Abantu abadala asifani. Ukongeza kwiintlobo ezahlukeneyo zokubonakala, siyahluka ngokuphakama nobunzima, okungekho mntu ukhathazekile ngokukodwa. Kodwa enye into - abantwana abancinci. Kwiintsana ezisandul 'ukuzalwa (kunye neentsana ezingakazalwa), imilinganiselo ekhethekileyo ibalwa, ukuphambuka okuqhelekileyo kuthetha ukuba kukho into engalunganga kumntwana. Isalathisi esikhulu sisisindo. Yingakho kubaluleke kakhulu ukulawula konke ukukhulelwa kwakhe kwangoku - umntwana omncinci unokuba sisifo esiyingozi kakhulu esingahambelani nobomi.
Ubunzima bomntwana ngokukhawuleza emva kokuzalwa kubaluleke kakhulu ekuphuhliseni phambili, ngakumbi kunyaka wokuqala wobomi. Unako ukuphazamisa yonke impilo yakhe kwixesha elizayo. Abantwana abazalwa benesisindo somzimba ophantsi (kufika kwi-2.5 kg.), Ngaba bavelele kwiinkcenkcesti zesibindi: zibi kakhulu ekuhambiseni ngokwawo; Kuzo, ngokuphindaphindiweyo kunabantwana abapheleleyo, i-hypoxia ye-intrauterine iyaqhubeka, kunye neengxaki ezahlukeneyo zeengxaki zegazi.
I-pathology okanye umbandela womgaqo-siseko?
Oogqirha banombono onjalo njengesithelo esincinci somgaqo-siseko. Kwezinye iintsapho, bonke abantwana kwizizukulwana ezininzi bazalwa benesisindo esinciphile, kodwa abanalo ukuphambuka okuphawulekayo kwintuthuko elandelayo. Abantwana abancinci bavame ukuzalwa ngabazali abancinci bezinga eliphezulu kakhulu (ngaphantsi kwe-160 cm). Kule meko, nangona ngexesha lokukhulelwa, umntwana omncinci uyafunyanwa, kwaye kamva umntwana onomzimba omncinci uyazalwa. Nangona kunjalo, unempilweni kwaye akanakufumana ubunzima obongezelelekileyo ngexesha lokuzilungelelanisa nabantu abadala.
Kodwa kunye ne-fetus encinci ingabonisa intsholongwane enzima yokukhulelwa - ukungafezeki kwe-fetoplacental. Kule meko, loo ntsholongwane, enesifo sengqondo sokubambezeleka kokukhula komntwana (kungenjalo - i-fetal hypotrophy), idinga ingqalelo ekhethekileyo. Ukwahlula i-hypotrophy ehambelanayo, xa zonke izitho zomzimba zancitshiswa ngokulinganayo kwaye zingenasemgangathweni, xa isifuba nengqondo zihambelana nexesha elikhoyo lokukhulelwa, kwaye izitho zangaphakathi zihlehla emva kokukhula. Izimbangela zezi zifo zibhema, utywala, i-chromosomal, i-infrausine.
Izizathu zokuzalwa kwabantwana abanesisindo esiphantsi
I-hypotrophy engapheliyo ivela kwi-trimester yokugqibela phambi kobunzima bokukhulelwa kunye nezifo ezingapheliyo kumama. Nawuphi na umqathango okhokelela ekuphuculeni ukujikeleza kwegazi kubangela ukulibaziseka ekukhuleni kwe-intrauterine kunye nophuhliso lomntwana. Izifo ezingapheliyo kwabasetyhini, phantsi kwezinto eziphilayo ezibonakaliswe ukuxiliswa kunye nokungahambi komoya-mpilo akunakuchukumisa umntwana, okukhokelela ekuphuhliseni i-hypotrophy efanayo.
Umbuzo wempembelelo yesondlo somama ekuphuculweni kwe-fetus iyaqhubeka iphikisana. Ngokwezibalo, abafazi abanesisindo sokusima, ekudleni kwe-calorie ephantsi, bavame ukuzala abantwana abanomzimba ophantsi. Nangona kunjalo, umntu akanakukungawunaki idatha ngokubhekiselele kuyo, nangona ngexesha lokukhutshwa kweLeningrad, abantwana (kwaye ngokuqhelekileyo) abantwana abanokuphakama nobukhulu obuqhelekileyo bazalwa.
