Preeclampsia

ʻO Preeclampsia ke kiʻekiʻe o ke koko a me nā hōʻailona o ke ake a me nā ʻino puʻuwai i kū i nā wahine ma hope o ka hebedoma 20 o ka hāpai ʻana. ʻOiai he kakaikahi, hiki i ka preeclampsia ke kū i kahi wahine ma hope o ka hānau ʻana i kāna pēpē, pinepine i loko o 48 mau hola. Kāhea ʻia kēia ʻo preeclampsia postpartum.

ʻAʻole maopopo ke kumu kūpono o preeclampsia. Hana ʻia ma kahi o 3% a 7% o nā hāpai āpau. Manaʻo ʻia ke ʻano e hoʻomaka i ka placenta. Nā kumu i alakaʻi i ka preeclampsia e ulu ana:

• Nā maʻi Autoimmune
• Nā pilikia o ke kīʻaha koko
• ʻO kāu papaʻai
• Kou genes

ʻO nā kumu pilikia no ke ʻano me:

• Hapai mua
• Ka mōʻaukala i hala o preeclampsia
• Hapai hāpai keiki (māhoe a ʻoi aku)
• ʻO ka mōʻaukala ʻohana o preeclampsia
• Ka momona
• Ma mua o 35 mau makahiki
• ʻO ʻAmelika ʻAmelika
  
• ʻO ka mōʻaukala o ka maʻi diabetes, ke koko kiʻekiʻe, a i ʻole nā ​​maʻi puʻupaʻa
• Mōʻaukala o ka maʻi thyroid

ʻO ka manawa pinepine, ʻaʻole maʻi nā wahine i loaʻa i ka preeclampsia.

Hiki i nā ʻōuli o preeclampsia ke hoʻopili pū me:

• ʻO ka pehu ʻana o nā lima a me ka maka a i ʻole nā ​​maka (edema)
• Loaʻa ka waiwai kaumaha ma mua o 1 a 2 mau lā a ʻoi aku paha ma mua o 2 paona (0.9 kg) i ka pule

Nānā: ʻO kekahi ʻōhū o nā wāwae a me nā kuʻekuʻe wāwae e manaʻo ʻia he maʻamau i ka wā hāpai.

ʻO nā ʻōuli o ka preeclampsia koʻikoʻi e komo pū me:

• Headache ʻaʻole e hele a hele a ʻoi aku ka ʻino.
• Hī pilikia.
• ʻEha ʻōpū ma ka ʻaoʻao ʻākau, ma lalo o nā iwi ʻaoʻao. ʻIke ʻia paha ka ʻeha ma ka poʻohiwi ʻākau, a hiki ke huikau ʻia me ka puʻuwai puʻuwai, ʻehaʻeha, ʻeha o ka ʻōpū, a kīkiʻi paha e ka pēpē.
• ʻAʻole pinepine i ka mimiki.
• ʻO Nusea a me ka luaʻi (kahi hōʻailona worrisome).
• Hoʻololi ka hihiʻo, e like me ka makapō pōkole, ke ʻike ʻana i nā kukui uila a i ʻole nā ​​kiko, ʻike i ka mālamalama, a me ka hihi pohihihi.
• Mālamalama a maule paha.

E hana ka mea mālama ola i kahi hoʻokolohua kino. Hōʻike paha kēia:

• ʻO ke koko kiʻekiʻe, ʻoi aku ka kiʻekiʻe ma mua o 140/90 mm Hg
• ʻO ka pehu i nā lima a me ka maka
• Kaumaha hoʻonui

E hana ʻia nā hoʻokolohua koko a me ka mimi. Hōʻike paha kēia:

• Protein i ka mimi (proteinuria)
• ʻO nā ʻenekia ate ʻoi aku ka kiʻekiʻe ma mua o ka maʻamau
• ʻO ka helu platelet ka mea haʻahaʻa
• Nā pae hana kine kiʻekiʻe ma mua o ka maʻamau i kou koko
• Nā pae acid uric kiʻekiʻe

E hana ʻia nā hoʻokolohua iā:

• E ʻike i ka maikaʻi o ke kahe o kou koko
• Nānā i ke olakino o ka pēpē

ʻO nā hopena o ka ultrasound hāpai keiki, ka hōʻike non-stress, a me nā hoʻokolohua ʻē aʻe e kōkua i kāu mea nāna e hoʻoholo inā pono e hānau koke kāu pēpē.

