Omusuwa gw’omu nnabaana gw’omwana wo guzingiddwa mu bulago? (Nuchal Cord) Tofaayo, ka twogere ku nsonga eno!

Bw’osemberera okufuuka maama, ebintu ebya buli ngeri bijja mu birowoozo ku mwana wo, si bwe kiri? Oluusi n’ebintu ebitonotono bisobola okutiisa ennyo. Bw’otyo bw’owulira nti, ‘Omuguwa gw’omu nnabaana guzingiddwa mu bulago bw’omwana.’ Kiwulira ng’omugugu munene, si bwe kiri? Naye kino ddala kye ki? Kino kya bulabe? Katukyogereko leero.

Omuguwa gwa Nuchal kye ki?

Mu ngeri ennyangu, omuguwa gwa nuchal gwe muguwa gw’omu nnabaana oguzinga mu bulago bw’omwana, omulundi gumu oba emirundi egiwerako. Ekigambo ‘nuchal’ kitegeeza ‘ekikwata ku bulago’. Kino kiyinza okubaawo ng’omwana akyali mu lubuto, oba kiyinza okubaawo ng’azaalibwa.

Kati oyinza okuba nga weebuuza omuguwa guno ogw’omu nnabaana kye ki. Omuguwa gw’omu nnabaana guba ttanka yokka. Mu kyo omwana mw’ayita okufuna buli kye yeetaaga okuva ku maama, gamba ng’omukka gwa oxygen, endya n’omusaayi. Mu ngeri endala, kiringa omuguwa gw’obulamu bw’omwana. Omuguwa guno ogw'omu nnabaana gwe gugatta omwana ku nnabaana .

Kale, kya bulijjo okuwulira ng’otya ng’owulira nti omuguwa gw’omu nnabaana guzingiddwa mu bulago bw’omwana wo. Naye ekisinga obukulu ky’olina okumanya nti emirundi egisinga, omuguwa guno ogw’omu nnabaana tegukola bulabe bwonna ku mwana. Omusawo wo oba omuzaalisa ajja kukubuulira ebisingawo ku nsonga eno.

Waliwo ebika bya koodi ya nukiriya?

Yee, waliwo engeri eziwerako abasawo gye bakozesa okunnyonnyola kino:

• Single Nuchal Cord: Kino kitegeeza nti omuguwa gw’omu nnabaana guzingibwa mu bulago bw’omwana omulundi gumu gwokka.
• Emiguwa Emingi: Wano, omuguwa gw’omu nnabaana guyinza okuzingibwa mu bulago bw’omwana emirundi egisukka mu gumu, kwe kugamba emirundi ebiri oba esatu.

Ate era okusinziira ku ngeri omuguwa gw’omu nnabaana gye guzingibwamu mu bulago, kigambibwa nti ‘gusumuluddwa’ oba ‘gunywevu’.

• Loose Nuchal Cord: Kino kye kika ekisinga okukozesebwa. Wano, omuguwa gw’omu nnabaana teguzingibwa bulungi mu bulago, wabula guzingibwa mu ngeri etali nnywevu ku nfuli. Oluusi, kiyinza okuva ku bwakyo ng’omwana atambula mu lubuto.
• Tight Nuchal Cord: Kino tekitera kubaawo katono. Wano, omuguwa gw’omu nnabaana guyinza okuzingibwa obulungi mu bulago bw’omwana. Ekika kino eky’omuguwa ogunywezeddwa (tight nuchal cord) kitera okuleeta ebizibu okusinga ogw’ekika kya nuchal cord. Naye era tekitera kubaawo nnyo.

Abalongo bameka abatuuka okulaba omuguwa guno ogwa nuchal?

Kino mu butuufu kitera okubaawo okusinga bw’oyinza okulowooza. Omwana omu ku buli bana (25%) azaalibwa n’omuguwa gumu ogw’omu nnabaana, ekitegeeza nti omuguwa gw’omu nnabaana guzingibwa mu bulago omulundi gumu. Abalongo wakati wa 2 ne 8 ku 100 (2.4% - 8.3%) bazaalibwa nga omuguwa gw’omu nnabaana guzingiddwa mu bulago emirundi ebiri oba okusingawo, ekitegeeza nti emiguwa gya nuchal mingi . Kale olaba nti kino si kintu kya kweraliikirira, nedda?

Bubonero ki obulaga nti oyinza okuba n’enkola ya nukiriya?

Akabonero akamu akayinza okulabibwa oluusi ng’omwana ali mu lubuto oba ng’anaatera okuzaalibwa bwe wabaawo omuguwa oguyitibwa nuchal cord.Okulondoola okukuba kw’omutima mu lubuto kuyinza okulaga enkyukakyuka mu kukuba kw’omutima. Okusingira ddala, embeera eyitibwa ‘variable decelerations’ esobola okulabibwa. Mu ngeri ennyangu, wano omutima gw’omwana, kwe kugamba, sipiidi y’okukuba kw’omutima, bwe gukendeera omulundi gumu katono n’edda mu mbeera eya bulijjo.

Enkyukakyuka zino mu kukuba kw’omutima zitera okulaga nti waliwo ekiziyiza okutambula kw’omusaayi okuyita mu nnabaana. Kino kiyinza okuba nga kiva ku kunyigirizibwa kw’emisuwa mu nnabaana. Kino kiyinza okuba nga kiva ku muguwa gwa nuchal . Wabula ensonga endala ng’ekikonde mu musuwa oba okugwa kw’omusuwa gw’omu nnabaana nazo zisobola okuleeta enkyukakyuka zino mu kukuba kw’omutima.

Naye ekisinga obukulu, bw’olaba enkyukakyuka ng’eno mu kukuba kw’omutima gw’omwana wo, abasawo ne ba nurse bajja kukola mangu era bakole kyonna ekisoboka okukukuuma n’omwana wo. Kale tosattira.

Biki ebivaako enkola ya nukiriya?

Emiguwa gya nuchal mu butuufu gibaawo mu ngeri ya kimpowooze. Kino kitegeeza nti kizibu omuntu yenna okwogera ekituufu ekizireeta. Wabula kizuuliddwa nti ebintu bino wammanga biyinza okwongera katono ku bulabe bw’okufuna omuguwa gw’omugongo:

• Okutambula kw’omwana mu lubuto okuyitiridde: Omwana bw’aba akola nnyo, omuguwa gw’omu nnabaana guyinza okwezinga mu bulago nga bwe yeekulukuunya ng’adda n’emabega.
• Omuguwa omuwanvu ogw’omu nnabaana: Singa omuguwa gw’omu nnabaana guwanvuwa okusinga yinsi 27 (sentimita nga 70), gutera okwezinga.
• Amazzi g’omu lubuto okweyongera mu nnabaana (Polyhydramnios): Singa wabaawo amazzi amangi okwetooloola omwana, omuguwa gw’omu nnabaana guyinza okwezinga kubanga omwana alina ekifo ekiwera okutambula.

Tewali ky’oyinza kukola kufuga bintu bino eby’akabi. Omwana wo bw’aba alina akaguwa akayitibwa nuchal cord, si musango gwo. Kale tokyeraliikirira.

Bizibu ki ebiyinza okubaawo olw’omuguwa gw’omubiri (nuchal cord)?

Nga bwe nnagambye emabegako, emiguwa gya nuchal egy’ekika kya loose tegitera kubaawo nnyo. Omwana bw’azaalibwa, omusawo oba nnansi asobola okusika mpola olukoba lw’omuguwa ku mutwe gw’omwana ng’afuluma mu mulyango gw’okuzaala.

Naye, abalongo abalina omuguwa gw’omubiri ogunywezeddwa – si bonna, naye oluusi – bayinza okufuna ebizibu bino ebitonotono oluvannyuma lw’okuzaalibwa:

• Subconjunctival hemorrhage (akasuwa akatono mu liiso kakutuka) .
• Puleesa eya wansi (Hypotension ) .
• Okukendeera kw’omusaayi mu mubiri ( Hypovolemia ) .
• Obuzibu mu kussa obutono
• Obutoffaali obutono obumyufu obw'okuvaamu omusaayi wansi w'olususu lwa ffeesi ( Facial petechiae ) .
• Enkwagulo entonotono ku lususu mu bulago
• Enkyukakyuka mu langi ya ffeesi okumala akaseera

Naye jjukira nti ebizibu bino ebiseera ebisinga tebiba bya maanyi era tebireeta buzibu bwonna bwa bulamu obw’ekiseera ekiwanvu.

Si bulijjo nnyo, ekitegeeza mu mbeera ezisinga obungi, omuguwa gwa nuchal ogunywezeddwa guyinza okuleeta ebintu nga bino:

• Okufiirwa omusaayi okw’amaanyi
• Asidi okweyongera mu musaayi (Acidosis ) .
• Anemia (obutaba na musaayi) .

Singa ekintu nga kino kibaawo, abasawo ne ba nurse abajjanjaba omwana wo bamanyi bulungi nnyo okuddukanya embeera ezo. Kale naawe tokyeraliikirira.

Omanya otya mu bukakafu oba olina enkola ya nukiriya?

Omusawo ayinza okulaba omuguwa oguyitibwa nuchal cord mu kiseera ky’okukebera ultrasound ng’oli lubuto. Kyokka, oluusi bayinza obutakubuulira. Kino kiri bwe kityo kubanga emiguwa gya nuchal gitera nnyo era gitera okutwalibwa nga egya bulijjo. Singa omusaayi oguyita mu nnabaana guba gwa bulijjo, ebiseera ebisinga tewabaawo kweraliikirira. Omusawo asobola okukozesa Doppler ultrasound okukebera oba omusaayi guno gutambula bulungi.

Omwana wo bw’asemberera okuzaalibwa, omusawo ayinza okukebera omubiri okukebera oba alina omuguwa oguyitibwa nuchal cord. Kino kizingiramu okunyiga mpola ku bulago bw’omwana wo, waggulu ddala w’olubuto lwo. Singa omutima gw’omwana wo gukendeera, kiyinza okulaga nti omuguwa gw’omu nnabaana guli mu bulabe bw’okunyigirizibwa. Kino bwe kibaawo, omusawo ajja kwongera okulondoola omutima gw’omwana wo era akolewo singa wabaawo ekizibu.

Abasawo bakola ki singa omwana aba n’akaguwa akayitibwa nuchal cord nga azaalibwa?

Omwana bw’aba n’omusuwa gw’omu nnabaana ng’azaalibwa, tewali ngeri yonna gy’ayinza kuguggyamu oba kuguddaabiriza. Abasawo ne ba nurse bajja kulondoola omutima gw’omwana nga tannazaalibwa n’okuzaalibwa okukebera oba alina obuzibu bwonna ku nnabaana. Singa omutima gw’omwana guba mutono, ttiimu y’abasawo ejja kukola ekyetaagisa. Kino kitera okuzingiramu:

• Okukyusa ekifo kyo (okugeza, okukyuka okuva ku ludda olumu okudda ku lulala) .
• Okuwa omunnyo (IV fluids) bwe kiba kyetaagisa
• Okuwa obujjanjabi bwa oxygen

Omwana bw’azaalibwa, omutwe gw’omwana bwe gumala okuva mu bukyala, omusawo oba nnansi ajja kuteeka emikono gyabwe mu bulago bw’omwana okukebera omusuwa gw’omu nnabaana. Singa wabaawo omuguwa oguyitiridde , ebiseera ebisinga basobola okuguggyako nga bagusika mpola ku mutwe gw’omwana.

Singa omuguwa gw’omu nnabaana gusibira mu bwangu (tight nuchal cord), omusawo ayinza okukola ‘Somersault maneuver’.Zaala omwana wo ng'okozesa enkola eyitibwa "breech delivery." Kino kizingiramu okukuuma omutwe gw’omwana okumpi n’ekisambi kyo n’okuggyamu omwana n’obwegendereza omuguwa gw’omu nnabaana guleme kunyiga mu bulago ng’omubiri gw’omwana gwonna guva mu bukyala.

Omwana alina omusuwa gw’omu nnabaana asobola okuzaalibwa mu ngeri eya bulijjo?

Emirundi egisinga omuguwa gw’obukyala tegutaataaganya kuzaala, ekitegeeza nti osobola okuzaala mu bukyala mu ngeri eya bulijjo nga bw’oteekateeka.

Kyokka, si bulijjo nnyo, omusuwa gw’omu nnabaana ogunywezeddwa guyinza okuziyiza omusaayi okutambula mu nnabaana, ne kireetera omwana ali mu lubuto okunyigirizibwa . Kino bwe kibaawo, kiyinza okwetaagisa okukeberebwa C-section mu bwangu .

Ate era, singa omwana aba mu mbeera ya breech ate nga waliwo omuguwa oguyitibwa nuchal cord, ebiseera ebisinga omusawo tajja kumuwa magezi ku nkola ya external cephalic version (ECV ) oba okuzaala mu bukyala. Ne mu kiseera ekyo, kisinga kirungi okulongoosebwa.

Kale nsaanidde okutya enkola ya nukiriya?

Mu butuufu, emirundi egisinga, omuguwa gwa nuchal si kintu kya kweraliikirira. Tekizuuliddwa nti kireeta mwana mufu oba obuzibu obw’amaanyi mu bulamu. Omusawo wo ajja kumanya engeri y’okuddukanyaamu omuguwa gwa nuchal. Singa kireetera omwana obuzibu bwonna ( fetal distress), bajja kukubuulira. N’olwekyo teweeraliikiriranga mu ngeri eteetaagisa.

Waliwo kye nsobola okukola okutangira omusuwa gw’omu nnabaana okuzinga mu bulago?

Tewali ky’oyinza kukola kuziyiza muguwa gwa nuchal okutondebwa. Tosobola kufuga ngeri mwana wo gy’atambulamu mu lubuto oba engeri omuguwa gw’omu nnabaana gye gutambulamu. Ekirala, singa omusuwa gw’omu nnabaana gutabuddwa, tewali ky’oyinza kukola kugusumulula. Ttiimu yo ey’abasawo ejja kumanya bulungi eky’okukola singa omwana wo aba n’omuguwa oguyitibwa nuchal cord ng’azaalibwa.

Wadde nga kiyinza okuwulikika ng’entiisa okuwulira nti omwana wo alina omuguwa gw’omu nnabaana oguzingiddwa mu bulago, osobola okukakasa nti ebizibu ebiva mu nnabaana bitono nnyo nnyo. Tekitera kuleetera mwana wo buzibu bwonna mu bulamu. Mu mbeera etasuubirwa nti omwana wo afuna obuzibu olw’omuguwa oguyitibwa nuchal cord, ttiimu yo ey’abasawo yeetegese okuzaala omwana wo mu ngeri ey’obukuumi nga bwe kisoboka.

Ebintu ebikulu by’olina okujjukira

Okay, kale, okusinziira ku bye twogeddeko, bino bye bintu ebikulu by’olina okujjukira:

• Nuchal cord gwe muguwa gw’omu nnabaana oguzinga mu bulago bw’omwana. Kino kya bulijjo nnyo.
• Ebiseera ebisinga, eno si mbeera ya bulabe. Omwana alina emikisa mingi nnyo okuzaalibwa nga talina bulabe bwonna.
• Kino kibaawo mu ngeri ya kimpowooze, era si musango gwo. Kale tokyeraliikirira.
• AbasawoKino tukirondoola nga tuyita mu sikaani n’okulondoola omutima gw’omwana.
• Ebiseera ebisinga, omwana asobola okuzaala mu ngeri eya bulijjo. Okulongoosa kyetaagisa mu mbeera ey’amangu yokka.
• Ebizibu ebivaamu tebitera nnyo, naye bwe bibaawo, ebiseera ebisinga tebiba bya maanyi.
• Tewali ky'oyinza kukola kuziyiza kino. Naye abasawo bo ne ba nurse beetegefu okukola ku mbeera yonna.

Kale, omusawo bw’akubuulira ku nuchal cord, tosattira, mubuuze ekibuuzo kyonna ky’olina. Bajja kukunnyonnyola buli kimu. Byonna birungi eri ggwe ne bbebi wo!

` Omuguwa gw’omu nnabaana, okuzinga mu nnabaana, olubuto, okuzaala, obulamu bw’omwana, omuguwa gw’omu nnabaana, okukuba kw’omutima gw’omwana ali mu lubuto