Pēpē pēpē

Hānau ʻia kahi pēpē premature ma mua o 37 mau hebedoma i hānau ai (ʻoi aku ma mua o 3 mau pule ma mua o ka lā palena pau).

I ka hānau ʻana, hoʻolaha ʻia ka pēpē e like me kekahi o kēia:

• Makahiki (ma lalo o 37 mau pule hānau)
• Ka wā piha (37 a 42 mau pule hānau)
• Kau manawa hope (hānau ʻia ma hope o 42 mau hānau hānau)

Inā hele ka wahine i ka hana ma mua o 37 mau pule, kapa ʻia ia ʻo ka hana mua.

ʻO nā pēpē preerm hope loa i hānau ʻia ma waena o 35 a me 37 mau wiki e hāpai nei ʻaʻole paha e nānā. ʻAʻole paha lākou e ʻae ʻia i kahi neonatal intensive care unit (NICU), akā aia nō lākou i ka makaʻu no ka nui o nā pilikia ma mua o nā pēpē wā piha.

ʻO nā kūlana olakino i ka makuahine, e like me ka maʻi diabetes, nā maʻi puʻuwai, a me nā maʻi puʻupaʻa, e hāʻawi i ka hana mua. ʻO ka pinepine, ʻike ʻole ʻia ke kumu o ka hana preterm. ʻO kekahi mau hānau hānau mua he mau hāpai hāpai, e like me nā māhoe a me nā kolikolu.

Hoʻonui ka pilikia pili i ka hāpai ʻana i ka makaʻu o ka hana mua a i ʻole ka hānau mua:

• ʻO kahi cervix nāwaliwali e hoʻomaka e wehe (dilate) i ka wanaʻao, i kapa ʻia hoʻi ka hiki ʻole o ka ʻehaʻeha
• Nā kīnā hānau o ka kōpū
• Mōʻaukala o ka lawe mua ʻana
• ʻO ka maʻi (kahi maʻi urinary tract a maʻi paha o ka membrane amniotic)
• Pono maikaʻi ʻole ka meaʻai ma mua a i ʻole i ka wā hāpai
• Preeclampsia: ke koko kiʻekiʻe a me ka protein i ka mimi e ulu ma hope o ka hebedoma 20 o ka hāpai keiki
• ʻO ka haki mua o nā membrane (placenta previa)

ʻO nā kumu ʻē aʻe e hoʻonui ai i ka makaʻu no ka hana mua a me ka lawe manawa ʻana e komo pū me:

• Makahiki o ka makuahine (makuahine ma mua o 16 a ʻoi paha ma mua o 35)
• ʻO ʻAmelika ʻAmelika
• Ka nele o ka mālama prenatal
• Kūlana haʻahaʻa haʻahaʻa haʻahaʻa
• Hoʻohana i ka paka, cocaine, a i ʻole amphetamines

Pilikia paha ka pēpē i ka hanu ʻana a me ka mālama ʻana i ka mahana o ke kino.

He mau hōʻailona paha ko ke kōkō pēpē o kēia mau pilikia:

• ʻAʻole lawa ke koko ʻulaʻula (anemia)
• Kahe i ka lolo a i ʻole hōʻino i ka mea keʻokeʻo o ka lolo
• Infection a neonatal sepsis
• Ke kō koko haʻahaʻa (hypoglycemia)
• ʻO ka maʻi hanu neonatal respiratory respiratory, keu o ke ea i loko o nā aʻa o nā māmā (pulmonary interstitial empysema), a i ʻole ke kahe ʻana o ka māmā (hemorrhage pulmonary)
• ʻO ka ʻili melemele a me nā keʻokeʻo o nā maka (jaundice hānau hou)
• Nā pilikia e hanu ana ma muli o nā mumū oʻo ʻole, pulumonia, a i ʻole patent ductus arteriosus
• ʻO ka maʻi ʻōpū nui loa (nekrotizing enterocolitis)

E loaʻa i kahi pēpē premature kahi haʻahaʻa o ka hānau hānau ma mua o kahi pēpē wā piha. ʻO nā hōʻailona maʻamau o ka prematurity:

