Iingxaki zamehlo nezendlebe kwiintsana ngaphambi kwexesha

Umxholo

• Zeziphi izinto ezinobungozi bokuzalwa ngaphambi kwexesha?
• Zeziphi iingxaki zamehlo ezinokufunyanwa kwiintsana ezizelwe ngaphambi kwexesha?
• Ukuphinda ubenakho ukuphazamiseka kwangaphambili (ROP)
• Strabismus
• Ubumfama
• Zeziphi iingxaki zendlebe ezinokufunyanwa kwiintsana ezizelwe ngaphambi kwexesha?
• Ukuphulukana nendlebe
• Ukungaqhelekanga komzimba
• Zichongwa njani iingxaki zamehlo nezendlebe?
• Uvavanyo lombono
• Uvavanyo lokuva
• Ziphathwa njani iingxaki zombono kunye namehlo?
• Zinyangwa njani iingxaki zokuva nendlebe?
• Yintoni imbonakalo yeentsana ezinengxaki yamehlo nendlebe?
• Zeziphi izibonelelo ezikhoyo zeentsana ezinengxaki yamehlo nendlebe?

Zeziphi iingxaki zamehlo nezendlebe ezinokuchaphazela abantwana abazelwe ngaphambi kwexesha?

Iintsana ezizalwe ngaphambi kwexesha ziintsana ezizalwe kwiiveki ezingama-37 okanye ngaphambili. Kuba ukukhulelwa okuqhelekileyo kuhlala malunga neeveki ezingama-40, abantwana abazelwe ngaphambi kwexesha banexesha elincinci lokukhula esibelekweni. Oku kubenza ukuba babenakho ukuba neengxaki zempilo kunye neziphene zokuzalwa.

Eminye yemicimbi yezempilo enokuthi ichaphazele abantwana abazelwe ngaphambi kwexesha kubandakanya umbono kunye neengxaki zokuva. Kungenxa yokuba amanqanaba okugqibela ombono kunye nokukhula kokuva kwenzeka kwiiveki ezimbalwa ezidlulileyo zokukhulelwa. Iingcali ziqaphela ukuzalwa kwangaphambi kwexesha lijongene neepesenti ezingama-35 zeemeko zokukhubazeka kombono kunye neepesenti ezingama-25 zeemeko zokuqonda okanye zokuva.

Funda ngokufunda malunga neengxaki zamehlo nezendlebe ezinokuchaphazela iintsana ngaphambi kwexesha, kwaye ufumane ulwazi ngonyango olufanelekileyo.

Zeziphi izinto ezinobungozi bokuzalwa ngaphambi kwexesha?

Ngo-Matshi we-Dimes uqikelela ukuba malunga ne-1 kwaba-10 kwiintsana e-United States bazalwa ngaphambi kwexesha ngonyaka. Akusoloko kusaziwa ukuba yintoni ebangela ukusebenza ngaphambi kwexesha nokuzalwa. Nangona kunjalo, iimeko ezithile zomngcipheko zinokuba negalelo ekuzaleni ngaphambi kwexesha. Ezinye zezinto ezinobungozi zidweliswe apha ngezantsi.

Izinto zomngcipheko ezingenakutshintshwa:

• Ubudala. Abasetyhini abangaphantsi kwe-17 nangaphezulu kwe-35 kunokwenzeka ukuba bazalwe ngaphambi kwexesha.
• Ubuhlanga. Iintsana ezinemvelaphi yaseAfrika zizalwa ngaphambi kwexesha ngakumbi kunabantwana bolunye uhlanga.

