I-Hydrops Fetalis: Izimbangela, i-Outlook, Ukwelashwa, nokuningi

-Delile

• Yini ama-hydrops fetalis?
• Izinhlobo zama-hydrops fetalis
• Ama-hydrops angenawo ama-immune fetalis
• Ama-immune hydrops fetalis
• Ziyini izimpawu ze-hydrops fetalis?
• Ukuhlonza ama-hydrops fetalis
• Uphathwa kanjani ama-hydrops fetalis?
• Uyini umbono we-hydrops fetalis?

Yini ama-hydrops fetalis?

IHydrops fetalis yisimo esibi, esisongela impilo lapho umbungu noma usana olusanda kuzalwa lunoketshezi olungajwayelekile kuzicubu ezizungeze amaphaphu, inhliziyo, noma isisu, noma ngaphansi kwesikhumba. Ngokuvamile kuyinkinga yesinye isimo sezokwelapha esithinta indlela umzimba olawula ngayo uketshezi.

Ama-Hydrops fetalis avela kuphela koku-1 kokunye kokuzalwa okungu-1 000. Uma ukhulelwe futhi ingane yakho ine-hydrops fetalis, udokotela wakho angafuna ukwenza ukubeletha kokuqala kanye nokulethwa kwengane. Ingane ezalwe ne-hydrops fetalis ingadinga ukumpontshelwa igazi nezinye izindlela zokwelapha ukususa uketshezi olweqile.

Ngisho nangokwelashwa, ngaphezu kwengxenye yezingane ezine-hydrops fetalis zizofa ngaphambi nje noma ngemuva kokubeletha.

Izinhlobo zama-hydrops fetalis

Kunezinhlobo ezimbili zama-hydrops fetalis: immune kanye non-immune. Uhlobo luxhomeke embangela yalesi simo.

Ama-hydrops angenawo ama-immune fetalis

Ama-non-immune hydrops fetalis manje uhlobo oluvame kakhulu lwe-hydrops fetalis. Kwenzeka lapho esinye isimo noma isifo siphazamisa amandla engane okulawula uketshezi. Izibonelo zezimo ezingaphazamisa ukuphathwa koketshezi kwengane zifaka:

• ama-anemias anzima, kufaka phakathi i-thalassemia
• ukuphuma kombungu (ukopha)
• ukukhubazeka kwenhliziyo noma kwamaphaphu enganeni
• ukuphazamiseka kofuzo kanye nokwakheka komzimba, kufaka phakathi i-Turner syndrome kanye nesifo sikaGaucher
• ukutheleleka ngegciwane kanye namagciwane, njengesifo se-Chagas, i-parvovirus B19, i-cytomegalovirus (CMV), i-toxoplasmosis, i-syphilis ne-herpes
• ukungasebenzi kahle kwemithambo yegazi
• izimila

Kwezinye izimo, imbangela ye-hydrops fetalis ayaziwa.

Ama-immune hydrops fetalis

Ama-immune hydrops fetalis ngokuvamile avela lapho izinhlobo zegazi zikamama nombungu zingahambelani. Lokhu kwaziwa ngokuthi ukungahambelani kwe-Rh. Amasosha omzimba omama angabe esehlasela futhi abhubhise amangqamuzana egazi abomvu engane. Izimo ezinzima zokungahambisani kwe-Rh zingaholela kuma-hydrops fetalis.

Ama-immune hydrops fetalis ajwayelekile kakhulu namuhla selokhu kwasungulwa umuthi owaziwa nge-Rh immunoglobulin (RhoGAM). Lo muthi unikezwa abesifazane abakhulelwe abasengozini yokungahambelani kwe-Rh ukuvimbela izinkinga.

Ziyini izimpawu ze-hydrops fetalis?

Abesifazane abakhulelwe bangathola lezi zimpawu ezilandelayo uma i-fetus ine-hydrops fetalis:

• okweqile kwe-amniotic fluid (polyhydramnios)
• I-placenta ejiyile noma enkulu ngokungajwayelekile

I-fetus ingahle ibe nesipele esandisiwe, inhliziyo, noma isibindi, kanye noketshezi oluzungeze inhliziyo noma amaphaphu, olubonakalayo ngesikhathi se-ultrasound.

