Ingaba umntwana wakho akakhulu njengoko bekulindelwe esibelekweni? Masithethe ngoMqathango wokukhula kwesisu (IUGR)!

Ixesha elininzi, njengomama, unethemba lokuzisa umntwana osempilweni nokhule kakuhle emhlabeni. Kodwa ngamanye amaxesha, umntwana wakho osesiswini sakho akakhuli ngokukhawuleza njengoko ubungathanda. Oogqirha babiza le meko ngokuthi yi-Intrauterine Growth Restriction (IUGR) , okanye ngamanye amaxesha yi-Fetal Growth Restriction (FGR) . Ngamafutshane, umntwana mncinci ngokweminyaka yakhe yokukhulelwa. Oku kuthetha ukuba ubunzima bakhe bungaphantsi kwesithoba kwishumi labantwana (ngaphantsi kwe-10th percentile) ngexesha elifanayo lokukhulelwa.

Ngoku, asizizo zonke iintsana ezikhula ngendlela efanayo. Ukuba nje umntwana "mncinci" akuthethi ukuba une-IUGR. Njengathi, ezinye zinde kwaye ezinye zimfutshane. Umntwana onobude obuyi-5'1" uphilile kakhulu kunomntwana onobude obuyi-6'4". Kunjalo, uninzi lweentsana ezizalwa zincinci ziphilile. Nangona kunjalo, abanye oomama baneengxaki ezithile zempilo ezinokuthintela ukukhula komntwana wabo.

Ziziphi iintlobo eziphambili ze-IUGR?

Oogqirha bahlula i-IUGR kwiintlobo ezimbini eziphambili:

1. I-Symmetric IUGR (I-Primary IUGR): Kulapho umzimba wonke womntwana – intloko, isisu, amalungu – ulingana ngobukhulu. Oku kubonakala malunga ne-30% yeentsana ezine-IUGR.

2. I-Asymmetric IUGR (i-secondary IUGR): Apha, intloko yomntwana kunye nobukhulu bobuchopho buqhelekile, kodwa isisu kuphela esincinci. Olu lolona hlobo luqhelekileyo, lumalunga nama-80% eentsana ezine-IUGR.

Ixhaphake kangakanani le miqathango yokukhula komntwana ongekazalwa?

Le meko ye-IUGR inokubonwa kwi-10% yokukhulelwa. Nangona kunjalo, into ebalulekileyo kukuba nokuba umntwana mncinci kunesiqhelo, akuthethi ukuba une-IUGR rhoqo. Ngoko ke, kungcono ukungoyiki ngokungeyomfuneko, akunjalo?

I-IUGR idla ngokuchongwa nini?

I-IUGR idla ngokurhanelwa emva kweeveki ezingama-20 zokukhulelwa. Ngalo lonke ixesha xa ubona ugqirha wakho, uza kulinganisa ubude bakho be-fundal - umgama ukusuka kwithambo lakho le-pubic ukuya phezulu kwesibeleko sakho. Ukuba olu vavanyo luphantsi kunokuba bekulindelwe, ugqirha wakho unokurhanela i-IUGR aze akuthumelele uvavanyo olongezelelweyo.

Le meko ye-IUGR iza kuyichaphazela njani ukukhulelwa kwam?

Ukuba ufunyaniswe une-IUGR, ukukhulelwa kwakho kuya kufuneka kulawulwe ngendlela eyahlukileyo kancinci. Ugqirha wakho unokuyalela ii-scan ezongezelelweyo (ii-ultrasound) , ezinye iimvavanyo, kunye nokutyelela rhoqo eklinikhi ukuze kujongwe ukukhula komntwana wakho. Ukuba unesinye isifo esibangela i-IUGR yakho, ugqirha wakho unokuqalisa ukunyanga eso sifo. Nangona kunjalo, konke oku kuxhomekeke kwimpilo yakho neyomntwana wakho.

