Zingaphi iiveki? Ngenye yezinto zokuqala abantu abazibuzayo malunga namawele kunye nokuphindaphinda. Ubungozi bokuqala kunokubeka ingozi ukuba uninzi lwaphindaphindiweyo lubhekane, kwaye imiphumo yokuzalwa kwasekuqaleni isuka kwi-minuscule ize isongela ubomi. I-Matshi ye-Dimes iqikelela ukuba ngaphezu kwama-50% amawele, i-90% yeethathu kunye nazo zonke ii-quadruplets kunye ne-multiple-order multiples zizalwa kuqala, okanye ngaphambi kweveki yama-37 yokukhulelwa.
Ekuqaleni ukuzalwa, umngcipheko omkhulu weengxaki zeentsana.
Nangona ukuqhubela phambili kwezobuchwepheshe bezobugcisa kuye kwaphucula kakhulu imbonakalo yabantwana abasebancinci, inani lokuzalwa kwangaphambi kokubeleka liye landa, okwenza ukungabi naluhlaza kungabangela isizathu sokufa kwabantwana abasanda kuzalwa kunye nesibini esibangela ukufa kwabantwana abangaphantsi kweminyaka emihlanu. Ehlabathini lonke, enye yezishumi kwiintsana ezisemhlabeni zizalelwa kwangaphambili.
Iziphumo zokuzalwa kwasekuqaleni
Ngenxa yobungozi obandayo, kubalulekile kubazali beeninzi ukuba baqonde impembelelo enokuthi i-prematurity ingabamba abantwana. Ukuqhaqhaqhaqhoza kuya kuthintela ubomi beentsapho kwiimilinganiselo ezihlukeneyo. Kweminye, kunokuthetha kuphela ukulaliswa kwezibhedlele. Kanti abanye bakhuthazela ukuhlala esibhedlele emva kokuba abantwana babo befika. Kwezinye iimeko, iingxaki zezokwelapha kunye nemiba yinto kuphela kwiiveki ezimbalwa zokuqala emva kokuzalwa, ngelixa ezinye iimeko zineempembelelo.
Isizathu sokumisela sihlandlo sokuzalwa. Iintsana ezizalwe ngokufutshane nomhla wazo wokugqibela zingenakwenzeka ukuba zibe neengxaki ezinkulu kuba izitho zabo zinexesha elininzi lokukhula kwisibeleko.
Ixhala leMpilo
Isibeleko sisebenza njengendawo epheleleyo yeintsana zokuphuhlisa. Xa iintsana zizalwa ngokukhawuleza, izitho zazo zifele kwaye azilungele ukusebenza "kwihlabathi langaphandle." Ukuqhaqhaqhaqhaqhazela kukuchaphazela yonke into ebalulekileyo emzimbeni.
- Imiba: Abantwana, ngokuyinene abo bazalwa ngaphambi kweveki ezingama-34, banenkathazo yokuphefumla umoya. I-respiratory depression syndrome inokuphathwa ngoncedo lokuphefumula kunye nomntu osebenza ngamandla, into eyenza ukukhupha imiphunga yanda. Ngamanye amaxesha iindlela zokulondoloza ubomi ezisetyenziselwa ukunyanzelisa imiphunga yamaphaphu zibangelwa kwisifo esingapheliyo samaphaphu okanye i-bronchopulmonary dysplasia (BPD) kwaye ingafuna unyango oluqhubekayo.
- Ubuchopho: I-Intraventricular Hemorrhage (IVH) iphuma kwiingqondo ezichaphazela kakhulu iintsana ezizalwe ngaphambi kweveki ezingama-32 okanye iintsana eziye zahlangabezana noxinzelelo oluvela kwelinye imeko yokungcoliswa kwangaphambili, njengengxaki yokuphefumula. Ingabangela umonakalo ebuchosheni okanye ukunciphisa umjelo wamanzi omgogodla okhokelela kwisakhiwo somninzi ophezulu kunye nengqungquthela yengqondo (i-hydrocephalus).
- Intliziyo: Esibelethweni, i-ductus arteriosus ivumela iintsana ukuba zithole i-oksijini ngokusebenzisa intambo, ngokugqithisa imiphunga. Ekuzalweni, le nqanawa yegazi kufuneka ivalwe. Iintsana ezinokuqala zikwazi ukuphuhlisa i-Patent Ductus Arteriosus, ebangela ukuhamba kwegazi okungavamile phakathi kwemithambo yegazi ejikeleze intliziyo. Ingakhokelela ekuphelelweni kwentliziyo.
- Amathumbu: Ukuqhelana nokufumana ukutya okunomsoco ukusuka kwi-placenta ngokusebenzisa intambo yomzimba, iintsholongwane zentsana zokuqala zokugaya azilungele ukulungisa ukutya. Iintsana zinokuvelisa ukutshabalala kwimbumba yamathumbu okanye izifo ezikhuselekileyo. I-entocolitis ye-Necrotizing (NEC) inokubangelwa isifo esasasazekayo okanye umonakalo wenyama yesifo okanye isifo somzimba esingaholela ekukhuselweni kwaye kungadinga ukuhlinzwa ukulungisa.
