Nā ho'āʻo no ka Rupture Premature o Membranes

Anter

• He aha nā hōʻailona o ka rupture premature o Membranes?
• ʻIke i ka rupture Premature o Membranes
• Hoʻāʻo pH
• Hōʻike Nitrazine
• Ferning
• Nā hoʻāʻo ʻē aʻe
• Aia kekahi mau pilikia i PROM?
• He aha ka hope?
• 37 mau pule a piʻi
• Ma kahi kokoke (34 a 36 mau wiki)
• Preterm (Ma lalo o 34 mau pule)
• He aha ka Outlook?
• Pehea e hiki ai iaʻu ke pale aku iā PROM?

Nānā Hou o Membranes: He aha ia?

I nā wahine hāpai, haki mua nā membrane (PROM) i ka wā e haki ai ke ʻeke amniotic e hoʻopuni ana i ka pēpē (ka membrane) ma mua o ka hoʻomaka ʻana o ka hana. Kāhea ʻia ʻo ia ʻo "ke haki kou wai." ʻO ka haki ʻana o ka membrane ma mua o ka hebedoma 37 o kahi hāpai hāpai ʻana i kapa ʻia ʻo PROM (PPROM). Kū ʻo PPROM ma kahi o 3 pākēneka o nā hāpai keiki a kumu e pili ana i ka hapakolu o nā hānau mua, e like me ka American Family Physician. Kū pinepine ia i loko o nā hāpai māhoe.

ʻO ka ma mua o ka haki ʻana o kou mau membrane, ʻoi aku ka nui o ke koʻikoʻi iā ʻoe a me kāu pēpē.

• Inā hala kāu hapai i 37 mau pule a haki kou mau membrane, ua mākaukau kāu pēpē e hānau.
• Inā ʻoi aku ka nui o kāu hāpai ma mua o 37 mau pule a haki kou mau membrane, e hoʻoholo kāu mea mālama ola inā e hoʻopakele koke kāu pēpē a i ʻole e hoʻāʻo e hoʻomau i ka hāpai keiki. Koho paha kāu mea mālama ola e hoʻokomo i kāu hana ma mua o ka hopena o ka maʻi i kāu pēpē.

ʻO nā wahine e hāʻawi i loko o 24 mau hola ma hope o ka wāwahi ʻana o kā lākou wai, ʻaʻole hiki ke loaʻa i kahi maʻi, no laila he mea nui e hele koke i ka haukapila ma hope koke o ka haki ʻana o nā membrane. Ma ka haukapila, hiki i nā hoʻokolohua maʻalahi ke hōʻoia ua haki kou mau membrane.

He aha nā hōʻailona o ka rupture premature o Membranes?

ʻO ka hōʻailona nui loa o PROM ke kahe ʻana o ka wai mai ka ʻōpala. E kolo mālie paha ka wai a i ʻole e kolo i waho. Kuhi hewa nā wahine i ka wai o ka mimi i kekahi manawa.

Inā ʻoe e ʻike i nā wai liu, e hoʻohana i kahi pad a pepa paha e ʻono i kekahi o ka wai. E nānā iā ia a honi. ʻAʻole pono ke pilau o ka wai Amniotic e like me ka mimi a ʻaʻohe kala i ka maʻamau.

Hiki i nā hōʻailona ʻē aʻe ke:

• kahi manaʻo e like me ʻoe hiki ʻole ke hoʻōki i ka mimi
• hoʻoheheʻe a huawū paha i ʻoi aku ma mua o ka maʻamau
• kahe ana ke kahe mai ka ʻōpū
• puʻe pelvis

Inā manaʻo ʻoe ua haki kou mau membrane, e kāhea koke aku i kāu kauka.

ʻIke i ka rupture Premature o Membranes

Inā kuhi ʻoe ua haki kou wai a aia ke kahe ʻana o ka wai mai ka ʻōpala, pono e hōʻoia i kāu kauka mālama ola ua haki maoli nā membrane.

E nānā kāu mea mālama ola iā ʻoe a nānā i ka wai e hele mai ana mai ka ʻōpala. E kauoha lākou i nā hoʻokolohua e kōkua e hōʻoia iā PROM a i ʻole PPROM. Pili nā hoʻāʻo no PROM i ke kālailai ʻana i nā hūnā o ka ʻōpū e hoʻoholo ai inā aia ka wai amniotic. No ka mea ua haumia nā wai i ke koko a i ʻole nā ​​huna ʻē aʻe, nānā kēia mau hoʻāʻo i nā mea a i ʻole kekahi mau ʻano i loaʻa maʻamau i ka wai amniotic. E hōʻiliʻili kāu mea mālama olakino i kahi wai mai ka pūnana e hoʻohana ana i kahi mea hana lapaʻau i kapa ʻia he speculum i mea e hana ai i ka hapa nui o kēia mau hoʻāʻo. E hoʻokomo lākou i ka speculum i loko o ka lua a hohola mālie i nā paia āpau. ʻAe kēia iā lākou e nānā i ka loko o ka lua a hōʻiliʻili pololei i ka wai mai ka ʻōpala.

