Haihuwar da ba a kai ga haihuwa ba, wato kafin makonni 37 shekarun haihuwa na faruwa tare da samun sauyin yanayi a duniya. Kimanin jarirai miliyan 15 da ba a kai ba a duniya ake haifa a duk shekara.
Fiye da kashi 60 cikin 30 na haihuwa da wuri na faruwa ne a kasashen da ke da karancin tattalin arziki inda yiwuwar kula da mace ya yi kadan, don haka mace mai ciki ta ragu, kamar Afirka da Kudancin Asiya, a halin yanzu a Spain an kiyasta cewa jariran da ba su kai ba suna tsakanin 40. da shekara 7. dubu (8-11% na jimlar haihuwa). A cikin mafi tsananin lokacin cutar ta Coronavirus, mai yiwuwa ba kawai saboda matsalolin mahaifa ko tayin da aka saba ba, har ma saboda matsalolin da suka shafi gudanar da Covid, rashin haihuwa ya kai XNUMX%.
A wajen balaga, akwai wasu tatsuniyoyi na karya da za a karyata da kuma abubuwa da yawa masu amfani da za a sani.
Tare da tsufa na uwa da karuwar ayyukan hadi, adadin tagwaye ya karu, kuma wannan yana daya daga cikin abubuwan da ke haifar da haihuwa kafin haihuwa. Wasu dalilai na iya zama cututtuka na membranes na tayin (chorioamnionitis), wanda kuma ke da alhakin har zuwa kashi 50 na haihuwa kafin haihuwa saboda suna haifar da karuwa a cikin mahaifa. Hakanan ana haifar da cututtukan mahaifa (alal misali, cututtukan jijiyoyin jini waɗanda ke haifar da ciwon sukari marasa kulawa ko hauhawar jini), wanda ke haifar da rashin aiki na mahaifa. Da kuma karuwar ruwan amniotic, wanda ke haifar da fashewar membranes na amniotic, ko ma raguwar girma na cikin mahaifa (IUGR), wanda ya samo asali daga sanadin uwa ko na mahaifa.
Shin yana yiwuwa a yi rigakafi?
“Ba a kowane hali ba, amma ta hanyar magance wasu cututtukan cututtukan mahaifa kamar su ciwon sukari, hauhawar jini, chorioamnionitis ko sau da yawa ta hanyar canza salon rayuwa, misali rage damuwa, bin ingantaccen tsarin abinci, guje wa shan taba, yana yiwuwa a rage haɗarin kamuwa da cuta. isar da lokaci. Yana da mahimmanci a kula da mata da ke cikin haɗarin haihuwa kafin haihuwa (musamman idan ana sa ran haihuwa da yawa kafin ajali) a cibiyoyin asibiti tare da duka obstetrics da Gynecology da Neonatology sabis tare da ingantacciyar gogewa wajen magance wannan matsala".
Yaya za ku shiga lokacin da aka haifi jariri kafin haihuwa?
“Matsalolin (matsalolin zuciya-na numfashi, cututtuka, gastrointestinal, neurological, da dai sauransu) wadanda galibi suna tare da rashin haihuwa (saboda an haife su kafin haihuwa yana nufin rashin kai ga cikakkiyar balaga na gabobin jiki da tsarin da yawa), suna da kamanni daban-daban da tsanani dangane da girman precocity. . Idan an haife shi kafin makonni 25 ya ci gaba da zama babban ƙalubale saboda rashin balagagge, musamman ma cututtukan zuciya (yana buƙatar shiga cikin Sashin Kulawa na Neonatal Intensive Care Unit tare da taimakon numfashi, gudanarwa na surfactant da sauran magunguna), tare da babban haɗarin mace-mace da cututtuka, haihuwa tsakanin makonni 25 zuwa 32, ko da yake yana da wuya, yawanci yana da sakamako mai kyau. Kuma yanzu, a cikin 2023, an haife shi tsakanin makonni 32 zuwa 36,6 wani lamari ne na yau da kullun a cikin ƙwararrun ƙwararrun ƙwararrun yara.
Yaushe jaririn da bai kai ba zai warke?
