Wonke umama ufuna ukuba ukukhulelwa kwakhe kuqhube ngaphandle kwempilo, kwaye umntwana wazalwa ngexesha. Nangona kunjalo, akuqhelekanga kwiimeko apho, ngenxa yezizathu ezininzi, abasebenzi basebenza ngaphambi komhla wokugqibela. Kunokuba ingasongela umntwana? Indlela yokujamelana neengxaki ezilindele umama wengane engaphambi komntwana? Ngaba ezi ngxaki zingaziphepha? Uphuhliso kunye nempilo yeintsana ezisandul 'intsha ngumxholo wendibano namhlanje.
Ubuntana obusandul 'ukuzalwa obunomzimba obuncinane obungaphantsi kwama-2.5 kg ekuzalweni kuthathwa njengengaphambi kwexesha. I-World Health Organisation ibonisa iintsana zangaphambi kokuba zizalwe ngaphambi kweiveki ezingama-37 ukususela ngomhla wokuqala wokugqibela. I-Malignant yintsana engaphambi kokuzalwa isisindo sokuzalwa esingaphantsi kwama-1.5 kg. Kungekudala, udidi oluphantsi kakhulu lomzimba lufakiwe, olungaphantsi kwe-1 kg. Ngaphambili, abantwana abanesisindo esifanayo abazange baphile.
Kukho iingxaki ezimbini ezahlukileyo kwiintsana zangaphambi kwexesha. Omnye wabo kukungathandi komntwana ukuhlala ngaphandle kwesibeleko - ukuphuhliswa kwamalungu, izicubu ezingafundiwe. Enye ingxaki ubunzima obuncinane, oko kukulibaziseka ekuphuculeni phambili komntwana. Kulo hlobo lokuqala lweintsana kukho inkxalabo enkulu yokutya kwikamva - abafuni ukutya, kufuneka bahlale bekhuthazwa, ngelixa abantwana bokugqibela balambile kwaye banelisekile, banesidlo esikhulu. Ngelishwa, akuqhelekanga ukuzala ngaphambi komntwana ngokulingana okuphantsi.
Imiba engozi yokunikezelwa kwangethuba
Kukho izinto ezinobungozi bokuzalwa kwangaphambi kokuzalwa:
Icandelo laseKesareya, elisetyenziselwa kwiimeko ezingekho phantsi kweemeko ezingekho phantsi kweengxaki ezingaphakathi. Oku kungabandakanya i-pre-eclampsia okanye ukuphazamiseka kwamaplazi. Izigqibo ezithatyathwayo, okokuqala, uvavanyo lweemeko kunye nokukhula komntwana kunye nempendulo yombuzo: "Yiyiphi imeko ekhuselekileyo kumntwana - ngaphandle okanye ngaphakathi kwesibeletho?". Yinto nje yengozi yokulinganisa.
- Ukukhulelwa okuninzi kumqolo kubakhokelela ekuzalweni kwangaphambi kokuzalwa, ngakumbi ukuba kukho ukukhulelwa okubanzi. Oku kunokuvusa ukuzalwa ngaphambi kokuzalwa, kuba kukho ukunyuka okukhulu kwimbumba.
- Iklasi yeklasi yinto engafanelekiyo yokuphuhliswa komlomo wesibeleko ngaphambi kokuba, ukukhulelwa nokuqhekeka kwangaphambili kweembrane kwaye ekuqaleni kungabonakali ngentsholongwane yomlomo wesibeleko. Ngokuqhelekileyo kubangela ukugqabhuka kwemisipha ye-musvix. Oku kuyingozi kumama. Ngomntwana, ihamba nayo yonke ingozi ehamba nophuhliso kunye nempilo yeintsana ezingaphambi kwexesha.
