Izinkinga Zokukhulelwa: I-Placenta Accreta

-Delile

• Ziyini Izimpawu zePlacenta Accreta?
• Ziyini Izimbangela?
• Itholakala Kanjani?
• Ngubani Osengozini?
• Iphathwa Kanjani I-Placenta Accreta?
• Ziyini Izinkinga?
• Uyini Umbono?
• Ingabe i-Placenta Accreta ingavinjelwa?

Kuyini i-Placenta Accreta?

Ngesikhathi sokukhulelwa, i-placenta yowesifazane inamathela odongeni lwayo lwesibeletho futhi iyanamathela ngemuva kokubeletha. I-Placenta accreta iyinkinga enkulu yokukhulelwa engenzeka lapho i-placenta izinamathela kakhulu odongeni lwesibeletho.

Lokhu kubangela ukuthi ingxenye noma yonke i-placenta ihlale ixhumeke ngokuqinile esibelethweni ngesikhathi sokubeletha. I-Placenta accreta ingadala ukopha okukhulu ngemuva kokubeletha.

Ngokusho kwe-American Congress of Obstetricians and Gynecologists (ACOG), owesifazane oyedwa kwabangu-533 baseMelika uba ne-placenta accreta unyaka nonyaka. Kwezinye izimo ze-placenta accreta, i-placenta yowesifazane izonamathisela ngokujulile odongeni lwesibeletho olunamathela emisipheni yesibeletho. Lokhu kubizwa ngokuthi yi-placenta increta. Kungangena ngokujule kakhulu odongeni lwesibeletho futhi kungene kwesinye isitho, njengesinye. Lokhu kubizwa ngokuthi yi-placenta percreta.

I-American Pregnancy Association, ilinganisela ukuthi kwabesifazane abathola i-placenta acreta, cishe amaphesenti ayi-15 ahlangabezana ne-placenta increta, kuyilapho cishe amaphesenti amahlanu ezwa i-placenta percreta.

I-Placenta accreta ibhekwa njengenkinga yokukhulelwa engasongela impilo. Kwesinye isikhathi kutholakala i-placenta accreta ngesikhathi sokubeletha. Kodwa ezimweni eziningi, abesifazane batholakala ngesikhathi sokukhulelwa. Odokotela bavame ukwenza ukulethwa kwasekuseni ngaphambi kwesikhathi bese besusa isibeletho sowesifazane, uma kutholakala inkinga ngaphambi kokubeletha. Ukususwa kwesibeletho kubizwa ngokuthi yi-hysterectomy.

Ziyini Izimpawu zePlacenta Accreta?

Abesifazane abane-placenta accreta imvamisa ababonisi zimpawu noma izimpawu ngesikhathi sokukhulelwa. Kwesinye isikhathi udokotela uzokuthola ngesikhathi se-ultrasound ejwayelekile.

Kepha kwezinye izimo, i-placenta accreta ibangela ukuphuma kwegazi esithweni sangasese phakathi ne-trimester yesithathu (amasonto 27 kuya ku-40). Xhumana nodokotela wakho khona manjalo uma uthola ukopha kwesitho sangasese sowesifazane ngesikhathi senyanga yakho yesithathu. Uma uhlangabezana nokopha okukhulu, njengokuphuma kwegazi okungena ngephedi ngaphansi kwemizuzu engama-45, noma lokho kusinda futhi kuhambisana nobuhlungu besisu, kufanele ushayele u-911.

Ziyini Izimbangela?

Akwaziwa kahle ukuthi yini ebangela i-placenta accreta. Kodwa odokotela bacabanga ukuthi kuxhunyaniswa nokungahleleki okukhona kulayini wesibeletho namazinga aphezulu e-alpha-fetoprotein, iphrotheni ekhiqizwa yingane engatholwa egazini likanina.

Lokhu okungahambi kahle kungahle kube nomphumela wesibazi ngemuva kokubeletha ngokuhlinzwa noma ukuhlinzwa kwesibeletho. Lezi zibazi zivumela ukuthi i-placenta ikhule ijule kakhulu odongeni lwesibeletho. Abesifazane abakhulelwe abane-placenta emboza ingxenye yomlomo wesibeletho (i-placenta previa) futhi basengozini enkulu ye-placenta accreta. Kodwa kwezinye izimo, i-placenta accreta ivela kwabesifazane ngaphandle komlando wokuhlinzwa kwesibeletho noma i-placenta previa.

Ukulethwa ngokuhlinzwa kuye kwandisa ubungozi besifazane be-placenta accreta ngesikhathi sokukhulelwa okuzayo. Ukulethwa kowesifazane ngokuhlinzwa okuningi, kuba nkulu ubungozi bakhe. I-American Pregnancy Association ilinganisela ukuthi abesifazane asebeke bathola okungaphezu kokukodwa ukulethwa kwe-akhawunti ngamaphesenti angama-60 awo wonke amacala we-placenta accreta.

Itholakala Kanjani?

Odokotela kwesinye isikhathi bahlola i-placenta accreta ngesikhathi sokuhlolwa kwe-ultrasound ejwayelekile. Kodwa-ke, udokotela wakho uvame ukuqhuba izivivinyo eziningana ukuqinisekisa ukuthi i-placenta ayikhuli odongeni lwesibeletho uma unezici eziningana zobungozi be-placenta accreta. Ezinye izivivinyo ezijwayelekile zokubheka i-placenta accreta zifaka phakathi ukuhlolwa kwe-imaging, njenge-ultrasound noma i-magnetic resonance imaging (MRI) nokuhlolwa kwegazi ukuhlola amazinga aphezulu we-alpha-fetoprotein.

