Yarinya da wuri

Yarinyar da ba a haifa ba jariri ne da aka haifa kafin 37 ya cika makonni na ciki (fiye da makonni 3 kafin ranar haihuwa).

A lokacin haihuwa, ana sanya jariri ɗayan ɗayan masu zuwa:

• Wanda bai kai ba (kasa da makonni 37)
• Cikakken lokaci (ciki zuwa makonni 37 zuwa 42)
• Bayanin lokaci (an haife shi bayan cikar makonni 42)

Idan mace ta fara nakuda kafin makonni 37, ana kiranta aikin haihuwa.

Yaran da ba su daɗe da haihuwa ba waɗanda aka haifa tsakanin ciki na makonni 35 zuwa 37 na iya zama ba da wuri ba. Wataƙila ba za a shigar da su cikin sashin kulawa mai kulawa da jarirai ba (NICU), amma har yanzu suna cikin haɗarin ƙarin matsaloli fiye da jariran cikakken lokaci.

Yanayin lafiya a cikin uwa, kamar ciwon sukari, cututtukan zuciya, da cututtukan koda, na iya taimakawa ga zafin ciki. Sau da yawa, ba a san musabbabin lokacin haihuwa ba. Wasu haihuwar da wuri sune yawancin ciki, kamar tagwaye ko plean uku.

Matsaloli daban-daban masu alaƙa da juna biyu suna ƙara haɗarin haihuwa ko haihuwa da wuri:

• Raunin mahaifa wanda ya fara buɗewa (dilate) da wuri, wanda kuma ake kira rashin ƙarfin mahaifa
• Launin haihuwa na mahaifa
• Tarihin isar da haihuwa
• Kamuwa (cututtukan fitsari ko cututtukan memn ɗin mahaifa)
• Rashin abinci mai gina jiki daidai kafin ko lokacin ɗaukar ciki
• Preeclampsia: cutar hawan jini da furotin a cikin fitsarin da ke bunkasa bayan makon 20 na ciki
• Rushewar saurin membranes (placenta previa)

Sauran abubuwan da ke haifar da haɗari ga aiki kafin lokacin haihuwa da isowar wanda bai kai ba sun hada da:

• Shekar mahaifiya (iyayen da shekarunsu suka gaza 16 ko sama da 35)
• Kasancewa Ba'amurke Ba'amurke
• Rashin kulawar haihuwa
• Matsayi maras tattalin arziki
• Amfani da taba, hodar iblis, ko amfetamines

Jariri na iya samun matsalar numfashi da kiyaye yanayin zafin jiki na yau da kullun.

Yarinyar da ba ta kai biki ba na iya samun alamun waɗannan matsalolin masu zuwa:

• Babu isasshen jajayen jini (anemia)
• Zub da jini cikin kwakwalwa ko lalacewar farin abin kwakwalwa
• Kamuwa da cuta ko sepsis na sabon haihuwa
• Sugararamar sikari (hypoglycemia)
• Ciwon mara na numfashi na jarirai, ƙarin iska a cikin ƙwayar huhun (emphysema na cikin huhu), ko zub da jini a cikin huhu (zubar jini na huhu)
• Fata mai launin rawaya da fararen idanu (jariri jariri)
• Matsaloli na numfashi saboda huhu wanda bai balaga ba, ciwon huhu, ko patent ductus arteriosus
• Mai tsananin kumburi na hanji (necrotizing enterocolitis)

Yarinyar da ba ta kai lokacin haihuwa ba za ta sami nauyin haihuwa na ƙasa da na ɗan lokaci. Alamun gama gari wadanda suka hada da:

• Yanayin numfashi mara kyau (mara zurfin, tsaiko na dakatar da numfashi da ake kira apnea)
• Gashin jiki (lanugo)
• Ciwon ciki (cikin jarirai mata)
• Karancin kitsen jiki
• Sautin tsoka da ƙarancin aiki fiye da jarirai masu cikakken lokaci
• Matsalolin ciyarwa saboda matsalar tsotsa ko daidaita haɗiya da numfashi
• Scananan maƙogwaro wanda yake mai santsi kuma ba shi da tudu, da ƙwayoyin cutar mara kyau (a cikin jarirai maza)
• Gashi mai laushi, sassauƙa
• Fata mai laushi, mai santsi, mai sheki wanda galibi a bayyane yake (yana iya ganin jijiyoyi a ƙarƙashin fata)

Gwaje-gwaje na yau da kullun da aka yi a kan jariri wanda bai haifa ba sun haɗa da:

• Nazarin iskar gas don bincika matakan oxygen a cikin jini
• Gwajin jini don bincika matakan glucose, alli, da bilirubin
• Kirjin x-ray
• Ci gaba da lura da cututtukan zuciya (lura da numfashi da bugun zuciya)

Lokacin da nakuda ba tare da bata lokaci ba ya bunkasa kuma ba za a iya dakatar da shi ba, kungiyar masu kiwon lafiya za su shirya don haihuwa mai hatsarin gaske. Ana iya tura mahaifiya zuwa cibiyar da aka kafa don kula da jarirai waɗanda ba a haife su ba a cikin NICU.

