Al'aura mara kyau

Al'aura mai rikitarwa nakasuwa ce ta haihuwa inda al'aurar waje ba ta da kamannin ɗa ko yarinya.

Halin jinsin yaro yana ƙaddara a lokacin ɗaukar ciki. Kwayar kwai ta uwa tana dauke da sinadarin X chromosome, yayin da kwayar halittar mahaifa ta mahaifinsa ta ƙunshi ko dai X ko Y chromosome. Waɗannan ƙwayoyin halittar X da Y sun ƙayyade yanayin jinsin yaron.

A yadda aka saba, jariri yakan gaji gado biyu na jima'i, 1 X daga uwa da 1 X ko Y ɗaya daga mahaifin. Uba yana "ƙaddara" jinsin jinsin yaron. Jaririn da ya gaji X chromosome daga mahaifinsa mace ce ta kwayar halitta kuma yana da chromosomes 2 X. Jaririn da ya gaji Y chromosome daga uba shi namiji ne kuma yana da chromosome 1 X da 1 Y.

Gabobin haihuwa na mata da na al'aura dukkansu sun fito ne daga nama guda a cikin tayi. Al'aura mara motsi na iya bunkasa idan aikin da ke haifar da wannan kwayar halittar tayi ta zama "namiji" ko "mace" ta rikice.Wannan yana da wahala a iya gane jariri a matsayin namiji ko mace. Gwargwadon shubuhar ya bambanta. Da wuya ƙwarai, bayyanar jiki na iya zama cikakkiyar haɓaka azaman akasin jinsi na asali. Misali, wani jinsi na iya haifar da bayyanar mace ta al'ada.

A mafi yawan lokuta, cututtukan al'aura a cikin mace (jarirai masu ɗauke da chromosomes 2 X) suna da siffofi masu zuwa:

• Kara girman kan mace wanda yayi kama da karamin azzakari.
• Budewar bututun mahaifa (inda fitsari ke fitowa) na iya kasancewa a ko'ina, a sama, ko belowasa da farji.
• Labia na iya hade kuma yayi kama da majina.
• Ana iya tunanin cewa jaririn namiji ne da kwayar cutar mara kyau.
• Wani lokaci ana jin dunƙun nama a cikin labia ɗin da aka haɗu, yana ƙara sa shi ya zama kamar mahaifa tare da kwayar cutar.

A cikin kwayar halittar namiji (1 X da 1 Y chromosome), al'aura mara kyau galibi sun hada da siffofin masu zuwa:

• Karamin azzakari (kasa da santimita 2 zuwa 3, ko inci 3/4 zuwa 1 1/4) wanda yayi kama da kumburarriyar mace (dattin mace sabuwar haihuwa galibi ya fadada lokacin haihuwa).
• Budewar fitsarin yana iya kasancewa a ko'ina, a sama, ko ƙasan azzakari. Zai iya zama ƙasa kamar perineum, yana ƙara sa jariri ya zama mace.
• Zai yiwu a sami ƙaramin maƙarƙashiya wanda ya rabu kuma yayi kama da na ɓarke.
• Magungunan da ba a tantance su ba yawanci suna faruwa tare da maɓallin al'aura.

Tare da 'yan kaɗan, yawancin abubuwan da ke faruwa a mahaifa ba kasada ba ce ga rayuwa. Koyaya, yana iya haifar da matsalolin zamantakewar yaro da dangi. A saboda wannan dalili, ƙungiyar ƙwararrun ƙwararru, waɗanda suka haɗa da likitocin neonato, masanan halitta, likitocin cikin gida, da likitocin mahaukata ko ma’aikatan jin daɗi za su shiga cikin kulawar yaron.

Abubuwan da ke haifar da al'aurar mahaifa sun hada da:

• Pseudohermaphroditism. Al'aura daga jinsi daya ne, amma wasu halaye na zahiri na sauran jinsi suna nan.
• Gaskiya hermaphroditism. Wannan yanayi ne mai matukar wuya, wanda nama daga duka kwayayen da na kwayayen ya kasance. Yaron na iya samun ɓangarorin al'aurar maza da mata.
• Cakuda cututtukan cututtuka (MGD). Wannan yanayin yanayin jima'i ne, wanda akwai wasu sifofin maza (gonad, testis), da kuma mahaifa, farji, da tublop fallopian.
• Hawan jini mai girma. Wannan yanayin yana da siffofi da yawa, amma yanayin da aka fi sani yana haifar da kwayar halittar mace da ta bayyana namiji. Jihohi da yawa suna yin gwajin wannan yanayin mai yin barazanar rai yayin gwajin gwajin haihuwa.
• Matsanancin cututtukan chromosomal, gami da ciwo na Klinefelter (XXY) da kuma cutar Turner (XO).
• Idan mahaifiya ta sha wasu magunguna (kamar su androgenic steroids), mace mai yin kwayar halitta na iya zama kamar ta namiji.
• Rashin samar da wasu sinadarai na homon na iya sa amfrayo ya ci gaba tare da nau'in jikin mace, ba tare da la'akari da jinsin mace ba.
• Rashin masu karɓar salula na testosterone. Kodayake jiki yana sanya homonin da ake buƙata don haɓaka zuwa na miji na zahiri, jiki ba zai iya amsa waɗannan homon ɗin ba. Wannan yana haifar da nau'in jikin mace, koda kuwa jinsin halittar namiji ne.

