Ingaba umntwana wakho mkhulu kakhulu esibelekweni? Masithethe nge-Fetal Macrosomia!

Ukuba ungumama okhulelweyo, kusenokwenzeka ukuba ukhe weva ugqirha wakho esithi, "Usana lubonakala lulukhulu kancinci," okanye "Usana lubonakala lunobunzima obuncinci." Okanye usenokuba ukhe wavakalelwa kukuba umntwana wakho mkhulu okanye unzima kunabanye. Enyanisweni, kukho igama elikhethekileyo lale nto kwezonyango. Namhlanje, siza kuthetha ngale meko ibizwa ngokuba yi- "Fetal Macrosomia." Ungakhathazeki, kubaluleke kakhulu ukuqaphela oku.

Yintoni le nto kuthiwa lusana olukhulu (i-Fetal Macrosomia)?

Ngamafutshane, `(I-Fetal Macrosomia)` ithetha ukuba umntwana wakho unzima nge-10% nangaphezulu kunobunzima obulindelekileyo kwiveki yokukhulelwa. Khawucinge nje, ukuba abantwana badla ngokuba malunga neekhilogram ezi-3 kule veki, umntwana wakho unokuba ziikhilogram ezi-3.3 nangaphezulu.

Ngoku usenokuba ucinga, "Owu, umntwana wam ebeya kuba mkhulu kwaye abe sempilweni." Liyinyaniso elokuba, umntwana osempilweni liphupha labo bonke oomama. Kodwa, ngamanye amaxesha xa umntwana emkhulu kakhulu , kunokuba nzima ukumzala ngokwesiqhelo, oko kukuthi, ngendlela yangasese. Ngamanye amaxesha umama unokuba nemingxuma yangasese, okanye kunokuba nzima ukumtyhala umntwana aphume. Ukuba ugqirha ucinga ukuba umntwana mkhulu kakhulu – oko kukuthi, ngaphezulu kweekhilogram ezili-11 (malunga neekhilogram ezi-5) okanye ngaphezulu kweekhilogram ezili-10 (malunga neekhilogram ezi-4.5) ukuba unesifo seswekile – mhlawumbi ukhetho olukhuselekileyo kukwenza i-cesarean section (C-section).

Ukuba umntwana uyakhula, zeziphi iingxaki ezinokuvela xa umntwana ezalwa?

Xa ukhulelwe umntwana omkhulu, kukho umngcipheko ophezulu kancinci weengxaki ezithile ngexesha lokubeleka. Makhe sijonge ukuba zeziphi ezo.

Iingxaki ezinokwenzeka kumama

• Umjelo wakho wokuzalwa, oyilungu lobufazi kunye nendawo ejikeleze wona (i-'perineum'), unokwenzakala. Ngenxa yokuba umntwana mkhulu, kunokubakho ukukrazuka njengoko ephuma.
• Ungopha igazi elingaphezulu kunesiqhelo. Ngamanye amaxesha oku kunokukhokelela ekuphumeni kwegazi eligqithisileyo emva kokubeleka (i-postpartum hemorrhage).
• Kukwakho nethuba elinqabileyo lokuqhekeka kwesibeleko, eliqheleke kakhulu koomama abaye benza utyando ngaphambili.
• Ixesha elikhokelela ekubelekeni, ingakumbi ixesha lokutyhala, linokuba lide. Oku kunokuba nzima kakhulu kumama.
• Ungabona utshintsho kwintliziyo yomntwana wakho ngelixa ubeleka .

Iingozi kumntwana - ingakumbi i-shoulder dystocia

Ukuba umntwana mkhulu, naye unemingcipheko ethile. Eyona nto ixhalabisayo kwezi yimeko ebizwa ngokuba yi-`(Shoulder Dystocia)`.Ngamafutshane, oku kwenzeka xa amahlombe omntwana enamathela ngaphakathi kwesibeleko sikamama emva kokuba intloko yomntwana iphumile kwilungu lobufazi. Nangona oku kunokwenzeka ngexesha lokuzala, kunokwenzeka ngakumbi kwiintsana ezinkulu.

I-Shoulder Dystocia yingxaki enkulu. Kodwa ungakhathazeki, ugqirha wakho kunye nombelethisi banesicwangciso sento abanokuyenza xa kwenzeka into efana nale. Baza kukujonga ngexesha lokubeleka kwakho.

