Ingabe i-umbilical cord yengane yakho inamathele emaphethelweni e-placenta? (Ukufakwa kwe-Marginal Cord) Ake sixoxe ngalokhu!

Omama abaningi bahlala bekhathazekile ngempilo yengane yabo ngesikhathi sokukhulelwa, kungakhathaliseki ukuthi ikhula kahle, akunjalo? Ngakho-ke, ngezinye izikhathi lapho udokotela wakho enza i-ultrasound scan bese ethi into efana nokuthi, "Kunomehluko omncane entanjeni yengane, ayikho phakathi kwe-placenta, kodwa inamathele ohlangothini," kuvamile ukuzizwa usaba futhi ukhathazekile ngokuzumayo. Yilokho esikubiza ngokuthi isimo esifana nalesi "Ukufakwa Kwentambo Emaphakathi". Ngakho-ke, ake sixoxe ngalokhu ngokucacile namuhla, ngendlela ongayiqonda? Ingabe kukhona okufanele ukwesabe, futhi ake sithole ukuthi kwenzekani ngempela kulokhu.

Uyazi ukuthi kuyini ukufakwa kwentambo ye-Marginal?

Kalula nje, `(Ukufakwa Kwentambo Emaphakathi)` kuyinguquko encane endleleni intambo yomntwana `(Intambo Yombilical)` exhunywe ngayo ku-`(Placenta)` ngesikhathi sokukhulelwa. Uyazi, `(Intambo Yombilical)` ifana nomzila wokuphila oxhumanisa umama nomntwana. Ingane ithola konke ukudla okunomsoco kanye nomoya-mpilo eyidingayo kumama ngale ntambo yombilical. Le ntambo yombilical ixhunywe esithweni esikhethekile esibizwa ngokuthi `(Placenta)`, esikhula kuphela ngesikhathi sokukhulelwa.

Ngokuvamile, intambo yomntwana kufanele ixhunywe enkabeni ye-placenta, noma eduze kakhulu nayo. Lokhu kungenxa yokuthi izakhamzimba zingageleza kahle zisuka kumama ziye kwi-placenta bese zisuka lapho ziye enganeni ngaphandle kwesithiyo. Leyo yindlela ephephile.

Kodwa-ke, uma kwenzeka `(Ukufakwa Kwentambo Emaphakathi)`, le ntambo yesisu ayixhumani nendawo ephakathi kwe-placenta, kodwa ixhuma emaphethelweni noma emaphethelweni e-placenta (cishe amamilimitha angu-20 ukusuka lapha). Ukuze kube sobala, lokhu kuxhumana kungamasentimitha amabili noma ngaphansi ukusuka emaphethelweni e-placenta. Uma lolu hlobo lokuxhumana lwenziwa emaphethelweni, ngezinye izikhathi (hhayi njalo) uhambo lokudla okunempilo oluvela kwi-placenta luya enganeni lungaba luncane kancane. Uma lokho kwenzeka, ukukhula komntwana kungase kube kancane kancane. Lokhu sikubiza ngokuthi `(IUGR - Intrauterine Growth Restriction)`. Futhi, ngezinye izikhathi izinga lokushaya kwenhliziyo lomntwana lingancipha ngesikhathi sokubeletha.

Kodwa-ke, into ebaluleke kakhulu lapha ukuthi ukukhulelwa okuningi okune-`(Marginal Cord Insertion)` kugcina ngokubeletha okunempilo ngaphandle kwezinkinga. Ngakho-ke, kungcono ukungesabi ngokushesha, akunjalo?

Sivame kangakanani lesi simo?

Lesi simo, esibizwa ngokuthi "Ukufakwa Kwentambo Emaphakathi", sivame kakhulu ekukhulelweni okubelethwe izingane eziningi, njengamawele noma amawele amathathu, kunasekukhulelweni kwezingane ezizalwa zingenawo ama-singleton. Sivela phakathi kuka-2% no-25% wokukhulelwa. Izinga liphansi ekukhulelweni kwezingane ezizalwa zingenawo ama-singleton futhi liphezulu ekukhulelweni okuningi.

