Ukunakekelwa Kwababelethisi Ezimweni Zangaphambi Kwesikhathi
I-Pendahuluan
Ukukhulelwa ngaphambi kwesikhathi, noma ukuzalwa ngaphambi kwesikhathi, ukuzalwa komntwana ngaphambi kwamasonto angu-37 okukhulelwa. Emsebenzini wokubeletha, ukuphatha ukuzalwa ngaphambi kwesikhathi kuyinselele edinga ukunakwa okukhethekile, uma kubhekwa izinkinga ezingaba khona kumama nomntwana. Lesi sihloko sizoxoxa ngokujulile ngokunakekelwa kwababelethisi bokubeletha ngaphambi kwesikhathi, okuhlanganisa ukuhlonza, ukungenelela, kanye nokuphathwa okuphelele ukuthuthukisa imiphumela yezempilo kamama nosana.
Ukuhlonza Ingozi Yangaphambi Kwesikhathi
Ukuhlonza ingozi yokuzalwa ngaphambi kwesikhathi kuyisinyathelo sokuqala esibalulekile emizamweni yokuvimbela kanye nokwelashwa. Izici eziningana ezingandisa ingozi yokuzalwa ngaphambi kwesikhathi zifaka:
1. Umlando Wangaphambilini Wokuzalwa Kungakafiki Isikhathi: Omama abake babeletha umntwana ngaphambi kwesikhathi basengozini enkulu yokuzalwa ngaphambi kwesikhathi ekukhulelweni kwabo okulandelayo.
2. Ukutheleleka: Ukutheleleka okufana nokutheleleka komgudu womchamo, i-bacterial vaginosis, noma ezinye izifo kungabangela ukuzalwa ngaphambi kwesikhathi.
3. Izinkinga Zokukhulelwa: Izimo zezokwelapha ezifana ne-preeclampsia, isifo sikashukela sokukhulelwa, kanye nokuqhekeka kwe-placenta kungandisa ingozi yokuzalwa ngaphambi kwesikhathi.
4. Izici Zendlela Yokuphila: Ukubhema, ukuphuza utshwala, kanye nokusebenzisa izidakamizwa ezingekho emthethweni kungabangela ingozi enkulu yokuzalwa ngaphambi kwesikhathi.
5. Ukucindezeleka Nezimo Zengqondo Nezenhlalo: Izici zokucindezeleka kanye nezimo ezimbi ngokomzwelo nazo zihlotshaniswa nengozi eyengeziwe yokuzalwa ngaphambi kwesikhathi.
Ukungenelela Kwezibeletho Ngaphambi Kokubeletha
Uma ingozi yokubeletha ngaphambi kwesikhathi isitholakele, isinyathelo esilandelayo ukungenelela ukuvimbela noma ukubambezela ukubeletha ngaphambi kwesikhathi. Nazi ezinye izindlela ababelethisi abangazenza:
1. Ukunikezwa kwe-Progesterone: Komama abanomlando wokubeletha ngaphambi kwesikhathi noma abanezimpawu zobungozi, ukunikezwa kwe-progesterone kungasiza ekwandiseni isikhathi sokukhulelwa.
2. Ukuqapha Nokuphatha Ukutheleleka: Ukuhlonza nokwelapha izifo ezitholwa ngabesifazane abakhulelwe kusenesikhathi.
3. I-Cerclage Yesibeletho: Kumama abanekhono elibuthakathaka lomlomo wesibeletho, ukubekwa kwe-cerclage noma ukuthungwa kwe-cervical kungasiza ekunciphiseni ingozi yokuzalwa ngaphambi kwesikhathi.
4. Ukuphumula Nokunciphisa Umsebenzi: Nciphisa umsebenzi womzimba futhi unikeze isikhathi esanele sokuphumula, ikakhulukazi kwabesifazane abakhulelwe abasengozini enkulu.
5. Imfundo Yezempilo: Imfundo nokwelulekwa mayelana nendlela yokuphila enempilo, ukugwema ukucindezeleka, kanye nokubaluleka kokunakekelwa njalo kwangaphambi kokubeletha.
Ukuphathwa Ngesikhathi Sokubeletha Kwangaphambi Kwesikhathi
Uma ukubeletha ngaphambi kwesikhathi kungenakugwenywa, ukuphathwa kahle kubalulekile ukuze kuncishiswe ingozi yezinkinga. Amasu angasetshenziswa afaka:
1. Ukulungiswa Kwegumbi Lokubeletha kanye Nethimba Lezokwelapha: Ukulungiswa kwegumbi lokubeletha elanele kanye nethimba lezokwelapha eliqukethe ochwepheshe abahlukahlukene njengodokotela bezingane ezisanda kuzalwa, odokotela bezidakamizwa, kanye nababelethisi abaqeqeshiwe.
2. Ama-Steroids Angaphambi Kokubeletha: Ukunikezwa kwama-corticosteroids kwabesifazane abakhulelwe esikhathini esibucayi ngaphambi kokubeletha ukuze kusheshiswe ukuvuthwa kwamaphaphu engane.
