Macrosomia Y'Uruhinja
Incamake
Ijambo "fetal macrosomia" rikoreshwa mu kuvuga umwana wavutse urebye urenze urugero rusanzwe.
Umwana ubonwa ko afite fetal macrosomia aba apima ibiro birenga 8, onsi 13 (garama 4000), bitabaye ngombwa ko bareba igihe amaze atwite. Abana bagera kuri 9% ku isi bapima ibiro birenga 8, onsi 13.
Ibyago bifitanye isano na fetal macrosomia byiyongera cyane iyo umwana apima ibiro birenga 9, onsi 15 (garama 4500).
Fetal macrosomia ishobora kubangamira kubyara mu nda kandi ishobora gushyira umwana mu kaga ko gukomereka mu gihe cyo kubyara. Fetal macrosomia inashyira umwana mu kaga ko kugira ibibazo by'ubuzima nyuma yo kuvuka.
Ibimenyetso
Macrosomia y'umwana iterwa n'uburemere bwinshi ishobora kugorana kuboneka no kubona mu gihe cyo gutwita. Ibimenyetso n'ibibonwa birimo:
-
Uburebure bw'ingingo nini. Mu buvuzi bwo gutwita, umuvuzi wawe ashobora kupima uburebure bw'ingingo yawe - intera kuva hejuru y'umura w'inda kugeza ku gice cy'amagufwa yawe. Uburebure bw'ingingo burebure kurusha ibyitezwe bishobora kuba ikimenyetso cya macrosomia y'umwana.
-
Amazi menshi mu nda (polyhydramnios). Kugira amazi menshi mu nda - amazi akikije kandi akarengera umwana mu gihe cyo gutwita - bishobora kuba ikimenyetso cy'uko umwana wawe ari munini kurusha ubwinshi.
Ubwinshi bw'amazi mu nda bugaragaza umusaruro w'inkari z'umwana wawe, kandi umwana munini akora inkari nyinshi. Amwe mu maganya atuma umwana aba munini ashobora kandi kongera umusaruro w'inkari ze.
Impamvu
Impamvu zishingiye kuri gene na bimwe mu bibazo by'umubyeyi nk'ubunyerere cyangwa diyabete bishobora gutera umwana wavutse akaba munini cyane. Gake, umwana ashobora kugira ikibazo cy'ubuzima kimutera gukura cyane no kuba munini.
Rimwe na rimwe, ntabwo bizwi icyatuma umwana aba munini kurusha ubundi.
Ingaruka zishobora guteza
Hari impamvu nyinshi zishobora kongera ibyago byo kubyara umwana munini cyane - zimwe urashobora kugenzura, ariko izindi ntushobora kugenzura.
Kurugero:
- Indwara ya diyabete ku mubyeyi. Kubyara umwana munini cyane bishoboka cyane niba waragize diyabete mbere y'inda (diyabete yabayeho mbere y'inda) cyangwa niba ugize diyabete mu gihe utwite (diyabete y'igihe cyo gutwita).
Niba diyabete yawe idagenzurwa neza, umwana wawe ashobora kugira amaboko manini kandi akagira ibinure byinshi kurusha umwana nyina atagira diyabete.
- Amateka yo kubyara umwana munini cyane. Niba warabyaye umwana munini mbere, uri mu kaga kenshi ko kongera kubyara undi mwana munini. Nanone, niba wapimaga ibiro birenga 8, onsi 13 (ibiro 4) wavutse, ushobora kongera kubyara umwana munini.
- Umuvuzo ku mubyeyi. Kubyara umwana munini cyane bishoboka cyane niba uri umubyibuho.
- Kwiyongera k'uburemere mu gihe cyo gutwita. Kwiyongera k'uburemere mu gihe cyo gutwita byongera ibyago byo kubyara umwana munini cyane.
- Inda zabanje. Ibyago byo kubyara umwana munini cyane byiyongera buri gihe utwite. Kugera ku gihe cyo gutwita cya gatanu, ibiro by'umwana wavutse kuri buri gihe cyo gutwita gikurikira bisanzwe byiyongera kugeza kuri onsi 4 (garama 113).
- Kugira umuhungu. Abana b'abahungu basanzwe bapima ibiro bike kurusha abana b'abakobwa. Abana benshi bapima ibiro birenga 9, onsi 15 (garama 4,500) ni abahungu.
- Gutwita kurenze igihe. Niba gutwita kwawe bikomeza ibyumweru birenga bibiri nyuma y'itariki yawe yo kubyara, umwana wawe ari mu kaga kenshi ko kubyara umwana munini cyane.
- Imyaka y'umubyeyi. Abagore barengeje imyaka 35 bafite ibyago byinshi byo kubyara umwana ufatwa nk'umwana munini cyane.
Kubyara umwana munini cyane bishoboka cyane kubera diyabete ku mubyeyi, umubyibuho cyangwa kwiyongera k'uburemere mu gihe cyo gutwita kurusha izindi mpamvu. Niba ibyo bintu byongera ibyago bitahari kandi bikekwa ko umwana azaba munini cyane, birashoboka ko umwana wawe ashobora kugira uburwayi bwose buke bugira ingaruka ku mikurire y'umwana.
