Ngaba kufuneka sazi ngokuqhekeka kwengxowa yamanzi ngaphambi kokuba umntwana azalwe? (Ukuqhekeka Kwangaphambi Kwexesha KweeNkumba - I-PROM)

Kuqhelekile ukuba nexhala ngezinto xa ukhulelwe, akunjalo? Mhlawumbi ukhe weva "ngokuphazamiseka kwamanzi," ingakumbi njengoko usondela kumhla wakho wokuzalwa. Ngamanye amaxesha, kunokuba yinto eyoyikisayo ukucinga ngento eza kwenzeka ukuba oku kwenzeka ngaphambi komhla wakho wokuzalwa. Ungakhathazeki, siza kuthetha ngale nto ngokweenkcukacha nangokulula.

Yintoni ukuqhekeka kwangaphambi kwexesha kwee-membranes (i-PROM)?

Ngamafutshane, 'Ukuqhekeka Kwangaphambi Kwexesha KweeNkumba' okanye 'i-PROM' ' kukubeleka' komntwana wakho, oko kuthetha ukuba 'ingxowa yakho yamanzi' okanye 'isikhwama se-amniotic' iyaqhekeka ngaphambi kokuba kuqale ukubeletha. Abanye oogqirha bakwabiza oku ngokuthi 'ukuqhekeka kwee-membrane' ngaphambi kokuba kubelekwe. Oku kuthetha ukuba 'ii-membrane' okanye ii-membrane ziyaqhekeka ngaphambi kokuba 'kubelekwe'.

Ngoku khangela, le `amniotic sac` ifana nengxowa ezele lulwelo. Olu lwelo yinto esiyibiza ngokuba yi-`amniotic fluid` . Le yinto ejikeleza kwaye ikhusela umntwana wakho kulo lonke ixesha lokukhulelwa. Ifana nomqamelo omncinci wokhuseleko lomntwana. Olu `amniotic fluid` lukhusela umntwana kwiintsholongwane, lugcina umntwana ekufumaneni imivumbo kunye nokwenzakala xa ehambahamba, kwaye lukwanceda ukukhula kwemisipha kunye namathambo omntwana.

Xa sithi "amanzi akho ayaphuka" okanye "amanzi akho ayaphuka," kungenxa yokuba la ma-membrane ayaphuka. Xa la ma-membrane ephuka, ulwelo lwe-amniotic olujikeleze umntwana wakho luqala ukuvuza kwilungu lobufazi bakho, nokuba kancinci okanye ngequbuliso. Oku kunokuba yingxaki. Kuba xa ulwelo lwe-amniotic luphelile, wena nomntwana wakho nisengozini enkulu yosulelo kunye nezinye iingxaki, ezifana nokuzalwa ngaphambi kwexesha .

Ngoko ke, ukuba ucinga ukuba ii-membrane zakho ziqhekekile, kufuneka wazise ugqirha wakho wokubelekisa okanye umsebenzi wezempilo wosapho ngoko nangoko.

Yintoni i-Preterm PROM (PPROM)?

Ngoku masithethe nge -'Preterm PROM' okanye i-'PPROM' . Kulapho i-'amniotic sac' yakho igqabhuka khona ngaphambi kweeveki ezingama-37 zokukhulelwa. Khawuthelekelele, ukukhulelwa kwakho kungaphantsi kweeveki ezingama-37, kodwa amanzi akho aya kugqabhuka. Ngeli xesha, ugqirha wakho uya kugqiba ukuba 'uzale' umntwana ngoko nangoko, okanye alibazise 'ukuzala' kangangeentsuku ezimbalwa.

Esi sisigqibo esinzima kancinci. Kuba, ukwandisa ixesha lokukhulelwa emva kokuba amanzi ephumile kwandisa umngcipheko wosulelo kunye nezinye iingxaki. Kodwa, kwelinye icala, kukwakho nemingcipheko yokubeleka umntwana kwangethuba, oko kukuthi, ngaphambi kwexesha. Ngoko ke ugqirha kufuneka alinganise zombini ezi ngozi ngononophelo ngaphambi kokuba enze isigqibo esifanelekileyo.