Bayan haihuwa, an shigar da jaririn a NICU. An sanya jariri a ƙarƙashin dumi ko a cikin akwati mai ɗumi, mai zafi da ake kira incubator, wanda ke sarrafa yanayin zafin. Injin saka idanu yana bin diddigin jaririn, bugun zuciya, da matakin iskar oxygen a cikin jini.

Cibiyoyin jarirai da wuri bai cika ba. Jariri na buƙatar kulawa ta musamman a cikin ɗakin ajiyar yara har sai gabobin sun haɓaka yadda ya kamata don kiyaye jaririn da rai ba tare da taimakon likita ba. Wannan na iya ɗaukar makonni zuwa watanni.

Yara yawanci ba sa iya daidaita tsotsa da haɗiye kafin ciki makonni 34. Yarinya da ba ta kai haihuwa ba na iya samun ƙaramin bututu mai taushi wanda aka saka ta hanci ko baki zuwa cikin ciki. A cikin ƙarancin lokaci ko jarirai marasa lafiya, ana iya ba da abinci mai gina jiki ta jijiya har sai jaririn ya daidaita da zai karɓi dukkan abinci mai gina jiki ta ciki.

Idan jariri yana da matsalar numfashi:

• Ana iya sanya bututu a cikin bututun iska (trachea). Injin da ake kira mai sanya iska zai taimaka wa jariri ya numfasa.
• Wasu jarirai wadanda matsalar numfashin su basu da karfi sosai suna samun ci gaba mai karfin iska (CPAP) tare da kananan bututu a hanci maimakon bututun iska. Ko kuma suna iya samun ƙarin oxygen.
• Ana iya ba da iskar oxygen ta hanyar iska, CPAP, ƙwanƙolin hanci, ko ƙwanjin iskar oxygen a saman kan jariri.

Jarirai na bukatar kulawa ta musamman na gandun daji har sai sun sami damar yin numfashi ba tare da karin tallafi ba, cin abinci ta baki, da kiyaye zafin jiki da nauyin jiki. Smallananan yara ƙanana na iya samun wasu matsalolin waɗanda ke rikitar da magani kuma suna buƙatar dogon zaman asibiti.

Akwai kungiyoyin tallafi da yawa ga iyayen jariran da ba su kai haihuwa ba. Tambayi ma'aikacin zamantakewar da ke sashen kulawa na musamman na jarirai.

Lokacin haihuwa ya kasance babban abin da ke haifar da mutuwar jarirai. Ingantattun dabarun likitanci da na jinya sun karawa jariran da basu isa haihuwa rai ba.

Tsarin lokaci na iya samun sakamako na dogon lokaci. Yaran da yawa da ba su kai haihuwa ba suna da matsalolin likita, na ci gaba, ko na ɗabi'a waɗanda suke ci gaba har zuwa ƙuruciya ko na dindindin. Thearancin haihuwa jariri kuma ƙaramin nauyin haihuwarsu shine, to haɗarin yafi girma ga rikitarwa.Koyaya, ba shi yiwuwa a yi hasashen sakamakon ɗan lokaci na jariri dangane da shekarun haihuwa ko nauyin haihuwa.

Matsalolin da za a iya dadewa sun hada da:

• Matsalar huhu na dogon lokaci da ake kira dysplasia bronchopulmonary (BPD)
• Rage girma da ci gaba
• Rashin hankali ko na jiki ko jinkiri
• Matsalar hangen nesa da ake kira retinopathy na lokacin tsufa, wanda ke haifar da ƙarancin gani ko makanta

Hanyoyi mafi kyau don hana saurin tsufa sune:

• Kasance cikin koshin lafiya kafin daukar ciki.
• Samu kulawar haihuwa tun da wuri-wuri a cikin ciki.
• Ci gaba da samun kulawar haihuwa har sai an haifi jaririn.

Samun wuri da kyakkyawar kulawa kafin haihuwa yana rage damar haihuwar wuri.

Wani lokaci wani magani da zai toshe mahaifa yana iya magance shi ko jinkirta shi. Sau da yawa, kodayake, ƙoƙari na jinkirta lokacin haihuwa ba su nasara.

Betamethasone (maganin cututtukan steroid) da aka baiwa uwaye masu fama da saurin haihuwa na iya sa wasu rikice-rikice saurin tsufa ya zama mai tsanani.

Yarinyar da ba ta wuce haihuwa ba; Preemie; Premie; Yaron haihuwa - premie; NICU - farashi

• Sabon jaundice - fitarwa

Brady JM, Barnes-Davis ME, Poindexter BB. Yarinyar mai hatsarin gaske 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 117.

Parsons KV, Jain L. Marigayi jariri. A cikin: Martin RJ, Fanaroff AA, Walsh MC, eds. Faranoff da Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020: babi na 40.

Simhan HN, Romero R. Tsarin aiki da haihuwa. A cikin: Landon MB, Galan HL, Jauniaux ERM et al, eds. Gabbe's Obetetrics: Ciki da Cutar Matsala. 8th ed. Philadelphia, PA: Elsevier; 2021: babi na 36.