Ukutheleleka komuntu nge-hepatitis egazini kwenzeka ezimweni eziningi esemncane. Yingakho isimo lapho i-hepatitis B ngesikhathi sokukhulelwa kutholakala owesifazane okokuqala, kuyinto engavamile. Yiqiniso, isimo esihle kakhulu lapho ukuhlolwa kwamakaki we-hepatitis egazini kwenzeka esiteji sokuhlela ukukhulelwa. Kodwa-ke, empilweni yangempela, ukuxilongwa kwe-hepatitis yegciwane ngokuvamile kuqhutshwa ngemuva kwesizinda sokukhulelwa. Kulesi simo, udokotela wezifo eziphathelene nezifo, udokotela wezifo ezithathelwanayo kanye nombhangqwana oshadile kudingeka baxoxisane ngesimo ndawonye bese bexazulula izinkinga eziningana.
Uma isifo sofuba sitholakale ngisho nasesiteji sokuhlela umndeni, isidingo sokuphuthuma kokuphathwa kwe-first-line ye-hepatitis egazini kuxoxwa kabanzi nochwepheshe. Ngesikhathi esifanayo, umuntu kufanele aqhubeke namathuba okuphulukiswa, ukuthi kungenzeka ngempela imiphumela enhle yokwelapha ngesikhathi sokukhulelwa. Futhi kubalulekile ukuhlanganisa konke lokhu ngesidingo sokubambezela ukukhulelwa isikhathi esithile - kuze kube unyaka emva kokuphela kokuphela kokwelapha.
Umthelela we-hepatitis ngesikhathi sokukhulelwa
Esinye sezingozi ezinkulu ze-hepatitis B ngesikhathi sokukhulelwa kuyisongo sokutheleleka kwe-intrauterine ye-fetus. Ukudluliswa okumsindo (ukudluliselwa kwegciwane kusuka kumama kuya ekuzalweni) kungenzeka ngezinhlobo ezahlukene ze-hepatitis ku-etiology futhi ziyahlukahluka kakhulu. Ngokuvamile, ukutheleleka kwesifo se-hepatitis B kwenzeka futhi kancane kancane C. Ukwelashwa kwengane ene-viral hepatitis A noma i-E kungase kwenzeke kuphela ngesikhathi sokuzalwa ngokwayo lapho kutholakala khona uhlobo olubaluleke kakhulu lwe-hepatitis kumama. Uma ukutheleleka kwe-intrauterine kwe-fetus kwenzeka ezinyangeni zokuqala zokukhulelwa, cishe njalo kuholela ekukhulelweni kokukhulelwa komzimba. Akunakwenzeka ukuthonya le nqubo. Ngakho umzimba "ugoqa" ingane engenakulinganiswa. Uma ingane isuleleke ezinyathelweni ezilandelayo zokukhulelwa, owesifazane ubeletha ingane ephilayo kodwa elelekile, kanti ngezinye izikhathi isivele inezifo zokutheleleka okuye kwasungulwa. Kulinganiselwa ukuthi izingane ezingaba ngu-10% ezizalwa ngamama ophethe isifo se-hepatitis B zingatheleleka ku-utero. Ngaphambi kokushisa kwesifo sofuba esibhedlela esebenzayo, igciwane lesandulela ngculazi selivele lingaba ngamaphesenti angu-90%. Yingakho incazelo yezimpawu zokukhiqiza igciwane kanye nenombolo yayo egazini (umthamo wegciwane) kubaluleke kakhulu. Lokhu kubaluleke kakhulu emithathu yesithathu nokukhulelwa kwezintathu zokukhulelwa, okuvumela ukuba uhlole ingozi yokuthuthukiswa kwesifo sofuba emntwaneni osanda kuzalwa. Ngokuvamile, ukutheleleka kwenzeka ngokuqondile ngesikhathi sokubeletha noma esikhathini esilandelayo ngemva kokubeletha, lapho igazi legciwane lesandulela ngculaza lidlula emkhunjini wokuzalwa ngokusebenzisa umsele wokubeletha esikhumbeni. Ngezinye izikhathi lokhu kwenzeka uma ingane igawula i-blood kanye ne-amniotic fluid yomama ngesikhathi sokubeletha.
