Ukuzalwa Ngaphambi kwesikhathi (Ukuzalwa Ngaphambi kwesikhathi): Izimpawu, Izimbangela, Ukwelashwa Nokuvimbela

Ukuzalwa ngaphambi kwesikhathi sekuyinkinga ekhulayo emhlabeni wonke ngenxa yemvelo yakho eyinkimbinkimbi. Izibalo zibonisa ukuthi minyaka yonke, cishe izigidi ezingu-15 zabantwana abazalwa ngaphambi kwesikhathi zenzeka emhlabeni wonke, okwenza kube yimbangela ehamba phambili yokufa kwezingane ezisanda kuzalwa. Kuphinde kubangele izinkinga zezempilo zesikhathi esifushane nezesikhathi eside ezinganeni futhi kuzivimbela ukuba ziphile impilo enempilo. Lesi sihloko sizonikeza wonke amaqiniso abalulekile mayelana nokuzalwa ngaphambi kwesikhathi ukuze abazali abakhulelwe bakugweme ukuthi kungenzeki. 

Kuyini Ukuzalwa Ngaphambi Kwesikhathi?

Ukuzalwa ngaphambi kwesikhathi wuhlobo lokubeletha lapho umntwana ezalwa ngaphambi kwamasonto angama-37 ekhulelwe. Uma kwenzeka ukukhulelwa okuvamile, kuthatha amasonto angu-4o ukubeletha ngaphandle kwezinkinga eziningi. Kodwa-ke, izingane ezizalwa ngaphambi kwamasonto angu-37 zithathwa njengezingane ngaphambi kwesikhathi njengoba zibhekana nezinselele ezihlukahlukene zempilo ngenxa yokungathuthuki kwazo ngokugcwele. Lapho izingane zisheshe zizalwa, ziyanda izinselele ezibhekana nazo. 

Izimpawu Eziyinhloko Zokuzalwa Ngaphambi Kwesikhathi 

Kunezimpawu ezithile ezibalulekile ngaphambi kokuphela kwamasonto angama-37 ezingase zibonise ukuzalwa ngaphambi kwesikhathi. Udinga ukuqaphela izimpawu ezilandelayo futhi uthintane nodokotela wakho wezifo zabesifazane ngokushesha nje lapho zivela. 

• Ukwehliswa ngezikhathi ezijwayelekile emahoreni angama-4-6. Ungakuzibi lezi noma zingebuhlungu. 
• Ubuhlungu obungapheli bokubuyela emuva bokuqina okuphansi.
• Ukuzwa uhlobo oluthile lomfutho we-pelvic njengokungathi ingane izama ukuphusha phansi\
• Okunegazi lamafinyila njengokuphuma kwesitho sangasese sowesifazane
• Ukopha esithweni sangasese
• Ukuvuza noma okuphuma uketshezi esithweni sangasese
• Uhudo noma izinkinga zesisu ngaphandle kwesizathu esithile

Ngisho noma izimpawu zithambile, udinga ukubonana nodokotela wakho ngokushesha. Ukutholwa kusenesikhathi nokwelashwa ngokushesha kungavimbela izinkinga zokuzalwa ngaphambi kwesikhathi. 

Izizathu Ezingemuva Kokuzalwa Ngaphambi Kwesikhathi

Kungase kube nezinhlobo ezahlukene zezizathu zokuzalwa ngaphambi kwesikhathi, futhi ngokuvamile isizathu esiqondile asikaziwa. Nokho, ezinye izimo ezivamile zingase zandise amathuba okuzalwa ngaphambi kwesikhathi. 

• Ukutheleleka: Ezinye izifo, ezifana ne-UTI (Urinary Tract Infection) noma i-STI (Izifo Ezithathelwana Ngocansi), zingavusa umhelo ngaphambi kwesikhathi. 
• Ukukhulelwa Okuningi: Uma uthwele izingane ezingaphezu kweyodwa, maningi amathuba okuzalwa ngaphambi kwesikhathi. 
• Izehlakalo Zangaphambilini: Uma u-yoy esevele ezelwe ngaphambi kwesikhathi, kunethuba lokuthi ungase ubhekane nakho futhi. 
• Izinkinga Ze-Placental: Izimo ezibucayi ze-placenta, lapho ihlukana khona nesibeletho (I-Placental Abruption) noma ivale umlomo wesibeletho (i-Placenta Previa), ingabangela ukusikwa ngaphambi kwesikhathi. 
• Ubudala: Ukuba mncane kakhulu noma ukuguga ngesikhathi sokukhulelwa (ngaphansi kweminyaka eyi-17 noma ngaphezulu kwama-35) kungaholela ekuzalweni ngaphambi kwesikhathi. Kulokhu, kubalulekile ukukhumbula ukuthi omama abasebancane babhekana nezinselele eziningi kunomama abadala ngesikhathi sokukhulelwa. 
• Ukuzikhandla ngokweqile: Ukusebenza ngokomzimba ngokweqile ngesikhathi sokukhulelwa, ikakhulukazi phakathi kwe-trimester yesibili neyesithathu, kungandisa ingozi yokuzalwa ngaphambi kwesikhathi. 
• Isici Sendlela Yokuphila: Ukubhema nokusebenzisa utshwala noma izidakamizwa ngesikhathi sokukhulelwa yizona zimbangela eziyinhloko zezinkinga ezihlobene nokukhulelwa futhi zingase ziholele ekuzalweni ngaphambi kwesikhathi. 

Uma unokukhathazeka mayelana nokuzalwa ngaphambi kwesikhathi, kufanele ukhulume nomhlinzeki wakho wokunakekelwa kwezempilo futhi uthathe izinyathelo ezifanele zokuvimbela. 

