Imivuzo emibini ehloniphekileyo yokuvavanya, ulonwabo olungenammiselo ukusuka kwingcamango yokuba ngumama ozayo, ukutyelela ngokuzayo kwintetho yabesifazane kunye neendlela ezininzi zokuhlalutya ... Ewe, ngokungathandabuzekiyo, ukhathala, kodwa emzabalazweni womntwana ophilileyo, zonke iinkqubo ziyimfuneko, kwaye kufuneka uziphathe enoxanduva eliphezulu, ukuze kamva kungabi bubuhlungu bubuhlungu.
Izifo ezingapheliyo zowesifazane, iimpawu ezingabonakaliyo kwilizwe eliqhelekileyo, "ziyakhupha phezulu" ngexesha lokukhulelwa, kwaye ukungahambi kakuhle kwintsholongwane engozini ye-intrauterine ngokuqhelekileyo kuyimpawu efihliweyo. Yingakho oogqirha bacebise ngokucacileyo kwisigaba sokucwangcisa ukukhulelwa ukuba bafumane uvavanyo losulelo, nangona umama okhuselekileyo eziva ephilileyo. Emva kwayo yonke into, iziphumo zabo ngexesha lokukhulelwa zihluke - ukuphulwa kophuhliso lwayo ukuya ekupheliseni ukukhulelwa okanye ukuzalwa komntwana eneendlela ezinzulu zokugula. Yaye unyango lwe-intrauterine ngexesha lokukhulelwa luyinkimbinkimbi ngenxa yokuthintela ukukhethwa kwezidakamizwa ezisetyenziswayo ngabafazi abakhulelweyo.
Usulelo lwe-intrauterine (VUI) lusulelo lwe-fetus okanye iintsholongwane ezitsha, iintsholongwane, ezinye iindilo ezincinci kwi-utero (ngokusebenzisa i-placenta, i-often-amniotic fluid) okanye ngethuba lokungena kwi-canal yokuzalwa. Kwiimeko ezininzi, umthombo wesifo - umzimba womama, izifo ezingapheliyo ze-genitourinary system (ukuguguzwa kwe-cervix vaginitis, endocervicitis, i-pyelonephritis, ukuvuvukala kwezixhobo ze-uterine, njl.). Ngexesha elifanayo, umngcipheko wokuphuhlisa i-VUI ukwandisa ngokusuleleka kwintsholongwane yesifo esisodwa ngenye ye-pathogen ngexesha lokukhulelwa. Kwakhona, ngezinga elincinci lokutheleleka kwe-intrauterine lingaba ziindlela eziphazamisayo zezifundo zokukhulelwa: i-amniocentesis, i-placentocentesis, ukuqaliswa kwemithi eyahlukahlukeneyo ngokusebenzisa intambo yesigidi, kunye nokunye okunjalo.
Kwizilwanyana ezikhokelela kwizifo ezinzulu kakhulu, zibandakanya izifo eziyinkimbinkimbi:
- i-toxoplasma (toxoplasma);
- (ezinye izifo, ezibandakanya i-syphilis, i-chlamydia, isifo se-enterovirus, i-hepatitis A, i-B, isifo sesifo se-gonococcal, i-listeriosis, isantya esingaba khona, iimvumba);
- rubella (rubella);
- i-cytomegalovirus (cytomegalovirus);
- herpes (herpes).
Makhe sihlolisise ngokubanzi iinkcukacha eziphambili ze-intrauterine izifo ezibangelwa zi zifo:
- I-Toxoplasmosis okanye okuthiwa "isifo sesandla esingcolileyo" ivuyiswa yi-parasite ye-toxoplasma, ephindaphinda ngexesha elibi lokusuleleka kwiiseli zabantu, iintaka kunye nezilwanyana. Usulelo lwamaxesha atholakala ngokuqhagamshelana ne-parasite yezilwanyana ezinomhlaza, umhlaba, kunye nokusetyenziswa kwenyama eluhlaza, imifuno engahlanjululwayo kunye neziqhamo, ngokuqhelekileyo - ngokufelwa igazi. Indlela yokudluliselwa kwesulelo yodwa ihamba ngokuthe tye: ukusuka kumama ukuya kumntwana. Isi sifo se-parasitic sinokufunyanwa ngohlalutyo lwegazi kunye nonyango oluthe ngqo ngexesha lokukhulelwa kunye ne-antibiotic equkethe i-spiramycin, enceda ukunciphisa umngcipheko wokuphuhlisa i-VUI emntwaneni ukuya ku-1%.
