IHydrops Fetalis: Oonobangela, ukujonga izinto ngaphandle, unyango kunye nokunye

Umxholo

• Yintoni i-hydrops fetalis?
• Iindidi ze-hydrops fetalis
• I-non-immune hydrops fetalis
• Ama-immune hydrops fetalis
• Ziintoni iimpawu zehydrops fetalis?
• Ukuchonga ii-hydrops fetalis
• Iphathwa njani i-hydrops fetalis?
• Iyintoni imbonakalo yehydrops fetalis?

Yintoni i-hydrops fetalis?

I-Hydrops fetalis sisimo esibi, esisongela ubomi apho umntwana ongekazalwa okanye usana olusandul 'ukuzalwa lunokwakheka okungaqhelekanga kolwelo kwizicubu ezijikeleze imiphunga, intliziyo, okanye isisu, okanye phantsi kolusu. Idla ngokuba yingxaki yenye imeko yonyango echaphazela indlela umzimba olawula ngayo ulwelo.

I-Hydrops fetalis yenzeka kuphela kumntwana omnye kwabali-1 abazalwayo. Ukuba ukhulelwe kwaye umntwana wakho une-hydrops fetalis, ugqirha wakho unokufuna ukunyanzelisa abasebenzi kunye nokuhanjiswa kosana. Umntwana ozelwe nge-hydrops fetalis unokufuna ukutofelwa igazi kunye nolunye unyango ukususa ulwelo olugqithisileyo.

Ngaphandle konyango, ngaphezulu kwesiqingatha seentsana ezine-hydrops fetalis ziya kufa kungekudala ngaphambi okanye emva kokubeleka.

Iindidi ze-hydrops fetalis

Kukho iintlobo ezimbini ze-hydrops fetalis: i-immune kunye ne-non-immune. Uhlobo luxhomekeke kwisizathu sale meko.

I-non-immune hydrops fetalis

I-non-immune hydrops fetalis ngoku lolona hlobo luqhelekileyo lwe-hydrops fetalis. Kwenzeka xa enye imeko okanye isifo siphazamisa amandla omntwana wokulawula ulwelo. Imizekelo yeemeko ezinokuphazamisa ulawulo lwamanzi omntwana zibandakanya:

• ii-anemias ezinzima, kubandakanya thalassemia
• ukuphuma komntwana (ukuphuma kwegazi)
• iziphene zentliziyo okanye zemiphunga emntwaneni
• ukuphazamiseka kwemfuza kunye nokuchaphazeleka, kubandakanya iTurner syndrome kunye nesifo sikaGaucher
• Intsholongwane kunye neentsholongwane, ezifana nesifo se-Chagas, i-parvovirus B19, i-cytomegalovirus (i-CMV), i-toxoplasmosis, i-syphilis kunye ne-herpes
• ukungasebenzi kakuhle kwemithambo
• amathumba

Kwezinye iimeko, isizathu se-hydrops fetalis asiyazi.

Ama-immune hydrops fetalis

I-immune hydrops fetalis ihlala isenzeka xa iintlobo zegazi zikamama kunye nomntwana zingahambelani. Oku kwaziwa ngokuba kukungangqinelani kweRh. Amajoni omama anokuhlasela aze atshabalalise iiseli ezibomvu zegazi lomntwana. Iimeko ezinzima zokungahambelani kwe-Rh zingakhokelela kwi-hydrops fetalis.

Amajoni omzimba e-hydrops fetalis axhaphake kakhulu namhlanje ukusukela oko kwasungulwa iyeza elibizwa ngokuba yiRh immunoglobulin (RhoGAM). Eli yeza linikwa abasetyhini abakhulelweyo abasemngciphekweni wokungahambelani kweRh ukuthintela iingxaki.

Ziintoni iimpawu zehydrops fetalis?

Abafazi abakhulelweyo banokufumana ezi mpawu zilandelayo ukuba umntwana une-hydrops fetalis:

• Ukugqithisa kwe-amniotic fluid (i-polyhydramnios)
• I-placenta eshinyeneyo okanye enkulu ngokungaqhelekanga

Umbungu usenokuba nepeni eyandisiweyo, intliziyo, okanye isibindi, kunye nolwelo olujikeleze intliziyo okanye imiphunga, eqaphelekayo ngexesha le-ultrasound.