ʻO nā wahine i loaʻa ke koko haʻahaʻa i ka hoʻomaka o ko lākou hāpai ʻana, a ukali ʻia e ka piʻi nui ʻana o ke kahe o ke koko e pono e nānā pono ʻia no nā hōʻailona ʻē aʻe o ka preeclampsia.

Hoʻoholo pinepine ʻo Preeclampsia ma hope o ka hānau ʻana o ka pēpē a hānau ʻia ka placenta. Eia naʻe, hoʻomau a hoʻomau paha ia ma hope o ka lawe ʻana.

ʻO ka pinepine, ma 37 mau pule, hoʻomohala ʻia kāu pēpē e lilo i olakino ma waho o ka ʻōpū.

A ʻo kahi hopena, makemake paha kāu mea hāʻawi i kāu pēpē i hānau ai no laila ʻaʻole e ʻoi aku ka maikaʻi o ka preeclampsia. Loaʻa paha iā ʻoe nā lāʻau e kōkua i ka hoʻoulu ʻana i ka hana, a i ʻole he pono iā ʻoe i kahi ʻāpana C.

Inā ʻaʻole hoʻomohala piha ʻia kāu pēpē a loaʻa iā ʻoe kahi preeclampsia akahai, hiki ke mālama pinepine ʻia ka maʻi ma ka home a oʻo i ke oʻo ʻana o kāu pēpē. E paipai ka mea hāʻawi:

• Kipa pinepine ke kauka e hōʻoia inā maikaʻi ʻoe a me kāu pēpē.
• ʻO nā lāʻau e hoʻohaʻahaʻa i kou kahe koko (i kekahi manawa).
• Hiki ke loli ke koʻikoʻi o ka preeclampsia, no laila pono ʻoe i ka ukali pono loa.

ʻAʻole i paipai hou ʻia ka hoʻomaha moe.

I kekahi manawa, ʻae ʻia kahi wahine hāpai me preeclampsia i ka haukapila. ʻAe kēia i ke kime mālama ola e nānā pono i ka pēpē a me ka makuahine.

Hiki ke hoʻopili ʻia i ka haukapila:

• Nānā kokoke i ka makuahine a me ka pēpē
• Nā lāʻau i kaohi i ke kahe o ke koko a pale i ka hopu ʻana a me nā pilikia ʻē aʻe
• ʻO nā kuʻi steroid no ka hāpai keiki ma lalo o 34 mau pule ma mua e kōkua i ka wikiwiki i ka ulu ʻana o nā māmā o ka pēpē

E hoʻomau ʻoe a me kāu mea lawelawe i ke kūkākūkā ʻana no ka manawa ʻoi aku ka palekana no ka hānau ʻana i kāu pēpē, e noʻonoʻo ana:

• Pehea kou kokoke loa i kāu lā palena pau.
• ʻO ke koʻikoʻi o ka preeclampsia. He nui nā kūpilikiʻi koʻikoʻi ʻo Preeclampsia i hiki ke hōʻeha i ka makuahine.
• Pehea ka maikaʻi o ka hana a ka pēpē i loko o ka ʻōpū.

Pono e hānau ka pēpē inā loaʻa nā hōʻailona o ka preeclampsia koʻikoʻi. Pākuʻi ʻia kēia mau mea:

• ʻO nā hoʻāʻo e hōʻike ana i kāu pēpē ʻaʻole e ulu maikaʻi a ʻaʻole lawa paha ke koko a me ka oxygen.
• ʻO ka helu lalo o kou kaomi koko ma luna o 110 mm Hg a ʻoi aku paha ma mua o 100 mm Hg mau ma kahi o 24 mau hola.
• Nā hopena hoʻokolohua hana ate maʻamau.
• ʻEha poʻo poʻo.
• ʻEha ma ka ʻōpū (ʻōpū).
• ʻO ka hopu ʻana a i ʻole nā ​​hoʻololi ʻana i ka hana noʻonoʻo (eclampsia).
• Kūkulu ka wai i nā ake māmā o ka makuahine.
• Maʻi HELLP (laha ʻole).
• Helu pā liʻiliʻi a hoʻokahe paha.
• Ka puka mimi haʻahaʻa, nui nā protein i ka mimi, a me nā hōʻailona ʻē aʻe e holo pono ʻole nā ​​puʻupaʻa.

