto.
• Okufuna embuto nga tuyita mu tekinologiya ow’ekikugu ow’okuzaala (ART - Artificial Reproductive Technology) (e.g. abalongo abagezesebwa mu ttanka).

Naye jjukira nti olw’okuba olina emu oba eziwera ku nsonga zino tekitegeeza nti ojja kuba n’okuyingiza omuguwa ogw’oku mabbali (Marginal Cord Insertion). Okugeza abantu bangi abafuna embuto nga bayita mu ART basobola okuteekebwamu omuguwa gw’omu nnabaana ogwa bulijjo. Ekikulu nti ne bwe wabaawo obutali bwa bulijjo mu kuyingiza omusuwa gw’omu nnabaana, abantu abasinga bagenda mu maaso n’okufuna olubuto olulamu.

Ddi Marginal Cord Insertion etera okuzuulibwa?

Ebika bino eby’obutabeera bulungi mu nnabaana bitera okuzuulibwa mu kiseera ky’okukebera amaloboozi aga ultrasound mu kiseera ky’olubuto olw’okubiri (wiiki 14 okutuuka ku 27) . Kyokka oluusi, kiyinza okuba ekizibu omusawo okulaga ekifo ekituufu omuguwa gw’omu nnabaana we gusibye ku nnabaana.

Mu mbeera ng’ezo, omusawo ayinza okukozesa enkola ey’enjawulo eyitibwa Doppler ng’akebera eddoboozi ery’omwanguka. Kino kikusobozesa okulaba obulungi omusaayi ogutambula wakati w’enkwaso n’omwana ekitegeeza engeri omwana gy’aliisibwamu. Okukebera kuno okwa Doppler kuyamba okuzuula ekifo ekituufu omuguwa gw’omu nnabaana we gukwatagana.

Bujjanjabi ki obukolebwa ku kino?

Mu kiseera kino tewali bujjanjabi bwa njawulo buyinza "kutereeza" mbeera eyitibwa ``Marginal Cord Insertion''. Kino kitegeeza nti omusuwa gw’omu nnabaana tegusobola kukyusibwa. Wabula omusawo ajja kukulondoola nnyo n’omwana wo mu lubuto lwo lwonna. Kino kikoleddwa okutangira ebizibu byonna ebiyinza okuvaamu. Era bajja kukebera okulaba oba omwana akula bulungi era oba waliwo ebintu ebirala ebiyinza okuleeta akabi. Mu mbeera ezimu, kiyinza okulagirwa okulongoosebwa (C-section) singa wabaawo akabi konna.

Singa olondoola ennyo bwe kuti, akabi kayinza okukendeezebwa ennyo. Kale mwesige abasawo bo era okole nga bwebagamba.

Waliwo engeri y’okuziyiza okuyingiza omuguwa ku mabbali?

Nedda.Toyinza kulemesa Marginal Cord Insertion kubaawo. Si kintu ky’osobola okufuga. Naye osobola okukolagana obulungi n’omusawo wo, okulondoola obulungi olubuto lwo, n’okukola kyonna ekisoboka okuyamba okulaba ng’omwana mulamu bulungi n’okuzaala obulungi.

Embeera (Marginal Cord Insertion) ewona ku bwayo?

Kiyinza okubaawo. Emirundi egisinga, `(Marginal Cord Insertion)` tekirina bulabe bwa maanyi eri olubuto, era tekiremesa mwana kufuna mmere gye yeetaaga. Mu mbeera eyo, teweetaaga kweraliikirira nnyo engeri omuguwa gw’omu nnabaana gye gukwataganamu. Wabula weesige nti omusawo ajja kulondoola n’obwegendereza enkula y’omwana, era essira lisse ku kukuuma obulamu bwo ng’oli lubuto.

Okuyingiza omuguwa ku mabbali mbeera ya bulabe?

Singa wabaawo obutali bwa bulijjo mu ngeri omuguwa gw’omu nnabaana gye gukwataganamu, kiyinza okuleeta obulabe obumu ng’oli lubuto. Wabula tolowooza nti ekisinga obubi ng’ozuuliddwa nti olina `(Marginal Cord Insertion)`. Kubanga mu mbeera ezisinga ezizuuliddwa nga zirina `(Marginal Cord Insertion)`, embuto ennungi n'abaana abalamu bazaalibwa.

