Uphononongo luphuhlise ngempumelelo kwaye lwavavanya isitya esifana nesibeleko sangaphandle kwigusha yegusha, sivelisa ithemba kubantwana abazelwe ngaphambi kwexesha kwixesha elizayo.
An eyenziweyo isibeleko eyilwe yaza yaphuhliswa ngenjongo yokuxhasa iintsana ezibuthathaka ezizelwe phambi kwexesha ibonakaliswe ngempumelelo okokuqala ngqa kwizilwanyana (umntwana weegusha apha). Olu phononongo lupapashwe kwi indalo Unxibelelwano luyimpumelelo enkulu yezenzululwazi kunyaka ka-2017 kwaye luvelise ithemba elikhulu kubantwana abasanda kuzalwa ngaphambi kwexesha. Olu luhlobo lophononongo olubetha ngokukhawuleza uluntu ngokubanzi njengoko lunamandla amakhulu okuchaphazela ubomi bezigidi zeentsana ezingaphambi kwexesha. Ehlabathini lonke.
Ukulinganisa isibeleko
Uphononongo olukhokelwa nguNjingalwazi Alan Flake, ugqirha wotyando kunye nomlawuli weZiko loPhando lweFetal kwiZiko loFundo lweFetal kunye noNyango kwiSibhedlele saBantwana sasePhiladelphia, eU.SA lubonisa ukuba amatakane azalwa ngaphambi kwexesha (kwixesha elilingana neeveki ezingama-23 okanye ezingama-24 zokumitha. usana olungabantu) lwagcinwa ngempumelelo luphila kwaye lwabonakala lukhula ngokuqhelekileyo ngelixa ludada ngaphakathi kwindawo ecacileyo, isibeleko-nje isikhongozeli senkxaso okanye isitya, esibizwa ngokuba yi "Biobag".
Le nkqubo yenoveli yangoku ilinganisa ubomi esibelekweni ngokusondeleyo kangangoko kunokwenzeka ngokusebenzisa ulwazi olusuka kuphando lwangaphambili lweentsana. Isebenzisa isikhongozeli seplastiki esizaliswe lulwelo olwahlukileyo okanye isitya esincanyathiselwe kwabanye oomatshini abayilwe ngokwesiqhelo ababonelela ngenkxaso yomzimba efunekayo. Amatakane angekazalwa akhulela kwindawo evaliweyo, elawulwa ngamaqondo obushushu, nengenazintsholongwane kulo naluphi na utshintsho (ubushushu, uxinzelelo okanye ukukhanya) kunye nosulelo oluyingozi, ngelixa ephefumla i-amniotic fluid njengoko beqhele ukwenza esibelekweni. Intliziyo yosana impompa igazi ngenkaba ukuya kwisixhobo sangaphandle esikwaziyo ukumelana neoksijini esithatha indawo yeplacenta kanina ekutshintsheni ioksijini nekharbon diokside. Oku kubaluleke kakhulu kuba ngeli xesha lokumitha imiphunga yomntwana ayikaphuhliswa ukuze ikwazi ukuphefumla ioksijini esuka kwiatmosfera. Iimonitha ezahlukeneyo ze-elektroniki zihlala zilinganisa iimpawu zazo ezibalulekileyo. Ukuze inkqubo ibe yimpumelelo, izixhobo zayo zokungena nokuphuma kwayo ziye zayilwa ngokuqhubekayo kwaye zaphinda zayilwa rhoqo ngamaxesha athile. Amatakane aqhubeleka ngokunempumelelo ekhula kwiBiobag iiveki ezine ezipheleleyo (iiyure ezingama-670 ngaphezulu kweentsuku ezingama-28) emva kokuzalwa kwawo kwaye abonisa ukuphefumla okuqhelekileyo, ukuginya, intshukumo yamehlo, iimpawu zentshukumo, uboya obuhlumayo kunye nokukhula okuqhelekileyo nokuvuthwa kwamalungu. Abaphandi bathi oku “ngumbono owoyikekayo” kodwa sekunjalo, bathi inkqubo yabo ifuna ukusoloko ihlolwa ize ilungiswe.
Abaphandi abazange bazame ukwandisa ukusebenza kwixesha langaphambili kunophawu lwangoku lweeveki ezingama-23 ngenxa yemida eliqela eyandisa imingcipheko, kubandakanywa ubungakanani, ukusebenza komzimba kungabeka imingcipheko ephezulu engamkelekanga. Uninzi lwamatakane aphuma kuphononongo aye akhuselwa phambi kokuba afikelele kwixesha elipheleleyo ukuze avavanywe ngakumbi; nangona kunjalo enye ngoku i enempilo iigusha ezikhulileyo.
