Futhi qaphela lokhu ngesikhathi sokukhulelwa: Kuyini i-Vasa Previa?

Ujabule kakhulu ngokuba ngumama, kodwa ngezinye izikhathi uzizwa wesaba kancane ngezinto ezincane, akunjalo? Lokho kujwayelekile. Namuhla sizokhuluma ngesimo esingaba khona ngesikhathi sokukhulelwa, esingavamile kancane, kodwa esingaphathwa kahle uma wazi ngaso kusenesikhathi. Lokhu kubizwa ngokuthi i-Vasa Previa. Ungakhathazeki, sizoxoxa ngakho ngokuningiliziwe.

Iyini i-Vasa Previa? Masiyiqonde kalula!

Kalula nje, i-Vasa Previa iyinkinga engenzeka ngesikhathi sokukhulelwa. Lokhu kwenzeka lapho eminye yemithambo yegazi entanjeni yesisu, ethwala izakhamzimba eziya enganeni yakho, idlula ingavikelekile emlonyeni wesibeletho. Ngokuvamile, le mithambo yegazi ivikelwe kahle yi-placenta.

Cabanga nje, lapho kuqala ukubeletha, lapho isikhwama se-amniotic siphuka, le mithambo yegazi engavikelekile entanyeni yomlomo wesibeletho ingaqhuma. Uma lokho kwenzeka, umntwana angopha kakhulu aze afe. ​​Kodwa-ke, uma lesi simo sibonakala kusenesikhathi futhi siphathwa kahle, ikakhulukazi uma umntwana ebelethwe ngokuhlinzwa (`C-section`), le ngozi ingagwenywa ngokuphelele. Yingakho kubalulekile ukuqaphela lokhu.

Kunezinhlobo ezimbili eziyinhloko ze-Vasa Previa:

Odokotela bahlukanisa lesi simo sibe izinhlobo ezimbili eziyinhloko. Ake sibone ukuthi siyini.

1. Uhlobo 1: I-Vesa Previa ene-Velamentous Cord Insertion

Lokhu kungase kuzwakale njengegama eliyinkimbinkimbi, kodwa akunzima ukuliqonda. Ukufakwa kwentambo ebuhlungu kwenzeka lapho intambo yesisu ingaxhumekile ngqo kwi-placenta, kodwa kunalokho inemithambo yegazi egijima ngaphandle kwe-placenta, ingavikelekile. Ngokuvamile, intambo yesisu ixhumeke ngqo kwi-placenta.

Ake ucabange nje, uma kukhona umthambo wegazi ongavikelekile njengalona, ​​otholakala phansi kwesibeletho, eduze komlomo wesibeletho (lokhu kubizwa ngokuthi 'i-placenta ephansi'), lapho kuqala ukubeletha futhi umntwana esondela emlonyeni wesibeletho, kunethuba elikhulu lokuthi lowo mthambo wegazi uzokwelula futhi uqhume.

2. Uhlobo 2: I-Vesa Previa ene-Bilobed Placenta

Lokhu kwenzeka lapho i-placenta yakho ingeyona ingxenye eyodwa, kodwa ihlukaniswe yaba ama-lobes amabili, njengamaphaphu amabili. Intambo yesisu ingabe isixhumanisa lezi zingxenye ezimbili. Uma imithambo yegazi engavikelekile phakathi kwalezi zingxenye ezimbili idlula eduze komlomo wesibeletho, ingaqhuma lapho kuqala ukubeletha.

Uyini umehluko phakathi kwe-Vasa Previa ne-Placenta Previa?

La magama amabili afana kancane, ngakho angadideka. Kodwa lawa amabili abhekisela ezimweni ezimbili ezahlukene.

• I-Placenta Previa yilapho i-placenta itholakala phansi esibelethweni, imboze wonke noma ingxenye yomlomo wesibeletho, esikhundleni sokuba phezulu. Lapho kuqala ukubeletha, imithambo yegazi exhuma i-placenta esibelethweni inganwebeka futhi yophe igazi.
• Okubalulekile, uma une-placenta previa bese iphela kamuva (i-placenta previa exazululiwe) noma ine-placenta ephansi, ingozi yokuthola i-vasa previa iyanda. Lokhu kusho ukuthi kungase kube nokuxhumana phakathi kwalezi zimo ezimbili.

