Ingabe ingane yakho ayinkulu njengoba kulindelekile esibelethweni? Ake sixoxe ngomkhawulo wokukhula kwesisu (IUGR)!

Esikhathini esiningi, njengomama, unethemba lokuletha umntwana onempilo nokhule kahle emhlabeni. Kodwa ngezinye izikhathi, ingane yakho encane esibelethweni sakho ayikhuli ngokushesha ngendlela ongathanda ngayo. Odokotela babiza lesi simo ngokuthi i-Intrauterine Growth Restriction (IUGR) , noma ngezinye izikhathi i-Fetal Growth Restriction (FGR) . Kalula nje, ingane incane ngokweminyaka yayo yokukhulelwa. Lokhu kusho ukuthi inesisindo esingaphansi kweziyisishiyagalolunye kweziyishumi zabanye abantwana (ngaphansi kwe-10th percentile) ngesikhathi esifanayo sokukhulelwa.

Manje, akuzona zonke izingane ezikhula ngendlela efanayo. Ukuthi nje ingane "incane" akusho ukuthi ine-IUGR. Njengathi, ezinye zinde kanti ezinye zimfushane. Ingane engu-5'1" inempilo efanayo nengane engu-6'4". Kunjalo, izingane eziningi ezizalwa zincane ziphilile. Kodwa-ke, abanye omama banezimo ezithile zempilo ezinganciphisa ukukhula kwezingane zabo.

Yiziphi izinhlobo eziyinhloko ze-IUGR?

Odokotela bahlukanisa i-IUGR ngezinhlobo ezimbili eziyinhloko:

1. I-Symmetric IUGR (I-Primary IUGR): Yilapho umzimba wonke womntwana – ikhanda, isisu, izitho – ulingana khona ngobukhulu. Lokhu kubonakala cishe ku-30% wezingane ezine-IUGR.

2. I-Asymmetric IUGR (i-secondary IUGR): Lapha, ikhanda lomntwana kanye nobukhulu bobuchopho bakhe kujwayelekile, kodwa isisu esincane kuphela. Lolu uhlobo oluvame kakhulu, oluhlanganisa cishe u-80% wezingane ezine-IUGR.

Kuvame kangakanani lokhu kuvimbela ukukhula komntwana osanda kuzalwa?

Lesi simo se-IUGR singabonakala cishe ku-10% wokukhulelwa. Kodwa-ke, into ebalulekile ukuthi noma ngabe ingane incane kunokujwayelekile, akusho ngaso sonke isikhathi ukuthi ine-IUGR. Ngakho-ke, kungcono ukungesabi ngokungadingekile, akunjalo?

I-IUGR ivame ukutholakala nini?

I-IUGR ivame ukusolwa ngemva kwamasonto angama-20 okukhulelwa. Njalo uma ubona udokotela wakho, uzokala ukuphakama kwe-fundal yakho - ibanga ukusuka ethanjeni lakho le-pubic kuya phezulu kwesibeletho sakho. Uma lesi silinganiso siphansi kunalokho obekulindelwe, udokotela wakho angase asole i-IUGR bese ekuthumelela ukuhlolwa okwengeziwe.

Lesi simo se-IUGR sizokuthinta kanjani ukukhulelwa kwami?

Uma kutholakale ukuthi une-IUGR, ukukhulelwa kwakho kuzodingeka kuphathwe ngendlela ehlukile kancane. Udokotela wakho angase akucele ukuthi kwenziwe ama-scan engeziwe (ama-ultrasound) , ezinye izivivinyo, kanye nokuvakashela njalo emtholampilo ukuze kuqashwe ukukhula komntwana wakho. Uma unesinye isimo sezokwelapha esibangela i-IUGR yakho, udokotela wakho angase aqale nokwelapha leso simo. Kodwa-ke, konke lokhu kuncike empilweni yakho neyengane yakho.

Ngezinye izikhathi udokotela wakho angase abheke ukukhulelwa kwakho “njengokuyingozi enkulu.” Kodwa-ke, izingane eziningi ezitholakale zine-IUGR ziphilile futhi zidinga ukunakekelwa okwengeziwe ngesikhathi sokukhulelwa.

Yiziphi izizathu zokuvimbela ukukhula komntwana?

Kunezizathu eziningana zokuthi kungani ukukhula komntwana kungavinjelwa ngale ndlela. Ngezinye izikhathi, lokhu kungenxa yenkinga nge-placenta noma i-umbilical cord. Lokhu kungenxa yokuthi umntwana uthola izakhamzimba, umoya-mpilo, kanye negazi alidingayo ngalezi zinto. Ngakho-ke, uma lezi zinto zinganeli, ukukhula komntwana kungancipha.

