Ingabe ingane yakho inkulu kakhulu esibelethweni? Ake sixoxe nge-Fetal Macrosomia!

Uma ungumama okhulelwe, kungenzeka ukuthi uke wezwa udokotela wakho ethi, "Ingane ibonakala inkulu kancane," noma "Ingane ibonakala ikhuluphele kancane." Noma kungenzeka ukuthi uke waba nomuzwa wokuthi ingane yakho inkulu kancane noma ikhuluphele kunabanye. Eqinisweni, kunegama elikhethekile lalokhu kwezokwelapha. Namuhla, sizokhuluma ngalesi simo esibizwa ngokuthi "i-Fetal Macrosomia." Ungakhathazeki, kubaluleke kakhulu ukuqaphela lokhu.

Iyini le nto ebizwa ngokuthi umntwana omkhulu (i-Fetal Macrosomia)?

Kalula nje, `(I-Fetal Macrosomia)` isho ukuthi ingane yakho inesisindo esingu-10% noma ngaphezulu kunesisindo esilindelekile ngesonto lokukhulelwa. Cabanga nje, uma izingane zivame ukuba namakhilogremu angu-3 kuleli sonto, ingane yakho ingaba namakhilogremu angu-3.3 noma ngaphezulu.

Manje ungase ucabange ukuthi, "O, ingane yami ingaba nkulu futhi iphile kahle." Kuyiqiniso, ingane enempilo iyiphupho lawo wonke umama. Kodwa, ngezinye izikhathi uma ingane inkulu kakhulu , kungaba nzima ukuyibeletha ngendlela evamile, okungukuthi, ngesitho sangasese sowesifazane. Ngezinye izikhathi umama angase abe nezinsini ezidabukile, noma kungaba nzima ukuyisunduza iphume. Uma udokotela ecabanga ukuthi ingane inkulu kakhulu - okungukuthi, ingaphezu kwamakhilogremu angu-5 (cishe amakhilogremu ama-5) noma ngaphezu kwamakhilogremu angu-4.5 (cishe amakhilogremu angu-4.5) uma unesifo sikashukela - mhlawumbe inketho ephephile kakhulu ukwenza ukuhlinzwa ngokuhlinzwa (ukuhlinzwa ngokuhlinzwa).

Uma umntwana ekhula, yiziphi izinkinga ezingase ziphakame lapho umntwana ezalwa?

Uma ukhulelwe umntwana omkhulu, kunengozi enkulu kancane yezinkinga ezithile ngesikhathi sokubeletha. Ake sibheke ukuthi ziyini lezo.

Izinkinga ezingaba khona kumama

• Umsele wakho wokuzalwa, okuyi-vagina kanye nendawo ewuzungezile (i-'perineum'), ungalimala. Ngenxa yokuthi umntwana mkhulu, kungase kube nokudabuka njengoba ephuma.
• Ungase wophe kakhulu kunokujwayelekile. Ngezinye izikhathi lokhu kungaholela ngisho nasekuphumeni kwegazi ngokweqile ngemva kokubeletha (ukuphuma kwegazi ngemva kokubeletha).
• Kukhona nethuba elingavamile kakhulu lokuqhekeka kwesibeletho, okuyinto evame kakhulu komama abake baba nokuhlinzwa kokubeletha ngaphambilini.
• Isikhathi esiholela ekubelethweni, ikakhulukazi isigaba sokusunduza, singaba side. Lokhu kungaba yinto ekhathazayo kakhulu kumama.
• Ungase uqaphele izinguquko ekushayeni kwenhliziyo yengane yakho ngesikhathi ubeletha .

Izingozi enganeni - ikakhulukazi i-shoulder dystocia

Uma umntwana emkhulu, unezingozi ezithile. Okukhathaza kakhulu kulokhu yisimo esibizwa ngokuthi `(Shoulder Dystocia)`.Kalula nje, lokhu kwenzeka lapho amahlombe omntwana ebhajwa ngaphakathi kwesibeletho sikamama ngemva kokuba ikhanda lomntwana liphume esithweni sangasese sowesifazane. Nakuba lokhu kungenzeka nganoma yikuphi ukubeletha, kungenzeka kakhulu ezinganeni ezinkulu.

I-Shoulder Dystocia iyisimo esiphuthumayo sangempela. Kodwa ungakhathazeki, udokotela wakho nombelethisi banecebo lokuthi benzeni uma kwenzeka into efana nale. Bazokuqapha phakathi nesikhathi sokubeletha kwakho.

