Ukubukeza Okuphelele Kokuzalwa Kwesisu

by Krissi Danielsson

Izimpawu, Izimpawu Zokuxwayisa, Izimbangela, Nokubhekana Ne-Stillbirth

Uma ufuna ulwazi mayelana nokubeletha, ungase uzwe udabukile futhi ukwesaba. Sizohlanganyela kancane mayelana nezimpawu, izixwayiso nezibonakaliso, kodwa okubaluleke kakhulu sizoxoxa ngalokho okungakusiza ukubhekana kahle nalesi sikhathi esinzima.

Kuyini Ukubeletha? - Incazelo

Ukubeletha okubizwa ngokuthi i-intrauterine fetal demise) kuvame ukuchazwa njengokulahlekelwa kwengane okwenzeka ngemva kweviki lama-20 lokukhulelwa lapho umntwana efa ngaphambi kokuzalwa.

(Ukulahlekelwa okwenzeka ngaphambi kwamaviki angu-20 ngokuvamile kubhekwa njengokungahambisani nesisu.)

Zivamile kangakanani Izibelethi Nengabe Zenzeka?

Ngeshwa, ukubeletha kwenzeka kakhulu kakhulu, cishe ku-1 ku-160 okukhulelwa. E-US kunamaphesenti angama-26,000 okubeletha ngonyaka, kanti kunezigidi ezingu-3.2 emhlabeni wonke. Cishe amaphesenti angu-80 okubeletha angaphambi kokuzalwa (okwenzeka ngaphambi kwamasonto angu-37 ukubeletha), nengxenye yazo zonke izibeletho ezenzeka ngaphambi kwamasonto angu-28.

Izingozi Zengozi Ye-Stillbirth

Njengezinye eziningi zokulahleka kokukhulelwa, ukubeletha ngokuvamile kubonakala ngaphandle kwezinto ezibonakalayo ezingozini. Ezinye izinto ezibeka ingozi ezihambisana nengozi enkulu yokuzalwa komzimba zihlanganisa:

Ubudala bomama bukhulu kunama-35 noma ngaphansi kwezingu-20 - Abesifazane abangaphezu kweminyaka engama-35 banamathuba amaningi okuba nokubeletha okungaqondakali kunabesifazane abasebasha.
Izimo zezempilo kumama, ikakhulukazi umfutho wegazi ophezulu nesifo sikashukela . Izimo ezifana ne-lupus, isifo sezinso, ezinye izifo zokugwedla igazi kanye nezinye izimo zezokwelapha nazo zandisa ingozi.

I-pre-eclampsia (ukukhulelwa kubangelwa ukucindezeleka okukhulu).
Ukukhuluphala .
Ukukhulelwa okuphindaphindiwe (amawele nambili.)
Ukubhema.
Ukuba nomlando wokubeletha, ukwehlukaniswa kwesisu, noma ukubulawa kwesifo sokubeletha (ukufa phakathi nezinsuku zokuqala ezingu-28 zokuphila.) Ukuba nomlando wokuzalwa kwangaphambi kokuzalwa, ukuxoshwa kwe-toxemia, noma ukukhulelwa kwe-intrauterine ngaphambi kokukhulelwa kungabangela ingozi.

Ukungabi nokunakekelwa kokubeletha.
Umjaho. Abesifazane abamnyama banesifo esiphakeme sokubeletha kunabesifazane baseCaucasus ngisho nalapho belawulwa isimo sezenhlalo.
Ukusetshenziswa kotshwala noma ukulawulwa kwezidakamizwa (kokubili umshwalense nokungafani) ngesikhathi sokukhulelwa.
Ukuhlukunyezwa kwesisu (okuhlobene nezingozi zemoto, ukuwa, noma udlame lwasekhaya.)
Isimo sokulala - Nakuba kusengakaqiniseki, abanye abacwaningi bakholelwa ukuthi ukulala endaweni ephakeme (ngemuva kwakho) kungase kuhlotshaniswe nengozi eyengeziwe yokubeletha.
Ukunciphisa ukukhula kwe-intrauterine .
Ukukhulelwa kwesikhathi eside - Ukukhulelwa okudlulile (okungaphezu kwamasonto angama-41 kuya kwangu-42 ukubeletha) kucatshangwa ukuthi kungene kumaphesenti angu-14 okubeletha.

