Amawuggwe g’omwana wo nago gakoseddwa okusesema okusooka? (Meconium Aspiration Syndrome) Ka twogere ku nsonga eno!

Ng’omuzadde, otya otya ng’olaba omwana eyaakazaalibwa ng’afuna obuzibu mu kussa? Oluusi ekivaako obuzibu buno mu kussa mu mwana gwe musulo gw’omwana ogusooka oguyitibwa meconium oguyingira mu mawuggwe g’omwana. Leero, tugenda kwogera ku mbeera eno eyitibwa `(Meconium Aspiration Syndrome)`.

Meconium kye ki? Kiki ekibaawo singa kiyingira mu mawuggwe g’omwana?

Mu ngeri ennyangu, meconium ye musulo oba omusulo gw’omwana wo ogusooka. Si nga omusulo ogwa bulijjo. Kiba kizito, kikwata, ekiddugavu ekiddugavu-ekiddugavu, ekiringa ttaala. Kikolebwa ebintu omwana wo by’amira ng’ali mu lubuto. Ekyo kitegeeza nti kikolebwa obutoffaali bw’olususu lw’omwana, omusulo (nga omusulo), enviiri ennungi ez’omwana (lanugo), entuuyo n’ebirala.

Abalongo batera okuyita meconium mu ssaawa 48 nga bamaze okuzaalibwa. Wabula oluusi naddala singa omwana aba afuna puleesa oba obutabeera bulungi mu lubuto (`(Fetal Distress)`), omwana asobola okuyita ebimu ku meconium eno nga tannazaalibwa, kwe kugamba, ng’akyali mu lubuto. Singa kiyitawo, meconium eyo ejja kwongerwa mu mazzi g’omu lubuto ageetoolodde omwana.

Obulwadde bwa Meconium Aspiration Syndrome (MAS) mbeera omwana gy’afuna obuzibu mu kussa olw’ekirungo kya meconium ekitabuddwa n’amazzi g’omu lubuto agayingira mu mawuggwe g’omwana. Amazzi gano agatabuddwamu meconium gasobola okuyingira mu mawuggwe g’omwana ng’omwana assa, nga tannazaalibwa oba nga tannazaalibwa.

Teebereza ekibaawo nga meconium eyo enzito era ekwata eringa ttaala ayingidde mu musulo n’amawuggwe g’omwana.

• Kiyinza okuziba omukutu gw'omukka gw'omwana .
• Amawuggwe gayinza okwonooneka .
• Meconium era asobola okuziyiza enkola y'ekintu ekikulu ekiyitibwa ``Surfactant'', ekiyamba amawuggwe okufuuwa n'okukola obulungi.

Kino kizibuwalira nnyo omwana okussa. Oluusi, embeera eno eyinza n’okuteeka obulamu mu matigga . N’olwekyo, kikulu nnyo okukimanya ku kino.

Embeera eno ya bulijjo etya?

Ku kigero, abaana nga 12 ku 20 ku buli 100 abazaalibwa bajja kuba ne meconium etabuddwa mu mazzi g’omu lubuto. Kino tukiyita "amazzi g'omu lubuto agasiigiddwa meconium." Embeera eno esinga kubeera mu baana abazaalibwa mu kiseera ekijjuvu (wiiki 40) n’abazaalibwa oluvannyuma lw’okuzaalibwa (oluvannyuma lwa wiiki 42).

Naye wuuno ekintu ky’osobola okulowoozaako. Si balongo bonna abazaalibwa n'amazzi agasiigiddwa meconium nti bafuna ``MAS''. Ebitundu bitono ku buli kikumi byokka, wakati wa 2% ne 10% ku balongo ng'abo, be bafuna embeera eno eya ``MAS''.

Bubonero ki obulaga omwana ng’assa meconium?

Kati tukimanyi nti meconium eyinza okuba ey’akabi singa ayingidde mu mawuggwe. Kale, omwana wo bw’aba assa omukka gwa meconium, ayinza okulaga obubonero nga:

• Obuzibu mu kussa:Omwana alabika alina obuzibu mu kussa.
• Omutima gukendeera: Omutima gw’omwana gukendeera.
• Olususu lwa bbululu (Cyanosis): Olususu lw’omwana naddala emimwa n’engalo lufuuka bbululu. Kino kiva ku mubiri obutafuna mukka gwa oxygen gumala.
• Okussa amangu: Oluusi omwana assa mangu nnyo.
• Okussa n'eddoboozi ery'okusinda: Eddoboozi nga "Huh... Huh..." likolebwa nga ossa.
• Okubbira mu kifuba: Ekifuba kirabika kibbira mu nga ossa.
• Atalina bulamu: Omwana alabika nga talina bulamu nnyo era nga talina bulamu.

