Ngaba imiphunga yomntwana wakho nayo iye yachaphazeleka kukukhwehlela kokuqala? (Meconium Aspiration Syndrome) Makhe sithethe ngale nto!

Njengomzali, uziva uloyiko olungakanani xa ubona umntwana osandul’ ukuzalwa enengxaki yokuphefumla? Ngamanye amaxesha unobangela wolu bunzima bokuphefumla kumntwana kukuba indle yokuqala yomntwana, ebizwa ngokuba yi-meconium, ingena emiphungeni yomntwana. Namhlanje, siza kuthetha ngale meko ebizwa ngokuba yi-`(Meconium Aspiration Syndrome)`.

Yintoni i-meconium? Kwenzeka ntoni xa ingena emiphungeni yomntwana?

Ngamafutshane, i-meconium sisitulo sokuqala somntwana wakho, okanye indle. Ayifani nendle eqhelekileyo. Yinto etyebileyo, enamathelayo, eluhlaza okwesibhakabhaka-mnyama, efana netha. Yenziwe ngezinto umntwana wakho aziginyayo esesibelekweni. Oko kuthetha ukuba yenziwe ngeeseli zolusu lomntwana, i-mucus (njenge-mucus), iinwele ezincinci zomntwana (i-lanugo), inyongo, nezinye izinto.

Iintsana zihlala zidlula i-meconium kwiiyure ezingama-48 emva kokuzalwa. Nangona kunjalo, ngamanye amaxesha, ingakumbi ukuba umntwana ufumana uxinzelelo okanye ukungakhululeki esibelekweni (`(Uxinzelelo lwe-Fetal)`), umntwana angadlula inxalenye yale meconium ngaphambi kokuzalwa, oko kukuthi, esesesibelekweni. Ukuba iyadlula, loo meconium iya kongezwa kwi-amniotic fluid ejikeleze umntwana.

I-Meconium Aspiration Syndrome (MAS) yimeko apho umntwana enengxaki yokuphefumla ngenxa ye-meconium exutywe nolwelo lwe-amniotic olungena emiphungeni yomntwana. Olu lwelo lwe-amniotic oluxutywe ne-meconium lunokungena emiphungeni yomntwana xa umntwana ephefumla, nokuba ngaphambi okanye ngexesha lokuzalwa.

Khawucinge ngento eyenzekayo xa loo meconium ityebileyo nenamathelayo efana netar ingena emchameni nasemaphaphu omntwana.

• Ingavimba indlela yomoya yomntwana .
• Imiphunga ingonakalisa .
• I-Meconium inokuthintela ukusebenza kwento ebalulekileyo ebizwa ngokuba yi-"Surfactant", enceda imiphunga ukuba ivuvuke kwaye isebenze kakuhle.

Oku kwenza kube nzima kakhulu kumntwana ukuphefumla. Ngamanye amaxesha, le meko inokuba yingozi nakubomi bakhe . Ngoko ke, kubaluleke kakhulu ukukwazi oku.

Ixhaphake kangakanani le meko?

Ngokomyinge, malunga ne-12 ukuya kwi-20 kwi-100 nganye yokuzalwa iya kuba ne-meconium exutywe kwi-amniotic fluid. Oku sikubiza ngokuba yi-"meconium-stained amniotic fluid." Le meko ixhaphake kakhulu kwiintsana ezipheleleyo (iiveki ezingama-40) kunye neentsana ezisandul' ukuzalwa (emva kweeveki ezingama-42).

Kodwa nantsi into onokuyicinga. Ayingabo bonke abantwana abazalwa benamanzi anombala we-meconium abafumana i-"MAS". Yipesenti encinci kuphela, phakathi kwe-2% kunye ne-10% yabantwana abanjalo, abafumana le meko ye-"MAS".

Zithini iimpawu ze-meconium efuthayo kumntwana?

Ngoku siyazi ukuba i-meconium inokuba yingozi ukuba ingena emiphungeni. Ngoko ke, ukuba umntwana wakho uphefumle i-meconium, unokubonisa iimpawu ezifana nezi:

• Ubunzima bokuphefumla:Usana lubonakala lunengxaki yokuphefumla.
• Ukwehla kwesantya sentliziyo: Ukubetha kwentliziyo yomntwana kuyehla.
• Ulusu oluluhlaza okwesibhakabhaka (iCyanosis): Ulusu lomntwana, ingakumbi imilebe kunye neminwe yakhe, luba luhlaza okwesibhakabhaka. Oku kungenxa yokuba umzimba awufumani ioksijini eyaneleyo.
• Ukuphefumla ngokukhawuleza: Ngamanye amaxesha umntwana uphefumla ngokukhawuleza kakhulu.
• Ukuphefumla ngesandi sokurhona: Isandi esifana nokuthi "Huh... Huh..." senziwa xa uphefumla.
• Ukutshona kwesifuba: Umqolo wesifuba ubonakala utshona xa uphefumla.
• Ayinabomi: Usana lubonakala lungenabomi kwaye lungenabomi.