- Ubume bentlalo yezantsi, ukungabi nantoni okanye ukunakekelwa okwaneleyo ngexesha lokukhulelwa kunye nesondlo esingenamsoco kamama - konke oku esifubeni kubandakanya ukuzalwa kwangaphambi kokuzalwa. Ukutshaya nokusetyenziswa ngokugqithiseleyo kotywala kusemngciphekweni.
- Ukukhanyela i-heroin okanye ukunciphisa ngokukhawuleza kwe-methadone kwi-trimester yokuqala yokukhulelwa kungaholela ekuzalweni kwangaphambi kokuzalwa. Abasetyhini abasebenzisa kakubi iziyobisi ngaphambi kokukhulelwa kufuneka bahambelane ngokuthe ngqo kummandla ochanekileyo wokunciphisa urhulumente. Ayinakwenziwa ngokukhawuleza - iya kubulala umntwana wakho! I-Cocaine ingakhokelela ekuzalweni kwangaphambi kokuzalwa. Idala impembelelo yokunyanzeliswa kwisisu, esinokuchaphazela umonakalo kwimisebenzi yepentecenta.
- Abantwana abanomzimba ophantsi, njengomthetho, bazalwa kwabasetyhini abangaphantsi kwe-17 okanye ngaphezulu kweminyaka engama-35.
- I-bacterium vaginosis ibeka phambili ekuzalweni kweintsana ezingaphambi kwexesha.
Iimpawu ezahlukileyo zokuphuhliswa kweintsana ezingaphambi kwexesha
Umntwana ozelwe ngaphambi kokuzalwa ubonakala 'engafanelekanga' phantsi kweemeko zangaphandle. Umntwana ozelwe ngaphambi kokuba ixesha eliqhelekileyo linamafutha amaninzi amancinci, kwaye isikhumba sakhe sibukeka sikhanyiswa. Umntwana osengaphambi kwexesha ujongene neengxaki ezininzi, ezibhekiselele ngakumbi kwimeko yokuphuculwa kwengqondo yomntwana.
I-Hypothermia yinto ebalulekileyo yengozi, ingakumbi ukuba umntwana unamafutha angaphantsi. Ubuntana obusanda kuqalisa kunzima ukulawula ukushisa komzimba wakhe. Kulula ukukrazula okanye, ngokuchaseneyo, ukugqithisa.
I-Hypoglycemia nayo ingozi, ingakumbi kubantwana abancinci abaswele emva kokuphuhliswa. Zingabangela u-hypocalcemia. Zombini iimeko zingabangela ukuxhwala, okuza kuthi, kukhokelela ekudakaleni komonakalo wengqondo.
Ekuqaleni umntwana wazalwa ngaphambi kwekota, umngcipheko omkhulu wokuphucula isifo sokuphefumula. Ukuthabatha oomama be-steroids ngaphambi kokuhambisa kunokunciphisa umngcipheko, kodwa kusekhona. Ukuba umntwana ufuna i-oksijeni, kufuneka uqaphelisise le nto, kuba ukuba izinga lakhe liphezulu kakhulu-umntwana osandul 'ulungelelaniso ulungele i-fibroplasia kunye nobumfama.
Iintsana ezinokuqala ziyakwazi ukuthatha i-jaundice. Isibindi sabo sidinga imeko enonophelo kunye nophuhliso. Okokuqala kukho konke ukutya okukhethekileyo. Iintsana ezisengaphambili zinomngcipheko ophezulu wokusuleleka kunye nokuqoqwa kwamathambo. Ziyakwazi ukuhlaselwa kwintsholongwane ebuchosheni kunye nemiphumo emibi kwixesha elizayo.
