I-Gastroschisis

I-Gastroschisis ukukhubazeka kokuzalwa lapho amathumbu engane engaphandle komzimba ngenxa yomgodi odongeni lwesisu.

Izingane ezine-gastroschisis zizalwa zinembobo odongeni lwesisu. Amathumbu engane avame ukuphuma (aphume) emgodini.

Isimo sibukeka sifana ne-omphalocele. I-omphalocele, noma kunjalo, ukukhubazeka kokuzalwa lapho amathumbu wosana noma ezinye izitho zesisu ziphuma ngembobo endaweni yenkinobho yesisu futhi zimbozwe ulwelwesi. Nge-gastroschisis, alukho ulwelwesi lokumboza.

Ukukhubazeka kodonga lwesisu kuyakhula njengoba ingane ikhula ngaphakathi kwesibeletho sikanina. Ngesikhathi sokukhula, amathumbu nezinye izitho (isibindi, isinye, isisu, nama-ovari, noma ama-testes) akhula ngaphandle komzimba ekuqaleni bese evame ukubuyela ngaphakathi. Ezinganeni ezine-gastroschisis, amathumbu (futhi kwesinye isikhathi isisu) ahlala ngaphandle kodonga lwesisu, ngaphandle kolwelwesi olubembozayo. Imbangela yangempela yamaphutha odonga esiswini ayaziwa.

Omama abanokulandelayo bangaba sengozini enkulu yokuba nezingane ezine-gastroschisis:

• Iminyaka emincane
• Izinsizakusebenza ezimbalwa
• Ukungondleki kahle ngesikhathi sokukhulelwa
• Sebenzisa ugwayi, i-cocaine, noma i-methamphetamines
• Ukuvezwa kweNitrosamine (ikhemikhali etholakala kokunye ukudla, izimonyo, osikilidi)
• Ukusetshenziswa kwe-aspirin, ibuprofen, i-acetaminophen
• Ukusetshenziswa kwama-decongestants ane-pseudoephedrine yamakhemikhali noma i-phenylpropanolamine

Izingane ezine-gastroschisis ngokuvamile azinazo ezinye izinkinga zokuzalwa ezihlobene.

I-gastroschisis ivame ukubonwa ngesikhathi se-ultrasound yangaphambi kokubeletha. Kungabonakala futhi lapho ingane izalwa. Kunembobo odongeni lwesisu. Amathumbu amancane avame ukuba ngaphandle kwesisu eduze kwenkaba. Ezinye izitho ezingabonakala futhi amathumbu amakhulu, isisu, noma i-gallbladder.

Imvamisa amathumbu acasulwa wukuchayeka ku-amniotic fluid.Ingane ingaba nezinkinga ekumungeni ukudla.

Ama-ultrasound angaphambi kokubeletha ngokuvamile akhomba izinsana ezine-gastroschisis ngaphambi kokuzalwa, imvamisa ngamaviki angama-20 okukhulelwa.

Uma i-gastroschisis itholakala ngaphambi kokuzalwa, umama uzodinga ukuqashwa okukhethekile ukuze aqiniseke ukuthi ingane yakhe engakazalwa ihlala iphilile.

Ukwelashwa kwe-gastroschisis kuhilela ukuhlinzwa. Imvamisa isisu somntwana esiswini sincane kakhulu ukuba amathumbu abuyele emuva lapho ezalwa. Ngakho-ke kuthungwa isaka lemeshi elizungeze imingcele yesici bese imiphetho yesici idonswa phezulu. Isaka libizwa ngesilo. Esontweni noma amabili ezayo, amathumbu abuyela emgodini wesisu bese isici singavalwa.

Izinga lokushisa lomntwana kumele lilawulwe ngokucophelela, ngoba ithumbu eliveziwe livumela ukushisa komzimba okuningi ukuba kuphume. Ngenxa yengcindezi ethintekayo ekubuyiseleni amathumbu esiswini, ingane ingadinga ukwesekwa ukuze iphefumule ngomshini wokuphefumula. Ezinye izindlela zokwelapha ingane zifaka izakhi zomzimba nge-IV kanye nemithi elwa namagciwane ukuvikela ukutheleleka. Ngisho nangemva kokukhubazeka kuvaliwe, umsoco we-IV uzoqhubeka njengoba ukondla ubisi kufanele kwethulwe kancane.