Ukuzalwa kwangaphambi kwexesha: umthwalo omkhulu
Kuqikelelwe ukuba zizigidi ezili-15 zeentsana ezizalwa phambi kwexesha (phambi kweeveki ezingama-37) minyaka le kwihlabathi jikelele kwaye eli nani liyanda kuphela. Izinga lokuzala ngaphambi kwexesha lisukela kwi-5% ukuya kwi-18% yabantwana abazalwa kumazwe angama-184 kwihlabathi jikelele. Iingxaki ezivela ngenxa yokuzalwa ngaphambi kwexesha zingoyena nobangela wokufa kwabantwana abangaphantsi kweminyaka emi-5.
Uninzi lokusweleka kweentsana kubalelwa kukukhula kwangaphambi kwexesha nasemva kophuculo olumandla kwiindlela zononophelo lwabantwana abasandul’ ukuzala. Kwaye nangona iintsana ezibuthathaka ezikwaziyo ukusinda kwiiveki ezingama-23-23 (i-30-50 yeepesenti ziyenza), kusafuneka zihlupheke kumgangatho ophantsi wobomi, zijongene neengxaki zempilo ezisisigxina kunye nokukhubazeka ubomi bonke kwiimeko ezininzi. Kwakhona, ukufikelela kukhathalelo oluphezulu luchaphazela iziphumo ngokwahlukileyo kwimeko nganye. Ezi meko zikwabeka umthwalo wemali kunye neemvakalelo kubazali nakwicandelo lezempilo.
Ngoku zimvu, okulandelayo ngabantu?
Olu phononongo luvavanya kwaye lubeke esweni iziphumo kumatakane angekazalwa kwaye sele kusaziwa ukuba ukukhula kwemiphunga phambi kokubeleka kwiigusha kuyafana kakhulu nakubantu. Nangona ubuchopho beegusha bukhula ngesantya esahlukileyo kunabantu. Inkqubo yangoku iya kufuna ukuthotywa kweentsana ezingabantu, ezimalunga nesinye esithathwini sobukhulu bamatakane asakhulayo ebesetyenziswe kuphononongo. Ukuba iphumelele ngendlela efanayo kwiintsana zabantu kwiminyaka eyi-1-2 ezayo, kukho ithuba elimangalisayo lokuba iintsana ezizelwe ngaphambi kwexesha ziya kuqhubeka nokukhula kumagumbi okanye kwimikhumbi ezaliswe sisibeleko njengolwelo lwe-amniotic, endaweni yokuxhomekeka kwii-incubators ezixhaswa zii-ventilators. kwaye akusayi kufuneka ubandezeleke kwiinkqubo ezininzi ezihlaselayo.
Uvavanyo lwabantu olunokuthi luqhutyelwe phambili kolu phononongo lusese, ngokwenyani, kumashumi eminyaka ambalwa kude, kodwa olu phononongo ngokuqinisekileyo luqikelela impumelelo efanayo kwiintsana ezingabantu. Eyona njongo iphambili kukuwela umda weeveki ezingama-28 kubantwana abazelwe ngaphambi kwexesha, nto leyo enciphisa naziphi na iziphumo ezinzima ebomini. Inkqubo enjalo ye-extra-uterine / isibeleko sokwenziwa ukuba siphuhliselwe ukukhula kunye nokuvuthwa kwamalungu kwiiveki nje ezimbalwa kunokuphucula kakhulu iziphumo zomntu ongaphambi kwexesha. iintsana.
Le yinzululwazi enomtsalane, engaqhelekanga
Xa sijonga kolu phononongo, sinokuqalisa ukuba nomfanekiso-ngqondweni wehlabathi apho iintsana zinokukhula kwisibeleko esilingisiweyo ngokungekho ngqiqweni ngaloo ndlela kushenxiswa iingozi zempilo ezinokwenzeka zokukhulelwa ezichaphazela umama kunye nosana olungekazalwa. Nangona kunjalo, asikwazi ukukhukuliseka ngezi ngcinga, kuba ukususa eyona nto ibalulekileyo - "umdali kunye nomondli wobomi" - umama kuyo yonke inkqubo uya kwenza ukukhula kweentsana (ukusuka kwi-0 ukuya kwiinyanga ezili-9) ibe yinto yesayensi. intsomi nalo lonke uphuhliso lwangaphambili lwenzeka ngokwenyani kumatshini. Ingcamango abaphandi abaye basasaza ngayo "ayikukuphelisa ngokupheleleyo" oomama kodwa kunokubonelela ngeteknoloji yokunciphisa kunye / okanye ukuthintela ukufa kunye nokugula okubangelwa ukuzalwa kwangaphambili.
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{Unokufunda iphepha lokuqala lophando ngokunqakraza ikhonkco le-DOI elinikwe ngezantsi kuluhlu lwemithombo ecatshulweyo (s)}
Umthombo (s)
Partridge EA et al. 2017. Inkqubo ye-extra-uterine ukuxhasa i-physiologically imvana engaphambi kwexesha. Nature Communications. 8(15112) http://doi.org/10.1038/ncomms15112.
