Asati akura mucheche

Mwana asati aberekwa mucheche anozvarwa pasati papera vhiki makumi matatu nemanomwe ekubata (anopfuura mavhiki matatu zuva risati rasvika).

Pakuberekwa, mwana anoonekwa seimwe yeanotevera:

• Nguva isati yakwana (asingasviki vhiki makumi matatu nemanomwe gestation)
• Nguva yakazara (vhiki makumi matatu nemakumi mana nemana makumi mana ekuberekwa)
• Post term (akazvarwa mushure memasvondo makumi mana nemaviri ekubata)

Kana mukadzi akapinda mumarwadzo asati asvika vhiki makumi matatu nenomwe, zvinonzi preterm labour.

Kwapera nguva yekutanga vana vanozvarwa pakati pemasvondo makumi matatu nemakumi matatu nemanomwe gestation inogona kutaridzika isati yakwana. Vanogona kunge vasina kubvumidzwa kune neonatal intensive care unit (NICU), asi ivo vachiri panjodzi yemamwe matambudziko kupfuura enguva-yakazara vacheche.

Mamiriro ehutano muna amai, akadai seshuga, hosha yemoyo, uye chirwere cheitsvo, anogona kuita kuti utange basa. Kazhinji, chikonzero chekutanga basa hachizivikanwe. Vamwe vanozvarwa nguva isati yakwana vane nhumbu dzakawanda, senge mapatya kana matatu.

Zvinetso zvakasiyana-siyana zvine chekuita nepamuviri zvinowedzera mukana wekutanga basa kana kubereka kwekutanga:

• Cervix isina kusimba iyo inotanga kuvhurika (dilate) kutanga, inonziwo kusagadzikana kwechibereko
• Kuremara kwekuzvarwa kwechibereko
• Nhoroondo yekutangisa kwekutanga
• Utachiona (hutachiona hwehutachiona kana hutachiona hweamniotic membrane)
• Chikafu chisina kunaka pamberi kana panguva yekuzvitakura
• Preeclampsia: yakakwira BP uye mapuroteni mune weti inozokura mushure mevhiki rechimakumi maviri rekuzvitakura
• Kukurumidza kupera kweiyo membreni (placenta previa)

Zvimwe zvinhu zvinowedzera njodzi yekutanga basa uye kuburitswa nguva isati yasvika zvinosanganisira:

• Zera raamai (vanaamai vari vadiki pane gumi nematanhatu kana kupfuura makumi matatu nemashanu)
• Kuve African American
• Kusava nekutarisirwa kwepamuviri
• Yakaderera mamiriro ezvehupfumi
• Kushandiswa kwefodya, cocaine, kana amphetamines

Mucheche anogona kunetseka kufema uye kuchengeta tembiricha yemuviri yenguva dzose.

Mwana asati aberekwa anogona kunge aine zviratidzo zvematambudziko anotevera:

• Masero matsvuku eropa (anemia)
• Kubuda ropa muuropi kana kukuvara kwenyaya chena yehuropi
• Utachiona kana neonatal sepsis
• Shuga shoma yeropa (hypoglycemia)
• Neonatal kufema kunetseka chirwere, mweya wakawedzera mumatumbu emapapu (pulmonary interstitial emphysema), kana kubuda ropa mumapapu (pulmonary hemorrhage)
• Yero ganda uye vachena vemeso (achangozvarwa jaundice)
• Matambudziko kufema nekuda kwemapapu asina kufanira, mabayo, kana patent ductus arteriosus
• Yakanyanya ura hutumbu (necrotizing enterocolitis)

Mwana asati aberekwa anozove nehuremu hwekuzvarwa hushoma pane hwakazara-nguva yemwana. Zviratidzo zvakajairika zve prematurity zvinosanganisira:

• Kufema zvisina kujairika maitiro (asina kudzika, asina kujairika kumbomira mukufema kunodaidzwa kufema)
• Bvudzi remuviri (lanugo)
• Yakawedzera clitoris (mune vakadzi vacheche)
• Pasina mafuta emuviri
• Yakaderera mhasuru toni uye kushoma chiitiko pane izere-temu vacheche
• Zvinetso zvekudyisa nekuda kwekunetseka kuyamwa kana kuronga kumedza uye kufema
• Diki scrotum iyo inotapira uye isina maburi, uye isina kukodzera machende (mune varume vacheche)
• Yakapfava, inoshanduka nzeve shwashwa
• Yakatetepa, yakatsetseka, inopenya ganda inowanzo kuve yakajeka (inogona kuona tsinga pasi peganda)

Ongororo dzakajairika dzinoitwa pamucheche asati aberekwa dzinosanganisira:

• Ropa gasi kuongorora kuongorora okisijeni muropa
• Ropa bvunzo kutarisa glucose, calcium, uye bilirubin mazinga
• Chest x-ray
• Inoenderera mberi cardiorespiratory kuongorora (kuongorora kufema uye kurova kwemoyo)

Kana basa risati rasvika richikura uye risingakwanise kumiswa, timu yehutano ichagadzirira kuberekwa kune njodzi huru. Amai vanogona kuendeswa kune imwe nzvimbo yakagadzirirwa kuchengetedza vana vasati vasvika muNICU.

