I naute chu a pum chhungah a thang tha lo em ni? Hei hi IUGR (Intrauterine Growth Restriction) a ni em? I zawng chhuak ang u!

Nu ni tur i nih chuan `IUGR` tih thumal hi i hre tawh mai thei. I doctor emaw midwife emaw pawhin hei hi a sawi tawh mai thei. Chuvangin hei hi eng nge a nih chiang takin nang leh i chhungte tan hriat a pawimawh hle. Vawiin hian `IUGR` chu eng nge a nih, engvanga lo awm nge a nih, eng nge tih theih tih te han sawi ila. Lungngai suh, hei hi awlsam takin i hrethiam ang u.

IUGR hi eng nge a nih tih tlem kan sawifiah thei ang em?

`IUGR` tih hi Intrauterine Growth Restriction tihna a ni. A awlsam zawngin, hei hian i fate chu beisei angin a lo thang lian lo tihna a ni a, an awmna kar chhung atan emaw, an naupai kum atan emaw a lo thang lian lo tihna a ni. Chumi awmzia chu Doctor-te beisei aia naute a te zawk tihna a ni. Entirnan, naupai kar 30 i nih chuan chu naupai kar 30 chhung atan chuan i rihna leh sei zawng pangngai i nei tur a ni. `IUGR`-ah chuan naute chu chu aia tlem zawkin a lang thei.

`IUGR` hi chi hnih a awm a. Doctor ten heng chi hnih chungchang hi an hrilh ang che.

• A chi khatna chu `(Symmetrical IUGR)` tih a ni. Hemiah hian naute taksa pumpui, chu chu a lu, a ke leh a ke, a pum, engkim hi a lian leh te a inang vek a ni. Naute pum pui chu a tikehsawm vek ang mai a ni. Hetiang dinhmun hi naupai tirh lam atang hian a intan thei a ni.
• A chi hnihna chu `(Asymmetrical IUGR)` tih a ni. Hei hi a danglam deuh hlek a ni. Naute lu leh thluak chu a pangngaiin a lo thang lian tawh a, beisei angin a lian tawh a ni. Mahse taksa dang zawng zawng, a bikin pumpui chu a te hle. Hetianga thil thleng chu naute taksain thluak mamawh ei leh in leh oxygen humhalh a tum a, chu chuan taksa peng dangte thanlenna a tikhawtlai a ni. Hetiang dinhmun hi naupai hun hnuhnung lamah a lang tam ber.

Engvangin nge IUGR hi a lo awm? A chhante chu engte nge ni?

Tunah chuan, ‘Engvangin nge ka naute chungah hetiang hian a thlen? Hei hi ka sualna a ni em?' Chutiang chuan ngai suh. `IUGR` a lo awm theih chhan tam tak a awm. A chhan ber chu nausen pum chhunga naute hian a mamawh chaw tha leh oxygen a hmuh loh vang a ni. Thlai pakhatin tui leh ei tur tha a tlakchham chuan a thang tha thei lo ang bawkin. Hetianga ei leh in tlakchhamna thlentu hi thil pawimawh engemaw zat a awm a:

• Placenta Problems: I hriat angin placenta hi nu atanga naute hnena oxygen leh nutrients phur thei tur bridge ang a ni. Chuvangin nausen chu a lo piang tha lo a, a lian lo va, a hnathawhnaah chak lohna engemaw a nei a nih chuan naute hian a mamawh chu a hmu lo. A chang chuan nausen (placenta) hi nausen pum (uterine wall)-ah a inzawm tha lo thei bawk.
• Umbilical cord thisen kal dan lama harsatna: Umbilical cord hi nausen atanga naute hnena ei tur tha leh oxygen pekna kawng a ni. Umbilical cord-a thisen kalna a tlahniam a nih chuan, entirnan, umbilical cord a tangled, compressed emaw, umbilical cord chhunga thisen kalna kawng a tlem chuan naute thanlenna a nghawng thei bawk.

