Ingaba umntwana wakho ukhathazekile esibelekweni? Makhe sithethe nge-"Fetal Distress" namhlanje!

Oomama abaninzi bayoyika ukuba kuza kwenzeka into ethile kumntwana wabo ongekazalwa. Ngamanye amaxesha, umntwana usenokungakhululeki xa umntwana esondela okanye ngexesha lokubeleka. Ngamaxesha anjalo, umntwana unokubonisa iimpawu zokuba 'ukwingxaki'. Namhlanje siza kuthetha ngale meko ibizwa ngokuba yi-'(Fetal Distress)'. Musa ukoyika, eyona nto ibalulekileyo kukwazi oku.

Yintoni `(Ingxaki Yomntwana Ongekazalwa)`? Ingaba iyafana `(Isimo Somntwana Ongekazalwa - NRFS)`?

Ngamafutshane, `(Ingxaki Yomntwana Ongekazalwa)` luphawu olubonisa ukuba umntwana wakho unengxaki ethile ngexesha lokugqibela lokukhulelwa kwakho, okanye ngexesha lokuzalwa komntwana wakho (oko kukuthi `ukuzala`). Kodwa into ekufuneka uyazi kukuba ngoku, endaweni yokuthi `(Ingxaki Yomntwana Ongekazalwa)`, oogqirha badla ngokusebenzisa igama elithi `(Isimo Somntwana Ongekaqinisekisi)`, okanye `(NRFS)` ngamafutshane. Zombini ezi zinto zibhekisa kwimeko efanayo. Ngoko ke, ungothuki xa usiva loo magama mabini, akunjalo?

Cinga ngayo, zininzi izizathu zokuba umntwana wakho abe nolu hlobo lokungakhululeki. Isenokuba yindlela umntwana azalwa ngayo, indlela asabela ngayo kumayeza athile owasebenzisayo, iingxaki ngentambo yosana, okanye kwaneengxaki ze-placenta.

Le meko inokuba yoyikisa kancinci , kuba inokubangela iingxaki kuwe nakumntwana wakho. Yiyo loo nto ugqirha wakho wokubelekisa eza kukujonga ezi mpawu ngexesha lokukhulelwa kwakho, ngalo lonke ixesha undwendwela ikliniki.

Ziziphi iimpawu zokuba umntwana unengxaki?

Ngoku makhe sijonge iimpawu eziphambili ezibonisa ukuba umntwana usengxakini. Nazi izinto oogqirha abazinika ingqalelo kakhulu:

• Utshintsho kwisantya sentliziyo yomntwana: Oku kuthetha ukuba isantya sentliziyo yomntwana sinokuba phantsi okanye siphezulu kunesiqhelo. Oogqirha bakubiza oku ngokuthi "isantya sentliziyo yomntwana ongekazalwa". Olu luphawu oluphambili nolokuqala ekufuneka lujongwe.
• Ukuncipha kweentshukumo zomntwana: Ngaba ukhe waziva umntwana wakho eshukuma okanye ekhaba esibelekweni? Ukuba ezo ntshukumo ziyancipha kakhulu kwixesha elide, oko kuthetha ukuba uziva umntwana wakho eshukuma kancinci kakhulu ngemini, loo nto nayo yinto ekufuneka uyiqwalasele.
• Ulwelo oluphantsi lwe-amniotic: Umntwana ujikelezwe lulwelo olubizwa ngokuba yi-amniotic fluid. Ubungakanani obuphantsi bolu lwelo lunokuba luphawu lokuba umntwana uneengxaki. Oogqirha bakwabiza oku ngokuthi ``Oligohydramnios''.

Ukuba kukho enye okanye ezingaphezulu kwezi mpawu, ugqirha uza kukuhlola ngakumbi.

Yintoni ebangela ukuba umntwana abe nobunzima obunjalo?

Kulungile, ngoku mhlawumbi uyazibuza ukuba kutheni lo mntwana enobunzima obungaka esibelekweni.Isizathu esiphambili nesiqhelekileyo kukuba umntwana akafumani ioksijini eyaneleyo.

Uyazi, umntwana wakho ufumana ioksijini kuwe. Xa uphefumla, ioksijini engena emiphungeni yakho ithwalwa ligazi lakho ukuya kwi-placenta. I-placenta kulapho ioksijini idluliselwa khona egazini lomntwana. Ukuba kukho into ephazamisana nale nkqubo ibalulekileyo, umntwana usenokungafumani ioksijini eyaneleyo, apho kwenzeka le meko "yokuKhubazeka koMbeleko". Cinga ngayo njengesityalo esibunayo xa singenamanzi.