Izinto ezinobungozi ezinxulumene nokukhulelwa kunye nempilo yokuzala:

• ukuzalwa kwangaphambili
• Imbali yosapho yokuzalwa ngaphambi kwexesha
• ukukhulelwa abantwana abaninzi
• ukuba ukhulelwe kungaphelanga iinyanga ezili-18 uzelwe
• ukukhulelwa emva kwe-vitro fertilization (IVF)
• Imicimbi edlulileyo okanye yangoku kunye nesibeleko sakho okanye umlomo wesibeleko

Imiba yomngcipheko enxulumene nempilo ngokubanzi:

• ukuba nengxaki yokutya
• ukutyeba kakhulu okanye ukutyeba kakhulu
• iimeko ezithile zonyango, kubandakanya isifo seswekile, i-thrombophilia, uxinzelelo lwegazi oluphezulu kunye ne-preeclampsia

Imiba yomngcipheko enxulumene nendlela yokuphila:

• uxinzelelo okanye ukusebenza iiyure ezinde
• ukutshaya nokutshaya
• ukusela utywala
• Ukusetyenziswa kweziyobisi

Eminye imingcipheko:

• Ubundlobongela basekhaya bonyusa umngcipheko weengxaki ngexesha lokukhulelwa. Ukuba awuziva ukhuselekile ekhayeni lakho okanye kukho ingozi yokuba umntu akubethe okanye akwenzakalise, funa uncedo lokuzikhusela kunye nosana lwakho olungekazalwa. Tsalela umnxeba ku-800-799-7233 ukuze ufumane uncedo.

Zeziphi iingxaki zamehlo ezinokufunyanwa kwiintsana ezizelwe ngaphambi kwexesha?

Amehlo akhula kakhulu kwiinyanga ezintathu zokugqibela zokukhulelwa. Oku kuthetha ukuba kwangethuba umntwana ezalwa, kokukhona kunokwenzeka ukuba afumane iingxaki zamehlo.

Imiba emininzi yamehlo isuka kuphuhliso olungaqhelekanga lwemithambo yegazi, enokuthi ikhokelele ekubonakaleni kombono. Ngelixa amehlo enokubonakala njengesiqhelo, unokuqaphela ukuba umntwana wakho akaphenduli kwizinto okanye kutshintsho ekukhanyeni. Oku kungaqhelekanga kunokuba yimiqondiso yengxaki yombono okanye isiphene samehlo.

Ukuphinda ubenakho ukuphazamiseka kwangaphambili (ROP)

Isifo se-retinopathy se-prematurity (ROP) sikhula xa imithambo yegazi ikhula ngokungaqhelekanga kwiliso. NgokweZiko leLiso leLizwe, i-ROP ixhaphake kakhulu kwiintsana ezizalwe ngaphambi kweeveki ezingama-31 okanye kubunzima bokuzalwa obuphantsi kakhulu.

Kwizigidi zeentsana ezizelwe ngaphambi kwexesha ezizalwe eUnited States minyaka le, iZiko leLiso leLizwe liphawula malunga neentsana ezingama-28,000 ezinobunzima obungama-2 3/4 eeponti okanye ngaphantsi. Phakathi kwe-14,000 kunye ne-16,000 ine-ROP, kodwa uninzi lweentsana zinetyala elincinci. Qho ngonyaka, kuphela i-1,100 ukuya kwi-1,500 yeentsana eziphuhlisa i-ROP enzulu ngokwaneleyo ukuba ifumane unyango.

I-ROP kunokwenzeka ukuba yenzeke kwiintsana ezingaphambi kwexesha kuba ukuziswa kwangethuba kuphazamisa ukukhula okuqhelekileyo kwemithambo yegazi. Oku kubangela ukuba iinqanawa ezingaqhelekanga zenze i-retina. Imithambo yegazi ibonelela ngokuhamba rhoqo kweoksijini emehlweni ukulungiselela ukukhula kwamehlo okufanelekileyo. Xa umntwana ezalwa ngaphambi kwexesha, ukuhamba kweoksijini kuyatshintshwa.

