Kodi mwana wanu ali ndi vuto la kukula kwa ubongo? Dziwani zambiri za Holoprosencephaly (HPE)

Mawu sangafotokoze chimwemwe ndi chikondi chomwe timamva tikamaona mwana wakhanda, sichoncho? Koma nthawi zina, makanda athu amatha kubwera m'dziko lino ndi mavuto azaumoyo omwe sitikuyembekezera. Lero, tikambirana za vuto lobadwa nalo lomwe ndi lovuta pang'ono, koma lomwe tiyenera kudziwa.

Kodi Holoprosencephaly (HPE) ndi chiyani?

Mwachidule, Holoprosencephaly, yomwe imadziwikanso kuti HPE, ndi vuto lobadwa nalo lomwe limachitika mwana akadali m'mimba. Ichi ndi vuto lobadwa nalo. Pa vutoli, ubongo wa mwana wosabadwayo sugawikana bwino m'magawo akumanja ndi akumanzere pamene ukukula. Kodi mukudziwa kuti ubongo wathu nthawi zambiri umagawidwa m'magawo awiri akuluakulu, gawo lamanja ndi gawo lakumanzere. Magawo awiriwa amalumikizana wina ndi mnzake ndipo amasinthanitsa chidziwitso kudzera mu mtolo wa ulusi wa mitsempha wotchedwa corpus callosum. Komanso, gawo lililonse la magawowa limagawidwa m'magawo ena, monga gawo lakutsogolo, gawo la parietal, gawo la occipital, ndi gawo la temporal.

Kugawikana kwa ubongo m'zigawo n'kofunika kwambiri. Chifukwa kugawikana kumeneku kumathandiza ubongo kukonza zambiri nthawi imodzi ndikuchita zinthu zosiyanasiyana. Choncho, monga momwe zilili ndi `(HPE)`, ngati kugawikana kumeneku sikuchitika pamene ubongo ukukula bwino, kungayambitse mavuto ambiri okhudzana ndi thupi ndi mitsempha.

Matendawa, otchedwa ‘HPE’, amapezeka msanga kwambiri mwana akamakula. Izi zikutanthauza kuti akhoza kuchitika musanadziwe kuti muli ndi pakati. Pali mitundu yosiyanasiyana ya matenda a holoprosencephaly, ndipo kuopsa kwawo ndi zizindikiro zake zimasiyana. Momwe matendawa amakhudzira mwana aliyense zimathanso kusiyana.

Kodi mitundu ikuluikulu ya holoprosencephaly (HPE) ndi iti?

Pali mitundu itatu ikuluikulu ya holoprosencephaly (HPE). Tiyeni tiiyang'ane motsatira kuyambira yaikulu mpaka yochepa kwambiri:

Alobar holoprosencephaly

Uwu ndi mtundu woopsa kwambiri . Chomwe chimachitika apa ndi chakuti ubongo wa mwana wosabadwayo sugawikana m'magawo awiri. Zotsatira zake, mapangidwe omwe ali pakati pa ubongo ndi nkhope amatayika, ndipo mabowo a ubongo amalumikizana. Pamodzi ndi izi, ziphuphu zazikulu za nkhope zimawonekera. Nthawi zambiri, makanda omwe ali ndi mtundu uwu wa `(HPE)` amabadwa akufa kapena kufa atangobadwa kumene.

Semilobar holoprosencephaly

Mu mtundu uwu, ubongo wa mwana wosabadwayo umagawidwa pang'ono m'magawo awiri okha . Izi zimachitika chifukwa mbali yakumanzere ya ubongo imalumikizidwa ku mbali yakumanja m'malo otchedwa ``frontal lobes`` ndi ``parietal lobes``. Komanso, mzere wolekanitsa pakati pa magawo akumanja ndi akumanzere a ubongo, ``interhemispheric fissure,`` uli kumbuyo kwa ubongo kokha.

Lobar holoprosencephaly

Mu mtundu uwu, ubongo wa mwana wosabadwayo umagawidwa kwambiri m'magawo awiri., koma osalekanitsidwa kwathunthu. Ngakhale kuti pali ma hemispheres awiri (kumanja ndi kumanzere), ma hemispheres a ubongo amalumikizidwa pamodzi mu ``frontal cortex``. Uwu ndi mtundu wovuta kwambiri wa ``(HPE)``.