Hoʻāʻo pH

Pili kēia hōʻike i ka hoʻāʻo ʻana i ka pH o kahi laʻana o ka wai aʻa. Aia ka PH maʻamau ma waena o 4.5 a me 6.0. Loaʻa i ka wai amniotic kahi pH kiʻekiʻe o 7.1 a 7.3. No laila, inā ua haki nā membrane, ʻoi aku ka kiʻekiʻe o ka laʻana o ka laʻana o ka wai ma mua o ka maʻamau.

Hōʻike Nitrazine

Hoʻopili kēia hōʻike i ke kau ʻana i kahi kulu o ka wai i loaʻa mai ka ʻōpū ma luna o nā ʻāpana pepa i loaʻa ka pena Nitrazine. Hoʻololi nā ʻāpana i ke kala i ka pH o ka wai. E uliuli nā ʻāpana inā ʻoi aku ka nui o ka pH ma mua o 6.0. ʻO kahi kahakaha polū ʻoi aku ka nui o ka haki o nā membrane.

Akā, hiki i kēia hoʻāʻo ke hana i nā hopena wahaheʻe. Inā loaʻa ke koko i kahi laʻana a i ʻole inā aia kahi maʻi i loaʻa, ʻoi aku ka kiʻekiʻe o ka pH o ka wai liʻiliʻi ma mua o ka maʻamau. ʻOi aku ka kiʻekiʻe o ka Semen i ka pH, no laila hiki i ka moe kolohe ke hana i kahi heluhelu wahaheʻe.

Ferning

Inā haki kou wai, ʻo ka wai i hui pū ʻia me ka estrogen e hana i kahi "fern-like" ma lalo o kahi microscope ma muli o ka crystallization paʻakai. E kau ʻia kekahi mau kulu wai ma luna o kahi kiʻi pākuʻi microscope a nānā ʻia ma lalo o kahi microscope.

Nā hoʻāʻo ʻē aʻe

ʻO nā hoʻokolohua ʻē aʻe no ka diagnose PROM me:

• Hōʻike hoʻoweliweli: Hoʻokomo i ka wai i loko o ka ʻeke amniotic ma o ka ʻōpū. Inā ua haki nā membrane, e loaʻa ka wai kala i loko o ka moku ma loko o 30 mau minuke.
• ʻO nā hoʻāʻo e ana i nā pae o nā kemika i ʻike ʻia e noho nei i ka wai amniotic akā ʻaʻole i ka wai aʻa. Hoʻopili kēia i ka prolactin, alpha-fetoprotein, glucose, a me diamine oxidase. ʻO nā kiʻekiʻe kiʻekiʻe o kēia mau mea i haʻi ua haki nā membrane.
• Nā hōʻike noninvasive hou e like me ka hōʻike AmniSure ROM mai QIAGEN ʻEpekema. ʻAʻole koi kēia hōʻike i kahi hoʻokolokolo kikoʻī. Hana ia ma ke ʻimi ʻana i ka biomarker alpha microglobulin-1 placental i loko o ka wai amniotic.

Ke hōʻoiaʻiʻo ʻia ʻo PROM, hana ʻia paha nā hoʻokolohua hou aku e loiloi i ka mea aʻe e hōʻike ai i ka mea aʻe:

• ke kū ʻana o ka maʻi ma ke hoʻāʻo ʻana i ka wai amniotic
• ke kēkelē o ka ulu ulu fetal, e hoʻoholo inā mākua nā māmā o ka pēpē e hana ma waho o ka ʻōpū
• ke kūlana a me ke olakino o ka fetus, me ka hoʻolohe ʻana i ka puʻuwai o ka pēpē

Inā ʻoe ma kahi manawa (ʻoi aku ma mua o 37 mau wiki hāpai), hiki iā ʻoe ke hele i kahi hana maʻamau a i ʻole hiki i kāu kauka olakino ke hoʻohuli i ka hana e kōkua ai e hōʻemi i ka pilikia o ka maʻi.

Inā hoʻoholo kāu mea mālama ola e hoʻopaneʻe i ka hānau ʻana, pono lākou e hoʻomau iā ʻoe a me kāu pēpē e hōʻoia i ka hopena o kēia hoʻoholo i ke ʻano ʻoi loa o ka hana. Inā hāʻule ka puʻuwai o ka pēpē, pono ka lawe koke ʻana.

Aia kekahi mau pilikia i PROM?

ʻO ka makaʻu nui o PROM ka maʻi. Inā lilo ka ʻōpū i maʻi (chorioamnionitis), pono e hāʻawi koke ʻia ka pēpē. Hiki i kahi maʻi ke hoʻopilikia i nā pēpē koʻikoʻi.