Niba uburwayi bwose buke bugira ingaruka ku mikurire y'umwana bukekwa, umuvuzi wawe ashobora kugusaba ibizamini byo kuvura mbere y'igihe kandi ashobora kukugeza ku muganga w'umutungo, bitewe n'ibisubizo by'ibizamini.
Ingaruka
Ukutagira ubushobozi bw'umwana mu nda bigira ingaruka ku buzima bwawe n'ubw'umwana wawe — haba mu gihe cyo gutwita no nyuma yo kubyara.
Kwirinda
Ushobora kudakora ikintu cyose ngo wirinde ko umwana wavuka afite umubiri munini cyane, ariko ushobora guteza imbere imbyaro nzima. Ubushakashatsi bwerekana ko gukora imyitozo ngororamubiri mu gihe utwite no kurya indyo ifite igipimo gito cya glycemic bishobora kugabanya ibyago byo kubyara umwana ufite umubiri munini cyane. Kurugero:
- Tegura inama mbere yo gutwita. Niba utekereza gutwita, hamagara umuganga wawe. Niba uri umubyibuhe, ushobora no koherezwa kwa muganga wundi — nka dietician wabigize umwuga cyangwa inzobere mu ndwara z'ubumubyibuhe — uzagufasha kugera ku bunyamanswa bwiza mbere yo gutwita.
- Kwirinda ibiro. Kugira ibiro bikwiye mu gihe utwite — akenshi ibiro 25 kugeza kuri 35 (hafi kg 11 kugeza kuri 16) niba ufite ibiro bisanzwe mbere yo gutwita — bishyigikira gukura kw'umwana wawe n'iterambere rye. Abagore bafite ibiro byinshi igihe batwite bazagira ibiro bike byateganijwe byo kwiyongera mu gihe cyo gutwita. Korana n'abaganga bawe kugira ngo umenye icyakubereye cyiza.
- Kwita kuri diyabete. Niba warwaye diyabete mbere yo gutwita cyangwa niba ufite diyabete iterwa no gutwita, korana n'abaganga bawe kugira ngo ubone uko uyirinda. Kugira urwego rw'isukari mu maraso ni bwo buryo bwiza bwo kwirinda ingaruka, harimo no kubyara umwana ufite umubiri munini cyane.
- Kora imyitozo ngororamubiri. Kora imyitozo ngororamubiri nkuko umuganga wawe abikugira inama.
Kupima
Umuntu mukuru w'uruhinja ntashobora kuvurwa kugeza nyuma y'aho umwana avutse akapimwa. Ariko rero, niba ufite ibyago byo kuba umwana wawe mukuru, umuvuzi wawe arashobora gukoresha ibizamini kugira ngo akurikirane ubuzima n'iterambere ry'umwana wawe mu gihe utwite, nka: Iskaneri y'amajwi. Mu mpera z'amezi atatu ya nyuma yo gutwita, umuvuzi wawe cyangwa undi muntu wo mu kigo nderabuzima ashobora gukora iskaneri y'amajwi kugira ngo apime ibice by'umubiri w'umwana wawe, nka umutwe, igifu n'umugongo. Umuvuzi wawe azashyira ibi bipimo mu buryo bwo kubara kugira ngo amenye ibiro by'umwana wawe. Ariko, uburyo bwo gupima umwana mukuru hakoreshejwe iskaneri y'amajwi ntibwizewe. Ibizamini byo gutwita. Niba umuvuzi wawe akekako umwana wawe mukuru, ashobora gukora ibizamini byo gutwita, nko gupima umutima w'umwana cyangwa gusuzuma imiterere y'umubiri w'umwana, kugira ngo akurikirane imibereho y'umwana wawe. Gupima umutima w'umwana bipima umuvuduko w'umutima w'umwana hashingiwe ku myanya ye. Gusuzuma imiterere y'umubiri w'umwana bihuza gupima umutima w'umwana n'iskaneri y'amajwi kugira ngo hakurikiranwe imiterere y'umwana, imbaraga ze, guhumeka kwe n'umubare w'amazi yo mu nda. Niba ubwinshi bw'umwana wawe butekerezwa ko ari ingaruka z'uburwayi bwa nyina, umuvuzi wawe ashobora kugutegeka gukora ibizamini byo gutwita - guhera mu cyumweru cya 32 cyo gutwita. Menya ko kuba umwana mukuru gusa atari impamvu yo gukora ibizamini byo gutwita kugira ngo hakurikiranwe imibereho y'umwana wawe. Mbere y'uko umwana wawe avuka, ushobora kandi gutekereza ku kuganira n'umuganga w'abana ufite ubunararibonye mu kuvura abana bafite uburwayi bw'umwana mukuru. * Iskaneri y'amajwi. Mu mpera z'amezi atatu ya nyuma yo gutwita, umuvuzi wawe cyangwa undi muntu wo mu kigo nderabuzima ashobora gukora iskaneri y'amajwi kugira ngo apime ibice by'umubiri w'umwana wawe, nka umutwe, igifu n'umugongo. Umuvuzi wawe azashyira ibi bipimo mu buryo bwo kubara kugira ngo amenye ibiro by'umwana wawe. Ariko, uburyo bwo gupima umwana mukuru hakoreshejwe iskaneri y'amajwi ntibwizewe. * Ibizamini byo gutwita. Niba umuvuzi wawe akekako umwana wawe mukuru, ashobora gukora ibizamini byo gutwita, nko gupima umutima w'umwana cyangwa gusuzuma imiterere y'umubiri w'umwana, kugira ngo akurikirane imibereho y'umwana wawe. Gupima umutima w'umwana bipima umuvuduko w'umutima w'umwana hashingiwe ku myanya ye. Gusuzuma imiterere y'umubiri w'umwana bihuza gupima umutima w'umwana n'iskaneri y'amajwi kugira ngo hakurikiranwe imiterere y'umwana, imbaraga ze, guhumeka kwe n'umubare w'amazi yo mu nda. Niba ubwinshi bw'umwana wawe butekerezwa ko ari ingaruka z'uburwayi bwa nyina, umuvuzi wawe ashobora kugutegeka gukora ibizamini byo gutwita - guhera mu cyumweru cya 32 cyo gutwita. Menya ko kuba umwana mukuru gusa atari impamvu yo gukora ibizamini byo gutwita kugira ngo hakurikiranwe imibereho y'umwana wawe.
