Nā Paʻi Pregnancy: Placenta Accreta

Anter

• He aha nā hōʻailona o ka Placenta Accreta?
• He aha nā kumu?
• Pehea e kuhikuhi ʻia ai?
• ʻO wai e ʻino?
• Pehea e mālama ʻia ai ka Placenta Accreta?
• He aha nā pilikia?
• He aha ka Outlook?
• Hiki ke pale ʻia ʻo Placenta Accreta?

He aha ka Placenta Accreta?

I ka wā o ka hāpai ʻana, hoʻopili ka placenta o ka wahine iā ia iho i kāna paia uterine a hoʻokaʻawale ma hope o ka hānau ʻana. ʻO ka Placenta accreta kahi pilikia kōpū hiki ke hana ʻia ke hoʻopili ka placenta iā ia iho i loko o ka paia uterine.

ʻO kēia ke kumu e paʻa paʻa ai kahi ʻāpana a i ʻole nā ​​placenta āpau i ka kōpū i ka wā o ka hānau ʻana. Hiki i ka Placenta accreta ke hopena i ke kahe o ke koko ma hope o ka lawe ʻana.

Wahi a ka ʻAmelika Hui Pū ʻIa o nā Obstetricians a me nā Gynecologists (ACOG), 1 i ka 533 mau wahine ʻAmelika e ʻike i ka placenta accreta i kēlā me kēia makahiki. I kekahi mau hihia o ka placenta accreta, e hoʻopili hohonu kahi placenta o ka wahine i loko o ka paia uterine e pili ana i ka mākala uterine. Kapa ʻia kēia ʻo placenta increta. Hiki iā ia ke hele hohonu i waena o ka paia uterine a i loko o kahi meaola ʻē aʻe, e like me ka pūpū. Kapa ʻia kēia ʻo placenta percreta.

ʻO ka American Pregnancy Association, kuhi ʻo ia o nā wahine i ʻike i ka placenta acreta, ma kahi o 15 pākēneka ʻike placenta increta, ʻoiai ma kahi o 5 pākēneka ʻike i ka placenta percreta.

Manaʻo ʻia ʻo Placenta accreta kahi pōpilikia hāpai keiki hoʻoweliweli. I kekahi manawa ʻike ʻia ka placenta accreta i ka wā e lawe ai. Akā i nā manawa he nui, ʻike ʻia nā wahine i ka wā hāpai. Hana pinepine nā kauka i kahi hānau cesarean mua a laila wehe i ka ʻōpū o ka wahine, inā ʻike ʻia ka pilikia ma mua o ka hānau ʻana. Kapa ʻia ka hemo ʻana o ka uterus he hysterectomy.

He aha nā hōʻailona o ka Placenta Accreta?

ʻAʻole hōʻike nā wahine me ka placenta accreta i kekahi hōʻailona a hōʻailona paha i ka wā hāpai. I kekahi manawa e ʻike ke kauka iā ia i kahi ultrasound maʻamau.

Akā i kekahi mau hihia, hiki i ka placenta accreta ke kumu o ke kahe ʻana o ka maʻi i loko o ke kolu o ka trimester (mau pule 27 a 40). Kāhea koke aku i kāu kauka inā ʻike ʻoe i ke kahe o ka maʻi ma loko o kāu ʻekolu trimester. Inā ʻike ʻoe i ke kahe nui, e like me ke kahe ʻana e kahe i loko o kahi pad ma lalo o 45 mau minuke, a i ʻole kaumaha a hele pū me ka ʻeha o ka ʻōpū, pono ʻoe e kāhea iā 911.

He aha nā kumu?

ʻAʻole maopopo ʻia ke kumu o ka accreta placenta. Akā manaʻo nā kauka ua hoʻopili ʻia i nā kūlike ʻole e kū nei i ka uhi ʻana o ka uterine a me nā kiʻekiʻe o alpha-fetoprotein, kahi protein i hana ʻia e ka pēpē i hiki ke ʻike ʻia i ke koko o ka makuahine.