Hei bakah hian nu hriselna dinhmun leh tih dan thenkhatte pawhin hei hi a nghawng thei bawk. Eng nge an nih i en ang u:

• Meizial zu, zu in leh ruihhlo hman: Naupai lai hian hengte hi a pawi hle tih i hre ngei ang. Naute hmasawnna tur direct-in an tibuai a, placenta-a thisen kal chu an ti tlem bawk.
• Infection thenkhat: Naupai laiin nuin a kai thin infection thenkhat, entirnan, cytomegalovirus, rubella, toxoplasmosis, emaw syphilis te hian naute a nghawng thei a, a thanlenna a ti tlem thei bawk.
• Damdawi thenkhat: Damdawi thenkhat, a bik takin epilepsy tan te hian IUGR a thlen thei bawk. Chuvang chuan damdawi ei tur eng pawh doctor hnenah hriattir a pawimawh hle. Hemi hun chhung hian doctor phalna lo chuan damdawi engmah ei loh tur a ni.
• Nuin a neih damdawi lam harsatna rei tak thenkhat: Entirnan, lupus, thisen tlakchhamna nasa tak, emaw thisen zam harsatna, kal natna, emaw thinlung natna te pawh a awm thei bawk.
• Hypertension: Naupai laiin nu thisen sang (a bik takin pre-eclampsia ang chi condition) hi IUGR thlentu ber pakhat a ni.
• Nauteah hian Genetic problems emaw, piansualna emaw: A chang chuan, naute ngeiin a genetic condition (Genetic disorder) emaw, piansualna emaw hian a than chak lohna a thlen thei bawk. Entirnan Down syndrome ang chi natna te hi a ni.
• Naupai tam tak, twins emaw triplets emaw ang chi: Nausen pum chhunga naute pakhat aia tam i neih chuan a chang chuan nutrients chu an zavaia hnenah inang tlang taka sem chhuah a ni lo thei. Chuti chung pawh chuan naute pakhat emaw, a aia tam emaw chu an te hle thei a ni.

Doctor-te hian engtin nge IUGR hi an hriat theih?

Okay, tunah chuan `IUGR` chu eng nge a nih leh engvangin nge a lo awm tih i hrethiam tawh mai thei. Chuti a nih chuan engtin nge doctor hian a hriat chian theih ang?

A tlangpuiin, i naupai lai hian thla tin clinic-ah i kal thin. Chutah chuan doctor emaw chhungkaw hriselna lama thawktu emaw chuan i pum san zawng a teh ang. Chu chu i pum hnuai lam pubic bone atanga i uterus chunglam thlengin tape measure hmangin an teh ang tihna a ni. Hei hi ``uterine fundal height'' tehna an ti a. Hei hian doctor-te chu naute ṭhanlenna chu kar khat chhunga a ṭhat leh ṭhat loh chungchangah rough idea a nei thei a ni. He tehna hi kar tin a tlem berah a pung tur a ni. A nih loh chuan IUGR rinhlelh a ni.

Mahse IUGR i nei tih finfiahna ber chu ultrasound scan hmangin a ni. Scan i nei tawh bawk. I pum chhungah gel hnawih a ni a, thil te tak te, probe an tih chu i pum chungah a kal a, naute thlalak chu computer screen-ah a lang chhuak a ni. Heng thlalak atang hian doctor-te chuan naute lu lian leh te, pum vel, leh hip ruh sei zawng te chu an teh thei a, naute rih zawng pawh an chhut thei bawk. Heng chhut dante hi 100% dik lo mah se, naute thanlen dan leh harsatna a awm leh awm loh hriat nan a pui hle. Anomaly scan, kar 20-a tih thin pawh hian naute than dan tur a hriat theih bawk. Chumi hnuah chuan a tul angin scan tam zawk tih theih a ni.

Ultrasound scan hian thil dang a en thei bawk. Entir nan:

• Nausen awmna hmun, a lian leh te, a lan dan.
• Naute chhehvela amniotic fluid awm zat a tlem emaw a tam emaw. He tui tlahniam hi IUGR chhinchhiahna a ni thei bawk.
• Doppler ultrasound an tih special scan hmangin nausen thisen chu placenta leh umbilical cord kaltlangin engtin nge a luang tih hriat theih a ni bawk. Hei hian naute hian thisen leh oxygen a dawng tlem em tih hriat nan a pui thei a ni.

