Ingabe umgogodla womntwana uyinkinga yokuzalwa? Ake sixoxe nge-myelomeningocele!

Yeka ukuthi kuhle kanjani ukucabanga ngomntwana wakho osesiswini sakho! Kodwa ngezinye izikhathi, izingane zethu ziza kuleli zwe zinezinkinga zempilo ezingalindelekile. Namuhla, sizokhuluma ngesici esiyinkimbinkimbi sokuzalwa esenzeka ngesikhathi sokuthuthukiswa komgogodla, noma umgogodla, ngenkathi umntwana esesesibelethweni. Lokhu kubizwa ngokuthi i-myelomeningocele. Kungenzeka ukuthi uke wezwa ngaso ngokuthi "i-Open Spina Bifida". Empeleni lesi yisimo lapho umgogodla womntwana, noma umgudu womgogodla, ungavaleki kahle.

Iyini ngempela i-myelomeningocele?

Kalula nje, i-myelomeningocele iyisici sokuzalwa lapho umgogodla womntwana wakho kanye nomsele womgogodla kungavaleki ngokuphelele ngaphambi kokuzalwa, esibelethweni. Lolu uhlobo lwesici se-neural tube (NTD). Ungase ube nesikhathi esinzima ukubiza leli gama, akunjalo? Libizwa ngokuthi 'my-e-lo-men-in-go-ceil'.

I-Myelomeningocele yenzeka phakathi kwamasonto amane okuqala okukhulelwa. Lokhu kwenzeka lapho ithubhu ye-neural yengane ihluleka ukuvala kahle, okubangela ukuthi isikhwama esigcwele uketshezi siphume ngemuva komgogodla wengane. Ngokukhethekile, isikhwama singase siqukathe:

• Ingxenye yomgogodla wabo
• Ama-meninges - izicubu ezimboze umgogodla wazo
• Imizwa
• Uketshezi lwe-cerebrospinal (CSF) luwuketshezi olubalulekile olutholakala ebuchosheni nasemgogodleni.

I-Myelomeningocele ingavela noma kuphi emgogodleni wengane, kodwa ivame ukubonakala emhlane ongezansi (ezindaweni ze-lumbar kanye ne-sacral) , okungukuthi, endaweni yesinqe.

Ingxenye edabukisayo ukuthi umgogodla kanye nemizwa engaphakathi kwesikhwama yonakele. Lokhu kuvame ukuholela ebuthakathakeni noma ekulahlekelweni umuzwa ezingxenyeni zomzimba ezingaphansi kwesikhwama . Kwezinye izimo, isikhwama singaqhuma. Lokhu kungenzeka ngenxa yokunyakaza okuvamile kwengane ngesikhathi isesibelethweni, noma kungenzeka ngesikhathi sokuzalwa.

I-Myelomeningocele uhlobo olubi kakhulu lwe-spina bifida, futhi ingabangela ukukhubazeka okuphakathi kuya kokubi kakhulu. Isibonelo, ubuthakathaka bemisipha, ukulahlekelwa ukulawula isinyi noma amathumbu, kanye/noma ukukhubazeka . Kodwa-ke, izingane ezinalesi simo zehla phansi emgogodleni zivame ukuba nezimpawu ezimbalwa kunezingane ezinalesi simo phezulu emgogodleni.

Kuyini ukukhubazeka kwe-neural tube?

Ama-Neural Tube Defects (ama-NTD) angamaphutha okuzalwa (izimo zokuzalwa) zobuchopho, umgogodla, noma umgogodla. Avame ukwenzeka phakathi nenyanga yokuqala yokukhulelwa - ngezinye izikhathi ngaphambi kokuthi wazi ukuthi ukhulelwe. Izinhlobo ezimbili eziyinhloko zamaphutha e-neural tube yi-spina bifida kanye ne-anencephaly.

Yilokhu okuvame ukwenzeka: Ngenyanga yokuqala yokukhulelwa, izinhlangothi ezimbili zomgogodla wombungu ziyahlangana ukuze zakhe isembozo esivikelayo somgogodla, imizwa yomgogodla, kanye ne-meninges (izicubu ezimboza umgogodla). Kuleli qophelo, ubuchopho obukhulayo kanye nomgogodla wombungu kubizwa ngokuthi i-neural tube.

Ngakho-ke, uma kukhona iphutha noma inkinga ekwakhekeni kwale payipi yemizwa, ibizwa ngokuthi i-neural tube defect.

Uyini umehluko phakathi kwe-Spina Bifida ne-Myelomeningocele?