Ngokukodwa, uninzi lwabantwana abazelwe ngaphambi kwexesha lifuna ioksijini eyongezelelweyo esibhedlele kwimiphunga yabo. Ukuhamba okuguqulweyo kweoksijini kuphazamisa inqanaba labo leoksijini eliqhelekileyo. Oku kuphazamiseka kungakhokelela kuphuhliso lweROP.

I-retina inokonakala ukuba imithambo yegazi engaqhelekanga iqala ukudumba kwaye ivuze igazi ngenxa yamanqanaba eoksijini angalunganga. Xa oku kusenzeka, i-retina inokuqhawuka kwiliso yamehlo, ibangele iingxaki zombono. Kwezinye iimeko, kunokukhokelela ekungaboni.

Ezinye iingxaki ezinokubakho ze-ROP zibandakanya:

• amehlo awele (strabismus)
• ukubona kwangaphambili
• ukubona kude
• iliso elinobuvila (amblyopia)
• iglaucoma

Iingxaki ezivela kwi-ROP aziqhelekanga zenzeke de kube kamva ebuntwaneni nasebudaleni.

Kukangaphi na ukuba umntwana wakho avavanyelwe i-ROP kuxhomekeke kwisimo se-retina. Ngokwesiqhelo, iimviwo zenziwa rhoqo kwiiveki ezimbini ukuya kuthi ga kwi-ROP inyange okanye izinze. Ukuba i-ROP isekhona, umntwana wakho uya kuvavanywa rhoqo kwiiveki ezine ukuya kwezintandathu ukuqinisekisa ukuba i-ROP ayibi mandundu okanye ayifuni nyango.

Uninzi lweentsana luza kufuna ukuhlolwa okwethutyana, nokuba imeko ithambile. Abo bane-ROP enzima banokufuna ukufumana iimviwo ebudaleni.

Zonke iintsana ezingaphambi kwexesha ziya kufumana uvavanyo rhoqo kunye nokubeka iliso kwi-ROP ukusuka kwinyanga enye ubudala ukuya phambili. Ukuba kukho nayiphi na inkxalabo, amehlo aya kujongwa ngeveki. Unyango luxhomekeke kusana kunye nobukrakra be-ROP. Unokuxoxa ngeendlela onokukhetha kuzo nogqirha wosana lwakho ukuzama ukuthintela ukuqhubela phambili.

Strabismus

I-Strabismus (amehlo aweleyo) yimeko yamehlo eqhelekileyo kubantwana abangaphantsi kweminyaka emi-5 ubudala. Kubangela ukungalungelelani kakuhle kweliso elinye okanye omabini. Ingakhokelela kwiingxaki zombono osisigxina ukuba akafumaneki kwaye anyangwe kwangoko.

Zininzi izinto ezinobungozi kwi-strabismus, kubandakanya i-ROP. Uphononongo lwango-2014 lwafumanisa ukuba ubunzima bokuzalwa obuphantsi bukwonyusa kakhulu umngcipheko wokuba usana lukhule strabismus kamva ebomini: Iintsana ezizalwe zinobunzima obungaphantsi kwama-2 000 iigrem, ezilingana neephawundi ezingama-4.41, zazingama-61 eepesenti ngakumbi amathuba okuphuhlisa i-strabismus.

I-Strabismus inokubangelwa xa imithambo-luvo ye-cranial ebangela intshukumo yamehlo ibuthathaka, okanye kukho ingxaki kwimisipha yamehlo. Iindidi ezahlukeneyo zestrabismus zineempawu ezahlukeneyo:

• I-strabismus ethe tye. Kolu hlobo, elinye okanye omabini amehlo ajikela ngaphakathi. Inokubhekiswa kuthiwe "unamehlo ahlukileyo." I-strabismus ethe tyaba inokubangela iliso okanye amehlo ajike ajonge ngaphandle. Kule meko, kunokubhekiswa kuthiwe "liliso lodonga."
• Nkqo strabismus. Kulolu hlobo, iliso elinye liphezulu okanye lisezantsi kuneliso eliqhelekileyo.

