Ukuhlolwa Kokuqhekeka Kwezingwengwezi Ngaphambi Kwesikhathi

-Delile

• Ziyini Izimpawu Zokuqhekeka Kwamalungu Ngaphambi Kwesikhathi?
• Ukuhlonza Ukuqhekeka Kwangaphambi Kwezimila
• Ukuhlolwa kwe-pH
• Ukuhlolwa kweNitrazine
• Ukushisa
• Olunye Uvivinyo
• Ingabe Zikhona Izinkinga ku-PROM?
• Kwenzekani Ngokulandelayo?
• Amaviki angama-37 nangaphezulu
• Isikhathi Esiseduze (amasonto angama-34 kuye kwangama-36)
• Ngaphambi kwesikhathi (Ngaphansi kwamaviki angama-34)
• Uyini Umbono?
• Ngingavimbela Kanjani i-PROM?

Ukuqhekeka kwangaphambi kwezimbambo: Kuyini?

Kwabesifazane abakhulelwe, ukuqhekeka ngaphambi kwesikhathi kwezingqamuzana (i-PROM) kwenzeka lapho isikhwama se-amniotic esizungeze ingane (ulwelwesi) siphuka ngaphambi kokuqala kokubeletha. Kuvame ukubizwa ngokuthi "lapho amanzi akho ephuka." Ukuqhekeka kolwelwesi okwenzeka ngaphambi kwesonto lama-37 lokukhulelwa kubizwa nge-preterm PROM (PPROM). I-PPROM ivela cishe kumaphesenti ama-3 okukhulelwa futhi idala cishe ingxenye eyodwa kwezintathu zokuzalwa kwangaphambi kokubeletha, ngokusho kwe-American Family Physician. Kwenzeka kaningi ekukhulelweni amawele.

Lapho ulwelwesi lwakho luqhekeka ekuqaleni, kuba kubi kakhulu kuwe nasenganeni yakho.

• Uma ukukhulelwa kwakho kudlule amasonto angama-37 futhi ulwelwesi lwakho ludabukile, ingane yakho isilungele ukuzalwa.
• Uma ukukhulelwa kwakho kungaphansi kwamasonto angama-37 futhi ulwelwesi lwakho ludabukile, umhlinzeki wakho wezokunakekelwa kwempilo kuzofanele anqume ukuthi uzobeletha ingane yakho ngokushesha noma uzame ukuqhubeka nokukhulelwa. Umhlinzeki wakho wezokunakekelwa kwempilo angakhetha ukuncelisa umsebenzi wakho kusenesikhathi ngenxa yengozi yokutheleleka enganeni yakho.

Abesifazane abathumela kungakapheli amahora angama-24 ngemuva kokuphuka kwabo mancane amathuba okuthi bathole ukutheleleka, ngakho-ke kubalulekile ukuya esibhedlela ngokushesha okukhulu ngemuva kokuqhekeka kwezinambuzane. Esibhedlela, izivivinyo ezilula zingaqinisekisa ukuthi ulwelwesi lwakho ludabukile.

Ziyini Izimpawu Zokuqhekeka Kwamalungu Ngaphambi Kwesikhathi?

Uphawu olukhulu lwe-PROM ukugeleza oketshezi esithweni sangasese. Uketshezi lungaconsa kancane noma lungaphuma. Abesifazane kwesinye isikhathi benza iphutha kuketshezi kube umchamo.

Uma ubona uketshezi oluvuzayo, sebenzisa iphedi noma iphepha ukumunca olunye uketshezi. Yibuke bese uyinuka. Amniotic fluid akufanele anuke njengomchamo futhi imvamisa awunawo umbala.

Ezinye izimpawu zingafaka:

• umuzwa wokuthi awukwazi ukuyeka ukuchama
• ukukhishwa kwesitho sangasese sowesifazane noma ubumanzi obungaphezu kokujwayelekile
• ukuphuma kwegazi esithweni sangasese
• ingcindezi okhalo

Uma ucabanga ukuthi ulwelwesi lwakho ludabukile, shayela umhlinzeki wakho wokunakekelwa kwezempilo ngokushesha.

Ukuhlonza Ukuqhekeka Kwangaphambi Kwezimila

Uma usola ukuthi amanzi akho aphukile futhi kukhona uketshezi oluvuzayo esithweni sangasese, umhlinzeki wakho wezokunakekelwa kwempilo uzodinga ukuqinisekisa ukuthi ulwelwesi seludabukile ngempela.

