Wehe Placenta

ʻO ka hemo ʻana o ka placenta (abruptio placentae) he pilikia koʻikoʻi ʻaʻole pinepine i ka hāpai keiki. Ke ulu nei ka placenta i loko o ka ʻōpū i ka wā hāpai. Hoʻopili ʻia ia i ka paia o ka ʻōpū a hoʻolako i ke keiki me nā meaʻai a me ka oxygen.

Hana ʻia ka hemo ʻana o ka placenta i ka wā e hoʻokaʻawale ai ka placenta ma ka hapa a i ʻole ka holoʻokoʻa mai ka paia o loko o ka ʻōpū ma mua o ka hānau ʻana. Hiki i kēia ke hoʻemi a i ʻole ke kāohi i ka lako oxygen a me nā meaʻai o ke keiki a hoʻokumu i ka nui o ke koko i ka makuahine.

Hiki pinepine loa ke hemo ʻana o ka pūpū ma ka hapa hope loa o ka hāpai ʻana, ʻoi aku hoʻi i nā pule hope loa ma mua o ka hānau ʻana. ʻO nā hōʻailona a me nā ʻōuli o ka hemo ʻana o ka pūpū, ʻo ia hoʻi:

• Ke kahe koko mai ka pepeiao wahine, ʻoiai ʻaʻole paha he kahe
• ʻEha ʻōpū
• ʻEha kua
• ʻEha a paʻakikī paha ka ʻōpū
• Nā ʻeha ʻōpū, e hele mai pinepine ana kekahi ma hope o kekahi

Hoʻomaka pinepine ka ʻeha ʻōpū a me ka ʻeha kua me ka wikiwiki. Hiki ke ʻokoʻa loa ka nui o ke kahe koko mai ka pepeiao wahine, a ʻaʻole ia e hōʻike pono i ka nui o ka pūpū i hemo mai ka ʻōpū. Hiki i ke koko ke komo i loko o ka ʻōpū, no laila ʻoiai me ka hemo nui ʻana o ka pūpū, ʻaʻole paha e ʻike ʻia ke kahe koko.

I kekahi mau hihia, ulu mālie ka hemo ʻana o ka pūpū (hemo mālie), kahi e hiki ai ke hana i kahe māmā, intermittent mai ka pepeiao wahine. ʻAʻole paha e ulu wikiwiki kāu pēpē e like me ka manaʻo, a loaʻa paha iā ʻoe ka wai amniotic haʻahaʻa a i ʻole nā pilikia ʻē aʻe.

E ʻimi i ka mālama pilikia inā loaʻa iā ʻoe nā hōʻailona a i ʻole nā ​​hōʻailona o ka placental abruption.

ʻAʻole pinepine i ʻike ʻia ke kumu o ka placental abruption. ʻO nā kumu hiki ke loaʻa, ʻo ia ka hōʻeha a i ʻole ka ʻeha i ka ʻōpū - mai kahi ulia kaʻa a i ʻole ka hāʻule ʻana, no ka laʻana - a i ʻole ka nalowale koke ʻana o ka wai e puni ana a me ka pale ʻana i ke keiki i loko o ka ʻōpū (wai amniotic).

Nā kumu e hiki ai ke hoʻonui i ka pilikia o ka placental abruption, eia kekahi mau mea:

• Placental abruption i ka hāpai mua ʻana ʻaʻole i hana ʻia e ka hōʻeha ʻana i ka ʻōpū
• Ke koko kiʻekiʻe mau (hypertension)
• Nā pilikia e pili ana i ka hypertension i ka wā hāpai, me ka preeclampsia, HELLP syndrome a i ʻole eclampsia
• Ka hāʻule ʻana a i ʻole kekahi ʻano hahau ʻana i ka ʻōpū
• Paka
• Hoʻohana Kokaina i ka wā hāpai
• Ka haki mua ʻana o nā membrane, ka mea e hoʻokahe ai i ka wai amniotic ma mua o ka pau ʻana o ka hāpai
• Ka maʻi i loko o ka uterus i ka wā hāpai (chorioamnionitis)
• Ka makahiki, ʻoi aku ka nui ma mua o 40

Hiki i ka hemo ʻana o ka placenta ke hoʻoulu i nā pilikia weliweli i ke ola no ka makuahine a me ke pēpē.

