Imibandela Yempilo Yengane Yengaphambi Kakhulu

Ingane engakazalwa (eyaziwa nangokuthi ingane yokuqala) ingumuntu ozalelwa ngaphambi kwamasonto angu-37 ukubeletha. Njengoba izingane zikhula ngokushesha kangaka ngesikhathi sokukhulelwa, umntwana osanda kuzalwa ozalwa izinyanga ezintathu kuya kwezine ekuqaleni kwawohluke kakhulu kulowo ozalelwa amasonto amathathu kuya kwamane nje ekuqaleni. Yingakho odokotela bavame ukusebenzisa leli gama elilandelayo ukuze bahlukanise phakathi kwezinhlobo ezahlukene zezingane ezingakafiki:

Lesi sihloko sizogxila ikakhulukazi emkhakheni wezingane osengaphambi kwesikhathi noma izinsana ezizalwa phakathi kwamasonto angu-27 no-30 ukubeletha.

Isilinganiso sokusinda

Izindaba ezinhle ukuthi amaphesenti angaphezu kwamaphesenti angama-95 ezinsana ezincane kakhulu ezingasaphumi. Nakuba lezi zinsana zingapheli futhi zingase zibhekane nezinkinga zempilo ezimbi, iningi lazo lilulame kusukela ekuzalweni kwazo ngaphambi kwesikhathi nemiphumela embalwa yesikhathi eside.

Ngabe Izingane Eziqala Ngaphambi Kokubukeka Zibukeka Kanjani?

Uma uvakashela ingane engakafiki isikhathi esiningi endaweni yokunakekelwa enezinkinga zokubeletha (i-aka NICU), ungase umangale ukuthi ingane encane kangakanani. Umntwana ozalwa emavikini angu-27 ulinganisa kuphela amagremu angu-1 000 (2 amakhilogremu, ama-ounces amathathu); umntwana ozalwa emavikini angu-30 ulinganisa cishe amagremu angu-1,450 (3 amakhilogremu, ama-ounces amathathu).

Izingane ezincane kakhulu ezingenasifo sinomzimba omncane onomzimba omncane onemivimbo ebonakalayo, futhi kukhona imishini eminingi yezokwelapha ekhona, evame ukufaka:

• Ukusekelwa ngokuphefumula : Izinsana eziningi kakhulu ezingakapheli zidinga ukwesekwa kokuphefumula ngemuva kokuzalwa. Ingane egula kakhulu noma engasanda kuzalwa ingadinga umoya owenzayo. Ezinye izinsana ezingakafiki zingase zidinge ukucindezela okuqhubekayo kwe-airway (aka CPAP) noma i- cannula yangasese .

• Imigqa ye-IV: Ngenxa yezinhlelo zabo zokugaya ukudla, izingane ezincane ezingakapheli zondliwa yi-intravenous (IV) imigqa ekuqaleni futhi zihanjiswa kancane kancane kubisi lwebele noma ifomula. Imigqa engu-IV ingavela emthonjeni wezintambo ( umclical catheters ), noma imigqa ye- peripheral IV noma i- PICC ingafakwa emkhawulweni wezingane ngaphambi kwesikhathi.
• Izikhumba ze-NG / OG : Ngaphambi kwamasonto angama-33 ukubeletha, izinsana azikwazi ukuncelisa, ukugwinya nokuphefumula ngesikhathi esifanayo. Izingane ezingakafiki ngaphambi kwesikhathi zondliwa ngethubhu ephuma emakhaleni noma emlonyeni phansi ukuya esiswini.
• Imishini yokuqapha: Izinsana ezingakafiki ngaphambi kwesikhathi zizoba nezinamathiselo ezifubeni nasezintweni noma ezinyaweni zokuhlola izinga lokushaya kwenhliziyo, izinga lokuphefumula, nokuphefumula kwe-oxygen.

Izinkinga zezempilo ku-NICU

Ingane engakafiki ngaphambi kwesikhathi ingase ibe ne-NICU ehamba phambili noma eyinkimbinkimbi. Izinkinga zempilo ezivame kakhulu ezinganeni ezingaphambi kwesikhathi zihlanganisa:

• I-Respiratory Depression Syndrome (RDS): Amaphesenti angaba ngu-70 kuya kuma-85 amaphesenti ezinsana ezingakapheli zidinga ukwelashwa kwe-RDS. Ukucindezeleka ngokuphefumula kuthathwa ngokusekelwa okuphefumula noma imithi.
• I-patent ductus arteriosus (i-PDA): Cishe isigamu sezingane ezizalwa emavikini angu-27 futhi amaphesenti angu-17 ezelwe abantwana phakathi kwamasonto angu-29 no-30 azalwa nge-PDA. I-ductus arteriosus iyisitsha segazi, futhi ivumela igazi ukuba lijikeleze emaphashini omntwana. Nakuba i-PDA ijwayelekile emantwaneni, lesi sikebhe segazi kufanele sivale lapho sizalwa. Imithi noma ukuhlinzwa kungasetshenziswa ukuvala i-PDA.

• I-Sepsis: Ngoba izinsana zangaphambi kwesikhathi zinamasosha omzimba omzimba, ziyakwazi ukutheleleka kakhulu kunezinsana zesikhashana. Amaphesenti angaba ngu-25 ezinsana ezindala kakhulu adinga imithi yokwelapha isifo.
• I-apnea ye-prematurity: Ngenxa yokuthi izinhlelo zabo zezinzwa zikhulile, izinsana ezingaphambi kwesikhathi zingase zibe nezikhathi ze-apnea noma i-bradycardia. Bavame ukukhipha lesi simo, esingasetshenziswa ngemithi, ngesikhathi beshiya i-NICU.
• I-anemia: i- anemia (ukungabi namangqamuzana egazi obomvu) kuvamile ezinganeni ezingaphambi kwesikhathi. I-anemia ye-prematurity ivame ukubonwa ezinganeni ezizalwa ngaphambi kwamasonto angu-32, futhi zingase ziphathwe nge-supplements ze-iron, ukumpontshelwa igazi , noma imithi.