Kunokwenzeka ntoni ukuba ingxowa yamanzi iqhekeke ngolu hlobo?

Ukuba ingxowa yamanzi iqhekeka ngokukhawuleza, umntwana usemngciphekweni wokuzalwa ngaphambi kwexesha kwayeKukho umngcipheko wokosuleleka. Ukuba ukukhulelwa kwakho kugqityiwe kwiiveki ezingama-37, iingxaki zokuzalwa ngaphambi kwexesha azinakwenzeka kangako. Nangona kunjalo, ukuba umntwana uzelwe ngaphambi kweeveki ezingama-37, kuya kufuneka ajongane neengxaki zokuzalwa ngaphambi kwexesha.

Imizekelo yoku yile:

• Iingxaki zokuphefumla .
• Ubunzima bokugcina ubushushu bomzimba .
• Oku kunokutshintsha nendawo yemveku esibelekweni , nto leyo enokuchaphazela ukuzalwa.

Ukongeza, xa ulwelo lwe-amniotic kunye ne-amniotic sac zingakhuselekanga, umntwana kunye nesibeleko sakho basengozini enkulu yokufumana usulelo . Ezi sulelo ngamanye amaxesha zinokuba yingozi.

Ixhaphake kangakanani le meko?

Imeko ebizwa ngokuba yi-'PROM' yenzeka malunga ne -10% yokukhulelwa. Ukuba i-'PROM' iyenzeka ngexesha lokukhulelwa (kwiiveki ezingama-37), i-95% yexesha umntwana ezalwa kwiiyure ezingama-28.

I-PPROM yimeko engaqhelekanga, eyenzeka malunga ne- 3% yokukhulelwa. Izifundo zibonise ukuba i-PPROM inokwenzeka kakhulu xa ukukhulelwa kusetyenziswa iindlela ezininzi .

Kutheni oku kusenzeka? Ziziphi izizathu eziphambili ze-'PROM' kunye ne-'PPROM'?

Izizathu ze-'PROM' kunye ne-'PPROM' zinokwahluka.

• Ukuba amanzi akho aphuka ngexesha elifanelekileyo, oko kukuthi, emva kweeveki ezingama-37 , isizathu esiphambili kukuba ii-membranes zakho ze-amniotic ziya zisiba buthathaka kancinci kancinci ngenxa yoxinzelelo lokuxinana ngexesha lokubeleka. Kuqhelekile ukuba ii-membranes ziqhekeke ngokuzenzekelayo, kodwa kudla ngokwenzeka emva kokuba kuqalile ukubeleka.

Into ebalulekileyo kukuba nokuba awuziva ukudumba, umzimba wakho usenokuba ulungiselela ukuzala. Oku kuthetha ukuba ngaphandle kokuba uqaphele, isibeleko sakho sisenokuba siyadumba, umlomo wesibeleko sakho usenokuba unciphile (uyacima), kwaye umlomo wesibeleko sakho usenokuba uvuleka (uyavuleka). Oku kunokubangela ukuba i-amniotic sac ibe buthathaka ize ekugqibeleni iqhekeke.

• I-PROM yangaphambi kwexesha (PPROM) idla ngokubangelwa yimeko yempilo okanye iingxaki ngexesha lokukhulelwa , kodwa ngamanye amaxesha inokwenzeka ngaphandle kwesizathu esicacileyo.

Ezinye zezizathu eziphambili zezi:

• Ukopha kwamalungu esini .
• Iimeko zokuzalwa esibelekweni sakho (ezifana ne -Ehlers-Danlos syndrome ).
• Ukungakwazi ukusebenza kakuhle komlomo wesibeleko.

Zithini iimpawu zoku? Uzibona njani?

Uphawu olucacileyo lokuba ii-membranes zakho ziyaphuka kukuba uziva ngathi ngequbuliso ukhupha ulwelo oluninzi kwilungu lobufazi bakho. Kodwa akusoloko kuvakala ngathi lukhulu. Abanye abantu baziva ngathi luvuza kancinci, njengokuthontsiza. Ukuphuphuma kwamanzi akho yinto ongenakukwazi ukuyilawula. Kufana nokuba awukwazi ukuyeka ukuchama .

