He aha te Macrosomia Fetal? Tohutohu, Take, me te Maimoatanga

Ko te tikanga o te macrosomia fetal, he nui atu te taumaha o to pepeke i te mea i tumanakohia mo tōna tau kōreka, e pā ana ki te 8 pauna 13 ounihi (4,000 karamu) i te whānau. He 8-10% pea te nui o ngā haputanga e pā ana ki tēnei āhuatanga, ā, ahakoa e rangona ana he āwangawanga, he maha ngā pepeke e whānau ora ana me te tiaki hauora tika.

Whakaarohia he nui ake te tipu o tō pepeke i te rahi noa mō ngā pepeke e whānau ana i te wā kotahi o te haputanga. Ka taea e te taumaha atu te whakawhāiti i te whānau, engari he maha ngā huarahi kei a tō rōpū hauora hei awhina i te pupuri i te ora o koe me tō pepeke i te katoa o te tukanga.

He aha ngā tohu o te macrosomia fetal?

Kaore pea koe e kite i ngā tohu marama i te wā haputanga, no te mea ko te macrosomia fetal te nuinga o te wā ka kitea mā ngā ine hauora. Heoi, ka taea e tō kaiwhakarato hauora te kite i tō kopu e ine ana i te nui atu i te mea i tumanakohia mō tō wā haputanga.

I ngā toro hauora whānau noa, ko ēnei tohu pea ka whakaatu mai kei te nui ake te tipu o tō pepeke i te noa:

• Ko tō teitei fundal (ine kopu) he nui atu i te noa mō tō tau kōreka
• Ka whakaatu ngā ine ultrasound kei runga ake i te 90th percentile te taumaha o tō pepeke
• He wai amniotic nui (polyhydramnios) koe, ka taea te whakaatu i tō kopu he nui rawa
• Ka kite koe i ngā nekehanga fetal kaha ake nā te rahi o tō pepeke
• Ka kite pea koe i te pēhanga nui atu i tō upoko, te uaua rānei ki te manawa i te wa e nui ake ai te wāhi e tangohia ana e tō pepeke

Kia mahara ko ēnei tohu kaore i te tikanga katoa he macrosomia, ā, ko ētahi whaea e mau ana i ngā pepeke nui ake kaore e kite i ngā rerekētanga e kitea ana. Ka whakamahi tō tākuta i ngā ine motuhake me ngā aromatawai hauora hei whakatau i tēnei.

He aha ngā take o te macrosomia fetal?

He maha ngā take ka āwhina i te tipu o tō pepeke i te nui atu i te mea i tumanakohia, ko te mate huka whaea te take tino nui. Ina nui atu te huka toto i te noa, ka whiwhi atu tō pepeke i te huka, ka penapena hei ngako, ka ārahi ki te tipu nui ake.

Ko ēnei ngā take matua ka taea te whanake o te macrosomia fetal:

• Te mate huka kōreka, te mate huka rānei i mua i te pānga ki te tukatuka o tō tinana i te huka
• Te hītori o mua o te whānau i te pepeke nui, ka nui ake te tūponotanga i ngā haputanga kei te heke mai
• Te momona o te whaea, no te mea ka taea e te taumaha nui te pānga ki ngā tauira tipu o tō pepeke
• Te haputanga roa e roa atu ana i te 42 wiki, ka hoatu ki tō pepeke te wā nui ake ki te tipu
• Te pakeke o te whaea neke atu i te 35 tau, ka taea te pānga ki te whakahaere hauora haputanga
• Te hītori whānau o te mate huka, te whānau rānei i ngā pepeke macrosomia i mua

Ko ngā take iti ake engari ka taea te whakauru i ētahi āhuatanga ira me ngā koretake o te homoni e pā ana ki te tipu fetal. Ka arotakehia e tō kaiwhakarato hauora tō hītori hauora me ngā take tūponotanga hei mārama ki te mea kei te āwhina i te rahi o tō pepeke.

Nōhea te toro atu ki te tākuta mō te macrosomia fetal?

Me whakapiri atu koe ki tō kaiwhakarato hauora ki te kite koe he nui rawa te rahi o tō kopu mō tō wā haputanga, te kite rānei koe i ngā tohu e awangawanga ana koe. Ko ngā whakaritenga whānau noa tō parenga pai rawa atu, no te mea ko te macrosomia te nuinga o te wā ka kitea mā ngā ine me te aroturuki noa.

