Ngaba kukho ukopha entlokweni yosana olusandul’ ukuzalwa? Ngaba oku kukopha okungaphantsi kwe-galeal? Masithethe!

Umele ukuba wonwabile kakhulu emva kokuba umntwana wakho ezelwe kweli hlabathi, akunjalo? Kodwa kwangaxeshanye, ngamanye amaxesha uziva usoyika ngezinto ezincinci. Ingakumbi ukuba ukuzala bekunzima kancinci, kuyinto eqhelekileyo ukuziva ukhathazekile ukuba ubona utshintsho oluncinci kangaka entlokweni yomntwana. Namhlanje siza kuthetha ngemeko enokwenzeka entlokweni ngexesha elinjalo, kwaye kufuneka ulumke kancinci.

Yintoni le nto yokuphuma kwegazi ngaphantsi kwe-galeal? Masiyiqonde ngokulula!

Ngamafutshane, le yingqokelela yegazi phantsi kwesikhumba sentloko yosana olusandul’ ukuzalwa, phakathi kweengqimba zezicubu ezithambileyo ngaphezulu kwentloko. Cinga nje, iintloko zethu nazo zineengqonga ezahlukeneyo phantsi kwesikhumba. Ngokufanayo, phantsi kwesikhumba sentloko yosana, kukho ingqamzana eyenziwe ngezicubu eziqinileyo nezinemicu, ezibizwa ngoogqirha ngokuthi `(galea aponeurotica)`. Ngaphantsi koko, kukho enye ingqamzana ejikeleze amathambo entloko, ebizwa ngokuba `(periosteum)`. Oku kuphuma kwegazi, okanye ukuqokelelwa kwegazi, kwenzeka phakathi kwezo ngqimba zimbini.

Isizathu esiphambili soku kukuba kukho imithambo yegazi emincinci edibana ukusuka entlokweni ukuya ngaphakathi kwentloko. Le ibizwa ngokuba yi-"emissary veins". Le mithambo yegazi ihamba ngemingxunya emincinci (``foramen``) entlokweni. Ngamanye amaxesha, ngexesha lokuzala okunzima, le mithambo yegazi inokutsalwa kwaye iqhekeke xa umntwana ephuma. Kulapho igazi liphuma khona lize liqokeleleke kuloo mngxuma.

Oku kunokuba yingozi kancinci. Kuba, inani elikhulu legazi, eliphakathi kwe-20% kunye ne-40% yomzimba wonke wosana, linokuqokelelana entlokweni ngale ndlela. Kodwa ungakhathazeki, ukuba oku kuyaqatshelwa kwaye kunyangwa ngokukhawuleza nangokukhawuleza, kunokunyangeka ngokupheleleyo. Le meko idla ngokuba ngcono kwiiveki ezimbini ukuya kwezintathu.

Ngubani onokuthi abe nale meko?

Le meko, ebizwa ngokuba yi-"Subgaleal Hemorrhage", yinto engaqhelekanga kakhulu kuye nawuphi na umntwana ozelwe ngexesha lokubeleka okuqhelekileyo. Nangona kunjalo, xa umntwana kunzima ukuphuma, oogqirha banokufuna ukusebenzisa izixhobo ezithile ukunceda ekubelekeni. Umzekelo, ukuba kusetyenziswa i-"vacuum extractor" (esiyibiza ngokuba yi-"vacuum" xa kuxoxwa) okanye i-"forceps" (isixhobo esifana ne-forceps), umngcipheko uphezulu.

Ixhaphake kangakanani le meko? Ngaba kufuneka soyike?

Enyanisweni, le yimeko engaqhelekanga kakhulu. Oko kukuthi, ayisiyonto ibonwa rhoqo. Oku kuxelwa kwiintsana ezimalunga ne-4 kwi-10,000 ezizalwayo eziqhelekileyo ngaphandle kokusebenzisa izixhobo. Ayilonani liphantsi kakhulu elo? Nangona kunjalo, njengoko benditshilo ngaphambili, ukuba isixhobo esifana ne-"vacuum extractor" sisetyenziselwa ukususa umntwana, eli nani liyanda kancinci. Kwiimeko ezinjalo, iingxelo zonyango zithi malunga neentsana ezingama-60 kwi-10,000 ezizalwayo zinokuba nale meko. Kodwa akunjalo kuwo wonke umntu.

Kutheni le nto kukho ukopha okungaphantsi kwe-galeal? Zithini izizathu?

