Stillbirth: I hriat tur chu

Nu emaw pa emaw naupai zawng zawngte duhthusam chu naute hrisel tak khawvela lo hmuak hi a ni. Mahse, ngaihtuah phak loh khawpin a chang chuan naupai lai, a bik takin kar 20 hnuah chuan naute chu pum chhungah a bo thei a ni. He dinhmun lungchhiatthlak tak hi damdawi lama `(Stillbirth)` kan tih hi a ni. Sinhala tawngah chuan hei hi ``stillbirth'' kan ti bawk. Hei hi thinlung ti na tak leh sawifiah theih loh khawpa hrehawm tak a ni tak zet a ni.

`(Stillbirth)` tih hi eng nge ni tak tak?

A awlsam zawngin ``Stillbirth`` tih chu naupai kar 20 hnua nausen pum chhunga thihna a ni. Mi tam tak chuan naute pian laia a lungphu a reh phawt chuan hetiang hi a thleng thei niin an ngai. Mahse a nihna takah chuan naute tam zawk hi nausen pum chhungah an thi thin. Nau neih lai, naute pian hnaih lai hian hetiang hi a thleng tlem hle. A tam zawkah chuan doctor-te chuan he natna hi an hre hmasa thei a, a hun tur hmain a tul angin hma an la thei a ni.

`(Stillbirth)` chu `(Miscarriage)` ang bawkin tuar harsa a ni. Amaherawhchu, `(Miscarriage)` ah chuan naute chu naupai kar 20 hmain a bo thin. `(Stillbirth)` ah chuan kar 20 hnuah a thleng thin. Amaherawhchu, hetiang thil hi a lo thlen chuan lungngaihna tuar chhuak tur leh chuta dam leh tur chuan hun tam tak i mamawh mai thei a, i hmangaih tak takte thlawpna nghet tak chu a pawimawh hle.

`(Stillbirth)` tih chi hrang hrangte chu engte nge ni?

Doctor-te chuan nau piang thi tawhte chu nausen pum chhunga a thih huna naupai kar engzat nge liam tawh tih a zirin an thliar hrang thin.

• Thih hmaa nau piang: Naute hi kar 20 leh kar 27 inkarah a thi.
• Thi piang tlai: Naute hi kar 28 leh kar 36 inkarah a thi.
• Term stillbirth: Naute hi kar 37 hnuah a thi.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Khawvel hmun hrang hrangah nau piang thi zat hi a inang lo hle. Ram changkang zawkah chuan nau piang 1,000-ah nau thi 22 vel an awm \hin. Mahse, ram changkang zawkah chuan he zat hi a tlem zawk hle. Entirnan, United States-ah chuan nau piang 1,000-ah nau thi 6 vel chauh an awm a, United Kingdom-ah chuan nau piang 1,000-ah thi 3.5 vel chauh an awm.

Nau neih hmaa enkawlna a ṭhat chhoh zel avangin khawvel pumah nau piang thi zat a tlahniam a ni. Mahse, mi ṭhenkhatin mi ṭhenkhat aiin nau piang thi an tawh tam zawkna tur hriselna enkawlna lama inthlauhna tihziaawmna turin thil tam tak tih a ngai a ni.

Tute nge `(Stillbirth)` neih theihna chance sang zawk?

Dik tak chuan naupai eng pawhah nau piang thi hi a awm thei a ni. Mahse, i hriselna, i nunphung leh i awmna hmun ang chi thilte hian he hlauhawmna hi a tipung thei a, a ti tlem thei bawk.

• Kum: He hlauhawmna hi nu naupang kum 20 hnuai lam leh nu kum 35 chunglam tan chuan a sang deuh hlek a ni.
• Hriselna dinhmun: 1.1.Damdawi lam harsatna thenkhat, zunthlum, thisen sang, thisen zam natna, thyroid natna, lupus, leh thau lutuk (body mass index (BMI) 30 aia tam) i neih chuan i hlauhawm zawk thei.
• Nature of pregnancy: Twins emaw a aia tam emaw i beisei chuan a hlauhawmna a sang zawk.
• Naupai hmasa atanga harsatna awm: Nau thi tawh i neih tawh chuan, emaw, nau piang hmaa nau neih ang chi harsatna dang i neih chuan nau thi tawh i neih leh theihna a sang deuh hlek a ni.
• Ruihhlo hman: Ruihhlo hman te, zu in te, zu in te hian nau piang thi a thlen thei a ni. Hengte hi hman dun a nih chuan a hlauhawmna a sang hle.
• Stress: Nunna atana harsatna lian tak tak, sum leh pai lama harsatna nasa tak emaw, chhungkaw buaina emaw te hmachhawn hian risk a pung thei bawk.
• Environment leh health care: Nau neih hmaa enkawlna awlsam tak awm lohna ram emaw, environment-a i awm chuan nau piang thi (thirth) hlauhawmna a sang zawk. Socioeconomic factors pawhin hmun a chang ve bawk. Khawvel hmun thenkhatah chuan population thenkhatah chuan nau piang thi chu midang aiin a let hnih zetin an tawng thin. Hei hi hriselna lama harsatna leh inthlauhna a awm vang a ni.