Mtundu wa Middle Interhemispheric (MIH)

Kuwonjezera pa mitundu itatu ikuluikulu iyi, pali mtundu wina wachinayi wotchedwa Middle Interhemispheric (MIH). Apa ndi pomwe ubongo wa mwana wosabadwayo umalumikizidwa pamodzi pakati.

Kodi kusiyana pakati pa hydranencephaly ndi holoprosencephaly ndi kotani?

Mungasokonezeke ndi mayina awiriwa. Hydranencephaly ndi holoprosencephaly zonse ndi zilema zobadwa nazo zomwe zimakhudza ubongo wa mwana, koma pali kusiyana pakati pa awiriwa.

Hydranencephaly ndi kutayika kwa gawo la ubongo wa mwana wanu. Ili ndi vuto losowa kwambiri lotchedwa hydrocephalus (mutu wamadzi). Makanda omwe ali ndi vutoli nthawi zambiri amakhala ndi mutu wokulirapo.

Komabe, Holoprosencephaly ndi pamene ubongo sugawanika bwino m'magawo a kumanja ndi kumanzere panthawi ya embryonic stage. Kodi mukumvetsa kusiyana kumeneko?

Kodi vutoli limakhudza ndani? Kodi ndi lofala bwanji?

Holoprosencephaly (HPE) ndi matenda omwe amakhudza ana osabadwa omwe akukula m'mimba. Nthawi zambiri amapezeka mkati mwa sabata lachiwiri ndi lachitatu la kukula kwa mwana wosabadwayo. Izi zikutanthauza kuti nthawi zambiri simunadziwe kuti muli ndi pakati.

Ofufuza akuti holoprosencephaly imakhudza pafupifupi mwana m'modzi mwa ana 250 omwe ali ndi mimba kumayambiriro kwa nthawi yobereka (sabata yachiwiri ndi yachitatu ya mimba). Komabe, mimba zambirizi zimatha ndi kutaya mimba kapena kubereka mwana wakufa.

Chifukwa chake, holoprosencephaly ndi vuto losowa kwambiri mwa ana obadwa amoyo, lomwe limapezeka pafupifupi mwana mmodzi mwa ana 16,000 obadwa amoyo.

Kodi zizindikiro za holoprosencephaly (HPE) ndi ziti?

Popeza pali mitundu yosiyanasiyana ya holoprosencephaly (HPE), kuopsa kwake ndi zizindikiro zake zimatha kukhala zosiyanasiyana. Izi zikutanthauza kuti zizindikirozi zimatha kusiyana malinga ndi mwana.

Zizindikiro zodziwika bwino

Zizindikiro zodziwika bwino zokhudzana ndi HPE ndi izi:

• Kuchedwa kwa chitukuko.
• Kulemala kwa nzeru.
• Khunyu ndi khunyu.
• Kukhala ndi mutu waung'ono (microcephaly).
• Kukhala ndi mutu waukulu (macrocephaly).
• Kuchuluka kwa madzi m'thupi (hydrocephalus).
• Zolakwika pankhope .
• Matenda a mano (monga kukhala ndi incisor imodzi yapakati).
• Mlomo wosweka ndi/kapena pakamwa.
• Kuvuta kulamulira kutentha kwa thupi, kugunda kwa mtima, ndi kupuma.
• Kuvutika kudya.

Makhalidwe a Alobar HPE

Uwu ndiye mtundu woopsa kwambiri, kotero zizindikiro zake zimakhala zoopsa kwambiri:

• Kukhala ndi diso limodzi (cyclopia), kukhala ndi maso oyandikana kwambiri (ethmocephaly), kapena kukhala opanda maso konse (anophthalmia).
• Kukhala ndi maso ang'onoang'ono kwambiri (microphthalmia) ndi mphuno yofanana ndi chubu (proboscis).
• Mphuno yathyathyathya yokhala ndi maso otsekeka (orbital hypotelorism) kapena mlomo wosweka womwe umapezeka pakati pa mlomo (median cleft lip) kapena mbali zonse ziwiri (bilateral cleft lip).

Makhalidwe a Semilobar HPE

• Maso okhala pafupi (orbital hypotelorism), maso ang'onoang'ono kwambiri (microphthalmia), kapena diso limodzi kapena angapo (anophthalmia).
• Kupindika kwa mlatho ndi nsonga ya mphuno.
• Mphuno imodzi.
• Mlomo wapakati wosweka kapena mlomo wosweka wa mbali zonse ziwiri.
• Mkamwa wosweka.