Bw’olaba obubonero nga buno, kikulu nnyo okutegeeza abakozi b’ebyobujjanjabi mu bwangu.

Lwaki kino kigenda mu maaso? Ensonga eri etya?

Ensonga enkulu lwaki meconium ayingira mu mawuggwe ye situleesi omwana gy'afuna mu lubuto oba ng'azaalibwa . Waliwo ensonga ez’enjawulo eziviirako situleesi eno. Okugeza nga:

• Okubeera n’obulwadde mu maama oba omwana.
• Okukendeera kw’omukka gwa oxygen eri omwana.

Mu mbeera ey’ekika kino ey’okunyigirizibwa, omwana assa omukka omungi mu bwangu. Nga bwetukwata omukka nga tutidde nnyo. Mu kaseera ako, amazzi amanene (ne meconium bwe gaba awo) gagenda mu mawuggwe g’omwana. Olwo meconium enzito n’esibira mu nsawo z’empewo (`(Alveoli)`) ez’amawuggwe, ekizibu okussa.

Omanya otya oba meconium ali mu mazzi?

Amazzi g’omu lubuto gatera kuba matangaavu. Kyokka, bwe bagiteekamu meconium, amazzi agafuluma ng’amazzi gakutuse gafuna langi ya kitaka eya kiragala . Ekirala, abalongo abakwatibwa eddagala lya meconium bayinza okuba n’olususu olwa kyenvu n’enjala nga bazaalibwa. Naye teweeraliikiriranga, abasawo bo ne ba nurse kino bakimanyi nnyo. Bali ku bunkenke okunoonya obubonero nga buno.

Kiba kizibu singa omwana amira meconium?

Kino nakyo kizibu bamaama bangi kye balina. Kya bulijjo omwana okumira amazzi g’omu lubuto ng’ali mu lubuto. Era kyetaagisa n’okukula kw’omwana. Kale, singa akatono aka meconium katabulwa mu mazzi g’omu lubuto n’akamira, tekijja kuba kizibu kinene. Eky’obulabe kwe kussa meconium mu mawuggwe so si kumira.

Abasawo kino bakizuula batya? Obujjanjabi bwe buruwa?

Singa amazzi go gakutuka n'olaba meconium mu mazzi go ag'omu lubuto, abasawo bajja kutunuulira omwana wo n'obwegendereza ennyo okulaba obubonero bwa ``MAS'' oluvannyuma lw'okuzaalibwa. Nga bwe kyayogeddwako emabegako, abalongo si bonna nti bafuna embeera eno olw’obulwadde bwa meconium.

Ebikulu ebizuuliddwa bye bino:

• Okulondoola embeera y’omwana: Okussa kw’omwana, langi y’omubiri n’emirimu gy’akola bilondoolebwa.
• Okuwuliriza ekifuba: Ekifuba ky’omwana awuliriza n’ekyuma ekiwuliriza okukebera oba tewali maloboozi gonna agatali ga bulijjo.
• X-ray y’ekifuba:Kino kiyinza okulaba obulungi oba meconium asibidde mu mawuggwe oba amazzi gakuŋŋaanyiziddwa.
• Okukebera omukka mu musaayi: Okukebera kuno kuyamba okuzuula omukka gwa oxygen ne carbon dioxide mu musaayi gw’omwana n’obuzibu bw’okussa.

Obujjanjabi buli butya?

Obujjanjabi businziira ku bungi bwa meconium omwana bw’alya, obugumu bw’ali n’obuzibu omwana bw’afuna okussa.

• Singa omwana akaaba bulungi ng’azaalibwa era ng’akola nnyo, emirundi mingi tekyetaagisa bujjanjabi obw’enjawulo.
• Okusonseka: Guno gwe mutendera ogusooka. Empiso entono eya bbaatule ekozesebwa okuggya meconium mu kamwa, mu nnyindo n’emimiro gy’omwana. Oluusi, n’akapiira akatono kayingizibwa mu payipu y’empewo (trachea) y’omwana okuggyawo meconium yonna ekwatiddwa awo.
• Okuwa omukka gwa oxygen: Omwana bw’aba akyafuna obuzibu mu kussa, muwe oxygen ng’oteeka masiki ya oxygen ku maaso.