Ukongeza kwesi sizathu siphambili, kukho nezinye izinto ezininzi ezinokubangela ukuba umntwana wakho azive engonwabanga. Makhe sijonge ukuba zeziphi:

• Ukushwabana kwesibeleko rhoqo (iTachysystole): Nangona kuqhelekile ukuba isibeleko sishwabane ngexesha lokubeleka, ukuba kwenzeka ngokukhawuleza kakhulu, rhoqo, kwaye ngaphandle kokuphumla , kunokuphazamisana nokunikezelwa kweoksijini yomntwana.
• I-anemia yosana olusandul’ ukuzalwa: Imeko apho umntwana eswele igazi, oko kuthetha ukunqongophala kweeseli ezibomvu zegazi.
• Ulwelo oluphantsi lwe-amniotic (`Oligohydramnios`): Njengoko besitshilo ngaphambili, kukho ukwehla komthamo wamanzi ajikeleze umntwana. Olu bungakanani bamanzi lukhusela umntwana kwaye luvumela umntwana ukuba ashukume.
• Uxinzelelo lwegazi olubangelwa kukukhulelwa: Ukuba ubungenalo uxinzelelo lwegazi oluphezulu ngaphambili, uxinzelelo lwakho lwegazi luyanda ngexesha lokukhulelwa.
• I-Preeclampsia: Le yimeko enzima neyingozi enxulunyaniswa noxinzelelo lwegazi oluphezulu ngexesha lokukhulelwa. Ingachaphazela nezinye izitho zomzimba, ezifana nezintso.
• Uxinzelelo lwegazi oluphantsi ngendlela engaqhelekanga: Uxinzelelo lwakho lwegazi lunokwehla kakhulu ngamanye amaxesha.
• Ukukhulelwa emva kwexesha: Oku kuthetha ukuba umntwana uzelwe emva kwexesha.
• Ukuthintelwa kokukhula kosana olusandul’ ukuzalwa (IUGR): Imeko apho umntwana engakhuli njengoko bekulindelwe esibelekweni aze abe nobunzima obungaphantsi kobunzima .
• Ukuqhawuka kwe-placenta: Ukwahlukana kwayo yonke okanye inxalenye ye-placenta eludongeni lwesibeleko ngaphambi kokuba umntwana azalwe. Le yimeko engxamisekileyo kwaye ifuna unyango olukhawulezileyo.
• I-Placental previa: I-Placenta previa yimeko apho i-placenta ikwinxalenye esezantsi yesibeleko, kufutshane okanye igqume umlomo wesibeleko.
• Ukucinezelwa kwentambo ye-umbilical: Intambo ye-umbilical, ethwala i-oksijini kunye nezondlo kumntwana, icinezelwe ngandlela thile (umzekelo, ngokubanjwa ngumzimba womntwana okanye ngenxa yolwelo oluphantsi lwe-amniotic).
• Izifo ezingapheliyo onazo: Umzekelo, ukuba unesifo seswekile esele sikhona, isifo sezintso, okanye isifo sentliziyo.
• Ukuba ulindele amawele (ingakumbi amawele afanayo)Umngcipheko unokuba phezulu kancinci.

Oogqirha bayixilonga njani le meko?

Oogqirha bajonga kakhulu izinga lentliziyo yomntwana ukuze babone ukuba unengxaki na. Ukuba izinga lentliziyo yomntwana licotha, okanye ukuba kukho utshintsho olungaqhelekanga kwindlela abetha ngayo intliziyo, oko kungaba luphawu "lweNgxaki yoMntwana ongekazalwa." Ukujonga eli zinga lentliziyo kunokukunika umbono olungileyo wendlela umntwana aza kujongana ngayo nokukhulelwa nokubeleka.

