Besivele sikhulumile maqondana nalolo cwaningo olushicilelwe ku-JAMA Pediatrics eleluleka ngokubambezeleka kokucijwa kwenkaba imizuzu embalwa ngemuva kokubeletha, kodwa ngicabanga ukuthi yisikhathi esihle sokuchaza ngokuningiliziwe izinzuzo ezitholakalayo. Lowo mbiko uqinisekise ukuthi isenzo esilula njengokulibazisa umzuzu wokushaya nokushaya, kungavimbela ukuntuleka kwensimbi ebuntwaneni bengane. Umsebenzi wangaphambilini waveza ukuthi yimizuzu emibili kuphela ethinta ukukhula kwengane ezinsukwini ezilandela ukuzalwa.
Uyini umbambo? UMaría José uchaze kahle kulokhu okuthunyelwe imisebenzi enayo, isitho esibaluleke kakhulu njengoba sinikeza ukondla embungwini ovela ku-placenta. Iyondla futhi inikeze i-oxygen, futhi iqhubeke nokuletha i-oxygen enganeni lapho amaphaphu ayo engasebenzi noma esebenza njengomhlinzeki. Kuyindaba yemizuzu, kepha uma uqinisa lungabophekile lapho, intambo iyaqhubeka nokusebenza njengesixhumanisi. Kungani ugcizelela kangaka? Kubaluleke kangakanani ukulinda ukusika inkaba?
Yebo lokho kubalulekile, kepha ngizoqhubeka: uma sikuvumela ukuthi iwele ngaphandle kokuqina, kungadingeka ulinde imizuzu emithathu kuphela, Yize kunezikhathi lapho inqubo ithatha isikhashana (kufika kumizuzu engama-20) akusilo iphakade futhi. Isizwa yi-placenta, ayenzi lutho olunye ngaphandle kokwenza omunye wemisebenzi yayo ebalulekile, futhi isebenze njengokuhloswe yiNdalo; Uma intambo isaphethe umoya-mpilo, ingane izoba nemithombo emibili yokuphakela. Kukholakala ukuthi ukufakwa kusenesikhathi kungaphazamisa lezi zinhlelo zokusekela impilo, okuholele ekulimaleni.
Intambo yombilical: ngemuva kokubeletha, yilinde iyeke ukushaya.
Umkhuba wokuvumela yonke into ithathe inkambo yayo yemvelo kuvimbela i-anoxia ye-cerebral, futhi iqhaza layo enhlalakahleni yezingane ezizalwe zinokucindezeleka okukhulu kwe-fetus akufanele kubhekwe phansi. Ngokwalolu lwazi olushicilelwe kuwebhusayithi ye-EPEN, I-WHO ifaka ukubambezeleka sekwephuzile noma ukungabambeki. Akukho mkhawulo wesikhathi, imizuzu emi-2? zingahle noma zanele; intambo kufanele iyeke ukushaya yodwa, futhi ngokufanele ochwepheshe abaya lapho kuhanjiswa khona nabo kufanele balinde ukulethwa kweplasenta.
Intambo engasayifezi imisebenzi yayo imhlophe, iyawushiya umsebenzi wayo lapho ingasadingeki. Sekunamazwi amaningi acela ukuthi iMvelo ivunyelwe ukuthatha inkambo yayo, kukhona uchungechunge lwemikhuba okungafanele lube njalo, kepha lube yingxenye yenqubo: ukungahlukaniswa kukamama nengane, ukuncelisa ibele, ukusika intambo sekwephuzile ... Ezimweni eziningi zalezi zinqubo zomzimba kungcono ukungangeneleli, kepha ochwepheshe kumele futhi bazilungiselele izinto ezingaba khona. Esihlokweni esasiseduze, inkolelo yokuthi kwakudingeka ukuba kucindezelwe kusenesikhathi ukuvimbela ukopha kumama yanqoba ngelinye ilanga, futhi yayihlobene nokubonakala kwe-jaundice yezinsana; ngendlela, ubungozi be-jaundice abuhlukile kuye ngokuthi senzani ngentambo yenkaba.
Kuthiwani uma kungabambeki? Futhi ibhajwe sekwephuze kakhulu?
Ukubuyekezwa kwezilingo zomtholampilo ezilawulwa ngokungahleliwe kubonakala sengathi kuphetha ngokuthi i-polycythemia yezimpawu ayinakuhlotshaniswa nokusikwa kwentambo sekwephuzile. Kuyisifo esidalwa ukwanda kwamaseli abomvu egazini, okuvimbela nokujikeleza kwegazi, futhi kungathinta izitho.
Nayi ingcaphuno evela kokuthunyelwe okucashuniwe okuvela ku-EPEN:
Kusekuchazwe icala elilodwa kuphela lapho kungaba khona ingozi yokuthi ingane ithole igazi eliningi kunalokho okufanele ikuthole: lapho idiliva amanzi, uma amanzi engaphezulu kwamadigri angama-37 kanti i-placenta-cord-baby trinomial ingaphansi kwamanzi ingaholela ekuphefumuleni . Kukhona i-athikili eyodwa kuphela kepha akukho cwaningo ngayo. Kunconywa ukubamba ngemuva kwemizuzu engu-5 noma ukhiphe ichibi uma kungenzeka. Lapho amanzi engasayimbozi intambo noma engaphansi kuka-5'37 abukho ubungozi.