Ubumfama

Ubumfama yenye into enokubangelwa kukuzalwa ngaphambi kwexesha. Ukufunyanwa kwe-Retinal okuhambelana ne-ROP ngamanye amaxesha kubangela oku. Ukuba i-detachment ihamba ingabonakali, inokukhokelela ekungaboni.

Amanye amatyala obumfama kwiintsana ezizelwe ngaphambi kwexesha ahlukile kwi-ROP. Abanye abantwana bazalwa bengenazo iinxalenye ezithile zamehlo, ezinjengebhola yamehlo okanye iris, ekhokelela ekuphulukaneni nombono. Le miba inqabile kwaye ayisiyonto ixhaphakileyo kwiintsana ezizelwe ngaphambi kwexesha.

Zeziphi iingxaki zendlebe ezinokufunyanwa kwiintsana ezizelwe ngaphambi kwexesha?

Iingxaki zeendlebe zinokubakho nakwiintsana ezizelwe ngaphambi kwexesha. Olunye usana lunokuba nobunzima bokuva nokubona. Abanye banokuba nemicimbi yokuva ngaphandle kwengxaki yokubona. Ukuphazamiseka emzimbeni kweendlebe kunokuchaphazela neentsana ezizelwe ngaphambi kwexesha.

Ukuphulukana nokuva kunye nobunzima bokuva zezona zinto zixhaphakileyo.

Ukuphulukana nendlebe

Ukuphulukana nendlebe kokuzalwa kubhekisa kwiingxaki zokuva ezikhoyo ngexesha lokuzalwa. Le micimbi inokuchaphazela indlebe enye okanye zombini iindlebe, okukhokelela ekubeni kukungeva ngokupheleleyo okanye ngokupheleleyo.

Ukuphulukana nokuva kwiintsana kuhlala kungumphumo wesiphene semfuza. Nangona kunjalo, umngcipheko wokungaboni kakuhle mkhulu kwiintsana ezizelwe ngaphambi kwexesha. Oku kuyinyani ngakumbi ukuba umama unesifo ngexesha lokukhulelwa, njenge:

• i-herpes, kubandakanya uhlobo olubizwa ngokuba yi-cytomegalovirus (CMV)
• igcushuwa
• Imasisi yaseJamani (irubella)
• toxoplasmosis, usulelo lwesinambuzane

Iingxelo zokulahleka kwendlebe zichaphazela phakathi kweentsana ezisemngciphekweni omkhulu. Iintsana ezizalwe ngaphambi kwexesha zithathwa njengomngcipheko omkhulu.

Ukungaqhelekanga komzimba

Ukungaqheleki emzimbeni kweendlebe akuqhelekanga njengokulahlekelwa kukuva kwiintsana ezizelwe ngaphambi kwexesha, kodwa zinokwenzeka. Oku kunokuvela kumcimbi osisiseko wezempilo. Rhoqo, ukubhengeza amayeza ngexesha lokukhulelwa kunokubangela ukungaqheleki kwendlebe kwiintsana ezingaphambi kwexesha.

Ukungaqheleki kwendlebe okunokuthi kuchaphazele iintsana kubandakanya:

• Ukudakumba okungekho nzulu ejikeleze indlebe
• iithegi zolusu, ezinokubonakala ngaphakathi nangaphandle kwendlebe
• ukungalunganga kwendlebe, okuhlala kubangelwa yimicimbi ye-chromosomal

Zichongwa njani iingxaki zamehlo nezendlebe?

Bonke abantwana abasandula kuzalwa abaziswe ezibhedlele okanye kumaziko okuzala bavavanyelwa umbono kunye neengxaki zokuva xa bezalwa.Nangona kunjalo, iintsana ezingaphambi kwexesha zinokuqhubeka nokuvavanywa ukufumana imiba enokubakho.