Ngamanye amaxesha ugqirha wakho unokucinga ukuba ukukhulelwa kwakho "kuyingozi kakhulu." Nangona kunjalo, uninzi lweentsana ezifunyaniswe zine-IUGR ziphilile kwaye zifuna nje ingqalelo eyongezelelweyo ngexesha lokukhulelwa.

Ziziphi izizathu zokuthintelwa kokukhula komntwana?

Kukho izizathu ezininzi zokuba ukukhula komntwana kunokuthi kuthintelwe ngale ndlela. Ngamanye amaxesha, oku kungenxa yengxaki ye-placenta okanye i-umbilical cord. Oku kungenxa yokuba umntwana ufumana izondlo, ioksijini, kunye negazi alidingayo ngezi zinto. Ngoko ke, ukuba ezi zinto azanelanga, ukukhula komntwana kunokuncipha.

Kukho nezizathu ezinxulumene nomama:

• Ukuba ulindele amawele okanye amawele amathathu .
• Ukuba ukhe waba nomntwana ngaphambili one-IUGR .
• Ukuba uneemeko ezifana noxinzelelo lwegazi oluphezulu, isifo sentliziyo, okanye umlinganiselo wegazi ophantsi .
• Ukuba uyatshaya, usela utywala, okanye usebenzisa ezinye iziyobisi . (Ezi ngokuqinisekileyo zizinto ekufuneka uyeke ukuzenza!)
• Ukuba unesifo sokuzikhusela komzimba , esifana ne -lupus .
• Ukuba unesifo sezintso .
• Ukuba uthatha amayeza athile (amayeza okulwa nokuxhuzula) ukunyanga izifo ezifana nesifo sokuwa .
• Ukuba unesifo seswekile (iDiabetes Mellitus) .
• Ukuba ufumana usulelo olufana ne -rubella, i-syphilis, i-cytomegalovirus (CMV), okanye i-toxoplasmosis ngexesha lokukhulelwa.

Ngamanye amaxesha i-IUGR ingabangelwa sisifo sokuzalwa okanye semfuza kumntwana, umzekelo , i-Down syndrome (iTrisomy 21) . Kukwafunyaniswe ukuba iintsana ezizelwe ngoomama abahlala kwiindawo eziphakamileyo zinokuba nobunzima obuphantsi.

Yintoni eyona nto ibangela ukuba umntwana angakwazi ukukhula kakuhle?

Kunzima ukutsho ngokuqinisekileyo ukuba yintoni unobangela wokuthintelwa kokukhula komntwana ongekazalwa. Ngamanye amaxesha kunokubakho izizathu ezininzi, okanye kungafumaneki sizathu sicacileyo. Ugqirha wakho uza kuzama ukufumana unobangela oyintloko (ukuba ukhona).

Zithini iimpawu ze-IUGR?

Uninzi loomama alunazo iimpawu ezithile ezibonisa ukuba umntwana wabo mncinci kuneeveki. Ngamanye amaxesha ungaziva ngathi isisu sakho okanye umntwana wakho akakhulu njengoko bekulindelwe. Nangona kunjalo, ngugqirha wakho kuphela onokuqinisekisa ukuba unayo i-IUGR.

Ifunyanwa njani le meko ye-IUGR?

Ukuze uxilonge i-IUGR, kufuneka uqale wazi umhla oza kuzalwa ngawo, odla ngokumiselwa ngosuku lokuqala lokuya kwakho exesheni lokugqibela kunye ne-ultrasound yekota yokuqala . Ukwazi olu suku kunika ugqirha wakho isiseko sokuxilonga i-IUGR.