I-'Spina Bifida' ibhekisela kunoma yisiphi isiphako sokuzalwa lapho ithubhu yemizwa ezungeze umgogodla ingavaleki ngokuphelele.

I-Spine Bifida ingavela noma kuphi emgogodleni wengane, njengoba kushiwo ngaphambili, uma i-neural tube ingavali ngokuphelele esibelethweni. Uma lokhu kwenzeka, i-spinal cord, evikela i-spinal cord, ayivali kahle. Lokhu kungabangela umonakalo emgogodleni wengane kanye nasezinzwa.

I-Myelomeningocele uhlobo lwe-spina bifida – futhi olunzima kakhulu. Luyisikhwama esigcwele uketshezi oluphuma emhlane womntwana, oluqukethe ingxenye yomgogodla kanye nemizwa. Ezinye izinhlobo ze-spina bifida yi-meningocele kanye ne-spina bifida occulta.

Uyini umehluko phakathi kweMeningocele neMyelomeningocele?

I-Myelomeningocele kanye ne-meningocele zombili izinhlobo ze-spina bifida, kodwa kunomehluko omncane.

I-Meningocele yisimo lapho isikhwama esigcwele uketshezi siphuma khona embotsheni emhlane wengane, kodwa isikhwama asinawo umgogodla wengane . Lokhu ngokuvamile kubangela umonakalo omncane noma akukho nhlobo emithanjeni.

Kodwa ku- myelomeningocele , kukhona kokubili ingxenye yomgogodla kanye nemizwa ngaphakathi kwaleso sikhwama, futhi zonakele . Yilokho okwenza kube kubi kakhulu.

Ubani othinteka yi-Myelomeningocele?

I-Myelomeningocele ingathinta noma yimuphi umbungu. Nakuba ososayensi bengaqiniseki ukuthi yini ebangela lokhu, bathole izici ezithile zofuzo, ezemvelo, kanye nezokudla okwandisa ingozi yomntwana yokuthola lesi simo.

Sivame kangakanani lesi simo?

I-Myelomeningocele yisimo esenzeka ohlelweni lwezinzwa oluphakathi.Isimo esivame kakhulu sokuzalwa (isici sokuzalwa). Isibonelo, lesi simo sithinta cishe izingane eziyi-1,645 ezizalwa minyaka yonke e-United States. Izingane nazo zizalwa zinalesi simo eSri Lanka.

Ziyini izimpawu ze-Myelomeningocele?

Ingane ene-myelomeningocele inesikhwama esigcwele uketshezi esigeleza emgogodleni sisuka phakathi nomhlane . Odokotela bavame ukubona lesi simo ngesikhathi sokukhulelwa nge-ultrasound scan.

Ingane ene-myelomeningocele ingase ibe nezinye izinkinga zokuzalwa . Cishe izingane ezingu-8 kwezingu-10 ezinalesi simo nazo zinesifo esibizwa ngokuthi i-hydrocephalus, okuyiqoqo loketshezi ebuchosheni .

Ezinye izinkinga zomgogodla noma uhlelo lwemisipha ezingase zihlotshaniswe ne-myelomeningocele zifaka:

• I-Syringomyelia (i-cyst egcwele uketshezi ngaphakathi komgogodla)
• Ukuhlukana kwenqulu

Ziyini izimbangela ze-Myelomeningocele?

Odokotela nososayensi abakayazi imbangela eqondile ye-myelomeningocele, kodwa bakholelwa ukuthi yisimo esiyinkimbinkimbi esibangelwa inhlanganisela yezici zofuzo, ezokudla okunempilo kanye nezemvelo .

Ikakhulukazi, amazinga aphansi e-folic acid emzimbeni kamama ngaphambi nangesikhathi sokukhulelwa aboniswe ukuthi anegalelo ekwakhekeni kwalolu hlobo lokukhubazeka kokuzalwa. I-folic acid (eyaziwa nangokuthi i-folate) ibalulekile ekuthuthukisweni kobuchopho bomntwana kanye nomgogodla.

I-Myelomeningocele ihlolwa kanjani ngaphambi kokuba umntwana azalwe?

