Nā kumu o ka hana Preterm: Hoʻomaʻamaʻa no Cervix kūpono ʻole

Anter

• Pehea e hana ʻia ai kahi Cerclage?
• Āhea e hoʻokō ʻia ai kahi Cerclage?
• He aha nā pilikia kūpono?
• He aha ka hana ma hope?
• He aha ka hana ma hope?
• Pehea ka kūleʻa o Cerclage?

Maopopo iā ʻoe?

ʻO Shirodkar ka cerclage cervical holomua mua loa i hōʻike ʻia ma 1955. Eia nō naʻe, no ka hana pinepine ʻana o kēia kaʻina hana i ka nui o ke kahe o ke koko a paʻakikī hoʻi e hemo nā sute, ua ʻimi nā kauka i nā hana ʻē aʻe.

ʻO ka McDonald cerclage, i hoʻolauna ʻia ma 1957, he mau helu kūleʻa i like me ke kaʻina hana Shirodkar-a hoʻoliʻiliʻi hoʻi i ka nui o ke ʻoki a me ke kahe o ke koko, ka lōʻihi o ke ʻoki ʻana, a me ka paʻakikī i ka hemo ʻana i nā sute. No kēia mau kumu, makemake nā kauka he nui i ke ʻano McDonald. Hoʻohana kekahi i kahi ala Shirodkar i hoʻololi ʻia, ʻoi aku ka maʻalahi a ʻoi aku ka palekana ma mua o ke ʻano kumu.

Inā kuhi kāu mea mālama mālama ʻaʻole lawa kāu cervix, e koi paha ʻo ia i ka hoʻoikaika ʻana o ka cervix me ka hoʻohana ʻana i kahi hana i kapa ʻia cercer cerclage. Ma mua o ka hoʻoikaika ʻana o ka cervix e nānā ke kauka no nā hanana fetal ma o ka hana ʻana i kahi ultrasound.

Pehea e hana ʻia ai kahi Cerclage?

Hana ʻia kahi cerclage i kahi lumi hana, me ka mea maʻi ma lalo o ka anesthesia. Hoʻopili ke kauka i ka cervix ma o ka lua. Kahi kahi sutures (humuhumu, wili a like me nā mea) i humuhumu ʻia a puni ka cervix e paʻa mau ai. Hoʻokomo ʻia ka suture kokoke i ka os o loko (ka hopena o ka cervix e hāmama ana i loko o ka kōpū).

ʻO kahi cerclage transabdominal kahi ʻano kūikawā o ka cerclage e koi ana i kahi incision i ka paia o ka ʻōpū. Hiki ke hoʻohana ʻia kēia hana inā ʻaʻole lawa nā kiko o ka cervix e paʻa ai ka suture a i ʻole ke kūleʻa ʻana o kahi cerclage i hoʻokau mua ʻia. No kahi wahine me ka mōʻaukala o nā pohō hāpai hāpai he nui, hiki i ke kauka ke waiho i kahi cerclage ʻōpū ma mua o ka hāpai ʻana.

Āhea e hoʻokō ʻia ai kahi Cerclage?

Hana ʻia ka hapa nui o nā cerclages i ka manawa o ka trimester ʻelua o ka hāpai ʻana (ma waena o 13 a 26 mau pule o ka hāpai ʻana), akā hiki ke kau ʻia i nā manawa ʻē aʻe, e pili ana i ke kumu o ka cerclage. O kahi laʻana:

• Nā cerclages koho kau ʻia ma kahi o ka pule he 15 o ka hāpai keiki, maʻamau ma muli o nā pilikia i ka wā o ka hāpai mua.
• Nā cerclages wikiwiki hoʻonoho ʻia inā hōʻike ʻia kahi hōʻike ultrasound i kahi cervix pōkole.
• Pilikia a i ʻole heroic? kālika hoʻonoho mau ʻia ma waena o ka pule 16th a me 24th o ka hāpai ʻana inā hoʻonui ʻia ka cervix ma mua o 2 cm a ua hana ʻia, a i ʻole inā ʻike ʻia nā membrane (ʻeke o nā wai) i ka puki ma ka os kūwaho (ka puka hāpū o ka ʻōpū ).

He aha nā pilikia kūpono?

Palekana ʻo cerclages elective. ʻOi aku ka nui o ka pilikia o nā cerclages urgent a i ʻole emergency cerclages, e like me ka haki ʻana o nā membrane e hoʻopuni ana i ka pēpē, ka hoʻoliʻiliʻi uterine, a me nā maʻi i loko o ka kōpū. Inā kū ka maʻi, hemo ka suture a hoʻokomo ʻia ka hana e hoʻopakele koke i ka pēpē. No nā makuahine i loaʻa i kahi cerclage ulia pōpilikia, aia ka makaʻu e hoʻolōʻihi ʻia ke kaʻina hana i ka hāpai ʻana a 23 a 24 mau pule. I kēia makahiki, nui ka pilikia o nā pēpē i nā pilikia lōʻihi.

Ua hōʻike ʻia nā noiʻi i nā wahine e koi ana i ka cerger cerclage i ka nui o ka makaʻu no ka hana mua a koi pinepine ʻia i ka haukapila i kā lākou hāpai keiki.

He aha ka hana ma hope?