I-Neonatologists ibanjana neengxaki ezifana nelo xesha. Into edabukisayo kukuba nangona umntwana ekugqibeleni ekhulelwe esibhedlele aze aye ekhaya kunye nonina, iingxaki azipheli apho. Ngokuqhelekileyo, baqala nje. Ukuzalwa ngaphambi kokuba ikhefu lingadluli kumntwana ngaphandle komkhondo. Umbuzo kuphela umonakalo omkhulu kunye nokuba kuyimfuneko kangakanani umzenzeko ukulungelelana nomntwana kwilizwe langaphandle. Ngamanye amaxesha iintsana ezingenabantwana, kunye nazo zonke iinzame ezenziwe ngabayingcali, abazibandakanyi nophuhliso kunye nempilo yabontanga babo abazalwa ngexesha elifanelekileyo.
Inkxaso kubazali
Xa umntwana esezantsi kwiwadi ekhethekileyo yabantwana abasengaphambi kwintsana - eli lixesha elimangalisa kakhulu kwaye elibuhlungu kumama kunye nentsapho yonke. Kufuneka ukhuthaze kwaye uxhasane, kwaye uhlale usondele kumntwana wakho kangangoko kunokwenzeka. Ukuncelisa kakhulu kunzima, kodwa kufuneka kwakhona kuxhaswe ngokubanzi kunokwenzeka. Ubisi lwebele lubona kukutya okulungileyo kunoma yimuphi umntwana, ngakumbi ukuzalwa ngaphambi kwesikhathi. Unina, ovelisa ubisi obuninzi kunokuba umntwana afune, kufuneka akhuthaze ukuvelisa ubisi kwixesha elizayo. Xa umntwana ezuza ubunzima, uya kudla kakuhle kwaye ubisi kuya kufuna enye.
Umntwana unamathele kwiindawo zokubeka esweni kunye neembhobho ezikhupha umzimba wakhe. Kuyikeka, kodwa kufuneka uhlale uzolile. Ndikholelwe, umntwana uziva yonke into. Ngelishwa, akunakwenzeka njalo ukubamba umntwana, kodwa oku kufuneka kukhuthazwe ubuncinane ngamanye amaxesha. Ukuzama ukugcina ithemba, abazali kufuneka baqhelisele ukuba umntwana unokufa. Kumele ulungele ukwenza izigqibo ezinzima malunga nomgangatho wobomi obunomdla wokuphila xa ephila. Oogqirha abahlali bechanekile ekuxoxaneni nabazali, kwaye ngamanye amaxesha kunzima kakhulu ukuba bamkele ngokukhawuleza amaqiniso awaxelele kweso sikhashana. Unokuxoxa ngesimo sakho nomntu owaziyo kakuhle kwaye uthembele. Kuyinto enqwenelekayo ukuba wayengumcebisi olungileyo okanye umntu unokukucebisa.
Ukugonywa
Iintsana ezinokuqala kufuneka zikhuselwe ngokugonywa, njengabanye abantwana. Iqiniso lokuzalwa ngaphambi kokuzalwa akusikho ukuchasana nokugonywa, nangona ukuba isistim somzimba siphumelele ngokwaneleyo. Ixesha lokugonywa lisekelwe kwiminyaka yokulandelana komntwana ukususela ngexesha lokuzalwa, kwaye kungekhona kwixesha elilinganiselwayo, ukuba wazalwa ngexesha.
Iingxaki zexesha elizayo malunga nophuhliso kunye nempilo yabantwana abasengaphambili
Amanani ngokuphathelele kwiziphumo zokufunda iintsana ezisengaphambili kufuneka aguqulelwe ngokuqaphela ukuqinisekisa ukuba amacala afanayo afaniswa. Inzala kufuneka ibalwe ngokucophelela. Kucacile ukuba xa umntwana ezalwa ngaphambili, umngcipheko wokufa okanye ukukhubazeka kwabo baphile. Kukho ukubeka ingozi. Ukuba umntwana wakho usekudala kwaye uncinci, enye ingozi idibaniswa ngokuzenzekelayo.
