korang pekaba rini?chat?ayu x bpe chat rini, cam nk demam sesema lak...tu yg mls nk mengarang per yg ptt dikarang...hehehe..
ok, kte continue story last post sy psl projek bersama auf...hehe...mcm projek juta2 plak bunyinyer..
projek nyer ialah.................hehe... SAYA BG AUF DIRECT BREASTFEED...bunyi mcm bese jer kan...tp ni la 1st time sy breastfeed die ble umo die nk msuk 2 bulan...alhamdulillah...auf ley bf sdri w/pun sucking die x mcm bb len...mse ni doc x tau pown yg sy bg auf bf...hoho...teruk kn...klu pape terjadi cemane???tp mse tu x pk sgt pown..naluri keibuan nk menyusukan anak n naluri anak ble dkt ngan kte secara automatiknya die akn mencari tempat tuttttt...nk nenen...mcm diajar2 plak...tp tu la hakikat sebenar nya...mase nga buat sessi kangaroo care tuh auf mencari2 nk nen...memule tkut gak...tp ble tgk auf cam kesian lak...mst dh lame die teringin nk nen kn..sy kuatkan hti gak bg die...tp slow2...alhamdulillah, ianya berjln ngan lancar...smpi tertido auf..mb sgt menikmati air susu mama, 1st time kot die rse cemane rse susu...cian ank mama...perasaan sy ketika itu??hurmm...jgn ckp la..mmg x dpt nk digambarkan..terasa der satu mende yg menusuk kt hati then pergi ke otak...n keluar melalui air mate...sebak sgt....alangkah indah nya tuhan beri nikmat menjadi seorang ibu..satu mende yg x dpt nk digambarkan....
hari berikutnya membuat sesi sy mst curi2 bf auf...hehe..kekadang mcm terase plak auf menunggu2 kedatangan sy..nk manje2 ngan die...setelah ianya berlarutan beberapa hari...sy pown rse serba salah gak la kn...kot la sy buat tu slah ke..x boleh ker...then sy decide utk gtau doc yg sy pnh try bg auf bf....igt doc nk marah...rupenye doc plak yg terkejut...??????hehe...doc ,c, x caye auf ley bf, sbb bese bby yg gne O2, mereka kurg tenaga utk bf..hoho..yeke???yer la kn...nk bernafas pown x larat, kne gne O2, apetah lg nk sucking...sdgkn sblm ni minum pown masukkan tiub direct dlm perut...ni kn nk sucking tuk kuarkan susu yer x???tp Allah tu maha kuasa, Dia boleh buat apa sahaja di luar kemampuan fikiran manusia.
Alhamdulillah doc x marah dgn ape yg sy gtau, malah doc encourage sy tuk bg bf, tp jgn terlalu lama sgt sbb tkt bb pnt..yess...seronoknya...so, hari2 selepas tu pasti akn bg auf bf..tp sket2 la...x mo bg die pnt..alhamdulillah, sumenyer berjaln dgn baik...
semakin hari auf semakin menunjukkan keadaan yg positif..berat naik...yayak ok (buang air besar)..susu bertambah...kadar O2 pown smkin berkurang...syukur sgt...doc gtau yg auf mgkn akn ditukar ke ZON KUNING .. alhamdulillah...zon kuning ni merupakan tempat bby yg separa kritikal...means, keadaan yg bertambah bagus...syukur Ya Allah...mmg ini yg kami harapkan...perubahan yg positif..setelah hampir 2 bln menetap di ZON MERAH ..mmg ade hikmahya kami bersabar...biar lambat asalkan sihat kn...hehe....mase kat zon ni bb x ramai sgt compare kt zon merah, der la dlm 4-5 org gtu...jd nurse yg je pown x ramai...1-2 org compare ngan zon merah ramai org...hehe...maknenye auf x perlukan perhatian penuh...walaupun kekadang auf ade mood malas utk bernafas dan menyebabkan die DESAT (ni klu oksigen bb down dlm bdn).. agk rsu gak mse kt zon ni...sbb x rmi yg jage...tp kami tawakal jer n yakin dgn nurse2 yg bertugas kt sane..