Izimbangela ze-Stillbirths

Izici ezihlukahlukene zingabangela ukuba izingane zizalwe, kepha ezinye izimbangela zokuzalwa zihlanganisa:

Ukukhubazeka kokubeletha, ikakhulukazi okungajwayelekile kwe-chromosomal emntwaneni - Ukukhubazeka kokuzalwa, isibonelo, i- anencephaly yiyona imbangela yamaphesenti angu-14 okubeletha.
Izingozi zezinyosi ze-umbilical - Izingozi ze- umbilical ezifana nefoshi emgqeni, intambo ephuthumayo (lapho intambo iphuma emgodini ngaphambi kokuba ingane iphinde icindezeleke) noma intambo ehlanganiswe ngokucophelela nge-akhawunti yentamo yengane cishe ngamaphesenti angu-10 wezinyanga zokuzalwa. Khumbula ukuthi izinsana eziningi zinezintambo ezungeze entanyeni ngesikhathi sokuzalwa (ngokukhululeka) futhi lokhu akuvangeli ukudala izinkinga.

Ukuphazamiseka kwamapayipi - Uma i-placenta ihlukanisa ngaphambi kwesikhathi kusukela odongeni lwe-uterine, lesi simo siyaziwa ngokuthi ukuphazamiseka kwamapayipi . Amanye amazinga okuphazamiseka kwamapayipi ayenzeka ngamaphesenti owodwa okukhulelwa. Ingozi yokubeletha incike ekungenikeni kokuhlukaniswa, ngokuhlukaniswa kwamaphesenti angu-50 noma ngaphezulu okubangela ukubeletha.
Izifo - Izifo ezinama-bacteria, amagciwane, noma i-protozoa zicatshangelwa ukuthi ziyimbangela yokuzala kuze kube ngamaphesenti angama-24 esikhathini emazweni athuthukile. Izinhlobo zezifo ezivame ukuhlotshaniswa nokuzalwa komzimba (kanye / noma ukukhulelwa komzimba) kufaka i-bacterial vaginosis, isifo seqembu B , i-parvovirus B19 (isifo sesihlanu), uListeria monocytogenes , i- cytomegalovirus , i-herpes yomzimba (ukutheleleka kokuqala), i-syphilis, nokunye okuningi. Izifo zingase zibangele ukubeletha kokuqala (amaviki angu-20 kuya kwangu-28 ukubeletha) kunokubeletha okubeletha (emva kwamasonto angu-28.)

Amaphesenti angamashumi amabili nanhlanu kuya kumaphesenti angama-60 ezinyanga zokubeletha azichaziwe.

Ingabe Odokotela Bangakuvimbela Ukubeletha?

Kunezikhathi ezithile lapho ukubeletha kungavinjelwa futhi nezinye izikhathi lapho ukuvimbela kungenzeki. Njengengxenye yokunakekelwa kokubeletha, odokotela baqaphela izimpawu zakuqala zezinkinga kumama nengane. Uma kunezici ezinobungozi, njengengcindezi ephezulu yegazi, udokotela ngezinye izikhathi angathatha isinyathelo ukunciphisa ingozi. Yingakho ukufuna ukunakekelwa kokubeletha kubaluleke kakhulu. Kulabo besifazane abasengozini enkulu yokubeletha, ukubonisana ne-perinatologist noma isazi sezidakamizwa ogxile ekukhulelweni okuphezulu kufanele kubhekwe. Kunezici eziningana okwamanje ezifundiswa ngendima yazo ekunciphiseni ingozi yokubeletha. Kusukela kuma-probiotic supplements kuya endaweni yokulala, kubalulekile ukuthola udokotela ongakusiza ufunde mayelana nocwaningo lwamuva mayelana nanoma yini ongayenza ukuze unciphise ingozi yakho.

