Maʻi maʻi ʻōpū

ʻO ka maʻi puʻuwai Congenital (CHD) kahi pilikia me ka hanana o ka puʻuwai a me ka hana e kū nei i ka wā hānau.

Hiki iā CHD ke wehewehe i nā pilikia like ʻole e pili ana i ka puʻuwai. ʻO ia ka ʻano maʻamau o ka hānau hānau kīnā. Hoʻokumu ʻo CHD i nā make he nui i ka makahiki mua o ke ola ma mua o nā kīnā hānau ʻē aʻe.

Hoʻokaʻawale pinepine ʻia ʻo CHD i ʻelua mau ʻano: cyanotic (kala ʻili polū i hoʻokumu ʻia e ka nele o ka oxygen) a me ka non-cyanotic. Mālama nā papa inoa aʻe i nā CHD maʻamau:

ʻO Cyanotic:

• ʻO Ebstein anomaly
• Puʻuwai hema Hypoplastic
• Pulseary atresia
• ʻO Tetralogy o Fallot
• Hoʻi ka huakaʻi anomaly pulmonary venous
• ʻO ka Transposition o nā moku nui
• Tricuspid atresia
• Truncus arteriosus

Ole cyanotic:

• Stenosis ʻaʻano
• ʻO ke kiwikā ākea Bicuspid
• Hewa septal Atrial (ASD)
• Kanal Atrioventricular (kīnā ʻole cushion endocardial)
• Coarctation o ka aorta
• Patent ductus arteriosus (PDA)
• Pulmonic stenosis
• Hewa septal Ventricular (VSD)

Hiki paha i kēia mau pilikia ke hele hoʻokahi a hui pū paha. ʻO ka hapa nui o nā keiki me CHD ʻaʻohe ʻano ʻē aʻe o nā hānau kīnā. Eia nō naʻe, hewa paha nā kīnā o ka puʻuwai a me nā syndrome a me nā chromosomal. Hoʻohui ʻia kekahi o kēia mau syndrome e nā ʻohana.

ʻO nā laʻana me:

• ʻO DiGeorge Syndrome
• Down syndrome
• Maʻi ʻo Marfan
• Noonan syndrome
• Edwards maʻi maʻi
• Trisomy 13
• Turner maʻi maʻi

Pinepine, ʻaʻohe kumu o ka maʻi puʻuwai e hiki ke loaʻa. Ke hoʻomau nei ka noiʻi ʻana a me ka noiʻi ʻana o CHDs. ʻO nā lāʻau e like me retinoic acid no ka huehue, nā kemikala, ka waiʻona, a me nā maʻi (e like me rubella) i ka wā hāpai hiki ke kōkua i kekahi mau pilikia puʻuwai congenital.

ʻO ke kō kō kōpaʻa maikaʻi ʻole ʻia i nā wahine i loaʻa i ka maʻi kō i ka wā o ka hāpai ʻana ua pili pū ʻia i kahi kiʻekiʻe o nā maʻi puʻuwai congenital.

Pili nā ʻōuli i ke kūlana. ʻOiai ʻo CHD ma kahi hānau, ʻaʻole paha ʻike koke ʻia nā ʻōuli.

ʻAʻole hiki i nā kīnā e like me ka coarctation o ka aorta ke kumu o nā pilikia no nā makahiki. ʻO nā pilikia ʻē aʻe, e like me VSD liʻiliʻi, ASD, a i ʻole PDA ʻaʻole paha e hoʻokumu i nā pilikia.

Loaʻa ka hapa nui o nā puʻuwai congenital i ka wā o ka ultrasound hāpai keiki. Ke loaʻa kahi kīnā, hiki i kahi kauka puʻuwai pediatric, ke kauka, a me nā loea ʻē aʻe ke loaʻa i laila ke hānau ka pēpē. ʻO ka mākaukau o ka mālama olakino ma ka hānau ʻana hiki ke manaʻo i ka ʻokoʻa ma waena o ke ola a me ka make no kekahi mau pēpē.

Hana ʻia nā hoʻokolohua ma ka pēpē i ka hemahema a me nā ʻōuli.

Hoʻohana ʻia ka lāʻau hea, a me ke ʻano o ka pane ʻana a ka pēpē iā ia, kaukaʻi ʻia i ke ʻano. Nui nā hemahema e ukali pono ʻia. E hoola kekahi i ka hala ʻana o ka manawa, a ʻo kekahi e mālama ʻia.

Hiki ke mālama ʻia kekahi mau CHD me ka lāʻau lapaʻau wale nō. Pono e mālama ʻia nā poʻe ʻē aʻe me hoʻokahi a ʻoi paha o nā kaʻina hana puʻuwai a i ʻole nā ​​ʻoki ʻana.

Pono nā wahine hāpai i ka mālama prenatal maikaʻi:

• Hōʻalo i ka wai ʻona a me nā lāʻau kū ʻole i ka wā hāpai.
• E haʻi i kāu mea mālama ola ua hāpai ʻoe ma mua o ka lawe ʻana i nā lāʻau hou.
• E ho'āʻo i ke koko i ka wanaʻao o kou hāpai ʻana e ʻike inā pale ʻia ʻoe i ka rubella. Inā ʻaʻole ʻoe e pale aku, pale i ka hiki ke loaʻa i ka rubella a loaʻa nā lāʻau āpau ma hope pono o ka hānau ʻana.
• Pono nā wahine hāpai i loaʻa i ka maʻi diabetes e hoʻāʻo e kāohi maikaʻi ma luna o kā lākou pae kō kō.

Hiki i kekahi mau genes ke pāʻani i ka CHD. Pilikia paha nā lālā ʻohana he nui. E kamaʻilio me kāu mea hāʻawi e pili ana i ka ʻōlelo aʻoaʻo a me ka loiloi inā loaʻa iā ʻoe kahi moʻolelo ʻohana o CHD.

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• Ultrasound, pēpē maʻamau - kuʻi puʻuwai
• Ultrasound, kīnā septal ventricular - kīʻaha puʻuwai
• Patent ductus arteriosis (PDA) - ke kaʻina

Fraser CD, Kane LC. Maʻi maʻi ʻōpū. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery: Ke kumu kumu olaola o ka hana ʻoki ʻana o kēia ao. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 58.

Webb GD, Smallhorn JF, Therrien J, Redington AN. ʻO ka maʻi puʻuwai Congenital i ke kanaka makua a me ka mea maʻi pediatric. 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 75.