Izimo zemvelo kanye nezakhi zofuzo zingabangela ukukhubazeka kokuzalwa
Ukukhubazeka kokuzala kungathonya indlela ukubukeka okusha, imisebenzi, noma kokubili. E-United States, omunye wabantwana abangu-33 uzalwa enesici sokuzalwa. Ezinye izifo ezinokuzalwa zibonakala kalula, njenge-lip or lip. Okunye ukukhubazeka kokuzalwa kudinga izivivinyo ezikhethekile zokuxilongwa ukuze zibone ngeso lengqondo, njengezifo zenhliziyo ezibangelwa ukubeletha.
Ukukhubazeka kokuzalwa kwenzeka lapho umntwana ekhula esibelethweni.
Amakhemikhali athile, imithi, nezidakamizwa-ezibizwa ngokuthi i-teratogens-zingandisa ingozi yokukhubazeka kokuzalwa. Phakathi nezinsuku ezingu-14 zokuqala zokukhulelwa, ama-teratogens angabangeli iziphambeko noma angabangela ukukhulelwa kwesisu . Phakathi kwezinsuku ezingu-15 kuya kwezingu-60 zokubeletha (ngesikhathi se-trimester yokuqala) isisu sithinteke kakhulu emiphumeleni ye-teratogens kanye nokukhubazeka okunzima okungabangela. Ngokuqondile, izitho ezinkulu zikhula ngalesi sikhathi. Kumele kuqashelwe ukuthi i-teratogens akuyona yodwa imbangela yokukhubazeka kokuzalwa. I-Genetics nayo idlala indima. Ngaphezu kwalokho, kokubili izidakamizwa kanye nezakhi zofuzo zingabangela umonakalo ndawonye.
Ayikho indlela eqinisekile yokuvimbela ukukhubazeka kokuzalwa, noma kunjalo. Ekugcineni, izimo zemvelo kanye nezakhi zofuzo zihlangene ukuze ziholele kulezi zinkinga. Ukugcina impilo enempilo nemihlangano ejwayelekile ne-OB-GYN yakho ngaphambi nangesikhathi sokukhulelwa kungakusiza ukuba nomntwana onempilo. Noma kunjalo, kunezinyathelo ongazithatha ukuze unciphise ingozi yokuba nomntwana onokukhubazeka kokuzalwa.
# 1: Akukho Utshwala Phakathi Nesikhathi sokukhulelwa
Ukusetshenziswa kotshwala kuyimbangela ebangela ukukhubazeka kokuzalwa ngesikhathi sokukhulelwa.
Ngokusho kweCDC:
Ayikho imali eyaziwayo yokuphuza utshwala ngesikhathi sokukhulelwa noma ngenkathi ezama ukukhulelwa. Awukho isikhathi esiphephile ngesikhathi sokukhulelwa ukuphuza. Zonke izinhlobo zotshwala ziyingozi ngendlela efanayo, kufaka phakathi wonke amawayini kanye nobhiya. Lapho owesifazane okhulelwe ephuza utshwala, kunjalo nomntanakhe.
Ngaphezu kwalokho, isigamu sabo konke ukukhulelwa e-United States akuhlelwe. Kungathatha phakathi kwamasonto amane nesithupha ngaphambi kokuba owesifazane azi ukuthi ukhulelwe. Phakathi nalesi sikhathi, utshwala bungaphazamisa ukuthuthukiswa komntwana.
Ukusetshenziswa kotshwala ngesikhathi sokukhulelwa kungaholela ekutheni u-fetal alcohol syndrome (FAS). Ukungahambi kahle okwenziwe nge-FAS kufaka lokhu okulandelayo:
- umkhawulo wokukhula kwe-intrauterine (okungukuthi, ukukhula okuncane komntwana ngesikhathi esiswini)
- microcephaly (okungukuthi, ukuthuthukiswa kwengqondo encane nokukhubazeka kwengqondo)
- ubuso obunamathele obuncane obuncane phakathi kwe-middleface engakhiwe
- ama-anomalies ahlangene
- ukusebenzisana kabi
- ukukhubazeka kwenhliziyo okuzalwa
- ukukhubazeka kwengqondo
Izindlela eziqondile lapho utshwala obangela khona i-FAS engaziwa. Siyazi ukuthi utshwala luwela kalula i-placenta emsakazweni we-fetus. Egazini lomntwana ongakazalwa, utshwala lufinyelela ezingxenyeni ezifana nalabo abathintekayo ekusakazweni komama.
