Myelomeningocele

Myelomeningocele nakasa ce ta haihuwa wanda a ciki ƙashin baya da jijiya ba sa rufewa kafin haihuwa.

Yanayin wani nau'in spina bifida ne.

A yadda aka saba, a lokacin watan farko na ciki, ɓangarorin biyu na kashin bayan jariri (ko kashin baya) suna haɗuwa don rufe jijiyoyin jijiyoyin, jijiyoyin jijiyoyi, da maninges (kyallen da ke rufe jijiya). Brainwaƙwalwar ƙwaƙwalwa mai tasowa da kashin baya a wannan gaba ana kiransu bututun ƙashi. Spina bifida na nufin duk wata nakasar haihuwa wanda bututun jijiyoyin da ke yankin kashin baya kasa rufewa gaba daya.

Myelomeningocele nakasar bututu ne wanda ƙashi na kashin baya baya cikakke. Wannan yana haifar da wata hanyar canjin baya. Cordwayar kashin baya da meninges suna fitowa daga bayan yaron.

Wannan yanayin na iya shafar kusan 1 cikin kowane jarirai 4,000.

Sauran al'amuran da suka shafi kashin baya:

• Spina bifida occulta, yanayin da kashin kashin baya rufewa. Cordashin kashin baya da meninges suna wanzuwa kuma fata yakan rufe lahani.
• Meningoceles, yanayin da meninges ke fitowa daga lahani na kashin baya. Cordashin kashin baya ya kasance a wurin.

Sauran cututtukan haihuwa ko lahani na haihuwa na iya kasancewa a cikin yaro tare da myelomeningocele. Takwas cikin yara goma masu wannan cutar suna da hydrocephalus.

Sauran cututtuka na laka ko tsarin musculoskeletal na iya gani, gami da:

• Syringomyelia (wani kwaro mai cike da ruwa a cikin jijiya)
• Hip dislocation

Ba a san dalilin sanadin myelomeningocele ba. Koyaya, ƙananan ƙwayoyin folic acid a jikin mace kafin da lokacin da suke da juna biyu suna bayyana suna taka rawa a cikin irin wannan matsalar ta haihuwar. Folic acid (ko folate) na da mahimmanci don ci gaban kwakwalwa da lakar kashin baya.

Idan an haifi yaro tare da myelomeningocele, yara masu zuwa a cikin wannan iyalin suna da haɗari fiye da yawan jama'a. Koyaya, a lokuta da yawa, babu haɗin iyali. Abubuwa kamar su ciwon suga, kiba, da kuma amfani da magungunan hana kamuwa da cutarwa a cikin mahaifiya na iya kara barazanar wannan lahani.

Jariri da ke cikin wannan matsalar zai sami waje a buɗe ko jakar da ke cike da ruwa a tsakiyar zuwa ƙasa ta baya.

Kwayar cutar na iya haɗawa da:

• Asarar mafitsara ko kulawar hanji
• M ko cikakken rashin abin mamaki
• M ko cikakken inna na kafafu
• Raunin kwatangwalo, ƙafafu, ko ƙafafun jariri

Sauran alamu da / ko alamomi na iya haɗawa da:

• Feetafafun da ba na al'ada ba, irin su kafa
• Ruwan ruwa a cikin kwanyar (hydrocephalus)

Yin gwaji kafin haihuwa zai iya taimakawa gano wannan yanayin. Yayin watanni uku na biyu, mata masu juna biyu na iya yin gwajin jini wanda ake kira quadruple screen. Wannan gwajin gwajin don myelomeningocele, Down syndrome, da sauran cututtukan cututtukan cikin cikin jariri. Yawancin mata da ke ɗauke da jariri tare da spina bifida za su sami haɓakar haɓakar furotin da ake kira maternal alpha fetoprotein (AFP).

Idan gwajin allo huɗu yana tabbatacce, ana buƙatar ƙarin gwaji don tabbatar da cutar.

Irin waɗannan gwaje-gwajen na iya haɗawa da:

• Hawan ciki duban dan tayi
• Amniocentesis

Ana iya ganin Myelomeningocele bayan an haifi yaron. Binciken neurologic na iya nuna cewa yaron yana da asarar ayyukan da suka shafi jijiya a ƙasa da lahani. Misali, kallon yadda jariri yake amsa wajan yin filo a wurare daban-daban na iya bayyana inda jaririn zai ji abubuwan da ke faruwa.

Gwajin da aka yi wa jariri bayan haihuwa na iya haɗawa da hasken rana, duban dan tayi, CT, ko MRI na yankin kashin baya.

Mai ba da sabis na kiwon lafiya na iya bayar da shawarar ba da shawarwarin kwayoyin halitta. Yin tiyata a cikin mahaifa don rufe lahani (kafin a haifi jaririn) na iya rage haɗarin wasu matsaloli na gaba.

Bayan haihuwarka, ana ba da shawarar tiyata don gyara lahani a cikin fewan kwanakin farko na rayuwa. Kafin ayi tiyata, dole ne a kula da jariri a hankali don rage lalacewar layin da aka fallasa. Wannan na iya haɗawa da:

• Kulawa ta musamman da sanyawa
• Na'urorin kariya
• Canje-canje a hanyoyin sarrafawa, ciyarwa, da wanka

Yaran da suma suke da hydrocephalus na iya buƙatar sanya shunt na ventriculoperitoneal. Wannan zai taimaka wajen fitar da karin ruwa daga ventricles (a cikin kwakwalwa) zuwa ramin kogin (a ciki).

Ana iya amfani da maganin rigakafi don magance ko hana kamuwa da cututtuka irin su sankarau ko cututtukan fitsari.