`(Stillbirth)` awm chhante chu engte nge ni?

Lungchhiatthlak takin nau piang thi pathum zinga pakhatah hian naute bo chhan dik tak chu doctor-te chuan an hre thei lo. A chhan chu a buaithlak hle thei. Nu chunga harsatna awm vang te, naute nghawng thei tur harsatna vang te, nu leh naute inzawmna vawng rengtu tissue leh taksa peng hrang hranga harsatna vang te pawh a ni thei.

Infection awm thei te

Ram changkang zawka nau piang thi zinga 50% vel leh ram changkang zawkah chuan 25% vel chu virus, parasite, bacteria, emaw hrik dang (pathogens) avanga natna hrik kai a ni. A châng chuan, heng natna hrik te hian engmah a lan chhuah loh avangin naupai laiin harsatna a thlen hma loh chuan harsatna a awm tih i hre lo mai thei.

Naupai hmaa enkawlna tha tak pek hian natna hrik vanga nau piang thi thei hi a tihziaawm fo thin.

Placenta emaw umbilical cord emaw lama harsatna nei

Placenta hi organ a ni a, i hnen atanga nutrients te chu umbilical cord kaltlangin i naute hnena insem darh tura puitu a ni. Heng nunna kawng hrang hrangah hian harsatna a awm chuan i naute hian a dam khawchhuahna atana a mamawh oxygen, thisen leh ei tur tha te chu a dawng tawh lo thei a ni.

• Placental abruption: Hei hi nausen pum leh nausen inthenna a ni . Nau piang thi zawng zawng zinga 10% leh 20% inkar a ni.
• Umbilical cord knotting tih hi: 1.1.Nausen umbilical cord a inher a, naute hian a mamawh oxygen a hmuh loh chuan ``Stillbirth`` a awm thei. Hei hi ``Stillbirth`` 10% vel a ni.

Naute nghawng thei dinhmun

A châng chuan, naute hian hmasawnna lama harsatna emaw, pianpui chak lohna / piansualna emaw a nei thei bawk. Naute hian genetic condition a nei thei bawk. Genes hi naute taksa thanlen dan leh hnathawh dan tur hrilhtu a ni. Heng instruction-ah hian dik lo a awm chuan naute taksa peng hrang hrangte chu a lo thang lian lo thei a, a thawk tha lo thei bawk. Entirnan, Down syndrome ang chi dinhmun te.

Naute hian hrisel taka a thanlen theih nan a mamawh ei tur a hmu lo mai thei. Hei hi intrauterine growth restriction an ti a . Hei hi thi nau piang chhan tlangpui a ni bawk.

Naupai laia harsatna awm thei

Damdawi lam natna rei tak, zunthlum, lupus, thisen sang, thau lutuk, emaw thisen zam harsatna i neih chuan naupai laiin harsatna i nei tam zawk.

Mahse, chronic condition i neih vang mai mai chuan complication i nei ngei ang tihna a ni lo. Doctor chuan i hriselna enfiah reng chungin i natna khirh tak takte enkawl dan tur leh i hlauhawmna tihziaawmna tur a pui thei che a ni.

Naupai laia harsatna awm thei thenkhat, nau piang thi thei te chu:

• Preeclampsia: Naupai lai a chanve hnihna atanga tan thin thisen sang natna.
• Cholestasis of pregnancy: Thin natna, naupai hnu lama lo awm thin a ni.
• Nau piang hma: Naute hi a pian hma (kar 37 hma) a ni.
• Preterm premature rupture of membranes (PPROM): Naute chhehvela tuiin a khat protective sac a rupture hma.