Uvavanyo ngexesha lokukhulelwa

Ngelixa ukhulelwe, ugqirha wakho unokucebisa uvavanyo olufana nolu ukuze ajonge ukubetha kwentliziyo yomntwana wakho:

• Uvavanyo olungengoxinzelelo (NST): Kolu vavanyo, unxiba ibhanti ene-sensor ye-elektroniki ejikeleze isisu sakho ngelixa ulele phantsi okanye uhleli. Le sensor ilinganisa kwaye irekhoda izinga lokubetha kwentliziyo yomntwana wakho. Olu vavanyo lunokujonga nokubhitya kwesibeleko sakho. Iziphumo zimiselwa kukuba umntwana wakho usebenza kangakanani (`reactive` okanye `non-reactive`).
• Iprofayili ye-Biophysical (BPP): Olu luvavanyo lwe-ultrasound. Lulinganisa iintshukumo zomntwana, ithoni yemisipha, iintshukumo zokuphefumla, kunye nomthamo wolwelo lwe-amniotic. Ngamanye amaxesha lwenziwa kunye ne-NST. Oku kunokunika umfanekiso olungileyo wempilo-ntle yomntwana.

Izinto eziqwalaselweyo ngexesha lokubeleka

Ngelixa ubeleka, ugqirha uza kujonga ukubetha kwentliziyo yomntwana rhoqo okanye rhoqo .

• Ukubeka esweni rhoqo kuthetha ukumamela ukubetha kwentliziyo yomntwana wakho ngamaxesha onke usebenzisa isixhobo esibekwe esifubeni sakho. Le yindlela esetyenziswa kakhulu, ingakumbi xa kukho umngcipheko.
• Ukubeka esweni rhoqo kuthetha ukuba ugqirha okanye umongikazi ujonga ukubetha kwentliziyo yomntwana rhoqo (umzekelo, rhoqo emva kwemizuzu engama-30).

Kukho iindlela ezimbini eziphambili ezisetyenziswayo ukujonga ukubetha kwentliziyo yomntwana:

• Isixhobo sokulawula isantya sentliziyo yosana olusandul’ ukuzalwa: Esi sisixhobo endisikhankanyileyo ngaphambili, isixhobo esine-'sensor' osifaka esiswini sakho. Sithumela isandi sentliziyo yosana lwakho 'kwikhompyutha', ukuze iqela lezonyango lisijonge. Usenokuba ukhe weva ngomatshini we-'CTG (Cardiotocography)' , yiloo nto uyiyo. Sirekhoda isantya sentliziyo yosana kunye nepatheni 'yee-contractions' zakho kwi-'graph' efanayo.
• Isixhobo seDoppler:Esi sisixhobo esincinci osiphethe ngesandla. Ugqirha usibeka esiswini sakho aze asebenzise amaza esandi ukumamela ukubetha kwentliziyo yomntwana. Ungakhumbula ukuba xa uqhele ukuya ekliniki, ugqirha uhlola ukubetha kwentliziyo yomntwana ngale Doppler.

Wenza ntoni ukuba umntwana unengxaki?

Khawucinge nje, ukuba oogqirha bayaqaphela ukuba umntwana unengxaki ngelixa ubeleka, banokwenza izinto ezinje ukunceda umntwana ngaphandle kokukhathazeka:

• Ukutshintsha indlela oma ngayo: Ngamanye amaxesha ukutshintsha icala olala kulo (rhoqo kwicala lasekhohlo) kunokuphucula ukuhamba kwegazi entliziyweni yakho kwaye kwandise ukunikezelwa kweoksijini kumntwana wakho.
• Ukukunika ioksijini ngemaski: Oku kunceda ukwandisa ubungakanani beoksijini efunyanwa ngumntwana wakho.
• Ukufaka i-saline (ulwelo oludlula kumgca we-IV) emthanjeni osengalweni yakho: Oku kunceda ukugcina umswakama ofanelekileyo kunye nokuphucula ukujikeleza kwegazi.
• Ukunika amayeza okucothisa okanye okumisa ukushwabana kwesibeleko: Ngamanye amaxesha, ukuba ukushwabana kukhawulezile kakhulu (tachysystole), amayeza anokunikwa ukulawula kancinci kwaye anike umntwana ixesha lokuchacha.
• Ukufakwa kwe-Amnioinfusion: Le yinkqubo ekhethekileyo. Ukuba umntwana akaziva kakuhle ngenxa yento efana nokucinezelwa kwe-umbilical cord, le nkqubo ibandakanya ukufaka ulwelo olulungiselelwe ngokukodwa (njenge-saline efudumeleyo) kwi-amniotic sac nakwi-uterus. Oku kunokunceda ukunciphisa uxinzelelo kwi-umbilical cord.

Eyona nto ibalulekileyo kukuba oogqirha benze izigqibo ezikhawulezileyo nezifanelekileyo ngokusekelwe kwimeko yomntwana.

