Isu isu vakuru hatifanane. Mukuwedzera kune kusiyana kwakasiyana-siyana muchitarisiko, tinosiyana pakureba uye kuyerwa, izvo hakuna munhu anonyanya kunetseka pamusoro. Asi iyo imwe nyaya-vana vaduku. Kune vacheche (uye kunyange vana vasati vaberekwa), zviyero zvakananga zvinoverengerwa, kupotsa kunowanzoti chimwe chinhu chakashata nemwana. Chiratidzo chikuru chiremu. Ndicho chikonzero nei zvakakosha kuzvidzora zvose zviripo iye zvino pamuviri - kamwana kadiki kanogona kuva chirwere chakakomba chisingawanzoenderana nehupenyu.
Kurema kwomwana pakarepo mushure mekuberekwa kunokosha zvikuru pakuwedzera kwayo, kunyanya mugore rekutanga rehupenyu. Anokwanisa kukanganisa utano hwake hwose munguva yemberi. Vana vanoberekwa vane uremu hwehuviri hwakadzika (kusvika pa2,5 kg), Vanowanikwa pane zvinetso zvisingabatsiri: zvakanyanya kuipa pakuendesa kwayo pachayo; Mavari, kakawanda kupfuura mumwana akazara, intrauterine hypoxia inowedzera, uyewo marwadzo akasiyana-siyana emagetsi anowanzoonekwa.
Chirwere chechipatara kana chiitiko chebumbiro remitemo?
Vanachiremba vane pfungwa yakadaro semichero yepamutemo ishoma. Mune mimwe mhuri, vana vose mumarudzi akawanda vanoberekerwa vane huwandu hwakaderedzwa, asi havana chavanokanganisa chakakosha mukugadzirwa kwakatevera. Vana vaduku kakawanda vanoberekerwa nevabereki vakaonda vasiri kureba yakakwirira (pasi pe 160 cm). Muchiitiko ichi, kunyange panguva yekuzvitakura, mwana mudiki anowanikwa, uye gare gare mwana ane uremu hutatu hunozvarwa. Zvisinei, iye ane hutano hwakakwana uye haawani matambudziko akawanda munguva yekuchinja kune munhu mukuru.
Asiwo kamwana kadiki kanogona kuratidza chirwere chakakomba chepamuviri - fetoplacental insufficiency. Muchiitiko ichi, chirwere chakadaro, icho chinonzi syndrome ye fetal kukura kunonoka (zvisinei - fetal hypotrophy), inoda kunyatsotarisirwa. Kusiyanisa hutano hwakasiyana-siyana, apo nhengo dzose dzomuviri dzinoderedzwa zvakaenzana uye dzisinganzwisisiki, apo skeleton nehuropi zvinoenderana neshoko rezvino rekuzvitakura, uye nhengo dzomukati dziri kuseri shure mukukura. Zvimwe zvinokonzera chirwere ichi ndiko kusvuta, doro, chromosomal kusagadzikana, zvirwere zveprauterine.
Zvinokonzera kuberekwa kwevana vane uremu hunorema
Kakawanda kazhinji kusagadzikana kwehutano kunowanikwa mumatatu ekupedzisira pakuvapo kwematambudziko ekudzivirira uye zvirwere zvisingaperi mumaamai. Chero mamiriro ezvinhu anokonzera kukanganisa kweropa kupararira kunokonzera kunonoka kwekuwedzera kwechitema nekukura kwe fetus. Zvirwere zvisingaperi zvevakadzi, izvo izvo zvipenyu zvinoratidzwa kudhakwa uye kusakwana kwe okisijeni hazvigoni kuchinja asi mwana, izvo zvinotungamirira mukusimudzirwa kwemaitiro akadaro.
Mubvunzo wekupikisa kwekudya kwemaamai pamugumo wakatevera we fetus unoramba uchikakavadzana. Maererano nehuwandu, vakadzi vane kukwana kwekurema, pane kudya kwekorikori, kazhinji vanoberekera vana vane uremu hwepanyama. Zvisinei, munhu haagoni kukanganwa deta maererano nezvayo, kunyange panguva yekudzivirira kweLeningrad, vana (uye kazhinji) vana vane zvizere zvakakwana kure uye kuyerwa kwakazvarwa.