Sifo

Ukuze uthole ukuxilongwa, udokotela uzoxoxa ngomlando wakho wezokwelapha kanye nendlela yokuphila ukuze aqonde izici eziyingozi. Bazophinde bahlole izimpawu nezimpawu obubhekene nazo. Odokotela bangase benze ukuhlola okulandelayo ukuze baqonde kabanzi isimo sakho. 

• Ukuhlolwa Komchamo: Odokotela bavame ukusikisela ukuhlolwa komchamo ukuze kutholakale ukuthi kukhona amagciwane athile.
• Ukuqapha Isibeletho: Lokhu kuvame ukwenziwa ukuze kubhekwe ubude besikhathi kanye nesikhathi sokufinyela kwakho. 
• I-Ultrasound: Lokhu ukuhlolwa okuvame kakhulu odokotela abavame ukukwenza ngesikhathi sokukhulelwa. Lokhu kubasiza ukuba baqonde indawo yomntwana kanye nevolumu yoketshezi.

Izinkinga Zokuzalwa Ngaphambi Kokuzalwa 

Ukuzalwa ngaphambi kwesikhathi kungabangela izinkinga eziningi enganeni kanye nomama. Ezinye zezinkinga zesikhashana zingabandakanya:

• Izinkinga Zokuphefumula
• Izinkinga zenhliziyo
• I-Intraventricular Hemorrhage 
• Izinga Lomzimba Eliphansi
• Izinkinga Zokugaya 
• Isistimu Yomzimba Ebuthakathaka
• jaundice 

Kukhona futhi izinkinga zesikhathi eside ezingase zivimbele ukukhula okunempilo kwengane. Lokhu kungase kuhlanganise:

• I-Cerebral Palsy
• Ukubambezeleka Kwentuthuko
• Izinkinga Zenkulumo
• Izinselelo Zokuziphatha njenge-ADHD
• Izinkinga Ezingapheli Zamaphaphu

Ukwelashwa

Ezinye izindlela zokwelapha ziyatholakala ukuze kuvikelwe ingane ezinkingeni zokuzalwa ngaphambi kwesikhathi. Lezi zindlela zokwelapha zingahlukaniswa zibe izingxenye ezimbili: 

1. Ngaphambi Kokuzalwa

• Imithi ye-Tocolytic: Le mithi inikezwa ukubambezeleka komsebenzi okwesikhashana ukuze isimo silawuleke.
• Ama-antibiotics: Udokotela uzonikeza ama-antibiotics uma amanzi akho ephuka kusenesikhathi. Kuzonciphisa amathuba anoma yiluphi uhlobo lokutheleleka. 
• I-Magnesium Sulfate: Imithi equkethe i-Magnesium sulfate ivame ukunikezwa ukuvikela ubuchopho bomntwana, ikakhulukazi ngaphambi kwamasonto angu-32. 
• I-Corticosteroids: Lokhu kusiza ekuvikeleni amaphaphu omntwana kanye nokunciphisa ubunzima bokuphefumula. 

2. Ngemva Kokuzalwa

• Ukunakekelwa kwe-NICU: Ngemva kokuzalwa, izingane zangaphambi kwesikhathi zifakwa ngaphakathi kwama-incubators ukuze zifudumale. Lokhu kusiza futhi ekugcineni izinga lokushisa lomzimba wabo.
• Ukwesekwa Kokungenisa umoya: Lokhu kuyadingeka uma amaphaphu ezingane engathuthukisiwe. 
• I-Phototherapy: Lokhu ukwelashwa okuvamile ezinganeni ezizalwa ngaphambi kwesikhathi eziba ne-jaundice. Zifakwa ngaphansi kokukhanya okukhethekile ukuze imisoco ingahlakazwa.
• Ukwesekwa Kokudla: Izingane ezizalwa ngaphambi kwesikhathi ngokuvamile zidinga umsoco we-IV lapho zinceliswa khona ngeshubhu zize zikwazi ukumunca noma ukugwinya.

Prevention 

Ukuvimbela ukuzalwa ngaphambi kwesikhathi ngokuvamile kungenzeka. Ukuguqulwa kwendlela yokuphila kudlala indima ebalulekile ekuqedeni amathuba. 

• Ukugcina Isisindo Esinempilo: Ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile ngokuvamile kuyimbangela yokuzalwa ngaphambi kwesikhathi. Gcina isisindo esinempilo ngokuzivocavoca okulula nokudla okufanele.
• Gwema Imikhuba Eyingozi: Yeka ukubhema nokuphuza utshwala ngesikhathi ukhulelwe ukuze uqinisekise ukukhulelwa okuphephile.
• Lawula Ingcindezi: Ukucindezeleka noma ukucindezeleka kungakhuphula amathuba okuzalwa ngaphambi kwesikhathi. Xhumana nodokotela wakho futhi ugcine ukulawula ukucindezeleka kwakho nezinye izindaba ezihlobene.
• Vimbela Amagciwane: Zijwayeze inhlanzeko ngesikhathi sokukhulelwa ukuze uvimbele izifo. Geza izandla njalo futhi uqiniseke ukuthi indlu yakho yangasese ifakwe isibulala-magciwane ngendlela efanele. 

Uzoyibona Nini Udokotela

Funa usizo lwezokwelapha ngokushesha uma uba nalezi zimpawu ezilandelayo

• Ukufinyela Okubuhlungu ngezikhathi ezivamile
• Ukunganyakazi enganeni
• Igazi emcimbini 
• Ukusuka kwamagciwane 
• Ukuvuza koketshezi oluqhubekayo esithweni sangasese