Yiziphi izimpawu ezingakusiza ukuthi wazi ukuthi une-Marginal Cord Insertion?

Nasi iphuzu elibalulekile. Esikhathini esiningi, umama one-"Marginal Cord Insertion" akabi nazo izimpawu ezithile.Ungase ungaboni mehluko. Udokotela wakho uzovame ukubona lokhu kuxhumana okungavamile kwe-umbilical cord ngesikhathi sokuhlolwa kwe-ultrasound okuvamile ngesikhathi sokukhulelwa.

Kungani lokhu (Ukufakwa Kwentambo Emaphakathi) kwenzeka? Ziyini izimbangela?

Abacwaningi abakakazi kahle ukuthi yini ebangela ukufakwa kwentambo emaphethelweni. Kodwa-ke, kucatshangwa ukuthi ezinye izici zandisa ingozi yalolu hlobo lokufakwa kwentambo. Njengoba sesishilo ngaphambili, kuvame kakhulu ekukhulelweni kwezingane eziningi (njengamawele). Ngaphezu kwalokho, kunezinye izici eziningana ezingaba nomthelela:

• Ukusetshenziswa kwezidakamizwa noma utshwala ngesikhathi sokukhulelwa.
• Ukuba nesifo esingamahlalakhona njengesifo sikashukela.
• Ubudala bomama buyiminyaka engama-35 noma ngaphezulu ( ubudala bomama obuthuthukile ).
• Lokhu ukuzalwa kwakho kokuqala (`Nulliparity`).
• Ukusebenzisa i-IUD (Intrauterine Device) ngaphambi kokukhulelwa.
• Ukukhulelwa ngobuchwepheshe bokuzala bokwenziwa (ART - Ubuchwepheshe Bokuzala Bokwenziwa) (isib. izingane ezizalwa ngethubhu lokuhlola).

Kodwa khumbula, ukuthi nje unesinye noma ngaphezulu kwalezi zici akusho ukuthi uzoba nokufakwa kwentambo ye-Marginal. Isibonelo, abantu abaningi abakhulelwa nge-ART bangaba nokufakwa kwentambo ye-umbilical okuvamile. Into ebalulekile ukuthi noma ngabe kukhona okungajwayelekile ekufakweni kwentambo ye-umbilical, abantu abaningi bayaqhubeka nokukhulelwa okunempilo.

Ukufakwa Kwentambo Ye-Marginal kuvame ukutholakala nini?

Lezi zinhlobo zokuphazamiseka kwentambo yesisu zivame ukutholakala ngesikhathi sokuskena kwe-ultrasound phakathi ne-trimester yesibili (amasonto angu-14 kuya kwangu-27) . Kodwa-ke, ngezinye izikhathi, kungaba nzima ngodokotela ukukhomba indawo eqondile lapho intambo yesisu inamathele khona ku-placenta.

Ezimweni ezinjalo, udokotela angasebenzisa indlela ekhethekile ebizwa ngokuthi i-Doppler ngesikhathi sokuhlolwa kwe-ultrasound. Lokhu kukuvumela ukuthi ubone kahle ukugeleza kwegazi phakathi kwe-placenta nomntwana, okusho indlela umntwana ondliwe ngayo. Lokhu kuhlolwa kwe-Doppler kusiza ukuthola indawo eqondile yokunamathiselwa kwe-umbilical cord.

Yiziphi izindlela zokwelapha lokhu?

Okwamanje akukho ukwelashwa okuqondile okungalungisa isimo esibizwa ngokuthi ``Ukufakwa Kwentambo Emaphakathi''. Lokhu kusho ukuthi intambo yesisu ayinakushintshwa. Kunalokho, udokotela wakho uzokuqapha wena nomntwana wakho eduze kakhulu phakathi nokukhulelwa kwakho. Lokhu kwenzelwa ukuvimbela noma yiziphi izinkinga ezingase zivele. Bazohlola futhi ukuze babone ukuthi ingane ikhula kahle yini nokuthi ngabe kukhona yini ezinye izinto eziyingozi. Kwezinye izimo, ukuhlinzwa ngokuhlinzwa (C-section) kunganconywa uma kukhona izingozi.

