Hydrops Fetalis: Kumu, Outlook, Hoʻomaʻamaʻa, a me nā mea hou aku

Anter

• He aha nā hydrops fetalis?
• Nā ʻano o hydrops fetalis
• Fetalis nā hydrops non-immune
• Fetus hydrops palekana
• He aha nā hōʻailona o ka hydrops fetalis?
• Nānā i nā hydrops fetalis
• Pehea e mālama ʻia ai nā hydrops fetalis?
• He aha ke kuanaʻike no nā hydrops fetalis?

He aha nā hydrops fetalis?

ʻO Hydrops fetalis kahi ʻano koʻikoʻi, hoʻoweliweli i ke ola kahi i kahi pēpē a i ʻole keiki hānau hou i kūkulu ʻia ai nā wai i nā mea āpau e pili ana i nā akemāmā, puʻuwai, a ʻōpū paha, a ma lalo o ka ʻili. ʻO ka maʻa mau kahi pilikia o kekahi kūlana olakino e hoʻopili i ke ʻano o ka mālama ʻana o ke kino i ka wai.

Hana wale ʻo Hydrops fetalis i ka 1 mai kēlā me kēia 1,000 hānau. Inā hāpai ʻoe a he hydrops fetalis kāu pēpē, makemake paha kāu kauka e hoʻokomo i ka hana mua a me ka hānau ʻana o ka pēpē. Pono paha kahi pēpē i hānau ʻia me hydrops fetalis i kahi transfusion o ke koko a me nā lāʻau ʻē aʻe e hoʻopau i ka nui o ka wai.

ʻOiai me ka mālama ʻana, e ʻoi aku ana ma mua o ka hapalua o nā pēpē me nā hydrops fetalis e make koke ma mua a ma hope paha o ka hānau ʻana.

Nā ʻano o hydrops fetalis

Aia ʻelua ʻano hydrops fetalis: pale a pale ʻole. Aia ke ʻano i ke kumu o ke ʻano.

Fetalis nā hydrops non-immune

ʻO nā hydrops fetalis non-immune i kēia manawa ka ʻano maʻamau o nā hydrops fetalis. Hana ʻia ia ke keakea ʻia kekahi kūlana a maʻi paha me ka hiki i ka pēpē ke hoʻoponopono i ka wai. ʻO nā laʻana o nā kūlana i hiki ke hoʻopilikia i ka mālama ʻana o ka wai o ka pēpē e like me:

• anemias koʻikoʻi, me thalassemia
• fetal kahe ana (hemorrhage)
• kīnā o ka puʻuwai a i ʻole ka māmā i loko o ka pēpē
• nā maʻi kūpuna a me nā metabolic, me Turner Syndrome a me ka maʻi o Gaucher
• nā maʻi viral a me nā koʻohune, e like me ka maʻi Chagas, parvovirus B19, cytomegalovirus (CMV), toxoplasmosis, syphilis, a me herpes
• malformations vascular
• ʻōiwi

I kekahi mau kumu, ʻaʻole ʻike ʻia ke kumu o nā hydrops fetalis.

Fetus hydrops palekana

Hana maʻamau nā Immune hydrops fetalis ke kūlike ʻole nā ​​ʻano koko o ka makuahine a me nā ʻōpū. ʻIke ʻia kēia ʻo Rh incompatibility. Hiki i ka ʻōnaehana pale o ka makuahine ke hoʻouka aku a luku i nā hunaola ʻulaʻula o ke pēpē. ʻO nā hihia koʻikoʻi o Rh incompatibility hiki ke alakaʻi iā hydrops fetalis.

ʻOi aku ka liʻiliʻi o ka maʻamau o Immune hydrops fetalis i kēia lā mai ka hoʻokumu ʻia ʻana o kahi lāʻau i kapa ʻia ʻo Rh immunoglobulin (RhoGAM). Hāʻawi ʻia kēia lāʻau i nā wahine hāpai i ka makaʻu o Rh incompatibility e pale ai i nā pilikia.

He aha nā hōʻailona o ka hydrops fetalis?

Hiki i nā wahine hāpai ke ʻike i kēia mau ʻōuli inā loaʻa ka hydrops fetalis i ka fetus:

• ʻoi aku o ka wai amniotic (polyhydramnios)
• mānoanoa a nui ʻole paha placenta

Loaʻa paha i ka fetus kahi māpala hoʻonui, puʻuwai, a i ʻole akepaʻa, a me ka wai e hoʻopuni ana i ka puʻuwai a i ʻole nā ​​māmā, e ʻike ʻia i ka wā o kahi ultrasound.

