Ime mgbanwe na ndụ n'èzí
Na ngwụcha afọ ime, nwa e bu n'afọ ga-ewere njem ịmụ nwa iji hapụ nne na-amụ nwa. Mgbe ọ banyere n'ụwa na-eku ume, Nwa ọhụrụ ga-amalite ime mgbanwe na ndụ n'èzí akpa nwa. Nke a bụ eziokwu maka ụmụ anụmanụ niile na-ebi ndụ; isiokwu a na-atụle ụmụ mmadụ dị ka ihe atụ a na-eme nnyocha.
Mpaghara dị n'èzí bụ mgbanwe dị egwu maka nwa ọhụrụ, ya mere a ghaghị inyocha nwa ọhụrụ ahụ ugboro ugboro na nke ọma. Ọnụ ọgụgụ apgar bụ nyocha a na-eme ozugbo amuchara. Ọ na-agụnye nyocha nke obi, mgbalị iku ume, ụda uru ahụ, iwe iwe, na ụcha akpụkpọ ahụ. A na-eme akara Apgar otu nkeji na nkeji ise mgbe amuchara. Ntinye akara sitere na 0 ruo 10, na 0 na-egosi nnukwu nsogbu nwa ọhụrụ na 10 na-egosi mgbanwe dị nro na ndụ extrauterine.[1]
Ụmụ ọhụrụ na-agafe na ndụ extrauterine ga-enwe oge mmeghachi omume. A na-ekewa oge ndị a n'ime usoro atọ. Nzọụkwụ mbụ na-ewere ọnọdụ na nkeji iri atọ mbụ nke ndụ; n'oge nke a, nwa ọhụrụ ahụ na-akpachara anya ma na-emeghachi omume na obi na-akụ na 160-180 kwa nkeji wee kwụsie ike na 100-120 kwa nkeji. Ọkpụkpụ mgbe a na-anụ ya na iku ume na-adịghị mma bụ nchọpụta dị mma. N'ọkwa nke abụọ, enwere mbelata na mmeghachi omume na ọrụ mmegharị nke a na-egosipụtakarị dị ka ụra. Oge a nwere ike ịdịru site na awa 1-2. Nzọụkwụ nke atọ na-egosi oge nke abụọ nke mmeghachi omume. Oge a nwere ike ime n'ebe ọ bụla n'ime awa 2 ruo 8 mbụ mgbe amuchara ma na-ewe oge ọ bụla site na nkeji 10 ruo ọtụtụ awa. Tachycardia na tachypnea nwere ike ịdị n'oge dị mkpirikpi. A na-emekwa ka meconium gafee.[1]
Obi
[dezie | dezie ebe o si]Physiology: N'ime akpa nwa, placenta na-enye nwa e bu n'afọ ọbara oxygenated site na umbilical vein. Mgbe a na-enyefe ya, a na-ebipụ eriri umbilical. Usoro obi ga-agbanwe ugbu a. CO2 ọbara na-arị elu n'ihi na placenta ewepụghị ya ugbu a. Nke a bụ ihe dị ike maka nwa ọhụrụ ịmalite iku ume. Ịṅụ ume na-abawanye O2 n'ime akpa ume, si otú a na-eweghachi ngwa ngwa hypoxic pulmonary vasoconstriction nke mere ka ikike vascular nke akpa ume dị elu n'oge ndụ akpa nwa. Mmiri iku ume na-agbatịkwa arịa akpa ume ndị dị mgbagwoju anya, ndị na-eme ka ọ daa ngwa ngwa na nke a na-ahụ anya na mgbochi nke akpa ume. N'ihi ya, oke dị elu nke mmepụta ventricle aka nri na-abanye n'ime arịa akpa ume karịa n'ime usoro mgbasa ozi site na ductus arteriosus. Ọpụpụ nke placenta na-akpata mmụba na