Uphononongo lubonisa ukuba abantwana abangama-300 abazalwa ngaphambi kweeveki ezingama-26 zokukhulelwa nangaphambili, basinda ngexesha lokubeleka kwaye bafakwa kwiwadi kwiintsana. Kule ndawo, abantwana abangama-30 kuphela bachazwa njengento eqhelekileyo. Abanye bafa ngaphambi kokuba babe neminyaka emibini, okanye bahlala ebomini abaneziphene ezinzima. Abantwana abazalwa ngaphambi kweeveki ezingama-26 zokukhulelwa banama-12% amathuba okuhlala iminyaka emibili. Ipesenti encinci yabantwana baphila ngeqondo elikhuseleyo lokukhubazeka.
Ukubona nokuva
Ingxaki ezinzulu ezifana nokukhubazeka kwe-cerebral, ukuphunga kunye nokungazithulu kunokuchaphazela phakathi kwe-10% kunye ne-15% yeentsana ezingapheliyo. Wonke umntwana wesine onesisindo esingaphantsi kwe-1.5 kg unendawo okanye iimeko eziphambili zokufunda, okanye zombini.
Ubunzima bokuzalwa ngaphantsi kwe-1.5 kg, kunye nokubeletha ukuya kwiiveki ezingama-33 zokukhulelwa, kukhokelela kumngcipheko wokuphuhliswa kweephene zokubamba kunye ne-strabismus. Kwaye akukho mgaqo-nkqubo osemthethweni wokunyanga nokunyamekela kwaba bantwana abanjalo. Nangona ininzi abantwana abaqala ukuhlaziya i-retinopathy, umonakalo omkhulu unobunqabile. Ngokweziphumo zolu cwaningo, ama-66% wabantwana ababalelwa ku-1.25 kg baxhomekeke kwi-retinopathy, kodwa kuphela i-18% yafikelela kwisigaba sesithathu, kwaye kuphela i-6% efuna unyango.
Ubulumko
Ucwaningo luye lwachaphazela ukuphuhliswa kwabantwana abayi-1000 abazalelwe ubuncinane kwiiveki ezi-15 ngaphambi kwekota (25 iiveki zokukhulelwa okanye ngaphantsi) ngeenyanga ezili-10 zokuqala zika-2009. Kuloo, abantwana abangama-308 basinda, 241 bavavanywa ukuhlolwa kwengqondo ngokusemthethweni basebenzise ukuhlola okuqhelekileyo, ulwimi, iifowuni kunye neentetho eziza kuhlola iimpumelelo zabo ezizayo esikolweni. Kule mivuzo, abantwana abangama-40% babenenkinga yokufunda ngokulinganayo kunye nobunzima (ngoxa abafana babenamaxesha angama-2 abachaphazelekayo ngaphezu kwamantombazana). Ipesenteji ezikhuselekileyo, ezicwangcisiweyo kunye nezicukucekileyo zise-22%, i-24% kunye ne-34%. Ukukhubazeka okupheleleyo kwe-cerebral kwatholakala kubantwana abangama-30, okuyi-12%. Phakathi kwabo babenabantwana abaneziphene ezikhuselekileyo, abaye bafikelela kwiinyanga ezingama-30. Ngokubanzi, i-86% yabantwana abasaphila banokuphulwa ngokukhawuleza kunye nokukhawuleza okukhulu ngaphambi kweminyaka engama-6.
Ngokomnye uhlolisiso, kwiintsana ezinokuqala, iintsingiselo zengqondo ziphela nje ngexesha, kunokuphucula. Iingcali ziqhathanisa abantwana abaneminyaka eyi-8 ukuya kwe-15 kwaye bafumanisa ukuba i-IQ yabo iyancipha amanqaku angama-104 ukuya kuma-95, kwaye inani labantwana abadinga imisebenzi eyongezelelweyo landa ngo-24%. Iziphumo zibonisa ukuba, kwiminyaka eyi-8 ukuya kwe-15 ubudala, kukho ukuhla okuncinci ekuphuhlisweni kweeseli zeentsholongwane kwiintsana ezingekafiki.