Mushure mokuberekwa, mwana anotumirwa kuNICU. Mucheche anoiswa pasi peinodziya kana mubhokisi rakajeka, rinopisa rinonzi incubator, iyo inodzora tembiricha yemhepo. Mishini yekutarisa inoteedzera kufema kwemwana, kurova kwemoyo, uye mwero weoxygen muropa.

Nhengo dzemucheche nguva isati yakwana hadzina kunyatso kukura. Mucheche anoda kutarisirwa kwakanyanya munzvimbo inochengeterwa vana kusvikira nhengo dzave kukura zvakakwana kuti mwana ararame pasina rutsigiro rwekurapwa. Izvi zvinogona kutora vhiki kusvika kumwedzi.

Vacheche kazhinji havagone kuratidzira kuyamwa nekumedza pamberi pemavhiki makumi matatu nemana ekubata. Mwana asati azvarwa anogona kunge aine diki, rakapfava rekudyisa chubhu inoiswa kuburikidza nemhino kana muromo mudumbu. Mune vacheche vasati vasvika kana vanorwara, chikafu chinogona kupihwa kuburikidza netsinga kusvikira mwana agadzikana zvakakwana kuti agamuchire kudya kwese kuburikidza nemudumbu.

Kana mucheche ane matambudziko ekufema:

• Chubhu inogona kuiswa mumhepo (trachea). Mushini unonzi mweya wekufema unobatsira mwana kufema.
• Vamwe vacheche vane matambudziko ekufema asinganyanye kugashira vanoramba vachifamba nemhepo (CPAP) ine machubhu madiki mumhino panzvimbo yetrachea. Kana ivo vanogona kungogamuchira chete yakawedzera okisijeni.
• Oxygen inogona kupihwa nemhepo inofefetira, CPAP, mapundu emhino, kana hood yeoksijeni pamusoro pemusoro wemwana.

Vacheche vanoda kutarisirwa kwakanyanya kwevanochengeta vana kusvikira vagona kufema vasina rubatsiro rwakawedzerwa, kudya nemuromo, uye kuchengetedza tembiricha yemuviri uye huremu hwemuviri. Vacheche vadiki kwazvo vanogona kunge vaine mamwe matambudziko anonetsa kurapwa uye anoda kugara kwenguva refu muchipatara.

Kune akawanda mapoka ekutsigira vabereki vevacheche vasati vazvarwa. Bvunza mushandi wezvemagariro muhutano hwekubereka hunotarisirwa.

Prematurity yaimbova honzeri huru yekufa kwevacheche. Kuvandudzwa kwemaitiro ekurapa nekuyamwisa kwakawedzera kupona kwevana vasati vasvika.

Prematurity inogona kuve neyakareba-mhedzisiro. Vazhinji vacheche vasati vasvika vane matambudziko ekurapa, ekukura, kana ehunhu anoenderera muhucheche kana zvachose. Iyo inowedzera nguva isati yasvika mwana ari uye iwo madiki iwo huremu hwekuzvarwa hwahwo, ipapo njodzi yakanyanya kune matambudziko. Zvisinei, hazvibviri kufanotaura mhedzisiro yenguva refu yemwana zvichibva pazera rekubata kana huremu hwekuzvarwa.

Zvinogona kuitika kwenguva refu matambudziko anosanganisira:

• Yakareba dambudziko remapapu anonzi bronchopulmonary dysplasia (BPD)
• Kunonoka kukura uye kusimudzira
• Urema hwepfungwa kana hwepanyama kana kunonoka
• Chiono chinetso chinonzi retinopathy ye prematurity, zvichikonzera kuona kwakaderera kana hupofu

Nzira dzakanakisa dzekudzivirira prematurity ndeyekuti:

• Iva noutano hwakanaka usati wabata pamuviri.
• Tora kuchengetwa kwepamuviri nekukasira mukubata.
• Ramba uchiwana rubatsiro rwepamuviri kusvikira mwana azvarwa.

Kuwana nekukurumidza uye kwakanaka kuchengetwa kwepabonde kunoderedza mukana wekuzvarwa nguva isati yakwana.

Basa risati rasvika dzimwe nguva rinogona kurapwa kana kunonoka nemushonga unovharidzira zvipenga zvechibereko. Nguva zhinji, zvisinei, kuyedza kunonoka kushanda nguva isati yakwana hakubudiriri.

Betamethasone (mushonga weSteroid) unopihwa vanaamai musati makurumidza kubata kunogona kuita kuti mamwe matambudziko ekutanga kusakwana ave mashoma.

Mwana asati aberekwa; Preemie; Premie; Kuberekwa - premie; NICU - pamberi

• Achangoberekwa jaundice - buditsa

Brady JM, Barnes-Davis ME, Poindexter BB. Mucheche ane njodzi huru. 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. 117.

Parsons KV, Jain L. Yekupedzisira preterm mucheche. Mune: Martin RJ, Fanaroff AA, Walsh MC, eds. Faranoff naMartin's Neonatal-Perinatal Mushonga. 11th ed. Philadelphia, PA: Elsevier; 2020: chitsuwa 40.

Simhan HN, Romero R. Preterm basa uye kuzvarwa. Mune: Landon MB, Galan HL, Jauniaux ERM et al, eds. Obstetrics yaGabbe: Yakajairika uye Dambudziko Pamuviri. 8th ed. Philadelphia, PA: Elsevier; 2021: chitsauko 36.