Kukhona futhi izizathu ezihlobene nomama:

• Uma ukhulelwe amawele noma amawele amathathu .
• Uma uke waba nomntwana ngaphambilini one-IUGR .
• Uma unezimo ezifana nomfutho wegazi ophakeme, isifo senhliziyo, noma inani eliphansi legazi .
• Uma ubhema, uphuza utshwala, noma usebenzisa ezinye izidakamizwa . (Lezi ngokuqinisekile yizinto okufanele uyeke ukuzenza!)
• Uma unesifo sokuzivikela komzimba , njenge -lupus .
• Uma unesifo sezinso .
• Uma uthatha imithi ethile (imithi yokulwa nokuquleka) yokwelapha izimo ezifana nesifo sokuwa .
• Uma unesifo sikashukela (i-Diabetes Mellitus) .
• Uma uthola ukutheleleka okufana ne -rubella, i-syphilis, i-cytomegalovirus (CMV), noma i-toxoplasmosis ngesikhathi sokukhulelwa.

Ngezinye izikhathi i-IUGR ingabangelwa yisifo sokuzalwa noma sofuzo enganeni, isibonelo , i-Down syndrome (i-Trisomy 21) . Kutholakale nokuthi izingane ezizalwa omama abahlala ezindaweni eziphakeme zingase zibe nesisindo esiphansi sokuzalwa.

Iyini imbangela eyinhloko yokuvinjelwa kokukhula kombungu?

Kunzima ukusho ngokuqinisekile ukuthi iyini imbangela yokuvinjelwa kokukhula kombungu. Ngezinye izikhathi kungaba nezimbangela eziningi, noma kungatholakali imbangela ecacile. Udokotela wakho uzozama ukuthola imbangela eyisisekelo (uma ikhona).

Ziyini izimpawu ze-IUGR?

Iningi lomama alibi nazo izimpawu ezithile ezibonisa ukuthi ingane yabo incane kunenani lamasonto. Ngezinye izikhathi ungase uzizwe sengathi isisu sakho noma ingane yakho ayinkulu njengoba kulindelekile. Kodwa-ke, udokotela wakho kuphela onganquma ngokuqinisekile ukuthi une-IUGR.

Lesi simo se-IUGR sitholakala kanjani?

Ukuze uxilonge i-IUGR, udinga kuqala ukwazi usuku lwakho lokuzalwa, oluvame ukunqunywa ngosuku lokuqala lwesikhathi sakho sokugcina sokuya esikhathini kanye ne-ultrasound yekota yokuqala . Ukwazi lolu suku kunikeza udokotela wakho isisekelo sokuxilonga i-IUGR.

Ngemuva kwalokho, udokotela uzozama ukuthola i-IUGR esebenzisa izindlela eziningana:

• Ukuphakama kwesibeletho: Njengoba kushiwo ngaphambili, udokotela wakho uzolinganisa ukuphakama kusukela ethanjeni lakho le-pubic kuya phezulu kwesibeletho sakho (usayizi "we-baby bump" yakho) ngetheyipu yokulinganisa yephepha. Ngemva kwamasonto angama-20, lokhu kuphakama kufanele kulingane nenani lamasonto okhulelwe ngamasentimitha (cm). Isibonelo, uma ukhulelwe amasonto angama-32, ukuphakama kwesibeletho sakho kufanele kube ngamasentimitha angama-32. Uma lokhu kulinganisa kungaphansi ngamasentimitha angu-4 kunalokho obekulindelwe (okungukuthi, amasentimitha angama-28 noma ngaphansi kulesi sibonelo), udokotela wakho angase asole i-IUGR. Ngezinye izikhathi, udokotela wakho uzolinganisa usayizi wengane yakho ngokuyithinta.
• Isisindo Sakho: Isisindo sakho siyahlolwa njalo lapho uvakashela emtholampilo. Uma ungakhuli kahle, kungaba uphawu lokuthi ingane yakho ayikhuli kahle.
• I-Ultrasound: Uma utholakale une-IUGR, kuzodingeka ukuthi uhlolwe njalo phakathi nokukhulelwa kwakho ukuze uqaphe ukukhula komntwana wakho. Phakathi nalokhu kuskena, udokotela wakho uzohambisa idivayisi (induku noma i-probe) phezu kwesisu sakho. Amaza omsindo adala isithombe somntwana wakho. Udokotela uzosebenzisa isithombe ukukala isisindo nosayizi wengane yakho. Ukuskena kungasetshenziswa futhi ukubheka ukugeleza kwegazi kusuka ku-placenta kuya enganeni ngentambo yesisu (ebizwa ngokuthi ukuhlolwa kokugeleza kwe-Doppler ). Ukugeleza kwegazi okubi kungaba uphawu lwe-IUGR. Ukuskena kungalinganisa nenani loketshezi lwe-amniotic oluzungeze ingane. Amazinga aphansi alolu ketshezi (i-oligohydramnios) nawo angaba uphawu lwe-IUGR.
• Ukuqapha ingane esanda kuzalwa: Udokotela wakho uzonamathisela idivayisi yokuqapha esibelethweni sakho ngentambo. Kuzodingeka ulale phansi bese ugqoka le divayisi cishe imizuzu engama-30. Lokhu kuzoqopha ukushaya kwenhliziyo yengane. Udokotela uzosebenzisa le miphumela ukuhlola noma yiziphi izinkinga zokukhula.
• I-Amniocentesis: Lokhu kuhlolwa kungasiza ekuboneni izimbangela zokuzalwa ze-IUGR. Lapha, udokotela ufaka inalithi encane esikhumbeni sakho esibelethweni sakho bese ethatha inani elincane loketshezi lwe-amniotic oluzungeze ingane bese eluthumela elabhorethri ukuze luhlolwe. Lokhu akulona ukuhlolwa okuvamile, futhi kwenziwa kuphela uma kudingeka.