Ngamanye amaxesha kunzima ukufumanisa ukuba lulwelo oluphuma kwi-amniotic, ulwelo oluphuma kwilungu lobufazi, okanye umchamo . Kwiimeko ezinjalo, ungathatha itawuli yephepha elimhlophe uze uyintywilisele kulwelo.

• Ukuba ityheli, okanye ivumba kakubi , mhlawumbi ngumchamo .
• Ukuba ayinambala kwaye ayinavumba , kufuneka ubone ugqirha ngokukhawuleza.

Nangona kunjalo, ukuba unamathandabuzo amancinci ngento ephuma kwisini sakho, qiniseka ukuba wazise ugqirha wakho.

Oogqirha bayixilonga njani le nto?

Ugqirha wakho uza kuqinisekisa i-PROM ngovavanyo lwe-speculum olungenazintsholongwane . Oku kuquka ukufaka i-speculum kwisini sakho. Oku kuvumela ugqirha ukuba ahambise udonga lwesini sakho ukuze abone umlomo wesibeleko sakho. Emva koko kuthathwa isampulu yolwelo ize ivavanywe. Ngamanye amaxesha, ukuba ugqirha ubona ukuqokelelana kolwelo lwe-amniotic kwinxalenye ephezulu yesini sakho ngexesha lovavanyo, ii-membranes zisenokuba ziqhumile.

Ukongeza, kunokwenziwa i -ultrasound scan ukujonga indawo yomntwana kunye nobungakanani bolwelo lwe-amniotic ngaphakathi kwesibeleko.

Ziziphi ezinye iimvavanyo ezikhoyo?

• Uvavanyo lwephepha leNitrazine: Olu lusetyenziselwa ukulinganisa i-pH (umlinganiselo we-asidi yento ethile) yesitho sakho sangasese sowesifazane. Ithontsi lokukhupha ulwelo lwakho lwesitho sangasese somfazi liyabekwa kweli phepha kwaye iphepha liyajongwa ukuba lijika libe luhlaza okwesibhakabhaka na. Ukuba lijika libe luhlaza okwesibhakabhaka, i-pH yolwelo ingaphezulu kwe-6.0, ngoko ke kunokwenzeka ukuba libe lulwelo lwe-amniotic. (Ukukhupha ulwelo oluqhelekileyo lwesitho sangasese somfazi kune-pH ephantsi kune-amniotic fluid.)
• Uvavanyo lweFern: IFerning ligama elinikwa ulwelo lwe-amniotic olomileyo olufana negqabi lefern. Kwakhona, isampuli yolwelo iyathathwa ize ihlolwe phantsi kwe-microscope.

Zithini iindlela zonyango zoku?

Unyango luxhomekeke kubudala bokukhulelwa , impilo yomntwana , kunye nobunzima bemeko yakho .

Kukho iindlela ezimbini ezidla ngokubakho: enye kukuzala umntwana, enye kukulawula umntwana ngokulindelekileyo. Ukulawula umntwana ngokulindelekileyo lunyango olulibazisa ukuzala. Oku kuquka ukuphumla ebhedini, amayeza, kunye nokujonga rhoqo usulelo okanye ukubandezeleka komntwana ongekazalwa.

Unyango lwe-PROM emva kweeveki ezingama-37

Ukuba ukhulelwe phakathi kweeveki ezingama-37 ukuya kwezingama-40 kwaye amanzi akho ayaphuma, malunga nama-90% abasetyhini baya kuzala ngokuzenzekelayo kwiiyure ezingama-24. Ugqirha wakho angakunika amayeza okubangela ukuzala, okanye angakuvumela ukuzala kuqhubeke ngokwendalo.Ngokwesiqhelo, ukuzala umntwana kwiiyure ezingama-24 yeyona ndlela ikhuselekileyo.

Unyango ukuba i-'PROM' yenzeka phakathi kweeveki ezingama-34 nezingama-37

Kwimeko enjalo, ugqirha wakho uza kulinganisa iingozi zokuba nomntwana ngaphambi kwexesha ngokuthelekisa iingozi zosulelo kunye nezinye iingxaki . Ukuba ugqirha ugqiba ekubeni azale umntwana, uza kulungiselela ukuba umntwana afumane naluphi na unyango olukhethekileyo (njengonyango olukwi- NICU - iYunithi yoKhathalelo oluNzulu lweZifo eziSandulelayo ) xa sele ezelwe.