No ka makuahine, hiki i ka hemo ʻana o ka placenta ke alakaʻi i:

• Ka haʻalulu ma muli o ka nalowale o ke koko
• Nā pilikia o ka hoʻopaʻa koko
• Ka pono no ka hoʻololi koko
• Ka hāʻule ʻana o nā puʻupaʻa a i ʻole nā ​​mea ʻē aʻe ma muli o ka nalowale o ke koko
• I nā manawa kakaikahi, ka pono no ka hysterectomy, inā hiki ʻole ke kaohi i ke kahe koko o ka uterus

No ke pēpē, hiki i ka hemo ʻana o ka placenta ke alakaʻi i:

• Ka ulu palena ʻole mai ka loaʻa ʻole o nā meaʻai lawa
• ʻAʻohe lawa oxygen
• Hānau mua
• Stillbirth

ʻAʻole hiki ke pale aku i ka hemo ʻana o ka placenta, akā hiki ke hoʻemi i kekahi mau kumu pilikia. No ka laʻana, mai puhi paka a hoʻohana paha i nā lāʻau lapaʻau kūʻē i ke kānāwai, e like me ka cocaine. Inā loaʻa iā ʻoe ke koko kiʻekiʻe, e hana pū me kāu mea mālama ola e nānā i ke kūlana. E kau mau i kāu kāʻei palekana i ka wā e noho ana i loko o kahi kaʻa. Inā ua loaʻa iā ʻoe ka hōʻeha ʻana o ka ʻōpū - mai kahi pōʻino kaʻa, hāʻule a i ʻole ka hōʻeha ʻē aʻe - e ʻimi koke i ka kōkua lapaʻau. Inā ua loaʻa iā ʻoe ka hemo ʻana o ka placenta, a ke hoʻolālā nei ʻoe i kahi hāpai ʻē aʻe, e kamaʻilio me kāu mea mālama ola ma mua o kou hāpai ʻana e ʻike inā aia nā ala e hōʻemi ai i ka pilikia o ka hemo ʻana hou.

Inā manaʻo kāu mea lawelawe ola kino ua ʻānai ka pūpū, e hana ʻo ia i kahi hoʻokolokolo kino e nānā ai i ka palupalu a i ʻole ka paʻakikī o ka ʻōpū. No ke kōkua ʻana i ka ʻike ʻana i nā kumu hiki ke koko mai ka pepeiao wahine, e ʻōlelo paha kāu mea lawelawe i nā hoʻokolohua koko a me ka mimi a me ka ultrasound.

I ka wā o ka ultrasound, hana nā haʻalulu leo kiʻekiʻe i kahi kiʻi o kou ʻōpū ma kahi mīkini. ʻAʻole naʻe mau ka hiki ke ʻike i kahi ʻānai pūpū ma ka ultrasound.

ʻAʻole hiki ke hoʻopili hou i ka placenta i hoʻokaʻawale ʻia mai ka paia o ka uterus. Ma muli o ke kūlana nā koho lapaʻau no ka placental abruption:

ʻAʻole kokoke ka pēpē i ka wā piha. Inā he māmā ka abruption, maʻamau ka helu puʻuwai o kāu pēpē a he nui ka manawa ma mua o ka hānau ʻana o ka pēpē, hiki paha ke hoʻokomo ʻia ʻoe i ka haukapila no ka nānā pono. Inā pau ka kahe koko a kūpaʻa ke kūlana o kāu pēpē, hiki paha iā ʻoe ke hoʻomaha ma ka home.

Hiki paha ke hāʻawi ʻia iā ʻoe i ka lāʻau lapaʻau e kōkua i ka ulu ʻana o nā māmā o kāu pēpē a e pale aku i ka lolo o ka pēpē, inā pono ka hānau mua.

No ka nui o ke kahe koko, pono paha ʻoe i ka transfusion koko.

• ʻAʻole kokoke ka pēpē i ka wā piha. Inā he māmā ka abruption, maʻamau ka helu puʻuwai o kāu pēpē a he nui ka manawa ma mua o ka hānau ʻana o ka pēpē, hiki paha ke hoʻokomo ʻia ʻoe i ka haukapila no ka nānā pono. Inā pau ka kahe koko a kūpaʻa ke kūlana o kāu pēpē, hiki paha iā ʻoe ke hoʻomaha ma ka home.

  Hiki paha ke hāʻawi ʻia iā ʻoe i ka lāʻau lapaