I naute chu a pum chhungah tlem a lian lutuk em? Fetal Macrosomia chungchang hi han sawi ila!

Nu naupai i nih chuan i doctor-in, "Naute chu a lian deuh niin a lang," emaw, "Naute chu a thau deuh niin a lang," a tih i hre tawh mai thei. A nih loh leh, i naute chu a dang zawng aiin a lian deuh emaw, a rit deuh emaw niin i hria a ni thei bawk. Dik tak chuan damdawi lamah pawh hei hi hming bik a awm a. Vawiin hian he natna "Fetal Macrosomia" tih hi kan sawi dawn a ni. Ngaihtuah buai suh, hei hi fimkhur a pawimawh hle.

He naute lian (Fetal Macrosomia) an tih hi eng nge ni?

A awlsam zawngin `(Fetal Macrosomia)` tih awmzia chu i naute chu naupai kar khat chhunga a rihna beisei aia 10% emaw a aia rit emaw a ni tihna a ni. Ngaihtuah teh, tun kar chhung hian naute hi kilo 3 vel an rit tlangpui a nih chuan i naute hi kilo 3.3 emaw a aia tam emaw a ni thei.

Tunah chuan, "Aw, ka naute hi a lian zawk ang a, a hrisel zawk ang," i ti mai thei. A dik a ni, naute hrisel hi nu tin duhthusam a ni. But, sometimes when the baby is too big , a normal taka nau neih chu a harsa deuh thei a, chu chu vaginally a ni. A châng chuan nu hian vaginal tears a nei thei a, a nih loh leh naute nawr chhuah a harsa thei bawk. Doctor chuan naute chu a lian lutuk nia a ngaih chuan – chu chu pound 11 aia tam (kilogram 5 vel) emaw, zunthlum i vei chuan pound 10 aia tam (kilogram 4.5 vel) emaw a nih chuan – a him ber chu cesarean section (C-section) tih hi a ni mai thei.

Naute chu a lo puitlin chuan, naute a pian hunah eng ang harsatna nge lo awm thei ang?

Naute lian tak i beisei lai hian nau neih laiin harsatna engemaw zat a awm theihna a sang deuh hlek a ni. Chu chu eng nge ni tih i han thlir teh ang.

Nu tan harsatna awm thei

• I birth canal, chu chu vagina leh a chhehvel (`perineum`) a ni thei. Naute a lian em avangin a chhuah rualin mittui a awm thei.
• I thisen pangngai aia tam i chhuak thei. A chang chuan hei hian nau neih hnua thisen chhuah tam lutuk (postpartum hemorrhage) pawh a thlen thei.
• Tin, uterine rupture chance pawh a tlem hle a, hei hi nu hmasa cesarean section nei tawhte zingah a tam zawk.
• Nau neih hma hun, a bik takin pushing phase hi a rei thei hle. Hei hi nu tan chuan hahthlak tak a ni thei.
• Naute i hrin laiin i naute thinlung thawk danah inthlak danglamna i hmu thei .

Naute tan hlauhawmna - a bik takin shoulder dystocia

Naute a lian a nih chuan risk engemaw zat an nei bawk. Chung zinga ngaihtuahawm ber chu `(Shoulder Dystocia)` tih dinhmun hi a ni.A awlsam zawngin, hei hi naute lu chu vagina atanga a chhuah hnua nu nausen pum chhunga a kekawrte a innghah lai a ni. Hei hi eng nau neih lai pawhin a thleng thei a, mahse naute lian zawkah chuan a thleng tam zawk.

Shoulder Dystocia hi emergency tak tak a ni. Mahse, lungngai suh, i doctor leh midwife te hian hetiang thil hi a lo thleng a nih chuan eng nge an tih ang tih ruahmanna an nei a. I nau neih chhung zawngin an lo enkawl reng ang che.

Hetiang dinhmun (Shoulder Dystocia) hian naute piang thar chungah a hnuaia thilte hi a thlen thei a ni:

• Naute hian ruh tliak a nei thei , a bik takin ruh ruh a tliak thei.
• Brachial Plexus Hliam a awm . Hei hi naute kut thlenga signal phurtu nerve bundle tihchhiatna a ni. Hei hian kutphah chak lohna a thlen thei a ni.
• A tlem hle a, thluak chhiatna a thleng thei.

Naute upa zawkte tan pawh nausen pian hnuah pawh heng hlauhawmnate hi a awm reng thei a ni.

Naute lian tak tak piangte hian an pian hnuah hriselna lama harsatna engemaw zat an nei tam zawk a:

• Thisen chhunga thisen sen (red blood cells) a punna. Hei hian naute chu jaundice vei theihna a tipung thei a ni.
• Thisen thlum hniam (hypoglycemia).
• Thâwk lakah harsatna a awm.

Naute a lian tih chhinchhiahna engte nge ni?

Dik tak chuan i naute hi a pian hma loh chuan a lian zia dik tak hriat a har khawp mai. Naupai laiin i natna lan chhuah tam tak hi a inang tlangpui a, i naute chu engtiang pawhin lo thanglian se. Chumi awmzia chu naupai pangngaiah chuan pum lian leh hahna ang chi thil hi a awm fo tihna a ni. Mahse, i doctor-in a rinhlelh theih tur thil thenkhat chu i naute hian a enfiah che hian a lian hle tih hi a ni.

Engvangin nge naute chu a pum chhungah a lian em em? A chhan engte nge ni?

I doctor chuan i naute hian macrosomia a vei tih a ringhlel thei a, hei hi hengte avang hian a ni:

• I ``Fundal Height'', chu chu nausen pum san zawng (a pum san zawng tehna) chu beisei aia sang a nih chuan. Doctor chuan check-up apiangin hei hi a teh thin tih i hre reng mai thei.
• Naupai laiin i thau lutuk a nih chuan. Naupai lai hian taksa rihna hi a pung tih kan hre vek a, mahse hriselna level-a vawn reng a pawimawh.
• Diabetes i neih chuan, emaw, naupai laiin zunthlum i vei a nih chuan (gestational diabetes). Hei hi nausen lian tak awm chhan ber a ni.
• Naute lian tak i hrin tawh chuan.
• I nau neih hun a liam tawh chuan ni a liam zel chuan i naute chu a lian deuh deuh ang.
• Nangmah ngei pawh naute lian tak anga piang i nih chuan a chang chuan thlahtu thil a ni thei.

Doctor-te hian engtin nge naute a lian leh lian loh an hriat?

I doctor-in i naute hi a lian nia a rinhlelh chuan naute rih zawng leh naute chhehvela amniotic fluid (amniotic fluid) awm zat enfiah turin ultrasound scan an ti thei ang. Ultrasound tih hi eng nge a nih i hria em? I naute thlalak emaw video emaw thawn nan high-frequency sound wave a hmang a ni.

Ultrasound chauh hmang hian chiang takin kan hre thei lo em ni?

Zawhna tha tak a ni. Ultrasound hian i naute rit zawng dik tak a hre thei lo . Rough idea chauh a pe che a, plus or minus 10% . Entirnan, scan-ah naute hi kilo 4 vel a rit tih a sawi a nih chuan chu chu "best guess" mai a ni. Naute hi a takah chuan kilo 3.6 leh 4.4 inkar khawi hmunah pawh a rit thei a ni.

Tin, ultrasound hian a hmaa kan sawi tawh ang khan shoulder dystocia ang hi a awm dawn em tih chiang takin a sawi thei lo bawk. Chuvangin, doctor chuan ultrasound a\anga thu hriatte, i naupai chanchin (naute i lo neih tawh dan, i hriselna dinhmun), leh i test-na te chu a thlunzawm ang a, naute hrin hun leh hmanraw \ha ber leh him ber a hriat theih nan.

Doctor hian eng thil dang nge a zawn?

Ultrasound scan i mamawh leh mamawh loh rel nan doctor chuan a hnuaia mi ang hian a ti bawk ang:

• I ``Fundal Height`` tehna. Hei hi i nausen pum chunglam atanga i pum hnuai lam ``Pubic Bone`` inkar hlat zawng a ni.
• I pum chhunga palpation. Doctor chuan i pum chhung hmun thenkhat enin naute lian leh te chu a hriat theih nan a bei ang.

Heng test-te hian naute chu a lian tih a hriat chuan, i doctor chuan naute hriselna enfiah lehzual turin test dang (Biophysical Profile emaw Nostress Test emaw ang chi) a ti thei ang.

Naute chu a lian a nih chuan eng enkawlna nge tih theih ang?

Macrosomia enkawl hi a bul berah chuan i hriselna dinhmun hnuaia awm eng pawh enkawl a ni , zunthlum emaw thau lutuk emaw ang chi. I naupai emaw, nau neih emaw tichhe thei dinhmun eng pawh enkawl turin nang leh i doctor chuan thawhhona tha tak nei tur a ni.

A tam zawkah chuan ei leh in hrisel ei te, exercise lak te, leh i zunthlum thunun (a tul chuan insulin ei) te hi i tih theih pawimawh ber a ni.

I doctor chuan vaginal delivery a hlauhawm dan a sawipui ang che. A then phei chuan C-section neih a tha thei bawk a, hei hian harsatna a thlen theihna tur a ti tlem thei a ni. Mahse hei hi hriat a pawimawh: Nau neih hma (i.e., kar 39 hmaa nau neih tum) hian harsatna a tihziaawm tih hmuhchhuah a ni lo. Chuvang chuan nausen lian tham leh lian leh te, damdawi lam chhan dang a awm loh chuan nau neih hmaa nau neih hi a tha lo.

Naute a lian a nih chuan cesarean section (C-section) neih a ngai em?

A ni hauh lo. Naute lian zawng zawng hian C-section an mamawh vek dawn lo. Mahse, a hnuaia mite hi C-section neih a ngai zawk a ni:

• Tun hmain `(Shoulder Dystocia)` nei naute i lo nei tawh a nih chuan.
• Zunthlum i vei a, i naute chu pound 10 (kg 4.5 vel) aia rit tura ngaih a nih chuan.
• Zunthlum i nei lo a, mahse i naute hi pound 11 (kilogram 5 vel) aia rit a ni tih i chhut a ni.

Heng thutlukna te hi i doctor-in a biak hnuah leh i dinhmun a zirin a siam thin.

Hetianga naute lo seilian tur ven dan tur a awm em?

Dik tak chuan `(Fetal Macrosomia)` hi dik taka sawi lawk a har fo thin. Naute a pian leh a rit hnuah chauh, "Aw, naute hi a lian hle mai," tih hi chiang takin kan sawi thei a ni. Naute thenkhat chu risk factor awm lo pawhin a tlangpui aia lian zawkin an piang thei.

Mahse, hriselna tha neih leh naupai hrisel neih hian he hlauhawmna hi eng emaw chen a tihziaawm thei a ni:

• Nau neih hmaa clinic pangngaiah kal rawh. Doctor tlawh fo hian nang leh i doctor chuan i naute hmasawnna chu ngun takin i en thei ang. Zawhna i neih apiang zawh theihna hun tha tak a ni bawk.
• I rit zawng ngaihtuah rawh. Naupai hmaa i rihna hriat a pawimawh ang bawkin naupai laia i rihna i tihpun zat hriat a pawimawh bawk. Kan rama ei tur thenkhat (e.g., flour foods, sweets) hi tlem tal ngaihtuah a tha.
• Zunthlum i vei chuan a thunun theih nan a tul angin hma la rawh. Pre-existing diabetes (Diabetes Mellitus) leh gestational diabetes (Naupai laia lo awm Diabetes) te hi nausen macrosomia thlentu lian ber an ni.

Nausen lian tak tak piangte hian nakin lawkah eng hriselna lama harsatna nge an neih theih ang?

Zirchianna atanga a lan dan chuan nausen lian tak tak piangte chu nakin lawkah a hnuaia mite hi an vei theihna a sang zawk a ni:

• Naupan laia thisen sugar level hniam (`Hypoglycemia`).
• Naupan laia thau lutuk.
• Metabolic syndrome hi natna chi hrang hrang, lung natna, stroke, leh zunthlum te vei theihna tipungtu a ni.

Mahse, nau piang laiin ruh tliak emaw, nerve tihchhiat emaw awm mah se, naute tam zawk chu chu hliam aṭang chuan an dam chhuak vek tih hre reng ang che.

``Fetal Macrosomia`` hi nau neih laiin harsatna lian tham a thlen thei a ni. Hei hi chhan tam tak awm mah se, thunun theih loh zunthlum leh thau lutuk hi a chhan ber pahnih a ni.Heng dinhmunte hi uluk taka enkawl hian naute lian tak neih theihna i tihtlem thei a ni. Exercise neih fo leh ei leh in hrisel ei ang chi thilte hian naupai hrisel tak neih theihna tur leh harsatna i tawh theihna a ti tlem thei a ni. Nang leh i naute enkawl dan tur tha ber chu i doctor zawt hlau suh. ``Fetal Macrosomia'' hi na tak ni thei mahse, naute lian tam zawk hi hrisel takin an piang thin.

Chuti a nih chuan, he thil atang hian eng thil nge kan hriat reng tur pawimawh ber?

Okay, chuvangin kan sawi tawh thenkhat i hriat reng tur chu khaikhawm ila:

• ``Fetal Macrosomia`` tih awmzia chu naute chu a pum chhungah beisei aia tam a thau tihna a ni.
• Hei hi a chhan ber chu nu zunthlum (a bik takin thunun theih loh) leh naupai laia a thau lutuk vang a ni.
• Naute a lo lian chuan nu leh naute pahnih hian nau neih laiin harsatna engemaw zat an tawk thei a ni. ``Shoulder Dystocia`` hi natna khirh tak a ni a, naute chungah a thleng thei a ni.
• Doctor-te chuan ultrasound scan leh test dang hmangin naute lian leh te hi an hre thei a ni.
• Naute lian zawng zawng hian C-section an mamawh vek lo a, mahse a then phei chuan a him ber a ni.
• He hlauhawmna hi nun hrisel tak neih te, ei leh in inthlau tak ei te, leh zunthlum ang chi dinhmun control te hian a tihziaawm theih a ni.
• Ngaihtuah buai suh, naute lian tam zawk hi hrisel taka piang an ni. I doctor nen engkim sawiho la, a thupek zawm rawh.

Hemi chungchanga zawhna dang i neih chuan doctor zawt ngei ang che. Thurawn tha ber ber pe thei che an ni.

` Fetal Macrosomia, Naute lian, Naupai, Nau neih, Cesarean Section, Zunthlum, Shoulder Dystocia