Hernia Diafragmatic Congenital (Cdh)

Hernia yeDiaphragmatic Congenital (CDH) chirwere chisingawanzoitika chinoitika mwana asati aberekwa. Inoitika pakutanga kwekumisikidzwa apo diaphragm yemwana — tsandanyama inoparadzanisa chipfuva nedumbu — inokundikana kuvhara sezvaifanira. Izvi zvinosiya gomba mudiaphragm. Gomba rinonzi hernia.

Hernia iyi mutsandanyama we diaphragm inoumba kuvhurika pakati pedumbu nechipfuva. Matumbo, dumbu, itsvo nedzimwe nhengo dzedumbu dzinogona kufamba nepa gomba iri kupinda muchipfuva chemwanakomana. Kana matumbo ari muchipfuva, haazokurire zvibatanidzwa zvakajairwa zvinozvichengeta munzvimbo munzvimbo yedumbu (malrotation). Zvinogona kuzvitenderedza, zvichicheka ropa rayo (volvulus).

Kurapwa kweCDH kunoenderana nekuti chirwere ichi chawanikwa riini, chakakomba sei uye kana paine matambudziko nemwoyo.

Hernia diafragmatic congenital inosiyana zvakanyanya pakukura. Inogona kunge iri nyoro uye ine zvishoma kana kuti pasina migumisiro pamwana, kana kuti inogona kuva yakakomba uye inokanganisa kukwanisa kuunza oxygen kune dzimwe nhengo dzemuviri.

Vana vanoberekwa vaine CDH vanogona kuva ne:

• Dambudziko guru rekufema nekuda kwemapapu madiki asingashande zvakanaka (pulmonary hypoplasia).
• Matambudziko ekukura kwemoyo.
• Kukuvadzwa kwezvimwe zvinhu zviri mudumbu, mudumbu, chiropa nedzimwe nhengo dzemudumbu kana dzikapinda nehernia muchidzanga.

CDH inogona kuwanikwa panguva yekutarisa nhumbu ne ultrasound. Chiremba wenyu anokurukura newe nezve marapirwo anowanikwa.

Muzviitiko zvizhinji, chikonzero chehernia ye diaphragmatic congenital hachizivikanwi. Muzvimwe zviitiko, CDH inogona kusanganiswa nedambudziko regenetic kana kuchinja kwe gene kusina kurongwa kunonzi mutations. Muzviitiko izvi, mwana angave nemamwe matambudziko pakuvapo, akadai se matambudziko emoyo, maziso, maoko nemakumbo, kana mudumbu nemarunda.

Zvinetso zvinogona kuitika neCDH zvinosanganisira:

• Matambudziko emumapfupa.
• Matambudziko esimba, ura, uye itsvo.
• Hosha yemoyo.
• Kuwanda kwehutachiona.
• Kurasikirwa kunzwa.
• Kushanduka kwechigadziko chechifuva nekutambanudza kwemusana.
• Gastroesophageal reflux — asidhi yemudumbu ichidzokera mubhokisi rinonzi esophagus, rinobatanidza muromo nemuviri.
• Matambudziko ekukura nekukura uremu.
• Kushaya simba mukukura nekudzidza.
• Matambudziko mamwe akaonekwa kubva pakuberekwa.

Hernia ye diaphragm inoberekwa nayo kazhinji inowanikwa pakuongororwa kwe ultrasound kwe fetus kunoitirwa usati wazvarwa mwana wako. Kuongororwa kwe ultrasound usati wazvarwa kunoshandisa mafungu ezwi kuita mifananidzo yemukati mako nemwana.

Dzimwe nguva, chirwere chacho chingasawanikwa kusvika pashure pokuberekwa. Zvisingawanzoitiki, CDH ingasawanikwi kusvika paudiki kana gare gare. Izvi zvinogona kunge zviri nekuda kwekuti hapana zviratidzo kana kuti zviratidzo zvakadai sezvinetso zvekufema nezamu zviri nyoro.

Chiremba wenyu anoshandisa ultrasound usati wazvarwa nemiedzo yakawanda kutevera kukura nekuita kwemapapu emwana wenyu, mwoyo nemamwe matunhu panguva yekuzvitakura kwenyu.

Kazhinji, unoita ultrasound yako yekutanga ye fetus mukati memwedzi mishomanana yekutanga (trimester yekutanga) yekuzvitakura kwako. Inosimbisa kuti uri nepamuviri uye inoratidza nhamba nehukuru hwemwana wako kana vana.