mase kat zon ni, barulah kami tau yg setiap bby yang menggunakan oksigen mesti melakukan pemeriksaan mata atau ROP (Retinopathy of prematurity) pemeriksaan ini bertujuan untuk mengesan perubahan abnormal mata bayi bagi mengesan tindak balas akibat daripada penggunaan oksigen..sbb bb yg lahir premature mempunyai mata yg belum complete..means premature jgk la,,,so klu gne oksigen lelame, ianya akn mengakibatkan mata bayi akan mengalami pertumbuhan yg abnormal..
sedikit info berkenaan dengan bayi pramatang..(sumber
dpd google)
Eye Problems
Retinopathy of
Prematurity (ROP)
Premature babies are at risk for aquiring a
disease of the developing eye called retinopathy of prematurity (ROP; formerly
called retrolental fibroplasia). ROP can occur in babies who are born at less
than 32 weeks of pregnancy, but the highest rate occurs in babies who are born
at less than 28 weeks.
Premature babies are at risk for ROP because the
retina (the membrane at the back of the eye that helps transform light into
images) is less developed and only partially covered with blood vessels at
birth. Many premature babies get supplemental oxygen soon after birth. High
levels of oxygen, or fluctuation in a baby's oxygen level, can damage the
partially formed blood vessels of the retina. (There have, however, been cases
of ROP in babies who have never received extra oxygen.)
When ROP develops, the blood vessels in the
baby's retina begin to grow irregularly and may bleed and form scar tissue. In
the most severe cases, scar tissue can pull on the retina and cause it to
detach from the eye, resulting in blindness. Ten to thirty percent of premature
babies may get ROP; however, only a few cases result in impaired vision or
blindness.
To prevent ROP, extremely premature babies
should have their blood oxygen levels closely monitored. Babies who are born
prematurely should have their eyes examined by a pediatric ophthalmologist at
four to six weeks of age, and then every two weeks until the blood vessels in
the retina are completely grown. If a baby has signs of severe ROP, frequent
eye exams and special therapy (for example, laser surgery) may be necessary to
treat the irregular growth and prevent ROP from progressing.
Other Eye Problems
Other common eye problems for premature babies
include nearsightedness (myopia) and lazy eye (strabismus). A baby with
strabismus may need to wear an eye patch or have surgery. Former premature
infants should continue to have their vision checked yearly by an eye doctor,
even after their ROP has gone away.
Hearing Problems
Premature babies are at increased risk for
hearing abnormalities and should have their hearing tested before discharge
from the hospital. If the tests are abnormal, the baby should see a specialist
for further evaluation and treatment.
Sedikit info tentang ROP (sumber dpd google)
Premature Babies At Risk For Eye Problems
By George Leposky
Advances in treating the
smallest, least developed premature babies now allow many to survive who would
have died a generation ago, but not all of these "super-preemies"
will grow up to lead normal, healthy lives. A serious complication that some of
them face is retinopathy of prematurity (ROP), an eye disorder formerly called
retrolental fibroplasia.
According to the
National Eye Institute (NEI), ROP can lead to blindness in one out of 48
infants weighing less than 2.7 pounds (1,251 grams) at birth.
What ROP Is
We are able to see
because the lens inside each of our eyes focuses light energy on the retina, a
layer of cells on the inner surface of the eye. The retina captures this light
energy and transforms it into electrical impulses, which the optic nerve sends
to the brain.
During the last few
weeks before the birth of a full-term baby, blood vessels grow outward from the
optic nerve into the retina. In some premature babies, something interrupts
this process. Then abnormal vessels begin to grow, accompanied by fibrous scar
tissue that in the worst cases forms a ring all the way around the inside of
the eye.
"Fortunately, most
premature infants do not develop ROP, and most infants with ROP improve
spontaneously," notes ophthalmologist Scott C. Richards., M.D., of the
Country Hills Eye Center in Ogden, Utah.
In other cases, however,
ROP can grow progressively worse. Ultimately the scar tissue contracts,
detaching the retina from the choroid, an inner layer of blood vessels
underneath the retina. A partial detachment may allow fluid from inside the eye
to seep behind the retina, enlarging the area of detachment and further
decreasing visual acuity. Complete detachment of the retina will leave the
infant blind.