Ungesabi uma udokotela ekucela ukuthi wenze izivivinyo ezengeziwe. Ezinye izingane zincane kunesilinganiso, kodwa ziphilile futhi ziyasebenza.

Kuphathwa kanjani ukuvinjelwa kokukhula kombungu?

Ukwelashwa kwe-IUGR kuncike ekutheni usunesikhathi esingakanani ukhulelwe kanye nempilo yengane yakho. Ngeshwa, asikho ikhambi elilodwa elifanelana nakho konke ekuvinjelweni kokukhula kwengane. Udokotela wakho uzokuqapha wena kanye nengane yakho eduze ukuqinisekisa ukuthi azikho izinkinga. Bazophinde baphathe noma yiziphi izimo zezokwelapha ezingase zibangele lesi simo.

Lokhu okulandelayo kungenziwa njengokwelashwa:

• Ukuqapha okwengeziwe: Udokotela uzokuqapha wena nomntwana wakho eduze kakhulu. Ukukhula komntwana kuzohlolwa njalo ngama-scan kanye nezinye izivivinyo.
• Ukubeletha kusenesikhathi: Uma ukukhulelwa kungaqhubeki kahle noma ingane isengozini, udokotela wakho angase anqume ukuqala ukubeletha kusenesikhathi (ngaphambi kwamasonto angu-37). Ngezinye izikhathi kunganconywa ukuhlinzwa ngokuhlinzwa (ukuhlinzwa ngokuhlinzwa) , njengoba ukubeletha ngesitho sangasese sowesifazane kungaba yinto ecindezelayo enganeni ekhungathekile ekukhuleni.
• Imithi ye-corticosteroid: Uma udokotela wakho encoma ukubeletha ingane yakho kusenesikhathi, ungase unikezwe imithi ye-corticosteroid ukusiza amaphaphu engane yakho akhule.

Ezimweni ezingavamile kakhulu, noma ezinzima kakhulu, udokotela wakho angase anqume ukukungenisa esibhedlela ukuze ahlolwe eduze.

Ingabe izingane ezinemikhawulo yokukhula ekugcineni zikhula njengezinye izingane?

Esikhathini esiningi, yebo! Iningi lezingane ezizalwa zine-IUGR zikhula zibe nobukhulu obufana nobabanye abantwana abaneminyaka yazo lapho sezineminyaka engaba ngu-3 ubudala. Kodwa-ke, kubalulekile ukukhumbula ukuthi ingane ngayinye ikhula ngendlela ehlukile. Futhi, ungayiphoqeleli ingane yakho ukondla. Ukwenza kanjalo kungaholela kwezinye izinkinga zempilo, njengokukhuluphala ngokweqile noma isifo sikashukela. Udokotela wezingane wengane yakho uzokweluleka uma ukukhula kwengane yakho kungahambi ngendlela obekulindelekile.

Yini okufanele ngiyenze ukuze ngandise ukukhula komntwana wami?

