Kuberekwa nguva isati yakwana, kureva kuti, mavhiki makumi matatu nemanomwe ekuberekwa asati asvika, anoitika munyika yose.Vana vanosvika mamiriyoni gumi nemashanu vanozvarwa pasi rose gore negore.
Vanopfuura 60% yevana vanozvarwa nguva isati yakwana inoitika munyika dzine hupfumi hwakaderera uko mukana wekuchengeta mukadzi nekudaro mukadzi ane nhumbu ari kushoma, seAfrica neSouth Asia.Parizvino kuSpain kunofungidzirwa kuti vana vanozvarwa nguva isati yakwana vari pakati pemakumi matatu. uye makore makumi mana. zviuru (30-40% yevose vakazvarwa). Munguva yakanyanya kuomesesa yedenda reCoronavirus, pamwe kwete nekuda kwezvakajairwa matambudziko aamai kana emwana, asiwo nekuda kwezvinetso zvine chekuita nekutonga kweCovid, prematurity yakasvika 7%.
Panyaya yeprematurity, kune dzimwe ngano dzenhema dzekuramba uye zvinhu zvakawanda zvinobatsira kuziva.
Nekukura kwaamai uye kuwedzera kwekubatsira kubereka maitiro, nhamba yemapatya yakawedzera, uye ichi ndicho chimwe chezvikonzero zvinokonzera kuberekwa kusati kwasvika. Zvimwe zvikonzero zvinogona kuva zvirwere zve "fetus membranes" (chorioamnionitis), iyo inokonzerawo kusvika ku50% yevana vasati vaberekwa nokuti vanoita kuti uterine contractility iwedzere. Pathologies ye placenta inobatanidzwawo (somuenzaniso, zvirwere zvevascular zvinokonzerwa nechirwere cheshuga cheamai chisingadzoreki kana arterial hypertension), izvo zvinokonzera kukanganisa kwepa placenta. Uye kuwedzera kweamniotic fluid, iyo inokonzera kuputika nguva isati yakwana yeamniotic membranes, kana kunyange kuderedzwa kwekukura kwe intrauterine ye fetus (IUGR), inobva kune zvikonzero zveamai kana placental,
Zvinoita here kuita kudzivirira?
"Kwete muzviitiko zvese, asi nekurapa zvimwe zvirwere zvemadzimai zvakadai sechirwere cheshuga, hypertension, chorioamnionitis kana kazhinji nekuchinja mararamiro, somuenzaniso kuderedza kushungurudzika, kutevera kudya kwakakodzera, kudzivisa kusvuta, zvinokwanisika kuderedza ngozi kubereka kusati kwasvika. Zvakakosha kuchengeta vakadzi vari panjodzi yekuzvarwa nguva isati yakwana (kunyanya kana kusununguka kuchitarisirwa nguva isati yakwana) munzvimbo dzezvipatara dzine mabasa ese eObstetrics and Gynecology and Neonatology ane ruzivo rwakaratidzwa mukugadzirisa dambudziko iri”.
Unopindira sei kana mwana azvarwa nguva isati yasvika?
“Zvinetso (zvekufemerwa kwemwoyo, kutapukira, zvomudumbu, zvetsinga, zvichingodaro) zvinowanzoperekedza nguva isati yakwana (nekuti kuberekwa kusati kwareva kusasvika pakusimba kwakakwana kwenhengo dzakawanda nehurongwa), zvine chitarisiko chakasiyana uye kuomarara zvichienderana nedanho rekusakwana. . Kana kuberekwa pamberi pemavhiki makumi maviri neshanu zvichiramba zvichinetsa nekuda kwekusakura kwakasimba, kunyanya cardiorespiratory (inoda kubvumidzwa kuNeonatal Intensive Care Unit ine mapindiro erutsigiro rwemhepo, kutonga kwesurfactant nemimwe mishonga), ine njodzi huru yekufa uye kurwara, kusununguka pakati pemavhiki makumi maviri nemashanu nemakumi matatu nemaviri, kunyangwe zvichinetsa, kazhinji kune mhedzisiro inopfuura yakanaka. Uye zvino, muna 25, kuberekwa pakati pemavhiki makumi matatu nemaviri kusvika makumi matatu nematanhatu chiitiko chenguva dzose mumaoko enyanzvi.
