I-NWFP - iyini? Isifo se-retardation retardation syndrome

Ukutholakala kwezidakamizwa "ze-NWFP" kwabeka zonke izingane ezibelethwe ngesisindo somzimba ngokulingana nobudala bazo. Abesifazane abaningi bafunda ngalesi sifo ngesikhathi sokukhulelwa. Kusukela ezintweni ezikulesi sihloko, uzothola ukuthi yiziphi izimpawu ezihambisana nokuthuthukiswa kokubambezeleka kwe-fetus, ukuthi kwenzekani.

I-NWFP - iyini?

Isifo se-retardation retardation syndrome (i-FGR) yisifo esichazwe yi-lag ebusweni bomntwana kusuka kumanani ajwayelekile aqoshwe njengendlela evamile esikhathini esithile sokukhulelwa. ERussia, ukusabalalisa kwalesi sifo kulesi sifo kusuka ku-5 ukuya ku-18%. Ubukhulu bezingane ezincane akubonisi ngaso sonke isikhathi lesi sifo. Abantwana abangaba ngu-70% abathola lokhu kuhlolisiswa, ngokwemvelo yabo banesisindo somzimba esincane. Kubo ubaba noma umama kungaba ukukhula okuncane. Ngaphezu kwalokho, ubulili kufanele bucatshangelwe (amantombazane ngokuvamile angaphansi kwabafana ngo-5%, okungaba ngu-200 g) nobuzwe.

Njengomthetho, isimo somntwana sihlawulelwa ngonyaka wokuqala wokuphila. Kancane kancane athola isisindo futhi enezela ekukhuleni, esondela ezinkomba ezijwayelekile. Uma ukuxilongwa okuqinisekisiwe udokotela kuba yisisusa esiyinhloko sokubambezeleka ekuthuthukiseni ingane, kuthinta impilo yakhe kanye nekhwalithi yokuphila, iphakheji yokwelapha ekhethekile libhekwa.

Kunezinhlobo ezimbili ze-NWFP: i-symmetrical and asymmetric. Ukuhlukahluka komzimba ngamunye kunezici zayo. Sizoxoxa ngazo kamuva kulesi sihloko.

Ifomu elingaphansi kwe-NWFP

I-pathology ngokuvamile ivela ku-trimester yesibili futhi ibonakala ngokuntuleka komzimba wesisu nokukhula okuvamile. Ingane ine-lag ekuthuthukiseni isisu nesisu sesifuba. Ngezinye izikhathi i-FWR engapheli ibonakala ngokubunjwa okungalingani kwezinhlelo zangaphakathi zelungu. Uma kungekho ukwelashwa okufika ngesikhathi, ubukhulu bekhanda lomntwana buyancipha futhi ubuchopho bokuthuthukiswa kwezingqondo, okungabangela ukufa kwakhe.

I-Symmetric shape ye-NWFP

I-pathology ibonakala ngokunciphisa ngokweqile ngobukhulu bomzimba wengane ngokuhambisana nokulinganisa okujwayelekile esikhathini esithile sokukhulelwa. Ngokuvamile itholakala ku-trimester yesibili. Ifomu le-symmetric le-syndrome ezikhathini eziningi libangelwa ukutheleleka kwe-intrauterine ye-fetus, okungavamile kwe-chromosomal. Izingane ezinezifo ezixilongwayo zizalwa ngokuthuthukiswa okungaphelele kwesistimu yenzwa yomphakathi.

Izimbangela eziyinhloko ze-pathology

Ingane ingavela ezweni elincanyana ngezizathu eziningana. Akufanele sikhiphe iqiniso lokuthi lokhu kuyisici sayo somzimba. Ingane encane ingathola i-height ephansi kubazali bayo. Kodwa-ke, ngisho nalesi simo, udokotela uzohlola ukuthi "ukukhulelwa kwe-fetal retardation syndrome". Uma emva kokubeletha umzimba wengane usebenza ngokugcwele, futhi ukucabanga kwayo kufana nemigomo, ukwelashwa okuqondile akudingeki.

Odokotela baveza izimbangela ezithile ze-FGRP, ezingabangela u-hypoxia ngisho nokukhulelwa kudlulele. Ukuphuthuma ukuphuthuma kubonakala uma ingane engaphakathi kwesibeletho ingamukeli oksijini kanye nezakhi ezidingekayo. Ngaphandle kwabo akunakwenzeka ukucabangela umsebenzi obalulekile wezinto eziphilayo.