Lesi simo (i-Shoulder Dystocia) singabangela ukuthi kwenzeke izinto ezilandelayo enganeni esanda kuzalwa:

• Ingane ingase ibe namathambo aphukile , ikakhulukazi i-collarbone.
• Ukulimala kwe-Brachial Plexus . Lokhu kuwukulimala kwenqwaba yezinzwa ezithwala izimpawu ezingalweni zomntwana. Lokhu kungabangela ubuthakathaka ezingalweni.
• Akuvamile kakhulu ukuthi kube nomonakalo ebuchosheni .

Lezi zingozi zingase ziqhubeke ngisho nangemva kokuzalwa kwezingane ezindala.

Izingane ezizalwa zinkulu zinamathuba amaningi okuthola izinkinga ezithile zempilo ngemva kokuzalwa:

• Ukwanda kwenani lamaseli abomvu egazini. Lokhu kungandisa ingozi yokuba umntwana abe ne-jaundice.
• Ushukela ophansi egazini (hypoglycemia).
• Izinkinga Zokuphefumula.

Yiziphi izimpawu zokuthi umntwana mkhulu?

Eqinisweni, kunzima ukwazi usayizi oqondile wengane yakho kuze kube yilapho izalwa. Izimpawu eziningi ozizwayo ngesikhathi sokukhulelwa ziyafana, kungakhathaliseki ukuthi ingane yakho ikhula kanjani. Lokho kusho ukuthi izinto ezifana nesisu esikhulu nokukhathala zivame ukwenzeka ngesikhathi sokukhulelwa okuvamile. Kodwa-ke, kunezinto udokotela wakho angase asole ukuthi ingane yakho inkulu uma ekuxilonga.

Kungani umntwana ekhula kangaka esibelethweni? Yiziphi izizathu?

Udokotela wakho angase asole ukuthi ingane yakho ine-macrosomia ngenxa yalezi zizathu:

• Uma "Ukuphakama kwe-Fundal" yakho, okungukuthi, ukuphakama kwesibeletho (ukulinganiswa kokuphakama kwesisu), kuphakeme kunokulindelekile. Ungase ukhumbule ukuthi udokotela ulinganisa lokhu kukho konke ukuhlolwa.
• Uma ukhuluphele kakhulu ngesikhathi sokukhulelwa. Sonke siyazi ukuthi ukukhuluphala kwenzeka ngesikhathi sokukhulelwa, kodwa kubalulekile ukukugcina kusezingeni elifanele.
• Uma unesifo sikashukela, noma uma unesifo sikashukela ngesikhathi sokukhulelwa (isifo sikashukela sokukhulelwa). Lesi yisona sizathu esiyinhloko sokuba nezinsana ezinkulu.
• Uma usuvele ubelethe umntwana omkhulu.
• Uma usuku lwakho lokuzalwa seludlulile, ingane yakho izokhula kancane njengoba izinsuku zihamba.
• Uma wazalwa njengomntwana omkhulu nawe, ngezinye izikhathi kungaba yinto ezuzwe njengefa.

Odokotela banquma kanjani ukuthi umntwana mkhulu?

Uma udokotela wakho esola ukuthi ingane yakho inkulu, angase acele ukuthi kwenziwe i-ultrasound scan ukuze kuhlolwe isisindo sengane kanye nenani loketshezi lwe-amniotic (uketshezi lwe-amniotic) oluzungeze ingane. Uyazi ukuthi iyini i-ultrasound. Isebenzisa amaza omsindo avame kakhulu ukuthumela izithombe noma amavidiyo engane yakho.

Asikwazi yini ukubona kahle nge-ultrasound kuphela?

Umbuzo omuhle. I-ultrasound ayikwazi ukukutshela ukuthi ingane yakho inesisindo esingakanani. Ikunikeza umbono oqondile, ohlanganisa noma osusa u-10% . Isibonelo, uma iskeni sithi ingane inesisindo esingamakhilogremu angu-4, lokho "kuwukuqagela okungcono kakhulu." Ingane ingaba nesisindo esiphakathi kwamakhilogremu angu-3.6 no-4.4.

