Nā hōʻailona o ka hānau mua ʻana, nā kumu a me nā pilikia kūpono

Anter

• Nā kumu nui
• Nā hōʻailona a me nā ʻōuli o ka hānau mua
• Nā pilikia i hiki
• Pehea e pale ai i ka hānau mua ʻana

Kūlike ka hānau mua ʻole i ka hānau ʻana o ka pēpē ma mua o 37 mau pule o ka hāpai ʻana, hiki ke hana ma muli o ka maʻi uterine, ka haki mua ʻana o ka ʻeke amniotic, ka wehe ʻana o ka placenta a i ʻole nā ​​maʻi e pili ana i ka wahine, e like me anemia a pre-eclampsia, no ka mea laʻana.

Hiki ke ʻike ʻia kēia kūlana ma o kekahi mau ʻōuli e like me ka pinepine a me ka maʻamau o nā uterine contractions, ka hoʻonui ʻana i ka hoʻokuʻu a me ke kaomi a i ʻole ka ʻeha ma ka wahi pelvic, no ka laʻana. He mea nui ka hele ʻana o ka wahine i ka haukapila ke ʻike ʻo ia i kēia mau hōʻailona a me nā ʻōuli, ʻoiai hiki i ka hana maʻa mau ke waiho i nā makaʻu i ka pēpē, ʻoiai ka hilinaʻi ʻana i ka wā hānau hiki ʻole i nā ʻōpū ke kino ʻole, a aia paha he mau pilikia i ka puʻuwai a paʻakikī e hanu, no ka laʻana.

No laila, i ka manawa o ka hana maʻa mau, hiki i ke kauka ke hoʻāʻo e hoʻopanee i ka hānau ʻana me ka hoʻohana ʻana i nā lāʻau a me nā ʻenehana e pale ai i ka hoʻohaʻahaʻa uterine a me ka dilation, akā, paʻakikī e hiki ke hoʻopaneʻe i ka lawe ʻana ma mua o 48 a 72 mau hola. I ke kumu o ka hānau hānau ʻana o kahi pēpē premature, he mea maʻamau ka noho ʻana i ka ICU neonatal i mea e nānā ʻia ai kona ulu a pale ʻia nā pilikia.

Nā kumu nui

Hiki ke hānau ʻia i ka wā ma mua i nā wahine ma mua o 35 a i ʻole ma lalo o 16, hāpai i nā māhoe, ua hānau ʻē aʻe a i ʻole ke nalowale ke koko ma o ka ʻōpū i ke kolu o ka trimester o ka hāpai ʻana. Hoʻohui ʻia, nā hanana ʻē aʻe i hiki ke kumu i ka hana maʻa mau:

• ʻO ka haki mua o ka ʻeke amniotic;
• Hoʻonāwaliwali o ka cervix;
• Maʻi maʻi koʻohune Streptococcus agalactiae (hui B streptococcus);
• Hoʻokaʻaʻike Placental;
• Pre eclampsia;
• Anemia;
• Nā maʻi e like me tuberculosis, syphilis, kidney kidney;
• Hapai māhoe;
• I ka hoʻouluulu vitro;
• Malformation Fetal;
• Ikaika hoʻoikaika kino;
• Hoʻohana i nā lāʻau lapaʻau kūpono ʻole a me nā mea inu ʻona;
• Ke kūʻana o nā fibroid i ka kōpū.

Eia hou, ʻo nā wahine me ka mōʻaukala o ka vaginosis hiki ke hoʻonui i ka makaʻu o ka hānau mua, no ka mea hiki i kekahi mau bacteria ke hoʻokuʻu i nā toxins a paipai i ka hoʻokuʻu ʻia o nā cytokine a me nā prostaglandins e makemake i ka hana. Hiki i kekahi mau meaʻai a me nā mea kanu lāʻau ke hoʻolauna i ka hoʻoneʻe ʻana o ka uterine a hoʻoulu i ka hana ma mua a, no laila, contraindicated i ka wā hāpai. E nānā i kahi papa inoa o nā tī e pono ʻole ai ka wahine hāpai.

Nā hōʻailona a me nā ʻōuli o ka hānau mua

Manaʻo paha ka wahine e hele ana ʻo ia i ka hana premature ke loaʻa iā ia kekahi mau hōʻailona a me nā ʻōuli, e like me:

• ʻO nā kuʻina Uterine;
• Kaomi ma lalo o ka ʻōpū;
• Hoʻonui i ka makemake e mimi;
• Hoʻonui i ka hoʻokuʻu ʻana o ka ʻōpū, a lilo ia i gelatinous a i ʻole ʻaʻohe paha i nā koʻi o ke koko.
• ʻEha ma lalo o ke kua;
• Diarrhea i kekahi mau hihia;
• Colic ikaika.