Makhalidwe a Lobar HPE

Uwu ndi mtundu wovuta kwambiri, koma zizindikiro zotsatirazi zingawonekere:

• Mlomo wosweka mbali zonse ziwiri.
• Kuyandikira kwa maso.
• Mphuno yathyathyathya kapena yolowa.

Matendawa, otchedwa holoprosencephaly, amathanso kuchitika ngati gawo la matenda osiyanasiyana a majini. Matenda aliwonsewa ali ndi zizindikiro zake zapadera.

Kodi chimayambitsa matenda a holoprosencephaly (HPE) n’chiyani?

Kawirikawiri, ubongo wa mwana wosabadwayo umagawikana m'magawo awiri a ubongo akangoyamba kukula. Holoprosencephaly (HPE) imachitika pamene gawo lakutsogolo la ubongo, prosencephalon, silimagawikana bwino m'magawo a kumanja ndi kumanzere. Izi zikutanthauza kuti, m'malo moti mbali zakumanzere ndi zakumanja za gawo lakutsogolo la ubongo zikhale zosiyana kwathunthu, pali kulumikizana kosayenera pakati pa ziwirizi.

Makamaka, holoprosencephaly ikhoza kuchitika chifukwa cha:

• Kusintha kwa majini kumachitika m'majini osachepera 14 osiyanasiyana .
• Kusakhazikika kwa ma chromosome .
• Matenda ena a majini .

Komabe, nthawi zambiri, madokotala sangapeze chifukwa chenicheni.

Kusintha kwa majini

Kusintha kwa majini ndi kusintha kwa dongosolo la DNA yanu. Dongosololi la DNA limapatsa maselo anu chidziwitso chomwe amafunikira kuti agwire ntchito zawo. Chifukwa chake, ngati gawo la dongosolo la DNA silikwanira kapena lawonongeka, mutha kuwona zizindikiro za vuto la majini.

Mwana akhoza kulandira kusintha kwa majini kuchokera kwa kholo limodzi kapena onse awiri, kutengera momwe kusinthaku kumafalikira. Komabe, kusintha kwina kumachitika mwachisawawa, zomwe zikutanthauza kuti palibe m'banjamo amene ali ndi mbiri ya kusinthaku.

Asayansi agwirizanitsa kusintha kwa majini otsatirawa ndi vuto (HPE):

• `SHH`
• `CHISANU NDI CHIMODZI 3`
• `TGIF1`
• `ZIC2`
• `PTCH1`
• `FOXH1`
• `NODAL`
• `CDON`
• `FGF8`
• `GLI2`

Kusintha kumeneku kumapangitsa majini ndi mapuloteni omwe amapanga kuti asagwire bwino ntchito. Izi ndi zomwe zimakhudza kukula kwa ubongo wa mwana wosabadwayo ndipo zimayambitsa holoprosencephaly.

Kusayenerera kwa chromosome

Tonsefe tili ndi ma chromosome 46 m'maselo athu, okonzedwa m'magulu 23. Ma chromosome amenewa amanyamula DNA yathu. Mwachidule, ali ndi malangizo oti matupi athu akule ndikugwira ntchito. Timapeza seti imodzi ya ma chromosome kuchokera kwa amayi athu ndi seti imodzi kuchokera kwa abambo athu.

Pafupifupi gawo limodzi mwa magawo atatu a ana obadwa ndi holoprosencephaly amakhala ndi vuto la chromosome. Vuto la chromosome lomwe limagwirizana kwambiri ndi HPE ndi kupezeka kwa makope atatu a chromosome 13, omwe amadziwika kuti trisomy 13. Trisomy 18 (makope atatu a chromosome 18) ndi triploidy (kukhalapo kwa ma chromosome 69 mu selo m'malo mwa 46 wamba) kungayambitsenso HPE.

Matenda a majini

Nthawi zina holoprosencephaly imatha kuchitika ngati gawo la matenda ena a majini omwe amayambitsa mavuto ena azachipatala kuphatikiza pa HPE.

Zina mwa matenda a majini okhudzana ndi HPE ndi awa:

• (Hartsfield syndrome)`
• `(Kallman syndrome yachiwiri)`
• `(Steinfeld syndrome)`
• (Matenda a Smith-Lemli-Opitz)`
• `(Stromme syndrome)`

Kodi matenda a holoprosencephaly (HPE) amawapeza bwanji?

