Ohss

ʻO ka maʻi hyperstimulation ovarian ka pane nui loa i nā hormones nui. Hana pinepine ʻia i nā wāhine e lawe ana i nā lāʻau hormone injectable e hoʻoulu i ka ulu ʻana o nā hua i loko o nā ovaries. Hoʻopilikia ka maʻi hyperstimulation ovarian (OHSS) i nā ovaries e pehu a ʻeha.

Hiki ke loaʻa ka maʻi hyperstimulation ovarian (OHSS) i nā wāhine e hele nei i ka fertilization in vitro (IVF) a i ʻole ka hoʻoulu ʻana i ka ovulation me nā lāʻau injectable. ʻAʻole pinepine, hana ʻia ka OHSS i ka wā o nā mālama hānau keiki e hoʻohana ana i nā lāʻau āu e lawe ai ma ka waha, e like me ka clomiphene.

Hilinaʻi ka mālama ʻana i ka nui o ka maʻi. Hiki ke hoʻomaikaʻi maoli ka OHSS i nā hihia māmā, ʻoiai nā hihia koʻikoʻi e pono ai ka hoʻokipa ʻana i ka haukapila a me ka mālama hou aku.

Hoʻomaka pinepine nā hōʻailona o ka maʻi ovarian hyperstimulation syndrome i loko o hoʻokahi pule ma hope o ka hoʻohana ʻana i nā lāʻau lapaʻau injectable e hoʻoulu ai i ka ovulation, ʻoiai i kekahi manawa he ʻelua pule a ʻoi aku paha ka lōʻihi o ka ʻike ʻia ʻana o nā hōʻailona. Hiki i nā hōʻailona ke ʻano mai ka māmā a i ka nui a hiki ke ʻoi aku ka nui a i ʻole ka emi ʻana ma muli o ka manawa.

Inā ke loaʻa nei iā ʻoe nā lāʻau lapaʻau hānau keiki a loaʻa iā ʻoe nā hōʻailona o ka maʻi ovarian hyperstimulation syndrome, e haʻi aku i kāu mea lawelawe ola. ʻOiai inā he māmā kāu hihia o ka OHSS, makemake kāu mea lawelawe e nānā iā ʻoe no ka hoʻonui koke ʻana o ke kaumaha a i ʻole ka ʻino o nā hōʻailona.

E kelepona koke aku i kāu mea lawelawe inā loaʻa iā ʻoe nā pilikia hanu a i ʻole ka ʻeha i kou mau wāwae i ka wā o kāu lāʻau lapaʻau hānau keiki. Hiki paha kēia ke hōʻike i kahi kūlana wikiwiki e pono ai ka mālama ola kino koke.

ʻAʻole maopopo loa ke kumu o ka maʻi ovarian hyperstimulation syndrome. He kuleana ko ka nui o ka human chorionic gonadotropin (HCG) - ka hormone maʻamau i hana ʻia i ka wā hāpai - i hoʻokomo ʻia i loko o kou kino. Hoʻololi nā kīʻaha koko ovarian i ka human chorionic gonadotropin (HCG) a hoʻomaka e kahe ka wai. Hoʻonui kēia wai i nā ovaries, a i kekahi manawa nui ka nui e neʻe aku i loko o ka ʻōpū.

I ka wā o nā lāʻau lapaʻau hānau keiki, hiki ke hāʻawi ʻia ka HCG ma ke ʻano he "trigger" i mea e hoʻokuʻu ai ka follicle makua i kāna hua. Hana pinepine ʻia ka OHSS i loko o hoʻokahi pule ma hope o kou loaʻa ʻana i ka inikini HCG. Inā hāpai ʻoe i ka wā o ka lāʻau lapaʻau, hiki ke ʻino aku ka OHSS i ka wā e hoʻomaka ai kou kino e hana i kāna HCG ponoʻī ma muli o ka hāpai keiki.

ʻOi aku ka nui o nā lāʻau lapaʻau hānau keiki inikini e hoʻokumu i ka OHSS ma mua o ka lāʻau lapaʻau me ka clomiphene, kahi lāʻau lapaʻau i hāʻawi ʻia ma ke ʻano he papa e inu ʻoe ma ka waha. I kekahi manawa, hana kūʻokoʻa ka OHSS, ʻaʻole pili i nā lāʻau lapaʻau hānau keiki.