Unyango lwe-Preterm PROM (PPROM) ngaphambi kweeveki ezingama-34

Ukuba umntwana wakho ukhulelwe ngaphantsi kweeveki ezingama-34, kukho umngcipheko omkhulu weengxaki zokuzalwa ngaphambi kwexesha. Ngeli xesha, ugqirha wakho uza kuzama ukukugcina esibhedlele, akubeke ebhedini, aze azame ukwandisa ixesha lokukhulelwa kwakho.

Banokukunika amayeza anjengala:

• IiCorticosteroids: Zinceda ekuphuhliseni imiphunga yomntwana.
• Ii-antibiotics: Zithintela usulelo kwaye zikhulise ixesha lokukhulelwa.
• IiTocolytics: Amayeza anikwa ukunqanda ukuzala.
• I-Magnesium sulfate: Inceda ekuphuhliseni ingqondo yomntwana.

Ugqirha wakho uza kukujonga rhoqo ukuze abone ukuba kukho iimpawu zosulelo. Uza kujonga nokubetha kwentliziyo yomntwana wakho kunye neentshukumo zakhe ukuqinisekisa ukuba umntwana akakhathazeki. Ithemba lale mithi kukwandisa ukukhulelwa kwakho ukuya kwiiveki ezingama-34 ubuncinane.

Eyona nto ibalulekileyo kukuba, ukuba unosulelo xa amanzi akho ephuma, okanye ukuba unosulelo kamva, kuya kufuneka ubeleke umntwana.

Ngaba ikho indlela yokuthintela oku?

Akukho ndlela ithile yokuthintela i-PROM. Eyona nto ingcono onokuyenza kukuyeka ngokupheleleyo ukutshaya, ukhulelwe kakuhle, kwaye uye kuzo zonke ii-pregnancy diagnosis zakho. Ukusebenzisa icuba kuyingozi kwi-PROM (kunye nezinye iingxaki ezininzi ngexesha lokukhulelwa).

Ngubani osengozini enkulu yokuba ne-'PROM' kunye ne-'PPROM'? (Izinto Ezinobungozi)

Usemngciphekweni omkhulu wokufumana i-PPROM okanye i-PROM ukuba unemeko eyenza i-chorioamniotic membrane yakho ibe buthathaka (umaleko wangaphandle we-amniotic sac), okanye ukuba isanda kuvela. Imizekelo yoku ibandakanya:

• Izifo: Izifo ezidluliselwa ngesondo (ii-STI) zizifo ezifana ne-bacterial vaginosis.
• Ubude obufutshane bomlomo wesibeleko.
• Ukuba kukho imbali yokuba wayekhe waba yi-'PROM' ngaphambili .
• Ukuba ulindele abantwana abanjengamawele okanye amawele amathathu (`Ukulindela ukuphindaphinda`).
• IiPolyhydramnios (oko kuthetha ukuba kukho ulwelo olugqithisileyo lwe-amniotic).
• Ukopha kwamalungu esini.
• `I-Amniocentesis`Ukuba (uvavanyo lwamanzi) lwenziwe.
• Ukuba kukho imbali yokuzala ngaphambi kwexesha .

Zeziphi iingozi eziphambili xa ingxowa yamanzi iphuka?

Umngcipheko omkhulu nge-PROM kukuzalwa ngaphambi kwexesha. Ukuzalwa ngaphambi kwexesha kuxa umntwana wakho ezalwa ngaphambi kweeveki ezingama-37. Iingxaki zokuzalwa ngaphambi kwexesha ziquka iingxaki zokuphefumla, ubushushu bomzimba obuphantsi, kunye neengxaki zokukhula. Ezinye iintsana ezisandula kuzalwa ngaphambi kwexesha zinokuba nokulibaziseka kokukhula kamva ebomini.