usoro vascular resistance, nke na-eduga na mmụba nke nrụgide gradient site na atrium aka ekpe. [2]Atrium aka ekpe ugbu a nwere nrụgide dị elu karịa atrium aka nri na-eme ka Foramen oval mechie. N'ime nkeji iri mbụ nke ọmụmụ, ọbara na-amalite ịba site n'aka ekpe gaa n'aka nri site na ductus arteriosus. Nke a na-akpata mmụba dị ịrịba ama na mmepụta nke ventricle aka ekpe na mmụba nke olu strok. N'ikpeazụ, ọrụ nke Ọwa calcium na-abawanye na ọwa potassium na-ebelata mkpakọ nke ductal. Mmechi ọrụ nke ductus arteriosus na-eme n'ime awa 24 mbụ, na mmechi na-adịgide adịgide na-esote n'ime izu 4. N'ikpeazụ, mmepụta obi na-abawanye ruo ihe fọrọ nke nta ka ọ bụrụ okpukpu abụọ nke ọ dị n'akpa nwa. Mgbanwe niile nke Usoro obi na akwara na-eme ka mgbanwe site na usoro mgbasa nke nwa ọhụrụ gaa na usoro mgbasa ozi nke okenye. N'oge mgbanwe a, ụdị ụfọdụ nke ọrịa obi a mụrụ amụ nke na-enweghị mgbaàmà n'ime akpa nwa n'oge nrugharị nwa ga-egosi cyanosis ma ọ bụ ihe ịrịba ama iku ume.
Ngosipụta: Mgbe nwa a mụrụ ọhụrụ na-eti mkpu, a na-enwe mgbanwe nke ọbara na-agafe na foramen ovale nke na-eme ka nwa a mụrụ amụ yie onye na-enweghị isi n'ụbọchị ole na ole mbụ nke ndụ. Obi nke nwa a mụrụ ọhụrụ kwesịrị ịdị n'etiti 110 na 160 ọ na-akụ kwa nkeji ma ọ bụ ihe a na-ahụkarị ka obi na-akụ n'ụzọ na-adịghị mma n'ime awa ole na ole mbụ mgbe amuchara. Ụda obi ga-enwe ọdịiche dị na ụda, ogologo oge, na ike karịa nke okenye. Mmiri ọbara kwesịrị ịdị site na 60 ruo 80 mm Hg systolic na 40-50 mm Hg diastolic. Ọrịa ọbara mgbali elu kwesịrị ịbụ otu ihe ahụ dị ka ime ime mgbe a mụrụ ya. N'ime awa mbụ mgbe amuchara, enwere ike ịdaba na 15 mm Hg na ọbara mgbali elu systolic. [1]
A na-akọwa eriri na-egbu oge dị ka ichere ihe karịrị nkeji 2 iji jide eriri umbilical nke nwa ọhụrụ. E gosipụtara na nke a bara uru n'imeziwanye hematocrit na iron ma belata ụkọ ọbara. Uru ndị a nwere ike ịdịru ọnwa isii maka nwa ọhụrụ.[3]
Nnyocha / Ntinye aka: Nnyocha na nlekota nke ihe ịrịba ama dị mkpa na ụcha akpụkpọ ahụ dị mkpa n'ịchọpụta nsogbu obi na nwa ọhụrụ.A ga-anụ ụda olu apical maka otu nkeji zuru ezu mgbe nwa ọhụrụ dị jụụ ma ọ bụ na-ehi ụra. A ga-enyocha ma nyochaa obi ọ bụla na-adịghị mma mgbe awa ole na ole mbụ nke ndụ nke na-emetụtaghị ịkwa ákwá ma ọ bụ ihe ọzọ dị n'èzí.[1]A ga-eji aka kwesịrị ekwesị were ọbara mgbali elu, ọkacha mma mgbe nwa ọhụrụ ahụ zuru ike. A ga-enyocha tachycardia na-adịgide adịgide maka ọnọdụ ndị dị ka ụkọ ọbara, hyperthermia, hypovolemia, na sepsis. Bradycardia na-adịgide adịgide nwere ike ịbụ ihe na-egosi nkụchi obi amụrụ ma ọ bụ hypoxemia. Pallor na cyanosis etiti (cyanosis n'aka na ụkwụ bụ nchọpụta a na-ahụkarị) nwekwara ike igosi nsogbu obi.[1]