- Amehlo: Uninzi lweintsana ezingaphambi kwexesha ziba neengxaki ngamehlo abo ngenxa yokuba imithwalo yegazi ye-retina ayilunganga ngokupheleleyo. I-Retinopathy ye-Prematurity (ROP) iziphumo xa uphuhliso lweemithwalo zegazi ezinqabileyo luphazamiseka ngokuzalwa kwangaphambi kokuzalwa kwaye keke ukukhula okanye ukukhula ngokwemvelo. Iziganeko ezinzima zingakhokelela kwimpembelelo yombono okanye ukungaboni. Ngamanye amaxesha imeko ingathatyathwa ngokukhawuleza kunye nokuhlinzwa okanye i-laser yonyango, kwaye amaninzi amaninzi aya kuzilungisa ngokwabo.
Ezi meko zimela "iimeko ezinzima kakhulu" ezijamelene neentsana eziza kusengaphambili, ezazalelwa ngaphambi kweveki ezingama-32.
Kwiimeko ezininzi, ukuphindaphinda kwexesha eliphambili elifumana unyango oluphambili kwizibonelelo zesibhedlele zanamhlanje luyakwazi ukunqoba imingeni yokuqala kwabo ekuqaleni.
Ukuxhalabisa ngezoMpilo
Emva kwesigaba sokuqala esibucayi emva kokuzalwa kokuqala, xa kugxininiswa ekuqhubekekeni, imiphumo yokuqhaqhaqhaqho ingakwazi ukukwazi ngokupheleleyo. Ezinye zeengxaki zexesha elide zingabonakaliswa de kube i-multiples iqale isikolo. Oku kunokuba nzima kubazali, abaye bagxininiswa ngumngeni wokunyamekela umntwana omnye.
Uvavanyo lwezokwelapha luka-2008 lwaphakamisa i-alamu malunga neengxaki ezongeziweyo kwiintshaba ngexesha lokuphila kwazo. Abaphandi abavela kwiDyuvesi yeZiko lezoLwaphulo zeDyunivesithi balandelwa ngaphezu kweenyanga ezizigidi ezizelwe eNorway kusukela ngo-1967-1988. Baphetha ukuba abantwana abasebancinci:
- Kungenzeka ukuba bafe ebuntwaneni
- Akunakwenzeka ukuba babe nabantwana babo njengabantu abadala
- Kubonakala kuncinci ukugqiba isikolo esiphakamileyo okanye ikholeji epheleleyo
Abaphandi bathi le ziphumo zengxaki zonyango ezibangelwa ngethuba elide kunye nesimo sezentlalo esinciphisa ngenxa yeemeko zonyango. Nangona kunjalo, idatha yabo ayizange iquke amawele okanye amaninzi, kwaye abantu abafundayo bazalwa ngaphezu kweminyaka engamashumi amabini edlulileyo kwaye babengenakufikelela kwi-teknoloji yezobugcisa ebanceda baninzi abantwana abasenakuqala namhlanje. Kubalulekile ukugcina le ngcaciso ngokufanelekileyo.
Ukunyaniseka kukuba ezinye izilwanyana ezingaphaya kwexesha ziya kuhlakulela ukukhubazeka okuhlala ixesha elide, ukusuka ekuphelelweni kwengqondo ukuya kuphazamiseka kwengqondo kumbono okanye ukulahlekelwa kwindlebe. Abanye bafumana ukulibaziseka kokuphuhliswa, iinjongo zokufunda esikolweni okanye ukulahlekelwa ingqalelo. Abanye banokufuna nje iilazi okanye bahlupheke ngenxa yokugula okanye i-asthma. Imiqathango emininzi inokukunqotshwa ngeenkqubo zokungenelela kwangaphambili kubandakanywa ngokwenyama, inkulumo okanye izigulane zomsebenzi. Ezinye izixazululo zinokulungiswa. Kwaye ininzi yeziphindaphindiweyo ziza kubakho ubomi ngokungekho miphumo ebusweni babo ekuqaleni.
Akukho ndlela yokuchaza kwangaphambili iziphumo. Akukho ugqirha une-crystal ibhola ukuqikelela ukuba umntwana oza kusengaphambili angakhula aphilile. Kodwa abazali banokukunceda ekuqinisekiseni iziphumo eziphambili zeempleso zabo ngokuqaphela iingxaki ezinokubambisana kunye nabantwana abanonophelo bonyango babo ukuba bajonge uphuhliso lwabo kwaye bafumane inkxaso xa kufuneka.
Umthombo:
Loftin, R., et al. "Ukuzalwa Kwangaphambi Kokuqala." Ukuphononongwa kwi-Obstetrics ne-Gynecology , ubusika 2010, iphe. 10.
Swamy, G., et al. "Umbutho Wokuzalwa Kwangaphambi Kwexesha Lokusinda Kwangexesha Elide, Ukuzaliswa, kunye Nesizukulwana Esizayo Sokuzalwa Kwangaphambili," I- Journal ye-American Medical Association, ngoMatshi 26, 2008, iphe. 1429.
"Ukukhulelwa ngamawele, kathathu kunye nezinye iziphindaphindi." Matshi weDeses Foundation. Kufumaneka ngoJanuwari 12, 2016. http://www.marchofdimes.org/multiples-twins-triplets-and-beyond.aspx
"Wazalelwa Ngokukhawuleza: I-Global Action Report ngo-Birth Preterm." Matshi weDeses Foundation. Kufumaneka ngoJanuwari 12, 2016. http://www.marchofdimes.org/materials/born-too-soon-global-action-port-on-pretermbird.pdf