Usuleleko luyintloko ebalulekileyo yokukhubazeka kokuzalwa
Ukukhulelwa ngexesha lokukhulelwa kuyimbangela ebalulekileyo yokukhubazeka kokuzalwa. Izifo eziza kubangela ukuba kungabikho mpawu okanye ezintle kumntu omdala unokuba nemiphumo emibi kumntwana ongakazalwa. Xa olo sulelo alubanga ukulahleka kokukhulelwa okanye ukubeleka, kunokukhokelela kwisisindo sokuzalwa esincinci kunye nokungasebenzi kweenkqubo ezininzi zomzimba kwintsana.
Ukufumanisa kwangaphambili intsholongwane ngexesha lokukhulelwa kubaluleke kakhulu.
Ukuhlola ukusuleleka kwiphulo kukunciphisa ukusulela kwintsholongwane ye-intrauterine kunye neziphene zokuzalwa . Amanyathelo athile angathathwa ekunciphiseni umngcipheko wokusuleleka ngexesha lokukhulelwa, kuquka ukugonywa kunye namanyathelo okukhusela.
Kubalulekile ukuba bonke abafazi abakhulelweyo okanye abacwangcise ukukhulelwa baqaphele ngezifo ezahlukeneyo ezibangelwa ukulahleka okanye ukukhubazeka kokuzalwa.
I-Cytomegalovirus Infection
Usulelo lwe-Cytomegalovirus (CMV) usulelo oluqhelekileyo lukhona ekuzalweni (okt isifo sosuleleko) eUnited States. Usulelo lwe-CMV ngexesha lokukhulelwa landisa umngcipheko wokuba umntwana azalwe yi-CMV yokuzalwa.
Uninzi lwaba bantwana abanesifo se-CMV ngexesha lokuzalwa abanalo iimpawu. Kodwa ezinye iintsana zizalise i-CMV yokuzalwa. Iimpawu zokuzalwa zakwa-CMV ziquka oku kulandelayo:
- ukuvuvukala kwe-retina
- ukukhawuleza kubakho ngexesha lokuzalwa
- intloko encinci kunye nentuthuko engaphelelanga yengqondo (okt, microcephaly)
- ukuphuka kwesikhumba, amehlo, kunye neembumba ze-mucus (okt, i-jaundice)
- Ukwandiswa kwesibindi kunye nepen
- bunzima bokuzalwa
- ukuxhamla
- iipompositi zamaminerali kwingqondo
Uninzi lweintsana ezineempawu zentsholongwane ekuzalweni ziza kuba neengxaki zeengxaki zexesha elide, ezifana nokulahlekelwa kwindlebe, ukulahleka kombono, ukuphazamiseka kwengqondo, ukuphazamiseka kwengqondo, nokunye okunjalo.
Kungathatha iminyaka kule ngxaki ukubonisa. Ukongezelela, ukukhulelwa kwe-CMV yesifo sobeleko kwandisa ingozi yesifo sikashukela, isifo se-thyroid, i-osteoporosis, njalo njalo. Iintsana ezitheleleke nge-CMV ngexesha lokuzalwa kodwa zingabonakali ziimpawu zingekho mngcipheko ophantsi kwezi ngxaki.
Kunzima ukuqikelela ukuba zeziphi iintsana eziza kuba nama-CVM ezinzima. Ngaphezu koko, akukho nonyango ye-CMV. Izicwangciso zonyango ziquka unyango oluthile, imfundo efanelekileyo, njalonjalo. Kwiintsana ezine-CMV yokuzalwa, unyango olunemithi yokulwa neyeza lunganciphisa ukulahlekelwa kwintetho kamva.
I-Cytomegalovirus inobuninzi kwindawo; Ngoko, kunokuba nzima ukuziphepha. Nangona kunjalo, abafazi abakhulelweyo bayacetyiswa ukuba banciphise ukusebenzisana kwabo nabantwana abancinci abangakwazi ukusasaza intsholongwane. Isikhokelo esicacileyo siquka oku kulandelayo:
- hlamba izandla ngokucwangcisa emva kokuthintana namathele okanye abantwana
- Ungazibambezeli abantwana abangaphantsi kweminyaka engama-6 ubudala kwisidanga okanye emlonyeni
- thintela ukutya nokusela kunye nabantwana abancinci
Ukongezelela, abafazi abakhulelweyo abasebenza njengabanikezeli bonyango kufuneka baphephe ukunxibelelana nabantwana abangaphantsi kweenyanga ezingama-30 ubudala.