Naute hian `IUGR` a nei nia rinhlelhna a awm chuan doctor-te chuan test dang engemaw zat an ti thei ang:

• Naute thinlung thawk leh che vel enfiah (Fetal monitoring): Hei hi ``CTG (Cardiotocography)'' test an ti bawk. Hei hian naute chu a pum chhungah a ti tha em tih leh stress a nei lo em tih a enfiah thin.
• Thisen test a, nu hian naute nghawng thei tur natna a nei em tih finfiah a ni.
• Amniocentesis: Hei hi tih fo a ni lo va, mahse thil bik thenkhatah chuan naute chhehvela amniotic fluid sample tlemte lak a ni a, IUGR awm chhan genetic a awm leh awm loh enfiah a ni. A châng chuan hei hi naute lung a lo than chhoh dan hriat nân pawh hman theih a ni a, a bîk takin naute chu a pian hma tûr a nih chuan.

IUGR hi engtin nge enkawl a nih?

Doctor-te chuan i naute hian `IUGR` a nei tih an hmuchhuak chauh ang tih han ngaihtuah teh. Chuti a nih chuan engtin nge i tih? Hei hi enkawl dan tur chu naupai lai a hlat zawng te, naute dinhmun te, leh `IUGR` lo awm chhan te a innghat a ni.

Doctor-te chuan naute IUGR vei chu naupai chhung zawngin uluk takin an enfiah thin. Ultrasound scan an nei fo (kar khatah vawi khat emaw vawi hnih emaw pawh ni thei), naute than dan an record a, Doppler scan an ti a, CTG test an ti a, harsatna dang an neih leh neih loh an enfiah bawk.

Nu hian IUGR thlentu hriselna lama harsatna a neih chuan doctor-te chuan a natna enkawl danah an pui thei a ni. Entir nan:

• Thisen sang i neih chuan a control theih nan damdawi pek i ni ang.
• Anni chuan ei leh in tha leh tha tak ei turin an fuih che a ni. Protein tamna ei tur, thlai leh thei chi hrang hrang ei turin an ti che a.
• Naupai lai hian a tul ang zat zat i tipung thei a ni.
• Nu thenkhat chu khumah chawlh tir an ni thei bawk a, chu chuan naute hnena thisen kal tamna a puih theih an beisei. Amaherawhchu hei hian mi zawng zawng tan hna a thawk lova, chuvangin i doctor thupek zawm rawh.
• Meizial i zu a nih chuan thurawn kan pe a, chawlhsan turin kan pui bawk.

A then phei chuan doctor te chuan ``Induce labor and delivery early'' tiin an rawt mai thei.He thutlukna hi siam theih a ni a, a bik takin naute thanna chu a tawp vek tawh nia a lan emaw, Doppler scan emaw CTG emaw atanga naute chu nu pum chhunga awm reng chu a hlauhawm tih a lan chuan emaw, nausen pum emaw, umbilical cord emaw-ah harsatna lian tak a awm a nih chuan emaw siam theih a ni. A tlangpuiin kar 37 hnuah naute lung a lo thang tha hle a, chuvangin chutiang hunah chuan naute hrin chu a him zawk mai thei.

A châng chuan naute chu a chak lo lutuk a, vaginal delivery pressure a tuar thei lo a nih chuan doctor chuan C-section tih a rel thei a ni. Heng thutlukna zawng zawng hi nang leh i naute himna ngaihtuah chunga siam a ni.

IUGR vang hian eng harsatna nge awm thei?

`IUGR` vei naute, a bik takin an pian tirh atanga rit lo tak tak (kilogram 2.5 aia tlem) te hian hriselna lama harsatna engemaw zat an neih theihna a sang hle.