Ngokuqapha okuseduze kangaka, izingozi zingancishiswa kakhulu. Ngakho-ke themba odokotela bakho futhi wenze njengoba besho.

Ingabe ikhona indlela yokuvimbela ukufakwa kwentambo emaphethelweni?

Cha. Awukwazi ukuvimbela ukufakwa kwentambo emaphethelweni ukuthi kungenzeki. Akuyona into ongayilawula. Kodwa ungasebenzisana eduze nodokotela wakho, uqaphe ukukhulelwa kwakho eduze, futhi wenze konke ongakwenza ukuqinisekisa ukuthi ingane iphilile futhi ibelethwa ngempumelelo.

Ingabe lesi simo (i-Marginal Cord Insertion) siyaphola ngokwaso?

Kungenzeka. Ezimweni eziningi, `(Ukufakwa Kwentambo Emaphakathi)` akubeki ingozi enkulu ekukhulelweni, futhi akuvimbeli ingane ekutholeni ukudla okudingayo. Kuleso simo, akudingeki ukhathazeke kakhulu ngendlela intambo yesisu exhunywe ngayo. Kunalokho, themba ukuthi udokotela wakho uzoqapha ngokucophelela ukukhula kwengane, futhi agxile ekugcineni impilo yakho ngesikhathi sokukhulelwa.

Ingabe ukufakwa kwentambo emaphethelweni kuyisimo esiyingozi?

Uma kukhona ukungajwayelekile endleleni intambo yesisu exhunywe ngayo, kungaba yingozi ngesikhathi sokukhulelwa. Kodwa-ke, ungacabangi ukuthi okubi kakhulu uma utholakala une-`(Ukufakwa Kwentambo Yesisu)`. Ngoba ezimweni eziningi utholakala une-`(Ukufakwa Kwentambo Yesisu)`, kuzalwa ukukhulelwa okunempilo kanye nezingane ezinempilo.

Udokotela wakho angaxoxa nganoma yiziphi izinkinga ongase ube nazo ngomlando wakho wezokwelapha kanye nemiphumela ye-ultrasound. Enye yezinto ezikhathaza kakhulu ukuthi ingane yakho ingase ikhule kancane kakhulu, isimo esibizwa ngokuthi i-Intrauterine Growth Restriction (IUGR). Uma ingane ingatholi ukudla okwanele okuvela ku-placenta, ingaba sengozini ye-IUGR. Lokhu okulandelayo kungenzeka enganeni yakho esanda kuzalwa:

• Isisindo sokuzalwa esiphansi: Ingane ezalwa inesisindo esingaphansi kwamakhilogremu angu-5 nama-ounces angu-8 (cishe amakhilogremu angu-2.5), ngokuvamile.
• Isilinganiso Esiphansi se-Apgar: Ukuhlolwa kwe-Apgar kuyindlela yokuhlola impilo yengane ngokushesha ngemva kokuzalwa. Isilinganiso esiphansi se-Apgar singase sibonise ukuthi ingane ingaba nenkinga ngenhliziyo noma amaphaphu ayo. Izingane ezinjalo zingadinga ukunakekelwa okwengeziwe.
• Amathuba akhulayo okuthi kudingeke ahlale eYunithi Yokunakekelwa Okujulile Kwezingane Ezisanda Kuzalwa (i-NICU): Ingane ingagcinwa e-NICU ukuze ithole ukunakekelwa okwengeziwe kuze kube yilapho ingane isilulama futhi ingadluliselwa ewadini evamile.

Uma udokotela wakho ecabanga ukuthi kukhona ingozi kuwe noma enganeni yakho, angase ancome ukuhlinzwa ngokuhlinzwa (C-section).

Ingabe i-(Marginal Cord Insertion) ingaba yi-(Velamentous Cord Insertion)?

