Ingaba amathumbu omntwana wakho aphuma ngaphandle? Masithethe ngesi sifo singaqhelekanga (iGastroschisis)

Ukuba ungumama oza kuzalwa, mhlawumbi ukhathazekile ngempilo yomntwana wakho ongekazalwa. Ngamanye amaxesha, emva kokuskena, ugqirha uxelela into enzulu, kwaye kuyinto eqhelekileyo ukuziva uloyiko olukhulu kunye nexhala. Namhlanje sithetha ngesiphene esingaqhelekanga sokuzalwa esoyikisayo kancinci, kodwa sinokuba neziphumo ezilungileyo ukuba silawulwa ngokufanelekileyo. Le meko ibizwa ngokuba yiGastroschisis (GAS-tro-schi-sis).

Ngamafutshane, yintoni iGastroschisis?

I-Gastroschisis yimeko apho umntwana ezalwa enemingxuma engaphantsi kweqhosha lesisu, apho amathumbu kunye namanye amalungu omzimba, njengesibindi nesisu, aphuma khona. Cinga ngayo, xa umntwana eqala ukukhula esibelekweni, izihlunu zesisu azikhuli kakuhle. Lo mngxuma mncinane uvumela la malungu ukuba aphume.

Iintsana ezinale meko zifuna utyando xa zizalwa. Kufuneka zihlale kwiYunithi yoKhathalelo oluNzulu lweZinsana okwethutyana ngaphambi nasemva kotyando. Njengabazali, oku kunokuba yinto eyoyikisayo, kodwa uninzi lweentsana luyaphila kakuhle emva kotyando.

Yintoni umahluko phakathi kweGastroschisis kunye neOmphalocele?

Zombini ezi meko zizinto ezingaqhelekanga apho amalungu omzimba aphuma khona ngomngxuma esiswini somntwana. Kodwa kukho umahluko ocacileyo phakathi kwezi zimbini. Jonga itheyibhile engezantsi ukuze uqonde umahluko.

Ugqirha wakho wokubelekisa unokuxilonga nayiphi na kwezi meko ngexesha lokuhlolwa rhoqo ngexesha lokukhulelwa.

Zithini iimpawu zale meko?

Usenokungaziva zimpawu ngexesha lokukhulelwa. Oku kubonwa kuphela ngokuskena umntwana. Ugqirha angabona izinto ezinje ngexesha lokuskena:

• Izitho zomntwana, ezinje ngamathumbu nesisu, zibonakala ngathi zintanta ngaphandle komzimba.
• Amathumbu avuvukile okanye ajijeke kunye.
• Ngamanye amaxesha ubushushu bomzimba womntwana buyehla (iHypothermia).

Zithini izizathu zeGastroschisis?

Akukho sizathu sithile sicacileyo sale nto okwangoku. Kwiimeko ezininzi, sisiphumo sendibaniselwano yezinto. Nazi ezinye zezinto ezichongiweyo njengezonyusa umngcipheko:

• Ukukhulelwa usemncinci: Umngcipheko uphezulu kakhulu koomama abakwishumi elivisayo.
• Ukutshaya: Ukutshaya ngexesha lokukhulelwa, ingakumbi kwiinyanga zokuqala.
• Ukusela utywala: Ukusetyenziswa kotywala ngexesha lokukhulelwa.
• Ukusetyenziswa kwamayeza okanye iziyobisi ezithile.
• I-Low mass body index (BMI) yomama: Ukwehla kobunzima obungaqhelekanga kumama ngexesha lokukhulelwa.
• Izifo ezifana nosulelo lomchamo: Umama ubenezifo ezifana nosulelo lomchamo kwiinyanga ezi-3 ngaphambi kokukhulelwa okanye kwiinyanga ezi-3 zokuqala zokukhulelwa.
• Utshintsho kwiijini okanye kwiikromosomu zomntwana.

Ungayibona njani le meko?

Le meko inokubonwa rhoqo ngexesha lokuhlolwa kwe-scan phakathi kweeveki ezili-18 nezingama-20 zokukhulelwa. Uvavanyo oluphambili olusetyenziswa koku zezi:

• I-Ultrasound: Le yindlela ephambili yokuxilonga. Izitho zomntwana zinokubonakala ngokucacileyo zidada esibelekweni.
• Uvavanyo lwegazi lukaMama:Ngamanye amaxesha igazi likamama liyavavanywa iproteni ebizwa ngokuba yi-alpha-fetoprotein (AFP). Ukuba inqanaba liphezulu kakhulu, kurhanelwa ukuba une-gastroschisis. Oku kuqinisekiswa ngokuskena.
• I-Echocardiogram yosana olusandul’ ukuzalwa: Olu luvavanyo olukhethekileyo. Ezinye iintsana ezine-gastroschisis nazo zinokuba neengxaki zentliziyo. Ngoko ke, olu vavanyo lwenzelwe ukujonga ukusebenza kwentliziyo yomntwana.

