Iimeko zeMpilo yeBantwana engaphambi kwexesha

Umntwana osengumntwana (owaziwa nangokuthi ungumntwana wokuqala) ungowokuzalwa ngaphambi kweeyonto ezingama-37. Ekubeni iintsana zikhula ngokukhawuleza ngexesha lokukhulelwa, umntwana osanda kuzalwa ozalwa emva kweenyanga ezintathu ukuya kwezine uhluke kakhulu kumntu ozalelwe emva kweentsuku ezintathu ukuya kwezine. Yingakho oogqirha badla ngokusebenzisa isigama esilandelayo ukuhlula phakathi kweentlobo ezahlukeneyo zeentsana ezingekafiki:

Eli nqaku liza kugxininisa ngokukhethekileyo kwintsana yengane okanye iintsana ezizalwa phakathi kweeveki ezingama-27 neye-30.

Umlinganiselo wokuSinda

Iindaba eziphambili kukuba ngaphezu kwama-95 ekhulwini abantwana abasanda kuzalwa basinda. Nangona ezi ziintsana zincinci kwaye zingabhekana neengxaki zempilo ezinzulu, ininzi yazo ibuyele ekuzalweni kwayo kwangaphambi kwexesha elifutshane nemiphumo emide.

Uthini Umntwana Okhusele Kangakanani?

Ukuba u tyelele umntwana osengaphambi kwangoko kwi-unit yokunakekelwa kwe-neonatal (aka NICU), unokumangaliswa yinto encinci yintsana. Usana oluzalwe kwiiveki ezingama-27 lukhulula kuphela kwi-1 grams (2 iipounds, ii-ounces ezi-3); Usana oluzalwe kwiiveki ezingama-30 luba lu-1,450 amagremu (ii-3, i-ounces ezi-3).

Iintsana ezinqabileyo kakhulu zinamaqabunga amancinci aneemvini ezibonakalayo, kwaye kukho izixhobo ezininzi zonyango ezikhoyo, ziquka rhoqo:

• Inkxaso yokuphefumula : Uninzi lweentsana ezisenakuqala lufuna inkxaso yokuphefumula emva kokuzalwa. Umntwana ogula kakhulu okanye umntwana osweleyo angadinga ukuphuma umoya. Ezinye iintsana ezingaphambi kwexesha zingadinga ukunyanzeliswa kwengcinezelo ehamba phambili (aka-CPAP) okanye i- canal .

• Imizila ye-IV: Ngenxa yeenkqubo zabo zokugaya iintsholongwane, iintsana ezisandul 'ukuzalwa zixhaswa ngama-intravenous (IV) emigqabeni yokuqala kwaye ziziswa ngokukhawuleza ubisi lwebele okanye ifom. Imizila ye-IV ingavela kwisigxina se-cord ( umbilical catheters ), okanye i-peripheral IVs okanye imigca ye-PICC ingafakwa kwimigangatho yesantya okanye intsasa.
• Iingxowa ze-NG / OG : Ngaphambi kweeyure ezingama-33 zokubeleka, iintsana azikwazi ukunxana, ukugwinya nokuphefumla ngexesha elinye. Iintsana ezindala kakhulu zisondliwa ngokusebenzisa ityhubhu ephuma ekhaleni okanye emlonyeni ukuya kwisisu.
• Izixhobo zokubeka esweni: Iintsana ezinokuthi ziza kusengaphambili ziza kuba neentsimbi kwiifubthi kunye neenyawo okanye iinyawo zokubeka esweni iqondo lentlawulo, ukunyusa ukuphefumula kunye ne-oxygen saturation.

Iingxaki zezeMpilo kwiNICU

Umntwana osengaphambi kwangoko unokuba nekhosi ehamba phambili yeNICU okanye eyinkimbinkimbi. Iingxaki zempilo eziqhelekileyo zeentsana eziza kusengaphambili ziquka:

• Isifo sokuphefumula kwesifo sokuphefumula (RDS): malunga neepesenti ezingama-70 ukuya kuma-85 ekhulwini kwiintsana ezingaphambi kwexesha zifuna unyango lwe-RDS. Ukuxinzezeleka kokuphefumula kuthathwa ngenkxaso yokuphefumula okanye amayeza.
• I-patent ductus arteriosus (PDA): Phantse isiqingatha seentsana ezizalwe kwiiveki ezingama-27 kunye neephesenti ezili-17 zeintsana ezizalwe phakathi kwee-29 ne-30 zeveki zizalelwa nge-PDA. I-ductus arteriosus iyisitya segazi, kwaye ivumela igazi ukuba lijikeleze emapapuseni omntwana. Nangona i-PDA iqhelekileyo kwimfesane, le nqanawa yegazi kufuneka ivalwe ngexesha lokuzalwa. Amachiza okanye ukuhlinzwa kunokusetyenziswa ukuvala i-PDA.

• I-Sepsis: Ngenxa yokuba iintsana ezingaphambi kwexesha zinamajoni omzimba omzimba omzimba, ziyakwazi ukusuleleka kwiintsholongwane kuneentsana ezisetyenziswayo. Phantse ama-25 ekhulwini lweintsana ezengaphambi kwexesha elide lifuna unyango lokunyanga.
• I-Apnea yokungcoliseka kwangaphambili: Ngenxa yokuba iinkqubo zabo zeentlanzi zikhulile, iintsana ezingaphambi kwexesha zingase zibe nexesha le-apnea okanye i-bradycardia. Ngokuqhelekileyo baxhomekeke kule meko, enokuphathwa ngamachiza, ngexesha lokushiya i-NICU.
• I-anemia: I- anemia (ukungabikho kwamaseli obomvu obomvu) iqhelekile kwiintsana ezingaphambi kwexesha. I-anemia ye-prematurity ininzi ibonakala kwiintsana ezizalwe ngaphambi kweeveki ezingama-32, kwaye inokuphathwa nge-iron supplements, ukumpontshelwa igazi , okanye unyango.

