Uma ungumama okhulelwe, cishe ukhathazeka ngempilo yengane yakho engakazalwa. Ngezinye izikhathi, ngemva kokuskena, udokotela usho into engathi sína, futhi kuyinto evamile ukuzizwa ukwesaba nokukhathazeka okukhulu. Namuhla sikhuluma ngesici sokuzalwa esingavamile kakhulu esesabekayo kancane, kodwa esingaba nemiphumela emihle uma siphathwa kahle. Lesi simo sibizwa ngokuthi i-Gastroschisis (GAS-tro-schi-sis).
Kalula nje, iyini i-Gastroschisis?
I-Gastroschisis yisimo lapho umntwana ezalwa enembobo engaphansi kwenkinobho yesisu sakhe, lapho amathumbu kanye nezinye izitho ngezinye izikhathi, njengesibindi nesisu, kuphuma khona. Cabanga ngakho, lapho umntwana eqala ukukhula esibelethweni, imisipha yesisu ayikhuli kahle. Lesi sikhala esincane sivumela lezi zitho ukuba ziphume.
Izingane ezinalesi simo zidinga ukuhlinzwa lapho zizalwa. Zidinga futhi ukuhlala eYunithi Yokunakekelwa Okujulile Kwezingane Ezisanda Kuzalwa isikhashana ngaphambi nangemva kokuhlinzwa. Njengabazali, lokhu kungaba yinto eyesabekayo, kodwa izingane eziningi ziyalulama kahle ngemva kokuhlinzwa.
Uyini umehluko phakathi kwe-Gastroschisis ne-Omphalocele?
Zombili lezi zimo ziyizimo ezingavamile lapho izitho zomzimba ziphuma khona ngembobo esiswini somntwana. Kodwa kukhona umehluko ocacile phakathi kwalezi zimo ezimbili. Bheka ithebula elingezansi ukuze uqonde umehluko.
| Isici | I-Gastroschisis | I-Omphalocele |
|---|---|---|
| Lapho umgodi ukhona khona | Eceleni kwenkinobho yesisu. | Ngaphakathi ngqo kwembobo. |
| Ukumbozwa kwezitho zomzimba | Akumboziwe ngendwangu evikelayo. | Imbozwe ngefilimu evikelayo (kodwa le filimu ingaphuka ngezinye izikhathi). |
| Ingozi eyinhloko | Ukuvezwa kwamathumbu ku-amniotic fluid ezungeze umntwana kwandisa ingozi yokuvuvukala nokulimala. | Kungenzeka kakhulu ukuthi ihlotshaniswa nezinye izinkinga zokuzalwa (ikakhulukazi isifo senhliziyo nezinkinga zofuzo). |
Udokotela wakho wokubeletha angakwazi ukuthola noma iyiphi yalezi zimo ngesikhathi sokuhlolwa okuvamile ngesikhathi sokukhulelwa.
Ziyini izimpawu zalesi simo?
Ungase ungezwa zimpawu ngesikhathi sokukhulelwa. Lokhu kutholakala kuphela ngokuskena kwengane. Udokotela angase abone izinto ezinjengalezi ngesikhathi sokuskena:
- Izitho zomntwana, njengamathumbu nesisu, zibonakala sengathi zintanta ngaphandle komzimba.
- Amathumbu avuvukele noma asontekile ndawonye.
- Ngezinye izikhathi izinga lokushisa lomzimba wengane liyehla (i-Hypothermia).
Yiziphi izimbangela ze-Gastroschisis?
Akukho imbangela eyodwa eqondile yalokhu okwamanje. Ezimweni eziningi, kuwumphumela wokuhlanganiswa kwezici. Nazi ezinye zezici ezitholakale njengezikhulisa ingozi:
- Ukukhulelwa usemncane: Ingozi iphezulu kakhulu komama abasebasha.
- Ukubhema: Ukubhema ngesikhathi sokukhulelwa, ikakhulukazi ezinyangeni zokuqala.
- Ukusetshenziswa kotshwala: Ukusetshenziswa kotshwala ngesikhathi sokukhulelwa.
- Ukusetshenziswa kwemithi ethile noma izidakamizwa.
- I-Low mass body index (BMI) yomama: Ukwehla kwesisindo okungavamile kumama ngesikhathi sokukhulelwa.
- Izifo ezifana nokutheleleka komgudu womchamo: Umama ube nezimo ezifana nokutheleleka komgudu womchamo ezinyangeni ezi-3 ngaphambi kokukhulelwa noma phakathi nezinyanga ezintathu zokuqala zokukhulelwa.
- Izinguquko ezakhiweni zofuzo noma kuma-chromosome omntwana.
Kodwa akubona bonke abanalezi zici eziyingozi abazoba nalesi simo. Ngisho nomuntu ongenazo lezi zici eziyingozi angaba nalesi simo. Ngakho ungazizwa unecala ngokungadingekile ngalokhu.
Ungasibona kanjani lesi simo?
Lesi simo singatholakala kaningi ngesikhathi sokuhlolwa kwe-ultrasound phakathi kwamasonto angu-18 no-20 okukhulelwa. Ukuhlolwa okuyinhloko okusetshenziselwa lokhu yilokhu:
- I-Ultrasound: Lena yindlela eyinhloko yokuxilonga. Izitho zomntwana zingabonakala ngokucacile zintanta esibelethweni.
- Ukuhlolwa kwegazi kukamama:Ngezinye izikhathi igazi likamama liyahlolwa iphrotheni ebizwa ngokuthi i-alpha-fetoprotein (AFP). Uma izinga liphezulu kakhulu, kusolwa ukuthi une-gastroschisis. Lokhu kuqinisekiswa ngokuskena.