Le meko (i-Shoulder Dystocia) inokubangela ukuba kwenzeke ezi zinto zilandelayo kumntwana osandul’ ukuzalwa:

• Umntwana usenokuba namathambo aqhekekileyo , ingakumbi i-collarbone.
• Ukulimala kweBrachial Plexus . Oku kukonakalisa imithambo-luvo ethwala imiqondiso kwiingalo zomntwana. Oku kunokubangela ubuthathaka kwiingalo.
• Kunqabile kakhulu ukuba kwenzeke umonakalo engqondweni .

Ezi ngozi zisenokuhlala zikho nasemva kokuzalwa kwiintsana ezindala.

Iintsana ezizalwa zinkulu zinamathuba amaninzi okuba neengxaki ezithile zempilo emva kokuzalwa:

• Ukwanda kwenani leeseli ezibomvu zegazi egazini. Oku kunokunyusa umngcipheko wokuba umntwana abe ne-jaundice.
• Iswekile ephantsi egazini (hypoglycemia).
• Iingxaki zokuphefumla.

Ziziphi iimpawu zokuba umntwana mkhulu?

Enyanisweni, kunzima ukwazi ubungakanani obuchanekileyo bomntwana wakho de azalwe. Iimpawu ezininzi ozifumanayo ngexesha lokukhulelwa ziyafana kakhulu, nokuba umntwana wakho ukhula njani. Oko kuthetha ukuba izinto ezifana nesisu esikhulu kunye nokudinwa ziqhelekile ngexesha lokukhulelwa okuqhelekileyo. Nangona kunjalo, kukho izinto ugqirha wakho anokuthi azicingele ukuba umntwana wakho mkhulu xa ekuxilonga.

Kutheni umntwana ekhula kangaka esibelekweni? Zithini izizathu?

Ugqirha wakho unokukrokrela ukuba umntwana wakho une-macrosomia ngenxa yezi zizathu zilandelayo:

• Ukuba "Ubude bakho beFundal", oko kukuthi, ubude besibeleko (umlinganiselo wobude besisu), buphezulu kunokuba bekulindelwe. Ungakhumbula ukuba ugqirha ulinganisa oku rhoqo xa uhlolwa.
• Ukuba utyebile kakhulu ngexesha lokukhulelwa. Sonke siyazi ukuba ukutyeba kwenzeka ngexesha lokukhulelwa, kodwa kubalulekile ukukugcina kukwinqanaba elifanelekileyo.
• Ukuba unesifo seswekile, okanye ukuba unesifo seswekile ngexesha lokukhulelwa (isifo seswekile sokukhulelwa). Le yeyona nto ibangela ukuba abantwana bakhule.
• Ukuba sele uzele umntwana omkhulu.
• Ukuba umhla wakho wokuzalwa udlulile, umntwana wakho uza kukhula kancinci njengoko iintsuku zihamba.
• Ukuba nawe wazalwa ungumntwana omkhulu, ngamanye amaxesha inokuba yinto yelifa.

Oogqirha bafumanisa njani ukuba umntwana mkhulu?

Ukuba ugqirha wakho ukrokrela ukuba umntwana wakho mkhulu, unokuyalela ukuba kwenziwe i-ultrasound scan ukujonga ubunzima bomntwana kunye nobungakanani bolwelo lwe-amniotic (ulwelo lwe-amniotic) olujikeleze umntwana. Uyazi ukuba yintoni i-ultrasound. Isebenzisa amaza esandi aqhelekileyo ukuthumela imifanekiso okanye iividiyo zomntwana wakho.

Asinakukwazi ukubona ngqo nge-ultrasound kuphela?

Umbuzo omhle. I-ultrasound ayinakukuxelela ukuba umntwana wakho unobunzima obungakanani. Ikunika nje ingcamango ecacileyo, i-plus okanye i-minus 10% . Umzekelo, ukuba iskeni ithi umntwana unobunzima obumalunga neekhilogram ezi-4, loo nto "yingqikelelo engcono." Umntwana unobunzima obuphakathi kweekhilogram ezi-3.6 nezi-4.4.

Kwakhona, i-ultrasound ayinakuqikelela ukuba kuya kwenzeka into efana ne-shoulder dystocia ekhankanyiweyo. Ke ngoko, ugqirha uya kudibanisa ulwazi oluvela kwi-ultrasound, imbali yakho yokukhulelwa (indlela owaba nabantwana ngayo ngaphambili, iimeko zakho zempilo), kunye novavanyo oludlulayo ukuze kuchongwe ixesha elilungileyo nelikhuselekileyo kunye nendlela yokuzala umntwana.