Ngokuvamile (kodwa hhayi njalo) odokotela bangakwazi ukuthola i-myelomeningocele kumntwana osanda kuzalwa ngesikhathi sokukhulelwa. Basebenzisa lezi zivivinyo:

• Ukuhlolwa kwegazi: Udokotela wakho uzoyala ukuhlolwa kwegazi phakathi kwamasonto ayi-16 kuya kwayi-18 okukhulelwa okulinganisa into ebizwa ngokuthi i-alpha-fetoprotein (AFP). Cishe u-75% kuya ku-80% wabesifazane abakhulelwe abathwele umntwana one-spina bifida banamazinga aphezulu kunavamile ale AFP. Uma izinga lakho liphezulu, udokotela wakho uzoyala ezinye izivivinyo, njenge-ultrasound scan, ukuze ahlole ingane kabanzi.
• I-ultrasound yengane ekhulelwe: Ukuskena kwe-ultrasound ngesikhathi sokukhulelwa kuyindlela enembile kakhulu yokuxilonga i-myelomeningocele. Odokotela bavame ukuncoma ukuskena kwe-ultrasound ku-trimester yokuqala (amasonto 11-14) kanye ne-trimester yesibili (amasonto 18-22). Ukuskena kwe-trimester yesibili kungasixilonga ngokunembile isimo.
• Ukuhlolwa kwe-Amniocentesis:Uma ukuhlolwa kwe-ultrasound kwengane esanda kuzalwa kuqinisekisa i-myelomeningocele, udokotela wakho angase ancome ukuhlolwa kwe-amniocentesis. Lokhu kwenzelwa ukuhlola izimo zofuzo ezingavamile ezihlobene ne-myelomeningocele. Lokhu kuhilela udokotela ukusebenzisa inalithi ukuthatha isampula yoketshezi oluvela esikhwameni se-amniotic esizungeze ingane esanda kuzalwa. Kunezingozi ezithile ngalolu vivinyo, ngakho-ke kubalulekile ukuxoxa ngalokhu nodokotela wakho.

Uma ingatholakali ngesikhathi sokukhulelwa, i-myelomeningocele itholakala ngemva kokuzalwa komntwana kusetshenziswa izivivinyo zezithombe ezifana ne-MRI (Magnetic Resonance Imaging) scan noma i-CT (Computed Tomography) scan.

Yiziphi izindlela zokwelapha i-Myelomeningocele?

Ukwelashwa okuvamile kwe-myelomeningocele ukuhlinzwa ukuvala isikhala emgogodleni womntwana .

Odokotela bangenza lokhu kuhlinzwa ngaphambi kokuba umntwana azalwe (ukuhlinzwa kwengane) noma ngokushesha ngemva kokuzalwa (ukuhlinzwa kwangemva kokubeletha) .

Ngenxa yokuthi izingane ezine-myelomeningocele zivame ukuba ne-hydrocephalus (ukunqwabelana koketshezi ebuchosheni), i-ventriculoperitoneal (VP) shunt nayo ingadingeka ukuze kususwe uketshezi oluthe xaxa ebuchosheni bomntwana.

Izingane eziningi zizodinga ukwelashwa impilo yonke ukuze kulungiswe izinkinga ezibangelwa ukulimala komgogodla kanye nemizwa yazo. Ukwelashwa okuvamile kufaka phakathi ama-antibiotic ukuvimbela izifo ezifana ne-meningitis (ukutheleleka kobuchopho) noma izifo zomgudu womchamo (UTIs) kanye nokwelashwa ngokomzimba.

Ukuhlinzwa kwe-myelomeningocele yengane esanda kuzalwa

Ukuhlinzwa kwengane esanda kuzalwa kuyindlela ekhethwayo kuye ngokuthi i-myelomeningocele ibucayi kangakanani kanye nempilo kamama okhulelwe. Lolu hlobo lokuhlinzwa luya ngokuya luvame kakhulu.

Nakuba lokhu kuhlinzwa kungavimbela izimpawu ukuthi zingabi zimbi kakhulu, akukwazi ukulungisa umonakalo osuvele wenziwe emgogodleni noma emithanjeni .

Okubalulekile: Kunezinkinga ezihlobene nalokhu kuhlinzwa komntwana osanda kuzalwa, njengengozi eyengeziwe yokubeletha ngaphambi kwesikhathi kanye nokuphuma kwesibeletho.

Ukuhlinzwa Kwangemva Kokubeletha kwe-myelomeningocele

Uma ingane yakho ingazange ihlinzwe ukuze kulungiswe i-spina bifida, ukuhlinzwa kufanele kwenziwe ngokushesha okukhulu ngemva kokuzalwa - okungcono kakhulu phakathi namahora okuqala angu-48 okuzalwa - ukuze kuncishiswe ingozi yokutheleleka.

Yibaphi odokotela okufanele ingane yami ene-myelomeningocele ibabone?

