Pakati pezvishamiso zvemazuva ano zvesayenzi, hatichizivi kuti amniotic fluid inotanga kupi. Tinoziva kuti mvura yakasviba mushure mokunge imwe pfungwa inenge ine fetal urine, asi tingaritsanangurira sei isu mwana asati aita urinhi? Zvimwe zvinhu zvinoshamisa zvinosanganisira kuti amniotic fluid inoramba ichizviisa pachedu paanenge maawa matatu oga oga.
Izvozvo zvakati, tave tichiedza kutsanangura zvinowanzoitwa amniotic fluid uye chii chisina kujairika.
Kune zvikamu zvina zveamniotic fluid:
- Oligohydramnios
- Mashokwe anoonekwa akareba kupfuura 1 cm muhupamhi (yakasarudzwa)
- Mvura yakakwana, inoonekwa kwose kwose pakati pe fetus uye uterine rusvingo (yakasikwa)
- Polyhydramnios
Ichi chiyero chinowanzotorwa kuburikidza nekushandisa ultrasound kuti ione Amniotic Fluid Index (AFI). Idzo zvidzidzo zvenguva ichangopfuura dzinoti iyo AFI haisi kunyatsogadzirira kweAmniotic fluid volume (chaiyo yakawanda yemvura). Ichokwadi, chimwe chidzidzo chakasimbisa izvi zvichiwana, nokuti zvakanyanya kupisa mumvura.
Oligohydramnios
Apo mukadzi anonzi ane zvishoma amniotic fluid iye ane oligohydramnios. Izvi zvinotsanangurwa seine mashoma anodarika 200 ml yemamniotic fluid panguva kana AFI yepasi pe5 cm. Izvi zvinoreva kuti panguva ye-ultrasound hombe huru yemvura inowanikwa haina kuenzana 1 cm kana yakakura pakukura kwayo kukuru.
Iko kliniki yakaoma zvikuru kuratidza kusati kwasunungurwa. Mushure mokuberekwa, kuongorora iyo placenta nokuda kwekuvapo kwe amnion nodosum pa placenta yakanyanyobatana neoligohydramnios.
Zvichienderana nekuti mukadzi wacho anonzi ane oligohydramnios, kune matambudziko akasiyana-siyana okutsvaga, kunyange zvazvo vazhinji vevakadzi vanoonekwa kuti havangave nezvinetso.
Pakuberekwa kwepakutanga , pane kushungurudzwa kweamniotic adhesions zvichikonzera kusvibiswa kana kusagadzikana kwemubilical cord. Panewo kunetseka pamusoro pemafungiro ekudzvinyirira, sechikwata chetsoka, kubva pakusisina nzvimbo yakakwana yemuviri mudumbu.
Kunyange neoligohydramnios, ultrasound kugadziriswa uye kuongorora kweanomalies yakakwana zvakakwana. Saka ultrasound ichiri nzira inobudirira yekugadzirisa zvigadziriswa zvose zvakabatanidzwa uye zvisingazobatanidzi nevorgohydramnios.
Gare gare pakuberekwa oligohydramnios imwe yezviratidzo zvekufukidzwa kwe fetal. Izvi zvinoitika zvinogona kukonzera kuwedzerwa kwetambo, iyo inogona kutungamirira ku fetal hypoxia, zvinoreva kuti mwana ari kuwana kuwana oksijeni yakakwana.
Kunyunyuta haisi nguva dzose yakanakisisa iyo kana oligohydramnios iripo. Pane zvinhu zvakawanda zvinoda kutorwa.
Meconium, kana yakapfuudzwa haigoni kucheneswa mumamiriro ezvinhu echokwadi oligohydramnios, zvisinei, kumwe kuongorora kwakawana kuti pakanga pane zvishoma zvisingabatanidzi zvemeconium kudonha apo pasi reamniotic fluid volume yakashushwa. Zvisinei, kwaive nekuwedzera kwezviverengero zvevana vane fetal kushushikana kunoda kuberekwa kwekusiya.
Zvimwe zvinetso neoligohydramnios:
- Intrauterine Growth Retardation
- Kubviswa kwenguva refu kweMumbu
- Fetal Malformations (Renal Agenesis, polycystic impso, kuvhiringidzika kwechiremba, nezvimwewo)
- Postmaturity Syndrome
Chirwere cheshuga chinowanzofungwa sechikonzero che oligohydramnios, hachifaniri kukonzera dambudziko nekudzivirira nekurapa kwakakodzera.
Ndezvipi zvirongwa zvokurapa zvinowanikwa kune vakadzi vane oligohydramnios?
Pakutanga taifunga kuti kutora mvura yakadai kuburikidza neamnioinfusion yaiva pfungwa huru. Zvisinei, izvi hazvina kuonekwa kuti zvinobatsira. Tinoziva kuti kubhabhatidza kunoshanda zvakanaka pakudzosa zviratidzo zve oligohydramnios.
Kana pasina IUGR uye fetal anomalies, vakadzi vanowanikwa vane oligohydramnios vanogona kuva nevana vakakodzera zvakakwana vasina zvirwere zvehutano.
Polyhydramnios
Polyhydramnios inopera pakatarisana nechiyero, iyo inotsanangurwa sa 2000 ml yemvura panguva kana kupfuura.
Izvi zvinowanikwa mune zvishomanana ne1% zvekudzivirira.
Nepo vamwe vachifunga kuti polyhydramnios inokonzera basa rekutanga nekuda kweuterine distension, polyhydramnios mukati uye pachayo haisi yekufananidzira kwekutanga kwebasa, asi chikonzero chekuwedzera mumvura inofanirwa kuti ingave here kuberekwa kuchaenda kune nguva.
Polyhydramnios inowanzoitika apo:
- Pane mazita ekugadzirisa akawanda.
- Kune chirwere cheshuga cheshuga.
- Iko kune hutano hwekusangana.
Kune zviyero zvakasiyana zve polyhydramnios. Kuoma kwe polyhydramnios hakune simba kune uremu hwemwana wako, sezvakangoita zvidzidzo zvekare zvakanga zvagara zvataurwa.
Mishonga inokonzera ma polyhydramnios, kusanganisira mishonga yezvinodhaka, kushandiswa kushandiswa kweamniocentesis kuderedza kusviba kwemvura.
Kusati kusatorwa ikoko kunogona kunge kune dzimwe njodzi pakuberekwa, zviduku nhamba, asi dzinofanira kutariswa. Izvi zvinosanganisira kukanganisa kukuru kwetambo inokonzera, kuberekwa kwemazamu, kubviswa kwepasita, uye shurepartum hemorrhage.
Tichifunga kuti kuongororwa kwemazuva ano hakubatsiri muzvinhu zvose zvekufanotaura, tinoda kutarisa nzira yekuwana nzira isiri iyo inopesana yekurapa matambudziko aya amniotic fluid. Saka mubvunzo unowanzoita kakawanda sei, tinoedza, uye tinoitei nemigumisiro? Parizvino, mhinduro dzacho hadzina kujeka uye dzinofanira kutorwa pachiitiko nemhosva.
Vakawanda vevakadzi vanoonekwa kuti vane imwe yezvinetso izvi, havazobereki mwana ane dambudziko, asi kunetseka kuripo uye kunoda kuti yakanyatsotaridzana nemutarisiri wake.
> Additional References:
> Acute Obstetrics: A Practical Guide, > Heppard >, uye Garite, 1996, Mosby.
Basa revanhu uye Kuberekwa, 5th Edition, Harry Oxorn, 1986, Prentice Hall.