Peripartum cardiomyopathy

ʻO Peripartum cardiomyopathy kahi maʻi laha ʻole kahi e nāwaliwali ai ka puʻuwai o ka wahine hāpai. Hoʻolālā ia i ka mahina hope o ka hāpai ʻana, a i ʻole ma waena o 5 mau mahina ma hope o ka hānau ʻana o ka pēpē.

Kū ka Cardiomyopathy ke hōʻino ka puʻuwai. ʻO ka hopena, nāwaliwali ka puʻuwai puʻuwai a ʻaʻole maikaʻi ka pauma. Hoʻopili kēia i nā māmā, ke ake, a me nā ʻōnaehana o ke kino.

ʻO Peripartum cardiomyopathy kahi ʻano o ka cardiomyopathy dilated kahi i loaʻa ʻole ai kahi kumu ʻē aʻe o ka nāwaliwali o ka puʻuwai.

Hiki paha i nā wahine hānau keiki o nā makahiki, akā ʻo ka mea maʻamau ma hope o ka makahiki 30.

ʻO nā kumu pilikia no ke ʻano me:

• Ka momona
• ʻO ka mōʻaukala pilikino o nā maʻi puʻuwai e like me myocarditis
• Hoʻohana o kekahi mau lāʻau
• Puhipaka
• ʻAlekohola
• Nā hāpai hāpai lehulehu
• ʻElemakule
• Preecclampsia
• He moʻokūʻauhau ʻAmelika
• ʻAi hānai maikaʻi ʻole

Pākuʻi ʻia paha nā ʻōuli:

• Ka luhi
• Ke ʻano o ka heihei puʻuwai a i ʻole ka lele ʻana i nā pā (palpitations)
• Hoʻonui i ka urination i ka pō (nocturia)
• Ka hanu ʻana me ka hana a i ka wā e moe pālahalaha ana
• ʻO ka pehu ʻana o nā kuʻekuʻe wāwae

I ka wā o kahi hoʻokolohua kino, e nānā ka mea mālama ola no nā hōʻailona o ka wai i nā akemāmā e ka hoʻopā ʻana a me ka paʻi ʻana me nā manamana lima. E hoʻohana ʻia kahi stethoscope e hoʻolohe i nā māwae māmā, kahi wikiwiki o ka puʻuwai, a i ʻole nā ​​kani naʻau kūpono ʻole.

Hoʻonui ʻia paha ke akepaʻa a pehu paha nā ʻāʻī o ka ʻāʻī. He haʻahaʻa paha ke kahe o ke koko a kū paha i ke kū ʻana i luna.

Hoʻonui ka puʻuwai, ka huʻihuʻi o nā ake a i ʻole nā ​​veins i loko o nā akemāmā, hoʻēmi i ka puka o ka naʻau, hoʻoliʻiliʻi ka neʻe ʻana a i ʻole ka hana ʻana o ka puʻuwai, a i ʻole e hōʻike ʻia ka puʻuwai puʻuwai ma:

• Pākuʻi x-ray
• Scanner CT pahu
• Angiography Coronary
• ʻEchocardiogram
• Nānā puʻuwai nuklear
• Cardiac MRI

Hiki ke kōkua i kahi biopsy puʻuwai e hoʻoholo inā ke kumu kumu o ka cardiomyopathy kahi maʻi puʻuwai puʻuwai (myocarditis). Eia naʻe, ʻaʻole hana pinepine ʻia kēia kaʻina hana.

Pono paha kahi wahine e noho i ka haukapila a hiki i ka hōʻemi ʻana o nā ʻōiwi koʻikoʻi.

Ma muli o ka hiki pinepine ke hoʻihoʻi i ka hana o ka puʻuwai, a ʻo nā wahine i loaʻa i kēia ʻano he ʻōpio a ʻano ʻē aʻe ke olakino, hoʻonāukiuki pinepine ka mālama.

Ke hiki mai nā hōʻailona koʻikoʻi, hiki i kēia ke hoʻopili i nā ʻanuʻu nui loa e like me:

• Hoʻohana o kahi pauma puʻuwai kōkua (aortic counterpulsation balloon, left ventricular assist device)
• Immunosuppressive therapy (e like me nā lāʻau i hoʻohana ʻia e mālama ai i ka maʻi ʻaʻai a pale i ka hōʻole ʻana i kahi mea kanu i kanu ʻia)
• Hoʻoneʻe puʻuwai inā hoʻomau ka naʻau kū ʻole

No ka hapanui o nā wahine, akā kau ka lāʻau lapaʻau i ka hoʻomaha ʻana i nā ʻōuli. Hele aku kekahi mau ʻōuli ma o lākou iho me ka ʻole o ka lāʻau.