Emva koko, ugqirha uza kuzama ukufumanisa i-IUGR esebenzisa iindlela ezahlukeneyo:

• Ukuphakama kwe-uterine fundal: Njengoko bekutshiwo ngaphambili, ugqirha wakho uza kulinganisa ubude ukusuka kwithambo lakho le-pubic ukuya phezulu kwesibeleko sakho (ubungakanani "be-baby bump" yakho) ngeteyipu yephepha. Emva kweeveki ezingama-20, obu bude kufuneka bulingane nenani leeveki ozikhulelweyo ngeesentimitha (cm). Umzekelo, ukuba uneeveki ezingama-32 ukhulelwe, ubude besibeleko sakho kufuneka bube malunga neesentimitha ezingama-32. Ukuba olu linganiso lungaphantsi ngeesentimitha ezi-4 kunokuba bekulindelwe (oko kukuthi, iisentimitha ezingama-28 okanye ngaphantsi kulo mzekelo), ugqirha wakho unokurhanela i-IUGR. Ngamanye amaxesha, ugqirha wakho uya kuqikelela ubungakanani bomntwana wakho ngokumchukumisa.
• Ubunzima Bakho: Ubunzima bakho bujongwa rhoqo xa undwendwela ekliniki. Ukuba awutyebi kakuhle, oko kungaba luphawu lokuba nomntwana wakho akatyebi kakuhle.
• I-Ultrasound: Ukuba ufunyaniswe une-IUGR, kuya kufuneka uhlolwe rhoqo ngexesha lokukhulelwa kwakho ukuze ujonge ukukhula komntwana wakho. Ngexesha lokuhlolwa, ugqirha wakho uza kuhambisa isixhobo (induku okanye iprobe) phezu kwesisu sakho. Amaza esandi enza umfanekiso womntwana wakho. Ugqirha uza kusebenzisa umfanekiso ukulinganisa ubunzima nobukhulu bomntwana wakho. Ukuhlolwa kungasetyenziselwa ukujonga ukuhamba kwegazi ukusuka kwi-placenta ukuya kumntwana ngentambo yesisu (ebizwa ngokuba luvavanyo lokuhamba kwegazi lweDoppler ). Ukuhamba kwegazi okungahambi kakuhle kunokuba luphawu lwe-IUGR. Ukuhlolwa kungalinganisa nobungakanani bolwelo lwe-amniotic olujikeleze umntwana. Amanqanaba aphantsi olu lwelo (oligohydramnios) angaba luphawu lwe-IUGR.
• Ukujonga umntwana ongekazalwa: Ugqirha wakho uza kuncamathisela isixhobo sokujonga esibelekweni sakho ngentambo. Kuya kufuneka ulale phantsi kwaye unxibe esi sixhobo malunga nemizuzu engama-30. Oku kuya kurekhoda izinga lokubetha kwentliziyo yomntwana. Ugqirha uza kusebenzisa ezi ziphumo ukujonga naziphi na iingxaki zokukhula.
• I-Amniocentesis: Olu vavanyo lunokunceda ekuchongeni izizathu zokuzalwa ze-IUGR. Apha, ugqirha ufaka inaliti encinci eluswini lwakho esibelekweni sakho aze athathe inani elincinci lolwelo lwe-amniotic olujikeleze umntwana aze aluthumele kwilebhu ukuze luvavanywe. Olu ayilovavanyo oluqhelekileyo, kwaye lwenziwa kuphela xa kuyimfuneko.

Musa ukoyika xa ugqirha ekucela ukuba wenze uvavanyo olongezelelweyo. Ezinye iintsana zincinci kunomndilili, kodwa ziphilile kwaye ziyasebenza.

Iphathwa njani imida yokukhula kosana olungekazalwa?

Unyango lwe-IUGR luxhomekeke ekubeni ukhulelwe ixesha elingakanani na kwaye impilo yomntwana wakho ixhomekeke kwimpilo yakhe. Ngelishwa, akukho sisombululo sinye esifanelekileyo kwimida yokukhula komntwana ongekazalwa. Ugqirha wakho uza kukujonga ngokusondeleyo wena nomntwana wakho ukuqinisekisa ukuba akukho ngxaki. Baza kunyanga naziphi na iimeko zempilo ezinokubangela esi sifo.

