Ngesikhathi uya emtholampilo ngesikhathi ukhulelwe, ingabe wahlolwa udokotela wathi, "Ingane ibukeka inkulu kancane"? Kujwayelekile ukuthi noma yimuphi umama azizwe esaba kancane uma ezwa lokho. Kusho ukuthini uma ethi "ingane enkulu"? Ingabe kuyingozi? Ingabe kuyathinta ukubeletha? Cishe unemibuzo eminingi efana nale engqondweni yakho. Ungesabi. Namuhla sikhuluma ngalokhu. Kwezokwelapha, lesi simo sibizwa ngokuthi i-Fetal Macrosomia. Sizoxoxa ngakho konke ngendlela elula ongayiqonda.
Kalula nje, iyini i-Fetal Macrosomia?
I-Fetal Macrosomia imane nje iyisimo lapho ingane inesisindo esingaphezu kwesijwayelekile lapho izalwa. Kodwa-ke, ayikho incazelo eyodwa phakathi kodokotela yokuthi yini eba "umntwana omkhulu."
- Abanye odokotela bathi uma ingane inesisindo esingamakhilogremu angu-4 (amakhilogremu angu-8 nama-ounces angu-13) noma ngaphezulu, ibizwa ngokuthi i-Fetal Macrosomia.
- Abanye bathi isisindo kufanele sibe amakhilogremu angu-4.5 (amakhilogremu angu-9 nama-ounces angu-14) noma ngaphezulu.
Nokho, okubaluleke kakhulu kunalezi zibalo yilokho okushiwo udokotela ngawe kanye nesimo somntwana wakho.
Ungase uzwe negama elithi "Okukhulu Ngeminyaka Yokukhulelwa" (LGA). Lokhu kusho ukuthi ingane yakho inzima kunezingane ezingu-9 kwezingu-10 ezineminyaka efanayo ngesonto olibelethayo.
Into ebalulekile ukuthi i-Fetal Macrosomia ayikwazi ukubikezelwa kusengaphambili ngaso sonke isikhathi. Ngezinye izikhathi, ngisho nomama abangenazo izici eziyingozi bangaba nezingane ezinkulu.
Kungani ingane ikhula kanje? Yiziphi izinto eziyingozi?
Kunzima ukukhomba isizathu esisodwa nje sokuthi kungani ingane ikhuluphele ngokweqile. Kungaba nezici eziningi ezibangela lokho. Kodwa-ke, kunezici eziningana eziyingozi ezandisa amathuba okuba ingane ikhuluphele ngokweqile.
Isici esiyinhloko nesibaluleke kakhulu sengozi isifo sikashukela kumama ngesikhathi sokukhulelwa. Kungaba isifo sikashukela sokukhulelwa, esenzeka kuphela ngesikhathi sokukhulelwa, noma kungaba isifo sikashukela esivele sikhona, njengohlobo 1 noma uhlobo 2.
Cabanga ngale ndlela. Ingane ithola ukudla kwayo egazini likamama nge-placenta. Ngakho-ke uma izinga likashukela egazini likamama liphezulu, ingane nayo ithola lelo nani likashukela eliphezulu. Ngenxa yalokho, umzimba womntwana ukhiqiza i-insulin eningi kanye ne-hormone yokukhula. Lawa ma-hormone abangela ukuthi ingane igcine amafutha amaningi, futhi usayizi womntwana uyanda. Izingane ezinkulu, ikakhulukazi lezo ezizalwa omama abanesifo sikashukela, zingase zibe namahlombe amakhulu. Lokhu kungaholela ezinkingeni ngesikhathi sokubeletha.
Ngaphezu kwesifo sikashukela, kunezinye izici eziningana eziyingozi ze-macrosomia yengane esanda kuzalwa kuthebula elingezansi.
| Isici Sengozi | Kuchazwe kalula |
|---|---|
| Ukukhuluphala ngaphambi kokukhulelwa | Uma ukhuluphele kakhulu ngaphambi kokuba ukhulelwe, amathuba akho okuba nomntwana omkhulu anganda ngokuphindwe kane kuya kweyishumi nambili. |
| Ukwanda kwesisindo ngesikhathi sokukhulelwa | Uma ukhuluphala kakhulu kunokudingekile ngesikhathi sokukhulelwa, ingane ingathola ukudla okunomsoco okwengeziwe futhi ikhule ibe nkulu. |
| Njengoba ngibe nezingane ezinkulu ekubelethweni kwangaphambilini | Uma uke waba nomntwana omkhulu ngaphambili, amathuba okuba umntwana wakho olandelayo abe mkhulu aphakeme ngokuphindwe kahlanu kuya kweyishumi. |
| Njengoba ezele izingane eziningi | Uma usuvele unezingane ezintathu noma ngaphezulu, ezilandelayo cishe zinkulu ngobukhulu. |
| Ukuba yingane enkulu uma uzalwa | Uma unesisindo esingaphezu kwamakhilogremu angu-8 ngesikhathi uzalwa, unamathuba aphindwe kabili okuthola umntwana omkhulu. |
| Emasontweni amabili edlule usuku lokugcina | Uma ukukhulelwa kudlula amasonto angu-42 ngemva kosuku lokuzalwa, umntwana angase akhuluphale njengoba eqhubeka nokuthola ukudla. |
Yiziphi izinkinga ezingavela uma unengane enkulu?