Whakaritea he whakatau i te wa poto ki te kite koe i ngā tohu kino penei i te uaua ki te manawa, te pēhanga nui o te upoko, te tohu rānei o te mahi whānau i mua i te wā.

Ki te whai koe i ngā take tūponotanga penei i te mate huka, te hītori whānau rānei o ngā pepeke nui, kōrerohia tēnei ki tō rōpū hauora i te tīmatanga o te haputanga. Ka taea e rātou te whakarato i te aroturuki tata atu me ngā rautaki aukati hei awhina i te whakahaere i te tipu o tō pepeke.

He aha ngā take tūponotanga mō te macrosomia fetal?

Ko te mārama ki ō take tūponotanga ka āwhina i a koe me tō rōpū hauora ki te whakarite mō te hua pai rawa atu. Ko ētahi take ka taea e koe te whakahaere mā ngā whiringa oranga, ko ētahi atu e pā ana ki tō hītori hauora, ki tō ira rānei.

Ko ēnei ngā take tūponotanga matua e nui ake ai te tūponotanga o te macrosomia fetal:

• Te mate huka (te kōreka rānei, te mea i mua rānei) e pā ana ki tō whakahaere huka toto
• Te haputanga o mua me te pepeke macrosomia, no te mea ko tēnei tauira te nuinga o te wā ka whakahokia
• Te nui o te taumaha, te momona rānei i mua i te haputanga
• Te pakeke o te whaea neke atu i te 35 tau
• Te hītori whānau o te mate huka, ngā pepeke nui rānei
• Te haputanga roa e roa atu ana i tō rā whānau
• Ngā take iwi motuhake, tae atu ki te reo Māori, te iwi Taketake o Amerika, te iwi African American rānei

Ko te whai i tetahi take tūponotanga, te maha rānei o ngā take tūponotanga kaore e whakamana ka whai macrosomia tō pepeke. Ka aromatawaihia e tō kaiwhakarato hauora tō āhuatanga takitahi, ka whakarato i ngā taunakitanga aroturuki me te tiaki motuhake e hāngai ana ki ō āhuatanga motuhake.

He aha ngā raruraru pea o te macrosomia fetal?

Ahakoa he maha ngā pepeke e whānau ora ana me te macrosomia, he maha ngā raruraru e tika ana kia titiro atu koe me tō rōpū hauora i te wā whānau me muri iho. Ko te mārama ki ēnei wā pea ka āwhina i te katoa ki te whakarite mō te wheako whānau haumaru rawa atu.

Ko ngā raruraru tino noa i te wā whānau ko:

• Te dystocia pakihiwi, ka mau ai ngā pakihiwi o tō pepeke i te wā whānau
• Ngā whara whānau penei i ngā whati i te ihu, te ringa rānei, ahakoa ko ēnei te nuinga o te wā ka ora pai
• Te mahi whānau roa nā te rahi o tō pepeke e whakawhāiti ana i te haere atu i te kaupapa whānau
• Te nui ake o te tūponotanga o te whānau caesarean mō ngā take haumaru
• Te toto nui i muri i te whānau nā ngā raruraru uterine

Mō tō pepeke, ko ngā raruraru pea ka taea te whakauru i ngā raruraru manawa i muri tonu i te whānau me ngā taumata huka toto iti e hiahia ana ki te aroturuki. I etahi wā, ka taea te whara iwi i te wā whānau, ahakoa ko te nuinga o ēnei ka ora katoa me te wā me te tiaki tika.

Kua rite pai tō rōpū hauora ki te whakahaere i ēnei āhuatanga, ka tango i ngā mahi hei whakaiti i ngā tūponotanga i te katoa o tō wheako whānau.

Me pēhea te whakatau i te macrosomia fetal?

Ko te whakatau i te macrosomia fetal te nuinga o te wā mā ngā ine ultrasound e whakatau ana i te taumaha o tō pepeke i mua i te whānau. Ka āwhina ēnei ine ki te kī he nui atu te taumaha o tō pepeke i te mea i tumanakohia mō tōna tau kōreka.

I ō toro whānau, ka inehia e tō tākuta tō teitei fundal, ko te tawhiti tēnei i waenga i tō wheua pubic ki te pito o tō kopu. Ki te nui atu tēnei ine i te mea i tumanakohia mō tō wā haputanga, ka tono pea rātou i ngā whakamātautau atu.

