Nā pilikia o ka hāpai hāpai lua

Anter

• Hōʻike Overview
• Kahena
• ʻO ka hana mua
• Nā ʻōuli
• Lapaʻau
• ʻO ka haki mua o nā membrane (PPROM)
• Lapaʻau
• Cervical incompetence (ʻeha o ka ʻohana)
• Nā ʻōuli
• Lapaʻau
• Kāohi
• Preeclampsia
• Nā ʻōuli
• ʻEhaʻeha
• Outlook

Hōʻike Overview

ʻO ka lua o ka trimester pinepine ka manaʻo o ka poʻe i kā lākou maikaʻi i ka wā hāpai. Hoʻoholo maʻamau ʻo Nusea a me ka luaʻi, ua iho ka makaʻu o ka hāʻule ʻole ʻana, a ua mamao loa ka ʻeha a me nā ʻeha o ka mahina ʻeiwa.

ʻOiai nō, aia kekahi mau pilikia i hiki ke hana. E heluhelu e aʻo ai i ka mea e nānā ai a pehea e pale ai i nā pilikia mai ka wā mua.

Kahena

ʻOiai ʻoi aku ka liʻiliʻi o ka hāʻule ʻana o ka hāʻule i ka trimester ʻelua, hiki nō ke hana. ʻO ka holo ʻana o ka luaʻi ka hōʻailona hōʻailona mua. ʻO nā miscarriages i ka trimester ʻelua (ma mua o 20 mau pule) i kumu ʻia e kekahi mau mea like ʻole, i hiki ke hoʻopili ʻia:

• Septum urterine. Māhele ka paia, a septum paha, i loko o ka kōpū i ʻelua ʻāpana ʻokoʻa.
• ʻO ka cervix kūpono ʻole. Ke wehe koke ʻia ka cervix, e hānau ana i ke kakahiaka nui.
• Nā maʻi maʻi autoimmune. ʻO nā laʻana me lupus a scleroderma paha. Hiki i kēia mau maʻi ke hana i kāu ʻōnaehana pale pale i nā hunaola olakino.
• ʻO nā kūlohelohe Chromosomal o ka fetus. ʻO kēia ke hewa kekahi mea me nā chromosome o ka pēpē, ʻo ia nā pūnaewele i hana ʻia e DNA.

ʻO nā kumu ʻē aʻe o ke kahe ʻana o ka lua o ka trimester me:

• hana mua
• nā pilikia me ka placenta, e like me ka placenta previa (placenta e uhi ana i ka cervix)
• abruption placental (placenta hoʻokaʻawale mai ka uterus)

ʻOi aku ka pinepine o kēia mau pilikia i ke kolu o ka trimester, akā hiki nō ke hala i ka hopena o ka trimester ʻelua.

Inā loaʻa iā ʻoe ke koko Rh-maikaʻi ʻole, e kiʻi i kahi injection o immunoglobulin (RhoGAM) inā ʻike ʻoe i ke kahe i ka wā o ka hāpai ʻana.

ʻO Immunoglobulin he antibody. ʻO kahi antibody kahi protein i hoʻokumu ʻia e kāu ʻōnaehana pale e hoʻomaopopo a hakakā i nā mea ʻino, e like me ka bacteria a me nā virus.

ʻO ke kiʻi ʻana i ka pana o immunoglobulin e kōkua i ka pale ʻana i ka hoʻomohala ʻia o nā Rh antodies, nāna e hoʻouka i ka fetus inā he ʻano koko ko Rh-maikaʻi.

Hiki paha iā ʻoe ke makaʻu inā ʻike ʻoe i ke kahe ʻana o ka maʻi puʻupuʻu, akā he mea nui e hoʻomanaʻo ʻaʻole ia ʻo ke kahe ʻana o ke kahe ʻana o ka hāpai ʻana.

