Uhlobo lwegazi lomntwana wakho ongekazalwa aluhambelani nolwakho? (I-Erythroblastosis Fetalis) Masifumanise ukuba yintoni kanye kanye le!

Ukuba ungumama ozayo, kusenokwenzeka ukuba woyika kancinci xa usiva amagama athi 'Erythroblastosis Fetalis'. Okanye mhlawumbi ugqirha wakho ukukhankanyile kudala xa wayethetha ngohlobo lwegazi lakho. Kunokuba yinto eyoyikisayo ukuva eli gama. Kodwa ungakhathazeki, namhlanje siza kuthetha ngalo ngendlela elula onokuyiqonda. Makhe sibone ukuba yintoni, kutheni isenzeka, kwaye singazikhusela njani kule meko.

Yintoni 'i-Erythroblastosis Fetalis'?

Ngamafutshane, oku kunqabile, oko kuthetha ukuba ayinguye wonke umntu okuqondayo, ingxaki enokwenzeka ngexesha lokukhulelwa. Oku kwenzeka ukuba kukho ukungangqinelani kohlobo lwegazi phakathi kwakho nosana lwakho olungekazalwa. Ayizizo zonke iintlobo zomahluko obangela iingxaki. Nangona kunjalo, lo mngcipheko uphezulu ngakumbi ukuba uhlobo lwegazi lakho 'lune-Rh-negative' kwaye uhlobo lwegazi lomntwana wakho 'lune-Rh-positive'.

Khawucinge nje, ukuba wawuchatshazelwe leli gazi le-Rh-positive, nokuba ngexesha lokukhulelwa kwangaphambili okanye ngexesha lokufakwa igazi, inkqubo yomzimba wakho yokuzikhusela (inkqubo esikhusela kwizifo) inokuqalisa ukuhlasela iiseli ezibomvu zegazi lomntwana. Njengokuhlasela utshaba. Oku kunokubangela ukuba iiseli ezibomvu zegazi lomntwana zibe sezantsi ngendlela eyingozi. Oku sikubiza ngokuba yi-anemia. Ukuba le anemia iba nkulu, inokuba yingozi kumntwana ukuba ayinyangwa.

Kodwa kukho iindaba ezimnandi! Kule mihla, uvavanyo oluqhelekileyo kwasekuqaleni kokukhulelwa lunokuchonga uhlobo lwegazi lakho. Ukuba awunayo i-Rh, oogqirha banokukunika amayeza okuthintela le ngxaki.

Le meko ikwabizwa ngokuba yi-`(alloimmune hemolytic disease of the newborn - HDN)` kunye ne-`(hemolytic disease of the fetus and the newborn - HFDN)`. Kodwa xa sithetha ngayo, siza kusebenzisa igama elithi `(Erythroblastosis Fetalis)`.

Zithini iimpawu ukuba umntwana unale meko?

Iintsana ezizelwe nale meko (i-Erythroblastosis Fetalis) zinokubonisa iimpawu ze-anemia. Ezinye iintsana zinokuba nayo kancinci, ngelixa ezinye zinokuba nayo kakhulu. Kwakhona, umntwana unokuba ne-jaundice kwiiyure ezingama-24 emva kokuzalwa. Nazi ezinye zeempawu:

• Ukutyheli kwamehlo nolusu.
• Ukuphaphatheka ngequbuliso kwesikhumba.
• Usana luziva ludiniwe kakhulu kwaye lungenabomi (ludiniwe).
• Intliziyo ibetha ngokukhawuleza (i-tachycardia).
• Ukungathandi ubisi.

Kwezinye iimeko ezinzima, umntwana ongekazalwa okanye osandul’ ukuzalwa unokuba nesifo esisongela ubomi esibizwa ngokuba yi-"hydrops fetalis." Iimpawu zaso ziquka:

• Ukudumba komzimba.
• Ukuqokelelana kolwelo esiswini somntwana, okanye phakathi kwamalungu abalulekileyo afana nentliziyo nemiphunga.

Kutheni oku kusenzeka? Zithini izizathu?