Uvavanyo lombono

Ugqirha wamehlo uza kujonga umbono wosana lwakho kwaye enze iimvavanyo zokujonga imiqondiso ye-ROP. Lo ngugqirha wamehlo ogxile ekunyangeni nasekuchongeni iingxaki zamehlo.

Ngexesha lovavanyo lwe-ROP, amathontsi afakwa emehlweni osana ukuze anciphise. Ugqirha uya kuthi emva koko anyuse i-ophthalmoscope entlokweni yabo ukuze bavavanye ii-retinas zomntwana.

Ngamanye amaxesha, ugqirha unokucinezela iliso ngesixhobo esincinci okanye uthathe iifoto zeso. Olu vavanyo luya kuphindwa rhoqo ukujonga kunye nokujonga i-ROP.

Ugqirha wamehlo wosana lwakho unokujonga kwakhona imeko yamehlo ukujonga iimpawu zestrabismus.

Uvavanyo lokuva

Ukuba umntwana wakho akaphumeleli kuvavanyo lokuva, ugqirha wezandi unokuzivavanya. Iingcali zeAudiologists zijolise ekuchongeni nasekunyangeni iingxaki zokuva. Banokuqhuba olunye uvavanyo ukufumanisa iingxaki zokuva.

Uvavanyo lokuva olunokuthi lwenziwe lubandakanya:

• Uvavanyo lwe-Otoacoustic emissions (OAE). Olu vavanyo lilinganisela indlela indlebe yangaphakathi esabela ngayo kwizandi.
• Ukuvavanywa kwempendulo ye-Brainstem (BAER) yovavanyo. Olu vavanyo luthatha amanyathelo okuphendula kwemithambo luvo kusetyenziswa ikhompyuter kunye nee-electrode. I-Electrodes zizinto ezincangathi. Ugqirha uya kunamathisela ezinye emzimbeni womntwana wakho. Baya kuthi emva koko badlale izandi kwaye barekhode iimpendulo zomntwana wakho. Olu vavanyo lukwabizwa ngokuba luvavanyo oluzenzekelayo lwempendulo yengqondo (AABR).

Ziphathwa njani iingxaki zombono kunye namehlo?

Uninzi lweentsana ezine-ROP aludingi nyango. Ukuba unyango luyafuneka, oogqirha bomntwana wakho baya kuthatha isigqibo malunga nolona nyango lulungileyo lomntwana wakho. Unokulandela kunye nogqirha wamehlo emva kokuba umntwana wakho efikile ekhaya.

Ezi nkqubo zilandelayo zinokunyanga iimeko ezinzima ze-ROP:

• Utyando kubandakanya ukubanda nokutshabalalisa imithambo yegazi engaqhelekanga kwi-retina.
• Unyango lweLaser isebenzisa ukukhanya kwemitha enamandla ukutshisa nokuphelisa imithambo yegazi engaqhelekanga.
• IVitrectomy isusa izicwili ezibomvu kwiliso.
• Ukugoba kwescleral ibandakanya ukubeka ibhendi ebhetyebhetye ejikeleze iliso ukunqanda ukubonwa kwe-retina.
• Ugqirha inokulungisa i-retina egqibeleleyo.

Ugqirha wosana lwakho unokunyanga iliso elilahlekileyo usebenzisa ukufakelwa kotyando xa umntwana wakho esiba mdala.

Unyango lwe-strabismus luxhomekeke kubukrakra bale meko. Ugqirha wosana lwakho unokusebenzisa indibaniselwano yonyango ukufezekisa iziphumo ezilungileyo. Unyango olunokusetyenziselwa i-strabismus lubandakanya:

• iiglasi, kunye okanye ngaphandle kwee-prism zokunceda ukukhanyisa ukukhanya
• isiziba sokubekwa ngaphezulu kweliso elinye
• umthambo wamehlo ukomeleza izihlunu zamehlo
• utyando, olubekelwe iimeko ezinzima okanye iimeko ezingalungiswa ngezinye iindlela zonyango

Zinyangwa njani iingxaki zokuva nendlebe?