Uma kwenzeka izintambo zentambo, izimo ze-chromosomal, noma ezinye izinkinga ezingalindelekile, noma kunjalo, ukubeletha kungenzeka ngaphandle kokuxwayisa ngakho-ke akuvimbeli ngaso sonke isikhathi.

Njengoba ukukhulelwa isikhathi eside kucatshangwa ukuthi kunomthelela kumaphesenti angu-14 okubeletha, ukuphathwa ngokucophelela kokukhulelwa okudlulele kubalulekile.

Izimpawu Zokuqala Nezixwayiso Zokuthi Ukubeletha Kungenzeka

Ukubeletha kungenzeka ngaphandle kwempawu, kodwa odokotela bavame ukufundisa abesifazane abadlule amasonto angama-28 abakhulelwe ukulandelela ukukhishwa kokufelwa okungenani kanye ngosuku. Uma isibalo sokukhahlela sibangela ukukhathazeka, udokotela wakho angathanda ukuthi ungenele ukuhlolwa okubizwa ngokuthi ukuhlolwa okungewona ukucindezeleka (NST) okuhlola ukuthi ingane yakho iphephile yini.

Njengabantu abadala, izinsana zinezinsuku uma zisebenza kakhulu kunabanye. Thembeka isisindo sakho. Uma ingane izwa ingasebenzi kangako kuwe, noma ngokuphambene, isebenza ngokweqile, ithembe igulane lakho bese ushayele udokotela wakho. Intukuthelo yowesifazane ayikwazi ukucatshangelwa uma kuziwa kahle kokuphila kwengane yakhe. Eqinisweni, isifundo se-2016 sathola ukuthi ukunyuka okuphawulekayo emisebenzini enamandla okwakushiwo umama ngezinye izikhathi kuhlotshaniswa nokuzalwa. Ngesikhathi esifanayo, ukucindezeleka akulungile kumuntu, futhi kubalulekile ukukhumbula ukuthi izinguquko eziningi emisebenzini yomntwana zijwayelekile.

Ezinye izimpawu zokuxwayisa kungenzeka zibandakanya ubuhlungu besisu noma ubuhlungu kanye nokuphuma kwamagciwane njengoba lokhu kungasho isimo esibizwa ngokuthi ukuphazamiseka kwamapayipi. Gwema njalo eceleni kokuqapha bese ushayele udokotela wakho uma ukhathazekile.

Kwenzekani Lapho Odokotela Bebona Ukuthi Ingane Ayikho Inhliziyo?

Uma kutholakala ukuthi ingane yakho ayinayo inhliziyo ekuhloleni kokubeletha ngaphambi kokubeletha, uzofuna kuqala ukuqinisekisa ukungabi khona kwenhliziyo. I-ultrasound ivame ukwenza kuqala. Uma kunqunywa ukuthi umntwana ushonele, owesifazane unezinketho ezimbalwa.

Kungenzeka ukuthi ihlelwe ukukhishwa kwemisebenzi yezokwelapha ngokushesha (noma ube nesigaba C uma kwenziwa uma kubonisiwe) noma angakhetha ukulinda ukuze abone ukuthi uyahamba yini phakathi kweviki noma amabili. Kunezingozi ezithile zokulinda (njengama-clots wegazi), ngakho-ke kubalulekile ukuqonda izingozi nezinzuzo zalezi zikhetho ngokugcwele.

Ingabe Abazali Kufanele Bakhetha Ukubamba Umntwana Ongazalwa?

Uma uzibuza ukuthi kufanele yini ubambe ingane yakho engakazalwa, impendulo iwukuthi akukho okulungile noma okungalungile, kuphela okukuhle kuwe. Abanye abazali bathola ukuthi ukubamba ingane kubalulekile ekwenzeni ukukopisha, kanti abanye abafuni ukubona ingane nhlobo. Ucwaningo luxubene ngokuthi ngabe ubambe ingane yini yokwelashwa (ucwaningo oluthile lubonisa ukuthi ukubamba ingane kungase kwandise ingozi yokucindezeleka kwemitholampilo), kodwa isinqumo kufanele senziwe ngabazali bodwa.