E ʻimi a mālama koke inā ʻoe e kahe ana i ka hāpai ʻana, akā e hoʻāʻo e noho mālie ʻoiai maopopo ke kauka no ke aha e kahe ana ke kahe. Hoʻokomo ʻia ʻoe i kahi moe a hiki i ke kū ʻana o ke kahe.

ʻO ka hana mua

Ke hana ʻia ka hana ma mua o ka hebedoma 38 o ka hāpai ʻana, ua manaʻo ʻia he preterm. Hiki i nā ʻano ʻokoʻa ke kumu i ka hana preterm, e like me:

• maʻi ʻaʻai
• puhipaka
• kūlana olakino olakino, e like me ka maʻi kō a i ʻole ka maʻi ʻaʻai

ʻO nā kumu pilikia no ka hana preterm me:

• he hānau mua ma mua
• māhoe hāpai keiki
• hāpai keiki he nui
• keu ka wai amniotic (ka wai e hoʻopuni ana i ka fetus)
• maʻi o ka amniotic wai a i ʻole nā ​​membrane amniotic

Nā ʻōuli

Maʻalahi paha nā ʻōuli a me nā ʻōuli o ka hana mua. Hiki iā lākou ke hoʻopili:

• puʻe puʻupuʻu
• ʻehaʻeha haʻahaʻa
• urination pinepine
• pāhoehoe
• hoʻonui i ka hoʻokuʻu wahine
• paʻa i ka ʻōpū o lalo

I nā hihia ʻē aʻe, ʻike maopopo ʻia nā ʻōuli o ka hana mua ʻole, e like me:

• hōʻemi ʻehaʻeha
• kulu o ka wai mai ka ʻōpū
• kahe koko

Kāhea i kāu kauka inā loaʻa kēia mau ʻōuli a hopohopo ʻoe i ka hana. Kaukaʻi ʻia i kāu mau ʻōuli, e haʻi aku kāu kauka iā ʻoe e hele koke i ka haukapila.

Lapaʻau

ʻO kēlā me kēia lā hou ʻaʻole ʻoe e hele i ka hana preterm hāʻawi i kahi manawa no ka liʻiliʻi o nā pilikia ke hānau ʻia ka pēpē. Hiki ke kōkua i kekahi mau lāʻau i ka hoʻōki ʻana i ka hana mua. Pākuʻi ʻia kēia mau mea:

• makanekiuma sulfate
• Corticosteroids
• tocolytic

Inā ʻaʻole hiki ke kāpae i ka hana preterm, e hāʻawi kāu kauka iā ʻoe i kahi lāʻau steroid. ʻO ka hana pēlā e kōkua i ka hoʻomohala ʻana i nā ake māmā o ka pēpē a hoʻemi i ka nui o ka maʻi maʻi. ʻOi aku ka maikaʻi i ʻelua mau lā ma hope o ka mahele mua, no laila e hoʻāʻo kāu kauka e pale i ka lawe ʻana no ʻelua mau lā.

ʻO ka haki mua o nā membrane (PPROM)

He mea maʻamau no kou mau membrane e haki (haki) i ka wā o ka hana. Kāhea pinepine ka poʻe iā ia ʻo "kou haki wai."

Kū kēia i ka wā i haki ai ke ʻeke amniotic e hoʻopuni ana i ka pēpē, e ʻae ana i ka wai amniotic e kahe i waho. Pale kēlā ʻeke i ka pēpē mai ka bacteria. Ke haki, aia kahi hopohopo no ka loaʻa ʻana o ka maʻi i ka pēpē.

ʻOiai e haki kou wai ke hele ʻoe i ka hana, hiki ke hoʻopilikia i kāu pēpē ke hiki wawe. Kāhea ʻia kēia ka wana mua o ka membrane (PPROM).

ʻAʻole maopopo ke kumu kikoʻī o PPROM. I nā manawa he nui, ʻo ke kumu o ka pilikia ka maʻi o nā membrane.

