Izinkinga Zamehlo Nezindlebe Ezinganeni Ezingaphambi kwesikhathi

-Delile

• Yiziphi izinto ezinobungozi bokuzalwa ngaphambi kwesikhathi?
• Iziphi izinkinga zamehlo ezitholakala ezinganeni ezizalwe ngaphambi kwesikhathi?
• I-retinopathy ye-prematurity (ROP)
• I-Strabismus
• Ubumpumputhe
• Iziphi izinkinga zezindlebe ezitholakala ezinganeni ezizalwe ngaphambi kwesikhathi?
• Ukulahleka kokuzwa okuzelwe
• Ukungajwayelekile komzimba
• Zitholakala kanjani izinkinga zamehlo nezendlebe?
• Ukuhlolwa kombono
• Ukuhlolwa kokuzwa
• Zelashwa kanjani izinkinga zokubona nezamehlo?
• Zelashwa kanjani izinkinga zokuzwa nezendlebe?
• Uyini umbono wezingane ezinenkinga yamehlo nezindlebe?
• Iziphi izinsiza ezikhona ezinganeni ezinenkinga yamehlo nezindlebe?

Yiziphi izinkinga zamehlo nezendlebe ezingathinta izingane ezizalwe ngaphambi kwesikhathi?

Izingane ezizalwe ngaphambi kwesikhathi yizingane ezizalwa zinamasonto angama-37 noma ngaphambili. Njengoba ukukhulelwa okujwayelekile kuthatha cishe amasonto angama-40, izingane ezizalwe ngaphambi kwesikhathi zinesikhathi esincane sokukhula esibelethweni. Lokhu kubenza babe sethubeni lokuba nezinkinga zempilo nezinkinga zokuzalwa.

Ezinye zezinkinga zezempilo ezingathinta izingane ezingakazalwa zihlanganisa izinkinga zokubona nezokuzwa. Lokhu kungenxa yokuthi izigaba zokugcina zombono nokukhula kokuzwa zenzeka emasontweni ambalwa edlule wokukhulelwa. Ochwepheshe bathi ukuzalwa ngaphambi kwesikhathi kubhekene namaphesenti angama-35 ezimweni zokukhubazeka kombono namaphesenti angama-25 ezimweni zokukhubazeka kwengqondo noma kokuzwa.

Funda ukuze ufunde ngezinkinga zamehlo nezendlebe ezingathinta izingane ezizalwe ngaphambi kwesikhathi, futhi uthole ulwazi ngezindlela zokwelashwa ezifanele.

Yiziphi izinto ezinobungozi bokuzalwa ngaphambi kwesikhathi?

UMashi weDimes ulinganisela ukuthi cishe ingane eyodwa kwezingu-10 e-United States izalwa ngaphambi kwesikhathi unyaka nonyaka. Akwaziwa njalo ukuthi yini ebangela ukusebenza ngaphambi kwesikhathi nokuzalwa. Kodwa-ke, izici ezithile zobungozi zingaba nomthelela ekuzalweni ngaphambi kwesikhathi. Ezinye zalezi zinto ezinobungozi zibhalwe ngezansi.

Izici zobungozi ezingenakuguqulwa:

• Ubudala. Abesifazane abangaphansi kweminyaka engu-17 nangaphezulu kwengu-35 basemathubeni amaningi okuthi bazalwe ngaphambi kwesikhathi.
• Ubuhlanga. Izingane ezinomdabu wase-Afrika zizalwa ngaphambi kwesikhathi kakhulu kunezingane zezinye izinhlanga.