Ingane inethuba elihle lokululama uma zingekho ezinye izinkinga futhi uma umgudu wesisu ukhulu ngokwanele. Umgodi omncane kakhulu wesisu ungaholela ezinkingeni ezidinga ukuhlinzwa okuningi.

Kufanele kwenziwe izinhlelo zokulethwa ngokucophelela kanye nokuphathwa ngokushesha kwenkinga ngemuva kokuzalwa. Ingane kufanele ilethwe esikhungweni sezokwelapha esinamakhono okulungisa ukukhubazeka kodonga lwesisu. Izingane kungenzeka zenze kangcono uma zingadingi ukuhanjiswa kwesinye isikhungo ukuze zithole ukwelashwa okuqhubekayo.

Ngenxa yokuchayeka ku-amniotic fluid, amathumbu ezingane kungenzeka angasebenzi ngokujwayelekile ngisho nangemva kokuba izitho zibuyiselwe ngaphakathi emgodini wesisu. Izingane ezine-gastroschisis zidinga isikhathi sokuthi amathumbu azo alulame futhi ajwayele ukuthatha okuphakelayo.

Inani elincane lezinsana ezine-gastroschisis (cishe u-10-20%) lingaba ne-atresia yamathumbu (izingxenye zamathumbu ezingazange zikhule esizalweni). Lezi zingane zidinga ukuhlinzekwa okuqhubekayo ukukhulula ukuvinjelwa.

Ingcindezi eyandisiwe evela kokuqukethwe okungaphakathi kwesisu okungafakwanga kahle kunganciphisa ukugeleza kwegazi kuya emathunjini nasezinsweni. Kungenza futhi ukuthi kube nzima enganeni ukukhulisa amaphaphu, okuholele ezinkingeni zokuphefumula.

Enye inkinga engaba khona yi-necrosis yokufa kwamathumbu. Lokhu kwenzeka lapho izicubu zamathumbu zifa ngenxa yokuhamba kwegazi okuphansi noma ukutheleleka. Le ngozi ingancishiswa ezinganeni ezithola ubisi lwebele kunefomula.

Lesi simo siyabonakala lapho kuzalwa futhi sizobonakala esibhedlela ngesikhathi sokubeletha uma singakaze sibonakale esivivinyweni esijwayelekile se-fetus ultrasound ngesikhathi sokukhulelwa. Uma ubelethele ekhaya futhi ingane yakho ibonakala inale nkinga, shayela inombolo ephuthumayo yendawo (efana ne-911) ngaso leso sikhathi.

Le nkinga itholakala futhi yelashwe esibhedlela lapho izalwa. Ngemuva kokubuyela ekhaya, shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma ingane yakho iqala noma yiziphi zalezi zimpawu:

• Ukwehla kokuhamba kwamathumbu
• Izinkinga zokondla
• Imfiva
• Ukuhlanza okuluhlaza okotshani noma okuphuzi
• Indawo yesisu evuvukile
• Ukuhlanza (kwehlukile kunokukhafula kwengane okujwayelekile)
• Izinguquko zokuziphatha ezimbi

Ukukhubazeka kokuzalwa - i-gastroschisis; Isici sodonga lwesisu - usana; Isici sodonga lwesisu - esisanda kuzalwa; Isici sodonga lwesisu - usana olusanda kuzalwa

• I-hernia yesisu esiswini (i-gastroschisis)
• Ukulungiswa kwe-Gastroschisis - uchungechunge
• ISilo

I-Islam S. Ukukhubazeka kodonga lwesisu esiswini: i-gastroschisis ne-omphalocele. Ku: Holcomb GW, Murphy P, St. Peter SD, eds. Ukuhlinzwa Kwezingane zeHolcomb ne-Ashcraft. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2020: isahluko 48.

UWalther AE, uNathan JD. Amaphutha odonga esiswini olusanda kuzalwa. Ku: Wyllie R, Hyams JS, Kay M, eds. Izifo Zamathumbu Emathunjini Nesibindi. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2016: isahluko 58.