Ngamanye amaxesha, ukuba imeko yomntwana ayiphucuki ngokukhawuleza ngala manyathelo, umntwana unokufuneka abelekwe ngoko nangoko.

• Ukuba umlomo wesibeleko sakho uvuleke ngokupheleleyo kwaye umntwana uhambile emjelweni wokuzalwa, ugqirha wakho angasebenzisa i-forceps okanye i-vacuum extractor ukukunceda ukhuphe umntwana. Oogqirha basebenzisa ezi ndlela ezingamlimaziyo umntwana.
• Kungenjalo, kunokufuneka kwenziwe utyando lwe-C-section olungxamisekileyo ukuze kukhuselwe umntwana.

Ngaphambi kokuba enze nayiphi na kwezi zinto, ugqirha uza kukuchazela wena nosapho lwakho okwenzekayo kunye nesizathu sokuba benze esi sigqibo. Yonke into yenziwa ngemvume yakho. Ngoko ke ungoyiki, kwaye ukuba unemibuzo, buza.

Ngaba le meko inokuba nemiphumo ehlala ixesha elide kumntwana?

Oku kusenokuvakala kuyoyikisa kancinci, kodwa kubalulekile ukwazi inyaniso. Ukubandezeleka kosana olusandul’ ukuzalwa kunokuba nemiphumo ethile ehlala ixesha elide kumntwana, ingakumbi ukuba umntwana akafumani ioksijini ixesha elide ngexesha lokubeleka.

Ukuba kwenzeka into efana nale, umntwana usenokuba nokulimala kwengqondo, imeko efana ne-cerebral palsy, okanye kwezinye iimeko ezibuhlungu nezinzima, umntwana usenokuzalwa efile.

Kodwa, eyona nto ibalulekileyo ekufuneka uyiqonde apha kukuba xa oogqirha nabasebenzi basesibhedlele beqonda ukuba umntwana usengxakini, benza konke okusemandleni abo ukugcina umntwana ekhuselekile ngaphambi kokuba kuvele iingxaki ezinkulu kangaka. Injongo yabo ephambili kukuphepha iimeko ezinjalo nokukunika umntwana ophilileyo.

Ngaba kukho into esinokuyenza ukuthintela "Ingxaki Yokukhulelwa" ngexesha lokukhulelwa?

Kwiimeko ezininzi, akukho nto unokuyenza ukuthintela ngokupheleleyo le meko ibizwa ngokuba yi-"Fetal Distress" ukuba ingenzeki. Kuba ezinye zezinto ezinokubangela oku (umz. iingxaki zentambo yosana) zingaphaya kwamandla ethu.

Kodwa, ungaphelelwa lithemba! Kukho izinto onokuzenza ukunciphisa le ngozi kwaye uncede ekufumaneni isifo kwangethuba:

• Ungaphoswa naliphi na idinga lakho leklinikhi. Landela imiyalelo kagqirha. Fumana iiskeni zakho kunye novavanyo lwegazi ngexesha.
• Yiba nokukhulelwa okunempilo. Oku kuthetha ukutya ukutya okunesondlo (iziqhamo, imifuno, iimbotyi, iiproteni), ukwenza umthambo ofunekayo (njengoko kuyalelwe ngugqirha wakho), ukusela amanzi aneleyo, ukulala ngokwaneleyo, kunye nokuphepha ukutshaya notywala. Ezi zinto zinokunciphisa umngcipheko wokufumana izifo ezithile (umz. isifo seswekile sokukhulelwa, uxinzelelo lwegazi oluphezulu) ezinokubangela "ingxaki yosana olungekazalwa".
• Thetha ngokukhululekileyo nogqirha wakho malunga nazo naziphi na iimpawu ozibonayo ngexesha lokukhulelwa kwakho kunye nokuzala. Ukuba kukho into engaqhelekanga, nokuba yinto encinci, mxelele.
• Umzekelo, jonga ngokusondeleyo iintshukumo zomntwana wakho (inani lokukhaba kwemveku). Ukuba uziva ngathi umntwana wakho akashukumi kakhulu imihla ngemihla, xelela ugqirha wakho .
• Kwakhona, ukuba ufumana ukopha kwilungu lobufazi, ukuphuma ngequbuliso kolwelo lwelungu lobufazi (ngokungathi amanzi akho aphumile), okanye ukudumba okungapheliyo, okubuhlungu (ingakumbi ngaphambi komhla wakho wokuzalwa), tsalela umnxeba ugqirha wakho okanye uye esibhedlele ngoko nangoko.