Omusawo wo asobola okukubaganya ebirowoozo ku kintu kyonna ekikweraliikiriza n’ebyafaayo byo eby’obujjanjabi n’ebyava mu kukebera amaloboozi. Ekimu ku bisinga okweraliikiriza omwana wo ayinza okuba ng’akula mpola nnyo, embeera eyitibwa Intrauterine Growth Restriction (IUGR). Singa omwana aba tafuna mmere emala okuva mu nnabaana, ayinza okuba mu bulabe bwa IUGR. Bino wammanga bisobola okutuuka ku mwana wo eyaakazaalibwa:

• Obuzito obutono ng’azaalibwa: Omwana azaalibwa ng’azitowa wansi wa pawundi 5 ne ounces 8 (kkiro nga 2.5), ebiseera ebisinga.
• Obukodyo bwa Apgar obutono: Okukebera Apgar nkola ya kwekenneenya obulamu bw’omwana amangu ddala ng’amaze okuzaalibwa. Obubonero bwa Apgar obutono buyinza okulaga nti omwana ayinza okuba n’obuzibu ku mutima oba amawuggwe ge. Abalongo ng’abo bayinza okwetaaga okulabirira okw’enjawulo.
• Okwongera ku mikisa gy’okubeera mu kifo ekirabirira abaana abato (NICU): Omwana ayinza okukuumibwa mu NICU okwongera okulabirira okutuusa ng’omwana awonye era n’asobola okutwalibwa mu waadi eya bulijjo.

Singa omusawo alowooza nti waliwo akabi eri ggwe oba omwana wo, ayinza okukuwa amagezi okulongoosebwa (C-section).

(Okuyingiza Omuguwa ku Marginal) kuyinza okufuuka (Okuyingiza Omuguwa mu Velamentous)?

Embeera eyitibwa ``Marginal Cord Insertion'' naddala mu kiseera ky'olubuto olw'okusatu (wiiki 29 okutuuka ku 40) esobola okufuuka embeera eyitibwa ``Velamentous Cord Insertion''. Kyokka kino tekitera kubaawo nnyo.Velamentous Cord Insertion kwe kuba nti omuguwa gw’omu nnabaana tegukwata butereevu ku nnabaana, wabula ku membranes eziri ebweru w’enkwaso. Embeera eno esingako katono okusinga Marginal Cord Insertion (ebeerawo mu bitundu nga 1% eby’embuto) era yeetaaga okufaayo okutono.

Omusawo wo ajja kwetegereza engeri omuguwa gw’omu nnabaana gye gukwataganamu era akuyamba okutuuka ku birungi ebisinga obulungi mu mbeera zino zombi, ``Marginal Cord Insertion`` ne ``Velamentous Cord Insertion``.

Kale, nsaana okweraliikirira ku Marginal Cord Insertion?

Nedda, teweetaaga kweraliikirira. Abantu abasinga obungi abalina Marginal Cord Insertion balina abalongo abalamu. Omwana bw’aba afuna emmere entuufu gy’alina okukula, okubeera n’enkola ya Marginal Cord Insertion kiyinza obutakosa lubuto lwo.

Yogerako n’omusawo wo ku kintu kyonna ekikweraliikiriza. Waliwo ebintu bingi ebiyinza okwongera ku bulabe bw’okufuna ebizibu ng’oli lubuto lwonna. Obutabeera bwa bulijjo mu nnabaana buyinza okuba obw’akabi oba obutaba bwa bulabe. Omusawo asobola okukulambika mu lubuto lwo n’okukukebera mu bwesimbu.

Bibuuzo ki ebikulu by’olina okubuuza omusawo wo?

Kya bulijjo okuba n’ebibuuzo bingi mu birowoozo mu kiseera nga kino. Bino bye bimu ku bibuuzo by’oyinza okubuuza omusawo wo:

• Emirundi emeka gye nja okwetaaga okukeberebwa ultrasound okulondoola olubuto lwange?
• Nze nneetaaga okukeberebwa ebirala?
• Kiyinzika kitya nti Marginal Cord Insertion ejja kukosa olubuto lwange?
• Kinaaba kyetaagisa okukeberebwa ebirala okukebera enkula y’omwana?
• Nsaanidde ntya okutereeza endya yange, dduyiro, n’okwegatta nsobole okufuna olubuto olulungi ennyo?
• Otulo ntya olunaku? Nnina kuwummula kimeka olunaku?

N’ekisembayo, ebintu by’olina okujjukira (Obubaka bw’okutwala awaka) .

Kya bulijjo okuwulira ng’otya katono ng’owulira nti olina `(Marginal Cord Insertion)`. Wabula toleka kuzuula kuno kwongerako situleesi eteyetaagisa ku lubuto lwo. `(Marginal Cord Insertion)` kiyinza okwetaagisa okulondoola oba okulabirira okw'enjawulo. Era kisoboka okuba nti embeera eno tejja kukosa lubuto lwo n’akatono.

Ekisinga obukulu nti omusawo akimanyi nti olina embeera eno. Amawulire gano gajja kubayamba okukuuma ggwe n’omwana wo nga mulamu bulungi nga bwe kisoboka. Jjukira nti bamaama bangi abalina obulwadde buno bagenda mu maaso n’okuzaala abaana abalamu obulungi. Kale lowooza bulungi, goberera amagezi g’omusawo wo, era buli kimu kijja kuba kirungi!

` Omuguwa gw’omu nnabaana, nnabaana, olubuto, enkula y’omwana, ultrasound, Marginal Cord Insertion, IUGR