I-Omphalocele kanye ne-laparoschisis yizinkinga zokuzalwa ezibonakala ngokukhubazeka ekuvaleni udonga lwesisu lwe-fetus, oluhambisana nokuphuma ngaphandle (i-herniation) yengxenye ye-viscera yayo yesisu. Lokhu konakala kudinga ukunakekelwa okukhethekile ngesikhathi sokuzalwa kanye nokuhlinzwa ukuze kuhlanganiswe i-viscera esiswini. I-prognosis iyathandeka ezimweni eziningi.

Incazelo

I-Omphalocele kanye ne-laparoschisis yizinkinga zokuzalwa ezibonakala ngokwehluleka ukuvala udonga lwesisu lombungu.

I-omphalocele ibonakala ngokuvuleka okubanzi noma okuncane odongeni lwesisu, olugxile enkabeni, lapho ingxenye yamathumbu futhi ngezinye izikhathi isibindi siphuma emgodini wesisu, sakhe lokho okubizwa ngokuthi i-hernia. Uma isici sokuvala udonga sibalulekile, le hernia ingaqukatha cishe wonke umgudu wokugaya ukudla kanye nesibindi.

I-viscera yangaphandle ivikelwe "isikhwama" esihlanganisa ungqimba lwe-amniotic membrane kanye nolwelwesi lwe-peritoneal membrane.

Ngokuvamile, i-omphalocele ihlotshaniswa nezinye izinkinga zokuzalwa:

• kaningi izinkinga zenhliziyo,
• ukuphazamiseka kwe-genitourinary noma ubuchopho,
• i-gastrointestinal atresia (okungukuthi ukuvinjelwa okuyingxenye noma okuphelele) ...

Kuma-fetus ane-laparoschisis, ukonakala kodonga lwesisu kutholakala kwesokudla senkaba. Ihambisana ne-hernia yamathumbu amancane futhi kwezinye izimo ze-viscera (ikholoni, isisu, isinye kanye nama-ovari angavamile).

Amathumbu, angavalwanga ngolwelwesi oluyisivikelo, antanta ngqo oketshezini lwe-amniotic, izingxenye zomchamo ezikhona kulolu ketshezi ezibangela izilonda ezivuvukalayo. Izinkinga ezihlukahlukene zamathumbu zingenzeka: ukuguqulwa nokuqina kodonga lwamathumbu, i-atresia, njll.

Ngokuvamile, azikho ezinye iziphambeko ezihlobene.

Izimbangela

Asikho isizathu esiqondile sokuvalwa okungalungile kodonga lwesisu oluboniswayo lapho i-omphalocele noma i-laparoschisis ibonakala yodwa.

Nokho, cishe ingxenye yesithathu kuya kwengxenye yezimo, i-omphalocele iyingxenye ye-polymalformative syndrome, evame ukuhlotshaniswa ne-trisomy 18 (i-chromosome eyodwa eyengeziwe 18), kodwa futhi nokunye okungavamile kwe-chromosomal njenge-trisomy 13 noma 21, i-monosomy X (a I-chromosome engu-X eyodwa esikhundleni sepheya lamakhromozomu ocansi) noma i-triploidy (ukuba khona kweqoqo elengeziwe lama-chromosome). Cishe kanye kweziyi-10 i-syndrome ibangelwa ukukhubazeka kwezakhi zofuzo (ikakhulukazi i-omphalocele ehambisana nesifo se-Wiedemann-Beckwith). 

kwesifo

Lezi zinkinga ezimbili zingaboniswa ku-ultrasound kusukela ku-trimester yokuqala yokukhulelwa, ngokuvamile okuvumela ukuxilonga ngaphambi kokubeletha.

Abantu abathintekayo

Idatha ye-Epidemiological iyahluka phakathi kwezifundo.

Ngokusho kwePublic Health France, kumarejista ayisithupha e-French anomalies yokuzalwa, esikhathini sika-2011 - 2015, i-omphalocele ithinte phakathi kwabantwana abangu-3,8 no-6,1 kwabangu-10 kanye ne-laparoschisis phakathi kuka-000 no-1,7 wokuzalwa kwabangu-3,6.