Oku kulandelayo kungenziwa njengonyango:

• Ukuhlolwa okukhawulezileyo: Ugqirha uza kukujonga wena nomntwana wakho ngokusondeleyo. Uphuhliso lomntwana luya kuhlolwa rhoqo ngeeskeni nezinye iimvavanyo.
• Ukubeletha kwangethuba: Ukuba ukukhulelwa akuqhubeki kakuhle okanye umntwana usemngciphekweni, ugqirha wakho unokugqiba ekubeni aqalise ukuzala kwangethuba (ngaphambi kweeveki ezingama-37). Ngamanye amaxesha utyando lwe-cesarean (C-section) lunokucetyiswa, njengoko ukubeletha kwangemva kwesisu kunokuba yingxaki kumntwana ongakwaziyo ukukhula kakuhle.
• Amayeza e-corticosteroid: Ukuba ugqirha wakho ucebisa ukuba ubelekise umntwana wakho kwangethuba, unganikwa amayeza e-corticosteroid ukunceda imiphunga yomntwana wakho ikhule.

Kwiimeko ezinqabileyo kakhulu, okanye ezinzima kakhulu, ugqirha wakho unokugqiba ekubeni akungenise esibhedlele ukuze ajongwe ngokusondeleyo.

Ngaba iintsana ezinemida yokukhula ekugqibeleni ziya kukhula njengabanye abantwana?

Amaxesha amaninzi, ewe! Uninzi lweentsana ezizalwa zine-IUGR zikhula zibe nkulu ngokulinganayo nabanye abantwana abaneminyaka yazo xa zifikelela kwiminyaka emi-3 ubudala. Nangona kunjalo, kubalulekile ukukhumbula ukuba wonke umntwana ukhula ngendlela eyahlukileyo. Kwakhona, musa ukunyanzela umntwana wakho ukuba amnyanzele. Ukwenza njalo kunokukhokelela kwezinye iingxaki zempilo, ezifana nokutyeba kakhulu okanye isifo seswekile. Ugqirha wezingane womntwana wakho uya kukunika iingcebiso ukuba ukukhula komntwana wakho akuhambanga njengoko bekulindelwe.

Ndingenza ntoni ukuze ndikhulise ukukhula komntwana wam?

Akukho siqinisekiso sokuba ukutya ukutya okuthile kuya kunyusa ubunzima bomntwana wakho. Nangona kunjalo, kuyacetyiswa ukuba utye ukutya okunempilo ngexesha lokukhulelwa. Ukutya okutyebileyo kwiziqhamo, imifuno, iicarbohydrates ezinempilo, kunye neeproteni kuya kunika wena nomntwana wakho zonke izondlo abazidingayo ngexesha lokukhulelwa. Ungalibali ukuthetha nogqirha wakho ngaphambi kokuba wenze naluphi na utshintsho olukhulu kwindlela otya ngayo ngexesha lokukhulelwa.

Ndingenza ntoni ukuthintela i-IUGR?

Kukho izinto ezithile ezonyusa umngcipheko we-IUGR, kodwa singazitshintsha:

• Ukusebenzisa iziyobisi, utywala, okanye ukutshaya. (Oku kufuneka kuyekwe ngokupheleleyo!)
• Ukulandela ukutya okungafanelekanga.
• Ukungatyebi ngokwaneleyo ngexesha lokukhulelwa.

Ziziphi iimeko zempilo endinazo ezindisa umngcipheko wokuba ne-IUGR?

Usenokuba sengozini enkulu ye-FGR/IUGR ukuba unenye yezi meko zilandelayo:

• Uxinzelelo lwegazi oluphezulu okanye isifo sentliziyo.
• Isifo seswekile.
• I-anemia okanye i-sickle cell anemia.
• Izifo zomzimba ezifana ne-lupus.

Ngaba i-IUGR iyaphela?

Umntwana usenokuthi "abambe" kancinci aze akhule. Nangona kunjalo, ukuxilongwa kwe-IUGR akupheli. Ugqirha uza kujonga ngononophelo ukukhula komntwana kude kube sekupheleni kokukhulelwa.