Yintoni enye efunwa ngugqirha?

Ukuze agqibe ukuba ufuna i-ultrasound scan, ugqirha uya kwenza oku kulandelayo:

• Ukulinganisa "Ubude beFundal" yakho. Lo ngumgama ukusuka phezulu kwesibeleko sakho ukuya kwi "Pubic Bone" esiswini sakho esisezantsi.
• Ukupeta isisu sakho. Ugqirha uza kuzama ukufumana umbono wobukhulu bomntwana ngokujonga iindawo ezithile zesisu sakho.

Ukuba ezi mvavanyo zibonisa ukuba umntwana mkhulu, ugqirha wakho unokuyalela iimvavanyo ezongezelelweyo (ezifana neBiophysical Profile okanye iNonstress Test) ukuze kujongwe impilo yomntwana ngakumbi.

Ukuba umntwana mkhulu, loluphi unyango olunokwenziwa?

Ukunyanga i-macrosomia ngokuyintloko kukulawula naziphi na iimeko zempilo onokuba nazo , ezinje ngesifo seswekile okanye ukutyeba kakhulu. Wena nogqirha wakho kufuneka sisebenzisane ukulawula naziphi na iimeko ezinokuchaphazela ukukhulelwa okanye ukuzala kwakho.

Kwiimeko ezininzi, ukutya ukutya okunempilo, ukuzilolonga, kunye nokulawula isifo sakho seswekile (ukuthatha i-insulin ukuba kuyimfuneko) zezona zinto zibalulekileyo onokuzenza.

Ugqirha wakho uza kuthetha nawe ngemingcipheko yokubeleka kwilungu lobufazi. Kwezinye iimeko, utyando lwe-C-section lunokucetyiswa ukunciphisa umngcipheko weengxaki. Kodwa kubalulekile ukwazi oku: Ukubeletha kwangethuba (oko kukuthi, ukucwangcisa ukubeletha ngaphambi kweeveki ezingama-39) akubonakali kunciphisa iingxaki. Ke ngoko, ukubeletha kwangethuba akukhuthazwa ngaphandle kokuba kukho esinye isizathu sezonyango sobukhulu bomntwana.

Ngaba kuyimfuneko ukwenza utyando lwebele (C-section) ukuba umntwana mkhulu?

Akunjalo ngokuyimfuneko. Asinguye wonke umntwana omkhulu oya kufuna utyando lwe-C-section. Nangona kunjalo, oku kulandelayo kunokwenzeka ukuba kufuneke utyando lwe-C-section:

• Ukuba ukhe waba nomntwana one-`(Shoulder Dystocia)` ngaphambili.
• Ukuba unesifo seswekile kwaye umntwana wakho kulindeleke ukuba abe nobunzima obungaphezulu kweekhilogram ezili-10 (malunga ne-4.5 kg).
• Awunaso isifo seswekile, kodwa uqikelela ukuba umntwana wakho unobunzima obungaphezulu kweekhilogram ezili-11 (malunga neekhilogram ezi-5).

Ezi zigqibo zenziwa ngugqirha wakho emva kokuthetha nawe kwaye zisekelwe kwimeko yakho.

Ngaba kukho iindlela zokuthintela umntwana ukuba akhule ngolu hlobo?

Inyaniso kukuba, `(Fetal Macrosomia)` kunzima ukuyiqikelela ngokuchanekileyo kwangaphambili. Kuphela emva kokuba umntwana ezelwe kwaye esikaliwe apho sinokutsho ngokuqinisekileyo, "Owu, umntwana mkhulu." Ezinye iintsana zinokuzalwa zinkulu kunesiqhelo nangona zingenazo naziphi na izinto ezinokubangela umngcipheko.