Izici zobungozi ezihlobene nokukhulelwa nempilo yokuzala:

• ukuzalwa kwangaphambi kwesikhathi ngaphambi kwesikhathi
• umlando womndeni wokuzalwa ngaphambi kwesikhathi
• ukukhulelwa izingane eziningi
• ukhulelwa kungakapheli izinyanga eziyi-18 uthole ingane yakho yokugcina
• ukukhulelwa ngemuva kwe-in vitro fertilization (IVF)
• izingqinamba ezedlule noma zamanje ngesibeletho sakho noma umlomo wesibeletho

Izici zobungozi ezihlobene nempilo ejwayelekile:

• ukuba nenkinga yokudla
• ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile
• izimo ezithile zezokwelapha, kubandakanya isifo sikashukela, i-thrombophilia, umfutho wegazi ophakeme kanye ne-preeclampsia

Izici zobungozi ezihlobene nendlela yokuphila:

• ukucindezeleka noma ukusebenza amahora amaningi
• ukubhema nentuthu kagwayi
• ukuphuza utshwala
• ukusetshenziswa kwezidakamizwa

Ezinye izinto ezinobungozi:

• Udlame lwasekhaya lwandisa ubungozi bezinkinga ngesikhathi sokukhulelwa. Uma ungazizwa uvikelekile ekhaya lakho noma kunengozi yokuthi othile ukushaye noma akulimaze, funa usizo ukuze uzivikele wena nengane yakho engakazalwa. Shayela Inombolo Kazwelonke Yodlame lwaseKhaya ku-800-799-7233 ukuthola usizo.

Iziphi izinkinga zamehlo ezitholakala ezinganeni ezizalwe ngaphambi kwesikhathi?

Amehlo akhula kakhulu ezinyangeni ezintathu ezedlule zokukhulelwa. Lokhu kusho ukuthi lapho umntwana ezalwa ngaphambi kwesikhathi, maningi amathuba okuthi abe nezinkinga zamehlo.

Izinkinga eziningi zamehlo zivela ekukhuleni okungavamile kwemithambo yegazi, okungaholela ekukhubazekeni kombono. Ngenkathi amehlo engabukeka ejwayelekile, ungaqaphela ukuthi ingane yakho ayiphenduli ezintweni noma ekushintsheni ekukhanyeni. Lokhu okungahambi kahle kungaba yizimpawu zenkinga yokubona noma ukukhubazeka kweso.

I-retinopathy ye-prematurity (ROP)

Isifo se-retinopathy se-prematurity (ROP) sivela lapho imithambo yegazi ikhula ngendlela engajwayelekile esweni. Ngokusho kweNational Eye Institute, i-ROP idlange kakhulu ezinganeni ezizalwe ngaphambi kwamasonto angama-31 noma ngesisindo sokuzalwa esiphansi kakhulu.

Ezigidini zezingane ezizalwe ngaphambi kwesikhathi ezizalwa e-United States unyaka nonyaka, iNational Eye Institute ithi izingane ezingaba ngu-28,000 zinesisindo esingamakhilogremu ama-2 3/4 noma ngaphansi. Phakathi kuka-14,000 no-16,000 bane-ROP, kepha iningi lezinsana linecala elincane. Ngonyaka, zingu-1,100 kuphela izinsana eziyi-1,500 kuphela ezithuthukisa i-ROP ezibucayi ngokwanele ukuqinisekisa ukwelashwa.

I-ROP kungenzeka ukuthi yenzeke ezinganeni ezizalwe ngaphambi kwesikhathi ngoba ukulethwa ngaphambi kwesikhathi kuphazamisa ukukhula okujwayelekile kwemithambo yegazi. Lokhu kubangela ukuthi kwakheke imikhumbi engajwayelekile ku-retina. Imithambo yegazi inikezela ukugeleza okuqhubekayo komoya-mpilo emehlweni ukuze kuthuthukiswe iso elifanele. Lapho umntwana ezalwa ngaphambi kwesikhathi, ukugeleza komoya-mpilo kuyashintsha.

Ngokuyinhloko, izingane eziningi ngaphambi kwesikhathi zidinga umoya-mpilo owengeziwe esibhedlela ngamaphaphu azo. Ukugeleza okushintshiwe komoya-mpilo kuphazamisa izinga labo le-oxygen ejwayelekile. Lokhu kuphazamiseka kungaholela ekwakhiweni kwe-ROP.