I-Vasa Previa ibaluleke kangakanani?

Eqinisweni, i-vesa previa yisimo esibi kakhulu esidinga ukunakekelwa. Uma singatholakali kusenesikhathi, umntwana angazalwa ngisho nokuzalwa eseshonile.

Kodwa, khumbula lokhu: Uma lesi simo sitholakala ngesikhathi sokukhulelwa (ukuxilongwa ngaphambi kokubeletha), selashwa kahle, futhi sibelethwe ngokuhlinzwa okuhleliwe (C-section), umntwana unethuba elingu-98.6% lokusinda!

Ngakho-ke, esikhundleni sokwesaba, into ebaluleke kakhulu ukuba nolwazi olufanele nokulandela iseluleko sezokwelapha.

Ubani othinteka kakhulu yilesi simo? (Izici eziyingozi)

Abantu abanamathuba amaningi okuthola i-Vasa Previa yilaba:

• Uma unezimo ezinjengokufakwa kwentambo ye-velamentous (intambo yesisu ayinamathele kahle ku-placenta) noma i-'placenta ene-bilobed/multilobed' (i-placenta ihlukaniswe izingxenye eziningana).
• Uma i-placenta yakho iphansi esibelethweni, imboze umlomo wesibeletho ngokuphelele noma ngokwengxenye (`i-placenta previa` noma 'i-placenta ephansi`).
• Uma uke wabelethwa ngokuhlinzwa (C-section) ngaphambilini.
• Uma ukhulelwe ngokuvundiswa kwe-in vitro (IVF - In Vitro Fertilization).
• Uma ulindele amawele noma amawele amathathu (`ama-multiples`).
• Uma uke wahlinzwa isibeletho ngaphambilini.

Uma unalezi zinto eziyingozi, udokotela wakho uzozinaka kakhulu.

Ivame kangakanani i-Vasa Previa?

Lesi yisimo esingavamile kakhulu. Ngokuvamile sivela cishe koyedwa kwabangu-2,500 abazalwa. Kodwa-ke, ezimweni zokukhulelwa kwe-in vitro (IVF), ukwenzeka kwaso kuphakeme kancane, cishe koyedwa kwabangu-200 abazalwa.

Ziyini izimpawu ze-Vasa Previa?

Ngokuvamile, umama one-vasa previa angase angakhombisi zimpawu. Yingakho ukuhlolwa kwe-ultrasound ngesikhathi sokukhulelwa kubaluleke kangaka. Odokotela bangakwazi ukuthola lesi simo ngalezi skeni.

Kodwa-ke, akuvamile kakhulu, abanye abantu bangase babe nokopha okuncane kwesitho sangasese sowesifazane ngesikhathi sekota yesibili noma yesithathu yokukhulelwa ngaphandle kobuhlungu. Leli gazi lingase libe bomvu kancane kunokuvamile. Kungase kungabi yigazi lakho, kodwa kube uphawu lwegazi lomntwana osanda kuzalwa. Uma uzwa ukopha kwesitho sangasese sowesifazane nganoma yisiphi isikhathi ngesikhathi sokukhulelwa, kungakhathaliseki ukuthi ubuhlungu bukhona noma cha, bona udokotela wakho ngokushesha, kungakhathaliseki ukuthi buncane kangakanani.

Yini ebangela i-Vasa Previa?

Isizathu esiyinhloko salokhu, njengoba kushiwo ngaphambili, ukuthi imithambo yegazi ye-umbilical cord exhumanisa wena nomntwana wakho idlula ingavikelekile eduze komlomo wesibeletho. Ngokuvamile, i-umbilical cord ixhunywe ngqo ne-placenta, futhi imithambo yegazi ivikelwe kahle. Kodwa-ke, ku-vesa previa, lo mthambo wegazi awuphumi nje kuphela, kodwa futhi useduze nomlomo wesibeletho, okuyindawo okungenzeka kakhulu ukuthi icindezelwe ngesikhathi sokubeletha.

I-Vasa Previa ihlolwa kanjani?