Ukuba nomntwana omkhulu kungandisa kancane ingozi yezinkinga kumama nomntwana ngesikhathi sokubeletha. Kodwa-ke, kubalulekile ukukhumbula ukuthi lokhu akwenzeki kuwo wonke umuntu. Ithimba lezokwelapha lihlala lilungele lesi simo.
Imiphumela engaba khona kumama
- Ukubeletha isikhathi eside: Isigaba sokusunduza, ikakhulukazi lapho umntwana ephuma, singathatha isikhathi eside.
- I-Shoulder dystocia: Lena inkinga evame kakhulu. Lokhu kwenzeka lapho amahlombe amakhulu engane ebhajwa phakathi kwamathambo e-pelvic kamama ngemva kokuba ikhanda lengane liphumile. Nakuba lokhu kuyisimo esiphuthumayo, odokotela nabahlengikazi baqeqeshwe ukukuphatha.
- Ukudabuka kwesitho sangasese sowesifazane: Uma umntwana omkhulu ephuma, kunethuba elikhulu lokulimala kwesitho sangasese sowesifazane kanye nezicubu ezizungezile.
- Ukopha ngemva kokubeletha: Ukopha ngokweqile ngemva kokubeletha kungenzeka ngoba isibeletho asifinyeleli kahle, okubangela ukopha okuningi kunokujwayelekile.
- Ukuqhekeka kwesibeletho: Lokhu akuvamile kakhulu, ikakhulukazi komama abake baba nokuhlinzwa kwesisu ngaphambilini (ukuhlinzwa kwesisu).
Imiphumela engaba khona enganeni ngemva kokuzalwa
- Ushukela wegazi ophansi: Ngenxa yokuthi umntwana wayejwayele ukukhiqiza i-insulin eningi esibelethweni, amazinga kashukela egazini lomntwana angase abe phansi ngemva kokuzalwa.
- Ubunzima bokuphefumula: Ezinye izingane zingase zibe nobunzima bokuphefumula ngokushesha ngemva kokuzalwa.
- I-Jaundice: Ukuphuzi kwesikhumba namehlo ngenxa yamazinga aphezulu e-bilirubin.
- Ukwanda kwenani lamaseli abomvu egazi.
Uma kuvela noma yiziphi zalezi zimo, ithimba lezokwelapha ewadini yezingane yesibhedlela lizonikeza ukwelashwa okudingekayo ngokushesha. Kungadingeka ukugcina ingane egunjini lokunakekelwa okujulile kwezingane ezisanda kuzalwa (i-NICU) izinsuku ezimbalwa.
Wazi kanjani ukuthi umntwana mkhulu kangakanani?
Lona umbuzo obaluleke kakhulu. Okuwukuphela kwendlela yokuqinisekisa i-macrosomia yengane ngokunemba okungu-100% ukukala ingane ngemva kokuzalwa.
Ngesikhathi sokukhulelwa, odokotela benza ukuqagela kuphela. Basebenzisa izindlela eziningana ukwenza lokho.
1. Ukulinganisa Ukuphakama Kwesifunda: Kungenzeka ukuthi uke wabona udokotela emtholampilo elinganisa isisu sakho ngetheyiphu yokulinganisa. Lokhu kulinganisa ukuphakama kwesibeletho futhi kunikeza umbono wokukhula komntwana. Uma isibeletho sikhulu kunalokho obekulindelwe, kungasolwa ukuthi umntwana naye mkhulu.
2. I-Ultrasound Scan: Uma usola ukuthi ingane yakho inkulu, udokotela wakho uzokuthumela ukuthi uyohlolwa. I-scan ilinganisa ubukhulu bekhanda lengane, isisu, kanye namathambo emilenze, futhi isebenzisa leyo datha ukulinganisa isisindo sengane.
Kodwa khumbula, ukuskena akukutsheli isisindo somntwana.Lokhu akusona isisindo esiqondile, kumane nje kuyisilinganiso. Lokhu kulinganisa kungahluka cishe ngo-10%. Isibonelo, uma iskeni sibonisa ukuthi ingane inesisindo esingamakhilogremu angu-4, isisindo sangempela cishe siphakathi kwamakhilogremu angu-3.6 no-4.4.