No laila, inā hōʻike ka wahine i kēia mau hōʻailona ma mua o 37 mau pule o ka hāpai ʻana, he mea nui ia e kāhea ʻo ia i kāna kaʻi hānau a hele i ka haukapila e loiloi ai a hiki ke hana ʻia nā ana kūpono.

I mea e hōʻoia ai aia ka makaʻu o ka hānau mua a hoʻoholo i ka mea e hana ai i kēia hihia, hiki i ke kauka ke nānā i ke ana o ka cervix uterine ma o ka ultrasound transvaginal a me ke alo o fetal fibronectin i loko o ka huna ʻōpū.

ʻO ke ana ma luna o 30 mm o ka cervix e hōʻike ana i kahi makaʻu ʻoi aku o ka lawe ma waena o 7 mau lā a me nā wahine i loaʻa kēia waiwai e pono e loiloi ʻia no fibronectin. Inā loaʻa nā ana i ka wahine ma waena o 16 a 30 mm akā ʻo ka maikaʻi ʻole o ka hānau fetal fibronectin maikaʻi, akā, ke maikaʻi ka fetal fibronectin, aia ka makaʻu o ka lawe ma waena o 48 mau hola.

Nā pilikia i hiki

Pili nā pilikia o ka hānau mua ʻana i ka wā hānau o ka pēpē i ka wā hānau, a aia paha:

• Ka lawe manawa ma 23 a 25 mau pule:hiki i ka hapanui o nā hihia ke hoʻomohala i nā kīnā ʻole koʻikoʻi, e like me ka cerebral palsy, ka makapō a me ke kuli paha;
• Hāʻawi mua ʻia ma 26 a me 27 mau pule: hiki i kekahi mau hihia ke hoʻomohala i nā kīnā kaulike, e like me ka hōʻino ʻana o ka ʻike, ka ʻole o ka kaʻa kaʻa, ka hānō mau a me ka paʻakikī i ke aʻo ʻana;
• Ka lawe manawa ma 29 a 31 mau pule: hoʻomōhala ka hapanui o nā pēpē me ka ʻole o nā pilikia, akā he ʻano palupalu paha kekahi o ka cerebral palsy a me nā pilikia ʻike maka;
• Hānau hānau ʻole ma 34 a 36 mau pule: hoʻomohala like nā pēpē premature i nā mea i hānau ma ka papa kuhikuhi, akā e loaʻa paha nā pilikia hoʻomohala a me ke aʻo ʻana.

ʻO ka maʻamau, hoʻonoho ʻia nā pēpē premature i loko o kahi incubator, no ka mea ʻaʻole hiki iā lākou ke mālama i ka mahana o ke kino. No laila, mālama kēia mea i ka mahana a me ka hoʻohaʻahaʻa e like me ka uterus, e ʻae ana i kona ulu.

Pili paha nā pēpē ma lalo o 34 mau pule o ka hāpai ʻana i kahi hāhā hanu, ma mua o 34 mau pule o ka hāpai ʻana nele lākou i ka surfactant, kahi mea e kōkua i ke komo ʻana o ka ea i loko o nā akemāmā, a no kēia kumu, ʻike ʻia nā hōʻailona e like me ke kala bluish. a me nā manamana lima, nā lehelehe a me nā ihu.

Hoʻohui ʻia, nui ka makaʻu o nā pēpē ma mua o ka retinopathy, ka mea e hōʻemi ai i ka hiki ʻana i ka ʻike, no laila pono nā pēpē āpau e ʻaʻa i ka pale maka i ka neu i ICU. Hoʻokuʻu wale ʻia ka pēpē i ka home ke hōʻea ʻo ia i 2 kg a ke hoʻomohala ʻia kāna mau meaola, i hiki ai iā ia ke ale me ka ʻole o kahi paipu a hanu me ka ʻole o ke kōkua o nā hāmeʻa.

Pehea e pale ai i ka hānau mua ʻana

I mea e hōʻalo ai i ka hānau mua ʻole, ka mea a ka wahine hāpai e hiki ai ke hana i ka wā o ka hāpai ʻana āpau e hōʻalo i ka hoʻoikaika kino nui a me ka ukali i nā ʻōkuhi āpau o ka obstetrician i ka wā o nā kūkākūkā mua

Eia nō naʻe, inā hoʻomaka ka lawe ʻana ma mua o ka manawa i manaʻo ʻia, hiki i ka obstetrician ke paipai i ka hoʻohana ʻana i nā lāʻau e like me corticosteroids a i ʻole oxytocin antagonists, i hiki ke hoʻohana ʻia ma waena o 25 a me 37 mau pule hānau. Pono e hana i kēia mau ʻenehana e pale ai i ka hānau mua ma ka haukapila a noi ʻia e like me nā pono no ka makuahine a me ka pēpē.