Le meko, ebizwa ngokuba yi-"Erythroblastosis Fetalis", yenzeka kuba, njengoko bekutshiwo ngaphambili, amajoni omzimba wakho ahlasela iiseli zegazi ezibomvu zomntwana.

Iiseli zethu ezibomvu zegazi zineempawu ezikhethekileyo kuzo. Sizibiza ngokuba "zii-antigens." Cinga ngezi "antigens" njengeelebheli ezinamagama kuzo. Ukuba inkqubo yakho yomzimba yokuzikhusela iyayiqonda le lebheli, ayizukuhlasela ezo seli zibomvu zegazi.

Oku kungenxa yomahluko kwiindidi zegazi lakho nelomntwana wakho. Iindidi zegazi zahlulwe ngokusekelwe kwi-"antigens" ezikumphezulu weeseli ezibomvu zegazi. Kukho iintlobo ezimbini eziphambili zegazi esithetha ngazo:

• I-Rh factor: Oku kuthetha ukuba igazi lilungile (+) okanye alilunganga (-).
• Ii-antigen ze-ABO: Oku kuthetha uhlobo lwegazi lwe-A, B, AB, okanye O.

Ukuba ukhulelwe, inkqubo yakho yomzimba yokuzikhusela, ukuba ayiziboni ii-"antigens" kwiiseli ezibomvu zegazi lomntwana wakho, iya kuqala ukwenza ii-"antibodies" ezichasene nazo. Ezi "antibodies" zezona zihlasela ezo seli zibomvu zegazi. Njengaxa umzimba wethu ufumana intsholongwane ebangela ukugula, umzimba wethu uyayilwa nayo. Kodwa ukuze oku kwenzeke, igazi lomntwana kufuneka lidibane negazi lakho. Uninzi lwexesha, oku kwenzeka xa umntwana eza kuzalwa. Nangona kunjalo, ngamanye amaxesha igazi linokuxubana nalo ngaphambi kokuba lizalwe. Umzekelo:

• Ukuba isisu siphumile.
• Ukuba ukukhulelwa kuphele phakathi, kubizwa ngokuba yi-"Miscarriage".
• Kwimeko efana nokukhulelwa okungaphandle kwesibeleko (ukukhulelwa kungaphandle kwesibeleko, njengakwityhubhu ye-fallopian).
• Xa kwenziwa ``(Amniocentesis)`` (uvavanyo olwenziwe ngexesha lokukhulelwa).
• Xa usenza `(Chorionic villus sampling)` (olunye uvavanyo lokukhulelwa).

Wakuba umzimba wakho uvelise ezi `(antibodies)`, uyakhumbula. Ukuba iiseli ezibomvu zegazi zomntwana zinezo `(antigen)` kwakhona ngexesha lokukhulelwa okulandelayo, ezi `(antibodies)` ziya kuhamba zize zitshabalalise ezo seli. Oku sikubiza ngokuba kukutshatyalaliswa kweeseli ezibomvu zegazi `(hemolysis)`.

Isizathu esiphambili: Ukungahambelani kwe-Rh

Eyona nto imbi neyaziwayo yale meko kukuba xa ungenayo i-Rh kwaye umntwana wakho ene-Rh. Xa oku kusenzeka, amajoni akho omzimba ahlasela iiseli zegazi ezibomvu ze-Rh zomntwana wakho. Kwilizwe elifana neMelika, malunga ne-15% yabantu banegazi le-Rh-negative. Kwiimeko ezininzi, umama notata, kunye nomntwana, bane-Rh-positive.

Ngokwesiqhelo, oku kungahambelani kwe-Rh akubangeli ngxaki zinkulu ngexesha lokukhulelwa kokuqala. Nokuba ungenayo i-Rh kwaye umntwana une-Rh-positive, kunqabile ukuba igazi lakho lixubane negazi lomntwana ngexesha lokukhulelwa ukuze kubangele impendulo enzulu (ii-antibodies). Nangona kunjalo, xa umntwana ezelwe, igazi lakho ngokuqinisekileyo liya kusabela negazi lomntwana. Ngelo xesha, ukuba awuzange uthathe amayeza okuthintela inkqubo yakho yokuzikhusela ekuyihlaseleni, umzimba wakho unokuvelisa ii-antibodies ezichasene neeseli ezibomvu zegazi ezine-Rh-positive.

