Hoʻomaʻamaʻa i ka Preterm Labor: Tocolytic

Anter

• Lāʻau lapaʻau Tocolytic
• He aha ke ʻano o ka lāʻau tocolytic e pono ai e hoʻohana?
• I ka manawa hea i koʻu wā hāpai e hiki ai iaʻu ke lawe i nā lāʻau lapaʻau tocolytic?
• Pehea ka lōʻihi e hoʻomau ai i nā lāʻau tocolytic?
• Pehea ka maikaʻi o nā lāʻau lapaʻau tocolytic?
• ʻO wai ka mea pono ʻole e hoʻohana i nā lāʻau lapaʻau tocolytic?

Lāʻau lapaʻau Tocolytic

ʻO Tocolytic nā lāʻau i hoʻohana ʻia e hoʻopaneʻe i kāu lawe ʻana no kahi manawa pōkole (a hiki i 48 mau hola) inā ʻoe e hoʻomaka i ka hana i ka wā mua o kou hāpai ʻana.

Hoʻohana nā kauka i kēia mau lāʻau e lohi ai i kāu lawe ʻana ke lawe ʻia ʻoe i kahi haukapila i loea i ka mālama mua, a i ʻole hiki iā lākou ke hāʻawi iā ʻoe i nā corticosteroids a i ʻole magnesium sulfate. Kōkua nā kuʻikuʻu corticosteroid i nā mākua o ka pēpē.

Mālama ka Magnesium sulfate i kahi pēpē ma lalo o 32 mau pule mai ka maʻi lolo, akā hiki ke hoʻohana ʻia ia me he tocolytic. Hoʻohana ʻia ka magnesium sulfate e pale i ka hopu ʻana i nā wahine hāpai me ka preeclampsia (ke koko kiʻekiʻe).

ʻO nā lāʻau ʻē aʻe i hiki ke hoʻohana ʻia ma ke ʻano he tocolytic me:

• beta-mimetics (ʻo kahi laʻana, terbutaline)
• nā poloka ʻauʻa calcium (ʻo kahi laʻana, nifedipine)
• nā lāʻau anti-inflammatory non-steroidal a i ʻole NSAIDs (e laʻa me, indomethacin)

Hāʻawi ʻia ma lalo ka ʻike ākea e pili ana i kēia mau lāʻau.

He aha ke ʻano o ka lāʻau tocolytic e pono ai e hoʻohana?

ʻAʻohe ʻikepili e hōʻike ana he ʻoi aku ka maikaʻi o kekahi lāʻau ma mua o kekahi, a he ʻokoʻa nā makemake a nā kauka i nā wahi like ʻole o ka ʻāina.

I nā haukapila he nui, hāʻawi ʻia ʻo terbutaline inā ʻoi aku ka makaʻu o ka wahine i ka hānau mua ʻana i kāna pēpē. No nā wahine i ka makaʻu nui i ka lawe ʻana i loko o ka pule aʻe, ʻo ka magnesium sulfate (lawelawe pinepine ʻia) ʻo ia ka lāʻau o ke koho.

I ka manawa hea i koʻu wā hāpai e hiki ai iaʻu ke lawe i nā lāʻau lapaʻau tocolytic?

ʻAʻole hoʻohana ʻia nā lāʻau Tocolytic no ka hana mua ma mua o 24 mau pule o ka hāpai ʻana. I kekahi mau hanana, hiki i kāu kauka ke hoʻohana iā ia aia ʻoe ma 23 mau pule o ka hāpai ʻana.

Kū ka nui o nā kauka i ka hāʻawi ʻana i nā tocolytic ma hope o ka hōʻea ʻana o kahi wahine i kāna hebedoma 34th o ka hāpai ʻana, akā hoʻomaka kekahi mau kauka i ka tocolytic a hala 36 mau pule.

Pehea ka lōʻihi e hoʻomau ai i nā lāʻau tocolytic?