"A mafi yawancin lokuta, farfadowa na auxological (nauyi da tsayi) yana faruwa a cikin shekaru biyu na farko na rayuwa. An keɓancewa ga waɗanda IUGR ya shafa waɗanda ke iya zama ƙasa da nauyi na ɗan lokaci kaɗan, kuma waɗanda a zahiri suna buƙatar kulawar abinci mai tsayi kuma, a wasu lokuta, har ma da kula da endocrinological a cikin shekarun yara. Daga ra'ayi na neurobehavioral (idan babu lalacewar kwakwalwar anatomic akan hypoxic-ischemic ko hemorrhagic tushe), ya kamata a tuna da cewa, ta hanyar haihuwa a baya, yara ya kamata a "saman" a cikin ikon isa ga matakan neurobehavioral. - ci gaban juyin halitta, tare da la'akari da cewa c' shekarun baya-bayan nan ne don girmamawa. Wannan yana nufin cewa sauran makonnin da suka rage kafin ranar cikawa za a ƙara su a cikin shekarun da suka gabata,
Shin jaririn da bai kai ba zai sami sakamako ko kuma ya haifar da cututtuka a cikin hanyar rayuwa?
“Yana da wani bangare na gaskiya dangane da ci gaban auxological da ci gaban neurodevelopment, amma tare da babban aikin dawo da aiki. Bugu da ƙari, tsofaffin jarirai na IUGR (waɗanda suka gabatar da ci gaban ci gaban intrauterine) suna da ɗan ƙaramin haɗari na fama da cututtukan cututtuka irin su ciwon sukari da hauhawar jini a cikin girma, don haka zai zama mahimmanci don yin aiki akan salon rayuwarsu tun suna ƙanana. Yaran da ba a kai ba a baya waɗanda, saboda cututtukan zuciya mai tsanani, sun kasance bronchodysplastic (watau fama da lalacewar huhu na yau da kullun) na iya buƙatar maganin iskar oxygen na wani ƙayyadadden lokaci, ciki har da a gida, da kuma lura da aikin su na numfashi na tsawon lokaci."
Shin zai yiwu yarinyar da aka haifa da wuri ta haifi jarirai?
"Akwai wasu sanannun, amma sake dawowar rashin haihuwa yana da alaƙa akai-akai da nacewa irin canjin salon rayuwar mata ko kuma bayyanar cututtuka iri ɗaya da suka haifar. aikin da bai kai ba".
Shin rashin haihuwa zai iya zama sanadin gazawar ci gaban fahimi?
"A cikin yanayin hypoxic-ischemic ko raunuka na jini (zai dogara ne akan iyakar), ƙarancin mota a cikin iyakar yana yiwuwa, amma tare da ilimin lissafi na jiki yana da fadi mai yawa don ingantawa ko ma cikakkiyar jin dadi. A cikin jariran da ba a kai ba sosai (musamman kasa da makonni 25), ko da idan babu raunin kwakwalwar jiki, an ba da rahoton wasu cututtuka na neurodevelopmental a cikin kindergarten ko makarantar firamare (misali, rashin kulawa, rashin natsuwa, rashin magana, da dai sauransu), wanda ya kamata. a yi magani nan da nan. Anan ga mahimmancin sabis na bin diddigin waɗannan jariran bayan an sallame su a asibiti ta Sashin Kula da Lafiyar Jarirai, wanda zai kasance aƙalla har zuwa shekaru 6-8”.
Shin jaririn da bai kai ba yana da matsalolin lafiya?
“Idan an taimaka wa jaririn da bai kai ba da na’urar hura iska na dogon lokaci saboda tsananin gazawar zuciya, musamman ma idan shi bronchodysplastic ne, yana da hatsarin asibiti a cikin shekaru 3 na farko na rayuwa saboda matsalolin numfashi. Yanzu, duk da haka, kamfen ɗin rigakafi da ad hoc immunoprophylaxis (kamar na ƙwayar cuta ta syncytial na numfashi) sun rage haɗarin sosai. Idan an yi wa jariri tiyata don matsalolin gastrointestinal tare da manyan sassan hanji, suna iya buƙatar ƙarin kulawar abinci mai gina jiki.