Iimpawu zokuzalwa ngaphambi kwexesha, oonobangela kunye neengxaki ezinokubakho

Umxholo

• Izizathu eziphambili
• Iimpawu kunye neempawu zokuzalwa ngaphambi kwexesha
• Iingxaki ezinokwenzeka
• Ungakuthintela njani ukuzalwa kwangaphambi kwexesha

Ukuzalwa kwangaphambi kwexesha kuhambelana nokuzalwa komntwana ngaphambi kweeveki ezingama-37 zokukhulelwa, ezinokuthi zenzeke ngenxa yosulelo lwesibeleko, ukuqhekeka ngaphambi kwexesha kwengxowa ye-amniotic, ukuhlangulwa kwepascenta okanye izifo ezinxulumene nowasetyhini, ezinje ngeanemia okanye pre-eclampsia, umzekelo.

Le meko inokubonwa ngezinye zeempawu ezinje ngokuhamba rhoqo kunye nokuphambana kwesibeleko, ukonyuka kokukhutshwa kwilungu lobufazi kunye noxinzelelo okanye iintlungu kwingingqi ye-pelvic, umzekelo. Kubalulekile ukuba owasetyhini aye esibhedlele kamsinya nje akuba eziva ezi zimpawu, kuba ukubeleka ngaphambi kwexesha kunokubangela umngcipheko kusana, kuba ngokuxhomekeke kubudala bokuthwala amalungu omzimba asenokungakhuli kakhulu, kwaye kusenokubakho iingxaki intliziyo kunye nobunzima bokuphefumla, umzekelo.

Ke, kwimeko yokusebenza kwangaphambi kwexesha, ugqirha unokuzama ukuhlehlisa ukuzalwa esebenzisa amayeza kunye neendlela zokuthintela ukubambana kwesibeleko kunye nokwanda, nangona kunjalo, kunzima ukubanako ukuhambisa ukuhambisa ngaphezulu kweeyure ezingama-48 ukuya kwezingama-72. Kwimeko yokuzalwa komntwana ngaphambi kwexesha, kuqhelekile ukuhlala kwi-ICU yeentsana ukuze uhlolo lwayo lubekwe esweni kwaye iingxaki zithintelwe.

Izizathu eziphambili

Ukuzalwa kwangaphambi kwexesha kunokwenzeka ukuba kwenzeke kubasetyhini abangaphezu kweminyaka engama-35 okanye ngaphantsi kwe-16, ukhulelwe amawele, uye wazalwa ngaphambi kwexesha okanye xa ephulukana negazi kwilungu lobufazi kwikota yesithathu yokukhulelwa. Ukongeza, ezinye iimeko ezinokubangela abasebenzi ngaphambi kwexesha zezi:

• Ukuqhekeka kwangaphambili kwengxowa ye-amniotic;
• Ukuncipha komlomo wesibeleko;
• Usulelo lweBacteria IStreptococcus agalactiae (iqela B streptococcus);
• Ukhuseleko lweplacental;
• Pre eclampsia;
• Anemia;
• Izifo ezifana nesifo sephepha, igcushuwa, isifo sezintso;
• Ukukhulelwa amawele;
• Ukuchumisa in vitro;
• Malformation Fetal;
• Umzamo omkhulu womzimba;
• Ukusetyenziswa kweziyobisi ezingekho mthethweni kunye neziselo ezinxilisayo;
• Ubukho be-fibroids kwisibeleko.

Ukongeza, abasetyhini abanembali ye-vaginosis bakwumngcipheko owandayo wokuzalwa ngaphambi kwexesha, kuba ezinye iibacteria zinokukhupha ityhefu kwaye zikhuthaze ukukhutshwa kwee-cytokines kunye ne-prostaglandins ezithanda umsebenzi. Olunye uhlobo lokutya kunye nezityalo ezingamayeza nazo zinokukhuthaza ukusasazeka kwesibeleko kunye nokukhuthaza ukusebenza ngaphambi kwexesha kwaye, ngenxa yoko, ziyaphikiswa ngexesha lokukhulelwa. Jonga uluhlu lwee-tea ezingafanelekanga ukuba zikhulelwe ngumfazi okhulelweyo.

Iimpawu kunye neempawu zokuzalwa ngaphambi kwexesha

Umfazi unokurhanela ukuba uya kusebenza ngaphambi kwexesha xa eneempawu kunye neempawu ezinje:

• Ukuncipha kwesibeleko;
• Uxinzelelo emazantsi esisu;
• Ukonyusa umnqweno wokuchama;
• Ukonyuka kokukhutshwa kwilungu lobufazi, eliba yi-gelatinous kwaye linakho okanye lingenakho ukuqulatha igazi;
• Ubuhlungu emazantsi omqolo;
• Urhudo kwezinye iimeko;
• Intshutshiso enzulu.

Ke ngoko, ukuba owasetyhini uzisa ezi mpawu phambi kweeveki ezingama-37 ekhulelwe, kubalulekile ukuba abize ugqirha wakhe wokubelekisa kwaye aye esibhedlele ayokuvavanywa kuze kuthathwe amanyathelo afanelekileyo.