Yawancin yara za su buƙaci magani na tsawon rai don matsalolin da ke haifar da lalacewar laka da jijiyoyin jijiyoyi.

Wannan ya hada da:

• Matsalar mafitsara da ta hanji - Matsalar ƙasa ƙasa a kan mafitsara na iya taimaka wajen zubar da mafitsara. Ana iya buƙatar bututun magudanan ruwa, waɗanda ake kira catheters. Shirye-shiryen horar da hanji da kuma cin abinci mai yawan fiber na iya inganta aikin hanji.
• Matsaloli na tsoka da haɗin gwiwa - neededarin jijiyoyin jiki ko na jiki ana iya buƙata don magance alamun musculoskeletal. Ana iya buƙatar takalmin gyaran kafa. Mutane da yawa tare da myelomeningocele da farko suna amfani da keken hannu.

Binciken gaba-gaba gabaɗaya yana ci gaba a rayuwar yaron. Ana yin waɗannan don:

• Duba ci gaban ci gaba
• Bi da duk matsalolin ilimi, na jijiyoyin jiki, ko na zahiri

Ziyartar masu jinya, sabis na zamantakewa, ƙungiyoyin tallafi, da ƙananan hukumomi na iya ba da goyon baya na motsin rai da taimakawa tare da kula da yaro tare da myelomeningocele wanda ke da manyan matsaloli ko iyakancewa.

Shiga cikin ƙungiyar mara baya ta kashin baya na iya taimakawa.

Myelomeningocele zai iya zama mafi yawan lokuta a gyara ta hanyar tiyata, amma jijiyoyin da abin ya shafa har yanzu ba sa aiki daidai. Mafi girman wurin da matsalar take a bayan jariri, yawancin jijiyoyin za su shafa.

Tare da magani na farko, tsawon rai ba ya tasiri sosai. Matsalar koda saboda rashin fitar fitsari sune suka fi saurin mutuwa.

Yawancin yara za su sami hankali na al'ada. Koyaya, saboda haɗarin hydrocephalus da sankarau, yawancin waɗannan yara za su sami matsalolin koyo da rikicewar kamuwa.

Sabbin matsaloli a cikin kashin baya na iya bunkasa a rayuwa, musamman bayan yaro ya fara girma cikin sauri yayin balaga. Wannan na iya haifar da ƙarin asara na aiki da kuma matsalolin ƙashi irin su scoliosis, ƙafa ko nakasar idon kafa, ƙyallen da aka watse, da matsi na haɗin gwiwa ko kwangila.

Mutane da yawa tare da myelomeningocele da farko suna amfani da keken hannu.

Rarraba na spina bifida na iya haɗawa da:

• Haihuwar mai rauni da wahalar haihuwa
• Yawan cututtukan fitsari
• Girman ruwa a kwakwalwa (hydrocephalus)
• Rushewar hanji ko fitsari
• Brain kamuwa da cuta (meningitis)
• Rashin ƙarfi na dindindin ko gurguntar ƙafafu

Wannan jerin bazai cika hada duka ba.

Kira mai ba da sabis idan:

• Ana ganin jakar jaka ko wani buɗaɗɗen yanki a ƙashin bayan jariri sabon haihuwa
• Yaron ku ya makara a tafiya ko rarrafe
• Kwayar cututtukan hydrocephalus suna tasowa, gami da bullowar tabo mai laushi, bacin rai, yawan bacci, da matsalolin ciyarwa
• Kwayar cututtukan sankarau na bunkasa, gami da zazzabi, taurin kai, tashin hankali, da kuka mai karfi

Arin abubuwan folic acid na iya taimakawa rage haɗarin larurar bututu kamar myelomeningocele. Ana ba da shawarar cewa duk macen da take tunanin yin ciki ta dauki kwayar cutar folic acid 0.4 a rana. Mata masu juna biyu da ke da babban haɗari suna buƙatar sashi mafi girma.

Yana da mahimmanci a tuna cewa dole ne a gyara raunin folic acid kafin yin ciki, saboda lamuran suna tasowa da wuri.

Matan da ke shirin yin ciki za a iya duba su don tantance yawan folic acid a cikin jinin su.

Meningomyelocele; Spina bifida; Tsagewar kashin baya; Launin bututun neural (NTD); Yanayin haihuwa - myelomeningocele

• Ventriculoperitoneal shunt - fitarwa

• Spina bifida
• Spina bifida (digiri na tsanani)

Kwamiti kan Ayyukan Obwararriyar haihuwa, Societyungiyar Kula da Magungunan Haihuwa. Kwalejin likitan haihuwa ta Amurka da na mata. Kungiyar ACOG ra'ayi ba. 720: tiyatar mata-tayi don myelomeningocele. Obstet Gynecol. 2017; 130 (3): e164-e167. PMID: 28832491 pubmed.ncbi.nlm.nih.gov/28832491/.

Kinsman SL, Johnston MV. Abubuwa masu haɗari na tsarin kulawa na tsakiya. A cikin: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Littafin koyar da ilimin yara. 21st ed. Philadelphia, PA: Elsevier; 2020: babi 609.

Licci M, Guzman R, Soleman J. Maternal da rikitarwa masu rikitarwa a cikin tiyatar tayi don gyaran myelomeningocele na ciki: nazari na yau da kullun.Matsayin Neurosurg. 2019; 47 (4): E11. PMID: 31574465 pubmed.ncbi.nlm.nih.gov/31574465/.

Wilson P, Stewart J. Meningomyelocele (spina bifida). A cikin: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Littafin koyar da ilimin yara. 21st ed. Philadelphia, PA: Elsevier; 2020: babi na 732.