Futhi, i-ultrasound ayikwazi ukubikezela ngokunembile ukuthi into efana ne-shoulder dystocia eshiwo ngenhla izokwenzeka yini. Ngakho-ke, udokotela uzohlanganisa ulwazi oluvela ku-ultrasound, umlando wakho wokukhulelwa (indlela owaba ngayo nezingane esikhathini esidlule, izimo zakho zempilo), kanye nokuhlolwa okudlula kukho ukuze kutholakale isikhathi kanye nendlela engcono kakhulu nephephile yokubeletha umntwana.

Yini enye udokotela ayifunayo?

Ukuze anqume ukuthi udinga yini ukuhlolwa nge-ultrasound, udokotela uzokwenza okulandelayo:

• Ukulinganisa "Ukuphakama Kwesisekelo" sakho. Leli ibanga ukusuka phezulu kwesibeletho sakho kuya "eThanjeni Lomhlathi" esiswini sakho esingezansi.
• Ukuhlikihla isisu sakho. Udokotela uzozama ukuthola umbono wosayizi wengane ngokubheka izindawo ezithile zesisu sakho.

Uma lezi zivivinyo zibonisa ukuthi umntwana mkhulu, udokotela wakho angase acele ukuhlolwa okwengeziwe (njenge-Biophysical Profile noma i-Nonstress Test) ukuze kuqashwe impilo yomntwana.

Uma ingane inkulu, yiziphi izindlela zokwelapha ezingenziwa?

Ukwelapha i-macrosomia kumayelana nokuphatha noma yiziphi izimo zempilo eziyisisekelo ongase ube nazo , njengesifo sikashukela noma ukukhuluphala ngokweqile. Wena nodokotela wakho kufanele nibambisane ekuphatheni noma yiziphi izimo ezingathinta ukukhulelwa noma ukubeletha kwakho.

Ezimweni eziningi, ukudla ukudla okunempilo, ukuzivocavoca, nokulawula isifo sikashukela sakho (ukuthatha i-insulin uma kudingeka) yizinto ezibaluleke kakhulu ongazenza.

Udokotela wakho uzokhuluma nawe ngezingozi zokubeletha ngesitho sangasese sowesifazane. Kwezinye izimo, ukuhlinzwa ngokuhlinzwa kwe-C kunganconywa ukunciphisa ingozi yezinkinga. Kodwa kubalulekile ukwazi lokhu: Ukubeletha kusenesikhathi (okungukuthi, ukuhlela ukubeletha ngaphambi kwamasonto angu-39) akubonakali kunciphisa izinkinga. Ngakho-ke, ukubeletha kusenesikhathi akukhuthazwa ngaphandle kokuthi kunesinye isizathu sezokwelapha ngobukhulu bomntwana.

Ingabe kuyadingeka yini ukwenza ukuhlinzwa kokubeletha (C-section) uma umntwana emkhulu?

Akunjalo ngempela. Akuwona wonke umntwana omkhulu ozodinga ukuhlinzwa kwe-C-section. Kodwa-ke, okulandelayo kungenzeka kakhulu ukuthi kudingeke ukuhlinzwa kwe-C-section:

• Uma uke waba nomntwana ngaphambilini one-`(Shoulder Dystocia)`.
• Uma unesifo sikashukela futhi ingane yakho kulindeleke ukuthi inesisindo esingaphezu kwamakhilogremu angu-4.5 (cishe amakhilogremu angu-4.5).
• Awunaso isifo sikashukela, kodwa ulinganisela ukuthi ingane yakho inesisindo esingaphezu kwamakhilogremu angu-5 (cishe amakhilogremu angu-11).

Lezi zinqumo zenziwa udokotela wakho ngemva kokukhuluma nawe futhi ngokusekelwe esimweni sakho.

Zikhona yini izindlela zokuvimbela umntwana ukuba akhule kanje?

Uma ngikhuluma iqiniso, `(I-Fetal Macrosomia)` kuvame ukuba nzima ukubikezela ngokunembile kusenesikhathi. Kungemva kokuzalwa kwengane nokukalwa lapho singasho khona ngokuqiniseka ukuthi, "O, ingane inkulu." Ezinye izingane zingazalwa zinkulu kunokujwayelekile ngisho nangaphandle kwezinkinga.