I kekahi manawa, hiki mai ka OHSS i nā wāhine ʻaʻohe kumu pilikia. Akā, ʻo nā kumu i ʻike ʻia e hoʻonui i kou pilikia o ka OHSS, ʻo ia hoʻi:

• Polycystic ovary syndrome — kahi maʻi hanau maʻamau e hoʻokumu ai i nā manawa ʻole o ka menstruation, ka ulu nui ʻana o ka lauoho a me ka hiʻohiʻona kūpono ʻole o nā ovaries ma ka nānā ultrasound
• Nui nā follicle
• ʻO ka makahiki ma lalo o 35
• Kaumaha kino haʻahaʻa
• Kiʻekiʻe a piʻi wikiwiki paha ke kiʻekiʻe o ka estradiol (estrogen) ma mua o ka pana HCG
• Nā hanana OHSS ma mua

He mea maʻamau ʻole ka maʻi ovarian hyperstimulation syndrome koʻikoʻi, akā hiki ke weliweli i ke ola. Hiki i nā pilikia ke komo pū me:

• Ka hōʻiliʻili wai i loko o ka ʻōpū a i kekahi manawa i ka umauma
• Nā pilikia electrolyte (sodium, potassium, a me nā mea ʻē aʻe)
• Nā ʻāpana koko i nā kīʻaha nui, maʻamau ma nā wāwae
• Ka hāʻule ʻana o ka puʻupaʻa
• Ka wili ʻana o ka ovary (ovarian torsion)
• Ka haki ʻana o ka cyst i loko o ka ovary, kahi e alakaʻi ai i ke kahe koko nui
• Nā pilikia hanu
• Ka nalowale ʻana o ka hapai keiki mai ka miscarriage a i ʻole ka hoʻopau ʻana ma muli o nā pilikia
• I nā manawa kakaikahi, ka make

No ka ho'emi 'ana i kou mau manawa e loa'a ai ka ovarian hyperstimulation syndrome, pono 'oe i kahi papahana kūikawā no kāu mau lā'au fertility. E kali i kāu mea mālama ola e nānā pono i kēlā me kēia pō'ai mālama, me nā ultrasound pinepine e nānā i ka ho'omohala 'ana o nā follicles a me nā ho'okolohua koko e nānā i kāu mau pae hormone. Nā 'ano hana e kōkua ai i ka pale 'ana i ka OHSS:

• Ho'oponopono 'ana i ka lā'au lapa'au. Ho'ohana kāu mea lawelawe i ka nui ha'aha'a loa o nā gonadotropins e ho'oulu i kou mau ovaries a ho'oulu i ka ovulation.
• Ho'opili 'ana i ka lā'au lapa'au. Me he mea lā ke emi iho nei ka pilikia o ka OHSS me kekahi mau lā'au lapa'au me ka ho'opilikia 'ole i ka manawa o ka hāpai keiki. Loa'a kēia i ka aspirin ha'aha'a; nā agonists dopamine e like me ka carbergoline a i 'ole ka quinogloide; a me nā infusions calcium. Hiki i ka hā'awi 'ana i nā wāhine i loa'a ka polycystic ovary syndrome i ka lā'au lapa'au metformin (Glumetza) i ka wā o ka ho'oulu 'ana o ka ovarian ke kōkua i ka pale 'ana i ka hyperstimulation.
• Coasting. Inā ki'eki'e kou pae estrogen a i 'ole he nui kāu mau follicles i ho'omohala 'ia, hiki i kāu mea lawelawe ke ho'ōki i nā lā'au lapa'au injectable a kali i kekahi mau lā ma mua o ka hā'awi 'ana i ka HCG, ka mea e ho'oulu ai i ka ovulation. Ua'ike 'ia kēia he coasting.
• Pale 'ana i ka ho'ohana 'ana i kahi pana HCG trigger. No ka mea, pinepine ka OHSS e ulu ana ma hope o ka hā'awi 'ia 'ana o kahi pana HCG trigger, ua ho'omohala 'ia nā mea'ē a'e ma mua o ka HCG no ka ho'oulu 'ana me ka ho'ohana 'ana i nā agonists gonadotropin-releasing hormone (Gn-RH), e like me ka leuprolide (Lupron), ma ke 'ano he ala e pale ai a i 'ole e kaupalena ai i ka OHSS.
• Ho'opa'a 'ana i nā embryos. Inā 'oe e hele nei i ka in vitro fertilization (IVF), hiki ke wehe 'ia nā follicles a pau (makua a me nā'ōpiopio) mai kou mau ovaries e ho'emi i ka manawa o ka OHSS. Ho'omake 'ia nā follicles makua a ho'opa'a 'ia, a ua'ae 'ia kou mau ovaries e ho'omaha. Hiki iā 'oe ke ho'omaka hou i ke ka'ina hana IVF ma hope, i ka wā mākaukau kou kino.