Ukuba uphinda ukhulelwe, kwaye loo mntwana naye une-Rh-positive blood type, ezo antibodies ezenziwe ngaphambili ziya kuhlasela iiseli zegazi ezibomvu zomntwana. Uyaqonda?

Ezinye izinto ezingaqhelekanga ezingahambelaniyo nohlobo lwegazi

Ngamanye amaxesha, inkqubo yakho yomzimba yokuzikhusela inokuhlasela iiseli ezibomvu zegazi lomntwana wakho nangona kukho ukungangqinelani ne-antigen engaqhelekanga yeseli ebomvu yegazi. Oku kwenzeka ukuba umntwana wakho une-antigen engaqhelekanga uze uyilahle. Oku kwenzeka ukuba ukhe wadibana ne-antigen ngexesha lokukhulelwa kwangaphambili okanye utofelo-gazi kwaye uvelise ii-antibodies kuyo. Ezinye zezi antigen zezi:

• `(Colton)`
• `(Duffy)`
• `(Diego)`
• `(Ee)`
• `(Gerbich)`
• `(H)`
• `(Kell)`
• `(Kidd)`
• `(AmaLuthere)`
• `(MNS)`
• `(P)`
• `(Xg)`

Uvavanyo lwegazi olwenziwe kwasekuqaleni kokukhulelwa lunokufumanisa ukuba wenza ii-antibodies ezichasene nezi ntlobo zinqabileyo zeeseli ezibomvu zegazi.

Ixhaphake kangakanani le meko?

Ehlabathini lonke, malunga nama-276 kwi-100,000 abantwana abazalwa bephila kuthiwa baneengxaki zokukhulelwa ezinxulumene nokungahambelani kohlobo lwegazi le-Rh. Ngokutsho kwabaphandi, ukuba akukho unyango, kukho amathuba angama-50% okuba umntwana ongakazalwa asweleke okanye abe neengxaki zempilo ezinzulu.

Kodwa ungakhathazeki! Ngovavanyo lohlobo lwegazi kunye namayeza afunekayo, iziphumo ezimbi kakhulu zinokuthintelwa. Kwezinye iindawo zehlabathi apho kukho unyango lwangaphambi kokukhulelwa, malunga ne-2.5 kuphela kwi-100,000 yokuzalwa eneengxaki ngenxa yokungahambelani kwe-Rh. Le yingxaki enkulu eSri Lanka.

Uyifumana njani le nto?

Ngokwesiqhelo, kwiikliniki zangaphambi kokubeleka, uhlobo lwegazi lakho kunye nazo naziphi na "ii-antibodies" ziyahlolwa. Ukuba ukhulelwe kwaye une-Rh-negative blood type, ugqirha wakho uya kujonga "ii-antibodies" ngokuchasene negazi le-Rh-positive. Ukuba awunazo ezo "antibodies", inkqubo yakho yomzimba iya kunikwa amayeza okuzithintela ukuba zingabikho.

Ukuba uvavanyo luqinisekisa ukuba unazo ezi antibodies, oko kuthetha ukuba ukuba umntwana une-Rh-positive, inkqubo yakho yomzimba yokuzikhusela isengozini yokuhlasela iiseli ezibomvu zegazi lomntwana. Ugqirha wakho uya kujonga amanqanaba akho e-antibody rhoqo emva kweeveki ezimbalwa. Ukuba amanqanaba akho e-antibody aphezulu ngendlela eyingozi, kunokwenziwa uvavanyo olongezelelweyo ukuze kubonwe ukuba umntwana wakho une-anemia na, kwaye unokufuna utofelo-gazi esibelekweni. Ukuba umntwana wakho usemngciphekweni wokuzalwa ene-anemia enzima, ugqirha wakho unokugqiba ekubeni abelethe umntwana kwangethuba.

