Myelomeningocele

Myelomeningocele kuremara kwekuberekwa umo musana uye musana wemusana hauna kuvhara usati waberekwa.

Mamiriro acho mhando yespina bifida.

Kazhinji, mukati memwedzi wekutanga wepamuviri, mativi maviri emusana wemwana (kana musana) anobatana pamwechete kuvhara musana, musana, uye meninges (zvinyama zvinovhara musana). Uropi huri kukura uye musana panguva ino inonzi neural tube. Spina bifida inoreva chero chakaremara chekuberekwa umo neural tube iri munzvimbo yemuzongoza inokundikana kuvhara zvachose.

Myelomeningocele ndeye neural tube chirema umo mapfupa emusana haana kunyatsoumbwa. Izvi zvinoguma musina kukwana musana wemuviri. Mutsipa wesipinha nemamenji zvinobuda kubva kumusana kwemwana.

Mamiriro aya anogona kukanganisa vakawanda sevacheche pavana vacheche zviuru zvina.

Mamwe maspina bifida kesi anowanzo kuve:

• Spina bifida occulta, mamiriro umo mapfupa emusana haavhare. Mutsipa wepelinha nemamenji zvinoramba zviri munzvimbo uye ganda rinowanzovhara hurema.
• Meningoceles, iyo mamiriro apo iwo meninges anobuda kubva mukuremara kwemusana. Mutsara wepelinha unoramba uripo.

Zvimwe kusagadzikana kwekuberekwa kana kuremara kwekuzvarwa kunogona kuve kuripo mumwana ane myelomeningocele. Vana vasere kubva pagumi vane chirwere ichi vane hydrocephalus.

Zvimwe zvinokanganisa tambo yemuzongoza kana musculoskeletal system inogona kuoneka, kusanganisira:

• Syringomyelia (cyst inozadzwa nemvura inoyerera mukati memuzongoza)
• Hip kubviswa

Chikonzero chemyelomeningocele hachizivikanwe. Nekudaro, yakaderera masosi e folic acid mumuviri wemukadzi pamberi uye panguva yekutanga kwepamuviri zvinoita sekutora chikamu mune urwu rudzi rwehurema hwekuzvara. Folic acid (kana folate) yakakosha mukuvandudza kwehuropi uye musana.

Kana mwana akazvarwa aine myelomeningocele, vana venguva yemberi mumhuri iyoyo vane njodzi yakakura kupfuura huwandu hwevanhu. Zvisinei, muzviitiko zvakawanda, hapana hukama hwemhuri. Zvinhu zvakaita seshuga, kufutisa, uye kushandiswa kwemishonga inorwisa kubatwa muna amai kunogona kuwedzera njodzi yekuremara uku.

Mwana achangozvarwa ane chirwere ichi anozove nenzvimbo yakavhurika kana bhegi rakazara nemvura mukati repakati kudzikira kumashure.

Zviratidzo zvinogona kusanganisira:

• Kurasikirwa kwedundira kana ura
• Kusarura kwakakwana kana kwakakwana kwekunzwa
• Kusarura kana kukwana kwakakwana kwemakumbo
• Kushaya simba kwehudyu, makumbo, kana tsoka dzemwana achangozvarwa

Zvimwe zviratidzo uye / kana zviratidzo zvinogona kusanganisira:

• Tsoka dzisina kujairika kana makumbo, senge nhabvu
• Kuvaka kwemvura mukati mehenya (hydrocephalus)

Kuongorora kwepabonde kunogona kubatsira kuona mamiriro aya. Munguva yetemu yechipiri, vakadzi vane nhumbu vanogona kuongororwa ropa kunodaidzwa kuti quadruple screen. Iyi bvunzo inoongorora myelomeningocele, Down syndrome, uye zvimwe zvirwere zvepamuviri mumwana. Vazhinji vakadzi vakatakura mwana vane musana bifida vanozove neyakawedzera huwandu hweprotein inonzi maternal alpha fetoprotein (AFP).