Nangona kunjalo, ukugcina impilo entle kunye nokukhulelwa okunempilo kunokunceda ukunciphisa le ngozi ngandlela ithile:

• Yiya kwiikliniki zangaphambi kokubeleka rhoqo. Ukutyelela ugqirha wakho rhoqo kuya kukuvumela wena nogqirha wakho ukuba nihlale nijonge ukukhula komntwana wakho. Lithuba elihle lokubuza nayiphi na imibuzo onokuba nayo.
• Lumka ngobunzima bakho. Njengokuba kubalulekile ukwazi ubunzima bakho ngaphambi kokukhulelwa, kubalulekile nokwazi ukuba ufumana ubunzima obungakanani ngexesha lokukhulelwa. Kulungile ukuqaphela kancinci ezinye zezinto zokutya kwilizwe lethu (umz. ukutya okuphekiweyo, iilekese).
• Ukuba unesifo seswekile, thatha amanyathelo afunekayo ukuze usilawule. Zombini isifo seswekile esele sikhona (iDiabetes Mellitus) kunye nesifo seswekile sokukhulelwa (iDiabetes esikhula ngexesha lokukhulelwa) zezona zinto ziphambili ezibangela i-macrosomia kwi-fetus.

Ziziphi iingxaki zempilo ezinokubakho kwiintsana ezizalwa zinkulu kwixesha elizayo?

Uphando lubonise ukuba iintsana ezizalwa zinkulu zisengozini enkulu yezi zinto zilandelayo kwixesha elizayo:

• Amanqanaba aphantsi eswekile egazini (`Hypoglycemia`) ebuntwaneni.
• Ukutyeba kakhulu ebuntwaneni.
• I-Metabolic syndrome liqela leemeko ezinyusa umngcipheko wokufumana izifo ezifana nesifo sentliziyo, isifo sohlangothi, kunye nesifo seswekile.

Kodwa khumbula, nokuba kukho amathambo aphukileyo okanye umonakalo wemithambo-luvo ngexesha lokuzalwa, uninzi lweentsana luyaphola ngokupheleleyo kuloo manxeba.

I-"Fetal Macrosomia" yimeko enokubangela iingxaki ezinkulu ngexesha lokubeleka. Nangona zininzi izizathu zoku, isifo seswekile esingalawulekiyo kunye nokutyeba kakhulu zezona zizathu zimbini ziphambili.Unganciphisa umngcipheko wokuba nomntwana omkhulu ngokulawula ezi meko kakuhle. Izinto ezifana nokuzilolonga rhoqo nokutya ukutya okunempilo kunokukunceda ube nokukhulelwa okunempilo kwaye kunciphise umngcipheko weengxaki. Ungoyiki ukubuza ugqirha wakho ngeyona ndlela ilungileyo yokunyamekela wena nomntwana wakho. Nangona i-"Fetal Macrosomia" inokuba yingozi, uninzi lweentsana ezinkulu zizalwa ziphilile.

Ngoko ke, zeziphi izinto ezibalulekileyo ekufuneka sizikhumbule koku?

Kulungile, masishwankathele ezinye zezinto esithethe ngazo ekufuneka uzikhumbule:

• ``I-Fetal Macrosomia`` ithetha ukuba umntwana ufumana ubunzima obungaphezulu kunoko bekulindelwe esibelekweni.
• Ezona zinto zibangela oku sisifo seswekile sikamama (ingakumbi esingalawulekiyo) kunye nokutyeba kakhulu ngexesha lokukhulelwa.
• Ukuba umntwana ukhula, umama nomntwana banokufumana iingxaki ezithile ngexesha lokubeleka. I-"Shoulder Dystocia" yimeko enzima enokwenzeka kumntwana.
• Oogqirha bafumana umbono wobukhulu bomntwana ngokusebenzisa ii-ultrasound scans kunye nezinye iimvavanyo.
• Ayizizo zonke iintsana ezinkulu ezidinga utyando lwe-C-section, kodwa kwezinye iimeko lolona khetho lukhuselekileyo.
• Le ngozi ingancitshiswa ngokuphila ubomi obusempilweni, ukutya ukutya okunesondlo, nokulawula izifo ezifana nesifo seswekile.
• Ungakhathazeki, uninzi lweentsana ezinkulu zizalwa ziphilile. Xoxa ngayo yonke into nogqirha wakho kwaye ulandele imiyalelo yakhe.

Ukuba uneminye imibuzo malunga noku, qiniseka ukuba ubuza ugqirha wakho. Ngabo banokukunika icebiso elingcono.

I- Macrosomia yosana olusesiswini, Usana olukhulu, Ukukhulelwa, Ukuzala, Utyando lweCesarean, Isifo seswekile, I-Dystocia yamagxa