ʻO ke kau ʻana i ka cerclage ka mea mua wale nō i ke kaʻina o nā kaʻina e pono ai e hōʻoia i ka kūleʻa o ke kaʻina hana a me kou hāpai ʻana. Ma hope o ka hana, hiki i kāu kauka ke kuhikuhi i ka lāʻau e hōʻoki i kou kōpū mai ka ʻaelike. E lawe paha ʻoe i kēia lāʻau no hoʻokahi a ʻelua paha lā. Ma hope o ka hoʻokuʻu ʻia ʻana mai ka haukapila, makemake kāu kauka e ʻike pinepine iā ʻoe e loiloi no ka hana mua.

ʻO ka maʻi ka hopohopo ma hope o nā kaʻina hana. Inā loaʻa iā ʻoe kahi cerclage urgent a heroic paha, ua hoʻonui ʻia ka makaʻu o ka maʻi.ʻO kēia no ka mea aia i loko o ka pūhaka ka bacteria i loaʻa ʻole i loko o ka kōpū. Ke kau nei ka ʻeke o ka wai i loko o ka lua, nui ka makaʻu o ka maʻi bacteria i loko o ka kōpū a ma loko o ka ʻeke amniotic e paʻa ana i ka pēpē. Kau kauka paha i kāu lāʻau ʻalopika e hōʻemi i ka makaʻu o ka maʻi. Inā loaʻa kahi maʻi i loko o ka ʻeke o ka wai, pono e hoʻopau ʻia ka hāpai ʻana i mea e pale ai i nā hopena olakino koʻikoʻi i ka makuahine.

Lawe ʻia ka suture ma kahi o ka 35th a i ka 37th wiki o ka hāpai ʻana, ke hiki a piha ka pēpē. ʻAʻole hiki ke hemo ʻia i kahi ʻōpū o ka ʻōpū, a ʻo nā wahine i loaʻa i nā cerclage ʻōpū e pono i nā ʻāpana C e hāʻawi.

He aha ka hana ma hope?

ʻO ke kau ʻana i ka cerclage ka mea mua wale nō i ke kaʻina o nā kaʻina e pono ai e hōʻoia i ka kūleʻa o ke kaʻina hana a me kou hāpai ʻana. Ma hope o ka hana, hiki i kāu kauka ke kuhikuhi i ka lāʻau e hōʻoki i kou kōpū mai ka ʻaelike. E lawe paha ʻoe i kēia lāʻau no hoʻokahi a ʻelua paha lā. Ma hope o ka hoʻokuʻu ʻia ʻana mai ka haukapila, makemake kāu kauka e ʻike pinepine iā ʻoe e loiloi no ka hana mua.

ʻO ka maʻi ka hopohopo ma hope o nā kaʻina hana. Inā loaʻa iā ʻoe kahi cerclage urgent a heroic paha, ua hoʻonui ʻia ka makaʻu o ka maʻi. ʻO kēia no ka mea aia i loko o ka pūhaka ka bacteria i loaʻa ʻole i loko o ka kōpū. Ke kau nei ka ʻeke o ka wai i loko o ka lua, nui ka makaʻu o ka maʻi bacteria i loko o ka kōpū a ma loko o ka ʻeke amniotic e paʻa ana i ka pēpē. Kau kauka paha i kāu lāʻau lapaʻau e hōʻemi i ka makaʻu o ka maʻi. Inā loaʻa kahi maʻi i loko o ka ʻeke o ka wai, pono e hoʻopau ʻia ka hāpai ʻana i mea e pale ai i nā hopena olakino koʻikoʻi i ka makuahine.

Lawe ʻia ka suture ma kahi o ka 35th a 37th wiki o ka hāpai ʻana, ke hiki ke pēpē i ka manawa piha. ʻAʻole hiki ke hemo ʻia i kahi ʻōpū o ka ʻōpū, a ʻo nā wahine i loaʻa i nā ʻōpū o ka ʻōpū e pono iā C-ʻāpana e hāʻawi.

Pehea ka kūleʻa o Cerclage?

ʻAʻole hiki i kahi lāʻau hoʻokahi a i ʻole ka hui ʻana o nā kaʻina hana no ka cervix lawa ʻole ke hōʻoia i kahi hāpai hāpai maikaʻi. ʻO ka mea nui i hiki i nā kauka ke hōʻemi i ka makaʻu iā ʻoe a me kāu pēpē. Ma ke ʻano he kūlana maʻamau, ʻoi aku ka maikaʻi o ka hana ʻana o nā cerclages ke hoʻokau ʻia lākou i ka wanaʻao a ke lōʻihi a mānoanoa ka cervix.

ʻO nā kumukūʻai no ka hāpai ʻana i ka hāpai ʻana a hiki i ka manawa ma hope o ka cerclage ʻokoʻa mai 85 a 90 pakeneka, e pili ana i ke ʻano o ka cerclage i hoʻohana ʻia. (Kuhi ʻia nā helu kūleʻa ma ka hoʻohālikelike ʻana i ka helu o nā hāpai hāpai i hāʻawi ʻia ma kahi a kokoke paha i ka manawa me ka helu o nā kaʻina hana i hana ʻia.) . ʻAʻole hana iki ʻia ka cerclage transabdominal a ʻaʻole i helu ʻia kahi helu kūleʻa holoʻokoʻa.

ʻOiai ka nui o nā noiʻi i hōʻike i nā hopena maikaʻi ma hope o ka cerclage, ʻaʻole hōʻike kiʻekiʻe kiʻekiʻe i hōʻike ʻia i nā wahine i loaʻa i ka cerclage he mau hopena maikaʻi aʻe ka mea e hele i kahi moe.