`(Stillbirth)` natna lan chhuah dan chu engte nge ni?

Vawi tam tak chu nau piang thi tawh hriatrengna awmchhun chu naute chu a hma angin a thawkrim lo tih i inhria a, a nih loh leh a beih tlem zawk tih i inhriat hi a ni. Mi thenkhat chuan pum a na thei a, vaginal bleeding an nei thei bawk.

Pawimawh: Heng symptoms te hian nau piang thi tihna a ni ngai lo. Mahse, heng inthlauhna te hi i hmuh chuan doctor pan nghal tur a ni.

Engtin nge diagnosis hi siam a nih?

Nau piang thi tam zawk hi nau neih hmain an thleng thin. I doctor chuan ultrasound a ti ang a, naute thinlung thawk dan a enfiah ang.

`(Stillbirth)` awm chhan hriat tumin eng test nge tih thin?

Nu leh pa ṭhenkhat tân chuan nau piang thi tawh chhan hriatna chuan hrehawmna chu tuar chhuakin, thutlukna siam tûrin a ṭanpui thei a ni. Tin, hetiang thil hi a thlen dan hriatthiamna hian nakin lawka naupai turah harsatna awm thei tur a ti tlem thei bawk.

I doctor chuan i medical record leh thil thleng chungchanga thil awmdan chu uluk takin a enfiah ang. Naute, umbilical cord emaw placenta emaw pawh an enfiah thei a, a chhan an hre thei bawk.

Heng test-ah hian:

• Infection test: Doctor-te chuan i zun, thisen emaw, i vagina emaw, i serh emaw atanga i cell sample an la ang a, infection a awm leh awm loh an enfiah ang.
• Thisen test: Thisen test hian naupai harsatna nena inzawm condition i nei em tih a hriat theih.
• Genetic test: Doctor chuan umbilical cord atanga sample lak chu a enfiah ang a, naute hian genetic problem a nei em tih a enfiah ang a, chu chu Down syndrome ang chi hi a ni a, chu chuan nau piang thi a thlen thei a ni.
• Autopsy: Autopsy hi surgery tih a ni. Doctor-in naute chu uluk taka enfiahin a thih chhan hriat theihna a siamsak a ni. Hei hian naute taksa peng hrang hrang enfiah turin incision te te siam a huam thei a ni. A tam zawkah chuan he exam neih leh neih loh chungchangah hian thutlukna siam theihna i nei a ni. Autopsy engzat nge tih tur tih pawh i rel thei bawk.

Engtikah nge ka naute hi autopsy tih ka tum ang?

Hei hi thutlukna harsa tak a ni. Nu leh pa thenkhat tan chuan hetiang thil lungchhiatthlak tak a thlen hnua autopsy neih tum hi chu tuar theih loh a ni. Insurance plan zawng zawng hian naute autopsy hi a huam vek lo va, chuvangin a senso pawh hi a pawimawh hle.

Autopsy tih hian a thatna lian ber chu nau thi tawh chhan hmuhchhuah theihna a tipung a ni. Tun hnaia zirchianna atanga a lan dan chuan autopsy hian a chhan hmuhchhuah theihna chance chu 20% atanga 90% aia tam thlengin a tisang thei a ni. He thu hian i doctor chu nakin lawka naupai turah harsatna a thlen loh nan a pui thei a ni.

Mahse, case tin hi a danglam vek a, hei hi mimal thutlukna a ni hle. I doctor nen inbia la, i tana tha ber tur chu i rel ang.

Naute thih hnuah eng nge thleng?

I doctor chuan i naute nau neihna atana him ber tur a rawn rawt ang che. He thil tawn hi naute nung hrin ang maiin a lang ang. I naupai enkawltu team chuan an kaihruai ang che a, natna tihziaawmna tur damdawi an pe ang che.

• Inducing labor: Doctor-te chuan nau piang thi hnua a rang thei ang bera inducing labor tih an rawt a ni. Damdawi lam harsatna i neih chuan nau neih tir hi i hriselna atan a tha ber mai thei. Nau neih atanga ni hnih chhungin nau neih tir turin damdawi pek i ni tlangpui ang.
• Natural birth: Nau neih hmaa rei vak lo nghah i duh chuan chu chu a theih bawk. Naute a chan atanga kar hnih chhungin nau neih hi a pianphungah a intan tlangpui. Mahse, pianphung anga nau neih i thlang a nih chuan autopsy tih hi tlem a harsa zawk thei.
• Cesarean section / C-section hmanga tihdam theih a ni.I hriselna dinhmun a hlauhawm a nih chuan emergency C-section neih a ngai mai thei. Mahse, nau thi tawhah chuan C-section hi a tlem hle.

