Ingaba i-umbilical cord yomntwana wakho inamathele kumphetho we-placenta? (Ukufakwa kwe-Marginal Cord) Masithethe ngale nto!

Oomama abaninzi bahlala bexhalabile ngempilo yomntwana wabo ngexesha lokukhulelwa, nokuba ukhula kakuhle na, akunjalo? Ngoko ke, ngamanye amaxesha xa ugqirha wakho esenza i-ultrasound scan aze athi into efana nale, "Kukho umahluko omncinci kwi-umbilical cord yomntwana, ayikho phakathi kwe-placenta, kodwa inamathele ecaleni," kuyinto eqhelekileyo ukuba ngequbuliso uzive usoyika kwaye ukhathazekile. Yiloo nto siyibiza ngokuba yimeko efana nale "Marginal Cord Insertion". Ngoko ke, masithethe ngale nto ngokucacileyo namhlanje, ngendlela onokuyiqonda? Ngaba kukho into omele uyoyike, kwaye masifumanise ukuba kwenzeka ntoni kanye kanye kule nto.

Ngaba uyazi ukuba yintoni iMarginal Cord Insertion?

Ngamafutshane, `(Ukufakwa kweNtambo yeMarginal)` lutshintsho oluncinci kwindlela intambo yesisu yomntwana `(Intambo yeUmbilical)` eqhagamshelwe ngayo kwi `(Placenta)` ngexesha lokukhulelwa. Uyazi, `(Intambo yeUmbilical)` ifana nomgca wobomi odibanisa umama nomntwana. Umntwana ufumana yonke isondlo kunye neoksijini ayidingayo kumama ngale ntambo yesisu. Le ntambo yesisu iqhagamshelwe kwilungu elithile elibizwa ngokuba yi `(Placenta)`, elikhula kuphela ngexesha lokukhulelwa.

Ngokwesiqhelo, intambo yomntwana kufuneka inamathele embindini we-placenta, okanye kufutshane kakhulu nayo. Oku kungenxa yokuba izondlo zinokuhamba kakuhle ukusuka kumama ukuya kwi-placenta kwaye ukusuka apho ziye kumntwana ngaphandle kokuphazamiseka. Leyo yindlela ekhuselekileyo.

Nangona kunjalo, kwimeko `(Ukufakwa kweNtambo yeMarginal)`, le ntambo yesisu ayidibani nombindi we-placenta, kodwa idibanisa nomphetho okanye umda we-placenta (malunga neemilimitha ezingama-20 ukusuka apha). Ukuchaneka, olu nxibelelwano luziisentimitha ezimbini okanye ngaphantsi ukusuka kumphetho we-placenta. Xa olu hlobo lonxibelelwano lwenziwa kumphetho, ngamanye amaxesha (akusoloko) uhambo lwesondlo ukusuka kwi-placenta ukuya kumntwana lunokuba lucotha kancinci. Ukuba oko kuyenzeka, ukukhula komntwana kusenokuba kucotha kancinci. Sibiza oku `(IUGR - Intrauterine Growth Restriction)`. Kwakhona, ngamanye amaxesha izinga lentliziyo yomntwana linokwehla ngexesha lokuzala.

Nangona kunjalo, eyona nto ibalulekileyo apha kukuba uninzi lokukhulelwa olune-`(Marginal Cord Insertion)` luphela ngokuzalwa okusempilweni ngaphandle kweengxaki. Ngoko ke, kungcono ukungoyiki ngoko nangoko, akunjalo?

Ixhaphake kangakanani le meko?

Le meko, ebizwa ngokuba yi-"Marginal Cord Insertion", ixhaphake kakhulu xa kukhulelwa abantwana abaninzi, njengamawele okanye amawele amathathu, kunaxa kukhulelwa abantwana abangamawele. Iyenzeka phakathi kwe-2% kunye ne-25% yokukhulelwa. Izinga liphantsi xa kukhulelwa abantwana abangamawele kwaye liphezulu xa kukhulelwa abantwana abaninzi.