Xa ulwelo lwe-amniotic lungakhuselekanga, iingxaki ezingakumbi zinokwenzeka ngexesha lokukhulelwa, umzekelo:

• Iintsholongwane , ezifana neChorioamnionitis (usulelo lwe-membranes kunye ne-amniotic fluid).
• Ukuqhawuka kwe-placenta .
• Ukucinezelwa kwentambo yombilical okanye ukutyhafa kwentambo yombilical .

Ugqirha wakho uza kuqwalasela umngcipheko wokuba nomntwana ngaphambi kwexesha kunye nomngcipheko wosulelo kunye nezinye iingxaki ukuze amisele ixesha elifanelekileyo lokubeleka umntwana wakho.

Ndingamfumana umntwana emva kokuba ndiphumile emanzini?

Izifundo zibonise ukuba abafazi abazala kwiiyure ezingama-24 emva kokuqhekeka kwe-membranes banomngcipheko ophantsi wosulelo kunabo bazala emva kweeyure ezingama-24 . Nangona kunjalo, le ngozi kufuneka ilinganiswe nomngcipheko wokuba nomntwana ngaphambi kwexesha. Ugqirha wakho uza kukunceda wenze isigqibo esifanelekileyo kuwe nakumntwana wakho.

Ungahlala ixesha elingakanani ukhulelwe emva kokuba uphumile amanzi?

Oku kuya kwahluka ngokuxhomekeke kwimeko yakho kunye neeveki ezingaphi ukhulelwe xa amanzi akho ephuma. Ukuba amanzi akho ephuma ngaphambi kweeveki ezingama-37, ugqirha wakho uya kukunceda wenze isigqibo esikhuselekileyo. Kwezinye iimeko, umngcipheko wosulelo kunye neengxaki ziphezulu kakhulu, ngoko ke umntwana unokufuna ukuzalwa.

Ngaba umntwana angasinda ukuba ingxowa yamanzi iqhekeka kwangethuba?

Ewe, kunokwenzeka. Nokuba ingxowa yamanzi iqhekeka ngokukhawuleza, umntwana usenokuphila. Kuxhomekeke kwizinto ezininzi, njengokuba ixesha lokukhulelwa lide kangakanani kwaye kusele ulwelo olungakanani lwe-amniotic. Ugqirha wakho uhlala ejonga umntwana ukuze abone iimpawu zokubandezeleka kosana olusandul’ ukuzalwa kunye nosulelo, kwaye uya kugqiba ukuba uza kumzala nini umntwana.

Khumbula eyona nto ibalulekileyo (Umyalezo Wokuya Ekhaya)

Ngexesha lokukhulelwa, ingxowa egcwele ulwelo, ebizwa ngokuba yi-amniotic sac , ijikeleza kwaye ikhusele umntwana. Ngokwesiqhelo, le ngxowa iyaphuka ngexesha lokubeletha. Nangona kunjalo, ngamanye amaxesha inokuqhekeka ngaphambi kokuba kuqale ukubeletha, okanye kwaneeveki ngaphambi kokuba kuqale ukubeletha. Oku kubizwa ngokuba yi -Premature Rupture of Membranes (PROM) .

• Ukuba oku kwenzeka emva kweeveki ezingama-37 , ugqirha uza kuzala umntwana.
• Oku kwenzeka ngaphambi kweeveki ezingama-37.Kwimeko ye-"Preterm PROM", ugqirha uza kuvavanya iingozi zokuba nomntwana ngaphambi kwexesha kunye neengozi zeengxaki ezinje ngosulelo kunye nokucinezelwa kwentambo yesisu ngaphambi kokuba enze isigqibo.

Kungothusa ukuva uphuma kwamanzi kwangethuba. Kodwa khumbula, ugqirha wakho wenza konke okusemandleni akhe ukugcina wena nomntwana wakho nikhuselekile kwaye nisempilweni. Ukuba unemibuzo okanye iinkxalabo, thetha nogqirha wakho ngazo. Kubaluleke kakhulu.

I- PROM, i-PPROM, ukuqhekeka kwengxowa yamanzi, iingxaki zokukhulelwa, ukuzalwa ngaphambi kwexesha, ulwelo lwe-amniotic, impilo yokukhulelwa