Ukuba umntwana uneGastroschisis, iphathwa njani ngexesha lokukhulelwa?

Ukuba umntwana wakho ufunyaniswe enale meko, wena nomntwana wakho niza kufuna ingqalelo ekhethekileyo. Ugqirha wakho uza kukuthumela kwiqela leengcali.

• Ingcali yamayeza okunyanga usana olusandul’ ukuzalwa: Ugqirha ogxile ekukhulelweni okunobungozi obukhulu.
• Ingcali yeentsana ezisandul’ ukuzalwa: Ugqirha ogxile kwiintsana ezisandul’ ukuzalwa, ingakumbi ezo zigulayo okanye ezisandul’ ukuzalwa ngaphambi kwexesha.
• Ugqirha wabantwana: Ingcebiso kagqirha ibalulekile kuba utyando lufuneka kwangoko emva kokuba umntwana ezelwe.

Ngeli xesha, kuya kufuneka uhlolwe rhoqo ukuze ujonge ukukhula komntwana wakho. Ungacetyiswa nokuba ubale iintshukumo zomntwana wakho (inani leentshukumo) malunga neeyure ezimbini ngosuku, uqale malunga neeveki ezingama-26.

Iphathwa njani?

Unyango lwe-gastroschisis lutyando .

Amaxesha amaninzi, oogqirha bagqiba ekubeni baqalise ukuzala kwangethuba kancinci kunesiqhelo, phakathi kweeveki ezingama-35 nezingama-37. Le meko ayithethi ukuba uza kubethwa ngotyando, kodwa kubalulekile ukucwangcisa ukubeleka esibhedlele esineyunithi yokhathalelo oluphezulu lweentsana (i-NICU) kuba umntwana uya kufuna ukhathalelo olukhethekileyo xa sele ezelwe.

Kwangoko nje umntwana ezelwe, kwenziwa utyando lokubuyisela amalungu aphumileyo esiswini aze avale umngxuma. Kukho iindlela ezimbini eziphambili zokwenza olu tyando.

1. Ukulungiswa Okuphambili (utyando olunye): Ukuba inani lamalungu aphumileyo lincinci kwaye awonakalanga kakhulu, amalungu abuyiselwa kutyando olunye emva kokuzalwa kwaye isisu siyavalwa.

2. Ukulungiswa Ngezigaba: Le nkqubo isetyenziswa ukuba uninzi lwamalungu luphumile okanye ludumbile. Kule nkqubo, amalungu omntwana afakwa kwingxowa yeplastiki ekhethekileyo yokukhusela (ebizwa ngokuba yi -'silo') emva nje kokuzalwa. Oku kukhusela amalungu. Emva koko, amalungu atyhalelwa kancinci kancinci esiswini kangangeentsuku ezininzi. Nje ukuba afakwe ngokupheleleyo, umngxuma uyavalwa ngotyando.

Emva kotyando, umntwana uza kufakwa kwi-ventilator ukuze amncede aphefumle ngenxa yoxinzelelo oluphezulu esiswini sakhe.Kusenokufuneka ukuba kudityaniswe. Kwakhona, de amathumbu aqale ukusebenza kakuhle, umntwana kuya kufuneka ondliwe ngemithambo yegazi (IV). Oku kunokufuna ukuba umntwana ahlale esibhedlele iiveki ezininzi, okanye nangaphezulu.

Ziziphi iingxaki ezinokwenzeka ngenxa yale meko?

Ukuvezwa kulwelo lwe-amniotic kunokonakalisa amathumbu. Ngenxa yoko, abanye abantwana banokufumana iingxaki ezifana nezi:

• Ubunzima bokwetyisa ukutya kunye nokufunxa izondlo.
• I-atresia yamathumbu.
• Ukujija amathumbu (iVolvulus).
• Ukonakala kwezicubu ngenxa yokuvaleka kokuhamba kwegazi ukuya emathunjini (infarction).

Kwanasemva kotyando, iingxaki ezinje ngezifo kunye nobunzima bokutya zinokubakho. Nangona kunjalo, zonke ezi zinto zijongwa ngokusondeleyo liqela lezonyango.