Njengoko benditshilo ngaphambili, eyona nto ibangela oku kukuba xa imithambo yegazi emincinci (imithambo yegazi) esuka entlokweni iye ekhakhayini iphuka ngenxa yoxinzelelo oluthile ngexesha lokubeleka. Emva koko, elo gazi liqokelelana kwindawo ephakathi kolusu kunye nekhakhayi (indawo engaphantsi kwegaleji). Oku kwenzeka kuphela ngexesha lokubeleka okuqhelekileyo , le meko ayiveli ngexesha lokubeleka okuqhelekileyo.

Ngamanye amaxesha ukuzala kunokuba nzima ngakumbi kunokuba besilindele. Kulapho oogqirha kufuneka basebenzise izixhobo ezifana ne-"vacuum extractor" okanye "i-forceps" ukuze bakhuphe umntwana ngokukhuselekileyo. Nazi ezinye zezizathu zokuba ukuzala kube nzima:

• Intloko okanye umzimba womntwana mkhulu kakhulu ukuba ungangena kwi-pelvis kamama. Oogqirha bathi oku "yi-cephalopelvic disproportion".
• Usana aluhla ngendlela efanelekileyo nangokukhuselekileyo ngomjelo wokuzalwa (i-fetal dystocia).
• Ubunzima bomntwana buphezulu kakhulu kunobuqhelekileyo (i-macrosomia).
• Ukuzala ixesha elide kuxa umntwana engazalwanga ixesha elingaphezulu kweeyure ezingama-20 emva kokuqala kokuzala.
• Ngamanye amaxesha, ukuzala kunokukhawuleza kakhulu, kwiiyure ezintathu nje kuphela, kwaye umntwana sele eza kuzalwa ('ukuzala okukhawulezileyo'). Ngamanye amaxesha iingxaki zinokuvela ngeli xesha.

Le meko inokwenzeka kakhulu xa umntwana esuswa kusetyenziswa i-`(vacuum extractor)`. Kuba, xa inxalenye efana nekomityi ye-`(vacuum)` inamathele entlokweni yomntwana, amandla okutsala awenzayo anokutsala ulusu lwentloko lusuke kancinci ekhakhayini. Emva koko izicubu ezithambileyo ezikwi-`(subgaleal space)` ziyakhululeka, zidale indawo apho igazi liqokelelwa khona. Ukuba igazi elininzi liqokelelwa ngale ndlela, linokuba yingozi kumntwana. Yiyo loo nto oogqirha belumkile kakhulu ngale nto.

Zithini iimpawu zoku? Uzibona njani xa uzibona?

Iimpawu ze-"Subgaleal Hemorrhage" ziqala ukubonakala emva kokuba umntwana ezelwe. Nazi ezinye zezinto onokuzibona:

• Ulusu lomntwana lubonakala ngathi luneemivumbo , ingakumbi entloko nasentanyeni.
• Ukubetha kwentliziyo okukhawulezayo kakhulu (i-tachycardia).
• Ukuba noxinzelelo lwegazi oluphantsi.
• Umbala wolusu ubonakala umhlophe kakhulu (`umhlophe`).
• Ngenxa yokulahleka kwegazi elininzi emzimbeni, amanqanaba eenxalenye egazini ezibizwa ngokuba yi-`hemoglobin`` kunye ne-`hematocrit`` ayehla.
• Kuvela ukudumba okuvakala ngathi ngamanzi entlokweni yomntwana (ukudumba okumanzi). Oku kubangelwa kukuhlangana kwegazi ngaphakathi. Oku kudumba kunokusasazeka ngasemva kweendlebe zomntwana nasentanyeni.

Ngethamsanqa, ayizizo zonke iintsana eziba neempawu ezinzima. Ngaphantsi kwama-25% azo zonke iimeko zokopha okungaphantsi kwe-galeal ziba neempawu ezinzima ngokwaneleyo ukuba zibe yingozi ebomini. Ezi ziquka:

• Ukopha kakhulu ngaphakathi okanye iingxaki zokujiya kwegazi (i-coagulopathy).
• Imeko ebizwa ngokuba yi-'hypovolemic okanye i-hemorrhagic shock', eyenzeka xa umzimba ulahlekelwa lulwelo oluninzi kunye negazi kangangokuba intliziyo ayikwazi ukupompa igazi ngokufanelekileyo.
• Ubunzima bokuphefumla (uxinzelelo lokuphefumla).
• Ukungabikho komoya-mpilo owaneleyo engqondweni ngexesha lokuzalwa (i-intrapartum hypoxia).
• Ukungasebenzi kakuhle kancinci kancinci kwamalungu angaphakathi, njengezintso (ukungasebenzi kakuhle kwamalungu omzimba).