Kazhinji kazhinji, unoita imwe ultrasound mukati memwedzi mina kusvika mitanhatu (trimester yechipiri) yekuzvitakura kwako. Chiremba wenyu anotarisa kukura nekukura kwemwana wako. Mupi wako anotarisa saizi nekwakagara mapapu emwana wako, mwoyo nemamwe matunhu.

Kana mwana wako akaratidza zviratidzo zveCDH, mupi wako angakuda kuti uite bvunzo dze ultrasound kazhinji. Izvi zvinogona kuratidza kuti CDH yakakomba sei uye kana iri kuipa.

Miedzo yakawanda inogona kuitwa kuongorora basa rematunhu emwana wako. Idzi dzinogona kusanganisira:

• Fetal magnetic resonance imaging (MRI). Iyi ndiyo nzira yekuongorora inoshandisa magnetic field ne radio waves dzakagadzirwa nekombiyuta kuita mifananidzo yakajeka yematunhu ne tishu muviri wemwana.
• Fetal echocardiogram. Echocardiogram inoshandisa mafungu ezwi kuita mifananidzo yemwoyo wemwana uchikwiza neropa. Mifananidzo kubva ku echocardiogram inogona kuziva matambudziko nemwoyo uri kukura.
• Genetic tests. Kuongororwa kwemajini kunogona kuziva zvirwere zvemajini kana mamwe kuchinja kwemajini anowanzoenderana neCDH. Kurayirwa kwemajini kunogona kukubatsira kunzwisisa mhinduro idzi dze bvunzo uye kukupa ruzivo rwakawanda nezve mamiriro emwana wako.

Kurapa hernia ye diaphragmatic congenital kunoenderana nekuti chirwere ichi chinowanikwa rini uye kuti chakakomba sei. Timu yako yekuchengetedza utano inokubatsira kusarudza kuti chii chinonyanya kukodzera iwe nemwana wako.

Timu yako yekuchengetedza utano inokutarisa zvakanyanya usati wamubereka mwana wako. Kazhinji unowanzoita ultrasound nemiedzo yakawanda kuongorora hutano hwe mwana wako nekusimukira kwake.

Kurapa kunobuda kwe CDH yakakomba kuri kudzidzwa ikozvino kunonzi fetoscopic endoluminal tracheal occlusion (FETO). Kuvhiya uku kunoitirwa mwana wako uri nepamuviri. Chinangwa ndechekubatsira mapapu emwana kukura sezvinobvira usati wamubereka.

FETO inoitirwa mumaitiro maviri:

• Maitiro ekutanga. Maitiro ekutanga anoitika pakutanga mwedzi mishoma yapfuura (trimester yechitatu) yekuzvitakura kwako. Chiremba wako anoita kucheka duku mudumbu rako nemuchidziro. Chiremba anopinda chubhu chaiyo ine kamera pamugumo, inonzi fetal endoscope, kuburikidza nemuromo wemwana wako uye kupinda mumhepo (trachea). Bhaluni diki inoiswa mu trachea yemwana wako uye inozvimba.

Mvura yemukati yemukati panguva yekuzvitakura, inonzi amniotic fluid, inoyerera mukati nekunze kwemapapu emwana wako kuburikidza nemuromo. Kuzvimba bhaluni kunoramba mvura ye amniotic iri mumapapu emwana wako. Mvura iyi inowedzera mapapu kuti avabatsire kukura.

• Maitiro echipiri. Mushure memavhiki anenge 4 kusvika ku6, une maitiro echipiri. Bhaluni inobviswa kuitira kuti mwana wako agadzirire kutora mweya mumapapu mushure mekuberekwa.

Nzira yekuzvarwa chaiyo inogona kushandiswa kana basa rekubereka richitanga usati wabvisa bhaluni uye kubvisa bhaluni ne endoscopy hazvibviri. Nzira iyi inonzi ex utero intrapartum treatment (EXIT) procedure. Kuberekwa kunoitirwa neC-section ne placental support. Izvi zvinoreva kuti mwana wako anoramba achigamuchira oksijeni kuburikidza ne placenta usati watemwa umbilical cord. Placental support inoramba iripo kusvika bhaluni yabuda uye chubhu yekufema iripo, ichibvumira muchina kutora kufema.

Maitiro ekutanga. Maitiro ekutanga anoitika pakutanga mwedzi mishoma yapfuura (trimester yechitatu) yekuzvitakura kwako. Chiremba wako anoita kucheka duku mudumbu rako nemuchidziro. Chiremba anopinda chubhu chaiyo ine kamera pamugumo, inonzi fetal endoscope, kuburikidza nemuromo wemwana wako uye kupinda mumhepo (trachea). Bhaluni diki inoiswa mu trachea yemwana wako uye inozvimba.