Indlela yokuvimbela ukutheleleka kwengane
Ukuvimbela ukutheleleka ekulethwa kwezidingo, indima ebalulekile idlalwe amaqhinga wokudiliva. Ngeshwa, kusenayo iphuzu eliqondile lokubheka ekuphathweni kokubeletha kwabesifazane abakhulelwe abanesandulela ngculazi. Kukhona idatha ukuthi amathuba okutheleleka kwengane ayancipha ngesikhathi sezinhlelo zokulahla ezihleliwe. Noma kunjalo, leli qiniso akuyona iphuzu lokubheka emhlabeni jikelele. Naphezu kokuntuleka kwezinkomba ezicacile zamasu okusebenza kwabesifazane abanesifo sofuba, ukulethwa kwesigaba sokudla kunconywa kuphela ngezinga eliphezulu le-viral load. Kubuye kudingeke lapho owesifazane ngesikhathi esifanayo ehlasela amagciwane amaningi we-hepatitis. Kusukela ngesikhathi sokukhulelwa, i-hepatitis B ingavinjelwa ngokugoma kanye nokuphathwa okuhleliwe kwe-immunoglobulin, ukuphathwa komsebenzi kuwesifazane onesifo sofuba esibhekene nesandulela ngculazi kuchazwa njengomama ongenasifo ekubelethweni. Ukungabi nalutho oluphelele lokuvikela ingane ekuthelelekeni ngesifo sofuba ngesikhathi sokubeletha kwenza okuyisisekelo sokubeletha kwe-prophylaxis. Ukuvimbela ukuthuthukiswa kwesifo sofuba ezinsana, ukugonywa kwenziwa, okwenza ithuba langempela lokuvimbela ukutheleleka nge-virus ye-hepatitis B nezinye izinhlobo. Izingane ezisuka kumaqembu obungozi zigonywa ngesikhathi esifanayo, okungukuthi, zijojowe nge-gamma globulin kuhlanganiswe nokugoma ngokumelene ne-virus ye-hepatitis B. Ukugoma okungahambi kahle nge-hyperimmune anti-globulin kwenziwa ekamelweni lokulethwa. Ukugonywa ngokumelene nesifo sofuba kwenziwa ngosuku lokuqala emva kokuzalwa nangemva kwezinyanga eziyisithupha nenyanga eziyisithupha, okunikeza izinga lokuzivikela lokulwa namagciwane ngamaphesenti angama-95%.
Ukuxazulula inkinga yokutheleleka kwengane evela kumama oye waba ne-hepatitis ngesikhathi sokubeletha, kunconywa ukuthi kuqhutshwe ukuhlolwa kwegazi lwe-laboratories ukuze kube khona ama-antibodies egazini kuwo. Uma ama-antibodies esanda kuzalwa abonakala ezinyangeni ezintathu zokuqala zokuphila, lokhu kubonisa ukutheleleka kwe-intrauterine. Ukwelashwa kwemiphumela yokuhlola kwengane ye-hepatitis virus kufanele kwenziwe ngokuqapha okukhulu, ngoba ngokuvamile izifo eziningi zamabhodana ezibeletha zingatholakala kuze kuphele izinyanga ezingu-15-18. Lokhu kudala isithombe samanga ngesimo somntwana futhi kuholela ezinyathelweni ezingenangqondo zokumphulukisa.
Ngingadlulisa yini ukutheleleka ngokuncelisa?
Ukunakekelwa kokuncelisa kuncike ekutheni i-etiology ye-hepatitis egazini. Kukholelwa ukuthi inzuzo yokuncelisa kunoma yikuphi ukuphakama kakhulu kunengozi engadingekile yokudlulisela igciwane kumntwana. Yiqiniso, isinqumo sokuthi ukondla noma ukungondli ingane isithathwe ngumama kuphela. Ezinye izinto ezibangelwa ingozi ziyizinhlanzi eziningi ezungeze izingono noma izinguquko ze-aphthous emgodini womlomo wengane esanda kuzalwa. Izingane ezizalwa kumama, abathwali be-hepatitis B, zingakhuliswa ngokwemvelo uma zigonywe ngegciwane ngesikhathi. Kunoma yikuphi, ukubeletha nokutholakala kwegciwane lesandulela ngculazi kunomfazi kunokwenzeka kuphela ngokugcina ngokuqinile yonke imithetho yokuhlanzeka kanye nokungaxilisi okunzima kumama.