Loaʻa i kahi pēpē i hānau ʻia me nā hydrops fetalis nā hōʻailona aʻe:

• ʻili mae
• ʻāpala
• ʻōhū nui (edema), keu hoʻi i ka ʻōpū
• hoʻonui ākea a me nā ʻāpala
• paʻakikī i ka hanu ʻana
• ʻeha ʻeha

Nānā i nā hydrops fetalis

Hana pinepine ʻia ka diagnostical o hydrops fetalis i ka manawa o kahi ultrasound. Hoʻomaopopo paha kekahi kauka i ka hydrops fetalis ma kahi ultrasound i ka wā o ka hāpai hāpai maʻamau. Hoʻohana kahi ultrasound i nā nalu kani pinepine e kōkua i ke kiʻi ʻana i nā kiʻi ola o loko o ke kino. Hāʻawi ʻia ʻoe i kahi ultrasound i ka wā hāpai inā ʻike ʻoe i ka neʻe pinepine ʻana o ka pēpē a i ʻole ke ʻike nei ʻoe i nā pilikia hāpai ʻē aʻe, e like me ke kiʻekiʻe o ke koko.

Hiki ke hana ʻia nā hoʻokolohua diagnostical ʻē aʻe e kōkua i ka hoʻoholo ʻana i ke koʻikoʻi a i ʻole ke kumu o kēia ʻano. Pākuʻi ʻia kēia mau mea:

• hāpana koko ʻālua
• amniocentesis, ʻo ia ka huki ʻia ʻana o ka wai amniotic no ka hoʻāʻo hou
• fetal echocardiography, ka mea nānā i nā hemahema o ka naʻau o ke ʻano

Pehea e mālama ʻia ai nā hydrops fetalis?

ʻAʻole hiki ke mālama maʻamau ʻo Hydrops fetalis i ka wā hāpai. ʻO ka manawa, hiki i ke kauka ke hāʻawi i ke kaola o ke pēpē (intrauterine fetal blood transfusion) e kōkua e hoʻonui i nā manawa e ola ai ka pēpē a hiki i ka hānau ʻana.

I ka hapanui o nā hihia, pono i ke kauka e hoʻokau i ka hānau mua ʻana o ka pēpē e hāʻawi i ka pēpē i ka manawa kūpono loa loa e ola ai. Hiki ke hana i kēia me nā lāʻau lapaʻau e hoʻoulu ai i ka hana mua a i ʻole me kahi ʻāpana Cesarean pilikia (ʻāpana C). E kūkākūkā kāu kauka i kēia mau koho me ʻoe.

Ke hānau ʻia ka pēpē, pili paha i ka mālama:

• me ka hoʻohana ʻana i ke kui kele e hoʻoneʻe i ka nui o ka wai mai ke ākea a puni nā māmā, ka puʻuwai, a me ka ʻōpū (thoracentesis)
• kākoʻo hanu, e like me ka mīkini hanu (ventilator)
• nā lāʻau e kaohi ai i ka puʻuwai ʻole
• nā lāʻau e kōkua i nā puʻupaʻa e hemo i ka nui o ka wai

No nā hydrops immune, loaʻa paha i ka pēpē kahi transfusion pololei o nā hunaola ʻulaʻula e kūlike me kāna ʻano koko. Inā kumu ʻia nā hydrops fetalis e kekahi kumu paʻa hou aʻe, e loaʻa pū ka pēpē i ka lāʻau no kēlā ʻano. ʻO kahi laʻana, hoʻohana ʻia nā antibiotic e mālama i kahi maʻi syphilis.

ʻO nā wahine nona nā pēpē i loaʻa hydrops fetalis i kahi makaʻu i kahi ʻano ʻē aʻe i ʻike ʻia ʻo mirror mirror. Hiki i ke aniani Syndrome ke hopena i ka hypertension hoʻoweliweli ola (ke kaomi kiʻekiʻe o ke koko) a i ʻole ka hopu ʻana. Inā hoʻomohala ʻoe i ka maʻi aniani, pono ʻoe e hānau koke i kāu pēpē.

He aha ke kuanaʻike no nā hydrops fetalis?

ʻO ka nānā ʻana no hydrops fetalis kaukaʻi ʻia i ke ʻano o ke kumu paʻa, akā ʻoiai me ka mālama ʻana, haʻahaʻa ka helu ola no ka pēpē. Ma kahi o 20 pākēneka wale nō o nā pēpē i ʻike ʻia me nā hydrops fetalis ma mua o ka hānau ʻana e ola a hiki i ka hānau ʻana, a ʻo kēlā mau pēpē, he hapalua wale nō e ola ma hope o ka hānau ʻana. ʻO ka makaʻu o ka make ke kiʻekiʻe loa no nā pēpē i ʻike ʻia i ke kakahiaka nui (ma lalo o 24 mau pule i ka hāpai ʻana) a i ʻole nā ​​mea ʻē aʻe e like me ke kino.

ʻO nā pēpē i hānau ʻia me nā hydrops fetalis i loaʻa paha i nā ake māmā underdeveloped a i ʻoi aku ka nui o ka makaʻu i:

• puʻuwai puʻuwai
• poino lolo
• hypoglycemia
• ka hopu ʻana