Hoʻohana pinepine ʻia nā lāʻau i:

• Digitalis e hoʻoikaika i ka puʻuwai hiki i ka hiki
• Diuretics ("wai huaʻai") e hoʻopau i ka nui o ka wai
• ʻO nā blockers beta haʻahaʻa
• ʻO nā lāʻau kahe koko ʻē aʻe

Paipai ʻia kahi papa paʻakai haʻahaʻa. Pākuʻi ʻia paha ka wai i kekahi mau hihia. Hiki ke kaupalena ʻia nā hana, me ka hānai ʻana i ka pēpē ke ulu nā ʻōuli.

Paipai ʻia ke kaupaona ʻana i kēlā me kēia lā. ʻO ke kaupaona o 3 a 4 mau paona (1.5 a 2 kilokilo) a ʻoi aʻe ma mua o 1 a 2 mau lā paha he hōʻailona o ka hana wai.

E aʻo ʻia nā wahine puhipaka a inu rama hoʻi e kū, no ka mea, ʻoi aku ka maikaʻi ʻole o nā ʻōuli ma muli o kēia mau maʻamau.

Nui nā hopena i hiki i ka peripartum cardiomyopathy. Noho paʻa kekahi mau wahine no nā wā lōʻihi, ʻoi aku ka ʻino o ka hele a hewa o kekahi.

ʻOi aku ka hewa o ka poʻe ʻē aʻe a lilo i moho no ka hoʻoliʻiliʻi puʻuwai. Ma kahi o 4% o ka poʻe e koi ana i ka lawe ʻana o ka naʻau a make paha i ka 9% a make paha mai nā pilikia o ke kaʻina hana.

Maikaʻi ka nānā ke hoʻi ka naʻau o ka wahine i ka maʻamau ma hope o ka hānau ʻana o ka pēpē. Inā kūleʻa ka puʻuwai, hiki i nā ʻōpū e hiki mai ana i ka hopena o ka puʻuwai. ʻAʻole ʻike ʻia pehea e wānana ai i ka mea e ola a ʻo wai ka mea e ulu i ka hōʻeha puʻuwai koʻikoʻi. Ma kahi o ka hapalua o nā wahine e ola hou loa.

ʻO nā wahine e hoʻomohala i ka cardiomyopathy peripartum i ka makaʻu nui i ka hoʻomohala ʻana i ka pilikia like me nā hāpai e hiki mai ana. ʻO ke ana o ka hoʻi hou ʻana ma kahi o 30%. No laila, ʻo nā wahine i loaʻa i kēia ʻano e kūkākūkā i nā ʻano hana hānau me kā lākou mea lawelawe.

Komo pū nā pilikia:

• Cardiac arrhythmias (hiki ke make)
• Hoka puʻuwai Congestive
• ʻO ka hana lole i ka puʻuwai e hiki ke embolize (huakaʻi i nā ʻāpana ʻē aʻe o ke kino)

Kāhea i kāu mea hāʻawi inā hāpai ʻoe i kēia manawa a i ʻole ua hānau ʻia i kahi pēpē a manaʻo he mau ʻōuli paha kāu no ka cardiomyopathy.

E kiʻi koke i ke kōkua lapaʻau inā hoʻomohala ʻoe i ka ʻeha o ka umauma, palpitations, maʻule, a i ʻole nā ​​hōʻailona hou a wehewehe ʻole paha.

E ʻai i ka papaʻai kaulike a loaʻa i ka hoʻoikaika kino mau e kōkua i ka ikaika o kou puʻuwai. Hōʻalo i nā kūpaka a me nā waiʻona. E aʻoaʻo paha kāu mea lawelawe iā ʻoe e hōʻalo i ka hāpai hou inā ua loaʻa ʻole ka puʻuwai i ka wā o ka hāpai mua.

Cardiomyopathy - peripartum; Cardiomyopathy - hāpai keiki

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• Peripartum cardiomyopathy

ʻO Blanchard DG, ʻo Daniels LB. Nā maʻi Cardiac. I: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. ʻO Medicine a Maternal-Fetal a Creasy a me Resnik: Nā Manaʻo a me ka Hoʻomeheu. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 52.

McKenna WJ, Elliott PM. Nā maʻi o ka myocardium a me ka endocardium. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 54.

ʻO Silversides CK, Warnes CA. ʻO ka hāpai a me ka maʻi puʻuwai. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 90.