Ezi zinto zinceda oogqirha ukuba baqonde ngokukhawuleza ukuba kukho imeko ebizwa ngokuba yi-"Fetal Distress".

Ndingenza ntoni xa ndifumanisa ukuba umntwana wam usengxakini?

Khawucinge nje, ukuba ugqirha ukuxelela ukuba umntwana wakho usengxakini, kuyinto eqhelekileyo ukuziva uxhalabile kwaye usoyika ngelo xesha. Nangona kunjalo, eyona nto ibalulekileyo kukumamela ngononophelo oko kuthethwa ngugqirha wakho kunye neqela lezonyango uze ulandele imiyalelo yabo ngokuchanekileyo.

Ngamanye amaxesha izinto zinokutshintsha ngokukhawuleza, ngoko ungoyiki ukubuza ugqirha wakho ukuba kwenzeka ntoni kwaye kutheni besenza oku.Baza kuchaza izinto ngendlela onokuyiqonda. Uninzi lwexesha, oogqirha baza kukubuza ukuba uziva njani kuba bakhathalele indlela oziva ngayo.

Khumbula, oogqirha bezifo zabesifazane kunye noogqirha bezifo zabesifazane baqeqeshwe kakhulu ukufumanisa ukuba umntwana usengxakini ngexesha lokukhulelwa kunye nokubeleka. Banokuyifumanisa le meko, eyaziwa ngokuba yi-"Non-Reassurance Fetal Status" okanye "Fetal Distress", ngokumamela ukubetha kwentliziyo yomntwana kunye nokuqaphela iimpawu zokuncipha kwentshukumo.

Ngamanye amaxesha, kusenokufuneka ukuba umntwana azalwe kwangethuba ukuze kuthintelwe iingxaki ezinkulu. Ukumamela umzimba wakho nokuxelela ugqirha wakho ngeempawu zakho yeyona nto ingcono onokuyenza ukunciphisa umngcipheko wokubandezeleka kosana olungekazalwa. Ukuhlala uzolile kwaye usebenzisane neqela lakho lezonyango kunokukunceda woyise lo mceli mngeni.

Ngoko ke, zeziphi izinto ezibalulekileyo ekufuneka sizikhumbule kweli bali?

Ndiyathemba ukuba ngoku uyiqonda ngcono imeko esithethe ngayo ebizwa ngokuba yi-`(Fetal Distress)` okanye `(Non-Reassurance Fetal Status)`. Akukho nto ifanele ikhathazeke ngayo, ukwazi yeyona nto ibalulekileyo.

• Eyona nto iphambili kukwazi ukuba umntwana usenokungakhululeki esibelekweni. Kodwa akukho mfuneko yokuba usoloko ukoyika ngokungeyomfuneko.
• Ungaphoswa ziintlanganiso zakho zasekliniki kwaye ulandele imiyalelo kagqirha ngqo. Yiloo nto ilungele wena nomntwana wakho.
• Qaphela iimpawu ezinje ngotshintsho kwisantya sentliziyo yomntwana, ukwehla kwentshukumo yomntwana, kunye nokwehla kolwelo lwe-amniotic. Ukuba ubona into efana naleyo, nokuba yinto encinci, okanye ukuba unamathandabuzo, xelela ugqirha wakho ngoko nangoko.
• Oogqirha baqeqeshwe kakuhle ukuxilonga nokunyanga ezi meko, ngoko ke bathembe kwaye ulandele iingcebiso zabo.
• Ngamanye amaxesha, nokuba kufuneka ubelekise umntwana ngokukhawuleza, kungenxa yokhuseleko lomntwana kunye nawe.
• Mamela umzimba wakho, thetha nogqirha wakho malunga neemvakalelo zakho, uloyiko lwakho kunye namathandabuzo akho.

Ndiyathemba ukuba olu lwazi luza kukunceda. Ndinqwenelela wonke umama okhulelweyo ukuzalwa okunempilo nokumnandi! Ndininqwenelela okuhle kodwa wena nomntwana wakho!

Uxinzelelo lwe - Fetal, Isimo se-fetal esingaqinisekisiyo, i-NRFS, ukukhulelwa, umntwana, ukuzala, isantya sentliziyo ye-fetal, i-oksijini, ukuzalwa, கார்பிர்வாத்து, ஬ான, கார்பாட்டு, கா（