Uburyo bwo kuvura
Igihe kigeze cyo kubyara umwana wawe, kubyara mu nda ntabwo bizaba ari ikibazo. Umuganga wawe azakuganiraho amahitamo, ibyiza n'ibibi byabyo. Azakurikirana imibyibuho yawe hafi kugira ngo arebe ibimenyetso byerekana ko kubyara mu nda bishobora kugorana.
Gutera imbaraga kubyara—gutera inkunga imikoko y'umubyibuho mbere y'uko kubyara gutangira ukwabyo—nta gaciro bifite. Ubushakashatsi bwerekana ko gutera imbaraga kubyara bidafasha kugabanya ibyago by'ibibazo bijyanye n'umwana ukomeye cyane kandi bishobora kongera ibyago byo kubagwa.
Umuganga wawe ashobora kugutegurira kubagwa niba:
Niba umuganga wawe akugiriye inama yo kubagwa, menya neza ko mwaganiriye ku byiza n'ibibi byabyo.
Nyuma y'uko umwana wawe avutse, azasuzumwa kugira ngo barebe niba hari ibikomere byo kubyara, isukari yo mu maraso iri hasi cyane (hypoglycemia) n'indwara y'amaraso igira ingaruka ku mubare w'utubuto tw'amaraso atukura (polycythemia). Ashobora kuba akeneye kwitabwaho mu bitaro mu cyumba cyita ku bana bavutse batarakuze.
Zirikana ko umwana wawe ashobora kuba afite ibyago byo kugira umubyibuho ukabije mu buto bwe no kudakora neza kwa insulin kandi agomba gukurikiranwa kuri ibyo bibazo mu bugenzuzi bw'ejo hazaza.
Kandi, niba utaravurwa diabete kandi umuganga wawe ahangayikishijwe n'amahirwe yo kurwara diabete, ushobora gupimwa kuri iyo ndwara. Mu gihe cyo gutwita mu gihe kizaza, uzakurikiranwa hafi kugira ngo barebe ibimenyetso bya diabete iterwa no gutwita—ubwoko bwa diabete butangira mu gihe cyo gutwita.
- Ufite diabete. Niba warwaye diabete mbere yo gutwita cyangwa ukayirwara mu gihe cyo gutwita kandi umuganga wawe abona ko umwana wawe apima ibiro 9, onsi 15 (garama 4,500) cyangwa birenga, kubagwa bishobora kuba uburyo bwiza bwo kubyara umwana wawe.
- Umwana wawe apima ibiro 11 cyangwa birenga kandi nta mateka ya diabete ya nyina ufite. Niba udafite diabete mbere yo gutwita cyangwa diabete iterwa no gutwita kandi umuganga wawe abona ko umwana wawe apima ibiro 11 (garama 5,000) cyangwa birenga, kubagwa bishobora kugutegurira.
- Wabyaye umwana wagize ikibazo cyo gufatwa n'ibitugu inyuma y'igitugu (shoulder dystocia). Niba wabyaye umwana umwe wagize ikibazo cyo gufatwa n'ibitugu inyuma y'igitugu, ufite ibyago byinshi byo kongera kugira icyo kibazo. Kubagwa bishobora kugutegurira kugira ngo wirinde ibyago bijyanye no gufatwa n'ibitugu inyuma y'igitugu, nko kuvunika kw'igitugu.
Umuhakana: Kanama ni urubuga rw'amakuru y'ubuzima kandi ibisubizo byayo ntibigize inama z'ubuvuzi. Jya ubona umuganga ufite uruhushya rwo gukorera hafi yawe mbere yo gukora impinduka izo ari zo zose.