Emva kokuba umntwana ezelwe, ugqirha unokufumanisa uhlobo lwegazi lomntwana. Oku kunokunceda ekufumaniseni ukuba i-anemia yomntwana ibangelwa kukungahambelani kohlobo lwegazi.

Ezinye iimvavanyo ezenziweyo zezi:

• Ubalo lweGazi olupheleleyo (CBC): Olu vavanyo lunokujonga ukuba iiseli ezibomvu zegazi zomntwana ziphantsi kangakanani na. Okukhona inqanaba liphantsi, kokukhona i-anemia iba mandundu.
• I-Peripheral Blood Smear (PBS): Oku kuquka ukuphonononga isampuli yegazi phantsi kwe-microscope. Oku kunokunika umbono wokuba ukwehla kungenxa yokutshatyalaliswa kwangaphambi kwexesha kweeseli ezibomvu zegazi (i-hemolysis).
• Uvavanyo lweBilirubin:Oku kulinganisa amanqanaba e-bilirubin. I-Bilirubin yimveliso ebangelwa kukuqhekeka kweeseli ezibomvu zegazi. Amanqanaba aphezulu e-bilirubin (hyperbilirubinemia) anokubonisa ukuba iiseli ezibomvu zegazi ziyatshatyalaliswa.
• Uvavanyo lwe-Antiglobulin oluQondisiweyo (DAT): Olu vavanyo lubonisa ukuba kukho ii-antibodies kumphezulu weeseli ezibomvu zegazi lomntwana. Oku kuthetha ukuba inkqubo yomzimba kamama ihlasela iiseli zomntwana.

Zithini iindlela zonyango?

Unyango luxhomekeke ekubeni ukhulelwe okanye usandul’ ukuzala umntwana.

Unyango ngexesha lokukhulelwa

Ukuba une-antibodies ezikubeka emngciphekweni we-Erythroblastosis Fetalis, ugqirha wakho uya kujonga amanqanaba akho e-antibody rhoqo emva kweeveki ezimbalwa. Ukuba amanqanaba akho e-antibody aphezulu, kunokufuneka wenze ezinye ii-ultrasound scans ukuze ubone ukuba umntwana wakho akanayo i-anemia. Ukuba i-anemia imbi kakhulu, umntwana wakho unokufuna utofelo-gazi.

Unyango emva kokuba umntwana ezelwe

Oogqirha banyanga iintsana ezisandul’ ukuzalwa ezine-"Erythroblastosis Fetalis" ngokunyanga i-anemia kunye ne-"hyperbilirubinemia" (i-jaundice). Iindlela zonyango zezi:

• I-Phototherapy: Oku kusebenzisa ukukhanya ukunyanga i-hyperbilirubinemia. Oku kukhanya kuguqula i-bilirubin ibe zizinto ezikhutshwa lula emzimbeni womntwana.
• Utofelo-gazi: Emva kokuba umntwana ezelwe, umntwana usenokufuna utofelo-gazi ukuqinisekisa ukuba uneeseli ezibomvu zegazi ezaneleyo.
• Ii-Erythropoiesis Stimulating Agents (ESA): Ezi zinokuba lukhetho lokunyanga i-anemia enganzima ngokwaneleyo ukuba ifune utofelo-gazi. Zisenokufuneka zinikwe kunye nezongezo zesinyithi ukunceda umntwana enze iiseli zegazi ezibomvu ezisempilweni.

Kwiimeko ezinzima kakhulu, umntwana usenokufuna uncedo oluxhaswayo, olufana nomatshini womoya kunye nolwelo lwe-IV.

Kwenzeka ntoni kumntwana emva kwale meko?

Iziphumo zixhomekeke ekubeni iimpawu zomntwana wakho zinzima kangakanani na. I-anemia enzima kunye ne-hyperbilirubinemia zinokubulala ukuba azinyangwa.

Nangona kunjalo, iintsana ezine-Erythroblastosis Fetalis zinokusinda kule meko ukuba zinyangwa ngokufanelekileyo. Zisenokufuna utofelo-gazi ukuze zizalise iiseli zazo ezibomvu zegazi ngexesha lokukhulelwa kunye/okanye emva kokuzalwa. Ugqirha kuya kufuneka azijonge kangangeenyanga eziliqela ukuqinisekisa ukuba akukho ngxaki.