Ubudala bomama budlala indima ebalulekileyo. Abafazi abaneminyaka engaphantsi kwe-18 kunye nangaphantsi kweminyaka engama-35 ubudala banomngcipheko ophezulu wokuba ne-fetal hypotrophy ngexesha lokukhulelwa. Umzimba usemncinci umama akakwazi ukulungiselela umthwalo womsebenzi ozayo, kwaye udidi lwesibini loomama luhlala lunesifo esingapheliyo. Kwakhona, uphuhliso lwe-hypotrophy lukhuthazwa ngokutshaya, njengoko lukhokelela ekuncinciweni kweempahla kunye nokunciphisa ukuhamba kwegazi.
Diagnostics
Indlela echanekileyo yokuxilongwa kwe-fetus yi-ultrasound. Kulo xesha, ugqirha uphathisa kwaye uvavanya amaninzi amaparitha. Ukuchaneka kokuxilongwa kugqiba umgangatho kunye nesisombululo sesixhobo, ithuba lokuqhuba iDoppler. Kwakhona, i-ultrasound ihlola imeko ye-amniotic fluid, evumela ukubonakalisa iimpawu zokungaqhelekanga ekusebenzeni kwephacenta, kwakunye neenguqu zokujikeleza kwegazi kwi-Doppler.
Ekugqibeleni ukucacisa ukuxilongwa, ukufundwa kweDoppler kwintambo yomgca kunye neempahla ze-fetus kunye nemithambo yegazi ye-placenta-ngelixa ugqirha ulandelela isantya kunye nesimo sokuhamba kwegazi kuzo. Ukongeza kwi-dopplerometry, i-cardiotocography yenzelwa ukurekhoda umlinganiso weenguqu kwiintsholongwane zentliziyo ekuphenduleni ukuphazamiseka kwayo okanye ukuphambana kwimbilini. Ukuba i-dopplerometry ne-CTG ibonisa idatha eqhelekileyo (nangona ukuba umntwana uyingcinci), oku kubonisa ukuhlala kwintsana. Ukuba uviwo alubonakalanga naluphi na ukuphambuka, ngoko sithetha ngomntwana obusemgangathweni obuncinci. Ibhinqa liyabonwa kuphela ngaphandle kwonyango olongezelelweyo.
Unyango
Ukuba umntwana omncinci uqala ngokuqhelekileyo ngexesha lokukhulelwa, ke akukho unyango olufunekayo. Kodwa ukuba kukho umngcipheko weengxaki okanye nayiphi na intsholongwane ekuphuhlisweni kwe-fetus, ngoko unyango lwe-hypotrophy luquka unyango lwezilwanyana zomama kunye neengxaki zokukhulelwa. Kwakhona, ukulungiswa kokungenakulungiswa kwembasa kwenziwa. Inani elingu-vasodilators linikezelwe ukuba ibhinqa liphucule ukunikezelwa kwegazi kwiinqanawa zesisu nomntwana. Kwakhona, izidakamizwa zinikezwa ukuba zikhulule izihlunu zesisu, ngokuba ithoni yayo yokwandisa ixinzelele imithana yegazi kwaye ibonakalisa ukuhamba kwegazi. Faka isicelo seziyobisi ezandisa ukwanda komntwana kwi-hypoxia - "iqabane" eliqhelekileyo le-fetal syndrome. Ngokuxhomekeka kwimeko yomntwana, unyango lunokwenziwa ekhaya okanye esibhedlele.
Indlela kunye nexesha lokunikezelwa lixhomekeke kakhulu kwiimeko zomntwana. Ukuba unyango luncedo kwaye umntwana uzuza ubunzima, ngoko akukho mqondo ukunyusa ukuqala komsebenzi. Ngokuqhelekileyo ekupheleni kokukhulelwa umntwana ngokwakhe ufikelela kwisayizi efanelekileyo. Ukuba umntwana akafumani ubunzima, nangona unyango, ke kubangele ukuhanjiswa kwangethuba. Ngethuba lokuxhamla kweeveki ezingama-36 kunye neendlela zokuzala ezilungiselelwe, oogqirha bayakhuthazwa ngumsebenzi wendalo. Ukubeleka kungaphantsi kokulawula ngokucophelela. Nge-fetp hypotrophy, ukuzalwa ngokuqhelekileyo kwenziwa ngokumalunga nemvelaphi ye-anesthesia ye-epidural ukwenzela ukufikelela ekuphumuleni okukhulu. Emva koko umlomo wesibeleko uvula ngokucwangcisekileyo, umntwana uhamba ngokulula ngokungena kwinqanaba lokuzalwa. Kodwa ukuba umntwana unobuthakathaka kangangokuthi ukuzalwa okuqhelekileyo kuye kuya kuba ngumvavanyo ongenakunqandeka, ngoko usebenzo lwenziwe ngecandelo elithintekayo.