Madokotala nthawi zambiri amatha kuzindikira matenda a holoprosencephaly (HPE), makamaka matenda oopsa, mwana asanabadwe, pogwiritsa ntchito ultrasound scan ya prenatal. Matendawa amathanso kupezeka mwana asanabadwe pogwiritsa ntchito fetal MRI (Magnetic Resonance Imaging scan).

Ngakhale kuti mayeso ojambulidwa a mimba asanabadwe amatha kuzindikira HPE, HPE nthawi zambiri imapezeka mwana akabadwa , pamene mavuto a nkhope kapena amitsempha ayamba kuwonekera. Kenako mayeso ojambulidwa a mutu amachitidwa kuti atsimikizire matendawa.

Makanda omwe ali ndi matenda a holoprosencephaly ofooka kwambiri sangadziwike mpaka atakwanitsa chaka chimodzi. Zikatero, kuchedwa kukula kungakhale chizindikiro chakuti pakhoza kukhala vuto ndi dongosolo la mitsempha. Kenako madokotala adzalamula kuti ayesedwe kujambula ubongo.

Mayeso ozindikira matenda

Madokotala amagwiritsa ntchito mayeso otsatirawa kuti adziwe matenda a holoprosencephaly mwana akabadwa:

• Ultrasound ya mutu: Ultrasound (yomwe imatchedwanso sonography) ndi njira yoyesera zithunzi yopanda ululu, yosavulaza yomwe imagwiritsa ntchito mafunde amphamvu kwambiri kuti ipange zithunzi kapena makanema a minofu monga ziwalo zamkati kapena mitsempha yamagazi.
• Kujambula ubongo pogwiritsa ntchito maginito (MRI):Kujambula kwa MRI ndi njira yoyesera yopanda ululu. Imatha kupanga zithunzi zomveka bwino za kapangidwe ndi minofu ya ubongo wa mwana wanu. MRI imagwiritsa ntchito maginito akuluakulu, mafunde a wailesi, ndi kompyuta. Sigwiritsa ntchito X-ray (radiation).
• Kujambula mutu pogwiritsa ntchito kompyuta (CT scan): Kujambula kwa CT ndi njira yoyesera yomwe imagwiritsa ntchito X-ray ndi kompyuta kuti ipange zithunzi zambiri za thupi lomwe likufufuzidwa (pankhaniyi, mutu ndi ubongo wa mwana wanu).

Ngati n'kotheka, madokotala adzachita kafukufuku wa DNA, kuphatikizapo kusanthula kwa chromosome, mayeso a cytogenetic ndi mamolekyu, kuti adziwe chomwe chimayambitsa HPE.

Ngati mayeso a majini akuwonetsa vuto la chromosome kapena majini okhudzana ndi holoprosencephaly, dokotala wanu angakulangizeni kuti mupeze upangiri wa majini ngati mukukonzekera kukhala ndi mwana wina.

Kodi mankhwala a holoprosencephaly (HPE) ndi ati?

Mwatsoka, pakadali pano palibe mankhwala kapena chithandizo chachikulu cha matenda a holoprosencephaly (HPE). M'malo mwake, madokotala amachiritsa mwana aliyense ndi HPE kutengera zizindikiro zake. Izi zikutanthauza kuti njira zochiritsira zimasiyana malinga ndi mwana.

Chithandizochi chingafunike khama logwirizana la gulu la akatswiri osiyanasiyana, kuphatikizapo:

• Madokotala a ana
• Akatswiri a za ubongo
• Akatswiri a Endocrinologists
• Madokotala a opaleshoni ya pulasitiki
• Akatswiri a zamaganizo ndi ntchito
• Gulu losamalira odwala ovutika maganizo
• Gulu losamalira odwala ovuta

Anthu ngati amenewo akhoza kuphatikizidwa.

Mankhwala ofala

Nazi zina mwa njira zochiritsira za HPE zomwe zimagwiritsidwa ntchito kwambiri:

• Mankhwala oletsa khunyu kuti apewe, achepetse, kapena athetse khunyu.
• Ngati mwana wanu ali ndi hydrocephalus, akhoza kuchiritsidwa ndi ventriculoperitoneal (VP) shunt.
• Mankhwala ndi chithandizo chamankhwala cha ntchito ndi physiotherapy zingathandize ndi matenda oyenda monga kuuma kwa minofu (spasticity) ndi kuyenda kosafunikira (dystonia).
• Opaleshoni yokonzanso milomo ndi pakamwa kapena nkhope zina.
• Mankhwala ochizira kusalinganika kwa mahomoni mu pituitary gland.
• Kuchitapo kanthu kuti ana omwe ali ndi vuto la kudya azidya zakudya zabwino. Mwachitsanzo, kudyetsa m'mimba kudzera mu chubu (chubu cha gastrostomy - G-tube).