• Nau piang hma: `IUGR` nei naute hi a hun hmaa piang theih an ni fo.
• Damdawi ina awm: Nau piang hnuah damdawi inah rei tak awm a ngai mai thei. Neonatal intensive care unit (NICU)-ah pawh enkawlna bik i dawng a ngai thei bawk.
• Thâwk harsa: Thâwk lama harsatna (Respiratory distress syndrome) a awm thei a, a chhan chu lung hi a ṭhang kim loh vang a ni.
• Nau hnute pek harsa: Nau hnute pek harsat hi hnute pek thiam loh vang a ni thei.
• Taksa lumna nghet tak vawn that harsatna (Hypothermia).
• Thisen sugar level hniam (Hypoglycemia).
• Thisena calcium level a tlahniam.
• Polycythemia: Thisen cell a pun zel avangin thisen a thick thin.
• Infection laka invenna a tlahniam.
• Perinatal asphyxia: Pian tirh atanga oxygen tlakchham.
• Neurological problems leh developmental delays: Hun rei tak chhung chu zirlai harsatna ang chi thil awm theihna chance tlemte a awm.

Mahse heng zawng zawng hi IUGR naute zawng zawngah a thleng vek lo. IUGR hian naute chunga hun rei tak a nghawng dan chu a tir atanga IUGR thlentu, IUGR nasat dan leh naute enkawl danah a innghat a ni.

Ka naute hian IUGR a neih chuan eng nge ka tih theih ang?

Doctor-in i naute hian `IUGR` a nei thei tih a sawi chuan hlauthawng suh la, muangchangin awm rawh. A pawimawh ber chu i doctor thupek dik taka zawm a, clinic tin leh test apiangah kal hi a ni. Chumi hnuah chauh chuan doctor chuan i naute hmasawnna leh hriselna dik takin a enfiah thei ang a, a hun takah thutlukna dik a siam thei ang.

Tin, i in enkawl tha a pawimawh hle bawk:

• Ei leh in inthlau tak, ei tur tha tak ei rawh. I doctor-in vitamin leh iron tablets extra a pek chuan dik tak leh a hun takah ei tur a ni.
• Chawlh hahdam tawk la, mu rawh.
• Zu te, ruihhlo te, meizuk te chu pumpelh vek tur a ni. Hengte hi naute tan a pawi hle. Meizial zu mi i nih chuan hei hi chawlhsan hun tha ber a ni.
• Rilru hahdam taka awm tum ang che. Thil tul lo vangin in stress suh. I rilru hriselna pawhin naute a nghawng a ni. I pasal leh chhungte hnen atangin tanpuina la rawh.
• I naute che vel (Fetal kick count) ngaihven rawh. Hemi chungchangah hian i doctor chuan thurawn a pe ang che. I naute chu ni khata vawi engzat nge a che tih en hian i naute chu a dam tha em tih ngaihtuahna engemaw zat i nei thei ang.

Chuvangin, kan sawi tawh chu khaikhawm ila. (In lama hruai tur thuchah)

Okay, chuti a nih chuan vawiin hian `IUGR` chungchang hi kan sawi nasa hle a ni lawm ni? He thu hi in tan a tangkai ngei ka beisei. Hriat reng tur pawimawh tak tak thenkhat chu hetiang hi a ni:

• `IUGR` tih awmzia chu pum chhunga naute chu beisei angin a thang tha lo tihna a ni. Hei hian naute hriselna a nghawng thei a ni.
• Hei hi thil engemaw zat avanga lo awm thei a ni a, chung zingah chuan nausen (placenta) lama harsatna te, nu hriselna dinhmun te, leh naute ngei dinhmun thenkhat te pawh a tel.
• Ultrasound scan hi IUGR hriatchhuah leh enkawl dan ber a ni.
• Enkawlna angin doctor-te chuan naute chu uluk takin an enfiah a, nu hriselna an enfiah a, naute pawh a hrin hma thei bawk.
• I tih theih ṭha ber chu i Doctor thurawn zawm a, hriselna ṭha tih dan phung, rilru lama hlim leh hahdam taka awm hi a ni.
• IUGR hi i sualna a ni lo tih hre reng ang che. Tu chungah pawh a thleng thei. Damdawi lam enkawlna dik leh i inpekna nen hian he dinhmun hi i enkawl thei a, khawvelah naute hrisel tak i rawn hruai thei bawk. Nangmah chauh i ni lo, i doctor, i chhungte leh mi zawng zawng an awmpui che a ni.

` IUGR, naupai, naute than dan, intrauterine growth restriction, placenta, ultrasound, nutrition, nausen than dan, naupai enkawl dan