Ngaphambi kokuba umntwana afike

Umxholo

• Oonobangela bokuzalwa ngaphambi kwexesha
• Iingxaki zempilo ezinokubakho kwiintsana ezingaphambi kwexesha
• Ukunyanga usana ngaphambi kwexesha
• Ukujonga ixesha elide kwiintsana ezingekazalwa
• Ukuthintela ukuzalwa ngaphambi kwexesha

Ushwankathelo

Ukuzalwa kuthathwa njengaphambi kwexesha, okanye ngaphambi kwexesha, xa kusenzeka ngaphambi kweveki yama-37 yokukhulelwa. Ukukhulelwa okuqhelekileyo kuhlala malunga neeveki ezingama-40.

Ezi veki zokugqibela esibelekweni zibalulekile ekufumaneni ubunzima bomzimba kunye nokukhula ngokupheleleyo kwamalungu abalulekileyo ahlukeneyo, kubandakanya nengqondo nemiphunga. Yiyo loo nto iintsana ezizelwe ngaphambi kwexesha zinokuba neengxaki zonyango kwaye zingafuna ukuhlala ixesha elide esibhedlele. Banokuba nemicimbi yezempilo yexesha elide, njengokukhubazeka kokufunda okanye ukukhubazeka komzimba.

Kwixesha elidlulileyo, ukuzalwa kwangaphambi kwexesha kwakungoyena nobangela wokufa kweentsana eUnited States. Namhlanje, umgangatho wokukhathalela abantwana abasandul 'ukuzalwa uphucukile, njengoko kunjalo nangamazinga okusinda kweentsana ezizelwe ngaphambi kwexesha. Ukanti ukuzalwa ngaphambi kwexesha isesona sizathu siphambili sokufa kweentsana kwihlabathi liphela, ngokuka. Ikwangunobangela ophambili weengxaki zexesha elide kubantwana.

Oonobangela bokuzalwa ngaphambi kwexesha

Unobangela wokuzalwa ngaphambi kwexesha ngokufuthi awunakuchongwa. Nangona kunjalo, izinto ezithile ziyaziwa ukuba zonyusa umngcipheko womfazi wokuya kusebenza kwangoko.

Umfazi okhulelweyo onayo nayiphi na kwezi meko zilandelayo kunokwenzeka ukuba azalwe ngaphambi kwexesha:

• isifo seswekile
• isifo sentliziyo
• isifo sezintso
• igazi elonyukayo

Izinto ezinxulumene nokukhulelwa ezinxulumene nokuzalwa kwangaphambi kwexesha kubandakanya:

• ukungondleki ngaphambi nangexesha lokukhulelwa
• ukutshaya, ukusebenzisa iziyobisi ngokungekho mthethweni, okanye ukusela utywala kakhulu ngexa lokukhulelwa
• usulelo oluthile, olufana nomchamo kunye nosulelo lwe-membrane ye-amniotic
• ukuzalwa kwangaphambi kokukhulelwa kwangaphambili
• isibeleko esingaqhelekanga
• umlomo wesibeleko obuthathaka uvulwa kwangoko

Abafazi abakhulelweyo banethuba elongeziweyo lokuhambisa ngokukhawuleza ukuba baneminyaka engaphantsi kwe-17 okanye ngaphezulu kunama-35.

Iingxaki zempilo ezinokubakho kwiintsana ezingaphambi kwexesha

Ukuzalwa komntwana kwangoko, kokukhona kunokwenzeka ukuba babe neengxaki zonyango. Usana ngaphambi kwexesha lunokubonisa le miqondiso kungekudala emva kokuzalwa:

• ingxaki yokuphefumla
• ubunzima obuphantsi
• amanqatha omzimba asezantsi
• ukungakwazi ukugcina ubushushu bomzimba rhoqo
• Umsebenzi ongaphantsi kunesiqhelo
• iingxaki zokuhamba nokulungelelanisa
• ubunzima ngokondla
• ulusu oluphandle ngokungaqhelekanga okanye tyheli

Iintsana ezisandula ukuzalwa nazo zinokuzalwa zineemeko ezisongela ubomi. Oku kunokubandakanya:

• ukopha ebuchotsheni, okanye ukopha kwingqondo
• ukopha kwimiphunga, okanye ukopha emiphungeni
• hypoglycemia, okanye iswekile esezantsi yegazi
• I-neonatal sepsis, usulelo lwegazi lwebacteria
• inyumoniya, usulelo kunye nokudumba kwemiphunga
• patent ductus arteriosus, umngxuma ongavalwanga kwisitshixo segazi sentliziyo
• i-anemia, ukunqongophala kweeseli ezibomvu zokuhambisa ioksijini emzimbeni wonke
• uxinzelelo lokuphefumla olusandula kuzalwa, isifo sokuphefumla esibangelwa yimiphunga engaphuhliswanga

Ezinye zezi ngxaki zinokusonjululwa ngokhathalelo olufanelekileyo olusemgangathweni kusana olusandul 'ukuzalwa. Abanye banokubangela ukukhubazeka ixesha elide okanye ukugula.

Oogqirha benza iimvavanyo ezahlukeneyo kubantwana abazelwe ngaphambi kwexesha nje emva kokubeleka. Ezi mvavanyo zinceda ukunciphisa umngcipheko weengxaki. Oogqirha baphinde bajonge iintsana ngokuqhubekayo ngexesha lokuhlala kwabo esibhedlele.

Uvavanyo oluqhelekileyo lubandakanya:

• X-ray yesifuba yokuvavanya ukukhula kwentliziyo kunye nemiphunga
• kuvavanyo lwegazi ukuvavanya iswekile, ikhalsiyam, kunye namanqanaba ebilirubin
• Uhlalutyo lwegesi yegazi ukumisela amanqanaba eoksijini egazini

Ukunyanga usana ngaphambi kwexesha

Oogqirha bahlala bezama ukuthintela ukuzalwa kwangaphambi kwexesha ngokunika umama amayeza athile anokulibazisa ukubeleka.

Ukuba umsebenzi ongaphambi kwexesha awunakumiswa okanye umntwana kufuneka aziswe ngaphambi kwexesha, oogqirha ke balungiselela ukuzalwa okusemngciphekweni omkhulu. Umama kusenokufuneka aye esibhedlele esineyunithi yokhathalelo olunzulu lweentsana (i-NICU). Oku kuyakuqinisekisa ukuba usana lufumana ukhathalelo kwangoko emva kokuzalwa.

Kwiintsuku zokuqala kunye neeveki ezimbalwa zobomi bosana ngaphambi kwexesha, ukhathalelo lwasesibhedlele lujolise ekuxhaseni ukukhula kwamalungu abalulekileyo. Usana olusandul 'ukuzalwa lungagcinwa kwisifukamisi esilawulwa bubushushu. Izixhobo zokubeka iliso zilandelela ukubetha kwentliziyo yomntwana, ukuphefumla, kunye nenqanaba leoksijini yegazi. Kungaba ziiveki okanye iinyanga ngaphambi kokuba umntwana akwazi ukuphila ngaphandle kwenkxaso yezonyango.

Uninzi lweentsana ezizelwe ngaphambi kwexesha azikwazi ukutya ngomlomo kuba azikakwazi ukulungelelanisa ukuncancisa nokuginya. Ezi ntsana zondliwa ngezondlo ezibalulekileyo ngokufakwa ngaphakathi okanye ngokufaka ityhubhu efakwe ngempumlo okanye emlonyeni kunye nasesiswini. Nje ukuba umntwana abe namandla ngokwaneleyo ukuba angafunxa kwaye aginye, ukuncancisa okanye ukuncancisa ibhotile kuhlala kunokwenzeka.

Umntwana ozelwe ngaphambi kwexesha unokunikwa ioksijini ukuba imiphunga yabo ayikakhuli ngokupheleleyo. Kuxhomekeke kwindlela usana olunokuphefumla ngayo, enye yezi zinto zilandelayo inokusetyenziselwa ukuhambisa ioksijini:

• umshini wokuphefumla, umatshini opompa umoya ngaphakathi nangaphandle kwemiphunga
• Uxinzelelo oluqhubekayo loxinzelelo lomoya, unyango olusebenzisa uxinzelelo lomoya olungephi ukugcina umoya uvulekile
• ioksijini hood, isixhobo esifanelana nentloko yosana ukubonelela ngeoksijini

Ngokubanzi, usana ngaphambi kwexesha lunokukhutshwa esibhedlele xa benako:

• ukuncancisa ibele okanye ukuncancisa ibhotile
• phefumla ngaphandle kwenkxaso
• gcina ubushushu bomzimba kunye nobunzima bomzimba

Ukujonga ixesha elide kwiintsana ezingekazalwa

Iintsana ezizalwe ngaphambi kwexesha zihlala zifuna ukhathalelo olukhethekileyo. Kungenxa yoko le nto behlala beqala ubomi babo kwi-NICU. I-NICU ibonelela ngendawo ethintela uxinzelelo emntwaneni. Ikwabonelela ngemfudumalo, isondlo, kunye nokhuselo olufunekayo ekukhuleni okufanelekileyo kunye nophuhliso.