Saboda tasirin tasirin zamantakewar da tunanin mutum na wannan yanayin, iyaye ya kamata suyi shawara game da ko zasu goya yaro a matsayin namiji ko mace da wuri bayan an gano cutar. Zai fi kyau idan an yanke wannan shawarar a tsakanin fewan kwanakin farko na rayuwa. Koyaya, wannan shawara ce mai mahimmanci, saboda haka bai kamata iyaye su hanzarta ba.

Tuntuɓi mai ba da kiwon lafiya idan kun damu game da bayyanar al'aurar ɗanku ta waje, ko jaririnku:

• Aukar sama da makonni 2 don dawo da nauyin haihuwa
• Amai yake yi
• Yana kama da bushewa (bushewa a cikin bakin, babu hawaye lokacin kuka, ƙasa da persaƙafan ruwa huɗu a cikin awanni 24, idanuwa sun lumshe)
• Yana da rage ci
• Yana da shuɗar shuɗi (gajeren lokaci lokacin da rage adadin jini yana gudana zuwa huhu)
• Yana da matsalar numfashi

Duk waɗannan na iya zama alamun cututtukan mahaifa na haihuwa.

Za'a iya gano al'aurar mahaifa a lokacin gwajin jariri na farko.

Mai ba da aikin zai yi gwajin jiki wanda zai iya bayyana al'aurar da ba ta dace da `` namiji ba '' ko `` mace ta al'ada, '' amma wani wuri a tsakanin.

Mai ba da sabis ɗin zai yi tambayoyin tarihin likita don taimakawa gano duk wata cuta ta chromosomal. Tambayoyi na iya haɗawa da:

• Shin akwai tarihin iyali na ɓarin ciki?
• Shin akwai tarihin iyali na haihuwa har yanzu?
• Shin akwai tarihin iyali na farkon mutuwa?
• Shin akwai wasu dangin da ke da jarirai wadanda suka mutu a farkon makonnin farko na rayuwarsu ko kuma waɗanda ke da alaƙar janaba?
• Shin akwai tarihin iyali na kowane cuta da ke haifar da al'aura maras tabbas?
• Waɗanne magunguna ne mahaifiya ta sha kafin ko lokacin da take da juna biyu (musamman magungunan sitrodiyo)?
• Waɗanne alamun bayyanar suna nan?

Gwajin kwayoyin halitta na iya tantancewa idan yaron ya kasance namiji ko mace. Sau da yawa ƙaramin samfurin ƙwayoyin cuta ana iya goge su daga cikin kumatun yaron don wannan gwajin. Yin nazarin waɗannan ƙwayoyin yakan isa don ƙayyade jinsin jinsin jariri. Nazarin chromosomal gwaji ne mai fa'ida wanda za'a iya buƙata a cikin ƙarin maganganun da ake tambaya.

Endoscopy, x-ray na ciki, duban dan tayi ko kuma duban dan tayi, da makamantan gwaje-gwajen ana iya buqatar su don tabbatar ko babu al'aura a ciki (kamar gwajin da ba ayi ba).

Gwajin gwaje-gwaje na iya taimakawa wajen gano yadda gabobin haihuwa suke aiki. Wannan na iya haɗawa da gwaji don adrenal da gonadal steroids.

A wasu lokuta, laparoscopy, laparotomy mai bincike, ko biopsy na gonads na iya buƙata don tabbatar da rikice-rikicen da ke iya haifar da al'aura mara kyau.

Dogaro da dalilin, ana amfani da tiyata, maye gurbin hormone, ko wasu jiyya don magance yanayin da zai iya haifar da al'aurar mahaifa.

Wani lokaci, dole ne iyaye su zaɓi ko su goya yaron a matsayin namiji ko mace (ba tare da la'akari da ƙwayoyin halittar yaron ba). Wannan zaɓin na iya haifar da babban tasirin zamantakewar jama'a da halayyar ɗan adam, don haka galibi ana ba da shawarar shawara.

Lura: Yana da sauƙin fasaha sauƙin magance (sabili da haka ɗaga) yaron a matsayin mace. Wannan saboda ya fi sauki ga likitan tiyata ya yi al'aura mace fiye da yin al'aurar namiji. Sabili da haka, wani lokacin ana bada shawarar wannan ko da kuwa yaron jinsi ne. Koyaya, wannan yanke shawara ce mai wahala. Ya kamata ku tattauna shi tare da danginku, mai ba da yaronku, likitan likita, likitan ilimin likitanku, da sauran membobin ƙungiyar kiwon lafiya.

Al'aura - mara shubuha

• Cigaban ci gaban farji da mara

Diamond DA, Yu RN. Rikicin ci gaban jima'i: ilimin ilimin halittu, kimantawa, da kula da lafiya. A cikin: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: babi na 150.

Rey RA, Josso N. Bincikowa da maganin rikicewar ci gaban jima'i. A cikin: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Manya da Yara. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: babi na 119.

Farin Kwamfuta. Rikicin ci gaban jima'i. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: babi na 233.

Farin Kwamfuta. Hawan hyperplasia na haihuwa da kuma rikice-rikice masu alaƙa. 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 594.