I-Rubella Virus Infection
Ukusulelwa ngentsholongwane ye-rubella ngexesha lokukhulelwa-ngokukodwa ngexesha le-trimester yokuqala-libi kakhulu.
Iingxaki eziqhelekileyo zibandakanya ukukhulelwa kwesisu , ukuhanjiswa kwangethuba, nokufa komntwana. Kwizo zintsana ezizalwe ziphila, imeko ebizwa ngokuba yi-congenital rubella syndrome ingakhokelela.
I-rubella syndrome yama Congenital ijongene nesohlo, indlebe, kunye neentliziyo ezinokukhubazeka kunye ne-microcephaly, okanye intloko encinci kunye nentuthuko engaphelelanga yengqondo, i-autism, kunye nokulibaziseka kwengqondo nokuhamba. Le miba ihlala isigxina.
Ngokucacileyo, iziphumo ezivela kwisifundo se-2011 ezipapashwe kwi-BMC yezeMpilo zikarhulumente zibonisa ukuba phakathi kuka-2001 no-2010, amatyala angama-16 600 ama-rubella syndrome ozalwa ngumntwana ayenqandwa yi-rubella yokugonywa. Ngaphezulu, ama-1228 amacala e-autism disorder disorder ayethintela ukugonywa kwe-rubella ngeli xesha.
Ukulahleka okufutshane okanye okwethutyana kubandakanya ukukhuliswa kwesibindi kunye neengxube, i-skinberry kunye negazi (imizekelo, "i-blueberry muffin syndrome"), kunye nokusuleleka kwengqondo.
Ngethuba lokunyamekela kokubeleka, umfazi kufuneka ahlolwe i-rubella immunity. Abasetyhini abakhulelweyo kodwa abangakhuselekanga nentsholongwane ka-rubella kufuneka batyilwe emva kokukhulelwa. Abo banesifo segciwane le-rubella ngexesha lokukhulelwa kufuneka bahlolwe ngokukhawuleza. Abasetyhini abanesifo sengculaza ye-rubella ngexesha lokuqala kweeveki ezili-11 zokukhulelwa banamathuba angama-90 ekhulwini lokusana umntwana ozalwa ngumntwana onomntwana okhulelwe yi-rubella syndrome; kanti ngeeveki ezingama-20 zokuqala, izinga lihla ukuya kuma-20 ekhulwini.
I-Herpesvirus Infection
Usulelo lwe-Herpes ngexesha lokukhulelwa lunokuba lunzima kakhulu kwintsana. Kungabangela ukulahleka kokukhulelwa, ukuguqulwa kwesantya, kunye nesisindo sokuzalwa esincinane. Ukutheleleka kwe-Herpesvirus yintsana inkulu kakhulu ekupheleni kokukhulelwa, ngexesha lokuzalwa, okanye ngokukhawuleza emva kokuzalwa. Ukusulela ekupheleni kokukhulelwa kunokubangela ukuba i-microcephaly, ukuvuvukala kwe-retina, ukugqithisa kunye ne-hydrocephalus.
Ngokutsho kweNIH:
Igama elithi hydrocephalus lithathwe kwigama lesiGrike elithi 'hydro' lithetha amanzi kwaye 'intloko' ithetha intloko. Njengoko igama libhekisela, yimeko apho umgangatho oyintloko uqokelelwa ngokugqithiseleyo kwintlupheko kwingqondo. Nangona i-hydrocephalus yaziwa ngokuba 'ngamanzi engqondweni,' 'amanzi' ngokwenene i-cerebrospinal fluid (CSF) - umbane ocacileyo ojikeleze ingqondo kunye nomgudu womgudu. Ukuqokelela ngokugqithiseleyo kweziphumo ze-CSF kwi-widening evamile yezikhala kwingqondo ebizwa ngokuthi i-ventricles. Ukwandisa ukudala uxinzelelo olunobungozi kwizicubu zengqondo.
Ukusulelwa i-herpes ngexesha lokuzalwa okanye kungekudala emva koko kunokubangela izifo zeso, umlomo, okanye isikhumba kunye nengqondo kunye nezinye iintlobo zentsholongwane.
Umngcipheko weempembelelo ezinjalo zesifo se-herpesvirus unokunciphisa ukulawulwa kwe-acyclovir, isicirho se-antiviral, kwiiveki zokugqibela ezine zokukhulelwa kwintombazana enokufumana isiqephu sokuqala se-herpes yokubeleka ngexesha lokukhulelwa.