Mmiri na ikuku oxygenation
[dezie | dezie ebe o si]Physiology: Mgbe amụrụ, akpa ume nwa ọhụrụ na-aghọ ebe mgbanwe gas. E nwere ọtụtụ ihe na-emetụta ọrụ iku ume a mụrụ ọhụrụ; ihe ndị a gụnyere kemịkal, igwe, okpomọkụ, na mmetụta. Mgba ume na-amalite mgbe aortic na carotid chemoreceptors na-akpali site na ịdịgasị iche iche nke oxygen na carbon dioxide. N'oge a na-amụ nwa n'ahụ nwanyị, a na-ejikọta obi nwa ọhụrụ site na ọwara ọmụmụ. Mgbe a na-ebute ya, nrụgide na-adịghị mma na-enye ohere ka ikuku banye n'ime akpa ume. Mkpu mbụ nke nwa ọhụrụ ahụ na-enye ohere maka mgbasawanye alveoli na ịmịkọrọ mmiri akpa ume nwa. Mgbanwe okpomọkụ na mkpali mmetụta ndị ọzọ na-enye aka n'ọrụ iku ume.
Ngosipụta: Usoro iku ume na-abụkarị nke na-adịghị mma na nke na-enweghị isi. Ọnụ ọgụgụ iku ume nke ụmụ ọhụrụ kwesịrị ịdị n'etiti iku ume 30 na 60 kwa nkeji na mmasị maka iku ume imi. Ribs na-agbasa n'ala. Ụda iku ume kwesịrị ịdị ọcha ma hara nhata na akpa ume abụọ ahụ. iku ume n'afọ dị mma. Acrocyanosis bụ nchọpụta dị mma.[1]
Nnyocha / Ntinye aka: Ntinye nke mmiri na-esi n'imi na n'ọnụ na-akwalite mwepụ mmiri. Ịnụrụ ụda akpa ume iji nyochaa ihe ọ bụla na-adịghị mma. A na-eme pulse oximetry iji chọpụta saturation oxygen. Nyochaa ihe ịrịba ama nke nsogbu iku ume dịka: ịfụ ụfụfụ imi, ịsụ ngọngọ, cyanosis etiti.[1]
Mmetụta nke nri
[dezie | dezie ebe o si]Physiology: Mgbe a mụrụ nwa ọhụrụ, a na-ewepụ glucose nke nne ya ma malite ịdabere na abụba echekwara maka ike. Glycogen na-echekwa na oge kachasị elu. N'ime awa mbụ nke ndụ, glucose ọbara ga-eru ebe kachasị ala wee kwụsie ike n'ime awa 2 ruo 4, ya mere a na-akwalite inye ara ozugbo. N'ọnọdụ ebe a na-egbu oge inye nri, nwa ọhụrụ ahụ nwere ike iji lactate, free-fatty acids, na ketone bodies.
Ngosipụta: Ọdịdị glucose dị n'ọbara dị site na 40 ruo 50 mg / dl. [1]Mgbọrọgwụ na ịmịkọrọ mmiri kwesịrị ịdị na nwa ọhụrụ ga-eri obere ihe ugboro ugboro. Ihe ịrịba ama niile dị mkpa kwesịrị ịdị n'ime oke kwesịrị ekwesị nke kwekọrọ na ngosipụta nke ịdị jụụ na afọ ojuju nke ụmụ ọhụrụ.
