Kwakhona qaphela oku ngexesha lokukhulelwa: Yintoni iVasa Previa?

Unomdla kakhulu wokuba ngumama, kodwa ngamanye amaxesha uziva uloyiko ngezinto ezincinci, akunjalo? Yinto eqhelekileyo leyo. Namhlanje siza kuthetha ngemeko enokwenzeka ngexesha lokukhulelwa, engaqhelekanga, kodwa enokulawulwa kakuhle ukuba uyazi ngayo kwangaphambili. Oku kubizwa ngokuba yiVasa Previa. Ungakhathazeki, siza kuthetha ngayo ngokweenkcukacha.

Yintoni iVasa Previa? Masiyiqonde ngokulula!

Ngamafutshane, iVasa Previa yingxaki enokwenzeka ngexesha lokukhulelwa. Oku kwenzeka xa eminye yemithambo yegazi ekwi-umbilical cord, ethwala izondlo kumntwana wakho, idlula ngaphandle kokuzikhusela emlonyeni wesibeleko. Ngokwesiqhelo, le mithambo yegazi ikhuselwe kakuhle yi-placenta.

Khawucinge nje, xa kuqala ukuzala, xa i-amniotic sac iphuka, le mithambo yegazi engakhuselekanga esemlonyeni wesibeleko inokuqhuma. Ukuba oko kuyenzeka, umntwana ungopha kakhulu aze afe. ​​Nangona kunjalo, ukuba le meko iqatshelwa kwangethuba kwaye ilawulwa ngokufanelekileyo, ingakumbi ukuba umntwana ubelekwe ngotyando (`C-section`), le ngozi inokuthintelwa ngokupheleleyo. Yiyo loo nto kubalulekile ukuqaphela oku.

Kukho iintlobo ezimbini eziphambili zeVasa Previa:

Oogqirha bahlula le meko ibe ziintlobo ezimbini eziphambili. Masibone ukuba ziyintoni na.

1. Uhlobo 1: I-Vesa Previa ene-Velamentous Cord Insertion

Oku kunokuvakala ngathi ligama elintsonkothileyo, kodwa akunzima ukuliqonda. Ukufakwa kwentambo eyoyikekayo kuxa intambo yesisu ingancamathiselwanga ngqo kwi-placenta, kodwa inemithambo yegazi ephuma ngaphandle kwe-placenta, ingakhuselekanga. Ngokwesiqhelo, intambo yesisu incamathiselwa ngqo kwi-placenta.

Khawucinge nje, ukuba kukho umthambo wegazi ongakhuselekanga ngolu hlobo, okwizantsi lesibeleko, kufutshane nomlomo wesibeleko (oku kubizwa ngokuba yi-'low-lying placenta'), xa kuqala ukuzala kwaye umntwana esiya emlonyeni wesibeleko, kukho ithuba elikhulu lokuba loo mthambo wegazi uya kwanda kwaye uqhume.

2. Uhlobo 2: I-Vesa Previa ene-Bilobed Placenta

Kulapho i-placenta yakho ingelolungu elinye, kodwa yahlulwe yaba zii-lobes ezimbini, njengemiphunga emibini. Intambo ye-umbilical ingadibanisa la macandelo mabini. Ukuba imithambo yegazi engakhuselekanga phakathi kwala macandelo mabini idlula kufutshane nomlomo wesibeleko, inokuqhekeka xa kuqala ukuzala.

Yintoni umahluko phakathi kweVasa Previa kunye nePlacenta Previa?

La magama mabini afana kancinci, ngoko ke anokudideka. Kodwa la magama mabini abhekisa kwiimeko ezimbini ezahlukeneyo.

• I-Placenta Previa kuxa i-placenta isezantsi kwisibeleko, igubungela yonke okanye inxalenye yomlomo wesibeleko, endaweni yokuba igqume phezulu. Xa kuqala ukuzala, imithambo yegazi edibanisa i-placenta kwisibeleko inokolulwa ize yophe igazi.
• Okubalulekileyo kukuba, ukuba une-placenta previa ize kamva iphele (i-placenta previa esombululweyo) okanye ine-placenta ephantsi, umngcipheko wokuba ne-vasa previa uyanda. Oku kuthetha ukuba kunokubakho unxibelelwano phakathi kwezi meko zimbini.

Ibaluleke kangakanani iVasa Previa?