Iingqondo kunye neengxaki zokuziphatha
Izifundo zabantwana abaneminyaka eli-7 ne-8 ubudala, abazalelwa ngaphambi kweiveki ezingama-32, babonisa ukuba uphuhliso lwabo lwanele ukuya esikolweni esiphakamileyo. Nangona kunjalo, iingxaki zifihliwe, ngoko ke uvavanyo olubanzi lwasetyenziswa. Ukunyuka kokuhamba-ingxaki ebalulekileyo kwiintsana zangaphambi kwexesha - yayisona siqhelo. Oku kwathintela impumelelo yabo esikolweni, ingakumbi ezimbi. Ngaphezu kwe-30% yabantwana abaye baphazamiseka ekuphuhliseni ukulungelelaniswa, xa kuthelekiswa nabantwana afunda nabo. Abantwana abangabanjwanga banomdla kakhulu, banokuphazanyiswa lula, banokugwenxa, bahlambulukanga, baxakeke. Ukunyaniseka ngenxa yokungabikho kwengqalelo kuye kwafunyanwa kwi-49% yabantwana abasengaphambili.
Ukuphuhliswa kwengqondo
Ukulahla ekuphuculweni kwisibeleko kunokubaluleka ekuphuhlisweni kwengqondo, oko kukukhokelela ekuveleni kwe-IQ ephantsi kunye nokuphuhlisa ukuphuhlisa izakhono. Kwabantwana abazalwa ngaphambi kweeveki ezingama-33 zokukhulelwa, ukunciphisa okukhulu kwimiqulu yengqondo kunye nokwanda okweqingqiwe ngobukhulu bekhanga ngexesha lobuncinci.
Uphuhliso lwengqondo kunye nokutshatyalaliswa
Uphononongo lwabantwana abaselula kwizikolo eziqhelekileyo ezazalelwa ngaphambi kokuba iiveki ezingama-29 zokukhulelwa zibonise ukuba aba bantwana baneengxaki ezininzi zengqondo, iingxaki zokugxininisa kunye nolwalamano nabanye abantwana. Bathi, ngootitshala nabazali, baninzi "baxoxwa" kwaye balala emva kobuntwaba. Naphezu kwezi ngxaki, ababonisi izifo ezinzulu zokuziphatha, ezifana nokuthambekela kokuzibulala, ukusetyenziswa kweziyobisi okanye ukudandatheka.
Ukufundwa kweentsana ezisengaphambili ezifikelela kwiminyaka engama-19 ukuya kweyesi-22 kubonisa ukuba ngokwemilinganiselo zinezinga eliphantsi lokukhula kunabalingane babo, bahlala begula kwaye banamathuba okungena kwimfundo ephakamileyo.
Indawo ekhuselekileyo yokuphuhliswa komntwana isibeleko somama. Kwaye kubalulekile ukuzama kanzima ukukhusela ukuzalwa kwangaphambi kokuqala kunye neengxaki ezinokuzalwa nakuphi na ukuzalwa ngaphambi kwekota. Kukho iimeko apho imeko yangaphakathi ye-intrauterine ingenakulungeleka ukuba umntwana uya kukhuseleka ngaphandle. Nangona kunjalo, iimeko ezinqabile. Ukunakekelwa kwePostpartum kubaluleke kakhulu. Iingxaki zentlalo nezentlalo, ukungondleki komama, kunye nokusetyenziswa kotywala kunye nokusetyenziswa kweziyobisi zizinto eziqhelekileyo zengozi. Ukubhema kufanele kugqitywe, ukusetyenziswa kotywala okunxilisayo kufuneka kube ngokulinganayo kakhulu, kuba akukho mda ophantsi okhuselekileyo kuwo. Ekuqaleni kufuneka kube yindlela yokuphila enempilo. Kule meko kuphela amathuba okuzalwa ngaphambi kokuba iphela liye linciphisa ngamaxesha amaninzi.