Ngaba kunokwenzeka ukuba umntwana abe ngumntwana kwangethuba ngenxa yokunciphisa ukukhula komntwana ongekazalwa?

I-FGR/IUGR ayisoloko ibangela ukuba umntwana azalwe kwangethuba, kodwa inokwenzeka. Ukuba umntwana wakho ukhula kancinci, okanye ukuba kukho iingxaki kwi-placenta yakho okanye kwi-umbilical cord, ugqirha wakho unokucebisa ukuba abelekwe kwangethuba. Njengoko bekutshiwo ngaphambili, ukuba uxinzelelo lokubeleka kwi-vaginal luphezulu kakhulu kumntwana wakho, unokunikwa i-cesarean section (C-section).

Zithini iingozi zomntwana ozelwe ene-IUGR?

Kukho ezinye iimeko kunye neengxaki ezinxulumene ne-IUGR:

• Kukho umngcipheko omkhulu wokuba nomntwana ngotyando (C-section) kunye nokuzalwa ngaphambi kwexesha.
• Ubunzima bokuphefumla nokondla bunokwenzeka emva nje kokuzalwa.
• Ukungabikho komoya-mpilo (hypoxia) xa umntwana ezalwa.
• Amanqanaba aphantsi eswekile egazini (hypoglycemia) ekuzalweni.
• Ubunzima bokulawula ubushushu bomzimba.
• I-Meconium aspiration (umntwana oginya indle yakhe yokuqala esibelekweni).
• I-Polycythemia (ukwanda kwenani leeseli ezibomvu zegazi).
• Ukuncipha kokuxhathisa izifo.

Ezinye iintsana ezizalwa ngaphambi kwexesha okanye ezincinci zisenokufuna ukuhlala esibhedlele ixesha elide okanye zifumane unyango olukhethekileyo kwiYunithi yoKhathalelo oluNzulu lweZifo eziSandulelayo (i-NICU) .

I-IUGR inokuba nemiphumo yexesha elide, kuxhomekeke kwezi zinto zilandelayo:

• Ingxaki yezempilo esisiseko eyabangela oku.
• Indlela ukukhula komntwana okulinganiselwe ngayo.
• Zingaphi iiveki emva kokukhulelwa xa umntwana ezalwa?

Umntwana wakho usenokuba semngciphekweni omkhulu weengxaki zengqondo okanye zokukhula ezifana nokusebenza kakhulu, i-cerebral palsy , amanqaku aphantsi ovavanyo esikolweni, kwaye usenokuba semngciphekweni omkhulu wokutyeba kakhulu kunye nesifo sentliziyo kamva ebomini.

Ndingenza ntoni ukuba umntwana wam une-IUGR?

Okokuqala, musa ukoyika.Ixesha elininzi, oku akuyonto oyenzileyo. Nazi ezinye izinto onokuzenza ukunceda:

• Qiniseka ukuba uyaya kuzo zonke iintlanganiso zakho zokukhulelwa kunye nokuhlolwa komntwana (njengee-scan).
• Ukuba usebenzisa iziyobisi, utshaya, okanye usela utywala, yeka ukwenza ezo zinto ngoku.
• Yitya ukutya okunempilo kwaye ufumane ubuninzi beekhalori ezifunekayo ngosuku.
• Phumla ngokwaneleyo, ulale ubuncinane iiyure ezisibhozo ebusuku.
• Ukuba uvakalelwa kukuba iintshukumo zomntwana wakho ziyancipha, yijonge. (Zikho iindlela zokubala ukuba umntwana wakho ukhaba kangaphi ngosuku, buza ugqirha wakho.)
• Xelela ugqirha wakho ngokunyanisekileyo malunga namayeza owasebenzisayo.

Sebenzisana nogqirha wakho ukuze uqonde ngokupheleleyo olu xilongo, iingxaki ezinokubakho, kunye notshintsho onokulwenza kwindlela yakho yokuphila.