Izingane eziningi ezine-myelomeningocele ziyazuza ekusekelweni yithimba elihlanganisa imikhakha eminingi ukuze lihlele ukunakekelwa nokuphathwa kwazo. Ochwepheshe abangase babe yingxenye yokunakekelwa kwengane yakho bahlanganisa:

• Udokotela wezinzwa
• Udokotela ohlinzayo wezinzwa
• Udokotela ohlinzayo wengane esanda kuzalwa
• Udokotela Wezifo Zomchamo
• Udokotela Wamathambo
• Udokotela Wesikhumba
• Udokotela wezokwelapha ngokomzimba

Yiziphi izici eziyingozi ze-myelomeningocele?

Ngeshwa, izinkinga zokuzalwa ezifana ne-myelomeningocele azinakuvinjelwa ngokuphelele - ingozi ingancishiswa kuphela . Esikhathini esiningi, lesi simo senzeka ngezikhathi ezithile. Kodwa ososayensi bathole izici eziningana eziyingozi ezihlobene nalesi simo. Lezi yizi:

• Ukuntuleka kwe-Folate (folic acid): I-Folate, uhlobo lwemvelo lwe-vitamin B9, ibalulekile ekukhuleni okunempilo kwengane ekhulelwe. Ukuntuleka kwe-Folate kwandisa ingozi ye-spina bifida kanye nezinye izinkinga ze-neural tube (NTDs). Uma ukhulelwe noma uhlela ukukhulelwa, kubalulekile ukuthatha amavithamini ngaphambi kokubeletha ukuqinisekisa ukuthi uthola i-folate (folic acid) kanye nezinye izakhamzimba ozidingayo ukuze ukhulelwe kahle.
• Umlando womndeni weziphambeko ze-neural tube: Abantu abaye baba nengane eyodwa ene-neural tube defect basengozini ekhuphuke ngo-3% yokuthola ingane yesibili enalesi sici. Futhi, abesifazane abaye baba ne-neural tube defect (NTD) banamathuba amaningi okuba nengane ene-myelomeningocele kunalabo abangenayo le nkinga. Kodwa-ke, iningi lezingane ezine-myelomeningocele lizalwa abazali abangenawo umlando womndeni walesi simo.
• Imithi yokulwa nokuquleka: Eminye imithi yokulwa nokuquleka itholakale ihlotshaniswa nengozi eyengeziwe yokukhubazeka kwe-neural tube uma ithathwa ngesikhathi sokukhulelwa.
• Isifo Sikashukela: Abesifazane abakhulelwe abanesifo sikashukela esingalawulwa kahle basengozini enkulu yokuthola umntwana one-myelomeningocele.
• Ukukhuluphala ngokweqile: Abesifazane abakhuluphele ngaphambi kokukhulelwa basengozini enkulu yokuthola umntwana one-neural tube defect, okuhlanganisa ne-myelomeningocele.
• Ukushisa komzimba okwenyukayo:Kutholakale ukuthi ukwanda kokushisa komzimba okuphakathi (i-hyperthermia) emasontweni okuqala okukhulelwa, kungakhathaliseki ukuthi kungenxa yomkhuhlane oqhubekayo noma ukusebenzisa i-sauna noma i-hot tub, kwandisa kancane ingozi ye-myelomeningocele.

Khumbula, ukuba nomntwana one-myelomeningocele akulona iphutha lakho. Wonke umuntu osemdala yokuzala usengozini yokukhulelwa ngenxa yesici sokuzalwa.

Iyini i-prognosis ye-myelomeningocele?

Abekho abantu ababili abane-myelomeningocele abathinteka ngendlela efanayo. Ukubikezela lesi simo kuncike ezintweni eziningana. Lezi zifaka:

• Isimo sokuqala somgogodla kanye nemizwa yabo.
• Ukuthi imbobo emgogodleni iphakeme noma iphansi kangakanani.
• Ingabe leso sikhwama sivuliwe noma sivaliwe?
• Kungakhathaliseki ukuthi bahlinzwe ngaphambi noma ngemva kokubeletha.

Izinga lokufa kwabantu abane-spina bifida licishe libe ngu-1% ngonyaka phakathi kweminyaka emi-5 nengama-30. Uma inxeba liphezulu emgogodleni, kulapho ingozi yezinkinga nokufa iba nkulu khona.

Imiphumela emibi kanye nezinkinga ze-myelomeningocele zingathinta kakhulu izinga lempilo. Abantu abanalesi simo banamathuba amaningi okubhekana nokucindezeleka, ukukhathazeka, kanye nokuziphatha okuthatha ingozi .

Yiziphi izinkinga ze-myelomeningocele?