I-Toxoplasmosis Infection
Ngokutsho kweCDC:
I-Toxoplasmosis ibangelwa i-protozoan parasite Toxoplasma gondii. E-United States kuqikelelwa ukuba i-11% yabemi abantu abaneminyaka engama-6 nangaphezulu sele banesifo se-Toxoplasma. Kwiindawo ezahlukeneyo kwihlabathi lonke, kuye kwaboniswa ukuba ukuya kuma-95% abantu abathile banesifo seTyxoplasma. Usulelo luvame ukuphakama kwiindawo zehlabathi ezifudumeleyo, iindawo ezishushu kunye neendawo eziphantsi.
I-Toxoplasma gondii yintsholongwane ye-parasitic kakhulu isasazwa ngamakati. Amagciwane atholeleka ngokutya iindundane kunye neentaka ezisuleleke kulo mzimba.
Ukuba ukhulelwe kwaye ube nekati, kubalulekile ukuba ugweme ukutshintsha i-kitty litter. I-Toxoplasmosis idluliselwa kumagqabi. Ezinye izikhokelo ziquka ukugcina iinkati zakho ngaphakathi kunye nokuzondla ukutya kwezorhwebo.
Enye imithombo ye-toxoplasmosis ibandakanya inyama engeyiyo okanye inyama ephekwe kunye nomhlaba kunye namanzi angcolileyo. Khumbula ukupheka inyama yakho ngokupheleleyo ngokushisa okwaneleyo. Kwinqaku edibeneyo, hlamba izandla ngokugqibeleleyo emva kokuthinta inyama engadliwayo kwaye uhlambe zonke izinto kunye ne-dishware esetyenziselwa ukulungiselela inyama. Ekugqibeleni, gwema ukusela amanzi angatshatyalaliswa kwaye ugqoke iiglavu ngexesha lokulima.
Abasetyhini abanesifo se-toxoplamosis ngexesha lokukhulelwa okanye ilungelo phambi kokukhulelwa kunokugqithisa isifo kumntwana. Uninzi lwabafazi abanesifo abasenalo iimpawu zentsholongwane, kwaye ezininzi iintsana ezithelelekileyo zivame ukungenazo izibonakaliso, kwakhona. Nangona kunjalo, ukusuleleka kwi-toxoplasmosis kunokubangela ukuphuphuma kwesisu okanye ukuzalwa komzimba kunye nokukhubazeka okubi, kuquka i-hydrocephalus, i-microcephaly, ukukhubazeka kwengqondo kunye nokuvuvukala kwe-retina.
Ngokuqhelekileyo, kwangaphambili ukuba umama unesifo se-toxoplasmosis ngexesha lokukhulelwa, kunzima kakhulu ukugula.
Ngokubhekiselele kwintsholongwane ye-toxoplasmosis kwintsana, ezi zinto zilandelayo zidibene nokukhubazeka kwexesha elide:
- ukulibazisa ukuxilongwa
- ukulibaziseka ekuqalekeni kweyeza
- Iishukela eziphantsi kwegazi (okt, i-hypoglycemia)
- ukusilela oksijini (oko kukuthi, i-hypoxia)
- iingxaki ezibonakalayo
- ukunyuka kweengcinezelo ezungeze ingqondo (oko kukuthi, ukunyuswa kwengcinezelo engaphezulu)
- i-hydrocephalus engaphendulwanga
Ukufikelela kuma-70 ekhulwini olutsha oluthola unyango olufanelekileyo kunye nxamnye namayeza e-pyrimethamine kunye ne-folinic acid esebenza ngokuqhelekileyo. Unyango kufuneka uqhubeke kunyaka wokuqala wobomi.
Zika Virus
I-Zika isasazwa ngumlingo we- Aedes ohlabayo emini. Ingasasazeka ngokulala ngesondo esingakhuselekanga kunye nomlingane ogulayo. Nangona i-Zika isasazekile kwiindawo zaseFlorida nakumazantsi eTexas, ukuphazamiseka kwe-Zika ukuqhuma kwangoku kwenzeka kwi-Central America, eMzantsi Melika nase-Caribbean.
I-virus ye-Zika eyadluliselwa kumama ukuya kumntwana ingabangela iziphene ezinzima zokuzalwa, eziquka i-microcephaly kunye nengqondo engafanelekiyo. Umngcipheko walezi ziphoso zokuzalwa unamaxesha angaphezu kwama-20 kwabasetyhini abanegciwane leZika.