I-retina ingahle ilimale uma imithambo yegazi engajwayelekile iqala ukuvuvukala futhi ivuze igazi ngenxa yamazinga e-oxygen angafanele. Uma lokhu kwenzeka, i-retina ingasuka enhlamviniweni yamehlo, idale izinkinga zokubona. Kwezinye izimo, kungaholela ekungaboni.

Ezinye izinkinga ezingaba khona ze-ROP zifaka:

• amehlo awele (strabismus)
• ukubona eduze
• ukubona kude
• iso elvilaphayo (amblyopia)
• i-glaucoma

Izinkinga ezivela ku-ROP azivame ukwenzeka kuze kube kamuva ebuntwaneni nasebudaleni.

Ukuthi ingane yakho ihlolwe i-ROP kangaki kuya ngesimo se-retina. Imvamisa, izivivinyo zenziwa njalo ngesonto elilodwa kuya kwamabili kuze kube yilapho i-ROP iselapheka noma izinzile. Uma i-ROP isekhona, ingane yakho izohlolwa njalo emavikini amane kuya kwayisithupha ukuqinisekisa ukuthi i-ROP ayibi kubi noma ayidingi ukwelashwa.

Iningi lezinsana lizodinga ukuhlolwa okwesikhashana, noma ngabe isimo singesincane. Labo abane-ROP enzima bangadinga ukuthola izivivinyo lapho sebekhulile.

Zonke izingane ezizalwe ngaphambi kwesikhathi zizothola ukuhlolwa nokuqapha okujwayelekile kwe-ROP kusukela ennyangeni eyodwa kuya phambili. Uma kukhona ukukhathazeka, amehlo azobhekwa masonto onke. Ukwelashwa kuncike enganeni nasekuqineni kwe-ROP. Ungaxoxa ngezinketho nodokotela wengane yakho ukuzama ukuvimbela ukuqhubeka okuqhubekayo.

I-Strabismus

I-Strabismus (amehlo awele) yisimo samehlo esivamile ezinganeni ezingaphansi kweminyaka engu-5 ubudala. Kubanga ukungahambi kahle kwamehlo noma zombili zamehlo. Kungaholela ezinkingeni zokubukwa unomphela uma kungatholakali futhi kwelashwe kusenesikhathi.

Kunezici eziningana zobungozi be-strabismus, kufaka phakathi i-ROP. Ucwaningo lwango-2014 luthole ukuthi isisindo esiphansi sokuzalwa sandisa kakhulu ingozi yokuba usana lukhule lube ne-strabismus kamuva empilweni: Izinsana ezizalwe zinesisindo esingaphansi kuka-2 000 amagremu, okulingana namakhilogremu angu-4.41, zinamathuba angamaphesenti angama-61 okuba ne-strabismus.

I-Strabismus ingabangelwa lapho izinzwa ze-cranial ezibangela ukunyakaza kwamehlo zibuthaka, noma kunenkinga ngemisipha yamehlo. Izinhlobo ezahlukene ze-strabismus zinezimpawu ezihlukile:

• I-strabismus evundlile. Kulolu hlobo, iso elilodwa noma womabili aphendukela ngaphakathi. Kungabizwa ngokuthi "ubheke ngamehlo." I-strabismus evundlile nayo ingadala iso noma amehlo aphumele ngaphandle. Kulokhu, kungabizwa ngokuthi "unamehlo obonda."
• I-strabismus eqondile. Kulolu hlobo, iso elilodwa liphakeme noma liphansi kunehlo elime kahle.

Ubumpumputhe

Ukungaboni kungenye inkinga engenzeka ehlotshaniswa nokuzalwa ngaphambi kwesikhathi. Ukuhlukaniswa kwe-retinal okuhambisana ne-ROP kwesinye isikhathi kudala lokhu. Uma iqembu lingatholakali, lingaholela ekungaboni.