Ngenxa yenkqubela phambili yamva nje kukhathalelo loomama neentsana ezisanda kuzalwa, amazinga okusinda kwiintsana ngaphambi kwexesha aphuculwe. Uphononongo olupapashwe lufumanise ukuba inqanaba lokusinda kweentsana ezizalwe ngaphambi kweeveki ezingama-28, ezithathwa njengaphambi kwexesha kakhulu, lenyuka ukusuka kuma-70 eepesenti ngo-1993 ukuya kuma-79 eepesenti ngo-2012.

Nangona kunjalo, zonke iintsana ezingaphambi kwexesha zisengozini yeengxaki zexesha elide. Iingxaki zophuhliso, ezonyango kunye nokuziphatha zinokuqhubeka ngokobuntwana. Ezinye zisenokudala ukukhubazeka okusisigxina.

Iingxaki eziqhelekileyo zexesha elide ezinxulunyaniswa nokuzalwa kwangaphambi kwexesha, ngakumbi ukungakhuli kakhulu, kubandakanya:

• iingxaki zokuva
• ukungaboni okanye ukungaboni
• ukukhubazeka ekufundeni
• ukukhubazeka emzimbeni
• ulibaziseko lokukhula kunye nokulungelelanisa okungalunganga

Abazali beentsana ezingekabikho ngaphambi kwexesha kufuneka banike ingqwalaselo enonophelo ekukhuleni kwengqondo yomntwana wabo kunye neemoto. Oku kubandakanya ukufezekiswa kwezakhono ezithile, ezinjengokuncuma, ukuhlala nokuhamba.

Intetho kunye nokukhula kokuziphatha kubalulekile ukongamela. Abanye abantwana abangaphambi kwexesha banokufuna unyango lwentetho okanye unyango lomzimba kubo bonke abantwana.

Ukuthintela ukuzalwa ngaphambi kwexesha

Ukufumana ukhathalelo olukhawulezileyo nolufanelekileyo ngaphambi kokubeleka kunciphisa kakhulu amathuba okuba kuzalwe ngaphambi kwexesha. Amanye amanyathelo abalulekileyo othintelo abandakanya:

Ukutya ukutya okusempilweni ngaphambi nangexesha lokukhulelwa kwakho. Qiniseka ukuba utya ukutya okuziinkozo okuninzi, iiproteni ezijiyileyo, imifuno kunye neziqhamo.Ukuthatha i-folic acid kunye ne-calcium supplements kuyacetyiswa kakhulu.

Ukusela amanzi amaninzi yonke imihla. Inani elicetyiswayo ziiglasi ezisibhozo ngemini, kodwa uya kufuna ukusela ngaphezulu ukuba uyawenza umthambo.

Ukuthatha i-aspirin yonke imihla ukuqala kwikota yokuqala. Ukuba unoxinzelelo lwegazi oluphezulu okanye imbali yokuzalwa ngaphambi kwexesha, ugqirha unokucebisa ukuba uthathe i-aspirin ezingama-60 ukuya kuma-80 ngosuku ngalunye.

Ukuyeka ukutshaya, ukusebenzisa iziyobisi ezingekho mthethweni, okanye ukusebenzisa iziyobisi ezithile kagqirha. Le mi sebenzi ngexesha lokukhulelwa ingakhokelela kumngcipheko ophezulu wokukhubazeka okuthile kokuzalwa kunye nokuphuma kwesisu.

Thetha nogqirha wakho ukuba ukhathazekile ngokuzalwa ngaphambi kwexesha. Ugqirha wakho unokukwazi ukucebisa ngeendlela ezongezelelweyo zokukhusela ezinokukunceda ukunciphisa umngcipheko wokuzala ngaphambi kwexesha.