Ngubani Osengozini?

Izici eziningana kucatshangwa ukuthi zandisa ubungozi besifazane bokuthola i-placenta accreta. Lokhu kufaka phakathi:

• ukuhlinzwa kwesibeletho okudlule (noma ukuhlinzwa), njengokulethwa ngokuhlinzwa noma ukuhlinzwa ukususa ama-uterine fibroids
• i-placenta previa, isimo esidala ukuthi i-placenta imboze umlomo wesibeletho ngokwengxenye noma ngokugcwele
• i-placenta etholakala engxenyeni engezansi yesibeletho
• ukuba ngaphezu kweminyaka engama-35
• ukubeletha okwedlule
• ukungahleleki kwesibeletho, okufana nokubola noma i-uterine fibroids

Iphathwa Kanjani I-Placenta Accreta?

Zonke izimo ze-placenta accreta zihlukile. Uma udokotela wakho ethole i-placenta accreta, bazokwakha uhlelo lokuqinisekisa ukuthi ingane yakho ibeletha ngokuphepha ngangokunokwenzeka.

Izimo ezinzima ze-placenta accreta ziphathwa ngokuhlinzwa. Okokuqala, odokotela bazokwenza ukulethwa kwe-cearean ukuletha ingane yakho. Okulandelayo, bangenza i-hysterectomy, noma basuse isibeletho sakho. Lokhu kwenzelwa ukuvimbela ukulahleka kwegazi okungathi sína okungenzeka uma ingxenye, noma konke, kwe-placenta kusale kunamathiselwe esibelethweni ngemuva kokubeletha kwengane yakho.

Uma ungathanda ikhono lokukhulelwa futhi, kunendlela yokwelashwa ngemuva kokubeletha okungagcina ukuzala kwakho. Kuyindlela yokuhlinza eshiya iningi le-placenta esibelethweni. Kodwa-ke, abesifazane abathola le mpatho basengozini enkulu yezinkinga. Udokotela wakho angancoma i-hysterectomy uma uqhubeka nokuzwa ukopha kwesitho sangasese sowesifazane ngemuva kwenqubo. Ngokusho kwe-ACOG, kunzima kakhulu ukukhulelwa ngemuva kwale nqubo.

Xoxa nodokotela wakho ngazo zonke izindlela zokwelashwa. Zizokusiza ukhethe ukwelashwa okuya ngezimo zakho.

Ziyini Izinkinga?

I-Placenta accreta ingadala izinkinga ezinkulu. Lokhu kufaka phakathi:

• ukopha okukhulu kwesitho sangasese sowesifazane, okungadinga ukumpontshelwa igazi
• izinkinga zokuqina kwegazi, noma ukusatshalaliswa kwe-coagulopathy ye-intravascular
• ukwehluleka kwamaphaphu, noma isifo sabantu abadala sokuphefumula
• ukwehluleka kwezinso
• ukuzalwa ngaphambi kwesikhathi

Njengakho konke ukuhlinzwa, ukwenza ukulethwa kwe-cearean kanye ne-hysterectomy ukususa i-placenta emzimbeni kungadala izinkinga. Izingozi kumama zifaka:

• ukusabela ku-anesthesia
• amahlule egazi
• izifo zesilonda
• ukwanda kwegazi
• ukulimala okuhlinzwa
• ukulimala kwezinye izitho, njengesinye, uma i-placenta inamathele kuzo

Izingozi ezinganeni ngesikhathi sokubeletha okungajwayelekile azivamile futhi zifaka phakathi ukulimala kokuhlinzwa noma izinkinga zokuphefumula.

Kwesinye isikhathi odokotela bazoshiya i-placenta iqinile emzimbeni wakho, ngoba ingancibilika ngokuhamba kwesikhathi. Kodwa ukwenza kanjalo kungadala izinkinga ezinkulu. Lokhu kungafaka:

• ukuphuma kwegazi esithweni sangasese esongela impilo
• izifo
• ihlule legazi elivimba imithambo eyodwa noma ngaphezulu emaphashini, noma embolism yamaphaphu
• isidingo se-hysterectomy yesikhathi esizayo
• izinkinga zokukhulelwa esikhathini esizayo, kufaka phakathi ukukhulelwa kwesisu, ukuzalwa ngaphambi kwesikhathi, kanye ne-placenta accreta

Uyini Umbono?

Uma i-placenta accreta itholakala futhi yelashwa kahle, abesifazane bavame ukubuyiselwa ngokugcwele ngaphandle kwezinkinga ezihlala njalo.

Owesifazane ngeke esakwazi ukukhulelwa izingane uma kwenziwa i-hysterectomy. Kufanele uxoxe ngakho konke ukukhulelwa okuzayo nodokotela wakho uma isibeletho sakho sishiywe singekho ngemuva kokwelashwa. Ucwaningo olushicilelwe ephephabhukwini i-Human Reproduction lukhombisa ukuthi izinga lokuphindeka kwe-placenta accreta liphezulu kwabesifazane abake baba nalesi simo phambilini.

Ingabe i-Placenta Accreta ingavinjelwa?

Ayikho indlela yokuvimbela i-placenta accreta. Udokotela wakho uzoqapha ukukhulelwa kwakho eduze ukuvimbela noma yiziphi izinkinga uma uthola ukuthi unalesi simo.