Ukuba ubona iimpawu ezinje, kubaluleke kakhulu ukwazisa abasebenzi bezonyango ngoko nangoko.

Kutheni oku kusenzeka? Yintoni unobangela?

Isizathu esiphambili sokuba i-meconium ingene emiphungeni luxinzelelo olufunyanwa ngumntwana esibelekweni okanye ngexesha lokuzalwa . Kukho izizathu ezahlukeneyo zolu xinzelelo. Umzekelo:

• Ukuba nosulelo kumama okanye kumntwana.
• Ukuncipha kokungenisa ioksijini kumntwana.

Kwimeko enjalo yoxinzelelo, umntwana ngequbuliso uphefumla nzulu, ngokukhawuleza. Kanye njengokuba sibamba umphefumlo wethu xa soyika kakhulu. Ngaloo mzuzu, ulwelo oluqinileyo (kunye ne-meconium ukuba ikhona) lungena emiphungeni yomntwana. Emva koko i-meconium etyebileyo inamathela kwiingxowa zomoya (`(Alveoli)`) zemiphunga, nto leyo eyenza kube nzima ukuphefumla.

Uyazi njani ukuba i-meconium isemanzini?

Ulwelo lwe-amniotic luhlala lucacile. Nangona kunjalo, xa kongezwa i-meconium kuyo, ulwelo oluphumayo xa amanzi ephuma luba nombala oluhlaza-mdaka . Kwakhona, abantwana abachatshazelwa yi-meconium banokuba nolusu olumthubi kunye neenzipho xa bezalwa. Kodwa ungakhathazeki, oogqirha bakho kunye nabahlengikazi bayazi kakuhle le nto. Bakhangela iimpawu ezinje.

Ingaba yingxaki ukuba umntwana uginya i-meconium?

Le yingxaki ebangwa ngoomama abaninzi. Kuqhelekile ukuba umntwana aginye ulwelo lwe-amniotic esesiswini. Kwakhona kuyimfuneko ekukhuleni komntwana. Ngoko ke, ukuba i-meconium encinci ixutywe nolwelo lwe-amniotic aze umntwana ayiginye, akuyi kuba yingxaki enkulu. Okuyingozi kukuphefumla i-meconium emaphashini, kungekhona ukuginya.

Oogqirha bayixilonga njani le nto? Zithini iindlela zonyango?

Ukuba amanzi akho ayaphuka uze ubone i-meconium kwi-amniotic fluid yakho, oogqirha baya kumjonga umntwana wakho ngononophelo olukhulu ukuze babone iimpawu ze-"MAS" emva kokuzalwa. Njengoko bekutshiwo ngaphambili, ayizizo zonke iintsana eziba nale meko ngenxa ye-meconium.

Ezona zinto ziphambili ezixilongayo zezi:

• Ukujonga imeko yomntwana: Ukuphefumla komntwana, umbala womzimba wakhe, kunye nomsebenzi wakhe kuyajongwa.
• Ukumamela isifuba: Isifuba somntwana simamela nge-stethoscope ukujonga naziphi na izandi ezingaqhelekanga.
• I-X-ray yesifuba:Oku kungabona ngokucacileyo ukuba i-meconium ibambeke emiphungeni okanye ukuba ulwelo luqokelelene.
• Uvavanyo lweGesi egazini: Olu vavanyo lunceda ekufumaneni inqanaba leoksijini kunye nekhabhoni-dayoksayidi egazini lomntwana kunye nobungakanani bokuphefumla okuxinezelekileyo.

Injani unyango?

Unyango luxhomekeke ekubeni umntwana utye kangakanani i-meconium, ukuba ityebe kangakanani, nokuba umntwana uphefumla nzima kangakanani.

• Ukuba umntwana ukhala kakuhle xa ezalwa kwaye ukhuthele kakhulu, unyango olukhethekileyo alusoloko lufuneka.
• Ukufunxa: Eli linyathelo lokuqala. Isirinji encinci yebhalbhu isetyenziselwa ukususa i-meconium emlonyeni, empumlweni, nasemqaleni womntwana. Ngamanye amaxesha, ityhubhu encinci ifakwa nakwi-windpipe yomntwana (i-trachea) ukuze kususwe nayiphi na i-meconium enamathele apho.
• Ukunika ioksijini: Ukuba umntwana usenengxaki yokuphefumla, nika ioksijini ngokubeka imaski yeoksijini ebusweni.

Ezinye iintsana ezine-MAS enzima zisenokufuna ukungeniswa kwiYunithi yoKhathalelo oluNzulu lweZifo eziSandulelayo (i-NICU) ukuze zifumane unyango olukhethekileyo. Ezi ziquka:

• Ukudibanisa nesixhobo somoya: Ukuba umntwana unengxaki yokuphefumla yedwa, lo matshini uyanceda.
• Unyango lwe-Surfactant: Into ebizwa ngokuba yi-surfactant inikwa ngendlela yokwenziwa ukunceda imiphunga ivuleke.
• Ii-antibiotics: Ukuba kukho usulelo emiphungeni, zinikwa ukunyanga.
• I-ECMO (i-Extracorporeal Membrane Oxygenation): Olu lunyango olukhethekileyo olusetyenziswa kwiimeko ezinzima kakhulu. Intliziyo kunye nemiphunga yomntwana iyaphumla, kwaye kusetyenziswa umatshini wokongeza ioksijini egazini.
• I-Radiant Warmer: Inceda ukulawula ubushushu bomzimba womntwana.
• Umatshini we-CPAP (Continuous Positive Airway Pressure): Unceda ukugcina amaphaphu omntwana evulekile.