- I-Echocardiogram Yengane Engenaso Isifo Senhliziyo: Lokhu futhi kuyiskeni ekhethekile. Ezinye izingane ezine-gastroschisis nazo zingase zibe nezinkinga zenhliziyo. Ngakho-ke, lokhu kuskeni kwenziwa ukuhlola ukusebenza kwenhliziyo yengane.
Uma umntwana ene-Gastroschisis, iphathwa kanjani ngesikhathi sokukhulelwa?
Uma ingane yakho itholakala inalesi simo, wena nomntwana wakho nizodinga ukunakekelwa okukhethekile. Udokotela wakho uzokudlulisela eqenjini lochwepheshe.
- Uchwepheshe wezokwelapha umama nomntwana: Udokotela ochwepheshe bokukhulelwa okuyingozi kakhulu.
- Udokotela Wezingane Ezisanda Kuzalwa: Udokotela ogxile ezinsaneni ezisanda kuzalwa, ikakhulukazi lezo ezigulayo noma ezingaphambi kwesikhathi.
- Udokotela ohlinzayo wezingane: Iseluleko sikadokotela sibalulekile ngoba ukuhlinzwa kuyadingeka ngokushesha nje lapho umntwana ezalwa.
Phakathi nalesi sikhathi, kuzodingeka ukuthi uhlolwe njalo ukuze uqaphe ukukhula kwengane yakho. Ungase futhi welulekwe ukuthi ubale ukunyakaza kwengane yakho (inani lokunyakaza) cishe amahora amabili ngosuku, kusukela cishe emavikini angama-26.
Iphathwa kanjani?
Ukwelashwa kwe-gastroschisis ukuhlinzwa .
Ngokuvamile, odokotela banquma ukubeletha kusenesikhathi kunokujwayelekile, phakathi kwamasonto angu-35 no-37. Lesi simo asisho ukuthi uzobeletha ngokuhlinzwa, kodwa kubalulekile ukuhlela ukubeletha esibhedlela esineyunithi yokunakekela izingane ezisanda kuzalwa (i-NICU) ngoba umntwana uzodinga ukunakekelwa okukhethekile uma esezelwe.
Lapho nje umntwana ezalwa, kwenziwa ukuhlinzwa ukuze kubuyiselwe izitho eziphume esiswini bese kuvalwa imbobo. Kunezindlela ezimbili eziyinhloko zokwenza lokhu kuhlinzwa.
1. Ukulungiswa Okuyinhloko (ukuhlinzwa okukodwa): Uma inani lezitho eziphumile lincane futhi zingalimele kakhulu, izitho zibuyiselwa ekuhlinzweni okukodwa ngokushesha ngemva kokuzalwa bese isisu sivalwa.
2. Ukulungiswa Okuhleliwe: Le nqubo isetshenziswa uma izitho eziningi seziphumile noma zivuvukele. Kule nqubo, izitho zomntwana zifakwa esikhwameni sepulasitiki esikhethekile esivikelayo (esibizwa ngokuthi ' isilo ') ngemva nje kokuzalwa. Lokhu kuvikela izitho. Ngemuva kwalokho, izitho ziphindiselwa kancane kancane esiswini phakathi nezinsuku eziningana. Uma sezifakwe ngokuphelele, imbobo ivalwa ngokuhlinzwa.
Ngemva kokuhlinzwa, umntwana uzofakwa kumshini wokuphefumula ukuze amsize aphefumule ngenxa yokucindezeleka okuphezulu esiswini sakhe.Kungadingeka ukuxhuma. Futhi, kuze kube yilapho amathumbu eqala ukusebenza kahle, umntwana kuzodingeka anikwe ukudla ngemithambo yegazi (IV). Lokhu kungadinga ukuthi umntwana ahlale esibhedlela amasonto amaningana, noma ngisho nangaphezulu.
Yiziphi izinkinga ezingaba khona ngenxa yalesi simo?
Ukuchayeka ku-amniotic fluid kungalimaza amathumbu. Ngenxa yalokho, ezinye izingane zingase zibe nezinkinga ezifana nalezi:
- Ubunzima bokugaya ukudla nokumunca izakhamzimba.
- I-atresia yamathumbu.
- Ukusonta amathumbu (i-Volvulus).
- Ukulimala kwezicubu ngenxa yokuvaleka kokugeleza kwegazi emathunjini (infarction).
Ngisho nangemva kokuhlinzwa, izinkinga ezifana nokutheleleka kanye nobunzima bokudla zingase zibe khona. Kodwa-ke, zonke lezi zinto ziqashwe ngokucophelela yithimba lezokwelapha.
Umlayezo Wokuya Nawe Ekhaya
- I-Gastroschisis yisimo esingavamile lapho amathumbu omntwana nezinye izitho zomzimba zizalwa ziphuma emzimbeni.
- Lokhu ngokuvamile kungatholakala ngokuskena ngesikhathi sokukhulelwa.
- Nakuba abazali bengase besabe lapho bezwa lokhu, cishe ama-95% ezinsana ezinalesi simo ziyalulama ngokuphelele ngemva kokuhlinzwa futhi ziphila impilo evamile.
- Lapho nje umntwana ezalwa, kudingeka ukuhlinzwa. Ukuze lokhu kwenzeke, ukulaliswa esibhedlela ngaphansi kokuqondisa kwethimba lodokotela abangochwepheshe kubalulekile.
- Ukugwema ukubhema notshwala ngesikhathi sokukhulelwa, nokudla ukudla okunempilo kunganciphisa ingozi yalezi ziphazamiso zokuzalwa.
- Uma unokungabaza noma ukwesaba ngalokhu, khuluma nodokotela wakho ngokukhululekile ngokushesha.
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