ʻO PPROM i ka lua o ka trimester kahi hopohopo nui, no ka mea hiki ke alakaʻi i kahi lawe preterm. ʻO nā pēpē i hānau ʻia ma waena o nā hebedoma 24 a me 28th o ka hāpai keiki ka mea nui o ka pilikia no ka hoʻomohala ʻana i nā pilikia olakino lōʻihi, ʻo ia hoʻi ka maʻi lolo.

ʻO ka nūhou maikaʻi me nā lawelawe mālama pēpē koʻikoʻi kūpono, ʻo ka hapa nui o nā pēpē preerm e hana maikaʻi loa.

Lapaʻau

Lapaʻau ka hoʻomaʻamaʻa no PPROM. Hiki iā ia ke hoʻokomo pinepine:

• haukapila
• antibiotic
• steroid, e like me betamethasone
• nā lāʻau i hiki ke hoʻōki i ka hana, e like me terbutaline

Inā loaʻa nā hōʻailona o kahi maʻi, e hoʻokomo ʻia ka hana e hōʻalo i nā pilikia koʻikoʻi. E hoʻomaka ʻia nā lāʻau antibiotic e pale aku i ka maʻi.

Hānau ʻia nā pēpē he nui i loko o ʻelua mau lā o ka haki ʻana, a ʻo ka hapa nui e hānau i loko o hoʻokahi pule. I nā hihia kakaikahi, keu hoʻi me kahi kulu lohi, hiki i ka ʻeke amniotic ke hoʻopau hou iā ia iho. Hiki ke hōʻalo i ka hana Preterm, a hānau ʻia ka pēpē kokoke i ko lākou lā kūpono.

Cervical incompetence (ʻeha o ka ʻohana)

ʻO ka cervix kahiʻiʻo e hoʻopili i ka ʻōpū a me ka uterus. I kekahi manawa, ʻaʻole hiki i ka cervix ke kū i ke kaomi o ka kōpū e ulu ana i ka wā hāpai. Hiki i ke kaomi hoʻonui ke hoʻonāwaliwali i ka cervix a hana iā ia e wehe i mua o ka iwa o ka malama.

ʻIke ʻia kēia ʻano he incompetence cervical, a i ʻole ka lawa ʻole o ka ʻeha. ʻOiai he kūlana maʻamau ʻole ia, hiki ke hana i nā pilikia koʻikoʻi.

ʻO ka wehe a me ka lahilahi o ka cervix e alakaʻi ai i ka haki o nā membrane a me ka lawe ʻana i kahi fetus premature loa. Hana ʻia kēia ma kahi o ka 20 mau hebedoma o ka hāpai ʻana. Ma muli o ka wikiwiki o ka ʻōpū e ola ma waho o ka kōpū i kēlā manawa, ʻaʻole hiki ke hoʻōla pinepine ʻia ka hāpai ʻana.

ʻOi aku ka makaʻu o nā wahine i ka hiki ʻole o ka cervix inā loaʻa iā lākou:

• kahi ʻeha o ke kino ma mua, e like me ka waimaka i ka wā o ka hānau ʻana
• he biopsy ʻohana kōpū
• hana ʻē aʻe ma ka cervix

Nā ʻōuli

ʻAʻole like me ka hana preterm, ʻaʻole hiki i ka cervical incompetence ke kumu i ka ʻeha a me ka hōʻemi ʻana. Aia paha he kahe koko a hoʻokuʻu paha.

Lapaʻau

Hoʻopau ʻia ka mālama ʻana no ka hiki ʻole o ka cervix. ʻO kahi cerclage ulia pōpilikia (stitch a puni ka cervix) hiki ke hiki inā ʻaʻole i haki nā membrane. ʻOi aku ka makaʻu o ka haki ʻana i nā membrane inā nui ka cervix (ākea). Pono ka hoʻomaha moe lōʻihi ma hope o ke kau ʻana o kahi cerclage.