Kodwa-ke, ukugcina impilo enhle nokukhulelwa okunempilo kungasiza ekunciphiseni le ngozi ngezinga elithile:

• Yiya emitholampilo evamile yokubeletha. Ukuvakashelwa njalo nodokotela wakho kuzokuvumela wena nodokotela wakho ukuthi niqaphele ukukhula komntwana wakho. Futhi kuyithuba elihle lokubuza noma yimiphi imibuzo ongase ube nayo.
• Qaphela isisindo sakho. Njengoba nje kubalulekile ukwazi isisindo sakho ngaphambi kokukhulelwa, kubalulekile futhi ukwazi ukuthi uthola isisindo esingakanani ngesikhathi sokukhulelwa. Kuhle ukuqaphela kancane okunye kokudla ezweni lakithi (isib. ukudla okusanhlamvu, amaswidi).
• Uma unesifo sikashukela, thatha izinyathelo ezidingekayo ukuze usilawule. Kokubili isifo sikashukela esivele sikhona (i-Diabetes Mellitus) kanye nesifo sikashukela sokukhulelwa (isifo sikashukela esikhula ngesikhathi sokukhulelwa) kuyizinto eziyingozi kakhulu ze-fetal macrosomia.

Yiziphi izinkinga zempilo izingane ezizalwa zinkulu ezingaba nazo esikhathini esizayo?

Ucwaningo lukhombisile ukuthi izingane ezizalwa zinkulu zisengozini enkulu yalokhu okulandelayo esikhathini esizayo:

• Amazinga kashukela aphansi egazini (`i-Hypoglycemia`) ebuntwaneni.
• Ukukhuluphala ngokweqile ebuntwaneni.
• I-Metabolic syndrome yiqembu lezimo ezandisa ingozi yokuthola izifo ezifana nesifo senhliziyo, isifo sohlangothi kanye nesifo sikashukela.

Kodwa khumbula, noma ngabe kukhona amathambo aphukile noma ukulimala kwemizwa ngesikhathi sokuzalwa, izingane eziningi ziyalulama ngokuphelele kulezo zilimele.

I-"Fetal Macrosomia" yisimo esingabangela izinkinga ezinkulu ngesikhathi sokubeletha. Nakuba kunezimbangela eziningi zalokhu, isifo sikashukela esingalawulwa kanye nokukhuluphala ngokweqile yizimbangela ezimbili eziyinhloko.Unganciphisa ingozi yakho yokuthola umntwana omkhulu ngokuphatha lezi zimo kahle. Izinto ezifana nokuzivocavoca njalo nokudla ukudla okunempilo kungakusiza ukuthi ukhulelwe kahle futhi kunciphise ingozi yezinkinga. Ungesabi ukubuza udokotela wakho ngendlela engcono kakhulu yokunakekela wena nomntwana wakho. Nakuba i-"Fetal Macrosomia" ingaba yingozi, iningi lezingane ezinkulu lizalwa liphilile.

Ngakho-ke, yiziphi izinto ezibaluleke kakhulu okudingeka sizikhumbule kulokhu?

Kulungile, ake sifingqe ezinye zezinto esikhulume ngazo okudingeka uzikhumbule:

• ``I-Fetal Macrosomia`` isho ukuthi umntwana uthola isisindo esiningi kunalokho obekulindelwe esibelethweni.
• Izimbangela eziyinhloko zalokhu isifo sikashukela sikamama (ikakhulukazi esingalawuleki) kanye nokukhuluphala ngokweqile ngesikhathi sokukhulelwa.
• Uma umntwana ekhula, bobabili umama nomntwana bangase babe nezinkinga ezithile ngesikhathi sokubeletha. I-"Shoulder Dystocia" iyisimo esibi kakhulu esingase senzeke enganeni.
• Odokotela bathola umbono ngosayizi womntwana ngokusebenzisa ama-ultrasound scan kanye nezinye izivivinyo.
• Akuwona wonke umntwana omkhulu odinga ukuhlinzwa ngokuhlinzwa, kodwa kwezinye izimo kuyindlela ephephile kakhulu.
• Le ngozi ingancishiswa ngokuphila impilo enempilo, ukudla ukudla okunempilo, nokulawula izimo ezifana nesifo sikashukela.
• Ungakhathazeki, iningi lezingane ezinkulu lizalwa liphilile. Xoxa ngakho konke nodokotela wakho bese ulandela imiyalelo yakhe.

Uma uneminye imibuzo mayelana nalokhu, qiniseka ukuthi ubuza udokotela wakho. Yibo abangakunikeza iseluleko esingcono kakhulu.

I- Fetal Macrosomia, Usana Olukhulu, Ukukhulelwa, Ukubeletha, Ukuhlinzwa Kwesisu, Isifo Sikashukela, I-Eyelash Dystocia