Ka whakarato ngā whakamātautau ultrasound i ngā korero taipitopito rawa atu mō te rahi o tō pepeke. Ka ine te kaiwhakahaere i te upoko, te kopu, me te wheua huha o tō pepeke hei tatau i te taumaha fetal i tumanakohia. Ahakoa ka taea e ēnei tatau te he i te 10-15%, ka hoatu e rātou ki tō rōpū hauora ngā korero whai hua mō te whakarite i tō whānau.

Ka arotake pea hoki tō tākuta i ō hua whakamātautau manawanui huka, ka aroturuki hoki mō ngā tohu o te mate huka, no te mea ko te huka toto kore whakahaere te mea nui e āwhina ana ki te tipu fetal nui.

He aha te maimoatanga mō te macrosomia fetal?

Ko te maimoatanga e aro ana ki te whakahaere i ngā take take me te whakarite mō te whānau haumaru rawa atu mō kōrua ko tō pepeke. Ki te āwhina te mate huka ki te rahi nui o tō pepeke, ko te whakahaere i ō taumata huka toto te mea nui rawa atu.

Ka mahi tahi tō rōpū hauora ki a koe hei whakawhanake i te mahere whakahaere whānui ka taea te whakauru i:

• Te aroturuki me te whakahaere huka toto kaha ki te whai koe i te mate huka kōreka, te mate huka rānei i mua
• Ngā whakarerekētanga kai hei awhina i te whakahaere i ngā taumata huka, te whakahaere i te taumaha
• Te whakakori tinana noa e whakaaetia ana e tō kaiwhakarato hauora
• Ngā whakaritenga whānau noa atu hei aroturuki i te tipu o tō pepeke
• Ngā ultrasound atu hei aroturuki i te whanaketanga fetal
• Te whakarite mō te whānau, ka taea te kōrero mō te waehere caesarean ki te whakaatu mai ngā tūponotanga o te whānau vaginal

Ka whakarite hoki tō tākuta mō ngā raruraru pea i te wā whānau mā te whai i te rōpū hauora tika me ngā taputapu e rite ana. Ka āwhina tēnei whakaaro whakamua ki te whakarite i te hua pai rawa atu mō kōrua ko tō pepeke.

Me pēhea te whakahaere i te macrosomia fetal i te kāinga?

Ko te whakahaere i te macrosomia fetal i te kāinga te nuinga o te wā e whai ana i ngā aratohu a tō kaiwhakarato hauora mō te whakahaere huka toto me ngā tikanga haputanga hauora. Ki te whai koe i te mate huka, ko te aroturuki pumau me te whakaritenga rongoā he mea nui mō te whakahaere i te tipu o tō pepeke.

Arotake ki te kai i ngā kai rite me ngā wāhi whakahaere, ina koa te whakaiti i ngā warowai ngāwari ka taea te piki i tō huka toto. Ka tohutohu pea tō rōpū hauora ki a koe tētahi kaiwhakaako kai ka taea te awhina i te hanga i te mahere kai e tautoko ana i tō hauora me te tipu fetal tika.

Noho mahi me ngā whakakori e whakaaetia ana e te tākuta penei i te hikoi, te kauhoe rānei, ka taea te awhina i te whakahaere huka toto me te hauora haputanga whānui. Tāruahia ngā nekehanga o tō pepeke, whakamōhiotia ngā huringa e awangawanga ana ki tō kaiwhakarato hauora.

Tangohia ngā rongoā kua tohua katoa kia rite ki ngā tohutohu, haere atu ki ngā whakaritenga whānau katoa kua whakaritea. He mea nui ēnei toro mō te aroturuki i te tipu o tō pepeke me te whakarerekē i tō mahere maimoatanga kia rite ki te hiahia.

Me pēhea te whakarite mō tō whakatau tākuta?

Ko te whakarite mō tō whakatau ka āwhina i a koe ki te whakamahi pai i tō wā me tō kaiwhakarato hauora, ka whakarite hoki kua whakautuhia ō awangawanga katoa. Tuhia ngā pātai, ngā tohu rānei kua kite koe mai i tō toro whakamutunga.

Kawe mai he rārangi katoa o ngā rongoā, ngā huaora, me ngā tāpiringa katoa e tangohia ana e koe, me ō rārangi huka toto ki te aroturuki koe i ngā taumata huka. Kia rite ō korero inihua me ō rēkōta hauora o mua.