Ukunciphisa inani lemithi engenayo kungabangelwa yizici eziningi:

1. Izinkinga ze-plaque. Lo mzimba unesibopho sokuthutha i-oksijini emfubusheni esibelethweni. Uma i-placenta ikhubazekile, ayikwazi ukusebenza ngokugcwele.
2. I-pathologies emsebenzini wezitho zangaphakathi ekubelethweni okuzayo (ukucindezeleka kwegazi, i-anemia, inhliziyo kanye nezifo zokuphefumula, isifo sikashukela).
3. Ekuthuthukiseni i-fetus, indima ekhethekile ingokwesethi ye-chromosome, ayithola kubazali bakhe.
4. Imikhuba emibi. Iningi lezocansi ezingcolile zobulili nokuphuza utshwala. Imikhuba emibi, ngisho noma owesifazane ewashiya masinyane ngaphambi kokukhulelwe, angabangela i-FGR ekukhulelwe.
5. Odokotela bahlale bephikelela ukuthi owesifazane osesimweni kufanele adle ngokoqobo ngamabili. Lokhu kunjalo ngempela. Ukuhambisana nokudla noma ukunciphisa okubukhali kokudla kwe-caloric kungathinta ingane kakhulu. Uma ingane engenamsoco, iqala ukuthatha emzimbeni womama. Ukudla kokubili akusho ukuthi udinga ukudla konke. Ukudla kumele kube nokulinganisela futhi kuhlanganiswe kuphela nemikhiqizo ewusizo. Ngesikhathi sokukhulelwa, akufanele ukwesaba ukuthi uphile kahle, kungavinjelwe ukuba uhlale ngokudla okuqinile.
6. Ukwamukelwa kwemithi. Kusukela kwizidakamizwa ngesikhathi sokubeletha kwengane kufanele kulahlwe. Ungathatha imithi kuphela ngeseluleko sikadokotela, lapho ungakwazi ukusiza.
7. Izifo zesifo esithathelwanayo zidluliselwe ngesikhathi sokukhulelwa (rubella, i-toxoplasmosis, isifo se-syphilis) ingayeka ukuthuthukiswa kwe-fetus. Yingakho odokotela banconywa kakhulu ukuba bagome isikhathi eside ngaphambi kokukhulelwa kwengane.
8. Ama-FERD wesibili-degree ajwayele ukufakwa kubesifazane abahlala endaweni ephakeme ngaphezu kwezinga lolwandle. Ezindaweni ezinjalo, ukucindezela kwanda, futhi lokhu kuvame ukuholela ku-hypoxia emntwaneni kanye nokuthuthukiswa okuncane kwe-fetus.

Ukuzimisela okwesikhashana imbangela ye-syndrome nokuqedwa kwayo okulandelayo kuvumela udokotela ukuba akhethe ukwelashwa okuphumelelayo.

Ziyini izimpawu zokugula kwe-fetal retardation syndrome?

Isithombe sesitholampilo salesi sifo sivame ukususwa. Akunakwenzeka ukusola ukuthi ukuxilongwa kwalowo wesifazane okhulelwe wedwa. Ukuqondiswa okujwayelekile kuphela kumgogeni wezinyanga eziyisishiyagalolunye kuvumela ukubona inkinga ngokuhamba kwesikhathi.

Kunombono wokuthi uma owesifazane ngesikhathi ekhulelwe akatholakali kakhulu, mhlawumbe izithelo ezincane. Ngokwengxenye lokhu kuyiqiniso, kodwa akuvamile ukuhlangabezana neqiniso. Lapho owesifazane ozayo ekubelethweni avimbela ukudla kwansukuzonke kuya ku-1500 kcal, uyakuthanda ukudla, amathuba okubukeka kokufelwa kwezingane eziphakemeyo ngokwanele. Ngakolunye uhlangothi, ukuvela kwamagciwane akufanele kukhishwe kulabo besifazane abanokunyuka okukhulu kwesisindo.

Isibonakaliso esicacile se-syndrome yizinyathelo ezingavamile nezingenangqondo zesisu. Isimo esinjalo kufanele siqaphe futhi sibe yisizathu sokukhalaza okuphuthumayo kumuntu ochwepheshe.

Ukuhlolwa kokunciphisa ukukhula kwesisu

Uma udokotela ecatshangelwa ukuthuthukiswa kwengane yomntwana, ukungafani phakathi kokuphakama kwe-uterine fundus kanye nemigomo ye-normative yemingcele yalesi sikhathi sokukhulelwa kungagcinwa. Ukuxilongwa okunokwethenjelwa kakhulu kuyi-ultrasound ukuhlolwa kwe-fetus, lapho uchwepheshe ehlola ubukhulu bayo nesisindo. Ngaphezu kwalokho, ukusebenzisa i-ultrasound kunganquma isimo sezitho zangaphakathi zengane.

