ʻO nā ʻanuʻu aʻe ma hope o ke kuhi ʻike kaulua ʻelua moku

Anter

• He aha ke kaula moku ʻelua?
• He aha ke kumu o kahi kaula ʻelua-moku?
• Pehea e kuhikuhi ʻia ai kahi kaula ʻelua-moku?
• Pono ʻoe e hopohopo e pili ana i kahi diagnostic Two-Vessel Diagnosis?
• Pehea ʻoe e nānā ʻokoʻa ai inā loaʻa iā ʻoe kahi hōʻike kaula kaula ʻelua-moku?
• Lawe ʻia

ʻO ka maʻamau, ʻelua aʻa a me hoʻokahi aʻa o ka umbilical cord. Eia nō naʻe, loaʻa i kekahi mau pēpē hoʻokahi aʻa a me nā aa koko. ʻIke ʻia kēia ʻano ma ke ʻano he kuhi kaula ʻelua moku.

Kapa aku nā kauka i kēia he umbilical artery (SUA) hoʻokahi. Wahi a Kaiser Permanente, ma kahi o 1 pākēneka o nā hāpai keiki i loaʻa i ke kaula moku ʻelua.

He aha ke kaula moku ʻelua?

He kuleana ke kaula umbilical no ka lawe ʻana i ke koko waiwai i oxygen i kahi pēpē a lawe aku i ke koko maikaʻi ʻole o ka oxygen a me nā huahana neoneo mai kahi pēpē.

Hāpai ka ʻōpū umbilical i ke koko momona i ka pēpē. Hāpai nā aʻa umbilical i ke koko ʻilihune o ke oxygen mai ka ʻōpū a i ka placenta. A laila hoʻihoʻi ka placenta i nā ʻōpala i ke koko o ka makuahine, a hoʻopau nā puʻupaʻa iā lākou.

Aia kekahi mau ʻano ʻie umbilical cord, me kahi kaula umbilical ʻoi aku ka pōkole a lōʻihi paha. ʻO kekahi he kaula moku ʻelua a SUA paha. He hoʻokahi aʻa a me ke aa ko kēia ʻano kaula ma kahi o ʻelua aʻa a me kahi aa.

He aha ke kumu o kahi kaula ʻelua-moku?

ʻAʻole maopopo maopopo i nā kauka ke kumu e ulu ai ke kaula moku ʻelua. ʻO kekahi kumumanaʻo ʻaʻole ulu pono ke aʻa i loko o ka ʻōpū. ʻO kekahi ka mahele ʻole o ke aʻa i ʻelua e like me ka maʻamau.

Loaʻa paha i kekahi mau wahine i ke kaula moku ʻelua ma mua o nā mea ʻē aʻe. ʻO nā kumu pilikia no ke kaula moku ʻelua:

• he kanaka keʻokeʻo
• ʻoi aku ma mua o 40 mau makahiki
• hāpai keiki ʻana i ke kaikamahine
• ke loaʻa nei kahi moʻaukala o ka maʻi kō a i ʻole nā ​​kō nui o ke kō i ka wā hāpai
• hāpai me nā pēpē he nui, e like me nā māhoe a i ʻole nā ​​kolikolu
• lawe i nā lāʻau i ʻike ʻia e pili i ka ulu ʻana o ka fetal, e like me ka phenytoin

Eia nō naʻe, ʻaʻole e hōʻoia kēia mau mea pilikia i ka loaʻa ʻana o kahi pēpē i ka makuahine i loaʻa ke kaula o nā moku ʻelua.

Pehea e kuhikuhi ʻia ai kahi kaula ʻelua-moku?

Hoʻomaopopo pinepine nā kauka i kahi kaula moku ʻelua ma ka ultrasound prenatal. ʻO kēia kahi aʻo kiʻi ʻana o ka pēpē.

Nānā pinepine nā kauka no nā aʻa umbilical i ka lua o ka hōʻike trimester ma kahi o 18 mau pule. Eia nō naʻe, i kekahi manawa paʻakikī ke kūlana o kahi pēpē i kāu kauka e nānā piha i ke kaula.

ʻO kahi koho ʻē aʻe kahi mīkini ultrasound Doppler kahe-kala, hiki ke kōkua i ke kauka e ʻike i kahi kaula moku ʻelua ma mua. ʻO ka maʻamau kēia ma kahi o 14 mau pule. Inā hopohopo ʻoe i ka pilikia o kāu pēpē no kahi kaula ʻelua moku, e kamaʻilio me kāu kauka.

Pono ʻoe e hopohopo e pili ana i kahi diagnostic Two-Vessel Diagnosis?