Whakaritea ki te kōrero mō tō kai, tō mahi whakakori, me ngā tohu katoa kua kite koe. Ka hiahia tō tākuta ki te mohio mō ngā huringa i te nekehanga fetal, te kore ngāwari noa, te awangawanga rānei mō te rahi o tō pepeke.

Whakaarohia te kawe mai i tētahi tangata tautoko ka taea te awhina i a koe ki te mahara ki ngā korero nui me te whakarato i te tautoko ngākau i te wā e kōrero ana mō te whakarite whānau me ngā raruraru pea.

He aha te mea nui mō te macrosomia fetal?

Ko te macrosomia fetal he āhuatanga ka taea te whakahaere e pā ana ki ngā haputanga maha, ā, me te tiaki hauora tika, ko te nuinga o ngā whaea me ngā pepeke e whai hua pai ana. Ko te mea nui ko te mahi tata atu ki tō rōpū hauora hei aroturuki i te tipu o tō pepeke me te whakarite mō te whānau haumaru rawa atu.

Ki te whai koe i ngā take tūponotanga penei i te mate huka, ko te tango i ngā mahi hei whakahaere i tō huka toto ka taea te pānga nui ki ngā tauira tipu o tō pepeke. Kia mahara ko te whai i te pepeke nui ake kaore i te tikanga ka puta ngā raruraru, engari ko te whakarite ka āwhina i te katoa ki te whakarato i te tiaki pai rawa atu.

Titiro ki te matauranga o tō rōpū hauora, kaua e whakaroa ki te ui pātai mō tō āhuatanga motuhake. He motuhake ia haputanga, ka whakaritea e ō kaiwhakarato tā rātou whakaaro hei hoatu i te hua pai rawa atu mō kōrua ko tō pepeke.

Ngā pātai e ui pinepinetia ana mō te macrosomia fetal

Ka taea te aukati i te macrosomia fetal?

Ahakoa kaore e taea e koe te aukati i ngā take katoa o te macrosomia fetal, ko te whakahaere i te mate huka me te pupuri i ngā taumata huka toto hauora ka whakaiti nui i te tūponotanga. Ko te kai i te kai rite, te noho mahi e whakaaetia ana e tō tākuta, me te haere atu ki ngā whakaritenga whānau katoa ka āwhina i te whakapai ake i ngā tauira tipu o tō pepeke.

Me whai C-section pea ahau ki te whai macrosomia taku pepeke?

Kāo pea. He maha ngā wāhine e whai ana i ngā pepeke macrosomia e whānau ana i te vaginal kaore he raruraru. Ka whakaarohia e tō kaiwhakarato hauora ngā take penei i te taumaha o tō pepeke, te rahi o tō upoko, me tō hauora whānui hei tūtohutia te huarahi whānau haumaru rawa atu mō tō āhuatanga motuhake.

He tika ngā tatau taumaha ultrasound mō ngā pepeke nui?

Ka taea e ngā tatau ultrasound te he i te 10-15% i tetahi ara, ā, ko tēnei tawhiti he nui ake mō ngā pepeke nui ake. Ka whakamahi tō rōpū hauora i ēnei tatau hei taputapu kotahi i roto i te maha hei whakarite i tō tiaki, ehara i te kī whakatau mō te taumaha whānau tika o tō pepeke.

Me whai raruraru hauora pea taku pepeke ki te whānau nui?

Ko te nuinga o ngā pepeke e whai ana i te macrosomia e ora ana i te whānau, ka haere tonu te whanaketanga noa. Ko ētahi pea ka hiahia ki te aroturuki mō ngā taumata huka toto i muri tonu i te whānau, engari he iti ngā raruraru hauora roa e kore e noa ina whakaratohia te tiaki hauora tika i te wā whānau me muri iho.

Ko te whai i tetahi pepeke nui te tikanga ka nui katoa aku pepeke kei te heke mai?

Ko te whai i tetahi pepeke macrosomia ka nui ake tō tūponotanga mō ngā pepeke nui kei te heke mai, engari kaore i te whakamana. Ka aroturuki tata atu e tō kaiwhakarato hauora ngā haputanga kei te heke mai, ka tūtohu pea i te tirotiro wawe mō te mate huka me ētahi atu take tūponotanga hei awhina i te whakahaere i te tipu fetal.