Enyanisweni, i-vesa previa yimeko enzima ekufuneka inyanyekelwe. Ukuba ayifunyaniswanga kwangethuba, umntwana usenokuzalwa efile.

Kodwa, khumbula oku: Ukuba le meko ifunyaniswa ngexesha lokukhulelwa (ukuxilongwa ngaphambi kokuzalwa), inyangwa ngokufanelekileyo, kwaye izalwe ngotyando olucwangcisiweyo (utyando lwe-C), umntwana unethuba elingama-98.6% lokusinda!

Ngoko ke, endaweni yokoyika, eyona nto ibalulekileyo kukufumana ulwazi olufanelekileyo nokulandela iingcebiso zonyango.

Ngubani ochaphazeleka kakhulu yile meko? (Izinto ezibangela umngcipheko)

Abantu abanokuthi babe neVasa Previa ngaba:

• Ukuba uneemeko ezinje `ngokufakwa kwentambo ye-velamentous` (intambo ye-umbilical ayincamatheliswanga kakuhle kwi-placenta) okanye `i-bilobed/multilobed placenta` (i-placenta yahlulwe yangamacandelo aliqela).
• Ukuba i-placenta yakho isezantsi esibelekweni, igubungela umlomo wesibeleko ngokupheleleyo okanye inxalenye yayo (`placenta previa` okanye `low-lying placenta`).
• Ukuba ukhe wabeleka utyando lwebele ngaphambili (C-section).
• Ukuba ukhulelwe nge-in vitro fertilization (IVF - In Vitro Fertilization).
• Ukuba ulindele amawele okanye amawele amathathu (`aphindaphindeneyo`).
• Ukuba ukhe watyandwa isibeleko ngaphambili.

Ukuba unazo ezi zinto zinobungozi, ugqirha wakho uza kuziqwalasela ngakumbi.

Ixhaphake kangakanani iVasa Previa?

Le yimeko engaqhelekanga kakhulu. Idla ngokuvela kumntu omnye kwabangama-2,500 abazelweyo. Nangona kunjalo, kwiimeko zokuchumisa nge-in vitro (IVF), ukwenzeka kwayo kuphezulu kancinci, malunga nomntu omnye kwabangama-200 abazelweyo.

Zithini iimpawu zeVasa Previa?

Amaxesha amaninzi, umama one-vasa previa usenokungabonakalisi zimpawu. Yiyo loo nto ii-ultrasound scans ngexesha lokukhulelwa zibaluleke kangaka. Oogqirha banokuxilonga imeko ngezi scans.

Nangona kunjalo, kunqabile kakhulu, abanye abantu banokuva ukopha okuncinci kwilungu lobufazi ngexesha lesibini okanye lesithathu leenyanga zokukhulelwa ngaphandle kwentlungu. Eli gazi linokuba bomvu bumnyama kancinci kunesiqhelo. Lisenokungabi ligazi lakho, kodwa luphawu lwegazi losana olungekazalwa. Ukuba ufumana ukopha kwilungu lobufazi nangaliphi na ixesha ngexesha lokukhulelwa, nokuba kukho intlungu okanye akukho ntlungu, bona ugqirha wakho ngoko nangoko, nokuba incinci kangakanani na.

Yintoni ebangela iVasa Previa?

Isizathu esiphambili soku kukuba, njengoko bekutshiwo ngaphambili, imithambo yegazi ye-umbilical cord edibanisa wena nomntwana wakho idlula ingakhuselekanga kufutshane nomlomo wesibeleko. Ngokwesiqhelo, i-umbilical cord iqhagamshelwe ngqo kwi-placenta, kwaye imithambo yegazi ikhuselekile kakuhle. Nangona kunjalo, kwi-vesa previa, le mithambo yegazi ayiphumi nje kuphela, kodwa ikwalele kufutshane nomlomo wesibeleko, indawo ekunokwenzeka ukuba icinezelwe ngexesha lokubeleka.

Ifunyaniswa njani iVasa Previa?