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuhlola futhi abone uketshezi oluvela esithweni sangasese. Bazobe sebe-oda izivivinyo zokusiza ukuqinisekisa i-PROM noma i-PPROM. Ukuhlolwa kwe-PROM kufaka phakathi ukuhlaziya uketshezi lwesitho sangasese sowesifazane ukuthola ukuthi kukhona yini i-amniotic fluid. Njengoba uketshezi lungangcoliswa yigazi noma okunye uketshezi, lezi zivivinyo zibheka izinto noma izici ezithile ezivame ukutholakala ku-amniotic fluid. Umhlinzeki wakho wokunakekelwa kwezempilo uzoqoqa uketshezi oluthile esithweni sangasese esebenzisa ithuluzi lezokwelapha elibizwa ngokuthi i-speculum ukuze enze iningi lalezi zivivinyo. Bazofaka i-speculum esithweni sangasese bese besabalalisa ngobumnene izindonga zangasese. Lokhu kubenza bakwazi ukuhlola ingaphakathi lesitho sangasese kanye nokuqoqa uketshezi ngqo kusuka esithweni sangasese.

Ukuhlolwa kwe-pH

Lokhu kuhlolwa kuhilela ukuhlola i-pH yesampula loketshezi lwesitho sangasese sowesifazane. I-pH ejwayelekile yesitho sangasese sowesifazane iphakathi kuka-4.5 no-6.0. I-Amniotic fluid ine-pH ephezulu ka-7.1 kuye ku-7.3. Ngakho-ke, uma ulwelwesi ludabukile, i-pH yesampula loketshezi lwesitho sangasese sowesifazane izobe iphakeme kunokujwayelekile.

Ukuhlolwa kweNitrazine

Lokhu kuhlolwa kufaka ukufaka ithonsi loketshezi elitholwe esithweni sangasese emapheshaneni ephepha aqukethe udayi weNitrazine. Imichilo ishintsha umbala kuye nge-pH yoketshezi. Imichilo iyoba luhlaza okwesibhakabhaka uma i-pH inkulu kuno-6.0. Umugqa oluhlaza okwesibhakabhaka usho ukuthi kungenzeka ukuthi ulwelwesi luqhume.

Lokhu kuhlolwa, noma kunjalo, kungaveza okuhle okungelona iqiniso. Uma igazi lingena kusampula noma uma kukhona ukutheleleka okukhona, i-pH yetshezi lesitho sangasese sangasese ingaba phezulu kunokujwayelekile. Isidoda naso sine-pH ephezulu, ngakho-ke ukuya ocansini kwangasese kungaveza ukufundwa okungelona iqiniso.

Ukushisa

Uma amanzi akho ephukile, uketshezi oluhlanganiswe ne-estrogen luzodala iphethini "efana ne-fern" ngaphansi kwesibonakhulu ngenxa ye-salt crystallization. Amaconsi ambalwa oketshezi azobekwa kwisilayidi semakhroskophu futhi abhekwe ngaphansi kwesibonakhulu.

Olunye Uvivinyo

Ezinye izivivinyo zokuthola i-PROM zifaka:

• Ukuhlolwa kwedayi: Ukujova udayi esikhwameni se-amniotic ngesisu. Uma ulwelwesi ludabukile, uketshezi olunemibala luzotholakala esithweni sangasese kungakapheli imizuzu engama-30.
• Ukuhlolwa okulinganisa amazinga wamakhemikhali aziwa ukuthi akhona ku-amniotic fluid kepha hhayi kuketshezi lwesitho sangasese sowesifazane. Lokhu kufaka phakathi i-prolactin, i-alpha-fetoprotein, i-glucose, ne-diamine oxidase. Izinga eliphakeme lalezi zinto lisho ukuthi ulwelwesi luphukile.
• Ukuhlolwa okusha okungenakuhlasela njengokuhlolwa kwe-AmniSure ROM kusuka ku-QIAGEN Sciences. Lokhu kuhlolwa akudingi ukuhlolwa kwe-speculum. Isebenza ngokuthola i-placenta alpha microglobulin-1 biomarker ku-amniotic fluid.

Lapho i-PROM isiqinisekisiwe, kungenzeka kwenziwe ezinye izivivinyo zokuhlola okulandelayo ukuhlola okulandelayo:

• ukutholakala kokutheleleka ngokuhlola i-amniotic fluid
• izinga lokukhula kwamaphaphu embungu, ukuthola ukuthi amaphaphu engane avuthwe ngokwanele yini ukusebenza ngaphandle kwesibeletho
• isimo nempilo yombungu, kufaka phakathi ukulalela ukushaya kwenhliziyo kwengane

Uma usesikhathini (ngaphezu kwamaviki angama-37 ukhulelwe), ungangena emsebenzini ngokwemvelo noma umhlinzeki wakho wezokunakekelwa kwempilo angenza abasebenzi basize ukunciphisa ingozi yokutheleleka.

Uma umhlinzeki wakho wezokunakekelwa kwezempilo enquma ukubambezela ukulethwa, kufanele aqhubeke nokuqapha wena nengane yakho ukuze aqiniseke ukuthi lesi sinqumo sihlala siyindlela engcono kakhulu yokwenza. Uma izinga lokushaya kwenhliziyo yengane lehla, ukulethwa ngokushesha kubalulekile.

Ingabe Zikhona Izinkinga ku-PROM?