• Ukwehla kwesisu (IVH): Izinsana ezincane kakhulu ezingenasandulela zinezitsha zegazi ezinzima, ikakhulukazi ebuchosheni. Uma lezi zitsha ziphuka, igazi lingadlulela ezingxenyeni zezobuchopho. Amaphesenti angaba ngu-10 ezinsana ezincane kakhulu ezingenaso isikhathi esinezingane ezine-IVH ezinzima.
• I-entocolitis ene-neecrotizing (NEC): E-NEC, ukuxubana kwamathumbu kugciwane futhi kuqale ukufa. Lesi yisimo esibucayi esiphathwa ngemithi noma ukuhlinzwa. Ngokujabulisayo, inamba encane kuphela (cishe amaphesenti angu-5) ezinsana ezincane kakhulu ezandulela i-NEC.

Izinkinga Zempilo Yesikhathi Eside Kungenzeka

Amantombazane amaningi kakhulu asanda kuzalwa alulame kusukela ekuzalweni okungakabiphi nemiphumela embalwa ehlala njalo. Kungenzeka babe nezidingo ezikhethekile eminyakeni embalwa yokuqala, kodwa ngokuvamile bachitha izimo zabo zezokwelapha ngokuhamba kwesikhathi. Izinkinga zempilo zesikhathi eside zesikhathi eside zezinsana zezingane ezingakafiki ziyizi:

• I-apnea ye-prematurity: Iningi lezingane ezingakabiphi ngaphambi kokuphuma ngaphambi kweNICU, kodwa ezinye zinezinhlamvu ngemuva kokuya ekhaya. Lezi zingane zingaya ekhaya ziqapha i-apnea ukuze ziqiniseke ukuthi zigcina izinhliziyo zabo nokuphefumula.
• Isifo samaphaphu angapheli : Ukusekelwa okuphefumula kungaphazamisa amaphaphu, kubangele isifo esingapheli sephaphu. Amaphesenti angaba ngu-33 ezinsana ezindala kakhulu adinga oksijini ngemva kokukhishwa kwe-NICU, futhi abaningi banesifo sokuphefumula noma ezinye izifo zokuphefumula njengezingane ezincane.
• Ukubambezeleka kokuthuthukiswa : Nakuba ukukhubazeka okunzima kwengqondo kungavamile ezinganeni ezingakafiki, ukulibaziseka kokuthuthukiswa kanye nenkinga esikoleni kuvame kakhulu. Amaphesenti angaba ngu-33 ezinsana ezingakafiki ngaphambi kwesikhathi zidinga usizo esikoleni njengoba zikhula.

Ngingayithuthukisa Kanjani Umphumela Wengane Wangaphambi Kwangaphambili?

Kunezinto eziningi ongayenza njengomzali ukusiza ukunikeza ingane yakho isiqalo esihle kakhulu:

• Thola ukunakekelwa kokuqala kokubeletha: Ukunakekelwa kwangaphambi kokubeletha kokuqala kungasiza abomama ukunciphisa izingozi zabo zokubeletha ngaphambi kwesikhathi futhi bavimbele noma bayeke ukusebenza ngaphambi kwesikhathi .
• Ubisi lwesifuba sebele : Ngisho noma omama bengacabangi ukuncelisa, ubisi lwebele- ngisho nangesikhathi esifushane-lungasiza ukunikeza izingane ezincane kakhulu ngaphambi kokuqala.
• Zama ukunakekelwa kwe-kangaroo: Ukubheka nge ukunakekelwa kwe-kangaroo kungasiza izingane ngaphambi kwesikhathi zikhule futhi zivuthiwe, futhi zinezinzuzo eziningi zabazali bobabili nabantwana abangaphambi kwesikhathi. Lokhu kuhilela ukumbamba umntwana (obembethe isikhumba esiphezulu kuphela) esikhumba esikhumbeni sakho, phakathi kwesifuba sakho, ukuze uhlale efudumele futhi ezwa evikelekile.
• Funa ukungenelela kwangaphambi kwesikhathi: Izinsana eziningi ezingakafiki ngaphambi kwesikhathi zizokwazi ukuthola usizo lokuqala. Lezi zinhlelo ezisemaphandleni zisiza izingane ezincane kakhulu ngaphambi kokubambisana nabangane babo futhi zihlangabezane nezigameko ngesikhathi.

_Imithombo:

_{I-Marlow, N. "Umphumela we-Neurocognitive Ngemuva kokuzalwa Kwangaphambi Kakhulu." Ukugcinwa Kwezinkinga Ezinganeni Ekuqaleni kukaJuni 2003; 89, 224-228.}

_{Qiu, X et al. "Ukuqhathaniswa kweMiphumela ye-Singleton kanye nemiphumela eminingi yokubelethwa kwezinsana ezazalwa ngaphambi noma ngemva kwamaviki angu-32 okuGestation." I-Obstetrics & Gynecology Feb 2008; 111, 365-371.}

_{Vohr, B et al. "Imiphumela ye-Neurodevelopmental yezingane ezincane kakhulu zokuzalwa zesisindo I-Pediatrics Sept 2005; 116, 635-643.}

_{https://www.nlm.nih.gov/medlineplus/article/001560.htm}