Hiki i kēia mau mea kūpono ʻole ke hopena i ka scarring ma hope o ka hoʻouna ʻana cesarean a i ʻole ke ʻoki uterine. ʻAe kēia mau scars i ka placenta e ulu hohonu i loko o ka paia uterine. ʻO nā wahine hāpai nona ka placenta hapa a uhi piha paha i kā lākou cervix (placenta previa) ʻoi aku ka nui o ka makaʻu o ka placenta accreta. Akā i kekahi mau hihia, ʻike ʻia ka placenta accreta i nā wahine me ka ʻole o ka mōʻaukala o ka ʻoki ʻana o ka uterine a i ʻole ka placenta previa.

ʻO ka loaʻa ʻana o kahi cesarean e hoʻonui i nā makaʻi o ka wahine i ka placenta accreta i ka wā e hāpai ana i ka wā e hiki mai ana. ʻO ka nui o ka hāʻawi cesarean i kahi wahine, ʻo ka nui o kāna mau pōpilikia. Ua kuhi ka ʻAhahui Pregnancy ʻAmelika e loaʻa nā wahine i loaʻa ma mua o hoʻokahi cesarean hoʻouna kālā no 60 pākēneka o nā placenta accreta hihia.

Pehea e kuhikuhi ʻia ai?

Hoʻomaopopo nā kauka i kekahi manawa i ka placenta accreta i nā hoʻokolohua ultrasound maʻamau. Eia nō naʻe, holo pinepine kāu kauka i mau hoʻokolohua e hōʻoia i ka ulu ʻole ʻana o ka placenta i loko o ka paia uterine inā he nui kāu mau pilikia no ka placenta accreta. ʻO kekahi mau hoʻokolohua maʻamau e nānā no ka placenta accreta e komo pū me nā hoʻokolohua kiʻi, e like me ultrasound a i ʻole magnetic resonance imaging (MRI) a me nā hoʻokolohua koko e nānā ai i nā kiʻekiʻe o ka alpha-fetoprotein.

ʻO wai e ʻino?

Manaʻo ʻia he mau mea he nui e hoʻonui i ka makaʻu o ka wahine i ka hoʻomohala ʻana i ka placenta accreta. Pākuʻi ʻia kēia mau mea:

• ʻoki kua uterine i hala (a i ʻole nā ​​ʻoki lāʻau), e like me ka hāʻawi ʻana i ka cesarean a i ʻole ke ʻoki ʻana e wehe i nā fibroids uterine
• placenta previa, kahi ʻano e kumu i ka placenta e ʻāpana a uhi piha paha i ka cervix
• kahi placenta aia ma ka ʻaoʻao haʻahaʻa o ka kōpū
• ma luna o 35 mau makahiki
• hanau i hala
• uterine abnormalities, e like me ka scarring a i ʻole uterine fibroids

Pehea e mālama ʻia ai ka Placenta Accreta?

Heʻokoʻa kēlā me kēia hihia o ka placenta accreta. Inā ua hōʻoia kāu kauka i ka placenta accreta, e hana lākou i kahi hoʻolālā e hōʻoia i ka hānau ʻia ʻana o kāu pēpē me ka palekana.

Mālama ʻia nā hihia koʻikoʻi o ka placenta accreta me ka ʻoki kino. ʻO ka mea mua, e hana nā kauka i kahi hānau cesarean e hānau ai kāu pēpē. ʻO ka mea aʻe, hana paha lākou i ka hysterectomy, a i ʻole wehe i kāu kōpū. Pale aku kēia i ke kahe o ke koko e hiki ke hana inā hapa, a i ʻole, o ka placenta ke waiho ʻia i ka pūpū ma hope o ka hānau ʻana o kāu pēpē.

