I-Ovarian hyperstimulation syndrome

I-Ovarian hyperstimulation syndrome (OHSS) yinkinga kwesinye isikhathi ebonakala kwabesifazane abathatha imithi yokuzala ekhuthaza ukukhiqizwa kwamaqanda.

Ngokuvamile, owesifazane ukhiqiza iqanda elilodwa ngenyanga. Abanye besifazane abanenkinga yokukhulelwa banganikezwa imithi yokubasiza ukukhiqiza nokukhulula amaqanda.

Uma le mithi ivuselela ama-ovari kakhulu, ama-ovari angavuvukala kakhulu. Uketshezi lungavuza endaweni yesisu nasesifubeni. Lokhu kubizwa nge-OHSS. Lokhu kwenzeka kuphela ngemuva kokukhishwa kwamaqanda esibelethweni (i-ovulation).

Ungahle ube sethubeni lokuthola i-OHSS uma:

• Uthola isibhamu se-chorionic gonadotropin (hCG).
• Uthola umthamo ongaphezu koyedwa we-hCG ngemuva kwe-ovulation.
• Uyakhulelwa phakathi nalesi sikhathi.

I-OHSS ayivamile ukuvela kwabesifazane abathatha kuphela izidakamizwa zokuzala ngomlomo.

I-OHSS ithinta abesifazane abangama-3% kuya ku-6% abadlula ku-in vitro fertilization (IVF).

Ezinye izinto ezinobungozi ze-OHSS zifaka:

• Ukuba mncane kuneminyaka yobudala engama-35
• Ukuba nezinga eliphezulu kakhulu le-estrogen ngesikhathi sokwelashwa kokuzala
• Ukuba ne-polycystic ovarian syndrome

Izimpawu ze-OHSS zingahluka ukusuka kumnene kuya kokubi. Iningi labesifazane abanesimo banezimpawu ezincane ezifana nalezi:

• Ukuqunjelwa kwesisu
• Ubuhlungu obuphansi esiswini
• Ukuzuza kwesisindo

Ezimweni ezingavamile, abesifazane bangaba nezimpawu ezimbi kakhulu, kufaka phakathi:

• Ukuzuza ngokushesha kwesisindo (ngaphezu kwamakhilogremu ayi-10 noma ama-4.5 kilograms ezinsukwini ezi-3 kuye kwezi-5)
• Ubuhlungu obukhulu noma ukuvuvukala esiswini
• Ukwehlisa ukuchama
• Ukuphelelwa umoya
• Isicanucanu, ukuhlanza, noma isifo sohudo

Uma unesimo esibi se-OHSS, umhlinzeki wakho wokunakekelwa kwezempilo uzodinga ukuqapha izimpawu zakho ngokucophelela. Kungenzeka ungeniswe esibhedlela.

Kuzolinganiswa isisindo sakho nosayizi wendawo yakho yesisu (isisu). Ukuhlolwa okungenziwa kufaka phakathi:

• I-ultrasound yesisu noma i-ultrasound yangasese
• I-x-ray yesifuba
• Qedela ukubalwa kwegazi
• Iphaneli ye-Electrolyte
• Isivivinyo somsebenzi wesibindi
• Ukuhlolwa kokulinganisa ukukhishwa komchamo

Amacala amancane we-OHSS ngokuvamile awadingi ukwelashwa. Isimo singenza ngcono amathuba okukhulelwa.

Izinyathelo ezilandelayo zingakusiza ukuthi unciphise ukungakhululeki kwakho:

• Thola ukuphumula okuningi ngemilenze yakho ephakanyisiwe. Lokhu kusiza umzimba wakho ukukhipha uketshezi. Kodwa-ke, umsebenzi olula njalo ngezikhathi ezithile ungcono kunokuphumula okuphelele kombhede, ngaphandle kokuthi udokotela wakho akutshele ngenye indlela.
• Phuza okungenani izingilazi eziyi-10 kuye kwezingu-12 (cishe amalitha ayi-1.5 kuya kwayi-2) ketshezi ngosuku (ikakhulukazi iziphuzo ezinama-electrolyte).
• Gwema utshwala noma iziphuzo ezine-caffeine (ezifana nama-colas noma ikhofi).
• Gwema ukuzivocavoca okukhulu nokuya ocansini. Le misebenzi ingadala ukungaphatheki kahle kwe-ovari futhi ingadala ukuthi ama-cysts ama-ovari aqhume noma avuze, noma kubangele ukuthi ama-ovari aguquke futhi anqume ukugeleza kwegazi (i-ovarian torsion).
• Thatha isidambisi sobuhlungu sasesitolo njenge-acetaminophen (Tylenol).

Kufanele uzilinganise usuku ngalunye ukuze uqiniseke ukuthi awufaki isisindo esiningi kakhulu (amakhilogremu amabili noma ngaphezulu noma cishe ikhilogremu elilodwa noma ngaphezulu ngosuku).

Uma umhlinzeki wakho ethola i-OHSS enamandla ngaphambi kokudlulisa imibungu ku-IVF, bangahle banqume ukukhansela ukudluliswa kombungu. Imibungu iqandisiwe futhi ilinda i-OHSS ukuthi ixazulule ngaphambi kokuhlela umjikelezo wokudluliswa kombungu ofriziwe.

Esimweni esingavamile lapho uba ne-OHSS enamandla, kuzodingeka ukuthi uye esibhedlela. Umhlinzeki uzokunikeza uketshezi ngomthambo (uketshezi olufakwa emithanjeni). Bazosusa noketshezi oluqoqwe emzimbeni wakho, futhi babheke isimo sakho.

Izimo eziningi ezimnene ze-OHSS zizozihambela zodwa ngemuva kokuqala ukuya esikhathini. Uma unesimo esibi kakhulu, kungathatha izinsuku ezimbalwa ukuthi izimpawu zithuthuke.

Uma ukhulelwa ngesikhathi se-OHSS, izimpawu zingase zibe zimbi kakhulu futhi kungathatha amasonto ukuthi zihambe.

Ezimweni ezingavamile, i-OHSS ingaholela ezinkingeni ezibulalayo. Lokhu kungafaka:

• Amahlule egazi
• Ukuhluleka kwezinso
• Ukungalingani okukhulu kwe-electrolyte
• Ukwanda oketshezi okukhulu esiswini noma esifubeni

Shayela umhlinzeki wakho uma uhlangabezana nalezi zimpawu ezilandelayo:

• Okukhipha umchamo omncane
• Isiyezi
• Ukwanda ngokweqile kwesisindo, ngaphezu kokhilogremu elilodwa ngosuku
• Isicanucanu esibi kakhulu (awukwazi ukugcina ukudla noma uketshezi phansi)
• Ubuhlungu obukhulu besisu
• Ukuphelelwa umoya

Uma uthola imijovo yemithi yokuzala, kuzodingeka uhlolwe njalo ngegazi kanye nama-ultrasound we-pelvic ukuze uqiniseke ukuthi ama-ovari akho awaphenduli ngokweqile.

I-OHSS

UCatherino WH. I-endocrinology yokuzala nokungazali. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier Saunders; 2020: isahluko 223.

I-Fauser BCJM. Izindlela zokwelashwa zokukhuthaza ama-ovari ngokungazali. Ku: Strauss JF, Barbieri RL, ama-eds.I-Endocrinology Yokuzala Yen & Jaffe. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 30.

Lobo RA. Ukungabi nenzalo: i-etiology, ukuhlolwa kokuxilongwa, ukuphathwa, ukubikezelwa. Ku: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. I-Gynecology ephelele. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 42.