• Nā hanana hanu maʻamau (pāpaʻu, hoʻomaha iki i ka hanu ʻana i kapa ʻia ʻo apnea)
• ʻO ka lauoho lauoho (lanugo)
• Hoʻonui clitoris (i nā pēpē wahine)
• ʻOi aku ka momona o ke kino
• ʻO ke kani haʻahaʻa a hoʻemi i ka hana ma mua o nā pēpē wā piha
• Nā pilikia e hānai ana ma muli o ka pilikia e omo a i ʻole ka hoʻohui ʻana i ka ale ʻana a me ka hanu ʻana
• ʻO ka scrotum liʻiliʻi i laumania a ʻaʻohe ona kualono, a me nā testicle undescended (i loko o nā pēpē kāne)
• Palolo pepeiao palupalu, maʻalahi
• Nani, laumania, ʻili ʻōlinolino i aniani moakaka (hiki ke ʻike i nā uaua ma lalo o ka ʻili)

Hana ʻia nā hoʻokolohua maʻamau i kahi pēpē pēpē:

• Nānā ke kinoea kōkō e nānā i nā pae oxygen ma ke koko
• Nā hōʻoia koko e nānā i nā pae glucose, calcium, a me bilirubin
• Pākuʻi x-ray
• Ka mālama ʻana i ka cardiorespiratory mau (ka nānā ʻana i ka hanu a me ka helu o ka puʻuwai)

Ke ulu a hana hiki ʻole ke hoʻopau ʻia, hoʻomākaukau ka pūʻulu mālama ola no ka hānau hānau kiʻekiʻe. E neʻe paha ka makuahine i kahi kikowaena i hoʻonohonoho ʻia e mālama no nā pēpē wawe i kahi NICU.

Ma hope o ka hānau ʻana, ʻae ʻia ka pēpē i ka NICU. Hoʻokomo ʻia ke pēpē ma lalo o kahi mehana a i ʻole i loko o kahi pahu hahana a wela i kapa ʻia he incubator, ka mea e hoʻomalu i ka mahana o ka ea. Mālama nā mīkini nānā i ka hanu ʻana o ka pēpē, ka helu o ka puʻuwai, a me ke kiʻekiʻe o ka oxygen i loko o ke koko.

ʻAʻole hoʻomohala piha ʻia nā ʻōnaehana pēpē. Pono ka pēpē i kahi mālama kūikawā i kahi kula hānai a hiki i ka hoʻomohala ʻana o nā meaola i mea e ola ai ka pēpē me ke ʻole o ke kākoʻo olakino. Hiki paha kēia i mau pule i mau mahina.

ʻAʻole hiki i nā pēpē ke hoʻonohonoho i ka hānai ʻana a me ka ale ʻana ma mua o ka 34 mau pule. Loaʻa paha i kahi pēpē premature kahi paipu hānai liʻiliʻi, waiho ʻia ma o ka ihu a waha paha i loko o ka ʻōpū. I nā kamaliʻi ʻole a maʻi paha, hāʻawi ʻia ka meaʻai ma o ke aa a hiki i ka paʻa o ka pēpē e loaʻa nā meaʻai āpau ma o ka ʻōpū.

Inā loaʻa nā pilikia hanu o ke pēpē:

• Hoʻokomo ʻia kahi paipu i loko o ka puka makani (trachea). ʻO kahi mīkini i kapa ʻia he ventilator e kōkua i ka pēpē hanu.
• ʻO kekahi mau pēpē nona nā pilikia hanu i ʻoi aku ka paʻakikī e loaʻa kaomi mau ʻana o ke ala maikaʻi (CPAP) me nā paipu liʻiliʻi i ka ihu ma kahi o ka trachea. A i ʻole loaʻa paha iā lākou ka oxygen.
• Hāʻawi ʻia ka oxygen e ka ventilator, CPAP, nasong prongs, a i ʻole he hood oxygen ma luna o ke poʻo o ka pēpē.

