Okuqukethwe
Fetros macrosomia: lapho ulindele ingane enkulu
Esikhathini esidlule, ukubeletha "ingane enhle" yayidumile. Namuhla, odokotela baqapha ubukhulu bengane ngesikhathi sokukhulelwa. I-Fetal macrosomia, okusho ukuthi isisindo sokuzalwa esingaphezu kuka-4 kg, singaba nzima ngempela ukubeletha.
Iyini i-fetus macrosomia?
I-Fetal macrosomia ngokuvamile ichazwa ngesisindo sokuzalwa esingaphezu kuka-4000g. Ithinta cishe u-5% wezingane ezisanda kuzalwa. Izingane ezimacrosome azinazo izinkinga eziningi ngokukhuluphala kunezinye izingane njengoba zikhula. Konke kuncike emsuka walawo magremu ambalwa ngaphezulu. Udokotela wezingane uzomane aqaphele kancane ukuvela kwesisindo sabo nokuphakama kwamajika.
kwesifo
Naphezu kwenqubekelaphambili yobuchwepheshe, ukubikezela i-fetus macrosomia akulula kangako. Ukushaya kwesisu kanye nesilinganiso sobude besibeletho ngesikhathi sokuhlolwa kwanyanga zonke nombelethisi noma udokotela wezifo zabesifazane kunikeza inkomba yobukhulu bombungu. Ingozi ye-fetus macrosomia nayo ingatholwa ngesikhathi se-ultrasound kodwa amasu okubala okulinganisa isisindo se-fetus maningi futhi awawona amaphutha.
Izimbangela
Isifo sikashukela sikamama, kungakhathaliseki ukuthi sikhona ngaphambili noma sikhula ngesikhathi sokukhulelwa (isifo sikashukela sokukhulelwa), siyimbangela ehamba phambili ye-fetus macrosomia. Siyazi futhi ukuthi ukukhuluphala komama kuphindaphinda ngo-4 ingozi ye-fetus macrosomia. Ezinye izici eziyingozi nazo ziye zahlonzwa: isisindo sokuzalwa komama esiphezulu, iminyaka kamama engaphezu kuka-35, umlando we-fetus macrosomia ekukhulelweni kwangaphambilini, ukukhuluphala ngokweqile ngesikhathi sokukhulelwa, isikhathi esiphelelwe yisikhathi.
Ungazinciphisa kanjani izingozi?
Isifo sikashukela sokukhulelwa siyimbangela eyinhloko yengozi ye-fetus macrosomia, omama abakhulelwe abathambekele kuso (ngaphezulu kweminyaka engama-35 ubudala, i-BMI engaphezu kuka-25, umlando womndeni wesifo sikashukela sohlobo 2, isifo sikashukela sokukhulelwa, i-macrosomia) inqunywe phakathi kwamaviki angu-24 no-28 we-amenorrhea. "I-hyperglycemia yomlomo". Lokhu kuhlolwa kwenziwa esiswini esingenalutho ukuze kubhekwe ukuthi umzimba ulawula kahle kangakanani amazinga kashukela egazini. Inezigaba ezimbalwa: ukuhlolwa kwegazi lapho ufika elabhorethri, ukumuncwa kuka-75g we-glucose ewuketshezi, kulandelwe ukuhlolwa kwegazi ihora eli-1, bese kuthi ngemuva kwamahora ama-2.
Lapho isifo sikashukela sokukhulelwa sibonakala, omama bakusasa bayazuza ekusekelweni okukhethekile kokuselapha (ukudla, imisebenzi yomzimba eguquliwe, ama-ultrasound avamile ukuze kuqashwe ukukhula kwengane) futhi ngaleyo ndlela banciphise ukuzuza kwesisindo sengane. Abesifazane ababekhuluphele ngaphambi kokukhulelwa noma ukuthola amakhilogremu amaningi ngesikhathi bekhulelwe nabo baqashwe ngeso elibukhali.
Ukubeletha lapho ulindele umntwana omkhulu
I-Fetal macrosomia ingaholela ezinkingeni ngesikhathi sokubeletha. Ngasohlangothini lukamama, ikhuthaza ukopha ngesikhathi sokubeletha, izifo zangemva kokubeletha, izilonda zomlomo wesibeletho, ukuphuka kwesibeletho. Ehlangothini lomntwana, inkinga evame kakhulu futhi esatshwayo yi-shoulder dystocia: ngesikhathi sokuxoshwa, amahlombe omntwana ahlala evinjiwe ku-pelvis kamama ngenkathi ikhanda lakhe seliphumile. Kuyisimo esiphuthumayo esidinga ukuqondisa okunembe kakhulu kokubelethisa ukuze kukhishwe usana ngaphandle kwengozi.
Ngenxa yalezi zingozi, iNational College of French Gynecologists and Obstetricians ikhiphe izincomo ezimbalwa:
- Uma isisindo se-fetus esilinganisiwe sikhulu noma silingana no-4500 g, ingxenye eyisisekelo yokuhlinzwa iyaboniswa;
- Ukusola kwe-macrosomia kungase kuthethelele ukungeniswa kokubeletha phakathi nesonto lama-39 le-amenorrhea;
- Ukukhetha indawo yokuhlinzwa noma umzila wesitho sangasese sowesifazane kufanele kwenziwe njalo. Kodwa uma kwenzeka ukuzalwa kwesitho sangasese sowesifazane, kunconywa ukuba usebenzise i-epidural analgesia futhi uqinisekise ubukhona obuphelele bethimba lokubelethisa (umbelethisi, udokotela wokubelethisa, i-anesthesiologist kanye nodokotela wezingane).