Ziziphi iimpawu ezinokukunceda wazi ukuba une-Marginal Cord Insertion?

Nantsi ingongoma ebalulekileyo. Uninzi lwexesha, umama one-"Marginal Cord Insertion" akabi nazimpawu zithile.Usenokungawuboni umahluko. Ugqirha wakho uya kuhlala ebona olu qhagamshelo olungaqhelekanga lwentambo yesisu ngexesha lokuhlolwa kwe-ultrasound rhoqo ngexesha lokukhulelwa.

Kutheni oku (Ukufakwa kweNtambo yeMarginal) kwenzeka? Zithini izizathu?

Abaphandi abakayazi kakuhle into ebangela ukufakwa kwentambo yeMarginal. Nangona kunjalo, kukho izinto ezithile ezicingelwa ukuba zonyusa umngcipheko wolu hlobo lokufakwa kwentambo. Njengoko besitshilo ngaphambili, kuxhaphake kakhulu xa kukhulelwa abantwana abaninzi (njengamawele). Ukongeza, kukho nezinye izinto ezininzi ezinokubangela oku:

• Ukusetyenziswa kweziyobisi okanye utywala ngexesha lokukhulelwa.
• Ukuba nesifo esingapheliyo esifana nesifo seswekile.
• Ubudala bomama buyiminyaka engama-35 nangaphezulu ( ubudala bomama osele ekhulile ).
• Olu lukuzalwa kwakho kokuqala (`Nulliparity`).
• Ndisebenzise i-IUD (Intrauterine Device) ngaphambi kokuba ndikhulelwe.
• Ukukhulelwa ngokusebenzisa ubuchwepheshe bokuzala obungeyonyani (ART - Artificial Reproductive Technology) (umz. abantwana abazalwa kwityhubhu yovavanyo).

Kodwa khumbula, ukuba nje unenye okanye ngaphezulu kwezi zinto akuthethi ukuba uza kuba neMarginal Cord Insertion. Umzekelo, abantu abaninzi abakhulelweyo nge-ART banokuba ne-umbilical cord insertion eqhelekileyo. Into ebalulekileyo kukuba nokuba kukho into engaqhelekanga kwi-umbilical cord insertion, uninzi lwabantu luyaqhubeka nokukhulelwa okunempilo.

Ukufakwa kweMarginal Cord kudla ngokuchongwa nini?

Olu hlobo lweengxaki zentambo yosana ludla ngokubonwa ngexesha le-ultrasound scans kwi-trimester yesibini (iiveki ezili-14 ukuya kwezingama-27) . Nangona kunjalo, ngamanye amaxesha, kunokuba nzima kugqirha ukukhomba indawo echanekileyo apho intambo yosana inamathele khona kwi-placenta.

Kwiimeko ezinjalo, ugqirha angasebenzisa indlela ekhethekileyo ebizwa ngokuba yiDoppler ngexesha lovavanyo lwe-ultrasound. Oku kukuvumela ukuba ubone ngokucacileyo ukuhamba kwegazi phakathi kwe-placenta nomntwana, oko kuthetha indlela umntwana ondliwe ngayo. Olu vavanyo lweDoppler lunceda ekufumaneni indawo echanekileyo yokuncamathiselwa kwe-umbilical cord.

Zithini iindlela zonyango zoku?

Okwangoku akukho nyango luthile "olunokulungisa" imeko ebizwa ngokuba yi-"Marginal Cord Insertion". Oku kuthetha ukuba i-umbilical cord ayinakutshintshwa. Endaweni yoko, ugqirha wakho uza kukujonga ngokusondeleyo wena nomntwana wakho kulo lonke ixesha lokukhulelwa kwakho. Oku kwenzelwa ukuthintela naziphi na iingxaki ezinokuvela. Baza kujonga nokuba umntwana ukhula kakuhle na kwaye kukho naziphi na ezinye izinto ezinobungozi. Kwezinye iimeko, utyando lwe-cesarean (C-section) lunokucetyiswa ukuba kukho naziphi na iingozi.