I-Vesa previa ivame ukutholakala ngesikhathi sokuhlolwa kwe-ultrasound phakathi kwamasonto angu-18 kuya kwangu-26 okukhulelwa. Uma ukuhlolwa kwakho kubonisa izici eziyingozi ze-vasa previa, njenge-placenta ene-bilobed noma ukufakwa kwentambo ye-velamentous, udokotela wakho angenza ukuhlolwa okukhethekile kwe-ultrasound ngesitho sakho sangasese sowesifazane (i-transvaginal ultrasound) . Lokhu kungabona ngokucacile ukuthi kukhona yini imithambo yegazi entanjeni yesisu eduze komlomo wesibeletho (cervical os). Ngezinye izikhathi odokotela basebenzisa nendlela ye-ultrasound ebizwa ngokuthi i-color Doppler . Lokhu kubonisa ukugeleza kwegazi ngemibala, okwenza kube lula ukuhlonza indawo yemithambo yegazi.

Udokotela uzobheka ngqo lezi zinto:

• Ikuphi i-placenta uma iqhathaniswa nomlomo wesibeletho?
• Ukuthi i-placenta inama-lobes amaningi yini.
• Lapho intambo yesisu itholakala khona.

Yiziphi izindlela zokwelapha i-Vasa Previa?

Uma kutholakala ukuthi une-vasa previa, udokotela wakho cishe uzonquma ukubeletha ingane yakho ngokuhlinzwa okuhleliwe (C-section). Bazokuqapha wena nomntwana wakho eduze phakathi nokukhulelwa kwakho. Umgomo oyinhloko wodokotela lapha ukugcina ingane esibelethweni isikhathi eside ngangokunokwenzeka, kodwa futhi nokuqala ukubeletha ngokushesha ngangokunokwenzeka nokubeletha ingane ngokuphephile ngaphambi kokuba imithambo yegazi yonakale.

Uhlelo lwakho lokukhulelwa lungafaka:

• Ukuhlolwa okungenazo ingcindezi: Lokhu kuhlolwa kwenziwa cishe kabili ngesonto ukuhlola ukushaya kwenhliziyo kwengane. Kuphephile ngokuphelele kuwe nakumntwana wakho.
• Ama-Corticosteroids: Le mithi inganikezwa ngaphambi kokuhlinzwa ukuze kusizwe amaphaphu engane akhule kahle. Lokhu kungenxa yokuthi, njengoba ingane ingadinga ukubeletha kusenesikhathi, ukuvuthwa kwamaphaphu kubalulekile.
• Ukuphathwa kweziguli ezilaliswe esibhedlela: Udokotela wakho angase anqume ukukugcina esibhedlela ukuze uqashwe kahle izinsuku ezimbalwa ngaphambi kokuba ingane yakho izalwe. Lesi sinqumo sizokwenziwa ngokusekelwe ezicini ezifana nezimo zakho zezokwelapha ezikhona, amathuba okubeletha kusenesikhathi, nokuthi uhlala kude kangakanani nesibhedlela.
• Ukuhlinzwa kokubeletha okuhleliwe (phakathi kwamasonto angu-34 no-37):Ukuze kuncishiswe izinkinga ezihlobene ne-vesa previa, udokotela wakho uzokhuluma nawe ngesikhathi esingcono kakhulu sokubeletha ingane yakho. Njengoba ivame ukubeletha kusenesikhathi, ingane yakho ingadinga ukwelashwa e-Neonatal Intensive Care Unit (NICU) ngemva kokuzalwa.

Uhlelo lwakho lokukhulelwa oluqondile luzonqunywa yisimo sakho, ngakho-ke kubalulekile ukulandela imiyalelo kadokotela wakho ngqo.

Ingabe i-Vasa Previa "ingalungiswa"?

Empeleni, ayikho indlela "yokulungisa" isimo esibizwa ngokuthi i-vesa previa. Okusho ukuthi, awukwazi ukushintsha indlela imithambo yegazi ekhona ngayo. Kodwa ungasiphatha lesi simo futhi udale uhlelo lokubeletha ngempumelelo umntwana onempilo. Khuluma nodokotela wakho ngesikhathi esingcono kakhulu sokubeletha ingane yakho ngokuphephile kokubili wena nomntwana wakho, nokuthi nini sokubeletha ngokuhlinzwa.

Ingabe ingozi ye-Vasa Previa ingancishiswa?

Awukwazi ukunciphisa ingozi yokuthola i-vesa previa. Akuyona into esingayilawula. Kodwa, unganciphisa ingozi yezinkinga ezinkulu kakhulu ezingavela kuyo. Ungakwenza kanjani lokho? Ngokuya emitholampilo evamile yokubeletha nokulandela iseluleko sikadokotela wakho. Ukuthola lesi simo kusenesikhathi kuyisihluthulelo sokuthola imiphumela emihle kakhulu.