The NEI says about 74
percent of the 27,000 "super-preemies" born each year survive, and
six percent of them develop severe ROP. Although treatments for ROP exist, they
don’t help every patient. According to the NEI, about 35 percent of eyes with
severe ROP are blind a year after treatment.
Risk Factors
Researchers still aren’t
sure what causes ROP. It is associated with premature birth - an inherently serious problem - and with a constellation of other
complications associated with prematurity. These include a chronic shortage of
oxygen before birth, circulatory and respiratory problems, anemia, seizures,
and the use of blood transfusions and mechanical ventilation to treat premature
infants. However, sorting out cause and effect from a mere association remains
a challenge.
After ROP was discovered
in 1941, the earliest efforts to find a cause focused on the practice of giving
premature newborns high levels of supplemental oxygen. When neonatologists
began administering less oxygen to their tiny patients, ROP should have gone
away - but it didn’t. In
fact, the number of cases began to rise in the 1970s. This coincided with major
advances in neonatal care that expanded the frontiers of survivability for the
smallest and most premature infants, in whom ROP is most likely to develop and
most likely to need treatment.
Selecting the
appropriate level of supplemental oxygen a premature infant should receive
involves a delicate balance. Too much oxygen increases the risk of ROP; too
little can cause other complications, or death. With current technology for
monitoring the oxygen level of an infant’s blood, that balance is being
achieved today.
Another possible risk
factor is the use of indomethacin, a drug similar to ibuprofen, to promote
closure of the ductus arteriosus, a small fetal blood vessel bypassing the
lungs. In a full-term infant, this vessel normally closes by itself soon after
birth. One study found an association between indomethacin and severe ROP, but
another did not.
Although the use of
calf-lung surfactant to treat respiratory distress syndrome in premature
infants has been associated with a decreased risk of ROP, Dr, Richards says
this may be due to improvements in lung function and nutritional status
"rather than a direct effect of the surfactant on the ROP process."
On the theory that bright light may cause ROP or
make it worse, many newborn intensive-care units have installed dim lights or
covered the babies’ isolettes or cribs with blankets. However, a clinical study
supported by the NEI found that "a reduction in the ambient-light exposure
does not alter the incidence of ROP."
Vitamin E deficiency
also has been considered as a cause of ROP. Although the results of studies to
explore this theory were ambiguous, they suggest that giving vitamin E to
premature infants doesn’t seem to hurt and may help.
Treatment of ROP
Most newborn
intensive-care units now screen for ROP with an indirect ophthalmoscope, a
device that provides a three-dimensional view of the retina. The procedure
involves use of a local anestethic and can be stressful to the infant. "We
do our initial examinations," Dr. Richards says, "at 33 weeks
gestational age or six weeks after birth, whichever comes first, assuming that
the infant is stable enough for the examination." If ROP is present, the
procedure is repeated at intervals of a week or two until the abnormal retinal
vessels disappear or until the disease progresses to the point of requiring
treatment. Four treatment methods are available:
· Cryotherapy, use
of a supercooled probe on the outside wall of the eye to freeze portions of the
retinal surface.
· Laser
photocoagulation, which is more precise than and has largely supplanted
cryotherapy. It treats the retina and choroid directly without affecting the
whole eye wall.
· Scleral buckle, a
surgical procedure in which a silicone band tightened around the eye helps to
relieve stress on a detached retina so it can reposition itself against the eye
wall.
· Vitrectomy, a complex procedure involving
replacement of the vitreous gel inside the eye with a saline solution, and
removal of the scar tissue on the retina. Sometimes the lens also has to be
removed. Reattachment of the retina to the eye wall succeeds in 25 to 50
percent of ROP victrecomy patients, but only about 25 percent of that group can
see "well enough to reach out and grab an object or recognize
patterns," Dr. Richards says. "The disappointing visual results of
surgery underscore the need for careful screening and timely laser treatment
for patients at risk for visual loss."
Later Complications
Infants with ROP - even a mild case that goes away by
itself - are prone to
complications that can cause vision loss later in life. These include:
· Glaucoma, a
disease in which increased pressure inside the eye damages the optic nerve,
gradually reducing visual acuity until blindness occurs.