- Ukukhusela i-infrauterine yezifo ezibangelwa yintsholongwane ye-rubella , kwinqanaba lokucwangcisa ukukhulelwa kuyimfuneko ukuba idlulise uhlalutyo lobukho bokuzimela kwesi sifo. Ukukhulelwa ngexesha lokukhulelwa, ngokukodwa kwi-trimester yokuqala, kuyingozi kakhulu ngenxa yokungabi nonyango olufanelekileyo kunye nobuchule obuphezulu bokungabikho kokuzalwa komntwana. Umngcipheko wokuphuphuma kwesisu kunye nokufa komntwana kukhula kumaxesha amane. Ukungena kwintsholongwane kwintsholongwane, kubandakanywa izitho zayo, kwenziwa ngokukhawuleza ngexesha lesiganeko sesifo somama. Isiphumo esilungileyo sokuvavanya i-rubella ngaphambi kokukhulelwa singabonisa ukukhubazeka kakuhle kwesi sifo ngenxa yesigqithiso sokutshintshela kubuntwaneni (ngokwemibare, malunga ne-90% yabantwana bahlushwa i-rubella ngokungenasicatshulwa) okanye bagonywe ngeli xesha.
- I-Cytomegalovirus (i-CMV) yi-agent causative ye-intrauterine cytomegalovirus isifo, esingabangela izifo zangaphakathi kunye nengqondo yomntwana. Umngcipheko wokuphuhlisa ii-IVF kunye nesimo se-fetus echaphazelekayo kuxhomekeke ekubeni khona kwama-antibodies kumama kunye nobude bentsholongwane yomntwana. Kwintsholongwane engundoqo yunina, amathuba okusulelwa ngumntwana ngumntwana we-30%. Ngoko ke, abafazi abangenayo i-anti-antibodies kwi-CMV, banconywa ukuhlolwa kwenyanga kwintsholongwane kwii-CMV kunye nezikhombisi zentsholongwane, ikakhulukazi ngexesha lokukhulelwa ngexesha lekwindla nobusika. I-CMV inokufunyanwa kuwo onke amanzi omzimba, ngokunxulumene nalokhu, inokusuleleka nge-airborne kunye neendlela zesondo, ngokugqithisa kwinqanaba lokuzalwa kunye nokuncelisa. Yingakho ubukhulu becala bentsholongwane buwela kunyaka wokuqala wobomi bomntwana. Umntu unokuba ngumphathiswa we-CMV ngaphandle kokubonakalisa iimpawu ezithile zesifo (umfanekiso weklinikhi ufana ne-ARD ye-banal), kodwa ngexesha elifanayo kuba ngumthombo wesifo, kwiimeko ezininzi kuncipha kwi-immunity jikelele.
- Usulelo lwe-intrauterine lwentsholongwane olusisifo sonyango lubangelwa yi-virus ye-herpes simplex, ephezulu kunye ne-CMV. I-Herpes yohlobo lokuqala luvela kuma-100% abantu abadala, ngelixa i-95% yamatyala, kubangelwa amaqanda. Usulelo lwe-fetus luyakwenzeka ngokusuleleka kwintsholongwane okanye ngegazi, elichaphazela i-placenta, umntwana, ubangele ukubunjwa kweentlungu zomntwana. Ukufa kwintsholongwane nanini na ixesha lokuphuhliswa, xa kudlula umda wokuzalwa usufumana usulelo lwe-1% yeziqhamo. Umngcipheko wokusuleleka usana olusandululweyo lwe-herpes (uhlobo lwentlobo yesibini) kwisigaba esicacileyo okanye xa kwenzeka ukunyanzeliswa kwesimo sakhe esingapheliyo ngu-40%. Ukusuleleka kweprayimari ekukhulelweni kwangaphambili kunokukhokelela kwisidingo sokukhupha isisu, ngomhla kamva, ngokujonga rhoqo ukuphuhliswa komntwana kunye nesimo sakhe, iindlela ezisekelwe kwi-ultrasound zingabakho unyango lwe-antiviral (acyclovir) kunye ne-immunomodulating drugs. Xa kunqatshelwe i-herpes yobulili, icandelo le-caesarean liyacetyiswa. Ukusuleleka kwintsholongwane emathunjini kungabonakaliswa zizilonda zendawo yesikhumba okanye amehlo (ophthalmoherpes).
Diagnostics yeVUI
Ukunikezelwa kwe-latency (latency) yeempawu ze-VUI, ukufumanisa ubukho bentsholongwane ye-intrauterine kunzima, kodwa kusenokwenzeka nangokunceda kwezi ndlela ezilandelayo zokuxilonga.
Uphando lwe-DNA usebenzisa indlela ye-PCR (impendulo ye-polym-chain chain) - esetyenziswe ekufumaneni izifo zezifo ezithathelwana ngesondo (STDs). Isiseko sophando sisuka kwizitho zangasese. Isiphumo sineenkcukacha malunga nomphathiswa okanye ubukho besifo esithathelwanayo. Ukucacisa ukuxilongwa, kuxhomekeke kwintlobo ethile ye-pathogen, uphando olongezelelweyo lunokwenziwa ngendlela ye-bacteriological culture kunye nokuhlaziywa kwegazi. Uhlalutyo lwegazi ngenxa yesifo se-intrauterine nge-ELISA (i-enzyme immunoassay)