Zonsezi zimachitika kuti mwanayo akhale ndi moyo wabwino kwambiri.

Kodi holoprosencephaly (HPE) ingapewedwe?

Mwatsoka, holoprosencephaly (HPE) imachitikaMilandu yambiri singathe kupewedwa. Izi zili choncho chifukwa nthawi zambiri imayamba chifukwa cha mavuto a majini "obisika". Ngati mukukonzekera kukhala ndi mwana, ndi bwino kulankhula ndi dokotala wanu za kuyezetsa majini kuti mumvetse chiopsezo cha mwana wanu chokhala ndi vuto la majini kapena kusintha kwa majini monga HPE.

Komabe, asayansi apeza zinthu zina zomwe zingawonjezere mwayi woti mwana wosabadwayo adzakhale ndi matenda a holoprosencephaly. Izi zikuphatikizapo:

• Kukhala ndi matenda a shuga: Ngati munali ndi matenda a shuga amtundu woyamba kapena wachiwiri musanakhale ndi pakati, mungakhale pachiwopsezo chachikulu chokhala ndi mwana wokhala ndi HPE. Izi siziyenera kusokonezedwa ndi matenda a shuga a mimba, omwe amapezeka panthawi ya mimba.
• Kusowa kwa folate (folic acid): Folate, mtundu wachilengedwe wa vitamini B9, ndi wofunikira kwambiri pakukula bwino kwa mwana wosabadwayo, makamaka ubongo ndi msana. Kusowa kwa folate musanayambe komanso panthawi ya mimba kungapangitse kuti pakhale chiopsezo chokhala ndi mwana ndi HPE.
• Kukumana ndi ma teratogens: Ma Teratogens ndi zinthu kapena zinthu zomwe zimayambitsa mavuto pakukula kwa mwana wosabadwayo ndipo zimayambitsa zilema zobadwa nazo. Kukumana ndi ma teratogens, monga ethanol (mowa), retinoic acid, ndi mycotoxins (poizoni wa nkhungu) kuchokera ku chakudya, kungapangitse kuti pakhale chiopsezo chokhala ndi mwana wokhala ndi holoprosencephaly.

Choncho, ndikofunikira kwambiri kutsatira moyo wathanzi, kudya zakudya zoyenera, komanso kutsatira malangizo a dokotala panthawi ya mimba komanso musanayambe kutenga pakati.

Kodi chiyembekezo cha matenda a holoprosencephaly (HPE) ndi chiyani?

Chiyembekezo, kapena kuti chiyembekezo, cha matenda a holoprosencephaly (HPE) chimasiyana malinga ndi kuopsa kwa matendawa komanso chifukwa chake.

Chiyembekezo cha HPE yapakati mpaka yoopsa nthawi zambiri chimakhala choipa. Ana ochepa kwambiri omwe ali ndi HPE yapakati mpaka yoopsa amakhalabe ndi moyo mpaka atakula. Ana omwe ali ndi HPE yocheperako mpaka yocheperako nthawi zambiri amakhala ndi moyo mpaka atakula, koma nthawi zambiri amakhala ndi mavuto azachipatala okhudzana ndi HPE.

Ana ambiri omwe ali ndi matenda a holoprosencephaly amafunika mankhwala ndi chithandizo cha tsiku ndi tsiku kuti apewe khunyu komanso kuchiza mavuto ena.

Chiyembekezo cha moyo

Moyo wa munthu amene ali ndi holoprosencephaly (HPE) umadalira mtundu wa HPE womwe ali nawo komanso chifukwa chake matendawa.

Makanda omwe ali ndi Alobar HPE (mtundu woopsa kwambiri) nthawi zambiri amamwalira atangobadwa kumene kapena mkati mwa miyezi isanu ndi umodzi yoyambirira ya moyo.

Ana opitilira 50% omwe ali ndi semilobar kapena lobar HPE, komanso opanda matenda ena a ziwalo, amakhala ndi moyo kwa miyezi yosachepera 12.