Khumbula, zonke ezi ndlela zonyango zenzelwe ukunceda umntwana wakho aphile ngokukhawuleza. Oogqirha kunye nabahlengikazi baya kubonelela ngononophelo olungcono kakhulu umntwana wakho aludingayo.

Ngaba ukufunxwa yi-meconium kungathintelwa? Zithini izinto ezinokubangela umngcipheko?

Inyaniso kukuba, akukho ndlela yokuthintela ngokupheleleyo ukufunxwa kwe-meconium kumntwana. Kuba yinto eyenzekayo xa umntwana exinezelekile. Nangona kunjalo, oogqirha bahlala beqaphela ukuba kukho i-meconium kwi-amniotic fluid na nokuba umntwana "ukwingxaki yosana olusandul' ukuzalwa". Ukuba le meko iqatshelwa kwangethuba, kunokwenzeka ukuthintela ukufunxwa kwe-meconium okuqatha kwaye uqalise unyango ngokukhawuleza.

Kukho izinto ezithile ezinokubangela umngcipheko kwi-meconium aspiration syndrome:

• Ukukhulelwa emva kwexesha lokukhulelwa:Oko kuthetha ukwandisa ukukhulelwa ngaphaya kweeveki ezingama-42.
• Umama unesifo seswekile okanye uxinzelelo lwegazi oluphezulu.
• Umsebenzi onzima okanye ohlala ixesha elide.
• Ukuncipha kwamanqanaba eoksijini kumntwana ngexesha lokukhulelwa.
• Uthintelo Lokukhula Kwemveku (FGR).

Oogqirha banika ingqalelo engakumbi kwiintsana ezizelwe ngoomama abanezi zinto zinobungozi.

Ziziphi iingxaki ezinokubakho? Kuthatha ixesha elingakanani ukuphola?

Iingxaki ze-MAS ezihlala ixesha elide aziqhelekanga kwaye zihlala zilawulwa kwaye zinyangeke kwiintsuku ezimbalwa.

Nangona kunjalo, iintsana ezine-"MAS" zinokuba semngciphekweni omkhulu wokufumana ezi meko kunezinye iintsana:

• I-Pneumonia ( usulelo lwemiphunga)
• Isifuba
• Uxinzelelo lwegazi oluphezulu lweMiphunga yoSana (PPHN)
• Ukuwa komphunga `(Pneumothorax)`
• Ukungabikho kweoksijini `(Hypoxia)`

Kodwa khumbula, ayingomntwana wonke oginya i-meconium ofumana i-`(MAS)`, kwaye ayingomntwana wonke one-`(MAS)` ofumana ezi ngxaki. Ukuba iqatshelwe kwaye inyangwa kwangethuba, le yimeko enokunyangeka kakhulu.

Uninzi lweentsana luyaphola emva kokuphefumla nge-meconium kwiiyure ezimbalwa. Kwiimeko ezinzima kakhulu, umntwana unokufuna ukuhlala kwi-NICU iintsuku okanye iiveki ezininzi, okanye unokufuna ukuxhomekeka kwi-oxygen eyongezelelweyo.

Oko sifanele sikukhumbule (Umyalezo Wokuya Ekhaya)

I-Meconium Aspiration Syndrome yimeko enzima, kodwa enyangekayo, enokwenzeka kwiintsana ezisandul’ ukuzalwa. Ugqirha wakho uza kujonga ulwelo lwe-amniotic lomntwana wakho ukuba aluna-meconium xa ezalwa. Ukuba umntwana wakho ubonisa naziphi na iimpawu zokukhathazeka, uza kuthatha amanyathelo okususa i-meconium empumlweni nasemlonyeni wakhe ngoko nangoko.

Eyona nto ibalulekileyo kukubona le meko kwangethuba uze uyinyange ngokukhawuleza. Ngale ndlela, amathuba okuba neengxaki aphantsi kakhulu. Uninzi lweentsana luyaphila ngokupheleleyo kwiintsuku ezimbalwa, kwaye iziphumo ebezingalindelekanga ezihlala ixesha elide azixhaphakanga.

Kwakhona, khumbula, ayizizo zonke iintsana ezine-meconium kwi-amniotic fluid eziya kuba ne-meconium aspiration syndrome. Ngoko ke ungoyiki ngokungeyomfuneko. Themba iqela lakho lezonyango. Liza kubonelela ngononophelo olungcono kuwe nakumntwana wakho.

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