Ukungahambelani kwe-Rh

Ukungahambelani kwe-Rh yisimo esikhulayo lapho owesifazane okhulelwe enegazi elingelona i-Rh nengane esibelethweni sakhe inegazi eline-Rh.

Ngesikhathi sokukhulelwa, amangqamuzana abomvu egazi avela enganeni engakazalwa angawela egazini likamama nge-placenta.

Uma umama engenayo i-Rh, amasosha akhe omzimba aphatha amangqamuzana ombungu ane-Rh njengokungathi ayinto yangaphandle. Umzimba womama wenza amasosha omzimba alwa namaseli egazi ombungu. La ma-antibody angawela abuyele emuva nge-placenta aye enganeni ekhulayo. Zibulala amangqamuzana abomvu egazi engane.

Lapho amaseli abomvu egazi ehla, enza i-bilirubin. Lokhu kudala ukuthi usana luphuzi (jaundiced). Izinga le-bilirubin egazini lengane lingahle lisuke phakathi komnene liye phezulu ngokuyingozi.

Izinsana eziyizibulo zivame ukungathinteki ngaphandle kokuthi umama wake wakhipha izisu noma wakhipha izisu. Lokhu kuzosimamisa amasosha akhe omzimba. Lokhu kungenxa yokuthi kuthatha isikhathi ukuthi umama akhe amasosha omzimba. Zonke izingane anazo kamuva nazo ezine-Rh zingathinteka.

Ukungahambelani kwe-Rh kukhula kuphela lapho umama ene-Rh futhi usana lune-Rh. Le nkinga seyande kakhulu ezindaweni ezinikeza ukunakekelwa okuhle ngaphambi kokubeletha. Lokhu kungenxa yokuthi ama-globulin akhethekile omzimba abizwa nge-RhoGAM asetshenziswa njalo.

Ukungahambelani kwe-Rh kungadala izimpawu ezisukela komoya omnene ziye ekufeni. Ngendlela yayo emnene, ukungahambelani kwe-Rh kubangela ukubhujiswa kwamaseli abomvu egazi. Ayikho eminye imiphumela.

Ngemuva kokuzalwa, usana lungaba:

• Ukuphuzi kwesikhumba nabamhlophe bamehlo (i-jaundice)
• Ithoni yemisipha ephansi (i-hypotonia) nobuthakathaka

Ngaphambi kokubeletha, umama angaba ne-amniotic fluid eyengeziwe enganeni yakhe engakazalwa (i-polyhydramnios).

Kungaba khona:

• Umphumela wokuhlolwa oqondile weCoombs oqondile
• Izinga eliphakeme kunokujwayelekile le-bilirubin egazini lomthambo wengane yengane
• Izimpawu zokubhujiswa kwamangqamuzana egazi abomvu egazini lengane

Ukungahambelani kwe-Rh kungavinjelwa ngokusetshenziswa kweRhoGAM. Ngakho-ke, ukuvimbela kuhlala kuyindlela engcono kakhulu yokwelashwa. Ukwelashwa kosana osuvele uthintekile kuncike ebukhulwini besimo.

Izinsana ezinokungahambisani okuncane kwe-Rh zingaphathwa nge-phototherapy kusetshenziswa amalambu e-bilirubin. Ama-immune globulin nawo angasetshenziswa. Ezinganeni ezithinteke kakhulu, kungadingeka ukufakwa kwegazi okushintshaniswa. Lokhu ukwehlisa amazinga we-bilirubin egazini.

Ukululama okugcwele kulindelwe ukungahambisani okuncane kwe-Rh

Izinkinga zingafaka:

• Ukulimala kobuchopho ngenxa yamazinga aphezulu e-bilirubin (kernicterus)
• Ukwakhela uketshezi nokuvuvukala enganeni (hydrops fetalis)
• Izinkinga zokusebenza kwengqondo, ukunyakaza, ukuzwa, ukukhuluma, nokuquleka

Shayela umhlinzeki wakho wezempilo uma ucabanga noma wazi ukuthi ukhulelwe futhi awukamboni umhlinzeki.

Ukungahambelani kwe-Rh kucishe kuvinjelwe ngokuphelele. Omama abangenayo i-Rh kufanele balandelwe eduze ngabahlinzeki babo ngesikhathi sokukhulelwa.

Ama-globulin akhethekile omzimba, abizwa nge-RhoGAM, manje asetshenziselwa ukuvimbela ukungahambisani kwe-RH komama abangena-Rh.

Uma ubaba wosana ene-Rh noma enegazi lakhe lingaziwa, umama unikezwa umjovo weRhoGAM phakathi ne-trimester yesibili. Uma ingane ine-Rh, umama uzothola umjovo wesibili ezinsukwini ezimbalwa ngemuva kokubeletha.

Le mijovo ivimbela ukwakhiwa kwamasosha omzimba alwa negazi eline-Rh. Kodwa-ke, abesifazane abanohlobo lwegazi olungenayo i-Rh kumele bathole imijovo:

• Ngesikhathi sonke sokukhulelwa
• Ngemuva kokuphuphuma kwesisu noma ukukhipha isisu
• Ngemuva kokuhlolwa kokubeletha okufana ne-amniocentesis ne-chorionic villus biopsy
• Ngemuva kokulimala esiswini ngesikhathi sokukhulelwa

Isifo se-hemolytic esibangelwa i-Rh sosana olusanda kuzalwa; I-Erythroblastosis fetalis

• I-jaundice esanda kuzalwa - ukukhipha

• I-Erythroblastosis fetalis - i-photomicrograph
• Usana olunguJaundiced
• Amasosha omzimba
• Ukushintshaniswa kwegazi - uchungechunge
• Ukungahambelani kwe-Rh - uchungechunge

UKaplan M, Wong RJ, uSibley E, uStevenson DK. Izifo ze-jaundice zesibindi kanye nezifo zesibindi. Ku: Martin RJ, Fanaroff AA, Walsh MC, ama-eds. UFanaroff kanye neMithi kaMartin's Neonatal-Perinatal Medicine. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 100.

IKliegman RM, iSt. Geme JW, iBlum NJ, i-Shah SS, iTasker RC, iWilson KM. Ukuphazamiseka kwegazi. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 124.

Moise KJ. Ukuhlanganiswa kwamaseli abomvu. Ku: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Ama-Obstetrics: Ukukhulelwa Okujwayelekile Nenkinga. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 34.