Nā Kanaka Chorionic Gonadotropin (hCG) a me nā hāʻule hewa: ka mea āu e ʻike ai

Anter

• Hōʻike Overview
• Nā pae HCG i ka hāpai ʻana
• Nā pae HCG i ka hāʻule ʻole
• Pono paha nā pae haʻahaʻa i ka hāʻule ʻole?
• Pono paha ka hāʻule ʻana i nā pae i ka hāʻule ʻole?
• ʻO ke ala lohi loa e pono ai ka hānau ʻole ʻana?
• Pehea e hōʻoia ai nā kauka i kahi hāʻule ʻole
• E hoʻihoʻi i nā pae hCG i ka ʻole ma hope o ka hāʻule ʻole ʻana
• ʻO ka lawe lawe ʻana

Hōʻike Overview

ʻO ka gonadotropin chorionic kanaka (hCG) kahi hormone i hana ʻia e ke kino i ka wā o ka hāpai ʻana. Kākoʻo ia i ka ulu fetal.

Hōʻaʻo nā kauka i nā pae hCG i ka mimi a me ke koko e hōʻoia i ka hāpai ʻana. Hoʻohana lākou i nā hoʻokolohua koko hCG e kōkua ai e hoʻoholo inā hiki i kekahi kanaka ke loaʻa i kahi hāpai ectopic a i ʻole hāpai keiki.

ʻAʻole hiki ke ʻike ʻia ka hāpai ʻana, hāpai hāpai ectopic, a me ka hāpai ʻole ʻana ma muli o hoʻokahi pae hCG wale nō, akā he mea kōkua ke ʻike pehea e hana ai kēia mau pae i kēlā mau hihia.

Nā pae HCG i ka hāpai ʻana

Inā manaʻo ʻoe he hāpai ʻoe, e hoʻāʻo kahi kauka i ke koko i huki ʻia mai kahi aa e nānā i kāu pae hCG.

Inā ʻaʻohe ou hCG i loko o kou koko, ʻaʻole ia he manaʻo ʻaʻole hāpai ʻoe. Ma mua paha o kou hāpai ʻana no ka piʻi ʻana o kāu pae hCG.

ʻOi aku ka kiʻekiʻe o ka HCG ma mua o 5 miliona mau kikowaena o ka honua ma ka milliliter (mIU / mL) e hōʻike ana i ka hāpai ʻana. Kuhi ʻia kāu hopena hōʻike mua he pae pae pae. Hiki ke pae i kēia pae mai nā liʻiliʻi liʻiliʻi o hCG (e like me 20 mIU / mL a i ʻole ʻo lalo) i nā nui nui (e like me 2,500 mIU / mL).

He mea nui ka pae haʻahaʻa ma muli o ke kumumanaʻo i kapa ʻia e nā kauka he manawa pālua. I nā pule ʻehā mua o ka hāpai hāpai ʻana, e pāpālua nā pae hCG ma kēlā me kēia ʻelua a ʻekolu paha lā. Ma hope o ʻeono pule, e pāpālua nā pae ma kēlā me kēia 96 hola.

No laila, inā ʻoi aku ka kiʻekiʻe o kāu pae haʻahaʻa ma mua o 5 mIU / mL, hiki i kāu kauka ke kauoha i kahi hoʻāʻo hou i kekahi mau lā ma hope e ʻike inā pālua ka helu.

I ka loaʻa ʻole o kekahi mau pilikia, lawa paha kēia (a i ʻole pae ʻē aʻe) e hoʻoholo ai i ka hāpai keiki. I nā manawa he nui, e paipai kāu kauka iā ʻoe i kahi ultrasound i kekahi manawa ma waena o 8 a me 12 mau pule ma ke ʻano he ʻāpana o ka mālama hāpai hāpai trimester mua.

Nā pae HCG i ka hāʻule ʻole

Inā pilikia ʻoe no ka hāpai keiki ʻana a i ʻole hāpai hāpai ectopic, ʻoi aku paha ka nui o kāu mau hCG pae i pāpālua ʻole. E emi paha lākou. No laila, e noi paha kāu kauka iā ʻoe e hoʻi i kā lākou keʻena i ʻelua a i ʻole ʻekolu mau lā ma hope o ka hoʻāʻo ʻana o ke koko palena e ʻike inā ua pālua ka pae o kāu pae.