Akukho siqinisekiso sokuthi ukudla ukudla okuthile kuzokwandisa isisindo somntwana wakho. Kodwa-ke, kunconywa ukuthi udle ukudla okunempilo ngesikhathi sokukhulelwa. Ukudla okucebile ngezithelo, imifino, ama-carbohydrate anempilo, kanye namaprotheni kuzokunikeza wena nomntwana wakho zonke izakhamzimba abazidingayo ngesikhathi sokukhulelwa. Ungakhohlwa ukukhuluma nodokotela wakho ngaphambi kokwenza noma yiziphi izinguquko ezinkulu ekudleni kwakho ngesikhathi sokukhulelwa.

Yini engingayenza ukuze ngivimbele i-IUGR?

Kunezici ezithile ezandisa ingozi ye-IUGR, kodwa singazishintsha:

• Ukusebenzisa izidakamizwa, utshwala, noma ukubhema. (Lokhu kufanele kuyekwe ngokuphelele!)
• Ukulandela ukudla okungenampilo.
• Ukungakhuli ngokwanele ngesikhathi sokukhulelwa.

Yiziphi izimo zempilo enginazo ezandisa ingozi yami yokuthola i-IUGR?

Ungase ube sengozini enkulu yokuthola i-FGR/IUGR uma unezinye zezimo ezilandelayo:

• Umfutho wegazi ophezulu noma isifo senhliziyo.
• Isifo sikashukela.
• I-anemia noma i-sickle cell anemia.
• Izifo zamasosha omzimba ezifana ne-lupus.

Ingabe i-IUGR iyaphela?

Ingane ingase "ibambe" kancane bese ikhula. Kodwa-ke, ukuxilongwa kwe-IUGR akupheli. Udokotela uzoqapha ngokucophelela ukukhula kwengane kuze kube sekupheleni kokukhulelwa.

Kungenzeka yini ukuba nomntwana osemusha ngenxa yokuvinjelwa kokukhula kwengane?

I-FGR/IUGR ngokuvamile ayibangeli ukubeletha kusenesikhathi, kodwa kungenzeka. Uma ingane yakho ikhula kancane, noma uma kunezinkinga nge-placenta yakho noma i-umbilical cord, udokotela wakho angase ancome ukubeletha kusenesikhathi. Njengoba kushiwo ngaphambili, uma ukucindezeleka kokubeletha kwesitho sangasese sowesifazane kuphakeme kakhulu enganeni yakho, kunganconywa ukuhlinzwa ngokuhlinzwa (C-section).

Yiziphi izingozi ezingaba khona enganeni ezelwe ine-IUGR?

Kunezimo nezinkinga ezithile ezihlobene ne-IUGR:

• Kukhona ingozi enkulu yokuthola umntwana ngokuhlinzwa (C-section) kanye nokuzalwa ngaphambi kwesikhathi.
• Ubunzima bokuphefumula nokudla bungase buvele ngokushesha ngemva kokuzalwa.
• Ukuntuleka komoya-mpilo (i-hypoxia) ngesikhathi sokuzalwa.
• Amazinga kashukela aphansi egazini (hypoglycemia) ngesikhathi sokuzalwa.
• Ubunzima bokulawula izinga lokushisa lomzimba.
• I-Meconium aspiration (umntwana ogwinya indle yakhe yokuqala esibelethweni).
• I-Polycythemia (ukwanda kwenani lamaseli abomvu egazi).
• Ukwehliswa kokumelana nezifo.

Ezinye izingane ezizalwa ngaphambi kwesikhathi noma ezincane zingase zidinge ukuhlala esibhedlela isikhathi eside noma zithole ukunakekelwa okukhethekile eYunithi Yokunakekelwa Okujulile Kwezinsana Ezisanda Kuzalwa (i-NICU) .

I-IUGR ingaba nemiphumela yesikhathi eside, kuye ngezici ezilandelayo:

• Isimo sezokwelapha esiyisisekelo esibangele lokhu.
• Ukuthi ukukhula komntwana kulinganiselwe kangakanani.
• Mangaki amasonto okukhulelwa adlulile lapho umntwana ezalwa.

Ingane yakho ingase ibe sengozini enkulu yezinkinga zokuqonda noma zokukhula njengokungasebenzi kahle kwengqondo, ukukhubazeka kobuchopho , amamaki amabi ezivivinyweni esikoleni, futhi ingase ibe sengozini enkulu yokukhuluphala kanye nesifo senhliziyo kamuva ekuphileni.

Ngenzenjani uma ingane yami ine-IUGR?