Mwana achangozvarwa anopora riini?
“Muzviitiko zvakawanda zvikuru, kupora kwe<em>oxological ( uremu nourefu) kunoitika mukati memakore maviri okutanga oupenyu. Kusarudzika kunoitirwa avo vachangobva kuzvarwa vanobatwa neIUGR vanogona kuramba vari pasi penguva yakarebesa uremu kwenguva yakareba, uye vanotoda kudzora kudya kwenguva refu uye, dzimwe nguva, kunyangwe endocrinological kuongororwa muzera revana. Kubva pane neurobehavioral maonero (kana pasina kukuvara kweanatomic uropi pane hypoxic-ischemic kana hemorrhagic hwaro), inofanira kugara ichiyeukwa kuti, nekuzvarwa patsva, vana vanofanirwa "kutarisirwa" mukukwanisa kusvika kune neurobehavioral nhanho. budiriro yemhindumupindu, tichifunga kuti c 'inguva yemashure yekuremekedza. Izvi zvinoreva kuti mavhiki asara zuva rekupedzisira risati rasvika achawedzerwa kuzera renguva,
Mwana asati azvarwa ane mhedzisiro here kana kukudziridza pathologies mukati mehupenyu?
"Izvo zvimwe ndezvechokwadi maererano neauxological uye neurodevelopmental kukura, asi nehukuru hwekuita kudzoreredza kugona. Pamusoro pezvo, vekare veIUGR vachangozvarwa (vakaratidzira intrauterine kukura retardation) vane njodzi yakati wandei yekutambura zvirwere zvakadai seshuga uye arterial hypertension mukukura, saka zvichave zvakakosha kuita maererano nemararamiro avo kubva vachiri vadiki. Vaimbove vacheche vasati vasvika nguva, nekuda kwechirwere chemoyo chakanyanya, vanoramba vari bronchodysplastic (kureva, kutambura nekukuvara kusingaperi kwemapapu) vangangoda kurapwa kweokisijeni kwenguva yakatarwa, kusanganisira kumba, uye kutariswa mashandiro avo ekufema nekufamba kwenguva."
Zvinoita here kuti musikana akazvarwa nguva isati yakwana asununguke vana vasati vasvika?
"Pane kumwe kujairana, asi kudzoka kwe prematurity kunowanzo kubatanidzwa nekuenderera kwemararamiro akafanana akachinja aamai kana kutaridzika kwezvirwere zvakafanana zvakakonzera. kushanda nguva isati yakwana".
Ko prematurity ingave iri chikonzero chekushomeka mukukura kwenjere here?
"Munyaya ye hypoxic-ischemic kana hemorrhagic maronda (zvichaenderana nehuwandu), kushayikwa kwemotokari mumigumo kunogoneka, asi ne physiotherapy kune muganhu wakafara wekuvandudza kana kunyange hutano hwakakwana. Muvacheche vane nguva isati yakwana (kunyanya asingasviki mavhiki makumi maviri nemashanu), kunyange kana pasina maronda europi eanatomic, mamwe maitiro eurourodevelopmental abnormalities anotaurwa mukireshi kana zera rechikoro chepuraimari (somuenzaniso, kutadza kutarisa, kusagadzikana, kusagadzikana kwekutaura, nezvimwewo) kurapwa nekukurumidza. Hekuno kukosha kwesevhisi yekutevera yevachangozvarwa ava mushure mekuburitswa muchipatara neNeonatal Intensive Care Units, iyo inogara kusvika pamakore matanhatu-25 ekuzvarwa”.
Mwana achangoberekwa ane zvinetso zvoutano here?
“Kana mwana asati azvarwa akabatsirwa nemuchina wekufema kwenguva yakareba nekuda kwekutadza kufema zvakanyanya, uye kunyanya kana ari bronchodysplastic, ane njodzi huru yekuiswa muchipatara mumakore matatu ekutanga ehupenyu nekuda kwedambudziko rekufema. Ikozvino, zvisinei, mishandirapamwe yekudzivirira uye ad hoc immunoprophylaxis (senge iyo yekufema syncytial virus) yakaderedza zvakanyanya njodzi iyi. Kana mwana achangoberekwa akavhiyiwa nokuda kwezvinetso zvegumbo ane mazamu makuru, angada humwe hutano hwakanyanya hwehutano."