I-Dopplerometry nayo inqunyelwe ukuthi ilungulwe uFGR. Kuyini? Lokhu kuhlolwa kwenziwa ukuhlola ukugeleza kwegazi ezitsheni zomntwana kanye ne-placenta. Indlela ebalulekile yokuxilongwa yi-cardiotocography ye-fetus (ukuhlolwa kwenhliziyo). Izinga elijwayelekile lezinga lezinhliziyo kusukela ku-120 ukuya ku-160 ukushaya ngomzuzu. Lapho umntwana esesibelethweni engenawo oksijeni, kancane kancane inhliziyo yakhe iyanda.

Ngokusekelwe emiphumeleni yokuhlolwa, udokotela angakwazi ukuqinisekisa ukuthi uhlolwe yini futhi anqume ukucindezeleka kwalesi sifo.

• I-degree ye-FERD eyi-1 ibhekwa njengento elula, ekhonjiswe ukulibaziseka ekuthuthukisweni kusuka kudatha yesilinganiso se- anthropometric yamaviki amabili.
• I-FERD yesibili-degree ihluke emahlakalweni avamile phakathi kwamasonto amabili kuya kwamane.
• Okubi kunazo zonke yizinga lesithathu le-FGR. Izinkomba zesayizi nesisindo somntwana esibelethweni asihlangabezani namazinga angaphezu kwamasonto amane. Ezimweni eziningi, imiphumela ye-3 degree ye-FERD ekukhusheni komzimba.

Izindlela zokwelapha

I-arsenal enkulu yezidakamizwa isetshenziselwa ukuphatha le syndrome ezinqenqemeni, ezihloswe ngokujwayelekile ukugeleza kwegazi kwe-uteroplacental.

1. Ama-tocolytic for relaxing the womb ("Ginipral", "Papaverin").
2. Amalungiselelo okumisa umzimba we-metabolism ngezicubu ("Kurantil", "Actovegin").
3. Ukwelashwa kwe-Infusion usebenzisa i-glucose nama-substitutes egazi.
4. Vitaminotherapy.

Zonke izidakamizwa zinqunywe isikhathi eside ngokuqapha okuqhubekayo kwe-fetus.

Ukugxila ikakhulu ekuphatheni i-FGRS ngesikhathi sokukhulelwa kunikezwa ukudla okunomsoco. Ukudla kumele kube nokulinganisela ngangokunokwenzeka. Akunconywa ukuthembela kwimikhiqizo ethile. Ungadla ngokuphelele konke. Ungabandakanyi inyama nemikhiqizo yobisi, ngoba iqukethe amaprotheni amaningi okuvela emfuyweni. Kukuphela kokuphela kokukhulelwa ukuthi isidingo sokuba ngu-50% sanda. Kubalulekile ukuthi ungakhohlwa ukuthi umgomo oyinhloko wokwelashwa akufanele ukondle ingane, kodwa ukunikeza ukukhula okugcwele nentuthuko ehambisanayo.

Abesifazane abakhulelwe bancoma futhi ukuhamba nsuku zonke, ukuzola ngokomzwelo. Ngokwesiko, kukholelwa ukuthi ukulala phakathi kwamasikati akuzuzisi nje kuphela esimweni sokubeletha esikhathini esizayo, kodwa nangomntwana ngaphakathi kwesibeletho.

Ukuqhuba ukukhulelwa eNWFP

Ngemuva kokuqinisekiswa kokutholwa kokugcina kwesifazane ozayo, ukuhlolwa okuqhubekayo yizintatheli kuyadingeka. I-Ultrasound inqunywe okungenani kabili ngenyanga. Ukutadisha okuningiliziwe kuyadingeka ukuze kubonakale ukukhubazeka kwengane kanye nokwehluleka kwesakhiwo, okungenzeka kube yimbangela yokubuyela emuva. Futhi, omama besikhathi esizayo banikezwa inqubo ye-amniocentesis ukuhlola okungavamile kwe-chromosomal uma i-ultrasound itholwe ukuthi ine-pathology.

Kungakhathaliseki ukuthi yiziphi izici ezithonya ukuvela kwe-FGR, imiphumela yengane ingahle ingenakwenzeka. Ukuze uzivimbele, owesifazane kufanele aqhube i-ultrasound njalo ngemva kwamasonto amabili. Kubalulekile ukuhlola ubukhulu be-fetus nesilinganiso sokukhula kwayo.

Lapho owesifazane evikini 37, odokotela ngokuvamile banquma ukugqugquzela ukubeletha. Kuze kube yileso sikhathi, ukuphathwa kokukhulelwa kuncike esimweni sezimvuthu ngaphakathi kwesibeletho. Uma owesifazane enezimpawu ze-pre-eclampsia, odokotela banquma ukuzalwa ngaphambi kwesikhathi.