Inā makemake ʻoe i ka hiki ke hāpai hou, aia kahi koho lapaʻau ma hope o kou hānau ʻana e mālama ai i kāu momona. He hana ʻoki kēia e waiho ana ka hapa nui o ka placenta i ka kōpū. Eia nō naʻe, ʻoi aku ka nui o ka pilikia o nā pilikia i nā wahine i loaʻa i kēia lāʻau. Hiki i kāu kauka ke koi aku i ka hysterectomy inā hoʻomau ʻoe i ka ʻike ʻana i ke kahe o ka maʻi ma hope o ke kaʻina hana. Wahi a ACOG, paʻakikī loa i ka hāpai ʻana ma hope o kēia kaʻina hana.

E kūkākūkā i kāu mau koho lapaʻau a pau me kāu kauka. E kōkua lākou iā ʻoe e koho i kahi lāʻau e pili ana i kāu kūlana.

He aha nā pilikia?

Hiki i ka Placenta accreta ke kumu i nā pilikia koʻikoʻi. Pākuʻi ʻia kēia mau mea:

• kahe nui ke kahe ʻana o ka maʻi puʻupaʻa, kahi e koi ai i kahi kōpili
• nā pilikia me ke kāpili ʻana o ke koko, a i ʻole dissemined coagulopathy intravaskular
• hanu pau ʻole, a i ʻole maʻi kūpilikiʻi hanu makua
• hakuʻala ʻole
• hānau hānau mua

E like me nā ʻoki ʻana a pau, ka hana ʻana i kahi cesarean a me ka hysterectomy e hemo ai ka placenta mai ke kino aku a hiki i nā pilikia. Nā pilikia i ka makuahine:

• nā hopena i ka anesthesia
• huʻi koko
• maʻi maʻi ʻeha
• māhuahua ke kahe ʻana
• ʻeha hōʻeha
• poino i nā mea ʻē aʻe, e like me ka ʻai, inā pili ka placenta iā lākou

Kākaʻikahi nā pōʻino i ke pēpē i ka wā o ka hānau cesarean a komo pū me ka ʻeha ʻoki a me nā pilikia hanu.

I kekahi manawa e haʻalele nā ​​kauka i ka placenta i loko o kou kino, no ka mea hiki ke hoʻopau i ka manawa. Akā ʻo ka hana ʻana pēlā ke kumu o nā pilikia koʻikoʻi. Pākuʻi ʻia kēia mau mea:

• hiki ke hoʻoweliweli i ke kahe o ke koko
• nā maʻi maʻi
• kahi kīʻaha koko e ālai ana i hoʻokahi a ʻoi paha o nā aʻa i loko o nā akemāmā, a i ʻole embolism pulmonary
• ka pono no ka hysterectomy e hiki mai ana
• nā pilikia me nā hāpai hānau e hiki mai ana, e like me ka hāpai ʻole ʻana, ka hānau mua ʻana, a me ka placenta accreta

He aha ka Outlook?

Inā hōʻoia a mālama pono ʻia ka placenta accreta, loaʻa pinepine i nā wahine me ka hoʻōla ʻole me nā pilikia hope ʻole.

ʻAʻole hiki i ka wahine ke hāpai keiki inā hana ʻia kahi hysterectomy. Pono ʻoe e kūkākūkā me nā kaukō e hiki mai ana me kāu kauka inā waiho paʻa ʻia kāu kōpū ma hope o ka mālama ʻana. Ua hōʻike ʻia kahi noiʻi i paʻi ʻia i loko o ka puke pai ʻo Human Reproduction e kiʻekiʻe ana ka helu o ka hoʻi hou ʻana no ka placenta accreta i nā wahine i loaʻa ka maʻi ma mua.

Hiki ke pale ʻia ʻo Placenta Accreta?

ʻAʻohe ala e pale aku ai i ka placenta accreta. E nānā pono kāu kauka i kou hāpai ʻana e pale i nā pilikia inā ʻike ʻia ʻoe me kēia maʻi.