Okokuqala, ungesabi.Esikhathini esiningi, lokhu akuyona into oyenzile. Nazi ezinye izinto ongayenza ukuze usize:

• Qiniseka ukuthi uya khona kuzo zonke izikhathi zakho zokubeletha kanye nokuhlolwa komntwana (njengokuskena).
• Uma usebenzisa izidakamizwa, ubhema, noma uphuza utshwala, yeka ukwenza lezo zinto njengamanje.
• Yidla ukudla okunempilo futhi uthole inani elidingekayo lama-calories ngosuku.
• Phumula ngokwanele, ulale okungenani amahora ayisishiyagalombili ebusuku.
• Uma uzizwa sengathi ukunyakaza kwengane yakho kuyehla, qaphela. (Kunezindlela zokubala ukuthi ingane yakho ikhahlela kangaki ngosuku, buza udokotela wakho.)
• Tshela udokotela wakho ngokwethembeka nganoma yimiphi imithi oyithathayo.

Sebenza nodokotela wakho ukuze uqonde ngokugcwele lokhu kutholakala kwesifo, izinkinga ezingaba khona, kanye nezinguquko ongazenza endleleni yakho yokuphila.

Ingabe kufanele ngikhathazeke uma ingane yami incane ngosayizi?

Esikhathini esiningi, cha. Izingane zikhula ngamazinga ahlukene. Kodwa-ke, kunomehluko phakathi kokuxilongwa ukuthi zincane ngesikhathi sokukhulelwa kanye nokuxilongwa ukuthi zinomkhawulo wokukhula kwengane (FGR/IUGR). I-FGR/IUGR itholakala lapho ingane incane kunezingane eziyisishiyagalolunye kweziyishumi ezineminyaka efanayo. Kungenzeka ngokuphelele ukuthi ingane ibe ncane ngesikhathi sokukhulelwa ukuze ibe nempilo futhi ingabi sengozini enkulu yezinkinga. Khuluma nodokotela wakho nganoma yiziphi izinkinga ongase ube nazo.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Kuvamile ukuba nemibuzo mayelana nokuxilongwa komkhawulo wokukhula kwesisu (i-IUGR). Nansi eminye imibuzo ongayibuza udokotela wakho:

• Uyazi ukuthi yini ebangela i-IUGR?
• Kukangaki lapho kuzodingeka ngize emitholampilo yangaphambi kokubeletha?
• Ingabe kukhona engingakwenza ukusiza ekukhuleni komntwana wami?
• Ingabe ingane yami isengozini yezinkinga zempilo?
• Ingabe ingane yami izohlala esibhedlela isikhathi eside ngemva kokuzalwa?
• Ingabe ingane yami ingaba nezinkinga zempilo kamuva?

Kunezizathu eziningi ezenza ingane ibe ncane ngaphambi kokuzalwa. Udokotela wakho uzonquma ukuthi kukhona yini inkinga eyisisekelo evimbela ukukhula kwengane. Ngezinye izikhathi, ngaphandle kwesizathu esibonakalayo, ingane ingazalwa incane kunokujwayelekile. Uma ingane yakho itholakala ine-IUGR, ithimba lakho lezokwelapha lizoqapha ngokuseduze ukukhula kwengane yakho phakathi nokukhulelwa. Okubaluleke kakhulu kubo ukuqinisekisa ukuthi wena nengane yakho nithola ukunakekelwa nokwelashwa abakudingayo. Iningi lezingane ezizalwa zine-IUGR azinazo izinkinga zempilo.

Umlayezo Wokuya Nawe Ekhaya

Kuvamile ukuzizwa wesaba futhi ukhathazekile lapho uthola ukuthi ingane yakho ayikhuli njengoba kulindelekile esibelethweni, noma ukuthi ine-IUGR. Kodwa sicela ukhumbule, izingane eziningi zizalwa ziphilile, ziphilile, futhi zikhula kahle kulezi zimo.

Into ebaluleke kakhulu yile:

• Bona udokotela wakho njalo bese ulandela imiyalelo yakhe ngqo.
• Ukuqedela zonke izivivinyo ezihleliwe ngesikhathi.
• Ukuphila impilo enempilo - ukudla kahle, ukugwema ukubhema notshwala.
• Noma yimiphi imibuzo noma ukwesaba onakho engqondweni kufanele kuxoxwe ngakho nodokotela futhi kuchazwe.

Awuwedwa, kunodokotela namalungu omndeni azokusiza. Cabanga kahle, zinakekele wena nomntwana wakho omncane.

Ukuvinjelwa kokukhula kwangaphakathi kwesibeletho, i - IUGR, i-FGR, ukuvinjelwa kokukhula kwengane, ukucindezeleka kwengane, impilo yokukhulelwa, ukukhula kwengane