No kekahi mau wahine, ʻaʻole kuhi ʻia kahi maʻi kaula moku ʻelua i kekahi mau ʻano ʻokoʻa i ko lākou hāpai ʻana. Nui nā pēpē i loaʻa i hoʻokahi aʻa umbilical i loaʻa i nā hāpai hāpai olakino a me nā hānau.

Eia nō naʻe, piʻi nui ka hopohopo o kekahi mau pēpē me ke aʻa hoʻokahi no nā hānau hānau. ʻO nā laʻana o nā kīnā hānau i loaʻa i nā pēpē me kahi hōʻailona ʻelua moku:

• pilikia puʻuwai
• nā pilikia ʻōpū
• kīnā kīwī

Pili pū ʻia ke kaula moku ʻelua me ka nui o ka makaʻu no ka genetic abnormality i ʻike ʻia ʻo VATER. Kū kēia i nā hemahema vertebral, anal atresia, transesophageal fistula me ka atresia esophageal, a me ka dysplasia radial.

ʻO nā pēpē me ke kaula moku ʻelua paha ka nui o ka makaʻu no ka ulu pono ʻole ʻana. Hiki i kēia ke hoʻokomo i ka hāpai preterm, ka lohi o ka ulu ʻana o ka fetal, a i ʻole ka hānau hānau ʻana. Hiki i kāu kauka ke kūkākūkā me kēia mau pilikia pilikino me ʻoe.

Pehea ʻoe e nānā ʻokoʻa ai inā loaʻa iā ʻoe kahi hōʻike kaula kaula ʻelua-moku?

ʻIke pinepine nā kauka i nā pilikia he nui i hiki i ka pēpē ke ʻike ma muli o ke kaula moku ʻelua ma kahi ultrasound kiʻekiʻe.

Inā ʻike kāu kauka a mea loea ultrasound paha i kahi kaula o ka moku ʻelua e ka ultrasound wehewehe haʻahaʻa, e ʻōlelo paha lākou i kahi scan hoʻonā kiʻekiʻe e nānā pono ai i ka anatomy o kāu pēpē. I kekahi manawa hiki i kāu kauka ke ʻōlelo aku i ka amniocentesis. Hiki i kēia hoʻāʻo ke kōkua i ka hoʻoholo ʻana i ke oʻo ʻana o nā māmā a me nā ʻano pili e pili ana i ka hoʻomohala.

Nā hoʻokolohua ʻē aʻe a i ʻole nā ​​loiloi e koi ai ke kauka e:

• mōʻaukala pilikino pilikino
• moʻolelo mōʻaukala ʻohana
• fetch echocardiogram (ke nānā nei i nā keʻena a me nā hana o ka puʻuwai fetal)
• ke kānana ʻana no nā pono kīnā ʻole i ka hāpai keiki, e like me ka kānana aneuploidy

Inā ʻaʻohe hopena maikaʻi o kāu pēpē mai ke kaula moku ʻelua, ʻike ʻia kēia ma ke ʻano he umbilical artery (SUA) i hoʻokaʻawale ʻia.

Inā kānalua ʻole kāu kauka ke ʻike nei kāu pēpē i nā hopena maikaʻi ʻole mai kahi maʻi kaula moku ʻelua, hiki iā lākou ke ʻōlelo i kahi ultrasound i ka wā e hiki mai ana. Hiki ke hoʻopili i kēia i kēlā me kēia mahina a i ʻole i kāu trimester ʻekolu, e hōʻoia i ka ulu ulu ʻana o kāu pēpē no kā lākou mau makahiki. ʻOiai inā ua kāhea ke kauka i kāu kaula moku ʻelua he SUA kaʻawale, aia nō kahi makaʻu no ka lohi ma mua o ka ulu fetal maʻamau. ʻIke ʻia kēia ʻo ka palena ulu ulu intrauterine (IUGR).

ʻAʻole pili ka loaʻa ʻana o ke kaula moku ʻelua me ka nui o ka makaʻu no ka ʻāpana C me ka lawe ʻana i ka ʻōpū. Eia nō naʻe, inā loaʻa i kāu pēpē kekahi maʻi ʻōpala, pono paha lākou e mālama i ka mālama mālama nui neonatal (NICU) ma hope o ka hānau ʻana.

Lawe ʻia

Inā ua kuhi kāu kauka i kāu pēpē me ka loaʻa ʻana o ke kaula ʻelua moku, pono e hoʻokolokolo hou ʻia.

ʻOiai ʻaʻohe pilikia o kekahi pēpē e like me ka hopena o ke kaula ʻelua moku, hiki i kekahi. Hiki i ke kauka a me ka loea paha ke kōkua i ka hoʻoholo ʻana i nā kaʻina hana hou a me kāu ʻike me ʻoe a me kāu hoa.