Kodwa-ke, imfucuza ayinayo i-enzyme utshwala dehydrogenase, eyenziwa yisibindi futhi edingekayo ukwephula utshwala. Esikhundleni salokho, izinsana zithembele kuma-enzymes angama-placental nokubeletha ukuze ususe utshwala. Lezi zinkimbinkimbi azifani ngendlela ephumelelayo njenge-dehydrogenase yotshwala ekudambiseni utshwala; ngakho-ke, utshwala obuningi buhlala emsakazweni we-fetal.
Utshwala lubangela umonakalo omkhulu ohlelweni lwezinzwa zomntwana. Akugcini nje ukuphazamisa ukuthuthukiswa kwamangqamuzana omzimba kodwa futhi uyawabulala (inqubo ebizwa ngokuthi i-apoptosis).
# 2: Akukho ukubhema ngesikhathi sokukhulelwa
Kungcono ukuyeka ukubhema ngaphambi kokukhulelwa; Kodwa-ke, kumama olindelekile oshayayo, akukaze kube sekwephuzile kakhulu ukuyeka. Ngaphezu kwalokho, abesifazane abakhulelwe kufanele bahlale bengabhemi umusi.
Nakhu eminye imiphumela emibi ukuthi umntwana ozelwe umama ophuza ngesikhathi sokukhulelwa angase athole:
- umkhawulo wokukhula kwe-intrauterine
- umlomo womlomo
- i-cleft palate
- SIDS
- umsebenzi wokuqala
- ukukhuphuka okukhulu (hyperexcitability)
- ukucasuka
- ukuphakama kwe-muscle (hypertonicity)
- ukuthuthumela
I-Nicotine ingaphezulu kwamaphesenti angu-15 okugxilwe egazini le-fetus kunalowo unina. Lapho umama ebhema kakhulu, ingozi eyengeziwe yokukhula kwe-intrauterine. Ngaphezu kwalokho, ngisho nalabo ababhema ugwayi 10 noma abambalwa ngosuku (ababhema ukukhanya), bafaka izingane zabo kabili ingozi yokuzalwa kwesisindo esiphansi.
# 3: Ayikho i-Marijuana noma enye ethi "Street" Izidakamizwa Phakathi Nokukhulelwa
I-Marijuana yisidakamizwa esivame ukusetshenziswa kakhulu emgwaqweni. Manje sezomthetho emazweni athile, anezintambo eziningi zokukhulelwa ochwepheshe abathintekayo.
Abanye ochwepheshe bakholelwa ukuthi insangu ayiyona isifo se-teratogenic futhi ayibangeli ukukhubazeka kokuzalwa. Kodwa-ke, i-CDC incoma ngokumelene nabesifazane abakhulelwe ukubhema noma ukusebenzisa ezinye izidakamizwa ezingekho emthethweni ngoba lezi zidakamizwa zingaholela ekulebeni kokuqala, ukuzala okuphansi, kanye nokukhubazeka kokuzalwa.
Ngaphezu kwalokho, kukhona ukusekelwa kokuxhumanisa phakathi kokusetshenziswa kwensangu ngesikhathi sokukhulelwa futhi kamuva nezinkinga ze-neurodevelopmental ezinganeni, njengokungabi nomfutho nokucindezeleka kanye nezinkinga zokucabanga okungabonakali nokubonayo.
Ayikho izinga eliphephile lezinambuzane elinqunyelwe abesifazane abahlela ukukhulelwa noma abakhulelwe. Ngakho-ke, kungcono ukuthi abesifazane bangabhemi noma bangadli isidakamizwa ngesikhathi sokukhulelwa noma ngesikhathi sokukhulelwa. Uma udinga inambuzane ngesimo sezokwelapha, kungcono ukuxoxa ngaleyo ndlela nge-OB-GYN yakho.
# 4: Ukuvimbela Ukwelashwa
Izifo ezithile ngesikhathi ukhulelwe zingabangela ukukhubazeka kokuzalwa. Izifo zingavinjelwa ngokuthatha izinyathelo ezithile, kubandakanya ukuhlala kude nabantu abanezifo, ukugaya izandla njalo, nokupheka inyama. Ngaphezu kwalokho, imithi ethile yokuvikela igciwane elivikela owesifazane ekutheleleni okungaholela ekufweni kokuzalwa.
Iningi lwakamuva, i-Zika igciwane selilokhu lithola ucingo oluningi lokubangela ukukhubazeka kwezinzalo ezinganeni ezithwele omama abathintekayo. Lezi zinkinga zokuzalwa zihlanganisa i-microcephaly (ikhanda elincane) nokungaqondakali kwengqondo. Kodwa-ke, ukudluliselwa kwegciwane leZika e-Continental e-United States kusalokhu kungavamile, futhi ukutheleleka kwamanye amagciwane we-teratogenic kuvame kakhulu.