Abalongo abamu abalina MAS ey’amaanyi bayinza okwetaaga okuweebwa ekitanda mu kitongole ekirabirira abaana abato (NICU) okulabirira mu ngeri ey’enjawulo. Mu bino mulimu:

• Okuyunga ku kyuma ekissa: Omwana bw’afuna obuzibu okussa ku lulwe, ekyuma kino kiyamba.
• Surfactant Therapy: Ekintu ekiyitibwa surfactant kiweebwa mu ngeri ey’ekikugu okuyamba amawuggwe okugguka.
• Eddagala eritta obuwuka: Singa wabaawo obulwadde mu mawuggwe, baweebwa okubujjanjaba.
• ECMO (Extracorporeal Membrane Oxygenation): Buno bujjanjabi bwa njawulo obukozesebwa mu mbeera ez’amaanyi ennyo. Omutima n’amawuggwe g’omwana biweebwa ekiwummulo, era ne bakozesa ekyuma okwongera omukka gwa oxygen mu musaayi.
• Radiant Warmer: Ayamba okufuga ebbugumu ly’omubiri gw’omwana.
• Ekyuma kya CPAP (Continuous Positive Airway Pressure): Kiyamba okukuuma amawuggwe g’omwana nga gaggule.

Jjukira nti obujjanjabi buno bwonna bukolebwa omwana wo okuwona amangu. Abasawo ne ba nurse bajja kukuwa obujjanjabi obusinga obulungi omwana wo bw’aba yeetaaga.

Okufuuwa meconium kuyinza okuziyizibwa? Biki ebiyinza okuvaako akabi?

Mu butuufu, tewali ngeri yonna gy’oyinza kuziyizaamu ddala meconium aspiration mu bbebi. Kubanga kintu ekibaawo ng’omwana alina situleesi. Wabula abasawo bulijjo bafaayo oba mu mazzi g'omu lubuto mulimu meconium era oba omwana ali mu ``Fetal Distress''. Singa embeera eno ezuulibwa nga bukyali, kisoboka okuziyiza okusikiriza okw’amaanyi okwa meconium n’otandika obujjanjabi mu bwangu.

Waliwo ebintu ebimu eby’obulabe ebiyinza okuvaako okulwala obulwadde bwa meconium aspiration syndrome:

• Okufuna olubuto oluvannyuma lw’ekiseera:Ekyo kitegeeza okwongezaayo olubuto okusukka wiiki 42.
• Maama alina obulwadde bwa sukaali oba puleesa.
• Okuzaala okumala ebbanga eddene oba okuzibu.
• Okukendeera kw’omukka gwa oxygen mu mwana ng’ali lubuto.
• Okuziyiza okukula kw’omwana mu lubuto (FGR).

Abasawo bafaayo nnyo ku balongo abazaalibwa bamaama abalina ensonga zino ez’obulabe.

Bizibu ki ebiyinza okuvaamu? Kitwala bbanga ki okuwona?

Ebizibu ebiwangaala ebya MAS tebitera kubaawo era ebiseera ebisinga bisobola okuddukanyizibwa n’okuwona mu nnaku ntono.

Wabula abalongo abalina ``MAS'' bayinza okuba mu bulabe obusingako katono obw'okufuna embeera zino okusinga abalongo abalala:

• Pneumonia ( obulwadde bw’amawuggwe) .
• Obulwadde bwa asima
• Puleesa y’omwana omuwere mu mawuggwe (PPHN) .
• Okugwa kw’amawuggwe `(Pneumothorax)`
• Obutabeera na oxygen `(Hypoxia)`

Naye jjukira nti si buli mwana amira meconium nti afuna `(MAS)`, era si buli mwana alina `(MAS)` nti afuna ebizibu bino. Singa emanyibwa era n’ejjanjabwa nga bukyali, eno embeera okusinga ewona.

Abalongo abasinga bawona oluvannyuma lw’okusiba eddagala lya meconium mu ssaawa ntono. Mu mbeera ezisingako obuzibu, omwana ayinza okwetaaga okubeera mu NICU okumala ennaku oba wiiki eziwera, oba ayinza okwetaaga okwesigama ku oxygen ow’okugatta.

Bye tusaanidde okukuuma mu birowoozo (Take-Home Message) .

Obulwadde bwa Meconium Aspiration Syndrome bulwadde bwa maanyi, naye nga bujjanjabibwa, era nga buyinza okubaawo mu baana abazaalibwa. Omusawo wo ajja kukebera amazzi g’omwana wo mu lubuto oba meconium ng’azaalibwa. Singa omwana wo alaga obubonero bwonna obw’okunyigirizibwa, amangu ago ajja kukola emitendera okuggya meconium mu nnyindo n’akamwa ke.

Ekisinga obukulu kwe kumanya embeera eno nga bukyali n’ogijjanjaba mangu. Mu ngeri eyo, emikisa gy’okufuna ebizibu giba mitono nnyo. Abalongo abasinga bawona ddala mu nnaku ntono, era ebizibu ebiwangaala tebitera kubaawo.

Ate era jjukira nti abalongo bonna abalina meconium mu mazzi gaabwe ag’omu lubuto si nti bajja kufuna obulwadde bwa meconium aspiration syndrome. Kale totya mu ngeri eteetaagisa. Wesige ttiimu yo ey’abasawo. Bajja kukulabirira n’omwana wo mu ngeri esinga obulungi.

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