Kana iyo quadruple skrini bvunzo iri yakanaka, kumwezve kuyedzwa kunodiwa kuti usimbise kuongororwa.

Miedzo yakadaro inogona kusanganisira:

• Kubata ultrasound
• Amniocentesis

Myelomeningocele inogona kuonekwa mushure mekuzvarwa kwemwana. Kuongororwa kwetsinga kunogona kuratidza kuti mwana arasikirwa nemabasa ane chekuita netsinga pazasi pehurema. Semuenzaniso, kutarisa kupindura kunoita mucheche kumatinji munzvimbo dzakasiyana kunogona kuudza panogona kunzwa manzwiro emwana.

Kuedzwa kunoitwa pamwana mushure mekuzvarwa kunogona kusanganisira x-ray, ultrasound, CT, kana MRI yenzvimbo yemuzongoza.

Anopa hutano anogona kupa zano nezvemajini. Kuvhiya kwepamuviri kuti uvhare hurema (mwana asati azvarwa) kunogona kudzora njodzi yemamwe matambudziko anotevera.

Mushure mekunge mwana wako aberekwa, kuvhiyiwa kugadzirisa hurema kunowanzo kurudzirwa mukati memazuva mashoma ekutanga ehupenyu. Asati avhiyiwa, mucheche anofanira kubatwa zvine hungwaru kuti aderedze kukuvara kwemuzongoza. Izvi zvinogona kusanganisira:

• Kuchengetedzwa kwakakosha uye kumisikidzwa
• Zvidziviriro
• Shanduko munzira dzekubata, kufudza, uye kugeza

Vana vane zvakare hydrocephalus vangangoda ventriculoperitoneal shunt yakaiswa. Izvi zvinobatsira kuburitsa iyo yekuwedzera mvura kubva kuma ventricles (muuropi) kuenda kune peritoneal cavity (mudumbu).

Mishonga inorwisa mabhakitiriya inogona kushandiswa kurapa kana kudzivirira hutachiona senge meningitis kana weti turakiti hutachiona.

Vazhinji vana vanozoda kurapwa kweupenyu hwese kumatambudziko anokonzerwa nekukuvara kwemuzongoza uye tsinga dzemusana.

Izvi zvinosanganisira:

• Matambudziko edundira uye ura - Kupfava kwekumanikidza pamusoro pebunduru kunogona kubatsira kukanda dundira. Drainage machubhu, anonzi catheters, anogona kudikanwa futi. Zvirongwa zvekudzidzira bowel uye yakakwira fiber kudya kunogona kuvandudza ura mashandiro.
• Matambudziko emhasuru pamwe nemajoini - Orthopedic kana kurapwa kwemuviri kunogona kudiwa kurapa musculoskeletal zviratidzo. Brace inogona kudikanwa. Vanhu vazhinji vane myelomeningocele vanonyanya kushandisa wiricheya.

Bvunzo dzekutevera dzinowanzoenderera muhupenyu hwese hwemwana. Izvi zvinoitirwa ku:

• Tarisa kufambira mberi kwekufambira mberi
• Bata chero matambudziko ehungwaru, etsinga, kana epanyama

Vanamukoti vanoshanya, rubatsiro rwemagariro, mapoka ekutsigira, uye vamiririri venzvimbo vanogona kupa rutsigiro rwepfungwa uye kubatsira nekuchengeta kwemwana ane myelomeningocele ane matambudziko akakosha kana kusakwana

Kutora chikamu mu spina bifida rutsigiro boka rinogona kubatsira.

Myelomeningocele inogona kazhinji kugadziriswa, asi tsinga dzakakanganiswa dzinogona kunge dzisingashande zvakajairika. Iyo yakakwira iyo nzvimbo yehurema kumusana kwemucheche, iyo yakawanda tsinga ichabatwa.