Ana omwe ali ndi matenda a HPE ochepa nthawi zambiri amakhalabe ndi moyo mpaka atakula.

Ngati mwana wanga ali ndi holoprosencephaly (HPE), kodi ndiyenera kuyembekezera chiyani?

Izi ndizofunikira kwambiri. Kumbukirani kuti palibe ana awiri omwe ali ndi holoprosencephaly (HPE) omwe amakhudzidwa mofanana. Palibe njira yodziwira motsimikiza momwe mwana wanu adzakhudzidwira. Chinthu chabwino kwambiri chomwe mungachite pokonzekera tsogolo ndikulankhula ndi akatswiri omwe amafufuza ndi kuchiza holoprosencephaly. Angakupatseni zambiri zokhudza izi.

Kodi ndingasamalire bwanji mwana wanga yemwe ali ndi holoprosencephaly (HPE)?

Kuti muthandize kusamalira mwana wanu amene ali ndi matenda a holoprosencephaly (HPE), tsatirani malangizo awa ochokera kwa madokotala awo:

• Perekani mankhwala aliwonse omwe mwapatsidwa monga mwalangizidwira.
• Pitani ku kuwunika chitukuko ndi njira zochizira.
• Onetsetsani kuti mwapita kukaonana ndi dokotala nthawi zonse.

Holoprosencephaly ingayambitse mavuto a ubongo, mitsempha, ndi/kapena kuyenda kwa thupi. Ana ambiri omwe ali ndi HPE ali ndi mavuto a kukula ndipo angafunike thandizo pa zochita zawo za tsiku ndi tsiku m'miyoyo yawo yonse.

Gulu lachipatala la mwana wanu likhoza kuyankha mafunso anu ndikukupatsani chithandizo. Angakutsogolereninso ku magulu othandizira mdera lanu kapena pa intaneti. Kumbukirani kuti simuli nokha.

Kodi ndiyenera kupita liti kwa dokotala wa mwana wanga?

Ngati mwana wanu wapezeka ndi matenda a holoprosencephaly (HPE), ayenera kupita ku gulu lake lachipatala nthawi zonse kuti atsimikizire kuti chithandizo chake chikugwira ntchito bwino komanso kuti awone momwe akukulira.

Kudziwa kuti mwana wanu ali ndi holoprosencephaly kungakhale kovuta. Koma dziwani kuti simuli nokha. Pali zinthu zambiri zomwe zingakuthandizeni inu ndi banja lanu. Ndikofunikira kulankhula ndi dokotala wodziwa bwino za vutoli. Izi zikuthandizani kudziwa zambiri za momwe mwana wanu adzakhudzidwire komanso momwe mungakonzekerere.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Holoprosencephaly (HPE) ndi vuto lovuta kubadwa nalo lomwe limachitika pamene ubongo wa mwana sugawanika bwino m'zigawo ziwiri m'mimba.

• Pali mitundu yosiyanasiyana ya kuopsa kwa matendawa , kotero zizindikiro zimasiyana malinga ndi mwana.
• Nthawi zambiri zimayambitsa majini ndi zolakwika za chromosome zimakhalapo, koma nthawi zina chifukwa chake sichingapezeke.
• Ngakhale kuti imatha kuzindikirika munthu asanabadwe pogwiritsa ntchito ultrasound kapena MRI, nthawi zambiri imapezeka munthu akangobadwa.
• Palibe mankhwala enieni , koma pali njira zosiyanasiyana zochepetsera zizindikiro ndikuthandizira mwanayo.
• Malingaliro amasiyana malinga ndi kuopsa kwa vutoli. Nthawi zina, ana amatha kupulumuka mpaka atakula.
• Ngati muli ndi pakati kapena mukukonzekera kutenga pakati, samalani ndi zinthu monga kuchepetsa matenda anu a shuga ndi kumwa folic acid.
• Simuli nokha mu mkhalidwe uwu. Mutha kupeza thandizo kuchokera kwa madokotala, alangizi, ndi magulu othandizira. Chidziwitso cholondola ndi chithandizo ndizofunikira kwambiri.

Holoprosencephaly , HPE, matenda a ubongo, zilema zobadwa nazo, kukula kwa mwana wosabadwayo, matenda a majini, zolakwika za chromosome, thanzi la mimba, thanzi la mwana