3. I-Magnesium Sulfate: Ukusetshenziswa kwe-magnesium sulfate kunganikezwa ukuvikela ubuchopho bomntwana engcupheni yokuba ne-cerebral palsy.
4. Ukuphathwa Kobuhlungu: Ukuphathwa kobuhlungu okuphumelelayo kwabesifazane abakhulelwe ukuze kuncishiswe ukucindezeleka nezinkinga ezihlobene nokubeletha.
Ukunakekelwa Kwangemva Kokubeletha
Ukunakekelwa kokubeletha ngemva kokubeletha kwezingane ezisanda kuzalwa kudinga ukunakwa okwengeziwe ngenxa yokuthi zisengozini yezinkinga ezahlukahlukene. Ezinye izinyathelo ezibalulekile ekunakekelweni kwangemva kokubeletha zifaka:
1. Ama-Incubator kanye Nokulawula Ukushisa: Izingane ezizalwa ngaphambi kwesikhathi ngokuvamile zidinga ukufakwa ku-incubator ukuze zigcine izinga lokushisa lomzimba lizinzile.
2. Ukudla Okunomsoco: Ukuhlinzeka ngokudla okwanele kubalulekile, kungaba ngobisi lwebele olukhanyiwe, ukuhlinzekwa kokwenziwa, noma inhlanganisela yakho kokubili.
3. Ukuqapha Impilo: Ukuqapha ngokucophelela kanye nokutholakala kusenesikhathi kwezinkinga ezifana nokutheleleka, izifo zokuphefumula, kanye nezinkinga zokugaya ukudla.
4. Ukungenelela Kwezokwelapha Okuthuthukisiwe: Izindlela zokwelapha ezithuthukisiwe ezifana nokwelashwa nge-phototherapy ye-jaundice, ukuphefumula kobunzima bokuphefumula, kanye nezinye izindlela zokwelapha ngokwesimo somntwana.
5. Ukusekelwa Kwengqondo Komama Nemindeni: Ukuhlinzekwa kwezinhlelo zokwelulekwa nokusekelwa komama nemindeni ukuze babhekane nezinselele zokunakekela izingane ezisanda kuzalwa.
Ukubaluleka Kokubambisana Kwemikhakha Ehlukahlukene
Ukunakekela izingane ezizalwa ngaphambi kwesikhathi kudinga indlela yokubambisana ehilela imikhakha eminingi. Ababelethisi basebenza njengabaxhumanisi, beqinisekisa ukubandakanyeka kwethimba lonke lezokunakekelwa kwempilo ekunakekeleni abesifazane abakhulelwe abasengozini yokuzalwa ngaphambi kwesikhathi kuze kube yilapho umntwana ezalwa futhi edlula isikhathi esibucayi. Ukubambisana okuphumelelayo nochwepheshe bezokudla, odokotela bezingane, odokotela bezingane ezisanda kuzalwa, kanye nodokotela bezengqondo kuyisihluthulelo sokunakekelwa okuphumelelayo kwababelethisi bezingane ezizalwa ngaphambi kwesikhathi.
Isiphetho
Ukunakekelwa kwababelethisi bokubeletha ngaphambi kwesikhathi kudinga isu elibanzi, kusukela ekuhlonzeni ubungozi kanye nokungenelela kwangaphambi kokubeletha kuya ekuphathweni kokubeletha kanye nokunakekelwa kwangemva kokubeletha. Imfundo kanye nokwelulekwa kwabesifazane abakhulelwe, ukubambisana nethimba lezokwelapha, kanye nokuqapha eduze kubalulekile ekunciphiseni ubungozi bezinkinga kanye nokuthuthukisa imiphumela yezempilo kamama nosana. Ngakho-ke, ukuthuthukiswa kolwazi namakhono ababelethisi ekuphatheni ukubeletha ngaphambi kwesikhathi kudinga ukuthuthukiswa okuqhubekayo ukuze kuhlinzekwe ukunakekelwa kwempilo okuhle kakhulu.
Ireferensi
Ukuze uthole okunye ukubhekisela, izincwadi ezilandelayo zingasetshenziswa njengereferensi:
1. Cunningham, FG, et al. (2021). UWilliams Obstetrics. ENew York: McGraw-Hill.
2. Kenner, C., & Lott, J. W. (2016). Ukunakekelwa Kokunakekelwa Kwabahlengikazi Abasanda Kuzalwa Okuphelele. Inkampani Yokushicilela yaseSpringer.
3. Goldenberg, R.L., et al. (2008). I-Epidemiology kanye nezimbangela zokuzalwa ngaphambi kwesikhathi. I-Lancet, 371(9606), 75-84.
Ngolwazi olwanele kanye nokusetshenziswa okufanele, ukunakekelwa kwababelethisi ezimweni zangaphambi kwesikhathi kungaletha izinguquko ezinhle nezibalulekile empilweni yomama nezingane.