Nau neih hnuah eng nge thleng?

I naute nena in inpawh tawnna tur chu duhthlan tur i nei a ni. Hetih lai hian hriatna dik leh dik lo leh chhanna a awm lo.

Entirnan, i duh chuan naute chu i kuah thei a. Mementos i dil thei a, chu chu naute sam lock emaw hospital ID tag emaw a ni. Damdawi in tam tak chuan birth certificate an pe chhuak thin. Naute kut leh ke hnuhma pawh a chungah telh turin i dil thei bawk.

I mamawh ang zat hun hmang la, midangte tanpuina dil hreh ngai suh. I hmangaih takte i kianga awm chuan he lungngaihna hi hmachhawn tûr leh i rilru chu kawng dik zawh leh tûrin ṭanpuitu lian tak a ni ang.

Thih nau piang hnuah hnute ka nei dawn em ni?

Nau neih hnu ni engemaw zat chhungin bawnghnute a lut tlangpui. Preeclampsia i neih loh chuan i hnute hnute siam chhuah tihtawp nan dopamine agonists tih damdawi i ei thei a ni. A nih loh leh, i duh chuan, a kalphung chu a pianphung anga a tawp hun chu i nghak thei bawk. I tana tha nia i hriatte chu i doctor nen sawiho rawh.

Nau thi tawh hnua naupai leh theih a ni em?

Ni e, a theih. Mi tam tak chuan naupai pangngai leh naute hrisel tak tak an nei chho ta a ni. Nau piang thi hi pianpui chak lohna emaw, umbilical cord problem vang emaw a nih chuan a dang neih theihna chance tlemte chauh a awm. A chhan chu natna emaw, genetic disorder emaw a nih chuan i naupai leh turah nau thi neih theihna chance 3% chauh a awm.

Thih nau neih hnu eng chen nge naupai leh tur?

Zirchianna thenkhatah chuan nau pai leh tura nau piang hnu kum khat tal nghah thin hmeichhiate chuan an naupai leh hunah lungngaihna leh lungkhamna an nei tlem zawk tih an hmuchhuak. Mahse, tisa leh rilru lama inpeih leh tum leh tura inpeih chu mi tin a inang lo.

I naupai leh tur chungchang chu i doctor nen sawiho rawh.

Thi nau piang hi ven theih a ni em?

A tam zawkah chuan nau thi tawh venna tur engmah tih theih a awm lo. Damdawi lam thil emaw, i thunun theih loh complication emaw avanga lo awm a ni fo. Mahse, naute hrisel tak neih theihna chance tihpun nan hengte hi i ti thei ang:

• Ruihhlo, zuk leh hmuam leh zu in loh: Ruihhlo hman hian nau piang thi neih theihna a tipung mai ni lovin, harsatna dang, fetal alcohol syndrome leh sudden infant death syndrome te pawh a tipung bawk.
• I ei leh in siamrem: Naupai laiin i ei leh in thlak danglam. Nang leh i naute mamawh ei tur pe turin i calorie ei tam la, ei tur tha tak tak ei bawk ang che. Tin, ei leh in atanga natna hlauhawmna kengtu ei tur thenkhat pawh i ei loh tur a ni.
• I taksa rihna hrisel tak vawng reng rawh: Nau i pai hmain i taksa rihna hrisel tak, i duh ang tak neih tum ang che.
• Infection laka invenna: Hei hian faina dan tha (kut sil, ei tur uluk taka siam) zawm te, naupai hma, naupai lai leh naupai hnua vaccine pek tura rawtna lak te a huam a ni.
• Nitin "kick count": Kar 26-28 vel ah chuan i naute che vel chu hre chiang rawh. I naute tana thil pangngai chu zir rawh. I naute chu a che tha lo a nih chuan doctor rawn rawh.
• I hnungzang chungah mu suh, i sir lamah mu rawh: Naupai kar 28 aia upa i nih chuan i hnungzang chunga mut hian nau thi thi neih theihna a tipung thei a ni. Hei hi a chhan dik tak erawh hriat chian a ni lo a, mahse mithiamte chuan naute hnena thisen leh oxygen kal dan nen hian inzawmna a nei niin an ring.
• A tul chuan checkup, ultrasound, leh/ emaw nausen thinlung enfiah fo thin ang che: Damdawi lam enfiah fo hian i naupai lai tichhe thei dinhmun eng pawh chu i doctor-in a hriat theih nan a pui thei a ni. Hei hi naupai laia harsatna i neih theihna tur risk sang tak i nih chuan a pawimawh hle.
• Simptoms report nghal rawh: Naupai laiin symptoms i neih chuan pum na emaw, vaginal bleeding emaw a nih chuan doctor pan nghal tur a ni.