Hōʻike ʻia paha ka maʻi o ka ovarian hyperstimulation syndrome ma:

• Ka nānā kino. E ʻimi kāu mea lawelawe ola i ka hoʻonui ʻana o ke kaumaha, ka hoʻonui ʻana o ka nui o kou pūhaka a me ka ʻeha ʻōpū paha āu e loaʻa nei.
• Ka ultrasound. Inā loaʻa iā ʻoe ka maʻi ovarian hyperstimulation syndrome (OHSS), hiki i ka ultrasound ke hōʻike i ka nui o kou mau ovaries ma mua o ka maʻamau, me nā cysts wai nui kahi i ulu ai nā follicles. I ka wā o ka mālama ʻana me nā lāʻau momona, e loiloi mau kāu mea lawelawe ola i kou mau ovaries me ka ultrasound vaginal.
• Ka hoʻokolohua koko. Hiki i kekahi mau hoʻokolohua koko ke hōʻoia i kāu mea lawelawe ola i nā mea kūpono ʻole i loko o kou koko a inā e hoʻopōʻino ʻia kāu hana o ka puʻupaʻa ma muli o ka OHSS.

Hoʻoponopono maʻamau ka maʻi hyperstimulation ovarian ma kona iho i loko o hoʻokahi pule a ʻelua paha, a i ʻole lōʻihi iki inā hāpai ʻoe. Hoʻolālā ʻia ka mālama ʻana e mālama i kou ʻoluʻolu, e hoʻemi i ka hana ovarian a pale aku i nā pilikia.

Hoʻoponopono maʻamau ka OHSS māmā ma kona iho. Hiki i ka mālama ʻana no ka OHSS waena ke komo pū me:

Me ka OHSS koʻikoʻi, pono paha ʻoe e komo i ka haukapila no ka nānā ʻana a me ka mālama ikaika, me nā wai IV. Hiki i kāu mea hoʻolako ke hāʻawi iā ʻoe i ka lāʻau lapaʻau i kapa ʻia ʻo cabergoline e hoʻemi i kou mau hōʻailona. I kekahi manawa, hiki i kāu mea hoʻolako ke hāʻawi pū iā ʻoe i nā lāʻau lapaʻau ʻē aʻe, e like me ka gonadotropin-releasing hormone (Gn-RH) antagonist a i ʻole letrozole (Femara) — e kōkua i ka hoʻopau ʻana i ka hana ovarian.

Hiki i nā pilikia koʻikoʻi ke koi i nā mālama hou aku, e like me ka ʻoki kino no ka cyst ovarian i haki a i ʻole ka mālama koʻikoʻi no nā pilikia ate a me nā māmā. Pono paha ʻoe i nā lāʻau anticoagulant e hoʻemi i ka pilikia o nā clots koko i kou mau wāwae.

• Hoʻonui i ka inu wai
• Nānā kino pinepine a me nā ultrasounds
• Kaupaona i kēlā me kēia lā a me nā ana ʻana o ka pūhaka e nānā i nā loli nui
• Ana ʻana i ka nui o ka mimi āu e hana ai i kēlā me kēia lā
• Nānā koko e nānā i ka nele wai, ka mahele ʻole o ka electrolyte a me nā pilikia ʻē aʻe
• Hoʻokahe ʻana i ka wai ʻōpū nui me ka nila i hoʻokomo ʻia i loko o kou ʻōpū
• Nā lāʻau lapaʻau e pale aku i nā clots koko (anticoagulants)

Inā loaʻa iā ʻoe ka maʻi ovarian hyperstimulation syndrome māmā, e hiki paha iā ʻoe ke hoʻomau i kāu mau hana maʻamau i kēlā me kēia lā. E hahai i ka ʻōlelo a kāu mea lawelawe, ʻo ia paha e komo pū me kēia mau ʻōlelo aʻo:

• E ho'āʻo i kahi lāʻau ʻeha maʻamau e like me ka acetaminophen (Tylenol, a me nā mea ʻē aʻe) no ka ʻeha ʻōpū, akā e pale i ka ibuprofen (Advil, Motrin IB, a me nā mea ʻē aʻe) a i ʻole ka naproxen sodium (Aleve, a me nā mea ʻē aʻe) inā ua hana ʻoe i kahi hoʻoili embryo i ka manawa koke, no ka mea, hiki i kēia mau lāʻau ke hoʻopilikia i ka hoʻokomo ʻana o ka embryo.
• E pale i ka moe kolohe, no ka mea, hiki ke ʻeha a hiki ke hoʻopuka i kahi cyst i loko o kāu ovary.
• E mālama i kahi pae hana kino māmā, e pale ana i nā hana ikaika a i ʻole nā ​​​​hana hopena kiʻekiʻe.
• E kaupaona iā ʻoe iho ma ka unahi hoʻokahi a me ke ana ʻana a puni kou ʻōpū i kēlā me kēia lā, e hōʻike ana i nā hoʻonui maʻamau i kāu mea lawelawe.
• E kāhea i kāu mea lawelawe inā ʻoi aku ka nui o kāu mau hōʻailona a me nā hōʻailona.