Pono nā pēpē i kahi kahu hānai kūikawā a hiki i ka manawa e hiki ai iā lākou ke hanu me ka ʻole o ke kākoʻo nui, ʻai i ka waha, a mālama i ka mahana o ke kino a me ke kaumaha o ke kino. Loaʻa paha i nā pēpē liʻiliʻi loa nā pilikia ʻē aʻe e hoʻopili i ka lāʻau lapaʻau a koi aku i kahi noho lōʻihi ma ka haukapila.

Nui nā hui kākoʻo no nā mākua o nā pēpē wawe. E noi i ka limahana kaiaulu i ka neonatal intensive care unit.

ʻO ka Prematurity kahi kumu nui o ka make ʻana o nā pēpē. ʻO ka hoʻomaikaʻi ʻana i nā hana lapaʻau a me nā kahu hānai i hoʻonui i ke ola o nā pēpē ʻōpio.

Hiki i nā Prematurity ke loaʻa nā hopena lōʻihi. He nui nā pēpē premature i loaʻa i nā pilikia olakino, hoʻomohala ʻana, a i ʻole nā ​​lawena e hoʻomau i ka wā kamaliʻi a paʻa mau paha. ʻO ka nui o ka pēpē a ʻoi aku ka liʻiliʻi o ko lākou hānau hānau, a laila ʻoi aku ka nui o ka makaʻi no nā pilikia. Eia nō naʻe, ʻaʻole hiki ke wānana i kahi hopena lōʻihi o ka pēpē e pili ana i nā makahiki hānau a i ʻole ke kaumaha hānau.

ʻO nā pilikia lōʻihi loa e pili pū ana paha:

• ʻO ka pilikia lung lōʻihi i kapa ʻia ʻo bronchopulmonary dysplasia (BPD)
• Hoʻoneʻe ka ulu a me ka hoʻomohala
• Ka noʻonoʻo a me ke kino kīnā a hoʻolohi paha
• ʻO ka pilikia o ka hihiʻo i kapa ʻia ʻo retinopathy o prematurity, e hopena ai i ka ʻike maka a makapō paha

ʻO nā ala maikaʻi e pale aku ai i ka prematurity e:

• E olakino maikaʻi i mua o ka hāpai ʻana.
• E mālama i ka mālama prenatal i ka wā hiki i ka hāpai ʻana.
• Hoʻomau i ka mālama prenatal a hānau ka pēpē.

ʻO ka mālama ʻana i ka wā mua a me ka mālama maikaʻi ʻana e hōʻemi ai i ka manawa hānau mua.

Hiki ke mālama ʻia a hoʻolohi ʻia paha ka hana maʻa mua e kahi lāʻau e ālai ana i ka hoʻoliʻiliʻi uterine. Akā i nā manawa he nui, ʻaʻole kūleʻa nā hoʻāʻo e hoʻopanee i ka hana maʻa.

ʻO Betamethasone (kahi lāʻau lāʻau steroid) i hāʻawi ʻia i nā makuwahine i ka hana maʻa mau hiki ke hana i kekahi mau pilikia prematurity i ʻoi aku ka paʻakikī.

ʻO ka pēpē Preterm; Preemie; Premie; Neonatal - premie; NICU - premie

• Jaundice hānau hou - hoʻokuʻu

ʻO Brady JM, Barnes-Davis ME, Poindexter BB. ʻO ke keiki hānai kiʻekiʻe. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 117.

Parsons KV, Jain L. ʻO ke keiki pēpē hope loa. I: Martin RJ, Fanaroff AA, Walsh MC, hua. ʻO Faranoff lāua ʻo Martin's Neonatal-Perinatal Medicine. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 40.

ʻO Simhan HN, ʻo Romero R. Preterm hana a hānau. I: Landon MB, Galan HL, Jauniaux ERM et al, eds. Nā Kāpena Gabbe: Nā Pregnancies Maʻamau a me nā Pilikia. 8th ed. Piladelapia, PA: Elsevier; 2021: chap 36.