Inā ʻaʻole kokoke kāu pae hCG i ka pāpālua ma hope o 48 a 72 mau hola, hopohopo paha kāu kauka no ka makaʻu o ka hāpai keiki. ʻO ke olakino, hiki ke kapa ʻia kēia he hiki "hāpai ʻole nonviable."

Inā e hāʻule a piʻi haʻahaʻa paha kāu mau pae, e hoʻouna ʻia paha ʻoe no nā hoʻokolohua ʻē aʻe. Hiki i kēia ke hoʻopili i nā hoʻokolohua koko progesterone a me kahi ultrasound transvaginal e nānā i kou kōpū no kahi ʻeke hāpai. E mālama pū ʻia nā ʻōuli ʻē aʻe, e like me ke kahe ʻana o ke kahe a i ʻole ke cramping.

Inā loaʻa ka hāʻule ʻole, e hoʻemi pinepine nā pae hCG mai nā ana i hala. ʻO kahi laʻana, kahi pae laina o 120 mIU / mL i hāʻule i 80 mIU / mL i ʻelua mau lā ma hope hiki ke hōʻike i ka embryo ʻaʻole e ulu hou ana a ʻaʻole ke kino e hana i nā mea hou e kākoʻo i kona ulu.

Pēlā nō, nā pae i pāpālua ʻole a piʻi mālie wale nō - no ka laʻana, mai 120 mIU / mL a 130 mIU / mL ma kahi o nā lā ʻelua - hiki ke hōʻike i kahi hāpai uterine nonviable kahi e hiki koke ai kahi hāʻule ʻole.

ʻO nā pae e lohi i ka piʻi aʻe hiki ke hōʻike i kahi hāpai ʻole uterine, i hana ʻia i ka wā e hoʻokomo ai ka hua manu momona i kahi ma waho o ka kōpū (ʻo ka maʻamau nā paipu fallopian). Ma muli o ka hāpai ʻana o kahi ectopic hiki i kahi pilikia olakino, he mea nui e ʻike ke kauka i kēia me ka hiki ke hiki.

Ma ka ʻaoʻao ʻē aʻe, hiki nō hoʻi ke loaʻa i nā pae hCG papalua me kahi hāpai hāpai ectopic. ʻO kēia ke kumu o ka lawa ʻole o nā pae hCG wale nō e hoʻoholo ai i nā mea e hana nei me ka 100 pakeneka pololei.

Pono paha nā pae haʻahaʻa i ka hāʻule ʻole?

ʻAʻole kahi kumu haʻahaʻa haʻahaʻa i hōʻailona o nā pilikia i loko ona iho. ʻO nā pae maʻamau no ka hCG ma nā kiko like ʻole o ka hāpai ʻana he ākea loa.

ʻO kahi laʻana, hoʻokahi lā wale nō ma hope o kāu manawa i hala, 10 a 15 paha mIU / mL kāu pae hCG. A i ʻoi aku paha ma mua o 200 mIU / mL. ʻOkoʻa kēlā me kēia hāpai ʻana i kēia mea.

ʻO ka mea nui maoli ka hoʻololi ʻana i ka manawa. E loaʻa i nā poʻe ʻokoʻa nā baseline ʻokoʻa a loaʻa mau i nā hāpai hāpai mau.

Pono paha ka hāʻule ʻana i nā pae i ka hāʻule ʻole?

Inā e hāʻule ana kāu mau pae, ʻaʻole ka maikaʻi ka maka o kou hāpai ʻana.

Hiki paha i kahi keʻena hoʻokolohua ke hana i kahi kuhi hewa. Pēlā nō paha ka hihia ma ke ʻano preexisting, e like me ovarian hyperstimulation Syndrome (OHSS) ma hope o nā hoʻomaʻamaʻa hoʻohua, ke hoʻololi nei i kāu pae hormon.