Amanye amacala obumpumputhe ezinganeni ezizalwe ngaphambi kwesikhathi ahlukile ku-ROP. Ezinye izingane zizalwa zingenazo izingxenye ezithile zeso, ezifana nenhlamvu yeso noma iris, okuholela ekulahlekelweni kombono. Lezi zimo zivame kakhulu futhi azivamile kakhulu ezinganeni ezizalwe ngaphambi kwesikhathi.

Iziphi izinkinga zezindlebe ezitholakala ezinganeni ezizalwe ngaphambi kwesikhathi?

Izinkinga zezindlebe nazo zingavela ezinganeni ezizalwe ngaphambi kwesikhathi. Ezinye izingane zingaba nokukhubazeka kokuzwa nokubona. Abanye bangaba nezinkinga zokuzwa ngaphandle kwezinkinga zokubona. Ukukhubazeka kwezindlebe kungaphazamisa nezingane ezizalwe ngaphambi kwesikhathi.

Ukuzwa ukulahlekelwa nobunzima bokuzwa kungezinye zezinto ezivame ukukhathazeka.

Ukulahleka kokuzwa okuzelwe

Ukulahlekelwa kokuzwa okuzalwa kusho izinkinga zokuzwa ezikhona lapho kuzalwa. Lezi zinkinga zingathinta indlebe eyodwa noma zombili izindlebe, okuholele ekubeni isithulu ngokwengxenye noma okuphelele.

Ukulahlekelwa ukuzwa ezinganeni kuvame ukubangelwa ukukhubazeka kofuzo. Kodwa-ke, ingozi yokukhubazeka kokuzwa inkulu ezinganeni ezizalwe ngaphambi kwesikhathi. Lokhu kuyiqiniso ikakhulukazi uma umama enesifo ngesikhathi sokukhulelwa, njenge:

• i-herpes, kufaka phakathi uhlobo olubizwa nge-cytomegalovirus (CMV)
• ugcunsula
• Isimungumungwane saseJalimane (rubella)
• i-toxoplasmosis, ukutheleleka okuyisidlakudla

Imibiko yokulahleka kokuzwa kuthinta phakathi kwezingane ezisengozini enkulu. Izingane ezizalwe ngaphambi kwesikhathi zibhekwa njengengozi enkulu.

Ukungajwayelekile komzimba

Ukungajwayelekile komzimba kwezindlebe akuvamile njengokulahlekelwa kwezindlebe ezinganeni ezizalwe ngaphambi kwesikhathi, kodwa kungenzeka. Lokhu kungavela enkingeni yezempilo eyisisekelo. Imvamisa, ukuvezwa kwemithi ngesikhathi sokukhulelwa kungaholela ekuphazamisekeni kwezindlebe ezinganeni ezingakazalwa ngaphambi kwesikhathi.

Okungajwayelekile kwendlebe okungathinta izingane kufaka:

• ukudangala okungajulile okuzungeze indlebe
• amathegi esikhumba, angavela ezingxenyeni ezingaphakathi nezangaphandle zendlebe
• ukukhubazeka kwendlebe, okuvame ukubangelwa izingqinamba ze-chromosomal

Zitholakala kanjani izinkinga zamehlo nezendlebe?

Zonke izingane ezisanda kuzalwa ezibelethelwa ezibhedlela noma ezikhungweni zokubelethisa zihlolwe izinkinga zombono nezokuzwa ngesikhathi sokuzalwa.Kodwa-ke, izingane ezingakashayi isikhathi zingase zihlolwe ngokuqhubekayo ukuthola izinkinga ezingaba khona.

Ukuhlolwa kombono

Udokotela wezifo zamehlo uzohlola umbono wengane yakho futhi enze izivivinyo ukuhlola izimpawu ze-ROP. Lo ngudokotela wamehlo ogxile ekwelapheni nasekuhloleni izinkinga zamehlo.