Ingozi enkulu ye-PROM ukutheleleka. Uma isibeletho sitheleleka (i-chorioamnionitis), ingane kufanele ibelethe ngokushesha. Ukutheleleka kungadala izinkinga ezinkulu enganeni.

Nge-preterm PROM, ingozi enkulu ukulethwa ngaphambi kwesikhathi, okwandisa ubungozi bezinkinga ezinganeni. Lezi zinkinga zifaka:

• ukukhubazeka ekufundeni
• izinkinga zezinzwa
• isifo sokuphefumula

Enye inkinga ebucayi ukucindezelwa kwentambo. Ngaphandle kwe-amniotic fluid, umbilical cord usengozini yokulimala. Intambo yenkaba iletha umoya-mpilo nezakhamzimba enganeni futhi imvamisa ivikelwa yi-amniotic fluid. Uma kuphuma uketshezi, inkaba ingacindezelwa phakathi kwengane nesibeletho noma kokunye, iphume ngaphandle kwesibeletho iye esithweni sangasese. Lokhu kungaholela ekulimaleni kanzima ebuchosheni ngisho nasekufeni.

I-Preterm PROM ngaphambi kwesonto lama-24 ayivamile. Kodwa-ke, kuvame ukuholela ekufeni kombungu ngoba amaphaphu engane awakwazi ukukhula kahle. Uma ingane isinda, bayoba nezinkinga zesikhathi eside, kufaka phakathi:

• isifo samaphaphu esingelapheki
• Izinkinga zentuthuko
• i-hydrocephalus
• ukukhubazeka kobuchopho

Kwenzekani Ngokulandelayo?

Okwenzekayo ngokulandelayo kuncike esigabeni sokukhulelwa kwakho.

Amaviki angama-37 nangaphezulu

Umhlinzeki wakho wokunakekelwa kwezempilo uzoqhubeka nokuletha ingane yakho. Umsebenzi ungahle uzenzele ngokwawo (ngokuzenzekelayo) noma umhlinzeki wakho wezokunakekelwa kwempilo angenza ukuthi abasebenzi basebenzise imishanguzo ethile.

Isikhathi Esiseduze (amasonto angama-34 kuye kwangama-36)

Umhlinzeki wakho wokunakekelwa kwezempilo uzoqhubeka nokuletha ingane uma isibhedlela sinokunakekelwa kwezinsana ezisanda kuzalwa. Ngokusho kweSanford Health, izingxenye ezimbili kwezinhlanu zabesifazane kulesi sigaba zizobeletha ingane kungakapheli isonto. Abaningi bazoletha kungakapheli amahora angama-48.

Ngaphambi kwesikhathi (Ngaphansi kwamaviki angama-34)

Ngaphandle kokuthi amaphaphu engane avuthwe ngokuphelele, umhlinzeki wezokunakekelwa kwezempilo uzofuna ukulinda ukubanga ukubeletha. Uzokhuluma ngesimo sakho nobungozi nezinketho zokwelashwa ongazithola wena nengane yakho.

Imithi ingafaka:

• ama-antibiotic ukuvikela izifo
• imijovo ye-steroid ukusheshisa ukukhula kwamaphaphu engane
• imishanguzo yokuvimbela ukusikwa

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuqapha futhi abheke wena nengane yakho ngama-ultrasound avamile futhi ahlole izifo. Kungadingeka ukuthi uhlale embhedeni ngalesi sikhathi.

Uyini Umbono?

Umbono uncike esigabeni sokukhulelwa kwakho. Izingane ezizalwe kusenesikhathi zisengozini enkulu yokuba nezinkinga. Ngaphandle kwemizamo yokwelula ukukhulelwa ngemuva kwe-PPROM, abesifazane abaningi bazobeletha kungakapheli isonto elilodwa. Imiphumela ye-PPROM ekufeni kwengane ngamaphesenti ama-1 kuya kwamabili wamacala, ngokusho kwe-American Family Physician.

Ngingavimbela Kanjani i-PROM?

Awukwazi njalo ukuvimbela i-PROM, kepha izinguquko ezithile zendlela yokuphila zinganciphisa ubungozi bakho. Umlando wezifo ezithathelwana ngocansi nokubhema ngesikhathi sokukhulelwa kungandisa ingozi yokuba ne-PROM (ukubhema kufanele kugwenywe).

Khuluma nomhlinzeki wakho wezokunakekelwa kwezempilo uma uthatha imishanguzo ye-steroid. Bangancoma ukuthi uyeke ukuwaphuza uma kungadingekile ngokuphelele ekwelapheni enye inkinga

Ukuzivocavoca ngesikhathi sokukhulelwa kulungile, kepha kufanele ukhulume nomhlinzeki wakho wezokunakekelwa kwezempilo mayelana nezinga lomsebenzi womzimba ongawenza ngokuphepha ngesikhathi sokukhulelwa kwakho. Umsebenzi okhandlayo womzimba nawo ungadala i-PROM.