I nā hihia ʻē aʻe, i ka wā i haki ai nā membrane a ua lawa ka nui o ka ʻōpū e ola ai, e hoʻokau paha kāu kauka i ka hana.

Kāohi

Hiki iā ʻoe ke pale i ka hemahema o ka ʻeha. Inā loaʻa iā ʻoe kahi moʻolelo o ia, hiki iā ʻoe ke loaʻa i kahi cerclage me nā hāpai e hiki mai ana ma kahi o 14 mau pule. E hoʻohaʻahaʻa kēia, akā ʻaʻole e hoʻopau, i ka makaʻu o ka hānau mua ʻana a me ka nalo ʻana o ka pēpē.

Preeclampsia

Kū ka Preeclampsia ke hoʻomohala ʻoe:

• kahe koko kiʻekiʻe
• proteinuria (kahi nui o nā protein i ka mimi)
• edema nui loa (ʻōhū)

Hoʻopili ka Preeclampsia i kēlā me kēia ʻōnaehana i ke kino, me ka placenta.

ʻO ka placenta ke kuleana no ka hāʻawi ʻana i nā meaʻai i ka pēpē. ʻOiai ke hana pinepine ʻia ka preeclampsia ma ke kolu o ka trimester no ka hāpai mua ʻana, hoʻomohala kekahi poʻe i ka preeclampsia i ka manawa o ka trimester ʻelua.

Ma mua o ka hana ʻana i kahi hōʻailona, ​​e loiloi kāu kauka iā ʻoe no nā kūlana ʻē aʻe e huikau paha me ka preeclampsia, e like me ka lupus (kahi e hoʻoulu ai i ke kino a puni) a me ka maʻi epilepsy (kahi maʻi hopu).

E loiloi pū kāu kauka iā ʻoe no nā kūlana i hiki ke hoʻonui i ka likelihood o ka hoʻomohala mua ʻana i ka preeclampsia, e like me nā maʻi maʻi koko a me ka hāpai ʻana o ka molar. He tumo noncancerous kēlā i ʻano i loko o ka kōpū.

Nā ʻōuli

ʻO nā ʻōuli o ka preeclampsia me ka hoʻohuli wikiwiki ʻana o kou mau wāwae, nā lima, a i ʻole ke alo. Kāhea koke i kāu kauka inā ʻike ʻoe i kēia ʻano pehu a i ʻole o kekahi o nā hōʻailona aʻe.

• ʻeha ke poʻo i hala ʻole ma hope o ka lawe ʻana i ka acetaminophen (Tylenol)
• nalo o ka hihiʻo
• "Floaters" i kou maka (specks a mau kiko i kāu hihiʻo)
• ʻeha ʻeha ma kou ʻaoʻao ʻākau a i ʻole ma kou wahi ʻōpū
• paopao maʻalahi

ʻEhaʻeha

ʻOi aku ʻoe i ka ʻeha i ka wā hāpai. Ke loli nei kou kikowaena o ka umekaumaha ke hāpai ʻoe, ʻo ia hoʻi ka maʻalahi o ka lilo ʻana o kāu kaulike.

I ka lua, e akahele i ka hehi ʻana i loko o ka ʻauʻau a i ʻole ka paipu. E makemake paha ʻoe e hoʻohui i nā papa nonskid i kou ʻauʻau i ʻole ʻoe e heʻe. E noʻonoʻo e hoʻohui i nā kī kī a i ʻole nā ​​ala i kou ʻauʻau pū kekahi. E nānā pū i kou hale no nā mea ʻino ʻē aʻe e hiki iā ʻoe ke hāʻule.

Outlook

Inā loaʻa iā ʻoe kekahi o nā ʻōuli i wehewehe ʻia ma kēia ʻatikala, e kāhea i kāu kauka. E hiki iā lākou ke hoʻoholo i ke kumu a hoʻomaka ʻoe i ka lāʻau kūpono - ʻo ia hoʻi kahi hāpai hauʻoli a olakino hoʻi nāu.