Izici zengozi

Ukukhulelwa sekwephuzile (emva kweminyaka engama-35) noma ngokufakwa kwe-in vitro fertilization kwandisa ingozi ye-omphalocele.

Izinto eziyingozi zemvelo ezinjengogwayi kamama noma ukusetshenziswa kwe-cocaine zingase zibandakanyeke ku-laparoschisis.

Isimo sengqondo sokwelapha ngaphambi kokubeletha

Ukuze ugweme izilonda eziningi zamathumbu ezinsaneni ezine-laparoschisis, kungenzeka ukwenza i-amnio-infusions (ukuphathwa kwe-serum ye-physiological ku-amniotic cavity) phakathi ne-trimester yesithathu yokukhulelwa.

Kulezi zimo ezimbili, ukunakekelwa okukhethekile kwethimba lezinhlaka eziningi okuhlanganisa ochwepheshe bokuhlinzwa kwezingane kanye nokuvuswa kwengane esanda kuzalwa kufanele kuhlelwe kusukela ekuzalweni ukuze kugwenywe izingozi ezinkulu ezithathelwanayo kanye nokuhlupheka kwamathumbu, okuhlanganisa umphumela ungabulala.

Ukulethwa okwenziwayo kuvame ukuhlelwa ukuze kube lula ukuphatha. Ku-omphalocele, ukulethwa kwesitho sangasese sowesifazane ngokuvamile kuyathandwa. Ingxenye yokuhlinzwa ngokuvamile ikhethwa i-laparoschisis. 

ukuhlinzwa

Ukuphathwa kokuhlinzwa kwezinsana ezine-omphalocele noma i-laparoschisis kuhloswe ukubuyisela izitho emgodini wesisu nokuvala ukuvuleka odongeni. Iqala ngokushesha ngemva kokuzalwa. Kusetshenziswa izindlela ezehlukene ukunciphisa ingozi yokutheleleka.

Umgodi wesisu ohlala ungenalutho ngesikhathi sokukhulelwa awuhlali umkhulu ngokwanele ukuze uvumelane nezitho ze-herniated futhi kungaba nzima ukuvala, ikakhulukazi uma ingane encane ine-omphalocele enkulu. Khona-ke kuyadingeka ukuqhubeka nokubuyiselwa kancane kancane kwanda ezinsukwini ezimbalwa, noma ngisho namasonto ambalwa. Izixazululo zesikhashana zamukelwa ukuvikela i-viscera.

I-Evolution kanye ne-prognosis

Izinkinga ezithathelwanayo nokuhlinzwa azikwazi ukugwenywa njalo futhi zihlale zikhathaza, ikakhulukazi uma kwenzeka ukuhlala isikhathi eside esibhedlela.

Omphalocèle

Ukubuyiselwa endaweni engaphansi kwesisu ye-omphalocele enkulu kungabangela ukucindezeleka kokuphefumula enganeni. 

Ngakolunye uhlangothi, ukubikezelwa kwe-omphalocele ehlukanisiwe kungcono kakhulu, ngokuqala kabusha ngokushesha ukuphakelwa ngomlomo kanye nokusinda unyaka owodwa weningi kakhulu lezingane, ezizokhula ngokujwayelekile. Uma kwenzeka ukukhubazeka okuhambisanayo, ukubikezelwa kubi kakhulu ngezinga lokufa eliguquguqukayo, elifinyelela ku-100% kuma-syndromes athile.

I-Laparoschisis

Uma kungekho izinkinga, ukubikezelwa kwe-laparoschisis kuhlotshaniswa nekhwalithi yokusebenza yamathumbu. Kungase kuthathe amasonto ambalwa ukuze amakhono emoto kanye nokumuncwa kwamathumbu kuphinde kululame. Ngakho-ke, ukondliwa kwabazali (ngokumnika) kufanele kusetshenziswe. 

Izingane eziyisishiyagalolunye kweziyishumi ziphila ngemva konyaka owodwa futhi ngobuningi, ngeke kube nemiphumela ekuphileni kwansuku zonke.