No ka PROM premerm, ʻo ka makaʻu nui ka lawe mua ʻana, kahi e hoʻonui ai i nā pilikia o nā pilikia no ka pēpē. Loaʻa kēia mau pilikia:

• kino kīnā
• pilikia neurological
• respiratory syndrome syndrome

ʻO kekahi pilikia kūpilikiʻi ka hoʻoliʻiliʻi umbilical cord. Me ka ʻole o ka wai amniotic, maʻalahi ka umbilical cord i ka hōʻino. Hāʻawi ka umbilical cord i ka oxygen a me nā meaʻai i ka pēpē a pale pinepine ʻia e ka wai amniotic. Inā puka ka wai i waho, hiki i ka umbilical cord ke hoʻopili ʻia ma waena o ka pēpē a me ka kōpū a i ʻole i kekahi mau hihia, e hāʻule i waho o ka pūpū i loko o ka ʻōpū. Hiki i kēia ke alakaʻi i nā hōʻeha lolo koʻikoʻi a me ka make paha.

Preterm PROM ma mua o ka hebedoma he kakaikahi ka hebedoma 24. Eia naʻe, hopena pinepine ia i ka make o ka pēpē no ka mea ʻaʻole hiki i nā māmā o ke pēpē ke hoʻomohala pono. Inā ola ka pēpē, loaʻa pinepine iā lākou nā pilikia lōʻihi, e like me:

• maʻi maʻi maʻi mau
• nā pilikia ulu
• ʻōlapa
• lolo lolo

He aha ka hope?

ʻO ka mea e hiki mai ana ma muli o ke kahua o kou hāpai ʻana.

37 mau pule a piʻi

E mālama kāu mea mālama ola i kāu pēpē. Hana ʻia ʻo Labour e ia iho (maʻa wale) a i ʻole kāu mea mālama mālama ola e hoʻohuli i ka hana me ka hoʻohana ʻana i kekahi mau lāʻau.

Ma kahi kokoke (34 a 36 mau wiki)

E hoʻomaka paha kāu mea mālama ola e hānau i ka pēpē inā loaʻa ka mālama maʻi neonatal i ka haukapila. Wahi a Sanford Health, ʻelima hapalima o nā wahine i kēia manawa e hānau i ka pēpē i loko o hoʻokahi pule. E hāʻawi ka hapa nui ma loko o 48 mau hola.

Preterm (Ma lalo o 34 mau pule)

Inā ʻaʻole mākua nā mākua o ka pēpē, makemake ka mea mālama ola e kali e hoʻohuli i ka hana. E kamaʻilio ʻoe e pili ana i kāu kūlana ponoʻī a me nā pilikia a me nā koho lapaʻau i loaʻa iā ʻoe a me kāu pēpē.

Pākuʻi ʻia paha nā lāʻau:

• antibiotics e pale aku i nā maʻi
• nā injection steroid e hoʻoholomua i ka ulu ʻana o nā māmā o ka pēpē
• nā lāʻau e pale ai i ka hoʻoliʻiliʻi

E nānā pono kāu mea mālama ola iā ʻoe a me kāu pēpē me nā ultrasound mau a e nānā i nā maʻi. Noho paha ʻoe i ka moena i kēia manawa.

He aha ka Outlook?

Aia ka nānā i ka pae o kou hāpai ʻana. ʻO nā pēpē i hānau mua ʻia aia i kahi kiʻekiʻe o ka pilikia o nā pilikia. Me nā hoʻāʻo e hoʻolōʻihi i kahi hāpai ma hope o PPROM, nui nā wahine e hānau i loko o hoʻokahi pule. ʻO nā hopena PPROM i ka make o ka fetal ma 1 a 2 pakeneka o nā hihia, e like me ka American Family Physician.

Pehea e hiki ai iaʻu ke pale aku iā PROM?

ʻAʻole hiki iā ʻoe ke pale mau aku iā PROM, akā hiki i kekahi mau loli nohona ke hoʻoliʻiliʻi i kou makaʻi. ʻO kahi moʻaukala o ka maʻi i lawe ʻia i ka moekolohe a me ka puhipaka i ka wā o ka hāpai ʻana hiki ke hoʻonui i kou makaʻu i ka loaʻa ʻana o PROM (pono e hōʻalo ʻia ka puhipaka)

E kamaʻilio me kāu mea mālama ola inā lawe ʻoe i nā lāʻau steroid. Paipai paha lākou iā ʻoe e hōʻoki i ka lawe ʻana iā lākou inā ʻaʻole pono ia no ka mālama ʻana i kahi pilikia ʻē aʻe

Maikaʻi ka hoʻolālā i ka wā o ka hāpai ʻana, akā pono ʻoe e kamaʻilio me kāu kauka olakino e pili ana i ka pae o ka hoʻoikaika kino hiki iā ʻoe ke hana palekana i kou wā hāpai. Hiki i ka hoʻoikaika kino ikaika ke hana i PROM.