Ukubeka ukufakelwa kwe-cochlear kwindlebe kunokwenziwa kwilahleko yokuva. Ukufakwa kwe-cochlear sisixhobo esincinci se-elektroniki esenza umsebenzi wamalungu owonakeleyo endlebe. Inceda ukubuyisela ukuva ngokunika imiqondiso yesandi kwingqondo.

Ukufakwa kwe-Cochlear ayizizo zonke iintlobo zokuphulukana nokuva. Thetha nogqirha wengane yakho ukuze ubone ukuba ukufakela i-cochlear kulungile kubo.

Ugqirha wosana lwakho unokucebisa:

• izixhobo zokuva
• unyango lokuthetha
• ukufunda imilebe
• iimpawu zolwimi

Utyando lwenziwa rhoqo ukulungisa iingxaki ngokwenziwa kwendlebe.

Yintoni imbonakalo yeentsana ezinengxaki yamehlo nendlebe?

Zonke iintsana zihamba kuthotho lweemvavanyo zokuhlola kungekudala emva kokuzalwa, nokuba bazalwa kwangoko okanye kade. Nangona kunjalo, ezi mvavanyo zibaluleke ngokukodwa kwiintsana ezizelwe ngaphambi kwexesha, kuba kunokwenzeka ukuba zifumane iingxaki. Ugqirha unokukwazi ukubona iingxaki ngoko nangoko kwaye anike iingcebiso ezithile zokhathalelo lwexesha elifutshane nelide.

Umngcipheko weengxaki zamehlo kunye neendlebe uhluka kakhulu phakathi kweentsana ezizelwe ngaphambi kwexesha. Kwangoko umntwana ezelwe, kokukhona kunokwenzeka ukuba babe nale micimbi. Ukufumanisa kwangoko kubalulekile, ngakumbi kuba eminye imiba inokuba mandundu ngokuhamba kwexesha. Ngelixa amazinga empumelelo kunyango eyohluka, ungenelelo lwakwangoko lunokusombulula uninzi lwengxaki yamehlo nendlebe.

Kuwo nawuphi na umntwana ozelwe ngaphambi kwexesha, kuya kubakho utyelelo olongezelelweyo kugqirha wabantwana ukuqinisekisa ukuba bakhula ngesiqhelo. Umntwana ongaphambi kwexesha ufuna ukhathalelo olongezelelekileyo kwiiveki zakhe zokuqala kunye neenyanga zokuphila, engaboni okanye engenangxaki zokuva.

Ukuba umntwana wakho unemeko yokubona, uya kuhlala undwendwela ugqirha wamehlo. Unyango lweemeko zokuva luya kubandakanya ukutyelelwa rhoqo yingcali yeendlebe.

Kubalulekile ukuba uthathe usana lwakho kuzo zonke iindawo zabo ezicwangcisiweyo. Olu vavanyo luya kunceda ugqirha wabantwana ukuba abambe nayiphi na imiba kwangoko kwaye aqinisekise ukuba umntwana wakho ufumana olona nyango lusemgangathweni.

Zeziphi izibonelelo ezikhoyo zeentsana ezinengxaki yamehlo nendlebe?

Oogqirha, abongikazi, kunye nabasebenzi bakhona ukukunceda. Zive ukhululekile ukubuza imibuzo emininzi malunga nokhathalelo kunye nempilo yosana lwakho ngaphambi kwexesha.

Kukwakho namaqela axhasayo anokunceda ekuphenduleni imibuzo kwaye akukhumbuze ukuba wena kunye nomntwana wakho aninodwa. Unokufumana ulwazi ngamaqela enkxaso kwindawo yakho, phakathi kwezinye izinto, ukusuka kwicandelo lakho lokhathalelo lweentsana olusandul 'ukuzalwa (NICU) unontlalontle.