Uma ngine-vasa previa, yini okufanele ngiyilindele?

Uma une-vasa previa, kufanele ulindele ukuhlinzwa ngokuhlinzwa (C-section) esikhundleni sokubeletha ngesitho sangasese sowesifazane. Kuzodingeka futhi wenze izivivinyo ezengeziwe zokuqapha phakathi nokukhulelwa kwakho. Lokhu kunakekelwa okwengeziwe kuzokusiza ukuthi ubelethe umntwana onempilo.

Ingabe i-Vasa Previa iyamthinta umntwana?

Indlela lesi simo esithinta ngayo ingane incike ekutheni isheshe itholakale. Uma i-vasa previa ingatholakali, izinga lokufa kwengane lingaba phezulu lifike ku-56% kuya ku-60%. Kodwa-ke, uma itholakala kusenesikhathi sokukhulelwa, iphathwa kahle, futhi ibelethwe ngokuhlinzwa, ingane inethuba elingu-97% lokusinda. Kwezinye izimo, ingane ingadinga ukunakekelwa okwengeziwe kwi-NICU ngemva kokuzalwa, ikakhulukazi uma ingane izalwa ngaphambi kwesikhathi. Kodwa-ke, imiphumela yokuhlinzwa nge-vasa previa mihle kakhulu.

Kufanele ngimbone nini udokotela wami?

Bona udokotela wakho njalo phakathi nokukhulelwa kwakho. Futhi, yiya kuzo zonke izikena ze-ultrasound ezinconywayo. Uma kutholakale ukuthi une-vesa previa, kungadingeka ukuthi ubonane nodokotela wakho kaningi.

Uma ubona ukopha kwesitho sangasese sowesifazane phakathi nekota yesibili noma yesithathu yokukhulelwa kwakho, bona udokotela wakho ngokushesha. Uma ukopha kukhulu, hamba ngokushesha esibhedlela esiseduze.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma une-vesicoureteral reflux, buza udokotela wakho ukuthi unganciphisa kanjani ingozi yezinkinga ezinkulu. Isibonelo:

• "Kungcono yini ukuthi ngizithibe ocansini (ukuphumula kwe-pelvic)?"
• "Yimiphi imikhuba engingayilandela ukuze ngikhulelwe kahle?"

Ukuba nezinkinga ngesikhathi sokukhulelwa kuyesabeka. Kodwa lokho akusho ukuthi awukwazi ukukhulelwa, ukubeletha, kanye nomntwana onempilo. Ukwazi ukuthi une-vasa previa kuyisinyathelo sokuqala sokuhlela ukuhlinzwa okuphumelelayo. Khuluma nodokotela wakho ngokuthi ukuxilongwa kwakho kuzothinta kanjani izinhlelo zakho zokubeletha.

Umlayezo Wokuya Nawe Ekhaya

I-Vasa Previa yisimo esingavamile kodwa esibucayi esingaba khona ngesikhathi sokukhulelwa.

• Okwenzekayo kulesi simo ukuthi imithambo yegazi yenkaba yomntwana idlula emlonyeni wesibeletho ingavikelekile.
• Ukutholwa kusenesikhathi kubaluleke kakhulu. Njengoba ngokuvamile kungekho zimpawu, kubalulekile ukuya kokuhlolwa njalo.
• Ukwelashwa okuyinhloko ukubeletha umntwana ngokuhlinzwa okuhleliwe (C-section).
• Uma kutholakala kusenesikhathi futhi kuphathwa kahle, amathuba okusindisa impilo yomntwana aphezulu kakhulu (ngaphezu kuka-97%).
• Khuluma nodokotela wakho njalo futhi ulandele iseluleko sakhe. Ungakhathazeki, awuwedwa. Ngolwazi olufanele kanye nokusekelwa kwezokwelapha, ungabhekana nalesi simo ngempumelelo.

I-Vasa Previa, ukukhulelwa, izinkinga zokukhulelwa, intambo yesisu, i-placenta, ukuhlinzwa, impilo yombungu, ukuxilongwa kokukhulelwa ngaphambi kokubeletha