Ukulimala kwe-plexus ye-Brachial ezinganeni ezisanda kuzalwa

I-plexus ye-brachial yiqembu lezinzwa ezizungeze ihlombe. Ukulahleka kokuhamba noma ubuthakathaka bengalo kungenzeka uma lezi zinzwa zilimele. Lokhu kulimala kubizwa nge-neonatal brachial plexus palsy (NBPP).

Izinzwa ze-brachial plexus zingathinteka ngokucindezela ngaphakathi kwesibeletho somama noma ngesikhathi sokubeletha okunzima. Ukulimala kungabangelwa:

• Ikhanda nentamo yosana kudonsela eceleni njengoba amahlombe edlula emseleni wokuzalwa
• Ukwelulwa kwamahlombe wosana ngesikhathi sokulethwa kwekhanda lokuqala
• Ingcindezi ezingalweni eziphakanyisiwe zengane ngesikhathi sokubeletha (izinyawo kuqala)

Kunezinhlobo ezahlukahlukene ze-NBPP. Uhlobo luxhomeke enanini lokukhubazeka kwengalo:

• I-brachial plexus palsy ivame ukuthinta kuphela ingalo ephezulu. Kubizwa nangokuthi iDuchenne-Erb noma i-Erb-Duchenne ukukhubazeka.
• Ukukhubazeka kweKlumpke kuthinta ingalo nesandla esingezansi. Lokhu akuvamile kakhulu.

Izici ezilandelayo zandisa ubungozi be-NBPP:

• Ukulethwa kweBreech
• Ukukhuluphala komama
• Usana olusanda kuzalwa olukhudlwana kunesilinganiso (njengengane yomama onesifo sikashukela)
• Kunzima ukuletha ihlombe lengane ngemuva kokuphuma kwekhanda (elibizwa nge-shoulder dystocia)

I-NBPP ayivamile kakhulu kunangesikhathi esedlule. Ukulethwa kwe-cearean kusetshenziswa kaningi lapho kunokukhathazeka ngokulethwa okunzima. Yize isigaba se-C sinciphisa ubungozi bokulimala, asisivimbi. Isigaba se-C sinezinye izingozi.

I-NBPP ingahle ididaniswe nesimo okuthiwa i-pseudoparalysis. Lokhu kubonakala lapho usana luphuke futhi lungahambisi ingalo ngenxa yobuhlungu, kepha akukho monakalo owenzakalayo.

Izimpawu zingabonakala ngokushesha noma ngemuva nje kokuzalwa. Zingafaka:

• Akukho ukunyakaza engalweni noma esandleni sengane esanda kuzalwa
• I-Reflex Moro engekho ohlangothini oluthintekile
• Ingalo yeluliwe (iqonde) endololwaneni futhi ibanjwe ngokumelene nomzimba
• Ukwehla kokubamba ohlangothini oluthintekile (kuya ngesiza sokulimala)

Ukuhlolwa komzimba kuvame ukukhombisa ukuthi usana aluhambisi ingalo noma isandla esingaphezulu noma esingezansi. Ingalo ethintekile ingabhakuza lapho usana ligoqwa lisuka ngapha nangapha.

I-Moro reflex ayikho ohlangothini lokulimala.

Umhlinzeki wezokunakekelwa kwempilo uzohlola i-collarbone ukufuna ukuphuka. Usana lungadinga ukuthi kuthathwe i-x-ray yokhololo.

Ezimweni ezimnene, umhlinzeki uzophakamisa:

• Ukubhucungwa ingalo ngobumnene
• Ukuzivocavoca kwebanga lokunyakaza

Usana lungadinga ukubonwa ngochwepheshe uma umonakalo omkhulu noma isimo singathuthuki emasontweni ambalwa okuqala.

Ukuhlinzwa kungacatshangelwa uma amandla engathuthuki ngezinyanga ezintathu kuya kwezi-9 ubudala.

Iningi lezingane lizolulama ngokugcwele zingakapheli izinyanga ezintathu kuya kwezi-4. Labo abangalulami ngalesi sikhathi banombono omubi. Kulezi zimo, kungahle kube nokuhlukaniswa kwempande yezinzwa nomgogodla (ukuvuswa).

Akucaci noma ukuhlinzwa ukulungisa inkinga yezinzwa kungasiza. Ukuhlinzwa kungabandakanya ukufakwa kwezinzwa noma ukudluliswa kwemizwa. Kungathatha iminyaka eminingi ukwelashwa ukwenzeka.

Ezimweni ze-pseudoparalysis, ingane izoqala ukusebenzisa ingalo ethintekile lapho kuphuka ukwaphuka. Ukuqhekeka kwezinsana kuphulukisa ngokushesha futhi kalula ezimweni eziningi.

Izinkinga zifaka:

• Ukuphambana kwemisipha okungavamile (izinkontileka) noma ukuqina kwemisipha. Lokhu kungaba unomphela.
• Ukulahlekelwa unomphela, okuyingxenye, noma okuphelele kokusebenza kwezinzwa ezithintekile, okudala ukukhubazeka kwengalo noma ubuthakathaka bengalo.

Shayela umhlinzeki wakho uma ingane yakho esanda kuzalwa ikhombisa ukunganyakazi kwengalo.

Kunzima ukuvimbela i-NBPP. Ukuthatha izinyathelo zokugwema ukulethwa okunzima, lapho kungenzeka khona, kunciphisa ubungozi.

Klumpke ukukhubazeka; Ukukhubazeka kwe-Erb-Duchenne; Ukukhubazeka kuka-Erb; Ukukhubazeka kweBrachial; I-plexopathy ye-Brachial; Ukukhubazeka kwe-brachial plexus palsy; Ukukhubazeka kwe-brachial plexus palsy okuhlobene nokuzalwa; I-Neonatal brachial plexus palsy; I-NBPP

Isifinyezo sokuphatha: i-neonatal brachial plexus palsy. Umbiko we-American College of Obstetricians and Gynecologists ’Task Force on pernus palsus palsus. Isikhubekiso seGynecol. 2014; 123 (4): 902-904. I-PMID: 24785634 pubmed.ncbi.nlm.nih.gov/24785634/.

IPaki TS, iRanalli NJ. Ukulimala kwe-brachial plexus. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans neWinn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 228.

I-Prazad PA, i-Rajpal MN, iMangurten HH, iPuppala BL. Ukulimala kokuzalwa. Ku: RJ, Fanaroff AA, Walsh MC, ama-eds. UFanaroff kanye neMithi kaMartin's Neonatal-Perinatal Medicine. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 29.