Ingxenye eyinkimbinkimbi kakhulu ukuthi imibhangqwana ingase ingazi izintandokazi zazo kuze kube yilapho isiphuzile kakhulu. Abanye abazali abangabamba izingane zabo bagcina bezisola ngokuhamba kwesikhathi. Uma ungaqiniseki ukuthi yini ofuna ukuyenza, khuluma nomhlengikazi wakho wesibindi. Yena (noma yena) cishe uzoba nomqondo wokuthi yini eye yasize kakhulu abanye ababhekene nesimo esifanayo.

Yini Abazali Abazokwazi Ngayo Ngezinqubo Zibhedlela?

Ngokuvamile abazali banokukhetha ukuthatha izithombe nokugcina izinwele zezinwele ezivela emntwaneni wabo osanda kuzalwa. Ngesikhathi sokubeletha, ngokuphambene nokuhlukunyezwa, kukhona nokukhetha kokubamba umngcwabo ngokomthetho kanye / noma ukushisa, futhi abazali kufanele babuze mayelana nezinqubomgomo zesibhedlela kuleyo ndawo. Kwezinye izimo, abazali nabo kudingeka bathathe isinqumo sokuthi kufanele babe ne-autopsy eyenziwe enganeni ukuze banqume isizathu sokubeletha.

Lezi zinqumo ezinzima kakhulu ukubhekana nazo lapho ulila ingane yakho, futhi konke okwakulindele kuye. Ungase ufise ukubukeza le miqondo ngokungcwaba ngemuva kokuzalwa kokuzalwa , kanye nezinzuzo kanye nokuqapha mayelana nokuzwakalisa ukukhulelwa komntwana .

Abazali Bangabhekana Kanjani Nokuba Nesana Esingakazalwa?

Uma uke wabhekana nokubeletha, usuvele wazi ukuthi ukukopisha kulula kunokushiwo. Ungase ubhekane nemizwa yokuzilahla (ngisho noma ukulahlekelwa kungenzeka ukuthi akuyona iphutha lakho) noma uthola ubunzima bokuqonda ukuthi kwenzekani. Kubomama, ungase ubhekene nezinkinga ezinjengezinyosi zesifuba nokucindezeleka kwangemva kokubeletha, ukuphulukiswa nokuphulukiswa ngokomzimba ngemuva kokubeletha, ngaphezu kokulila kwakho okujwayelekile.

Into ebaluleke kakhulu okudingeka ukwazi ukuthi kulungile ukulila. Kunezinyathelo eziningana ezithintekayo ekuphulukeleni ngokomzwelo ngemuva kokubeletha kodwa owesifazane ngamunye (kanye nomlingani wakhe) bahlangabezana nakho ngezindlela ezahlukene futhi ngezikhathi ezahlukene.

Abazali abaningi banesibopho esijulile nezingane zabo isikhathi eside ngaphambi kokuzalwa, futhi ukuba nesibopho esinjalo ngokungazelelwe siphume ngokubeletha kuyaqondakala. Akudingeki ukuba ulungele usizi lwakho; abangani abangenalwazi kodwa abangenalwazi nezihlobo bangakunikela ngezimvo ezinjengokuthi "Usemncane; uzoba nomunye," noma "Kwakungafanele kube khona." Kulungile ukulila. Lezi zici zengqondo zingahle zibonakale zingenangqondo, futhi zenze ube nomuzwa wokuthi uthukuthele kakhulu. Akukhathaleki ukuthi uneminyaka emingaki. Into yokugcina engqondweni yakho njengamanje kungenzeka ukuba neyomunye, futhi akekho ongathi akuzange kube khona. Lona kwakungumntwana wakho futhi awuzange nje ulahlekelwe ngumntanakho kuphela kodwa wonke amaphupho kanye nethemba onalo ngomntanakho.

Ukuxhumana nomndeni wakho

Ekubhekaneni nosizi lwakho, zama ukuzwela umlingani wakho.

Ngamama, qonda ukuthi umlingani wakho usizi futhi, ngisho noma engayichazi imizwa ngendlela efanayo. (Abesilisa nabesifazane bavame ukusabela ngendlela ehluke kakhulu nakuba enhliziyweni yendaba bazwa imizwa efanayo.) Kungenzeka ukuthi uzama ukubeka phambili ukuze akusekele.