Zera remadzimai rinoitawo basa rinokosha. Vakadzi vasati vava nemakore gumi nemasere kusvika kumakore makumi mapfumbamwe nemakore makumi matatu (35) vane dambudziko rakakura rekuberekwa kwehutachiona panguva yekuzvitakura. Muviri muduku muduku amai havana kungogadzirira basa rinouya, uye chikamu chechipiri cheamai chinowanzova nezvirwere zvisingaperi. Uyezve, kukurudzirwa kwehupfungwa kunokurudzirwa nekusvuta, sezvo kunotungamirira kune kunonzi kuderedza midziyo uye kuderera kweutteroplacental blood flow.
Diagnostics
Nzira yakanyatsonaka yekuongorora iyo fetus is ultrasound. Muchikamu chacho, chiremba anoyera uye anoongorora maitiro akawanda. Kururama kwekuongororwa kunogadzirisa kunaka nekugadzirisa kwechigadzirwa, mukana wokuita Doppler. Uyewo, ultrasound inoongorora mamiriro eamniotic fluid, ichibvumira kuziva zviratidzo zvekusakanganisika mukushanda kwepa placenta, pamwe nekuchinja kwekupararira kweropa muDoppler.
Kuti pakupedzisira tsananguro kuongororwa, Doppler kuongorora kombilical cord nemidziyo ye fetus uye mutezo weropa wepa placenta - asi chiremba anocherechedza kukurumidza uye maitiro eropa iri mukati mavo. Mukuwedzera kune dopplerometry, cardiotocography inowanikwa kuti inyore hutano hwekuchinja mu fetal heart beats mukupindura kukanganisa kwayo pachako kana zvipikano mukati mechibereko. Kana dopplerometry neCCTG zvichiratidza zvakakwana data (kunyange kana fetus iri duku), zvino izvi zvinoratidza hupenyu hwemucheche. Kana kuongororwa kusina kujekesa chero kukanganisa, saka tiri kutaura nezvehutano hwakanyanya hutsika-fetus fetus. Mukadzi ari kungocherechedza asina kanazve mamwe mazano.
Kurapa
Kana mwana muduku achikura zvakanaka paanenge aberekwa, chirwere hachidiwi. Asi kana pane njodzi yezvinetso kana humwe hutachiona mukukudziridza fetus, ipapo kurapwa kwehutano kunosanganisira kurapwa kwezvirwere zvekuberekwa uye zvinetso zvepamuviri. Uyewo, kugadziriswa kwekushaya kukwana kunoitwa. Nhamba yevasodilator inorayirwa kuti mukadzi awedzere kuwedzerwa ropa kune midziyo yemubereki uye fetus. Uyezve, zvinodhaka zvinopiwa zvinosunungura maronda emuchedzo, nokuti inzwi rayo rinowedzera rinomesa midziyo yeropa uye rinowedzera ropa. Shandisa mishonga inowedzera fetal resistance kushandiswa kune hypoxia - inowanzo "shamwari" ye fetal malnutrition syndrome. Zvichienderana nemamiriro ezvinhu emucheche, kurapa kunogona kuitwa kumba kana kuchipatara.
Nzira uye nguva yekubudisira zvinowanzoenderana nemamiriro ehutusi. Kana kurapwa kunobatsira uye mwana ari kuwedzera kuwanda, saka hapana chinangwa mukukurudzira kutanga kwebasa. Kazhinji pamagumo ekudzivirira mwana wacho pachake anosvika pakukura kwakakura. Kana mwana wacho asina kuwedzera muviri, pasinei nokurapa, zvinoita kuti atange kuberekwa. Nenguva yekuita kwemavhiki makumi matatu nemaviri uye makonji ekugadzirira kuberekwa, vanachiremba vanokurudzirwa nekushanda kwepanyama. Kuberekwa kunotungamirirwa nekuchenjerera. Uine fetal hypotrophy, kuberekwa kunowanzotarisana nechepamusoro pepidural anesthesia kuitira kuti uwane rusununguko rukuru. Ipapo muromo wechibereko unotanga kuzarura, mwana anotama nyore nyore kuburikidza nezera rekuberekwa. Asi kana mwana wacho asina simba zvokuti kuberekwa kwemazuva ose kwaanova kuedza kusingagoneki, ipapo kushanda kunoitwa nechikamu chekudzivirira.