I-Vesa previa idla ngokuchongwa ngexesha le-ultrasound scan phakathi kweeveki ezili-18 ukuya kwezingama-26 zokukhulelwa. Ukuba i-scan yakho ibonisa izinto ezinokubangela umngcipheko we-vasa previa, njenge-bilobed placenta okanye ukufakwa kwentambo ye-velamentous, ugqirha wakho unokwenza i-ultrasound scan ekhethekileyo nge-vaginal ultrasound yakho . Oku kunokubona ngokucacileyo ukuba kukho imithambo yegazi kwi-umbilical cord kufutshane ne-cervix (cervical os). Ngamanye amaxesha oogqirha basebenzisa indlela ye-ultrasound ebizwa ngokuba yi-color Doppler . Oku kubonisa ukuhamba kwegazi ngemibala, okwenza kube lula ukubona indawo yemithambo yegazi.

Ugqirha uza kujonga ezi zinto ngokukodwa:

• Iphi i-placenta xa ithelekiswa nomlomo wesibeleko?
• Ingaba i-placenta inee-lobes ezininzi na.
• Apho intambo yesisu ikhoyo khona.

Ziziphi iindlela zonyango lweVasa Previa?

Ukuba ufunyaniswe une-vasa previa, ugqirha wakho uya kugqiba ekubeni azale umntwana wakho ngotyando olucwangcisiweyo (C-section). Baza kukujonga wena nomntwana wakho ngokusondeleyo kulo lonke ixesha lokukhulelwa kwakho. Injongo ephambili yoogqirha apha kukugcina umntwana esibelekweni ixesha elide kangangoko kunokwenzeka, kodwa nokuqala ukuzala ngokukhawuleza kwaye azale umntwana ngokukhuselekileyo ngaphambi kokuba imithambo yegazi yonakale.

Isicwangciso sakho sokukhulelwa singabandakanya:

• Uvavanyo olungengoxinzelelo: Olu vavanyo lwenziwa kabini ngeveki ukujonga ukubetha kwentliziyo yomntwana. Lukhuselekile ngokupheleleyo kuwe nakumntwana wakho.
• IiCorticosteroids: La mayeza anokunikwa ngaphambi kokuba umntwana abelekwe ngotyando ukuze ancede imiphunga yomntwana ikhule kakuhle. Oku kungenxa yokuba, ekubeni umntwana enokufuna ukuzalwa kwangethuba, ukuvuthwa kwemiphunga kubalulekile.
• Ulawulo lwezigulane ezilaliswayo: Ugqirha wakho angagqiba ekubeni akugcine esibhedlele ukuze ajongwe ngokusondeleyo kangangeentsuku ezimbalwa ngaphambi kokuba umntwana wakho azalwe. Esi sigqibo siza kwenziwa ngokusekelwe kwizinto ezifana neemeko zakho zempilo esele zikhona, amathuba okuba ubeleke kwangethuba, kunye nokuba uhlala kude kangakanani nesibhedlele.
• Utyando lotyando olucwangcisiweyo (phakathi kweeveki ezingama-34 nezingama-37):Ukuze kuncitshiswe iingxaki ezinxulumene ne-vesa previa, ugqirha wakho uza kuthetha nawe ngexesha elifanelekileyo lokubeleka umntwana wakho. Ekubeni edla ngokubeleka kwangethuba, umntwana wakho unokufuna ukunyangwa kwiYunithi yoKhathalelo oluNzulu lweZifo eziSandulelayo (i-NICU) emva kokuzalwa.

Isicwangciso sakho sokukhulelwa siya kuxhomekeka kwimeko yakho, ngoko ke kubalulekile ukulandela imiyalelo kagqirha wakho ngokuchanekileyo.

Ngaba iVasa Previa "ingalungiswa"?

Enyanisweni, akukho ndlela "yokulungisa" imeko ebizwa ngokuba yi-vesa previa. Oko kukuthi, awunakuyitshintsha indlela imithambo yegazi eyiyo. Kodwa ungayilawula le meko kwaye wenze isicwangciso sokuzala umntwana osempilweni ngempumelelo. Thetha nogqirha wakho malunga nexesha elifanelekileyo lokuzala umntwana wakho ngokukhuselekileyo kuwe nakumntwana wakho, kunye nexesha lokuzala ngotyando.

Ngaba umngcipheko weVasa Previa ungancitshiswa?

Awunakunciphisa umngcipheko wokuba ne-vesa previa. Asinto esinokuyilawula. Kodwa, unganciphisa umngcipheko weengxaki ezinkulu ezinokuvela kuyo. Ungayenza njani loo nto? Ngokuya rhoqo kwiikliniki zokukhulelwa nokulandela icebiso likagqirha wakho. Ukufumanisa kwangethuba le meko yeyona nto ibalulekileyo ekufumaneni iziphumo ezilungileyo.