Oogqirha bayixilonga njani le nto? Zeziphi iimvavanyo abazenzayo?

Kwangoko nje umntwana ezelwe, iqela lezonyango liza kumjonga ngononophelo umntwana ukuze libone ukuba akanazo na iimpawu ezikhankanyiweyo ngaphambili. Umzekelo, baza kujonga ulusu lomntwana ukuze babone ukuba lumhlophe na, intloko idumbile, okanye ukuba kukho naziphi na izivubeko ezingaqhelekanga.

Ukuba kukho norhano oluncinci lokuba kukho "i-Subgaleal Hemorrhage", ugqirha uya kuyalela uvavanyo olukhethekileyo entlokweni yomntwana.

• I-ultrasound yentloko.
• Mhlawumbi `(CT scan - Computed Tomography scan)`.
• Okanye i-MRI (iMagnetic Resonance Imaging).
• Ngamanye amaxesha i-X-ray ingathathwa.

Olu vavanyo lunokubonisa kanye ukuba ukopha ngaphantsi kolusu kubonakala njani kwaye kukhulu kangakanani.

Khawucinge ukuba kusetyenziswe isixhobo sokukhupha ulwelo ukususa umntwana wakho. Ukuba oko kuyenzeka, nokuba umntwana wakho akabonisi zimpawu zinkulu ngoko nangoko, oogqirha baza kumgcina umntwana wakho kwigumbi lokugcina abantwana okanye, ukuba kuyimfuneko, iyunithi yokhathalelo oluphezulu lweentsana (i-NICU) kangangeeyure ezimbalwa ukuze bamjonge ngokusondeleyo. Oku kungenxa yokuba ngamanye amaxesha oku kuhlangana kwegazi kunye nomonakalo wezicubu obangela ukutshintsha kombala wesikhumba kuthatha ixesha ukwenzeka. Oku kuthetha ukuba ezi mpawu zinokuvela naphi na ukusuka kwiyure enye ukuya kwiiyure ezingama-72 (iintsuku ezi-3) emva kokuba umntwana ezelwe.

Inganyangwa njani le nto? Ngaba umntwana uza kuphila kungekudala?

Xa oogqirha beqinisekisa ukuba ``yi-Subgaleal Hemorrhage'', baqala unyango ngoko nangoko. Olu nyango ludla ngokwenziwa kwiyunithi yokhathalelo oluphezulu lweentsana ezisandul' ukuzalwa (``NICU'') .

Eyona nto iphambili kukubuyisela umthamo wegazi lomntwana ukuba uhlile. Oku kwenziwa ngokunika umntwana izinto ezifana negazi kunye notofelo-gazi.

Ukongeza, iqela lezonyango lomntwana liza kuqhubeka nokujonga amanqanaba egazi lomntwana (i-hemoglobin, i-hematocrit), isantya sentliziyo, kunye noxinzelelo lwegazi. Umjikelezo wentloko yomntwana uza kulinganiswa rhoqo ukuze kubonwe ukuba ukudumba kuyancipha okanye kuyanda.

Ngamanye amaxesha, ukuba ukopha kukhulu kwaye akunakulawulwa ngokutofelwa ulwelo, utyando olungxamisekileyo lunokufuneka, lunqabile kakhulu. Oku kwenzelwa ukunqanda ukopha kwindawo yokopha entloko nokususa igazi eliqokelelweyo.

Umntwana uza kuphila ngokukhawuleza kangakanani emva konyango?

Xa ukopha kuyekile emva konyango, ukudumba entloko kuyehla kancinci kancinci kwaye ezinye iimpawu ziyanyamalala. Ezi zihlala ziphela kwiiveki ezimbini ukuya kwezintathu.

Nangona kunjalo, kufuneka uqhubeke unxibelelana noogqirha bomntwana wakho kunyaka wokuqala womntwana, kwaye uye kwiikliniki kunye novavanyo abalucebisayo. Oku kukujonga ukuba kukho naziphi na ezinye iimpawu ezinokuchaphazela ukukhula komntwana wakho. Kwiimeko ezininzi, malunga ne-75% yamatyala, ukuba unyango luphumelele, umntwana uya kuphila kakuhle kwaye uya kukwazi ukuya ekhaya nomntwana wakho.