• I-hemorrhage (IVH): Iintsana ezinengaphambi kwexesha ziye zatshatyalaliswa imilambo yegazi, ingakumbi kwingqondo. Ukuba ezi nqanawa ziyahlukana, igazi lingadlulela kwii-ventricles zengqondo. Phantse iipesenti ezili-10 zamantombazana angaphambi kwexesha anesifo esibi se-IVH.
• I-entocolitis ye-Necrotizing (NEC): Kwi-NEC, iinqununu zamathumbu zisulelekile kwaye ziqala ukufa. Le yimeko ebalulekileyo ephathwa ngamachiza okanye ukuhlinzwa. Ngombulelo, kuphela inani elincinci (malunga neepesenti ezi-5) zeintsana ezisekudala zihlupheke kwi-NEC.

Iingxaki zeMpilo zexesha elide

Uninzi lweentsana ezisandul 'ukuzalwa luvela emva kokubeleka kwangaphambi kwexesha kunye nemiphumo embalwa engapheliyo. Bangaba neemfuno ezizodwa kwiminyaka embalwa yokuqala, kodwa ngokuqhelekileyo baxhomekeke kwiimeko zabo zonyango ngexesha. Iingxaki eziqhelekileyo zempilo zexesha elide zeentsana ezisandul

• I-Apnea yokungcoliswa kwangaphambili: Ininzi kakhulu intsana engaphambi kwexesha ngaphambi kokuba ihambe kwi-NICU, kodwa abanye basoloko behlamba emva kokuya ekhaya. Ezi zintsana zingaya ekhaya zijonge i-apnea i-monitor ukuze ziqinisekise ukuba zigcina iintliziyo zabo kunye namazinga okuphefumla.
• Isifo sesifo sengculazi : Impempo yokuphefumula inokutshabalalisa imiphunga, ibangela izifo ezingapheliyo. Phantse iipesenti ezingama-33 zeentsana eziza kusengaphambili zifuna i-oksijeni emva kokukhutshwa kwe-NICU, kwaye abaninzi banesifo se-asthma okanye ezinye izifo zokuphefumula njengabantwana abancinci.
• Ukulibaziseka okuphuhlisayo : Nangona ukukhubazeka okunzulu kwengqondo kunokuqhelekanga kwiintsana ezingaphambi kwexesha, ukulibaziseka kokuphuhliswa kunye neengxaki esikolweni ziqhelekileyo. Phantse iipesenti ezingama-33 zeentsana eziza kusengaphambili zifuna uncedo esikolweni njengoko zikhula.

Ndingayithucula njani Imiphumo Yethu Yengane Ekuqaleni?

Kukho izinto ezininzi onokuzenza njengomzali ukunceda umntwana wakho aqale ukuqala:

• Ukufumana unyango olungaphantsi kokubeletha: Ukunakekelwa kwangaphambi kokubeleka kwangaphambili kunokunceda abomama banciphise ubungozi babo bokuzalwa ngaphambi kokuzalwa kwaye banqande okanye bayeke ukusebenza kwangaphambili .
• Ubisi lwebele lomfuba : Nangona umama angacwangcisi ukumncelisa, ubisi lwebele- mhlawumbi ixesha elifutshane-lunokunceda ukunika iintsana ezingaphambi kwexesha kuqala.
• Zama ukunakekelwa kwe-kangaroo: Ukunyamekela ngononophelo lwe-kangaroo kunokunceda iintsana zakuqala zikhule kwaye ziqokelele, kwaye zineenzuzo ezininzi kubazali bobabini kunye neentsana ezingekafiki. Oku kubandakanya ukubamba umntwana (ombethe i-diaper kuphela) isikhumba esikhumbeni sakho, phakathi kwamabele akho, ukugcina umfudumala kunye nokuziva ekhuselekile.
• Funa ukungenelela kwangethuba : Amantombazana amaninzi asekuqaleni aya kufumana iinkonzo zokungenelela kwangethuba. Ezi projekthi ziqhutywa zikarhulumente zinceda iintsana ezingaphambi kwexesha ukufikelela kwiontanga zabo kwaye zihlangabezane neziganeko ezinkulu kwixesha.

_Imithombo:

_{Marlow, N. "IsiPhumo seNtsholongwane emva kokuzalwa kwangaphambili." IiNqoloba zeZifo ebuntwaneni ngoJuni 2003; 89, 224-228.}

_{Qiu, X et al. "Ukuqhathaniswa kweZimbonakaliso kunye nokuPhumela kweziNzala eziNinzi zeZintsana ezizalwe okanye ngaphambi kweeveki ezingama-32 zoBugcisa." I-Obstetrics & Gynecology Feb 2008; 111, 365-371.}

_{Vohr, B et al. IziPhumo ze-Neurodevelopmental of Children's Weight Weight Births <32 Iiveki 'Ukulingana Phakathi kuka-1993 no-1998. " Pediatrics Sept 2005; 116, 635-643.}

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