Eia nō naʻe, ma ka laulā, ʻo ka hōʻemi ʻana i nā pae o ka hCG ma hope o kahi hopena hāpai maikaʻi ʻaʻole ia he hōʻailona maikaʻi. ʻO nā manawa kūpono ka hāpai ʻana he nonviable, e like me ka puke pai ʻo Fertility a me Sterility.

ʻO ke ala lohi loa e pono ai ka hānau ʻole ʻana?

Ke hoʻonui nei me ka lohi i nā pae hCG ʻaʻole pono ia e hāʻule hemahema ʻoe, ʻoiai lākou e hōʻailona maʻamau i nā hoʻokolohua hou e ʻike inā ʻoe.

Hoʻohana nā kauka i ka ʻikepili e pili ana i nā haʻawina liʻiliʻi i ka poʻe i hāpai ma hope o nā hāpai hāpai ʻana, e like me ka puke pai ʻo Fertility a me Sterility. Hiki ke kōkua i nā helu hCG i ke alakaʻi ʻana i nā kaʻina e hiki hou mai ana, akā ʻaʻole ia he hōʻailona paʻa o ka hāpai ʻana a i ʻole ka hāpai hāpai ʻana.

Hoʻohana kauka i nā manawa papalua i e hoʻokūpaʻa he hāpai keiki, ʻaʻole hōʻike i ka ʻōpū. Wahi a ka puke pai, he 53 pākēneka a i ʻole piʻi aʻe i nā pae hCG ma hope o ʻelua mau lā hiki ke hōʻoia i kahi hāpai kūpono i 99 pakeneka o nā hāpai keiki.

ʻO kahi mea nui e noʻonoʻo ai me nā manawa pālua ka hoʻomaka ʻana o ka waiwai hCG. ʻO kahi laʻana, ʻo ka poʻe me kahi pae hCG pae lalo ma lalo o 1,500 mIU / mL he nui ka "lumi" e hoʻonui ai i kā lākou pae hCG.

ʻO kekahi mea ʻoi aku paha ma mua o kā lākou e noʻonoʻo ai a hoʻomaka i kahi kiʻekiʻe hCG kiʻekiʻe o 5,000 mIU / mL a ʻoi aku ka nui o ka maʻamau i loaʻa ʻole ka helu like o ka hCG piʻi, e like me.

Lawe i nā kinikini (māhoe, ʻekolu, a me nā mea ʻē aʻe) hiki ke hoʻopili i ka piʻi ʻana o ka hCG, a pēlā pū me ʻoe.

Hiki i ka hāpai Ectopic a me ka hāʻule ʻole ke hopena i nā pae hCG haʻahaʻa. Hiki i kahi hāpai molar ke hopena i nā kiʻekiʻe kiʻekiʻe.

Pehea e hōʻoia ai nā kauka i kahi hāʻule ʻole

E hoʻohana nā kauka i nā ʻano hoʻokolohua like ʻole e hōʻoia i ka hāʻule ʻole ʻana. Pākuʻi ʻia kēia mau mea:

• hana i nā hoʻokolohua koko, me hCG a me progesterone
• ke noʻonoʻo nei i nā ʻōuli, e like me ke pelvic cramping a i ʻole ke kahe ʻana o ka manu
• ke hana nei i kahi ultrasound vaginal a me ka hoʻokolohua pelvic
• ke alakaʻi nei i ka puʻuwai puʻuwai fetal (inā hōʻike kāu mau lā e ʻike ʻia kahi puʻuwai fetal)

Lawe pono kāu kauka i kekahi mau ʻikepili i loko o ka helu ma mua o ka hōʻoia ʻana i kahi hāʻule ʻole. Inā wanaʻao loa ka hāpai ʻana, ʻo ka hōʻole ʻana i nā pae hCG wale nō ke ala e hoʻoholo ai a hiki i ka hala ʻana o kahi manawa liʻiliʻi.

He mea nui nā kauka e hoʻomaopopo i ka hāpai ʻana a i ʻole hāpai ectopic i ka wā hiki. Hiki i kahi hāpai ectopic ke hopena i ka haki o kahi paipu fallopian a i ʻole nā ​​ʻeha ʻē aʻe e hoʻoweliweli i kou momona a me kou ola. ʻO kahi hāʻule ʻole i hopena i nā mea i hoʻopaʻa ʻia e hoʻonui ai i ka maʻi a me ke kahe o ke kahe.