Ngokubekwa esweni ngokusondeleyo ngolu hlobo, iingozi zingancitshiswa kakhulu. Ngoko ke bathembe oogqirha bakho kwaye wenze njengoko bethetha.

Ngaba ikho indlela yokuthintela ukufakwa kweMarginal Cord?

Hayi. Awunakukuthintela ukufakwa kweMarginal Cord. Asinto onokuyilawula. Kodwa ungasebenzisana nogqirha wakho, ujonge ukukhulelwa kwakho ngokusondeleyo, kwaye wenze konke okusemandleni akho ukuqinisekisa ukuba umntwana usempilweni kwaye uza kuzala ngempumelelo.

Ingaba le meko (Marginal Cord Insertion) iyaziphilisa ngokwayo?

Inokwenzeka. Kwiimeko ezininzi, `(Ukufakwa kweNtambo yeMarginal)` akubeki mngcipheko mkhulu ekukhulelweni, kwaye akuthinteli umntwana ekufumaneni izondlo azidingayo. Kwimeko enjalo, akufuneki ukhathazeke kakhulu ngendlela intambo yesisu enamathele ngayo. Endaweni yoko, themba ukuba ugqirha wakho uya kujonga ngononophelo ukukhula komntwana, aze agxile ekugcineni impilo yakho ngexesha lokukhulelwa.

Ngaba ukufakwa kwentambo yeMarginal Cord kuyingozi?

Ukuba kukho into engaqhelekanga kwindlela enamathele ngayo intambo yomlomo, inokubangela iingozi ezithile ngexesha lokukhulelwa. Nangona kunjalo, musa ukucinga ukuba kubi kakhulu xa ufunyaniswa ukuba une-`(Ukufakwa kweNtambo yoMmandla)`. Kuba kwiimeko ezininzi ufunyaniswa ukuba une-`(Ukufakwa kweNtambo yoMmandla)`, ukukhulelwa okusempilweni kunye neentsana ezisempilweni kuyazalwa.

Ugqirha wakho unokuxoxa ngazo naziphi na iingxaki onokuba nazo ngembali yakho yezonyango kunye neziphumo ze-ultrasound. Enye yezona zinto zixhalabisayo kukuba umntwana wakho usenokuba ukhula kancinci kakhulu, imeko ebizwa ngokuba yi-Intrauterine Growth Restriction (IUGR). Ukuba umntwana akafumani izondlo ezaneleyo kwi-placenta, unokuba semngciphekweni we-IUGR. Oku kulandelayo kunokwenzeka kumntwana wakho osandul’ ukuzalwa:

• Ubunzima bokuzalwa obuphantsi: Usana oluzelwe lunobunzima obungaphantsi kweekhilogram ezi-5 kunye nee-ounces ezi-8 (malunga neekhilogram ezi-2.5), ngesiqhelo.
• Amanqaku aphantsi e-Apgar: Uvavanyo lwe-Apgar yindlela yokuvavanya impilo yomntwana kwangoko emva kokuzalwa. Amanqaku aphantsi e-Apgar anokubonisa ukuba umntwana unokuba nengxaki yentliziyo okanye imiphunga yakhe. Abantwana abanjalo banokufuna ukhathalelo olongezelelekileyo.
• Amathuba amaninzi okuhlala kwiYunithi yoKhathalelo oluNzulu lweZifo eziSandulelayo (i-NICU): Umntwana angagcinwa kwi-NICU ukuze anyamekelwe ngakumbi de umntwana aphile aze adluliselwe kwigumbi eliqhelekileyo.

Ukuba ugqirha wakho ucinga ukuba kukho umngcipheko kuwe okanye kumntwana wakho, unokucebisa ukuba kwenziwe utyando lwe-cesarean (C-section).

Ngaba i-(Marginal Cord Insertion) ingaba yi-(Velamentous Cord Insertion)?