Mvura yemukati yemukati panguva yekuzvitakura, inonzi amniotic fluid, inoyerera mukati nekunze kwemapapu emwana wako kuburikidza nemuromo. Kuzvimba bhaluni kunoramba mvura ye amniotic iri mumapapu emwana wako. Mvura iyi inowedzera mapapu kuti avabatsire kukura.

Maitiro echipiri. Mushure memavhiki anenge 4 kusvika ku6, une maitiro echipiri. Bhaluni inobviswa kuitira kuti mwana wako agadzirire kutora mweya mumapapu mushure mekuberekwa.

Nzira yekuzvarwa chaiyo inogona kushandiswa kana basa rekubereka richitanga usati wabvisa bhaluni uye kubvisa bhaluni ne endoscopy hazvibviri. Nzira iyi inonzi ex utero intrapartum treatment (EXIT) procedure. Kuberekwa kunoitirwa neC-section ne placental support. Izvi zvinoreva kuti mwana wako anoramba achigamuchira oksijeni kuburikidza ne placenta usati watemwa umbilical cord. Placental support inoramba iripo kusvika bhaluni yabuda uye chubhu yekufema iripo, ichibvumira muchina kutora kufema.

FETO ingave isiri sarudzo yakakodzera kune wese munhu. Uye hapana vimbiso pamusoro pemhedzisiro yekuvhiya. Timu yako yekuchengetedza utano inokuyera iwe nemwana wako kuti uone kana muri vakakodzera kuvhiya uku. Taura nechikwata chako nezvemabhenefiti nezvinogona kuitika kwauri nemwana wako.

Kazhinji, unogona kubereka mwana wako kana uchizviberekera kana neC-section. Iwe neanokupa utano munhu anosarudza kuti nzira ipi iri nani kwauri.

Mushure mekuberekwa, timu yekuchengetedza utano inokubatsira kuronga kurapa kunosangana nezvinodiwa nemwana wako. Mwana wako angangoda kutarisirwa mune newborn intensive care unit (NICU).

Mwana wako angangoda kuva nechubhu yekufema. Chubhu yakabatana nemuchina unobatsira mwana wako kufema. Izvi zvinopa mapapu nemwoyo nguva yekukura nekusimukira.

Vana vane matambudziko akaoma emapapu angangoda kurapwa kunonzi extracorporeal membrane oxygenation (ECMO). Izvi zvinozivikanwawo se extracorporal life support (ECLS). Muchina weECMO unoita basa remwoyo nemaphu emwana wako, uchibvumira nhengo idzi kupumha nekurapa.

Nguva yakareba mwana wako anoda rutsigiro rwekufema kunoenderana nekupindura kurapwa nezvimwe zvinhu.

Vana vazhinji vane CDH vane kuvhiya kuvhara gomba mu diaphragm. Kana kuvhiya uku kuchitorwa kunoenderana nehutano hwemwana wako nezvimwe zvinhu. Kutarisirwa kwekuenderera mberi kuve nechokwadi chekuti kugadziriswa kunoramba kuripo kazhinji kunosanganisira chest X-rays.

Mushure mekubva muchipatara, mwana wako angangoda rutsigiro rwakawanda. Izvi zvinogona kusanganisira oksijeni yekuwedzera. Oksijeni inopiwa ne tubing diki yepurasitiki ine prongs inokwana mumhino kana tubing diki yakabatana nemask inopfekwa pamusoro pemhino nemuromo. Rutsigiro rwekudyisa runogona zvakare kudiwa kubatsira kukura nekusimukira. Mishonga inogona kupiwa nezvirwere zvinobatanidzwa ne CDH, senge acid reflux kana pulmonary hypertension.

Kuongororwa kwenguva dzose neanokupa utano wemwana wako kunogona kugadzirisa matambudziko chero api nekukurumidza.

Kudzidza kuti mwana wako ane congenital diaphragmatic hernia kunogona kuunza manzwiro akasiyana-siyana. Ungave une mibvunzo yakawanda nezvechirongwa chekurapa kwauri nemwana wako.

Haufanire kusangana neizvi wega. Kune zviwanikwa zvakawanda zveku kukutsigira iwe nemwana wako. Kana uine mibvunzo nezvemamiriro emwana wako nekurapa, taura nechikwata chako chekuchengetedza utano.