· Amblyopia (lazy eye), dimness of vision
without a detectable organic cause.
· Myopia
(nearsightedness).
· Nystagmus (a
rapid, involuntary shaking of the eyeball).
· Retinal detachment
during adolescence and early adulthood.
· Strabismus
(crossed eyes).
Thus, anyone who was
treated for ROP as an infant should see an eye doctor frequently during
childhood and at regular intervals throughout life. Furthermore, because
careful screening for ROP is a relatively recent practice, adults who know that
they were born prematurely and don’t know whether they had ROP also should have
regular eye exams, to detect and receive prompt treatment for any late-onset
complications of ROP that may threaten their vision.
George Leposky is editor of Ampersand
Communications, a news-features syndicate based in Miami, Florida.
For More Information
National Eye Institute -
http://www.nei.nih.gov/neitrials_script/studydtl.asp?id=58
© Ampersand Communications
sedikit info bergambar tentang ROP
Parents'
Guide to Their Premature Baby's Eyes
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Overview
More than 80% of premature babies who weigh less than 1000
grams (2.2 lbs) will develop ROP. Most will resolve without treatment. Those
who require treatment much receive it in a timely manner in order to obtain
the best possible outcome. This may occur after discharge
from the hospital. For this reason, it is critical that premature babies be
examined according to the schedule that will be communicated to you at
discharge. There is risk of retinal detachment from the active form of ROP
until about ten weeks after the babies due date (50 weeks after conception.)
Vision is a highly complex act which requires the functioning
of the visual pathways in the brain. Even with timely screening and proper
treatment, other factors may lead to less than normal vision in premature
infants. Modern treatment has reduced the devastating effects of ROP on the
eye, yet worldwide it remains the leading cause of pediatric retinal
blindness. With or without ROP, there can be profound vision loss due to
amblyopia (lazy eye,) eye misalignment or the need for glasses. For
this reason, every premature infant deserves the lifelong attention of an
ophthalmologist.
What is ROP?
Retinopathy of Prematurity (ROP) is a potentially blinding
disease which in the United States affects several thousand premature infants
each year. It was unknown prior to 1942 because premature infants did
not survive long enough to show the effects of ROP. With improvements
in the medical care of the smallest premature infants, the rate and severity
of ROP have increased. The diagnosis of ROP is made by an
ophthalmologist who examines the inside of the eye. Premature infants
qualify for eye examinations based on their birthweight. Although the
majority of examined babies will show some degree of ROP, most will not
require surgery. Nevertheless, premature babies require lifelong
follow-up by an ophthalmologist because of their increased risk for eye
misalignment, amblyopia and the need for glasses to develop normal
vision.
How the Eye Works
The eye functions much like a camera. The front of the
eye contains the structures which focus the image and regulate the amount of
light that enters the eye, similar to the lens and shutter of a camera.
The inside of the eye is filled with a gel-like substance called
vitreous. In the back of the eye is the retina which functions like the
film in a camera. Without film a camera cannot take a picture and
without the retina, the eye cannot see. A normal full term infant has a
nearly fully formed retina. Blood vessels which provide nutrition to
the retina grow from the back of the eye to the front, with this process
completed just after birth.
The Premature Eye
When a baby is born prematurely, the retina is only partially
formed. The blood vessels have grown into the retina at the very back
of the retina at the very back of the eye but not into the rest of the
retina. The amount of abnormal underdeveloped retina proportional to
the severity of prematurity. The closer that a premature baby is to
full term, the more normally developed is the retina. The greater the
prematurity, the greater is the amount of undeveloped retina.
Zones of Involvement
Two factors influence vision loss from ROP: the amount
of retina that is undeveloped at the time of birth and the severity of the
disease. The retina is divided into Zones 1, 2 and 3 and the severity
of ROP is graded as Stage 1, 2, 3, 4 or 5.
ROP-Stages and
Treatment
If the retina detaches, removal of the vitreous (vitrectomy)
and lens may be needed. Rarely, a band of silicone may be placed around
the eye (a scleral buckling operation).
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