Ngaba oku akunakuthintelwa?

Ngokuqinisekileyo kunokwenzeka! I-Erythroblastosis I-Fetalis inokuthintelwa kakhulu ngovavanyo lohlobo lwegazi kunye namayeza okuthintela ngexesha lokukhulelwa.Imeko. Ukuba awunayo i-Rh-negative, ungathatha i-Rh immune globulin (i-Rh immune globulin - i-RhIg okanye i-RhoGAM®) ukuthintela umzimba wakho ekwenzeni ii-antibodies ezichasene negazi le-Rh-positive. Kufuneka uthathe eli yeza kwiiveki ezingama-28 zokukhulelwa, zingadlulanga iiyure ezingama-72 zokuphela kokukhulelwa (emva kokubeleka, ukuphuphuma kwesisu), kwaye ukuba uphuma igazi elininzi ngexesha lokukhulelwa (nakwi-trimester yokuqala).

Oku kusebenza kuphela ukuba uthatha eli yeza ngaphambi kokuba igazi lakho livezwe egazini le-Rh. Yiyo loo nto lijongwa ngakumbi kwiikliniki zokukhulelwa.

Izinto onokuzibuza ugqirha wakho

Ukuba uneminye imibuzo malunga noku, ungoyiki ukubuza ugqirha wakho okanye umongikazi. Nazi ezinye zemizekelo:

• Luluphi uhlobo lwegazi lam?
• Ngaba kukho naziphi na "ii-antibodies" endifanele ndizixhalabise ngazo?
• Ngaba kufuneka ndikhathazeke nge-`(Erythroblastosis Fetalis)`?
• Ngaba ndiza kufuna ukubekwa esweni okongezelelweyo okanye ukutyelela rhoqo ekliniki?
• Ngaba kuya kufuneka ndithathe i-Rh immune globulin (RhIg)?
• Ndingenza nini idinga okanye ndifune unyango olungxamisekileyo?

Kwenzeka ntoni ukuba umama une-Rh-positive kwaye umntwana akanayo i-Rh-negative?

Oku akuqhelekanga ukuba kuxhalatyelwe ukungahambelani kohlobo lwegazi. Imveku engena-Rh ayinayo i-Rh-antigen enokuhlaselwa yinkqubo yomzimba kamama. Ngaphandle kokuba kukho ezinye izinto ezingaqhelekanga ezingahambelaniyo nohlobo lwegazi, oku akufanele kube yingxaki.

Ezona zinto zibalulekileyo ekufuneka uzikhumbule

Ingcinga yokuba inkqubo yakho yomzimba yokuzikhusela inokuhlasela usana lwakho olungekazalwa iyoyikisa. Kodwa iindaba ezimnandi zezokuba oku kungangqinelani kwegazi okuyingozi akuqhelekanga. Kwaye, oogqirha benza konke okusemandleni abo ukuthintela ezi ngxaki ukuba zenzeke. Uvavanyo lohlobo lwegazi luyinxalenye ebalulekileyo yokhathalelo lwangaphambi kokukhulelwa. Kwakhona, ukujonga nokunyanga ukungangqinelani kohlobo lwegazi okunokuba yingozi kumntwana wakho yinxalenye eqhelekileyo yokhathalelo lwangaphambi kokukhulelwa. Ugqirha wakho uya kuba nawe kuyo yonke inyathelo lendlela ukugcina wena nomntwana wakho nikhuselekile. Ngoko ke, musani ukoyika ngokungeyomfuneko, kwaye nilandele imiyalelo kagqirha ngononophelo. Emva koko wena nomntwana wakho ninokuhlala niphilile!

I- Erythroblastosis I-Fetalis, ukungangqinelani kwe-Rh, iingxaki zokukhulelwa, uhlobo lwegazi lomntwana, uhlobo lwegazi likamama, i-anemia, i-jaundice, i-RhoGAM