Umntwana ozelwe enehydrops fetalis unokuba nezi mpawu zilandelayo:

• ulusu oluthuthu
• ukugruzuka
• ukudumba okunzima (edema), ngakumbi esiswini
• ukwandisa isibindi kunye ne-spleen
• ubunzima bokuphefumla
• ijundice ebukhali

Ukuchonga ii-hydrops fetalis

Ukuchongwa kwe-hydrops fetalis kuhlala kwenziwa ngexesha le-ultrasound. Ugqirha unokuqaphela i-hydrops fetalis kwi-ultrasound ngexesha lokuhlolwa kokukhulelwa kwesiqhelo. I-ultrasound isebenzisa amaza esandi ahamba ngesantya esiphezulu ukunceda ukubamba imifanekiso ephilayo engaphakathi komzimba. Unokunikwa i-ultrasound ngexesha lokukhulelwa xa uqaphela ukuba umntwana uhamba kancinci okanye ufumana ezinye iingxaki zokukhulelwa, ezinje ngoxinzelelo oluphezulu lwegazi.

Olunye uvavanyo lokuqonda isifo lunokwenziwa ukunceda ukumisela ubuzaza okanye unobangela wale meko. Oku kubandakanya:

• isampulu yegazi esiswini
• i-amniocentesis, ekurhoxisweni kwe-amniotic fluid kuvavanyo olongezelelweyo
• i-fetal echocardiography, ejonga ukusilela kwentliziyo

Iphathwa njani i-hydrops fetalis?

I-Hydrops fetalis ihlala inyangeka ngexesha lokukhulelwa. Ngamaxesha athile, ugqirha unokunika umntwana igazi (intrauterine fetal igazi) ukunceda ukwandisa amathuba okuba umntwana aphile ade azalwe.

Kwiimeko ezininzi, ugqirha kuya kufuneka akhuthaze ukuziswa kwangoko kosana ukuze anike umntwana elona thuba lifanelekileyo lokusinda. Oku kunokwenziwa ngamayeza enza ukuba abasebenzi basebenze kwangoko okanye ngecandelo le-Cesarean likaxakeka (icandelo-C). Ugqirha wakho uya kuxoxa nawe ngezi zinto unokukhetha kuzo.

Xa umntwana ezelwe, unyango lunokubandakanya:

• usebenzisa inaliti ukususa ulwelo oluninzi kwindawo ejikeleze imiphunga, intliziyo, okanye isisu (thoracentesis)
• inkxaso yokuphefumla, njengomatshini wokuphefumla (i-ventilator)
• amayeza okulawula ukusilela kwentliziyo
• amayeza okunceda izintso zisuse ulwelo oluninzi

Kwii-hydroprop immune, umntwana angafumana utofelo-gazi ngokuthe ngqo lweeseli ezibomvu zegazi ezihambelana nodidi lwegazi lakhe. Ukuba i-hydrops fetalis ibangelwe yenye imeko engaphantsi, usana luya kufumana unyango kuloo meko. Umzekelo, ii-antibiotics zisetyenziselwa ukunyanga usulelo lwegcushuwa.

Abasetyhini abanabantwana abane-hydrops fetalis basemngciphekweni wenye imeko eyaziwa ngokuba sisipili isifo. I-Mirror syndrome inokubangela uxinzelelo lwegazi olusongela ubomi (uxinzelelo lwegazi oluphezulu) okanye ukuxhuzula. Ukuba ukhula nesipili, kuya kufuneka uhambise umntwana wakho kwangoko.

Iyintoni imbonakalo yehydrops fetalis?

Imbonakalo ye-hydrops fetalis ixhomekeke kwimeko engaphantsi, kodwa nangonyango, inqanaba lokusinda komntwana liphantsi. Kuphela malunga neepesenti ezingama-20 zeentsana ezifunyaniswe zinama-hydrops fetalis ngaphambi kokuzalwa eziya kuphila xa zizala, kwaye kwezo ntsana, sisiqingatha kuphela esiya kuphila emva kokubeleka. Umngcipheko wokufa uphezulu kakhulu kwiintsana eziye zafunyaniswa zisencinci (ngaphantsi kweeveki ezingama-24 zikhulelwe) okanye ezinesiphene esime kakuhle, njengesiphene sentliziyo.

Iintsana ezizalwe nge-hydrops fetalis zinokuba nemiphunga engaphucukanga kwaye zibe semngciphekweni omkhulu woku:

• ukumelwa yintliziyo
• ukulimala kwengqondo
• hypoglycemia
• ukuxhuzula