Chingwe kukodwa

Onse miyezi inayi ya mimba mayi ndi mwana ndi kugwirizana kudzera chingwe umbilical anakafika ku khoma m'mimba wa mwana wosabadwayo (malo awa, ndi pambuyo pa kubadwa kwa chilonda, wotchedwa Mchombo) ndi Ufumuyo latuluka lapansi. Chingwe umbilical ndi chingwe mu mawonekedwe a swirling mwauzimu kupanga munthu ndi awiri umbilical mtsempha mitsempha. Wolumikizira magazi ndi mpweya ndi chakudya kwa mwana wosabadwayo ku nsengwa ndi umayenda mwa mtsempha wamagazi ndi umbilical. Mwa mtsempha ku latuluka akubwereranso ku magazi mwana wosabadwayo, olemera ndi mpweya woipa ndi mankhwala kagayidwe kachakudya. N'zotheka kukodwa umbilical chingwe n'loopsa moyo yoopsa chifukwa chakuchepa mpweya (yoopsa hypoxia). Pambuyo kudula chingwe umbilical pobadwa, amayamba kukhala mosiyana ndi mayi ake. kudula oyambirira a chingwe umbilical (choyamba masekondi angapo pambuyo yobereka) kumabweretsa imfa ya magazi wolumikizira ndi akusowa wa chitsulo ndi hemoglobin m'magazi neonatal.

Kumatetezera zipangizo za mchombo umbilical (asatengere iliyonse zoipa ndi kuwononga makina) ozungulira zakudya zawo zapadera monga chuma ongokhala mucopolysaccharides ndipo anaitana odzola Wharton a. Umbilical chingwe osati amalola nzeru wolumikizira ndi magazi venous pakati pa thupi la mayi ndi mwana wosabadwayo, komanso kupanga magulu ake madzimadzi amniotic, imene pa zifukwa zosiyanasiyana, angayambe chingwe kukodwa. Kukulitsa ndi mwanayo, chingwe umbilical kuti tsiku la kubadwa wakhanda limafanana zambiri kuwonjezera (pafupifupi 55 cm) ndipo ali awiri ndi theka masentimita awiri.

Pali kuvutika ambiri chingwe umbilical, izo Sizotheka kukhazikitsa mothandizidwa ndi ultrasound akalandire chithandizo. Ambiri a iwo sali zoonekeratu mpaka yobereka. Only mu nkhani ya monochorionic mapasa (mapasa ofanana, nawo latuluka wamba), chosagawanika khoma latuluka previa (ndi chiopsezo detachment ake) mukhonza kuwapeza Chenjezo. Zoterezi anomaly ngati njira chingwe kukodwa zinthu chiopsezo, amene yodziwika ndi zosiyanasiyana mavuto ndipo amafuna makhalidwe ena kuteteza odwala kugwirizana ndi imfa.

chingwe kutalika zifukwa osadziwika mu 5% milandu mwina osakwana 35 cm, ndi 5% yaitali kuposa masentimita 80. Short zingwe umbilical kuchepetsa ndi kuphwanya intrauterine yoopsa kuyenda ndi kulenga chiopsezo detachment msanga wa latuluka lapansi. Nthaŵi yaitali umbilical chingwe kukodwa zimathandiza kuti mwana wosabadwayo, kuti ndi chingwe kukodwa kumachitika chifukwa mapangidwe mfundo zoona. Chiwerengero cha kutalika kwa chingwe umbilical prenatally (i.e., isanafike yobereka) sizingatheke. Koma mfundo zoona pa mimba akhoza kupangidwa pa chingwe umbilical ndi malo onyenga. Pa mfundo woona kuimira pafupifupi 1% ya mimba ndi chiwerengero mkulu wa milandu mapasa monochorionic. mfundo Zonama (anaŵerama ziwiya chingwe umbilical) ndi ambiri, koma si owopsa kwa mwana wosabadwayo.

N'zoona chingwe msonkhano kumachitika chifukwa kayendedwe ka mwana wosabadwayo ndipo angayambe mu magawo oyambirira mimba pamene pali ndi wambirimbiri madzimadzi amniotic (amniotic madzimadzi), kotero kayendedwe wa mwana wosabadwayo kwambiri. Chiopsezo mapangidwe mfundo zoona mwachindunji amadalira zaka mayi, kutalika kwa chingwe umbilical ndi kuchuluka kwa madzimadzi amniotic. Pafupipafupi nkhawa ndi kuonjezera mlingo wa zikuwonjezereka masiku ano mu thandizo magazi kuonjezera sayenda wa mwana wosabadwayo.

N'zotheka chingwe kukodwa diagnoztsiruyut wa hypoxia yoopsa pa Cardiotocographic kafukufuku. Ndiye kuphunzira echographic ikuchitika, imene kukhalapo imatengedwa zingwe zopota popangidwa ndi chingwe umbilical m'dera khosi. Komanso kunyamula mtundu Doppler kuphunzira ndi kuphunzira kayendedwe ka magazi kudzera ziwiya. Ngati mukukayikira kuti hypoxia yoopsa, maphunziro awa abwerezedwa lonse mkazi mimba kangapo chifukwa cha kayendedwe ka ndi mfundo wosabadwa akhoza osati zosokoneza, komanso kumasulira. Entwining umbilical chingwe pobadwa amachititsa yoopsa bradycardia. Kuchepetsa chiopsezo kulola polojekiti apitirize mtima yoopsa, nawonso ntchito imathandizira kukondoweza ntchito, ndipo mu nkhani ya opaleshoni mwadzidzidzi amachitidwa pa m'zigawo mwamsanga mwana wosabadwayo - Kaisara gawo.