ʻĀpana C

ʻO kahi C-ʻāpana ka hāʻawi ʻana i kahi pēpē e ka hana ʻana i kahi hāmama ma ka ʻōpū o ka ʻōpū o ka makuahine. Kapa ʻia ia he hoʻouna cesarean.

Lawe ʻia kahi hānau ʻāpana C inā ʻaʻole hiki a palekana paha i ka makuahine e hānau i ka pēpē ma o ka ʻōpū.

Hana pinepine ʻia nā kaʻina hana i ka wā e ala ana ka wahine. Hoʻomoʻa ʻia ke kino mai ka umauma a hiki i nā wāwae e hoʻohana ana i ka anesthesia epidural a i ʻole ka spinal.

1. ʻOki ka ʻokiʻoki i ka ʻōpū ma luna o ka ʻōpū ma luna pono o ka wahi pubic.

2. Wehe ʻia ka ʻōpū (uterus) a me ka ʻeke amniotic.

3. Hānau ʻia ka pēpē ma o kēia wehe.

Hoʻomaʻemaʻe ka hui olakino i nā wai mai ka waha a me ka ihu o ka pēpē. ʻOkiʻoki ʻia ka umbilical cord. E hōʻoia ka mea mālama ola i ka hanu ʻana o ka pēpē he maʻamau a paʻa paʻa nā hōʻailona koʻikoʻi ʻē aʻe.

E ala ana ka makuahine i ka wā o ke kaʻina hana i hiki iā ia ke lohe a ʻike i kāna pēpē. I nā manawa he nui, hiki i ka wahine ke loaʻa i kahi mea kākoʻo me ia i ka wā o ka hānau ʻana.

ʻO ke kahakaha ma kahi o 1 hola.

Nui nā kumu e pono ai i ka wahine e loaʻa kahi ʻāpana C ma kahi o ka lawe ʻana i ka ʻōpū.E hoʻoholo ka hoʻoholo i kāu kauka, kahi e loaʻa ai iā ʻoe ka pēpē, kāu hānau mua ʻana, a me kāu mōʻaukala olakino.

Pili pū paha nā pilikia me ka pēpē:

• Kuhi naʻau maʻamau
• ʻO ke kūlana maʻamau i loko o ka ʻōpū, e like me ke keʻa (transverse) a i ʻole ka wāwae-mua (breech)
• Nā pilikia e ulu ana, e like me hydrocephalus a i ʻole spina bifida
• Multiple hāpai keiki (triplets a māhoe paha)

Hiki paha i nā pilikia olakino i ka makuahine ke komo pū me:

• ʻO ka maʻi herpes genital ikaika
• Nā fibroids uterine nui kokoke i ka cervix
• Maʻi HIV i ka makuahine
• Paukū C i hala
• ʻO ke kahakaha i hala ma ka kōpū
• ʻO nā maʻi nui, e like me ka maʻi puʻuwai, preeclampsia a i ʻole eclampsia

ʻO nā pilikia i ka manawa hana a hāʻawi paha e komo pū:

• Nui loa ke poʻo o pēpē e hele i loko o ke kahawai hānau
• Hana lōʻihi a kū paha
• Bebe nui loa
• ʻO ka maʻi a me ke kuni paha i ka wā hana

Nā pilikia me ka placenta a i ʻole umbilical cord e hoʻopili pū paha:

• Uhi ka Placenta i nā ʻāpana āpau a i ʻole ʻāpana o ka wehe ʻana i ke kahawai hānau (placenta previa)
• Hoʻokaʻawale ʻo Placenta mai ka paia uterine (placenta abruptio)
• Hiki mai ke kaula uila ma o ka wehe ʻana o ke kahawai hānau ma mua o ka pēpē (ka pīpī umbilical cord)

ʻO kahi ʻāpana C kahi hana palekana. He haʻahaʻa loa ka helu o nā pilikia koʻikoʻi. Eia naʻe, ʻoi aku ka nui o kekahi mau pilikia ma hope o ka paukū C ma mua o ka lawe ʻana o ka ʻōpū. Pākuʻi ʻia kēia mau mea:

• ʻO ka maʻi o ka bladder a i ʻole ka uterus
• Hoʻopilikia i ka maʻi urinary
• ʻO ke kiʻekiʻe o ke kahe o ke koko

ʻO ka hapa nui o ka manawa, ʻaʻole pono kahi transfusion, akā ʻoi aku ka kiʻekiʻe o ka makaʻu.

Hiki i kekahi ʻāpana C ke hoʻopilikia i nā hāpai i ka wā e hiki mai ana. Pākuʻi ʻia kēia i kahi kiʻekiʻe kiʻekiʻe no:

• ʻO Placenta previa
• Ke ulu nei ka Placenta i loko o ka mākala o ka kōpū a loaʻa ka pilikia i ka hoʻokaʻawale ʻana ma hope o ka hānau ʻana o ka pēpē (placenta accreta)
• Haki ka Uterine

Hiki i kēia mau kūlana ke alakaʻi i ke kahe nui (hemorrhage), kahi e koi ai i ke koko a lawe ʻia paha o ka uterus (hysterectomy)

ʻO ka hapa nui o nā wahine e noho i ka haukapila no 2 a 3 mau lā ma hope o kahi ʻāpana C. E hoʻohana i ka manawa e hoʻopaʻa ai me kāu pēpē, e hoʻomaha iki, a loaʻa i kahi kōkua me ka hānai ʻana a me ka mālama ʻana i kāu pēpē.

ʻOi aku ka lōʻihi o ka hoʻōla ma mua o ka wā hānau mai kahi hānau wahine. E hele wāwae ʻoe ma hope o ka ʻāpana C e wikiwiki ai i ka hoʻōla. Hiki i nā lāʻau ʻeha ke lawe ʻia e ka waha ke kōkua i ka hōʻoluʻolu ʻole.

ʻOi aku ka hoʻōla ma hope o kahi ʻāpana C ma ka home ma mua o ka hopena o ka lawe ʻana. Loaʻa paha iā ʻoe ke kahe o kou lua a hiki i 6 mau pule. Pono ʻoe e aʻo e mālama i kou ʻeha.

Hana maikaʻi ka hapa nui o nā makuahine a me nā pēpē ma hope o kahi ʻāpana C.

Hiki i nā wahine i loaʻa kahi ʻāpana C ke hānau wahine inā loaʻa kekahi hāpai hou, e like me:

• ʻO ke ʻano o ka ʻāpana C i hana ʻia
• No ke aha i hana ai ka ʻāpana C

ʻO ka hānau hānau ʻana ma hope o ka hānau ʻana o cesarean (VBAC) kūleʻa pinepine. ʻAʻole hāʻawi nā haukapila āpau i nā koho o VBAC. Aia kahi liʻiliʻi liʻiliʻi o ka haki o ka uterine, kahi e hōʻeha ai i ka makuahine a me ka pēpē. Kūkākūkā i nā pono a me nā pilikia o VBAC me kāu mea hāʻawi.

Lawe i ka ʻōpū; Hānau ʻōpū; Hānau Cesarean; Hāpai keiki - cesarean

• ʻĀpana Cesarean
• ʻĀpana C - moʻo
• ʻĀpana Cesarean

Berghella V, Mackeen AD, Jauniaux ERM. Hāʻawi Cesarean. I: 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 19.

Hull AD, Resnik R, kālā RM. ʻO Placenta previa a me accreta, vasa previa, subchorionic hemorrhage, a me abruptio placentae. 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 46.