I-Cytomegalovirus (CMV) yimbangela evamile yokutheleleka kwabantwana abasha. Abaningi besifazane banamabhodlela omzimba we-CMV. Ngokuvamile, ukutheleleka okuyinhloko nge-CMV (ukutheleleka okokuqala) kuholela engozini ye-CMV ekusaneni (okungukuthi, i-CMV yokuzalwa). Noma kunjalo, ukuvuselelwa kwe-CMV noma ukutheleleka komama nge-strain ehlukile kungabangela futhi ku-CMV yesifo sofuba.
Iningi labantu abanesandulela ngculaza abonakali izimpawu zokutheleleka kanye nokuhlangenwe nakho akukho zimpawu. Umuntu onesivikelo somzimba omzimba angagcina ukutheleleka nge-CMV kokuhlola. Kodwa-ke, i-CMV ingabangela ukutheleleka okunzulu kulabo abanamasosha omzimba abuthakathaka. Ngaphezu kwalokho, i-CMV ingalimaza ingane futhi ingabangela ukukhubazeka kokuzalwa.
Iningi lezingane ezizalwa nge-CMV ukutheleleka ziphilile. Ngesinye sezingane ezinhlanu ezizalwa nge-CMV ukutheleleka zigula lapho zizalwa noma ziqhubeka nokuthuthukisa izinkinga zempilo yesikhathi eside. Ezinye izingane zibonisa izimpawu zokutheleleka kwe-CMV ngesikhathi sokuzalwa. Izingane ezincane zibonakala ziphilile ekuzalweni kodwa ngokuhamba kwesikhathi zihlakulele izimpawu zokutheleleka, njengokulahlekelwa kokuzwa.
Nazi ezinye izimpendulo ezingase zibe khona zokutheleleka kwe-CMV kusana olusanda kuzalwa:
- i-petechiae (okungukuthi, izindawo ezincane ezibomvu noma ezibomvu esikhumbeni esabangelwa ama-capillaries aphukile)
- ukwandiswa kwesibindi nesipere
- izinkinga zesibindi, amaphaphu, kanye ne-spleen
- i-jaundice
- i-microcephaly
- isifo sofuba
- ukuhlukunyezwa
- usayizi omncane ekuzalweni
- i-hemolytic anemia (i-autoimmune disorder disorder)
- ukulinganisa okungahambi kahle
- i-chorioretinitis (isib. ukuvuvukala kwe-choroid ne-retina) nezinye izinkinga zamehlo
- izinkinga zamazinyo
- izinkinga zokuzwa
- izinkinga ze-psychomotor
- ukukhubazeka kwengqondo
Kunzima ukubikezela ukuthi yiziphi izinsana ezizohlakulela ukutheleleka okukhulu kwe-CMV, futhi akukho ukwelashwa kwe-CMV ekukhulelwe okuzovimbela izifo ezinganeni. I-CMV ingadluliselwa kusuka komuntu oyedwa kuya komunye ngamathe, ubulili, njalonjalo.
# 5: Gwema Imithi ethile ye-Prescription
Imithi eminingi inemiphumela emibi engathinta ukukhulelwa. Kodwa-ke, izidakamizwa ezingaba ngu-30 kuphela ziyaziwa yi-teratogens, ezingabangela ukukhubazeka kokuzalwa. Imiphumela engaba khona ye-teratogenic ihlanganisa okulandelayo:
- umkhawulo wokukhula kwe-intrauterine
- ukukhubazeka
- izidakamizwa ezingelapheki
- izidakamizwa zokuziphatha (okungukuthi, imiphumela emibi yezidakamizwa ezonakalisa ukusebenza kwemisebenzi yansuku zonke)
- ukufa kwe-fetus
Kuze kube phakathi nekhulu leminyaka lamashumi amabili, odokotela bakholelwa ukuthi lo mntwana wayehlala endaweni evikelekile ehluke kumama. Le nkolelo yokuthi amantombazane avikelwe emithini yemithi kadokotela kanye nezinye izinto ezinobuthi ezinobuthi zawela ngemuva kwemiphumela ye-thalidomide yabangela inhlekelele eyande kakhulu ngawo-1960. I-Thalidomide yayisetshenziselwa ukuphatha ukugula kwasekuseni kodwa yabangela ukukhubazeka okukhulu kwesilungu, ukukhubazeka komzimba, njalonjalo ezinsana.
Kusukela kulesi sigameko se-thalidomide, odokotela baye basondela ginger ngokudokotela kwezidakamizwa ngesikhathi bekhulelwe ngenxa yokwesaba imiphumela ye-teratogenic. Ngenhlanhla, amanxusa amaningi ase-teratogenic awaqashiwe ngesikhathi sokukhulelwa.