Ukuba ndine-vasa previa, ndimele ndilindele ntoni?

Ukuba une-vasa previa, kufuneka ulindele utyando lwe-cesarean (C-section) endaweni yokubeleka kwilungu lobufazi. Kuya kufuneka wenze uvavanyo olongezelelweyo lokujonga ngexesha lokukhulelwa kwakho. Olu nyango longezelelweyo luya kukunceda ubeleke umntwana osempilweni.

Ngaba iVasa Previa iyamchaphazela umntwana?

Indlela esi sifo esichaphazela ngayo umntwana ixhomekeke ekubeni sifunyenwe kwangethuba kangakanani. Ukuba i-vasa previa ayifunyaniswanga, izinga lokufa komntwana ongekazalwa linokuba phezulu ukuya kuma-56% ukuya kuma-60%. Nangona kunjalo, ukuba sifunyenwe kwangethuba ekukhulelweni, silawulwa kakuhle, kwaye sizalwe ngotyando, umntwana unethuba elingama-97% lokusinda. Kwezinye iimeko, umntwana unokufuna unyango olongezelelweyo kwi-NICU emva kokuzalwa, ingakumbi ukuba umntwana uzelwe ngaphambi kwexesha. Nangona kunjalo, iziphumo zotyando nge-vasa previa zilungile kakhulu.

Ndifanele ndimbone nini ugqirha wam?

Bona ugqirha wakho rhoqo ngexesha lokukhulelwa kwakho. Kwakhona, yiya kuzo zonke ii-ultrasound scans ezicetyiswayo. Ukuba ufunyaniswe une-vesa previa, kunokufuneka ubonane nogqirha wakho rhoqo.

Ukuba ubona ukopha kwegazi kwilungu lobufazi ngexesha lekota yesibini okanye yesithathu yokukhulelwa kwakho, bona ugqirha wakho ngoko nangoko. Ukuba ukopha kukhulu, yiya kwicandelo lezonyango elikufutshane ngokukhawuleza.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ukuba une-vesicoureteral reflux, buza ugqirha wakho indlela yokunciphisa umngcipheko weengxaki ezinkulu. Umzekelo:

• "Ingaba kungcono ukuba ndingazibandakanyi nesondo (ukuphumla kwesinqe)?"
• "Zeziphi izinto endinokuzisebenzisa ukuze ndikhulelwe kakuhle?"

Ukuba neengxaki ngexesha lokukhulelwa kuyoyikisa. Kodwa oko akuthethi ukuba awunakuba nokukhulelwa okunempilo, ukubeleka, kunye nomntwana. Ukwazi ukuba une-vasa previa linyathelo lokuqala lokucwangcisa utyando oluphumelelayo. Thetha nogqirha wakho malunga nendlela ukuxilongwa kwakho okuya kuzichaphazela ngayo izicwangciso zakho zokuzala.

Umyalezo Wokuya Ekhaya

I-Vasa Previa yimeko engaqhelekanga kodwa enzulu enokwenzeka ngexesha lokukhulelwa.

• Okwenzekayo kule meko kukuba imithambo yegazi yomntwana idlula emlonyeni wesibeleko ingakhuselekanga.
• Ukufunyanwa kwangoko kubaluleke kakhulu. Ekubeni kungekho zimpawu, kubalulekile ukuya kuskeni rhoqo.
• Unyango oluphambili kukuzala umntwana ngecandelo lotyando olucwangcisiweyo (C-section).
• Xa kufunyenwe kwangethuba kwaye kulawulwe ngendlela eyiyo, amathuba okusindisa ubomi bomntwana aphezulu kakhulu (ngaphezulu kwe-97%).
• Soloko uthetha nogqirha wakho kwaye ulandele iingcebiso zakhe. Ungakhathazeki, awuwedwa. Ngolwazi olufanelekileyo kunye nenkxaso yezonyango, ungamelana nale meko ngempumelelo.

I-Vasa Previa, ukukhulelwa, iingxaki zokukhulelwa, intambo yesisu, i-placenta, i-cesarean section, impilo yosana olungekazalwa, ukuxilongwa kokukhulelwa ngaphambi kokukhulelwa