Ukuqinisekisa ukuba kukho umngcipheko wokuzalwa ngaphambi kwexesha kwaye uthathe isigqibo malunga nento ekufuneka uyenzile kule meko, ugqirha uya kuba nakho ukuvavanya umlinganiso wesibeleko sesibeleko ngokusebenzisa i-ultrasound yangaphantsi kunye nobukho be-fetal fibronectin kwimfihlo yelungu lobufazi.

Umlinganiso ongaphezulu kwe-30 mm kumlomo wesibeleko ubonakalisa umngcipheko omkhulu wokuhanjiswa kwiintsuku ezisi-7 kwaye abasetyhini abaneli xabiso kufuneka bavavanyelwe i-fibronectin. Ukuba owasetyhini unemilinganiselo phakathi kwe-16 kunye ne-30 mm kodwa i-fibronectin engeyiyo yomntwana inomngcipheko ophantsi wokuhanjiswa, nangona kunjalo, xa i-fetal fibronectin ilungile, kukho umngcipheko wokuhanjiswa ngaphakathi kweeyure ezingama-48.

Iingxaki ezinokwenzeka

Iingxaki zokuzalwa ngaphambi kwexesha zihambelana nexesha lokuzalwa komntwana ekuzalweni, kwaye kunokubakho:

• Ukuhanjiswa kwangaphambi kwexesha kwiiveki ezingama-23 ukuya kuma-25:uninzi lwamatyala anokukhulisa ukukhubazeka okuqatha, njengokukhubazeka kwengqondo, ubumfama okanye isithulu;
• Ukuhanjiswa kwangaphambi kwexesha kwiiveki ezingama-26 kunye nama-27: ezinye iimeko zinokuphuhlisa ukukhubazeka okuphakathi, njengokungaboni kakuhle, ukungabikho kolawulo lweemoto, isifuba esinganyangekiyo kunye nobunzima ekufundeni;
• Ukuhanjiswa kwangaphambi kwexesha kwiiveki ezingama-29 ukuya kuma-31: uninzi lweentsana lukhula ngaphandle kwengxaki, kodwa ezinye zinokuba neendlela eziphantsi zokukhubazeka kwengqondo kunye neengxaki ezibonakalayo;
• Ukuzalwa ngaphambi kwexesha kwiiveki ezingama-34 ukuya kuma-36: Iintsana ezizelwe ngaphambi kwexesha zikhula ngokufanayo nakwabo bazalwe ngexesha, kodwa kunokwenzeka ukuba babe neengxaki zokukhula kunye nokufunda.

Ngokubanzi, iintsana ezizelwe ngaphambi kwexesha zibekwa kwisifukamisi, kuba azikwazi ukugcina ubushushu bomzimba. Ke, esi sixhobo sigcina ubushushu kunye nokufuma okufana nesibeleko, kuvumela ukukhula kwaso.

Iintsana ezingaphantsi kweeveki ezingama-34 zokukhulelwa zinokudityaniswa nezixhobo zokuphefumla, naphambi kweeveki ezingama-34 zokumitha azinakho ukusebenza, into eyenza ukuba kungene umoya emiphungeni kwaye, ngenxa yesi sizathu, iimpawu ezinje ngombala oluhlaza zingavela. kunye neminwe, imilebe kunye neempumlo.

Ukongeza, abantwana abazelwe ngaphambi kwexesha basemngciphekweni wokuphindaphindwa kwengqondo, nto leyo enciphisa ukubonwa, ngenxa yoko bonke abantwana abangaphambi kwexesha kufuneka banxibe isikhewu samehlo ngelixa bekwi-ICU. Umntwana ukhululwa kuphela ekhaya xa efikelela kwi-2 kg kwaye xa amalungu akhe sele ephuhlisiwe, ukuze aginye ngaphandle kwetyhubhu kwaye aphefumle ngaphandle koncedo lwezixhobo.

Ungakuthintela njani ukuzalwa kwangaphambi kwexesha

Ukuthintela ukuzalwa kwangaphambi kwexesha, into enokwenziwa ngumfazi okhulelweyo ngexesha lokukhulelwa lonke kukuthintela umsebenzi ogqithisileyo kwaye ulandele zonke izikhokelo zoogqirha ngexesha lokubonisana ngaphambi kokubeleka.

Nangona kunjalo, ukuba ukuhanjiswa kuqala ngaphambi kwexesha elilindelweyo, ugqirha wokubelekisa unokucebisa ngokusetyenziswa kwamayeza afana ne-corticosteroids okanye i-oxytocin antagonists, enokusetyenziswa phakathi kweeveki ezingama-25 ukuya kwezingama-37 zokukhulelwa. Obu buchule bokuthintela ukuzalwa kwangaphambi kwexesha kufuneka kwenziwe ngelixa usesibhedlele kwaye busetyenziswe ngokwezibonelelo zomama nomntwana.