No kēia mau kumu, inā ʻoe e ʻike nei i kahi nalo o ka hāpai ʻana, hiki i kāu kauka ke koi aku i ka lawe ʻana i nā lāʻau a i ʻole ke loaʻa ʻana i kekahi mau lāʻau ʻoki e hoʻoliʻiliʻi i nā pilikia.

Hiki ke lilo i ka lilo o ka hāpai i mea kaumaha. Hiki i kahi hōʻailona ke hāʻawi i ka pani a ʻae i ka ʻeha a me ke kaʻina hana hoʻōla e hoʻomaka.

E hoʻihoʻi i nā pae hCG i ka ʻole ma hope o ka hāʻule ʻole ʻana

Ke hana hewa ʻoe (a i kēlā me kēia manawa hānau ʻoe), ʻaʻole hana hou kou kino i ka hCG. E hoʻi hope kāu mau pae i 0 mIU / mL.

ʻO ka ʻoiaʻiʻo, ʻo nā mea ma lalo o 5 mIU / mL he "maikaʻi ʻole," no laila, ʻo 1 a 4 mIU / mL i manaʻo ʻia he "zero" e nā kauka.

Inā loaʻa iā ʻoe kahi hāʻule ʻole, ʻo ka manawa no kāu mau pae e hele ai i ka ʻole e loli ma muli o ke kiʻekiʻe o kāu mau pae i ka manawa o ka hānau ʻole. Inā hāʻule mua ʻoe i kou hāpai mua ʻana a ʻaʻole i hoʻonui nui ʻia kāu mau hCG, hoʻi pinepine kāu mau pae i ka ʻole i loko o kekahi mau lā.

Inā kou mau hCG ma kahi o nā kaukani a i ʻole he mau kaukani ka wā āu i hānau hewa ʻole ai, he mau pule paha ka lōʻihi e hoʻi ai kāu pae i ka ʻole, e like me ka American Association for Clinical Chemistry

Ke hiki ʻoe i ka ʻole, hoʻomaka ʻoe i kāu manawa a me ka ovulate hou.

ʻAʻole hoʻolaha nā kauka i ka hoʻāʻo hou ʻana e hāpai hou a hiki i kou loaʻa ʻana i kēlā wā mua ma hope o kou hāpai keiki ʻana. Māmā kēia i ka helu ʻana i kāu lā palena pau.

Inā loaʻa iā ʻoe kahi kaʻina D a C (dilation and curettage) ma ke ʻano he hapa o kāu hāʻule ʻole, hiki i kāu kauka ke ʻōlelo aku e kali i ʻelua a ʻekolu paha mau kau ma mua o ka hoʻāʻo ʻana e hāpai hou. ʻO kēia no ka mea hiki i kahi D a me C ke lahilahi i ka uhi o ka uterine, aʻoi aku ka maikaʻi o ka uhi mānoanoa i ka hāpai keiki. E kūkulu hou ka pale ma luna o kekahi mau mahina.

ʻO ka lawe lawe ʻana

Hiki i ka hāʻule mua ʻana ke lilo i ʻike kaumaha a me ke kino. Inā manaʻo ʻoe he hāpai keiki paha kāu, e kamaʻilio me kāu kauka. Hiki i kāu kauka ke kauoha i nā hoʻokolohua, me ka hōʻike koko hCG, e hāʻawi iā ʻoe i ka ʻike hou aku.

Inā loaʻa ʻoe i kahi hānau ʻole, ʻike ʻaʻole ia manaʻo ʻaʻole ʻoe e hele i kahi hāpai hāpai kūleʻa. ʻO ka ʻoiaʻiʻo, hana ka hapa nui o ka poʻe.

ʻIke pū he nui nā hui e hāʻawi i ke kākoʻo no ka poʻe i ʻike i ka pohō hāpai. E kamaʻilio me kāu kauka no ka ʻike hou aku.