Nekurapa kwekutanga, kureba kwehupenyu hakukanganisike zvakanyanya. Matambudziko eitsvo nekuda kwekushaikwa kwemvura weti ndiyo inonyanya kukonzera rufu.

Vazhinji vana vanozove nehungwaru chaihwo. Nekudaro, nekuda kwenjodzi yehydrocephalus uye meningitis, vazhinji vevana ava vanozove nematambudziko ekudzidza uye matambudziko ekubatwa.

Matambudziko matsva mukati memutsipa wepelinha anogona kukura gare gare muhupenyu, kunyanya mushure mekunge mwana atanga kukura nekukurumidza panguva yekuyaruka. Izvi zvinogona kutungamira mukurasikirwa kwakawanda kwebasa pamwe nezvinetso zvemapfupa senge scoliosis, tsoka kana kukanganisika kwemakumbo, kusununguka hudyu, uye kusimba kwekubatana kana zvibvumirano.

Vanhu vazhinji vane myelomeningocele vanonyanya kushandisa wiricheya.

Zvinetso zve spina bifida zvinogona kusanganisira:

• Kuberekwa kunorwadza uye kusununguka kwemwana
• Kazhinji urinary turakiti hutachiona
• Fluid buildup pane uropi (hydrocephalus)
• Kurasikirwa kwematumbo kana kudzora dundira
• Utachiona hwehuropi (meningitis)
• Permanent kushaya simba kana kuremara kwemakumbo

Urongwa urwu hunogona kunge husinga sanganisira zvese.

Fonera mupiki wako kana:

• Saga kana nzvimbo yakavhurika inoonekwa pamusana wecheche achangozvarwa
• Mwana wako anonoka kufamba kana kukambaira
• Zviratidzo zvehydrocephalus inokura, kusanganisira kupopota nzvimbo nyoro, kushatirwa, kurara zvakanyanya, uye kunetsa kunetseka
• Zviratidzo zve meningitis zvinokura, zvinosanganisira kupisa muviri, kuomesa mutsipa, kutsamwa, uye kuchema kwakanyanya

Folic acid inowedzera inogona kubatsira kudzikisa njodzi yeiyo neural chubhu hurema senge myelomeningocele. Zvinokurudzirwa kuti chero mukadzi anofunga kuve nepamuviri atore 0,4 mg yefolic acid pazuva. Vakadzi vane pamuviri vane njodzi huru vanoda mwero wakakwirira.

Izvo zvakakosha kuti urangarire kuti kushaikwa kwe folic acid kunofanirwa kugadziriswa usati wava nepamuviri, nekuti hurema hunokurumidza kwazvo.

Vakadzi vanoronga kubata pamuviri vanogona kuongororwa kuti vaone huwandu hweiyo folic acid muropa ravo.

Meningomyelocele; Spina bifida; Yakachena musana; Neural chubhu chirema (NTD); Kuremara kwekuzvarwa - myelomeningocele

• Ventriculoperitoneal shunt - kubuda

• Spina bifida
• Spina bifida (madhigirii ekuomarara)

Komiti yeOstetric Practice, Sosaiti yeMaternal-Fetal Mushonga. American College yeVadzvinyiriri uye Gynecologists. ACOG Komiti maonero kwete. 720: kuvhiyiwa amai-fetal kune myelomeningocele. Obstet Gynecol. 2017; 130 (3): e164-e167. PMID: 28832491 pubmed.ncbi.nlm.nih.gov/28832491/.

Kinsman SL, Johnston MV. Congenital anomalies epakati etsinga system. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsiko 609.

Licci M, Guzman R, Soleman J. Maternal uye obstetric matambudziko mukuvhiya kwe fetus kwekubata prenatal myelomeningocele kugadzirisa: kurongeka kwakarongeka.Neurosurg Focus. 2019; 47 (4): E11. PMID: 31574465 pubmed.ncbi.nlm.nih.gov/31574465/.

Wilson P, Stewart J. Meningomyelocele (spina bifida). Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chits. 732.