Ngesikhathi sokuhlolwa kwe-ROP, amaconsi afakwa emehlweni engane ukuze awanwebe. Udokotela uzobe esefaka i-ophthalmoscope ekhanda labo ukuze bakwazi ukuhlola ama-retina engane.

Kwezinye izimo, udokotela angacindezela iso ngethuluzi elincane noma athathe izithombe zeso. Lokhu kuhlolwa kuzophindwa njalo ukuqapha nokuhlola i-ROP.

Udokotela wamehlo wengane yakho futhi angahlola ukuma kwamehlo ukubheka izimpawu ze-strabismus.

Ukuhlolwa kokuzwa

Uma ingane yakho ingaphumeleli ukuhlolwa kwayo kokuzwa, isazi sokuzwa singase sizihlole. Izazi zezilaleli zigxile ekuhloleni nasekwelapheni izinkinga zokuzwa. Bangakwazi ukwenza olunye uvivinyo ukuthola izinkinga zokuzwa.

Ukuhlolwa kokuzwa okungenziwa kufaka phakathi:

• Ukuhlolwa kwe-Otoacoustic emissions (OAE). Lokhu kuhlolwa kukala ukuthi indlebe yangaphakathi iphendula kahle kangakanani emisindweni.
• Ukuhlolwa kwe-Brainstem auditory evoked response (BAER). Lokhu kuhlolwa kukala ukusabela kwezinzwa zokuzwa kusetshenziswa ikhompyutha nama-electrode. Ama-electrode ayizigaxa ezinamathelayo. Udokotela uzonamathisela okunye emzimbeni wengane yakho. Bazobe sebedlala imisindo bese beqopha ukusabela kwengane yakho. Lokhu kuhlolwa kwaziwa nangokuthi ukuhlolwa okuzenzakalelayo kokuhlolwa kwe-brainstem response (AABR).

Zelashwa kanjani izinkinga zokubona nezamehlo?

Iningi lezingane ezine-ROP azidingi ukwelashwa. Uma kudingeka ukwelashwa, odokotela bengane yakho bazothatha isinqumo mayelana nokwelashwa okungcono komuntu ngamunye kwengane yakho. Ungalandela nodokotela wamehlo ngemuva kokuthi ingane yakho ifike ekhaya.

Izinqubo ezilandelayo zingaphatha amacala abucayi kakhulu we-ROP:

• I-Cryosurgery kuhilela ukuqandisa nokubhubhisa imithambo yegazi engajwayelekile ku-retina.
• Ukwelashwa nge-Laser isebenzisa imishayo yokukhanya enamandla ukushisa nokuqeda imithambo yegazi engajwayelekile.
• I-Vitrectomy isusa izicubu ezibomvu esweni.
• Ukugoqa kwesikrini siqukethe ukubeka band nezimo ezungeze iso ukuvimbela ithimba retinal.
• Ukuhlinzwa ingalungisa iqembu eliphelele le-retinal.

Udokotela wengane yakho angalapha iso elilahlekile esebenzisa izimila ezihlinzekwayo lapho ingane yakho ikhula.

Ukwelashwa kwe-strabismus kuncike ebucayi besimo. Udokotela wengane yakho futhi angasebenzisa inhlanganisela yokwelashwa ukufeza imiphumela emihle kakhulu. Ukwelashwa okungasetshenziselwa i-strabismus kufaka:

• izibuko, noma ngaphandle kwama-prism okusiza ukukhanyisa ukukhanya
• isichibi seso okufanele sibekwe ngaphezu kweso elilodwa
• izivivinyo zamehlo ukuqinisa imisipha yamehlo
• ukuhlinzwa, okugcinelwe izimo ezinzima noma izimo ezingalungiswa nezinye izindlela zokwelapha

Zelashwa kanjani izinkinga zokuzwa nezendlebe?