Ngaba ikho indlela yokunciphisa ukwenzeka kwale meko?

Kunzima kakhulu ukuthintela ngokupheleleyo "i-Subgaleal Hemorrhage". Oku kungenxa yokuba idla ngokuvela ngenxa yobunzima bokuzala. Amaxesha amaninzi, ubukho bobunzima obunjalo bufunyanwa kuphela ngexesha lokuzala.

Nangona kunjalo, kubalulekile ukufumana unyango olufanelekileyo ngaphambi kokukhulelwa nokulandela imiyalelo kagqirha wakho ngexesha lokukhulelwa kwakho. Ngexesha le-ultrasound yokukhulelwa, ugqirha wakho uza kujonga indawo yomntwana, ubungakanani, kunye nobukhulu be-pelvis yakho ukuze abone ukuba ukuzala okuqhelekileyo lolona khetho lukhuselekileyo kuwe nakumntwana wakho, okanye ukuba kufuneka ucinge ngezinye iindlela.

Kuza kwenzeka ntoni ukuba umntwana wam unale meko? Ngaba kufuneka ndikhathazeke?

Ngelishwa, ipesenti encinci kakhulu yeentsana (phakathi kwe-10% kunye ne-25%) ziyafa zisebancinci ngenxa yokopha kakhulu. Oku kuyadanisa ukuva. Nangona kunjalo, ngaphezulu kwe-75% yeentsana ezifunyaniswe zine-"Subgaleal Hemorrhage" ziyaphila kakuhle kwaye ziphila ubomi obuqhelekileyo. Ukufunyanwa kwangoko kunye nonyango zezona ndlela zilungileyo zokunceda umntwana wakho. Yiyo loo nto oogqirha belumkile ngale nto.

Olu phawu lokuphuma kwegazi olungaphantsi komhlaba luza kuhlala ixesha elingakanani?

Ngokwesiqhelo, emva konyango, iimpawu zomntwana wakho ze-"(Subgaleal Hemorrhage)," ingakumbi ukudumba kwentloko , ziya kunyamalala ngokupheleleyo kwiiveki ezimbini ukuya kwezintathu. Oogqirha baya kuqhubeka nokujonga impilo yomntwana nasemva kokuba ephumile esibhedlele. Baza kujonga ukuba kukho naziphi na iziphumo ezibi kunyango, ukuba ukudumba kuye kwehla ngokupheleleyo, kunye nokuba amanye amalungu omntwana asebenza kakuhle na.

Unyamekela njani umntwana onesi sifo? Nawe kufuneka uzinyamekele!

Usana lwakho olusandul’ ukuzalwa olune-subgaleal hemorrhage lusenokugcinwa kwi-NICU okanye kwiyunithi ekhethekileyo yosana olusandul’ ukuzalwa kangangeentsuku ezimbalwa de oogqirha bagqibe kwelokuba umntwana usempilweni kwaye uzinzile ngokwaneleyo ukuba angathunyelwa ekhaya.

Nokuba umntwana sele ebuyile ekhaya, kubalulekile ukumsa ekliniki xa ebonana noogqirha kunyaka wokuqala. Olu vavanyo luqinisekisa ukuba unyango luphumelele na kwaye kukho naziphi na ezinye iingxaki ezinokuthi zivele ngenxa yale meko.

Oku kubaluleke kakhulu:Xa izinto zixinezelekile kwaye zinzima kakhulu emva kokuzalwa komntwana wakho, kubalulekile ukuba wena njengomama uzinyamekele. Eli asiloxesha lilula. Fumana inkxaso kusapho lwakho, kumyeni wakho nakubahlobo bakho. Ukuba uziva uxinezelekile, uxhalabile, ulusizi, okanye uyoyika, nceda uthethe nogqirha wakho okanye umbelekisi. Musa ukuba namahloni okucela uncedo ukuba uyalufuna.

Ndifanele ndiphinde ndimbone ugqirha kwakhona?

Emva kokuba umntwana wakho ebuyile ekhaya, bonana nogqirha ukuba ubona nayiphi na kwezi zilandelayo:

• Ukuba ukudumba entlokweni yomntwana akuyehli emva konyango, kuhlala kufana okanye kuyanda.
• Ukuba ulusu lomntwana wakho luqhubeka luba mhlophe, okanye ukuba amhlophe emehlweni okanye kulusu lwakhe abonakala emthubi (njenge-jaundice).
• Ukuba amanyathelo okukhula komntwana wakho - njengokuncuma, ukubamba intamo yakhe, nokuqengqeleka - abonakala ngathi asemva kwabanye abantwana abakunyaka wakhe wokuqala,

Ufanele uye nini esibhedlele (ER) ngoko nangoko?