Ingane ezalwe ine-hydrops fetalis ingaba nalezi zimpawu ezilandelayo:

• isikhumba esiphaphathekile
• ukulinyazwa
• ukuvuvukala okukhulu (i-edema), ikakhulukazi esiswini
• isibindi esikhulisiwe nobende
• ukuphefumula kanzima
• i-jaundice enamandla

Ukuhlonza ama-hydrops fetalis

Ukuxilongwa kwama-hydrops fetalis kuvame ukwenziwa ngesikhathi se-ultrasound. Udokotela angahle aqaphele ama-hydrops fetalis ku-ultrasound ngesikhathi sokuhlolwa kokukhulelwa okujwayelekile. I-ultrasound isebenzisa amaza omsindo wemvamisa ephezulu ukusiza ukuthwebula izithombe ezibukhoma zengaphakathi lomzimba. Unganikezwa futhi i-ultrasound ngesikhathi sokukhulelwa uma ubona ukuthi ingane ihamba kaningi noma uhlangabezana nezinye izinkinga zokukhulelwa, ezifana nomfutho wegazi ophezulu.

Ezinye izivivinyo zokuxilonga zingenziwa ukusiza ukuthola ubunzima noma imbangela yalesi simo. Lokhu kufaka phakathi:

• isampuli yegazi lombungu
• i-amniocentesis, okuwukukhishwa kwe-amniotic fluid ukuze iqhubeke nokuhlolwa
• i-fetal echocardiography, ebheka ukukhubazeka kwesakhiwo senhliziyo

Uphathwa kanjani ama-hydrops fetalis?

Ama-Hydrops fetalis ngokuvamile awakwazi ukwelashwa ngesikhathi sokukhulelwa. Kwesinye isikhathi, udokotela anganikeza ingane ukumpontshelwa igazi (intrauterine fetal blood transfusion) ukusiza ukwandisa amathuba okuthi ingane iphile ize izalwe.

Ezimweni eziningi, udokotela kuzodingeka akhuthaze ukulethwa kwengane kusenesikhathi ukuze anikeze ingane ithuba elihle kakhulu lokusinda. Lokhu kungenziwa ngemithi edala ukubeletha ngaphambi kwesikhathi noma ngengxenye ephuthumayo ye-Cesarean (C-section). Udokotela wakho uzoxoxa nawe ngalezi zinketho.

Lapho nje ingane izelwe, ukwelashwa kungabandakanya:

• usebenzisa inaliti ukususa uketshezi oluningi esikhaleni esizungeze amaphaphu, inhliziyo, noma isisu (thoracentesis)
• ukusekelwa kokuphefumula, njengomshini wokuphefumula (umshini wokuphefumula)
• imithi yokulawula ukwehluleka kwenhliziyo
• imithi yokusiza izinso zisuse uketshezi oluningi

Kuma-immune hydrops, ingane ingathola ukumpontshelwa ngqo kwamangqamuzana abomvu egazi afana nohlobo lwegazi layo. Uma i-hydrops fetalis ibangelwe esinye isimo esingaphansi, ingane nayo izokwelashwa ngaleso simo. Isibonelo, ama-antibiotic asetshenziselwa ukwelapha ukutheleleka kukagcunsula.

Abesifazane abanezingane ezine-hydrops fetalis basengozini yesinye isimo esaziwa nge-mirror syndrome. I-Mirror syndrome ingabangela umfutho wegazi ophezulu osongela impilo (ukucindezela kwegazi okuphezulu) noma ukuquleka. Uma uba ne-mirror syndrome, kuzofanele ubelethe ingane yakho ngokushesha.

Uyini umbono we-hydrops fetalis?

Umbono we-hydrops fetalis uncike esimweni esingaphansi, kepha noma ngabe kwelashwa, izinga lokusinda kwengane liphansi. Cishe amaphesenti angama-20 kuphela ezingane ezitholwe zine-hydrops fetalis ngaphambi kokuzalwa ezizosinda ziye ekubelethweni, futhi kulezo zingane, isigamu kuphela esisinda ngemuva kokubeletha. Ingozi yokufa iphezulu kakhulu ezinganeni ezitholwa zisencane kakhulu (ngaphansi kwamasonto angama-24 zikhulelwe) noma ezinokukhubazeka okuhlelekile, njengokukhubazeka kwenhliziyo okuhlelekile.

Izingane ezizalwe ngama-hydrops fetalis nazo zingaba namaphaphu angathuthuki futhi zibe sengcupheni enkulu yoku:

• ukuhluleka kwenhliziyo
• ukulimala kwengqondo
• hypoglycemia
• isithuthwane