Imeko ebizwa ngokuba yi-"Marginal Cord Insertion", ingakumbi kwi-trimester yesithathu (iiveki ezingama-29 ukuya kuma-40) zokukhulelwa, ingaguquka ibe yimeko ebizwa ngokuba yi-"Velamentous Cord Insertion". Nangona kunjalo, oku kunqabile kakhulu.Ukufakwa kwentambo yeVelamentous kuxa intambo yesisu ingancamathiselwanga ngqo kwi-placenta, kodwa inamathele kwiinwebu ezingaphandle kwe-placenta. Le meko inqabile kancinci kune-Marginal Cord Insertion (eyenzeka malunga ne-1% yokukhulelwa) kwaye ifuna ingqalelo engakumbi.

Ugqirha wakho uza kujonga indlela intambo yesisu enamathele ngayo aze akuncede ufumane iziphumo ezilungileyo kuzo zombini ezi meko, ``Ukufakwa kwentambo yesisu'' kunye ``Ukufakwa kwentambo yesisu yeVelamentous''.

Ngoko ke, ngaba kufuneka ndikhathazeke ngeMarginal Cord Insertion?

Hayi, akufuneki ukhathazeke. Uninzi lwabantu abane-Marginal Cord Insertion baneentsana ezisempilweni. Ukuba umntwana ufumana isondlo esifanelekileyo ukuze akhule, ukuba ne-Marginal Cord Insertion kusenokungachaphazeli ukukhulelwa kwakho.

Thetha nogqirha wakho ngayo nayiphi na into ekuxhalabisayo. Zininzi izinto ezinokunyusa umngcipheko weengxaki ngexesha lokukhulelwa. Ukungaqheleki kwi-umbilical cord kunokuba yingozi okanye kungabi yingozi. Ugqirha wakho unokukukhokela ngexesha lokukhulelwa kwakho aze akunike uvavanyo olunyanisekileyo.

Yeyiphi imibuzo ebalulekileyo omele uyibuze ugqirha wakho?

Kuqhelekile ukuba nemibuzo emininzi engqondweni yakho ngexesha elinje. Nazi ezinye zemibuzo onokuzibuza ugqirha wakho:

• Kuza kufuneka ndihlolwe kangaphi ukukhulelwa kwam nge-ultrasound ukuze ndijonge ukuba ndikhulelwe?
• Ngaba kufuneka ndenze olunye uvavanyo?
• Kunokwenzeka kangakanani ukuba ukufakwa kweMarginal Cord kuchaphazele ukukhulelwa kwam?
• Ngaba kuza kufuneka iimvavanyo ezongezelelweyo ukujonga ukukhula komntwana?
• Ndingalutshintsha njani ukutya kwam, umthambo, kunye nemisebenzi yam yesondo ukuze ndikhulelwe kakuhle kangangoko?
• Ndifanele ndilale ixesha elingakanani ngosuku? Ndifanele ndiphumle ixesha elingakanani ngosuku?

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kuqhelekile ukuba uzive usoyika kancinci xa usiva ukuba une-`(Ukufakwa kweNtambo yeMarginal)`. Nangona kunjalo, musa ukuvumela olu xilongo longeze uxinzelelo olungeyomfuneko ekukhulelweni kwakho. `(Ukufakwa kweNtambo yeMarginal)` kunokufuna ukubekwa esweni okanye ukunyanyekelwa okungakumbi. Kusenokwenzeka nokuba le meko ayizukuyichaphazela kwaphela ukukhulelwa kwakho.

Eyona nto ibalulekileyo kukuba ugqirha wakho azi ukuba unale meko. Olu lwazi luya kubanceda ukuba bahlale bephilile wena nomntwana wakho kangangoko. Khumbula, oomama abaninzi abanesifo esinjalo baya kuzala abantwana abasempilweni. Ngoko ke cinga kakuhle, landela icebiso likagqirha wakho, kwaye yonke into iya kulunga!

Intambo yoMbilical, i-placenta, ukukhulelwa, uphuhliso lomntwana, i-ultrasound, ukufakwa kwentambo emaphethelweni, i-IUGR