Ihydrops fetalis

I-Hydrops fetalis yimeko embi. Kwenzeka xa izixa ezingaqhelekanga zamanzi zakha kwiindawo ezimbini okanye nangaphezulu zomzimba wosana olungekazalwa. Luphawu lweengxaki ezisisiseko.

Kukho iintlobo ezimbini ze-hydrops fetalis, immune kunye ne-nonimmune. Uhlobo luxhomekeke kwisizathu solwelo olungaqhelekanga.

• Ama-immune hydrops fetalis amaxesha amaninzi ukuxakeka kwefom eqatha yokungahambelani kweRh, enokuthintelwa. Le yimeko apho umama one-Rh engalunganga uhlobo lwegazi enza izilwa-buhlungu kwi-Rh yomntwana wakhe iiseli zegazi, kwaye izilwa-buhlungu ziwela kwi-placenta. Ukungahambelani kwe-Rh kubangela ukuba inani elikhulu leeseli ezibomvu zegazi elingekazalwa zitshatyalaliswe (Oku kukwabizwa ngokuba sisifo se-hemolytic sosana olusandul 'ukuzalwa.) Oku kukhokelela kwiingxaki kubandakanya ukudumba komzimba okupheleleyo. Ukudumba okukhulu kungaphazamisa indlela amalungu omzimba asebenza ngayo.
• Iimpawu ze-hydrops ezingezizo ezomzimba ixhaphake kakhulu. Ibalelwa kuma-90% amatyala e-hydrops. Imeko yenzeka xa isifo okanye imeko yonyango ichaphazela amandla omzimba okulawula ulwelo. Kukho izizathu ezintathu eziphambili zolu hlobo, iingxaki zentliziyo okanye zemiphunga, i-anemia enzima (efana ne-thalassemia okanye usulelo), kunye neengxaki zemfuza okanye zophuhliso, kubandakanya ne-Turner syndrome.

Inani leentsana ezenza i-immune hydrops fetalis lehlile ngenxa yeyeza elibizwa ngokuba yiRhoGAM. Eli chiza linikezelwa njengesitofu koomama abakhulelweyo abasemngciphekweni wokungahambelani kweRh. Iyeza libathintela ekwenzeni ii-antibodies ngokuchasene neeseli ezibomvu zegazi zabantwana babo. (Kukho ezinye, ezinqabileyo kakhulu, ukungahambelani kweqela legazi kunokubangela ama-immune hydrops fetalis, kodwa iRhoGAM ayincedi kwezi.)

Iimpawu zixhomekeke kubukrakra bale meko. Iifom ezinobumnene zinokubangela:

• Ukudumba kwesibindi
• Utshintsho kumbala wolusu (pallor)

Iifom ezinzima kakhulu zingabangela:

• Iingxaki zokuphefumla
• Ukuqunjelwa okanye ukufiphala okufana namabala atyumkileyo kulusu
• Ukumelwa yintliziyo
• Anemia kakhulu
• I-jaundice enzima
• Ukudumba komzimba xa uwonke

I-ultrasound eyenziwe ngexesha lokukhulelwa ingabonisa:

• Amanqanaba aphezulu e-amniotic fluid
• I-placenta enkulu engaqhelekanga
• Ulwelo olubangela ukudumba ngaphakathi nangakujikeleze amalungu omntwana ongekazalwa, kubandakanya isibindi, udakada, intliziyo, okanye indawo yemiphunga

I-amniocenteis kunye nokuhamba rhoqo kwe-ultrasound kuya kwenziwa ukumisela ubungqongqo bale meko.

Unyango luxhomekeke kwisizathu. Ngexesha lokukhulelwa, unyango lunokubandakanya:

• Iyeza lokubangela ukubeleka kwangethuba kunye nokuhanjiswa kosana
• Ukuhanjiswa kwangoko kwe-cesarean ukuba imeko iba mandundu
• Ukunika umntwana umntwana igazi ngelixa esesibelekweni (ukufakwa kwegazi kwi-intrauterine igazi)

Unyango losana olusanda kuzalwa lunokubandakanya:

• Kwii-hydroprops zomzimba, ukongezwa ngokuthe ngqo kweeseli ezibomvu zegazi ezihambelana nodidi lwegazi losana. Utshintshiselwano lotofelo-gazi lokususa umzimba wosana lwezinto ezitshabalalisa iiseli ezibomvu zegazi nalo luyenziwa.
• Ukususa ulwelo olongezelelweyo kwimiphunga nakwizitho zesisu ngenaliti.
• Amayeza okulawula ukusilela kwentliziyo kunye nokunceda izintso zisuse ulwelo olongezelelekileyo.
• Iindlela zokunceda umntwana ukuba aphefumle, njengomatshini wokuphefumla (i-ventilator).

IHydrops fetalis ihlala ikhokelela ekuswelekeni kosana kungekudala ngaphambi okanye emva kokubeleka. Umngcipheko uphezulu kakhulu kwiintsana ezizalwa kwangoko okanye ezigulayo xa zizalwa. Iintsana ezinesiphene kulwakhiwo, kwaye abo bengenaso isizathu esichongiweyo sehydrops nabo basemngciphekweni omkhulu.

Umonakalo wobuchopho obizwa ngokuba yi-kernicterus unokwenzeka kwimeko yokungahambelani kweRh. Ukulibaziseka kophuhliso kuye kwabonwa kwiintsana ezifumene igazi kwi-intrauterine.

Ukungahambelani kwe-Rh kunokuthintelwa ukuba umama unikwe iRhoGAM ngexesha nasemva kokukhulelwa.

• Ihydrops fetalis

UDahlke JD, uMagann EF. Ama-hydrops omzimba kunye ne-nonimmune hydrops fetalis. Ku: UMartin RJ, uFanaroff AA, uWalsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 24.

ILanglois S, iWilson RD. Umbungu weentsana. Ku: Pandya PP, Oepkes D, Sebire NJ, Wapner RJ, ii-eds. Unyango lwe-Fetal: iSayensi esisiseko kunye nokuziqhelanisa neKlinikhi. Ngomhla wesi-3. IPhiladelphia, PA: Elsevier; 2020: isahluko 36.

ISuhrie KR, iThabbah SM. Ukukhulelwa okuphezulu. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahl 114.