Izinkinga ezihlobene ne-myelomeningocele yilezi:

• Ukukhubazeka kanye/noma ukulahlekelwa umuzwa ezingxenyeni zomzimba ezingaphansi kwendawo yesikhwama esigcwele uketshezi (isilonda).
• Ukuncipha kokunyakaza ngenxa yobuthakathaka bemisipha.
• Izinkinga zamathambo ezihambisana nokukhubazeka , isibonelo i-scoliosis (ukugoba komgogodla), ukugoba, kanye nokukhumuka kwesinqe.
• Ukulahlekelwa ukulawula isinyi kanye/noma amathumbu.
• Ukutheleleka njalo kwe-urinary tract (UTIs).
• I-Meningitis (ukutheleleka kobuchopho).
• Ukungezwani komzimba ne-latex.
• Umehluko wokufunda noma ukubambezeleka kokukhula (ukukhubazeka kwengqondo).
• Isifo Sokuxhuzula `(Ukuxhuzula)`.

Ngingamnakekela kanjani umntwana wami one-myelomeningocele?

Into ebaluleke kakhulu okufanele uyikhumbule ukuthi abekho abantu ababili abane-myelomeningocele abathinteka ngendlela efanayo. Ayikho indlela yokwazi ngokuqinisekile ukuthi ingane yakho izothinteka kanjani. Into engcono kakhulu ongayenza ukukhuluma nodokotela ochwepheshe ekucwaningeni nasekwelapheni i-spina bifida kanye ne-myelomeningocele.

Njengoba ingane yakho ikhula, ithimba lodokotela abangochwepheshe lizosiza ekunakekeleni izidingo zayo.Angaba usizo.

Kufanele ngikhulume nini nodokotela wengane yami nge-myelomeningocele?

Uma ingane yakho izalwa ine-myelomeningocele, kuzodingeka ibone udokotela wayo - noma ithimba lodokotela - njalo empilweni yayo yonke.

Ikakhulukazi, kubaluleke kakhulu ukukhuluma nodokotela wengane yakho ngalezi zizathu:

• Uma ingane yakho sekwephuze kakhulu ukuqala ukuhamba noma sekwephuze kakhulu ukuqala ukukhasa.
• Uma ingane yakho inezimpawu ze-hydrocephalus, isibonelo, indawo ethambile ebunzini, ukucasuka, ukozela ngokweqile, kanye nobunzima bokudla.
• Uma ingane yakho inezimpawu ze-meningitis, ingaba nomkhuhlane, intamo eqinile, ukucasuka, kanye nokukhala kakhulu.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami mayelana ne-myelomeningocele?

Uma udokotela wakho esola i-myelomeningocele, kungaba usizo ukukubuza le mibuzo:

• Yini engingayenza ukuze ngihlale ngiphilile phakathi nesikhathi esisele sokukhulelwa kwami?
• Ungabancoma odokotela nochwepheshe abangochwepheshe be-Spina Bifida kanye ne-Myelomeningocele?
• Yiziphi izindlela zokwelapha i-myelomeningocele?
• Yiziphi izingozi nezinzuzo zokuhlinzwa kokulungiswa kombungu kanye nokuhlinzwa kokulungiswa kwangemva kokubeletha?
• Ingabe ngisengozini yokuthola omunye umntwana one-myelomeningocele?
• Ingabe unolwazi mayelana namaqembu okusekela abantu abane-myelomeningocele kanye nabazali bezingane ezinjalo?

Ukuthola ukuthi ingane yakho inesimo esibucayi sezokwelapha kungaba nzima kakhulu. Kodwa khumbula ukuthi awuwedwa - kunezinsiza eziningi zokusiza wena nomndeni wakho. Kubalulekile ukukhuluma nodokotela onolwazi nge-myelomeningocele ukuze ufunde kabanzi ngokuthi iyithinta kanjani ingane yakho nokuthi ungayilungiselela kanjani.

Umyalezo Ovela Kithi Okufanele Uwuthathe Ekhaya

I-Myelomeningocele iyisifo esiyinkimbinkimbi kakhulu sokuzalwa. Kodwa ngokunakekelwa kwezokwelapha okufanele, ukwesekwa, nothando, laba bantwana bangaphila impilo enhle . Kubalulekile ukuqaphela lesi simo embungwini bese ucela ukwelashwa okusheshayo. Ukuthatha izinyathelo ezifana nokuthola i-folic acid eyanele kunganciphisa nengozi yalesi simo. Uma uneminye imibuzo mayelana nalokhu, ungangabazi ukukhuluma nodokotela wakho.

I- Myelomeningocele, i-spinal bifida, ukukhubazeka kokuzalwa, ukukhubazeka kwe-neural tube, umgogodla, impilo yomntwana, ukukhulelwa