Thi nau piang hnuah engtin nge ka in enkawl ang?

Nau piang thi hnua lungngaihna leh process turin i mamawh ang zat hun hmang rawh . I tana nuam ber nia i hriat angin lungngai rawh. Hei hian he huna ṭanpui duhtu ṭhiante leh chhûngte nêna hriatrengna inkhâwmpui neih a huam thei a ni. A nih loh leh, nangmah chauha i rilru put hmang tihfel nâna hun hman emaw, naupang enkawlna lama ṭanpuina dîl emaw tihna a ni thei bawk.

Counselling leh naupai hloh thlawptu pawlte pawh tun dinhmunah chuan thil hlu tak an ni. Naupai stage eng ang pawhin awm mah la, nu leh pa i la ni reng a ni. I inzawmna (bond) i enkawl chu a tak tak a ni. Depression leh post-traumatic stress disorder (PTSD) neih hi thil awmze nei tak a ni a, chutiang hlohna lian tak hmachhawn tur chuan professional puihna a ngai a ni.

Thi piang chu hlohna rapthlak tak a ni. Chuta tang chuan dam leh turin hun a duh thei. Hetiang hunah hian rilru hah lutuk hi thil pangngai a ni tih hre reng ang che. Hemi kawngah hian support group leh mental health professional te hnen atanga tanpuina dil hi thil dik lo a ni lo.

Nakin lawka nau piang thi tawh i neih theih dan tur i ngaihtuah a nih chuan i naupai enkawltu emaw, maternal-fetal medicine (MFM) specialist emaw hnen atangin thurawn la rawh. I hlauhawmna tehna atan test emaw, genetic counselling emaw neih an rawt thei bawk. Nau pai leh tum tura thutlukna siam hi thil lian tak a ni. Mithiam, thurawn pe thei leh thlawp thei che an awm.

A tawp berah chuan take-home message:

Thi nau neih hi thinlung ti na tak leh thil harsa tak a ni. Hei hi hriat a pawimawh a, a hlauhawmnate hriatthiam a pawimawh a, a tul hunah tanpuina zawng a pawimawh bawk.

• Nangmah chauh i ni lo: Nangmah chauh hian hetiang lungngaihna hi i tawng lo. Hmun hrang hrangah hian thlawpna leh hriatthiamna i hmu thei a ni.
• A chhan hrang hrang a awm a, a chang chuan a chiang lo: Nau piang thi zawng zawng hian chhan chiang tak an nei vek lo. Chumi avang chuan nangmah leh nangmah mawhpuh suh.
• Damdawi lam thurawn zawng rawh: Naupai laia i naute che vel hi fimkhur la, natna lan chhuah dan danglam tak i neih chuan doctor pan nghal rawh.
• Lungngaihna hun pe rawh: Hei hi hneh theih nan hun a ngai dawn a ni. I rilru put hmang chu i hriat theih nan phal la, a tul chuan professional tanpuina zawng rawh.
• Nakin hun chungchangah beiseina nei rawh: Mi tam tak chuan naute thi tawh hnuah naute hrisel tak tak an nei chhunzawm zel a. I hmalam hun atana i ruahmannate chu i doctor nen sawiho rawh.

He thu hian he thupui harsa tak chungchangah hian hriatthiamna engemaw chen i neih theih nan a puih che kan beisei. Chutiang thil tawn i lo tawng tawh a nih chuan chakna i hmuh theih nan kan tawngtai a ni.

` Nau piang thi, Nau piang thi, Naupai, Nausen hloh, Nausen pum chhunga thihna, Naupai harsatna, Nu hriselna