Hāpai keiki Ectopic

ʻO ka hāpai hāpai ectopic kahi hāpai i kū ma waho o ka ʻōpū (uterus). He mea make paha ia i ka makuahine.

I ka hapanui o nā hāpai ʻana, hele ka huʻa momona i loko o ka pahu fallopian i ka ʻōpū (uterus). Inā kāohi ʻia a hoʻōlohi ʻia ka neʻe ʻana o ka hua ma o nā paipu, hiki iā ia ke alakaʻi i kahi hāpai hāpai ectopic. ʻO nā mea i hoʻokumu i kēia pilikia me:

• Hānau hānau kīnā i nā paipu fallopian
• Scarring ma hope o ka hoʻopau appendix
• Endometriosis
• Loaʻa i ka hāpai hāpai ectopic i ka wā i hala
• ʻO ka scarring mai nā maʻi i hala a i ʻole ke ʻoki ʻana o nā ʻā wahine

Hoʻonui ka mea aʻe i ka makaʻu no ka hāpai hāpai ectopic:

• Makahiki ma mua o 35
• Hāpai i ka hāpai ʻana i kahi hāmeʻa intrauterine (IUD)
• Ke nakinaki nei i kāu mau paipu
• Ke ʻoki ʻana e wehe i nā paipu e hāpai
• He nui nā hoa kolohe
• Nā maʻi i loaʻa i ka moekolohe (STI)
• ʻO kekahi mau hōʻailona infertility

I kekahi manawa, ʻike ʻole ʻia ke kumu. Hoʻokani paha nā Hormones i kahi hana.

ʻO ka pūnaewele maʻamau no ka hāpai hāpai ectopic ka paipu fallopian. I nā hihia maʻamau, hiki i kēia ke hana i ka ovary, ʻōpū, a i ʻole ka cervix.

Hiki i kahi hāpai ectopic ke hana inā ʻoe e hoʻohana i ka kaohi hānau.

Pākuʻi ʻia paha nā ʻōuli o ka hāpai hāpai ectopic:

• ʻO ke kahe o ke kahe maʻamau
• Mālamalama iki ma kekahi ʻaoʻao o ka pelvis
• ʻAʻohe wā
• ʻEha ma ka ʻōpū o lalo a i ʻole pelvic wahi

Inā haki a kahe ka wahi e pili ana i ka hāpai hāpai ʻole ʻana, eʻoi aku ka maikaʻi o nā ʻōuli. Pākuʻi ʻia lākou:

• Maule a maʻule paha
• Kaomi ikaika ma ka poli
• Kaomi haʻahaʻa
• ʻO kaʻeha ma ka poʻohiwi
• ʻOi loa, ʻāʻī, a ʻehaʻeha hoʻi i ka ʻōpū o lalo

E hana ka mea mālama ola i kahi hōʻike pelvic. Hōʻike paha ka hōʻike i ka palupalu ma ka wahi pelvic.

E hana ʻia kahi hōʻike hāpai a me nā ultrasound vaginal.

ʻO ka gonadotropin chorionic kanaka (hCG) kahi hormone i hana ʻia i ka wā hāpai. Ke nānā nei i ke kiʻekiʻe o ke koko o kēia hormone hiki ke ʻike i ka hāpai ʻana.

• Ke piʻi aʻe nā pae hCG ma luna o kekahi waiwai, e ʻike ʻia kahi ʻeke hāpai i ka kōpū me ka ultrasound.
• Inā ʻike ʻole ʻia ke ʻeke, hōʻike paha kēia i ka loaʻa ʻana o kahi hāpai ectopic.

Hoʻoweliweli ke ola ʻo Ectopic. ʻAʻole hiki i ka hāpai ke hoʻomau i ka hānau (kau). Pono e hemo i nā pūnaewele ulu e mālama i ke ola o ka makuahine.

Inā ʻaʻole i haki ka ʻōpū ectopic, hiki i ka mālama ke hoʻopili ʻia:

• ʻOki kino
• ʻO ka lāʻau e hoʻopau ai i ka hāpai ʻana, a me ka nānā pono ʻana e kāu kauka

Pono ʻoe i kōkua kōkua olakino inā wehe ka wahi o ka hāpai hānau ectopic (haki). Hiki i ka Rupture ke alakaʻi i ke kahe a me ka haʻalulu. Hoʻomaopopo pū ʻia ka hana no ka haʻalulu:

• Hoʻohuli koko
• Hāʻawi ʻia nā wai i loko o kahi aa
• E mālama mahana ana
• Oxygen
• Ke hāpai nei i nā wāwae

Inā loaʻa ka haki, hana ʻia ke kaukoki e hōʻoki ai i ke kahe o ke koko a hemo i ka hāpai ʻana. I kekahi mau hihia, pono paha i ke kauka e wehe i ka ʻōpū fallopian.

Hoʻokahi o nā wahine ʻekolu i loaʻa i hoʻokahi hāpai wahine ectopic hiki ke loaʻa i kahi pēpē i ka wā e hiki mai ana. ʻO ka hāpai ʻana o kahi ectopic hāpai ʻē aʻe. ʻAʻole hāpai hou kekahi mau wahine.

ʻO ka likelihood o kahi hāpai hāpai kūleʻa ma hope o ka hāpai ʻana ectopic hilinaʻi ʻia:

• ʻO ka makahiki o ka wahine
• Inā paha he keiki kāna
• No ke aha i hāpai ai ka hāpai mua ectopic

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe:

• ʻO ke kahe o ke kahe maʻamau
• ʻO ka ʻeha o ka ʻōpū lalo a i ʻole ke pelvic

ʻO ka hapa nui o ka hāpai ʻana ectopic e kū nei ma waho o nā paipu fallopian ʻaʻole hiki ke pale ʻia. Hiki paha iā ʻoe ke hōʻemi i kou makaʻu ma ka ʻalo ʻana i nā kūlana e hōʻeha ai i nā paipu fallopian. Aia kēia mau ʻanuʻu i:

• Ke hoʻomaʻamaʻa nei i ka moekolohe palekana ma o ka hana ʻana i nā ʻanuʻu ma mua a i ka wā o ka moekolohe, hiki ke pale iā ʻoe mai ka loaʻa ʻana i kahi maʻi
• Ke kiʻi nei i ka hōʻailona mua a me ka mālama ʻana i nā STI āpau
• Kaohi ʻana i ka paka

Hapai Tubal; Hapai kōpū; ʻO Tubig ligation - hāpai hānau ectopic

• Pelvic laparoscopy
• Ultrasound i hāpai keiki
• Anatomia hānau wahine
• Uterus
• Ultrasound, pēpē maʻamau - ka wāwae
• Hāpai keiki Ectopic

Alur-Gupta S, Cooney LG, Senapati S, Sammel MD3, Barnhart KT. ʻElua hopena ma mua o hoʻokahi-dose methotrexate no ka mālama ʻana i ka hāpai ʻana ectopic: kahi meta-analysis. ʻO Am J Obstet Gynecol. 2019; 221 (2): 95-108.e2. PMID: 30629908 pubmed.ncbi.nlm.nih.gov/30629908/.

Kho RM, Lobo RA. ʻO ka hāpai Ectopic: etiology, pathology, diagnose, hoʻokele, prognosis momona. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 17.

ʻO Nelson AL, ʻo Gambone JC. Hāpai keiki Ectopic. I: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2016: chap 24.

Salhi BA, Nagrani S. Kūpilikiʻi koʻikoʻi o ka hāpai ʻana. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 178.