Ngakho-ke, udokotela uzoxoxa nawe ngendlela engcono kakhulu yokubeletha ngemva kokucabangela umbiko weskeni kanye nezinye izinto eziyingozi.
Ungasiphatha kanjani lesi simo bese uhlela ukulethwa?
Uma usola ukuthi ingane yakho inkulu, udokotela wakho uzokhuluma nawe ngendlela yokuhlela ukubeletha kwakho. Kunezinketho ezimbili eziyinhloko lapha.
- Ukubeletha Ngesitho Sangasese Sowesifazane: Uma ingane ingenkulu kakhulu futhi kungekho ezinye izinkinga, ungazama ukubeletha ngesitho sangasese sowesifazane. Kodwa-ke, ithimba lezokwelapha likhathazeke kakhulu ngezingozi ezifana ne-Shoulder Dystocia.
- Ukuhlinzwa Kwesisu (C-section): Uma ingane yakho inesisindo esingaphezu kwamakhilogremu angu-4.5, noma uma unesifo sikashukela, udokotela wakho angase ancome ukuhlinzwa kwesisu okuhleliwe ukuze kuncishiswe ingozi yezinkinga.
Abanye abantu bacabanga ukuthi kungcono ukubeletha umntwana kusenesikhathi ngoba umntwana uyakhula. Kodwa-ke, ucwaningo lwezokwelapha lubonisa ukuthi ukubeletha umntwana ngaphambi kwamasonto angu-39 ngaphandle kwesinye isizathu sezokwelapha akunciphisi izinkinga. Ngakho-ke, kubaluleke kakhulu ukulandela iseluleko sikadokotela wakho.
Yini esingayenza ukuvimbela i-macrosomia yengane esanda kuzalwa?
Ngenxa yokuthi kunezinto eziningi ezithinta ukukhula komntwana, lesi simo asinakuvinjelwa ngokuphelele. Kodwa-ke, kunezinto ezimbalwa ongazenza ukuze unciphise ingozi.
- Yiya emitholampilo ejwayelekile yokukhulelwa: Yiya kuyo yonke imitholampilo njalo. Lokhu kuzovumela udokotela ukuthi aqaphe impilo yakho kanye nentuthuko yomntwana. Futhi, qiniseka ukuthi uthola ukuhlolwa kokubekezelela ushukela ukuze kuhlolwe isifo sikashukela sokukhulelwa.
- Ukuzivocavoca ngesikhathi sokukhulelwa: Khuluma nodokotela wakho ngokuthi yikuphi ukuzivocavoca okuphephile nokufanelekile kuwe, bese uhlanganyela kukho. Ngisho nento elula njengokuhamba ingaba usizo kakhulu.
- Ukuphatha Isifo Sikashukela: Uma unesifo sikashukela sokukhulelwa, landela iseluleko sikadokotela wakho kanye nochwepheshe wezokudla. Uma unesifo sikashukela esivele sikhona, lawula amazinga kashukela egazini lakho ngangokunokwenzeka.
- Ukulawula Isisindo: Zama ukugcina isisindo esinempilo ngaphambi kokuba ukhulelwe. Lokhu kungafezwa ngokudla okunempilo kanye nokuzivocavoca umzimba. Kwabanye abantu abakhuluphele kakhulu, iseluleko sezokwelapha singadingeka futhi ukuze ucabangele izinketho ezifana nokuhlinzwa kwe-bariatric.
Okokugcina, ungesabi uma uthola ukuthi ingane yakho inkulu. Akusho ukuthi kuzoba nenkinga. Into engcono kakhulu ongayenza ukuphatha izici zakho eziyingozi bese ulandela imiyalelo kadokotela wakho ngokucophelela. Khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho.
Umlayezo Wokuya Nawe Ekhaya
- I-fetal macrosomia yisimo lapho umntwana enesisindo esingaphezu kwesijwayelekile lapho ezalwa. Lesi yisimo esingaphathwa ngempumelelo.
- Ingozi eyinhloko yalokhu umama onesifo sikashukela ngesikhathi sokukhulelwa.
- Ukuskena okwenziwa ngesikhathi sokukhulelwa akunikezi isilinganiso esinembile esingu-100% sesisindo somntwana, kodwa kunikeza isilinganiso kuphela.
- Into engcono kakhulu ongayenza ukuya emtholampilo njalo, ulandele indlela yokuphila enempilo, futhi ulawule isisindo sakho kanye namazinga kashukela egazini.
- Khuluma ngokukhululekile nodokotela wakho ukuze wenze isinqumo esingcono kakhulu mayelana nokubeletha kwakho. Yabelana naye ngazo zonke izinto ezikukhathazayo kanye nokwesaba kwakho.
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