E hoʻāʻo mua paha kāu kauka e mālama i kāu hana mua me ka hoʻomaha moe, nā wai keu aʻe, ka lāʻau ʻeha, a me kahi mahele lāʻau o ka lāʻau tocolytic. Hiki iā lākou ke hana i kahi kānana hou (e like me ka hoʻāʻo fetal fibronectin a me transvaginal ultrasound) e hoʻoholo pono ai i kāu makaʻi no ka lawe mua ʻana.

Inā kū ʻole kāu kuʻikahi, ʻo ka hoʻoholo e hoʻomau i nā lāʻau lapaʻau tocolytic, a no ka lōʻihi, e kau ʻia ia i kāu makaʻu maoli o ka lawe mua ʻana (e like me ka mea i hoʻoholo ʻia e nā hōʻike loiloi), ka makahiki o ka pēpē, a me ke kūlana o ka pēpē. māmā.

Inā hōʻike nā hōʻike e hopohopo nui ʻoe no ka lawe mua ʻana, e hāʻawi paha kāu kauka iā ʻoe no ka magnesium sulfate ma kahi o 24 a 48 mau hola a me ka lāʻau corticosteroid e hoʻomaikaʻi ai i ka hana o ka pēpē o ka pēpē.

Inā kū nā kuʻikahi, e hoʻoliʻiliʻi kāu kauka a laila hoʻopau i ka magnesium sulfate.

Inā hoʻomau ka hoʻohaʻahaʻa ʻana, hiki i kāu kauka ke kauoha i nā hoʻokolohua hou aku e kāpae i ka maʻi o ka uterus. E hana paha ke kauka i kahi hoʻokolohua e hoʻoholo ai i ke kūlana o nā māmā o ka pēpē.

Pehea ka maikaʻi o nā lāʻau lapaʻau tocolytic?

ʻAʻole hōʻike ʻia kahi lāʻau lapaʻau tocolytic e lohi i ka lawe ʻana no kekahi manawa nui o ka manawa.

Eia nō naʻe, hiki i nā lāʻau lapaʻau tocolytic ke hoʻolohi i ka lawe ʻana no ka manawa liʻiliʻi (maʻa mau i kekahi mau lā). Hāʻawi kēia i ka manawa kūpono e loaʻa ai kahi papa o nā steroid. Hoʻoemi nā kōpiko corticosteroid i nā mea pilikia no kāu pēpē inā hiki wawe lākou.

ʻO wai ka mea pono ʻole e hoʻohana i nā lāʻau lapaʻau tocolytic?

ʻAʻole pono nā wahine e hoʻohana i nā lāʻau tocolytic ke ʻoi aku ka maikaʻi o ka hoʻohana ʻana i nā lāʻau ma mua o nā pono.

Hiki i kēia mau pilikia ke komo pū me nā wahine me ka preeclampsia koʻikoʻi a i ʻole eclampsia (ke koko kiʻekiʻe e ulu ana i ka wā o ka hāpai ʻana a hiki ke kumu i nā pilikia), ke kahe koko nui (hemorrhage), a i ʻole ka maʻi i loko o ka ʻōpū (chorioamnionitis).

ʻAʻole pono e hoʻohana ʻia nā lāʻau lapaʻau Tocolytic inā i make ka pēpē i loko o ka ʻōpū a i ʻole he maʻi ʻē ka pēpē e alakaʻi ai i ka make ma hope o ka hānau ʻana.

I nā kūlana ʻē aʻe, akahele paha ke kauka e pili ana i ka hoʻohana ʻana i nā lāʻau tocolytic, akā kuhikuhi paha iā lākou no ka mea ʻoi aku ka maikaʻi ma mua o nā pilikia. Pili pū paha kēia mau hanana i ka manawa a ka makuahine i:

• preeclampsia akahai
• kūleʻa ke kahe ʻana i ka lua a i ke kolu o ka trimester
• nā kūlana olakino koʻikoʻi
• kahi cervix i hoʻonui ʻia i ka 4 a i ka 6 kenimika a ʻoi paha

Hiki paha i ke kauka ke hoʻohana i nā tocolytic ke loaʻa ka pēpē i ka helu o ka puʻuwai maʻamau (e like me ka hōʻike ʻana ma ka monitor fetal), a me ka ulu lohi.