Nnyocha / Ntinye aka: nyochaa ọkwa glucose n'ọbara ma gbaa ume inye ara ma ọ bụ inye nri ngwa ngwa o kwere mee. A ga-enye agụmakwụkwọ inye nwa ara na inye nwa ara dịka o kwesịrị.
Nchịkwa okpomọkụ
[dezie | dezie ebe o si]Physiology: Ụmụ ọhụrụ enweghị ikike nke thermogenesis n'ihi usoro ịma jijiji na-adịghị emepe emepe. Okpomọkụ ahụ na-efu site na conduction, convection, na okpomọkụ radiant. [1]A na-enweta njikwa okpomọkụ site n'ọtụtụ ụzọ: metabolism nke abụba na-acha nchara nchara na nlekọta Kangaroo, nke a makwaara dị ka akpụkpọ ahụ na akpụkpọ ahụ. "Mkpụrụ abụba na-acha nchara nchara" bụ anụ ahụ abụba pụrụ iche nke nwere oke mitochondria e mere iji mee ka abụba acid dị ngwa ngwa iji mepụta okpomọkụ metabolic. Akpụkpọ ahụ na akpụkpọ ahụ iji lekọta bụ itinye nwa ọhụrụ ozugbo n'obi onye na-elekọta ya. [citation needed]Nke a na-akwalite njikwa okpomọkụ nke nwa ọhụrụ site na okpomọkụ sitere na onye nlekọta.
Ngosipụta: Okpomọkụ dị mma sitere na 97.7 ruo 100.0 . Ụmụ ọhụrụ oyi nwere ike iti ákwá ma ọ bụ yie ndị na-enweghị obi iru ala. Aka na ụkwụ ụmụ ọhụrụ na-anọgide na-enwe ọnọdụ nwa ọhụrụ, na-ebelata ebe ha dị n'elu ahụ ma na-ebepụ okpomọkụ.[1]
Nnyocha / Ntinye aka: Nwa ọhụrụ kpọrọ nkụ ozugbo amuchara ma malite mmekọrịta akpụkpọ ahụ na akpụkpọ ahụ. Nye blanket na-ekpo ọkụ na okpu. Jiri ihe na-ekpo ọkụ na-egbuke egbuke ma ọ bụrụ na akpụkpọ ahụ na akpụkpọ anụ adịghị mma. Na-enyocha okpomọkụ nke ahụ axillary ugboro ugboro. Mbelata ikpughe nwa ọhụrụ n'oge mgbanwe na nyocha.
Hụkwa
[dezie | dezie ebe o si]Ihe odide
[dezie | dezie ebe o si]Nnyocha / Ntinye aka: Nwa ọhụrụ kpọrọ nkụ ozugbo amuchara ma malite mmekọrịta akpụkpọ ahụ na akpụkpọ ahụ. Nye blanket na-ekpo ọkụ na okpu. Jiri ihe na-ekpo ọkụ na-egbuke egbuke ma ọ bụrụ na akpụkpọ ahụ na akpụkpọ anụ adịghị mma. Na-enyocha okpomọkụ nke ahụ axillary ugboro ugboro. Mbelata ikpughe nwa ọhụrụ n'oge mgbanwe na nyocha.
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 Lowdermilk. D. (2016). Maternity & Women's Health Care. St. Louis: Mosby. Lowdermilk. D.; Perry, S. E.; Cashion, K.; Alden, K.R. (2016). Maternity & Women's Health Care. St. Louis: Mosby. Kpọpụta njehie: Invalid
<ref>tag; name "Lowdermilk" defined multiple times with different content - ↑ Morton (September 2016). "Fetal Physiology and the Transition to Extrauterine Life". Clinics in Perinatology 43 (3): 395–407. DOI:10.1016/j.clp.2016.04.001. PMID 27524443.
- ↑ Anderson (15 November 2011). "Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial". The BMJ 343. DOI:10.1136/bmj.d7157. PMID 22089242.