Obaba, zama ukubekezela nomlingani wakho futhi ube nehlombe lokulalela futhi ulalele. Ukukhuluma ngokulahlekelwa kungase kube usizo ngaye (abesifazane ngokuvamile badinga ukukhuluma ngezinto hhayi ukukhuluma ngakho ngeke kumsize angacabangi ngalokhu.) Zama ukubuka izimpawu zokucindezeleka okulandelayo ngemuva komlingani wakho bese uphakamisa ukuthi bheka udokotela noma ukhulume nomeluleki uma ukhathazekile.

Wonke umuntu uphatha ngokuhlukile ngokuzalwa komzimba, kepha abesifazane abaningi bathola ukuthi amaqhinga afana nokugcina iphephandaba noma ukuya emaqenjini asekelayo angabasiza ekubhekaneni nokulahlekelwa ukukhulelwa . Kungakhathaliseki ukuthi umndeni wakho kanye nabangani bakho banothando kangakanani, uma bengakaze babhekane nokubeletha, abakwazi ngempela ukuthi uzizwa kanjani. Kunezinhlangano eziningana zokusiza ukulahlekelwa ukukhulelwa okumangalisayo lapho ungaxhuma khona nabanye ukuthola ukwesekwa okudingayo. Ezinye ezimbalwa zalezi zinhlangano zenzelwe kuphela ukusiza abazali ukuba babhekane nokulandela ukubeletha.

Uma unezinye izingane, ungase uzibuze ukuthi ungakhuluma kanjani ngokulahlekelwa kwakho. Sinamasu amathiphu afanelekayo okukhulumisana nezingane mayelana nokukhulelwa kokukhulelwa , kodwa noma ngabe yini enqume ukuthi ingcono kakhulu, kubalulekile ukuqaphela ukuthi izingane zingakwazi ukuhlupheka ngokukhulelwa kokukhulelwa kanye. Uma uhlekisana noma uma ingane yakho ithatha imibukiso encane yengxoxo, ingase ibe nokukhathazeka kakhulu futhi icabange ukuthi yiphutha layo. Uyazi kuphela ukuthi yini engcono kakhulu kumntanakho, ngakho-ke uzofuna ukuqinisekisa ukuthi abantu abanenhloso enhle empilweni yakho bahlonipha ukuthi kanjani nokuthi nini ukhetha ukukhuluma nengane yakho ngokulahlekelwa komndeni wakho.

Kulabo Abafisa Ukukhulelwa Esikhathini Esizayo

Kungenzeka ukuthi awufuni ukuzwa ngokukhulelwa futhi angase afise ukuma lapha. Uma futhi ufinyelela lelo phuzu, ungase ufise ukufunda ngokukhulelwa ngemuva kokubeletha , ukuthi kufanele ulinde isikhathi esingakanani, nokuthi yiziphi izingozi ezingaba khona. Okwamanje, udinga ukudabuka ngendlela yakho nangesikhathi sakho. Ngenkathi ususizi futhi ululame ungase ufise ukuthola indlela ekhethekile yokukhumbula ingane yakho, kungakhathaliseki lokho kusho ukutshala insimu yokukhumbula noma into enenjongo kuwe. Lokhu kungasiza uma unquma ukukhulelwa futhi; awuyithathi esikhundleni somntwana owalahlekile, kunalokho, lowo mntwana uzohlala enendawo yakhe ekhethekile enhliziyweni yakho.

_Imithombo

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_{Utshani, J., Blencowe, H., Waiswa, P. et al.} _{Stillbirths: Amanani, Izingozi, Nokusheshisa Kuzo 2030. Lancet .} _{2016. 387 (10018): 587-603.}
_{Warland, J., Mitchell, E., noL. O'Brien.} _{Izindlela Zenveli Zokuvimbela Ukubeletha.} _{Ama-Seminar e-Fetal ne-Neonatal Medicine .} _{2017 Feb 2. (Epub ngaphambi kokuphrinta).}