Nazi ezinye izidakamizwa ezaziwayo eziyi-teratogens:
- i-cyclophosphamide
- i-diethylstilboestrol
- i-warfarin
- lithium
- isotretinoin
- i-carbamazepine
- phenytoin
- tetracycline
- ACE inhibitors
# 6: Thatha ama-Folate Supplements
Ifolate, noma folic acid, uhlobo lwe-vitamin B. Ngesikhathi sokukhulelwa, isidingo sohlobo luyakhula phakathi kwezikhathi eziyisihlanu neshumi ngoba le vithamini idluliselwa emntwaneni. Ukwehluleka kwezintambo kungaba nzima ukuthola ngesikhathi sokukhulelwa, futhi owesifazane odla kahle angakuzwa. Inothi, imifino eluhlaza, amaqabunga aphezulu aphezulu.
Ngenxa yokuthi ingxenye yokukhulelwa zonke e-United States ayihlelekile futhi ihlukumezeka ingathinta ingane ngokushesha-ngaphambi kokuba umama azi ukuthi ukhulelwe-i-CDC incoma ukuthi bonke abesifazane besikhathi sokuzala (phakathi kuka-15 no-45) kufanele bathathe ama-micrograms angu-400 i-folate nsuku zonke.
Lezi zici ezilandelayo zandisa izidingo zobungani kumama:
- ukudla okungenamsoco
- ukuhlala ne-anemia
- imithi ye-anticonvulsant
- ukuncelisa
- ukutheleleka
Ukwehluleka kwezintambo kungabangela ukukhubazeka okunzulu okubandakanya i-spina bifida kanye ne-anencephaly. Zombili lezi zimo ziyiziphambeko ze-neural tube. Nge-spina bifida, amathambo omgogodla awenzi kahle ngokuzungeza intambo yomgogodla. Nge-anencephaly, izingxenye zekhanda nobuchopho azifomu kahle.
Ucwaningo lubonisa ukuthi i-folic acid supplementation ngesikhathi sokukhulelwa iqhubeka ngamaviki angu-12 okukhulelwa kunganciphisa ingozi ye-neural tube defects ngamaphesenti angaba ngu-70.
# 7: Londoloza Indlela Yokuphila Enempilo
Isifo sikashukela esingalawuleki ngesikhathi sokukhulelwa kanye nokukhuluphala ngaphambi nangesikhathi sokukhulelwa kungakhuphula ubungozi bokukhubazeka kokuzalwa kanye nezinye izimo zempilo ezimbi.
Uma isifo sikashukela singalawulwa kahle ngesikhathi sokukhulelwa, ishukela ephezulu yegazi ingathinta kokubili umntwana kanye nomama. Amantombazane abelethwe omama abanesifo sikashukela ajwayelekile kakhulu, futhi abe nezitho ezinkulu, okwenza inqubo yokuzalwa ibe nzima nakakhulu. Lezi zingane nazo zithola ishukela ephansi yegazi ngemva kokuzalwa. Ngaphezu kwalokho, izinsana ezelwe omama abanesifo sikashukela ziyingozi kakhulu yokuzalwa, kanti izingane ezisengozini yokukhulelwa isisu.
Nazi ezinye izimo eziqondile ezitholwa izinsana ezalwa ngamanesi onesifo sikashukela:
- isikhumba esiluhlaza okwesibhakabhaka nesimanzi, ukushaya kwenhliziyo ngokushesha nokuphefumula okusheshayo (izimpawu zamaphaphu nokuhluleka kwenhliziyo)
- ukudla okunomsoco
- ubuqili
- ukukhukhumeza
- ukuthuthumela
- i-jaundice
- ukukhubazeka kwenhliziyo okuzalwa
Abesifazane abanesifo sikashukela kumele bazame ukufeza isisindo esiphephile ngaphambi kokukhulelwa. Ngesikhathi sokukhulelwa, abesifazane abanesifo sikashukela kufanele basebenze ukunciphisa inzuzo yesisindo kanye nokuzivocavoca, ukuqapha ushukela wegazi, nokuthatha imithi njengoba kunqunywe udokotela.
Ngokufanayo, abesifazane abakhuluphele kufanele bazame ukulahlekelwa isisindo ngaphambi kokukhulelwa ngokudla, ukuzivocavoca, nezinye izindlela zokuphila.
> Imithombo:
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> Chung, W. "I-Teratogens Nemiphumela Yabo." I-Columbia University Medical Centre. http://www.columbia.edu.
> I-Hoffbrand A. I-Megaloblastic Anemias. Ku: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Izimiso zikaHarrison ze-Internal Medicine, 19e eNew York, NY: McGraw-Hill; 2014.
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