Ukufakwa kwe-cochlear endlebeni kungenziwa ekulahlekelweni kokuzwa. Ukufakwa kwe-cochlear kuyinto encane esebenza ngogesi eyenza umsebenzi wezingxenye ezilimele zendlebe. Kuyasiza ukubuyisela ukuzwa ngokunikeza amasiginali womsindo ebuchosheni.

Ukufakwa kwe-Cochlear akuzona zonke izinhlobo zokulahlekelwa kokuzwa. Khuluma nodokotela wengane yakho ukuze ubone ukuthi ukufakelwa kwe-cochlear kulungile yini kubo.

Udokotela wengane yakho angancoma futhi:

• izinsiza-kuzwa
• ukwelashwa kokukhuluma
• ukufundwa kwezindebe
• Ulwimi lwezandla

Ukuhlinzwa kuvame ukwenziwa ukulungisa izinkinga ngokwakhiwa kwendlebe.

Uyini umbono wezingane ezinenkinga yamehlo nezindlebe?

Zonke izingane zidlula ochungechungeni lwezivivinyo zokuhlola ngokushesha ngemuva kokuzalwa, noma ngabe zizalwe kusenesikhathi noma sekwephuze kangakanani. Kodwa-ke, lezi zivivinyo zibaluleke kakhulu ezinganeni ezizalwe ngaphambi kwesikhathi, ngoba kungenzeka ukuthi zibhekane nezinkinga. Udokotela angakwazi ukuthola izinkinga khona manjalo futhi anikeze izincomo ezithile zokunakekelwa kwesikhashana nesikhathi eside.

Ubungozi bezinkinga zamehlo nezindlebe buhluka kakhulu ezinganeni ezizalwe ngaphambi kwesikhathi. Lapho umntwana ezalwa ngaphambi kwesikhathi, maningi amathuba okuthi babe nalezi zinkinga. Ukutholwa kwangaphambi kwesikhathi kubalulekile, ikakhulukazi ngoba ezinye izingqinamba zingaba zimbi ngokuhamba kwesikhathi. Ngenkathi amazinga okuphumelela ekwelashweni angahluka, ukungenelela kusenesikhathi kungaxazulula izinkinga eziningi zamehlo nezendlebe.

Kunoma yimuphi umntwana ozalwe ngaphambi kwesikhathi, kuzoba nokuvakashelwa okwengeziwe kudokotela wabo wezingane ukuqinisekisa ukuthi bakhula ngokujwayelekile. Ingane engakashayi isikhathi idinga ukunakekelwa okwengeziwe phakathi namasonto ayo okuqala nezinyanga zokuphila, noma ngaphandle kombono noma izinkinga zokuzwa.

Uma ingane yakho inesimo sokubona, khona-ke uzoba nokuvakashelwa njalo nodokotela wezifo zamehlo. Ukwelashwa kwezimo zokuzwa kuzobandakanya ukuvakashelwa njalo nodokotela wezwi.

Kubalulekile ukuthi uhambise ingane yakho kuzo zonke izikhathi ezihleliwe. Lokhu kuhlolwa kuzosiza udokotela wezingane ukuba abambe noma yiziphi izingqinamba kusenesikhathi futhi kuqinisekiswe ukuthi ingane yakho ithola ukunakekelwa okungcono kakhulu ukuze iqale kahle.

Iziphi izinsiza ezikhona ezinganeni ezinenkinga yamehlo nezindlebe?

Odokotela, abahlengikazi, kanye nabasebenzi bakhona ukukusiza. Zizwe ukhululekile ukubuza imibuzo eminingi ngokunakekelwa nempilo yengane yakho engakazalwa.

Kukhona namaqembu amaningi osizo angasiza ukuphendula imibuzo futhi akukhumbuze ukuthi wena nengane yakho aninodwa. Ungathola futhi imininingwane ngamaqembu osizo endaweni yangakini, phakathi kokunye, kusuka kusisebenzi senhlalakahle se-NICU.