E hele pinepine ka hōʻailona a me nā ʻōuli o ka preeclampsia i loko o 6 mau pule ma hope o ka lawe ʻana. Eia naʻe, ʻoi aku kaʻino o ke koko kiʻekiʻe i kekahi manawa i nā lā mua ma hope o ka hānau ʻana. Aia ʻoe i ka makaʻu no ka preeclampsia a hiki i 6 mau pule ma hope o ka lawe ʻana. Hāpai kēia preeclampsia postpartum i kahi kiʻekiʻe o ka make. Inā ʻike ʻoe i kekahi ʻōuli o preeclampsia, e hoʻokaʻaʻike koke aku i kāu kauka.

Inā ua loaʻa iā ʻoe ka preeclampsia, e hoʻomohala hou iā ia i ka wā o ka hāpai ʻana. I ka hapanui o nā hihia, ʻaʻole kaumaha ia e like me ka manawa mua.

Inā loaʻa ʻoe i ke koko kiʻekiʻe ma ka ʻoi aku o hoʻokahi hāpai ʻana, ʻoi aku ka nui o ke kahe o ke koko ke ʻelemakule ʻoe.

Hiki i nā pilikia ulia pōpilikia loa no ka makuahine ke hoʻopili pū:

• Nā pilikia koko
• Ka hopu ʻana (eclampsia)
• Hoʻopiʻi ulu Fetal
• Hoʻokaʻawale premature o ka placenta mai ka kōpū ma mua o ka hānau ʻana o ka pēpē
• Nahu o ke ake
• Hahau
• Make (kākaʻikahi)

Loaʻa i ka moʻaukala o preeclampsia e hoʻonui i ka wahine i nā pilikia e hiki mai ana e like me:

• Maʻi maʻi puʻuwai
• Diabetes
• ʻO ka maʻi kīwī
• Kikokiko kiʻekiʻe

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o preeclampsia i kou wā hāpai a ma hope paha o ka hānau ʻana.

ʻAʻohe ala kūpono e pale ai i ka preeclampsia.

• Inā manaʻo kāu kauka aia ʻoe i ka makaʻu nui i ka hoʻomohala ʻana i ka preeclampsia, manaʻo paha lākou e hoʻomaka ʻoe i ka aspirin pēpē (81 mg) i kēlā me kēia lā i ka hopena o ka trimester mua a i ʻole i ka mua o ka lua o ka trimester o kou hāpai ʻana. Eia naʻe, Mai hoʻomaka i ka aspirin pēpē ke ʻole ʻoe i nīnau mua me kāu kauka.
• Inā manaʻo kāu kauka he haʻahaʻa kou lawe ʻana i ka calcium, ʻōlelo paha lākou iā ʻoe e lawe i kahi kōpona i kēlā me kēia lā.
• ʻAʻohe mea ʻē aʻe e pale ai i ka preeclampsia.

He mea nui i nā wahine hāpai āpau e hoʻomaka i ka mālama prenatal a hoʻomau iā ia ma o ka hāpai ʻana a ma hope o ka hānau ʻana.

Toxemia; Hypertension i hāpai ʻia i ka hāpai ʻana (PIH); Piʻi kiʻekiʻe Gestational; ʻO ke koko kiʻekiʻe - preeclampsia

• Preeclampsia

Ke KulanuiʻAmelika o nā Obstetricians a me nā Gynecologists; Hana Hana ma ka hanu kiʻekiʻe i ka hāpai ʻana. Hypertension i hāpai keiki. Hōʻike o ka American College of Obstetricians and Gynecologists ’Task Force on Hypertension in Pregnancy. ʻO Obstet Gynecol. 2013; 122 (5): 1122-1131. PMID: 24150027 pubmed.ncbi.nlm.nih.gov/24150027/.

Harper LM, Tita A, Karumanchi SA. Hypertension pili i ka hāpai ʻana. 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 48.

Sibai BM. Preeclampsia a me nā maʻi hypertensive. Landon MB, Galan HL, Jauniaux ERM, et al, eds. Nā Kāpena Gabbe: Nā Pregnancies Maʻamau a me nā Pilikia. ʻEpekema 7 Piladelapia, PA: Elsevier; 2021: chap 38.