Isimo esibizwa ngokuthi "Ukufakwa Kwentambo Emaphakathi", ikakhulukazi ngesikhathi sekota yesithathu (amasonto angama-29 kuya kwangu-40) yokukhulelwa, singaphenduka isimo esibizwa ngokuthi "Ukufakwa Kwentambo Emaphakathi". Kodwa-ke, lokhu akuvamile kakhulu.Ukufakwa Kwentambo Ene-Velamentous kwenzeka lapho intambo yesisu ingaxhumene ngqo ne-placenta, kodwa inamathele kuma-membrane angaphandle kwe-placenta. Lesi simo singavamile kakhulu kunokufakwa Kwentambo Ene-Marginal (okwenzeka cishe ku-1% wokukhulelwa) futhi sidinga ukunakwa okwengeziwe.

Udokotela wakho uzobona indlela intambo yesisu enamathele ngayo futhi akusize uthole imiphumela emihle kakhulu kuzo zombili lezi zimo, ``Ukufakwa Kwentambo Emaphethelweni`` kanye ``Ukufakwa Kwentambo Emaphethelweni``.

Ngakho-ke, ingabe kufanele ngikhathazeke ngokufaka i-Marginal Cord?

Cha, akudingeki ukhathazeke. Iningi labantu abane-Marginal Cord Insertion banezingane ezinempilo. Uma ingane ithola ukudla okufanele ukuze ikhule, ukuba ne-Marginal Cord Insertion kungase kungathinti ukukhulelwa kwakho.

Khuluma nodokotela wakho nganoma yikuphi ukukhathazeka ongase ube nakho. Kunezici eziningi ezingandisa ingozi yezinkinga ngesikhathi sokukhulelwa. Ukungajwayelekile kwe-umbilical cord kungaba yingozi noma kungabi yingozi. Udokotela wakho angakuqondisa ngesikhathi sokukhulelwa kwakho futhi akunike ukuhlolwa okuqotho.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela wakho?

Kuvamile ukuba nemibuzo eminingi engqondweni yakho ngesikhathi esinjengalesi. Nansi eminye imibuzo ongayibuza udokotela wakho:

• Kukangaki ngidinga ukuhlolwa nge-ultrasound ukuze ngiqaphe ukukhulelwa kwami?
• Ingabe ngidinga ukwenza ezinye izivivinyo?
• Kungenzeka kangakanani ukuthi ukufakwa kwe-Marginal Cord kuzothinta ukukhulelwa kwami?
• Ingabe kuzodingeka ukuhlolwa okwengeziwe ukuze kuhlolwe ukukhula komntwana?
• Ngingayilungisa kanjani indlela engidla ngayo, ukuzivocavoca umzimba, kanye nemisebenzi yami yocansi ukuze ngikhulelwe kahle ngangokunokwenzeka?
• Kufanele ngilale isikhathi esingakanani ngosuku? Kufanele ngiphumule isikhathi esingakanani ngosuku?

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kuvamile ukuzizwa wesaba kancane uma uzwa ukuthi une-`(Ukufakwa Kwentambo Emaphethelweni)`. Kodwa-ke, ungavumeli lokhu kuxilongwa kufake ukucindezeleka okungadingekile ekukhulelweni kwakho. `(Ukufakwa Kwentambo Emaphethelweni)` kungadinga ukubhekwa okwengeziwe noma ukunakekelwa. Kungenzeka futhi ukuthi lesi simo ngeke sithinte ukukhulelwa kwakho nhlobo.

Into ebaluleke kakhulu ukuthi udokotela wakho azi ukuthi unalesi simo. Lolu lwazi luzobasiza ukuthi bagcine wena nomntwana wakho niphilile ngangokunokwenzeka. Khumbula, omama abaningi abanalesi sifo bayaqhubeka nokubeletha izingane ezinempilo. Ngakho cabanga kahle, landela iseluleko sikadokotela wakho, futhi konke kuzolunga!

Intambo yomntwana , i-placenta, ukukhulelwa, ukukhula komntwana, i-ultrasound, ukufakwa kwentambo yasemaphethelweni, i-IUGR