Nangona umsebenzi wokugonywa kwe-Zika okwenziwa ngoku, akukho nonyango okanye unyango oluthile lwe-Zika virus. Abafazi abakhulelweyo bayacetyiswa ukuba basebenzise i-bug repellant, gwebela ukuhamba kwiindawo apho iZika isasazeka khona, kwaye ugweme ukuziphatha okubi kunye nomlingane onokusuleleka ngu-ntsholongwane.
Igama elivela kwi-Verywell
Kwiintsana ezingakazalwa, iintlobo ezithile zentsholongwane zingakhokelela kwiziphoso zokuzalwa, ukubola kwangaphambili nokufa.
Kubalulekile ukuba abafazi bacinga ngokukhulelwa bafumane imithi yokugonywa kwe-measles-mumps-rubella (MMR) kwiinyanga ezintathu ngaphambi kokuba ukhulelwe. Kulabo abangamkeli ukugonya kwe-MMR ngaphambi kokukhulelwa, kubalulekile ukuba bayifumane ngokukhawuleza emva kokukhulelwa. Ngaphezulu, izitofu malunga nomkhuhlane, i-tetanus, i-diphtheria, ne-pertussis zikhuselekile ngexesha lokukhulelwa kwaye ziyacetyiswa kwakhona.
Abasetyhini abanesifo se-herpesvirus ngexesha lokukhulelwa kufuneka bafumane unyango nge-acyclovir, i-agent ye-antiviral, ngexesha lokugqibela kweeveki ezine zokukhulelwa. Ukwenza njalo kuya kunciphisa umngcipheko weziphene zokuzalwa kunye nezinye izifo kunye nosulelo olufunyanwa emva kokuzalwa.
Nangona kunokuba kunzima ukuthintela usuleleko lwe-cytomegalovirus ngexesha lokukhulelwa, amanyathelo angathathwa ngumfazi okhulelweyo ukuba angabikho ukuthintana nabantwana abancinane.
Ukunciphisa umngcipheko wokutheleleka kwe-toxoplasmosis, abafazi abakhulelweyo mabaphephe ukudibanisa ne-kitty litter kunye ne-cat feces.
Ekugqibeleni, abafazi abakhulelweyo mabaphephe ukuhamba kwiindawo apho igciwane lesandulela ngculaza lihanjiswa khona, kwaye ukuba sele behlala kwiindawo ezinjalo basebenzise izigulane ezikhuselekileyo phakathi kwamanye amanyathelo okukhusela.
> Imithombo:
> Barbieri RL, Repke JT. Izifo zonyango ngexesha lokukhulelwa. Ku: Kasper D, Fauci A, Hauser S, uLongo D, Jameson J, Loscalzo J. eds. Imigaqo yeHarrison ye-Medicine yangaphakathi, i-19e eNew York, i-NY: i-McGraw-Hill; 2014.
> Berger, BE, Navar-Boggan, AM, Omer, SB. I-rubella syndrome ye Congenital kunye ne-autism i-disorder disorder ikhuselwe ukugonywa kwe-rubella - e-United States, ngo-2001-2010. BMC yezeMpilo. 2011; 11: 340.
> Levin MJ, Asturias EJ, Weinberg A. Izifo: I-Viral & Rickettsial. Ku: Hay WW, Jr., Levin MJ, Ukurhoxiswa kweRR, Abzug MJ. eds. UKUPHATHWA KWEZINDAWO ZONYAKA Nonyango lwezilwanyana, 23e eNew York, NY: McGraw-Hill; .
> Kim K, Kasper LH. Izifo ezibangelwa i-Toxoplasma. Ku: Kasper D, Fauci A, Hauser S, uLongo D, Jameson J, Loscalzo J. eds. Imigaqo yeHarrison ye-Medicine yangaphakathi, i-19e eNew York, i-NY: i-McGraw-Hill; 2014.
> Rudnick, CM, Hoekzema, GS. Izifo ezithintekayo ze-Heronatal ze-Simplex Virus. WaseMerika ugqirha. 2002; 65 (6): 1138-1142.
> Zheng, X, et al. Izifo ezithintekayo kwi-Intrauterine kunye noLwahlulo lokuzalwa. I-Biomedical and Environmental Sciences. 2004; 17: 476-491.