Izinzuzo zokubambezeleka sekwedlule isikhathi / ukunganqampuli entanjeni.
Ngaphezu kokuthi i-hyperbilirubinemia ngenxa yokubambezeleka sekwedlule isikhathi ayiboniswanga, kuneminye imiphumela emibi yokuboshwa kwentambo kusenesikhathi: izingane eziphuza ukusabela, ezibuthakathaka, 'umthombo' wamaplanethi uphazanyiswe kusenesikhathi, uvimba ukumpontshelwa igazi, okuhlobene nokushoda kwensimbi okukhulunyiwe. Ngokuphambene nalokho, izinzuzo:
Uma igazi i-placenta eqhubeka nokumpompa lithathwa njengesakhi, kusobala ukuthi lokhu kukodwa kuyinzuzo, ngaphezu kwalokho amaphaphu ngeke 'aphoqwe' futhi akudingekile ukuthi kubangele ukukhala, ngaleyo ndlela kwehlukanise ingane unina.
Lezi zincomo ziyasiza futhi ukulandela lapho ingane ilethwe ngengxenye yokuhlinzwa.
Isithombe - Tbsdy Uyaphila
Macarena, ngiyabonga ngalokhu okuthunyelwe. Kepha ngicabanga ukuthi inzuzo yokubambezeleka sekwedlule isikhathi ayicaci kangako. Eqinisweni, i-WHO iyincoma kuphela emazweni anenkinga yenhlanzeko noma yokudla okunempilo. Emazweni athuthukile njengakithi, ukungayiqedi intambo ize iyeke ukushaya kungaba nomphumela omuhle. Ezimweni ezithile kungadala umphumela ohlukile kulowo oyifunayo: Leyo ngxenye yegazi lengane ibuyela emuva ku-placenta, ngaleyo ndlela inciphise inani eliphelele legazi lengane. Kukhona nokwanda ezimweni zezingane ezine-polycythemia (ukukhiqizwa kwehaba kwamaseli abomvu egazi) phakathi kwamacala okubambezeleka sekwedlule isikhathi.
Ukubambezela ukunqwabelana kwentambo ngokweqile futhi kuvimbela ukuqoqwa kwegazi lenkaba ekuqoqweni, ngaleyo ndlela kuvimbele ukusetshenziswa kwesikhathi esizayo kwamaseli ama-stem. U-80% wegazi lentambo lingena enganeni ngomzuzu wokuqala ngemuva kokubeletha. Ngakho-ke, lokhu kubonakala sengathi, ngokusho kochwepheshe engike ngathintana nabo, isikhathi esikahle sokusika inkaba, ukuvumela ingane ukuthi ithole inani eliphakeme legazi futhi ngasikhathi sinye, iqoqe okusele entanjeni.
Sawubona Augustine, ngiyabonga ngokuphawula kwakho. Bheka, ngokusho kwemibhalo esiyibuyekezile, futhi ngaphandle kwezwe okhuluma ngalo, kubukeka sengathi isikhathi esikahle sokucindezela intambo singaba phakathi kwemizuzu engu-1 no-3 ngemuva kokuzalwa.
Isibonelo, lokhu okuthunyelwe (http://apps.who.int/iris/bitstream/10665/120076/1/WHO_RHR_14.19_spa.pdf?ua=1) esayinwe yizinhlangano ezi-3 (kubandakanya i-WHO) ifundeka kanjena: «I-World Health Organisation incoma ukubambezeleka kokubambezeleka kwenkaba. Ukuncipha kokubambezeleka komgogodla (okwenziwa phakathi kwemizuzu engu-1 no-3 ngemuva kokubeletha) kunconywa kukho konke ukudiliva, ngesikhathi esifanayo lapho ukunakekelwa okubalulekile kanyekanye kosana olusanda kuzalwa kuqala ”.
Noma idokhumenti elandelayo ye-PAHO: http://publications.paho.org/spanish/Capitulo_1_OT_195.pdf. Kusuka lapho ngikhetha isigaba “Kungakhathalekile ukuthi yiziphi izizathu ezithile ezenze ushintsho enkambisweni yokubambezela ukuncinwa kwentambo, kucace bha ukuthi kuncane kakhulu noma, kunalokho, abukho ubufakazi besayensi obuthethelela ukubambeka kusenesikhathi njengomkhuba wokusizakala usana olusanda kuzalwa noma unina.
Ngakolunye uhlangothi, ekubhalweni kwe-EPEN, ukhuluma ngokubuyekezwa okuhlelekile, okuphetha ngokuthi abukho ubufakazi phakathi kokucinana sekwedlule isikhathi ne-polycythemia (https://www.elpartoesnuestro.es/informacion/6-el-cordon-umbilical).
Singakuthanda lokho, uma ukubheka kufanele, ungasinikeza izixhumanisi eziwusizo. Sanibonani