Izinkinga ezingenzeka kanye nemiphumela

Izingane ezine-syndrome zivame ukurekhoda izinkinga ezinkulu hhayi kuphela ngesikhathi sokuphila kwangaphakathi, kodwa nangemva kokuzalwa. Izinga lentengo ngokuqondile lixhomeke ezimbangela zenqubo yokwelapha, ukuqina kwayo kanye nesikhathi sokuqala. Ngokwezibalo, ukutholakala kwezinkinga kungenzeka kakhulu kulabo bantwana abanesisindo sokubeletha asidluli 1 kg.

Ngenxa yokuthi i-oksijeni nezakhi ezitholayo zingenele ngokwanele emntwaneni onesi sifo, izingane ezinjalo zingase zizalwe zifile kakade. Ngokuvamile abakwazi ukulwa nomthwalo ngesikhathi sokuzalwa, ngakho odokotela ngokuvamile banquma isigaba sokugcina.

Ezinganeni ezizalwe nge-FGR, imiphumela yalesi sifo sitholakala ngokuqondile emsebenzini wezinhlelo eziyisisekelo zezitho zangaphakathi. Ngokuvamile bane-hypoglycemia, ukumelana kabi nezifo. Zijwayele i-jaundice ne-aspiration ye-meconium, okungukuthi, ukufaka isikhumba semifino yangempela.

Uma odokotela bexilonga i-second degree degree FVR, imiphumela ye-pathology ayinakwenzeka ukubikezela. Ikhwalithi yokuphila yengane ngokuyinhloko ixhomeke kwizimbangela ze-syndrome. Ezinye izingane zihamba kancane kancane nontanga yazo ekuthuthukisweni. Abanye banezinkinga ezinkulu zempilo. Basheshe baxilongwa ngokukhuluphala, okuholela ekuphazamiseni inhliziyo, isifo sikashukela kanye nomfutho wegazi ophakeme.

Izinyathelo zokuvimbela

Ungamnaki i-FERD. Kuyini, sesitshele kakade. Kungavinjelwa?

I-prophylaxis engcono kakhulu ye-FGRS yikuhlelwa kusengaphambili kokukhulelwa. Ngaphambi kokukhulelwa ngokushesha kwengane, abazali abazayo kumele badlule izivivinyo eziningi, baphathe izifo ezingapheli. Izifo ze-genital sphere kanye ne-caries akufanele zishiye ngaphandle kokunakwa.

Ukuvakashelwa njalo kumgogeni wezinzwa emva kokubhalisa ukukhulelwa kudlala indima ebalulekile ekuvimbeleni i-FGRS. Ngaphambili udokotela uthola i-pathology, ephakeme kakhulu amathuba okubamba izinkinga eziyingozi ekuthuthukiseni umntwana ngesikhathi nangemva kokuzalwa kwengane.

Owesifazane okhulelwe kufanele anakekele imodi yomsebenzi nokuphumula. Ukulala okuphelele kufanele kube okungenani amahora angu-10 ebusuku kanye namahora amabili ntambama. Uma ungakwazi ukulala ngemuva kokudla, ungakwazi ukulala phansi isikhashana endaweni esinqunyiwe. Ukulala kwansuku zonke kunomthelela ekwenzeni ukujikelezwa kwegazi phakathi komntwana nomama, ukuthuthukisa ukudluliselwa kwezakhi.

Ukuhamba emoyeni ovulekile, ukudla okulinganiselayo nomsebenzi wokuzivocavoca olinganiselayo - ukuvimbela okuhle kwe-NWFP. Kusho ukuthini lokhu? Owesifazane kufanele adle ukudla okunempilo okukhethekile, amavithamini acebile kanye nezici zokulandelela. Abanye odokotela batusa ukudla okuphezulu kuma-carbohydrate, njengoba lezi zinto zithuthukisa isimo sowesifazane okhulelwe kanye nempilo ye-fetus ngaphakathi kwesibeletho. Ngokuphathelene nokuzivocavoca, isisombululo esihle kakhulu yi-yoga, ukubhukuda echibini.

I-syndrome yokuthuthukiswa komntwana wesibindi akuyona isigwebo sabazali esizayo abalindele ngokulangazela ukubukeka kwengane. Indima enkulu ekunakekeleni lokhu kuphazamiseka kungokwesikhathi sokuxilongwa. Noma kunjalo, ukungathí sina kwalo akusizathu sokushiya ingane. Azikho izithiyo abazali abanothando abakwazi ukunqoba. Ikakhulukazi uma umbuzo ubhekane nenjabulo yangempela yomama.