Ukuba umntwana oye waba (okanye onayo) "I-Subgaleal Hemorrhage " unesithuthwane, yingxamiseko yezonyango. Isithuthwane singaba yiyo nayiphi na into evela:

• Usana lubonakala ngathi lulahlekelwa zingqondo okwethutyana.
• Amalungu am ahlala eshukuma kwaye eshukuma ngokungalawulekiyo.
• Usana lubonakala luphazamisekile ngequbuliso, lusoyika, okanye lwenza izinto ngendlela engaqhelekanga.

Ukuxhuzula kudla ngokuthatha imizuzwana engama-30 ukuya kwimizuzu emibini. Nangona kunjalo, ukuba ukuxhuzula kuthatha imizuzu engaphezu kwemihlanu, kuyingozi kakhulu. Ingakumbi ukuba umntwana unengxaki yokuphefumla, fowunela u-911 ngoko nangoko, okanye umse umntwana kwigumbi likaxakeka lesibhedlele esikufutshane ngokukhawuleza.

Ndimele ndibuze ntoni kugqirha wam?

Ngexesha elinje, usenokuba nemibuzo emininzi engqondweni yakho. Kunganceda ukubuza ugqirha wakho le mibuzo:

• "Gqirha, imeko yomntwana wam imbi kangakanani?"
• "Ingaba umntwana udinga utyando ngenxa yoku? Okanye kukho ezinye iindlela zonyango?"
• "Ndingamthatha nini umntwana esibhedlele?"
• "Ngaba ikho indlela ekhethekileyo endifanele ndimnyamekele ngayo umntwana emva kokuba ndifikile ekhaya?"

Yintoni umahluko phakathi kweHematoma kunye neHemorrhage?

Usenokuba ukhe waweva la magama mabini. Igama elithi ``Subgaleal`` libhekisa apho le meko iyenzeka khona. Oko kukuthi, isithuba esiphakathi kolusu kunye nentloko entloko.

• `Ukuphuma kwegazi` kuthetha ukuba kusekho ukopha, okanye ukuba kukho ukopha okuqhubekayo, kwindawo `engaphantsi kwentloko`. Oko kukuthi, ukopha okusebenzayo.
• I-'Hematoma' ithetha ukuba igazi liqokelelene kwindawo enye laza laqhekeka . Oku kuthetha ukuba igazi, elalilulwelo, liye lajiya kancinci laza laba njengeqhubu.

Kule ``Subgaleal Hemorrhage``, kuqala kubekho ukopha (hemorrhage), emva koko igazi linokujiya ngokuhamba kwexesha (hematoma). Zombini ezi zinto zenzeka xa imithambo yegazi kuloo ndawo yonakele ngenxa yokwenzakala okanye umonakalo othile.

Okokugqibela, izinto ekufuneka uzikhumbule...

Emva kokubeletha okunzima, njengomama, kuyinto eqhelekileyo ukuba uzive uxhalabile kwaye uxinezelekile njengoko oogqirha bekhawuleza ukuthatha inyathelo malunga nempilo yomntwana wakho. Ngexesha elinje, kubaluleke kakhulu ukuzingqonga nosapho lwakho, umyeni wakho, kunye nabahlobo bakho ngenxa yothando lwabo kunye nenkxaso yabo, endaweni yokubandezeleka wedwa. Yabelana nabo ngeemvakalelo zakho.

Ngonyango olukhawulezileyo nolucoselelo oluvela koogqirha, umntwana wakho unethuba elingcono lokufumana iziphumo ezilungileyo. Kwangoko nje umntwana wakho wakuphila esibhedlele, uya kukwazi ukumthatha aye naye ekhaya ngothando. Ngoko ke hlala uqinile. Ndikunqwenelela wena nomntwana wakho ukuphiliswa ngokukhawuleza!

Ukopha kwegazi okungaphantsi kwe- galeal , Iintsana ezisandul' ukuzalwa, Ukopha entloko, Ukuhanjiswa kwe-vacuum, Ukuhanjiswa kwe-forceps, Iingxaki zokuzalwa, Impilo yeentsana ezisandul' ukuzalwa