Ngaba kufuneka ndikhathazeke ukuba umntwana wam mncinci ngobukhulu?

Ixesha elininzi, hayi. Iintsana zikhula ngamanqanaba ahlukeneyo. Nangona kunjalo, kukho umahluko phakathi kokufunyanwa zincinci ngexesha lokukhulelwa kunye nokufunyanwa zinomda wokukhula kwe-fetal (FGR/IUGR). I-FGR/IUGR ifunyaniswa xa usana luncinci kuneentsana ezilithoba kwezilishumi ezineminyaka efanayo. Kunokwenzeka ukuba usana lube ncinci ngexesha lokukhulelwa ukuze lube sempilweni kwaye lungabi semngciphekweni omkhulu weengxaki. Thetha nogqirha wakho malunga nazo naziphi na iingxaki onokuba nazo.

Ndingayibuza yiphi imibuzo ugqirha wam?

Kuqhelekile ukuba nemibuzo malunga nokuchongwa komngcipheko wokukhula kwesisu (IUGR). Nazi ezinye zemibuzo onokuzibuza ugqirha wakho:

• Ngaba uyazi ukuba yintoni ebangela i-IUGR?
• Kuza kufuneka ndize kangaphi kwiikliniki zangaphambi kokubeleka?
• Ngaba kukho into endinokuyenza ukunceda ekuphuhliseni umntwana wam?
• Ingaba umntwana wam usengozini yeengxaki zempilo?
• Ngaba umntwana wam uza kuhlala esibhedlele ixesha elide emva kokuzalwa?
• Ngaba umntwana wam angafumana naziphi na iingxaki zempilo kamva?

Zininzi izizathu zokuba umntwana abe mncinci ngaphambi kokuba azalwe. Ugqirha wakho uya kugqiba ukuba kukho ingxaki efihlakeleyo ethintela ukukhula komntwana. Ngamanye amaxesha, ngaphandle kwesizathu esicacileyo, umntwana unokuzalwa emncinci kunesiqhelo. Ukuba umntwana wakho ufunyaniswe ene-IUGR, iqela lakho lezonyango liya kujonga ngokusondeleyo ukukhula komntwana wakho kulo lonke ixesha lokukhulelwa. Eyona nto iphambili kubo kukuqinisekisa ukuba wena nomntwana wakho nifumana unyango abaludingayo. Uninzi lweentsana ezizelwe zine-IUGR azinazo naziphi na iingxaki zempilo.

Umyalezo Wokuya Ekhaya

Kuqhelekile ukuba noloyiko kwaye uxhalabe xa ufumanisa ukuba umntwana wakho akakhuli ngendlela ebekulindelekile esibelekweni, okanye ukuba une-IUGR. Kodwa nceda ukhumbule, abantwana abaninzi bazalwa bephilile, bephilile, kwaye bekhula kakuhle kwezi meko.

Eyona nto ibalulekileyo yile:

• Bona ugqirha wakho rhoqo uze ulandele imiyalelo yakhe ngokuchanekileyo.
• Ukugqiba zonke iimvavanyo ezicwangcisiweyo ngexesha.
• Ukuphila ubomi obusempilweni - ukutya ukutya okunempilo, ukuphepha ukutshaya notywala.
• Nayiphi na imibuzo okanye uloyiko onalo engqondweni kufuneka uxoxwe ngalo nogqirha kwaye ucaciswe.

Awuwedwa, kukho oogqirha kunye namalungu osapho abanokukunceda. Cinga kakuhle, zinyamekele kakuhle wena kunye nomntwana wakho omncinci.

Uthintelo lokukhula ngaphakathi kwesibeleko, i - IUGR, i-FGR, uthintelo lokukhula komntwana ongekazalwa, ukubandezeleka komntwana ongekazalwa, impilo yokukhulelwa, uphuhliso lomntwana ongekazalwa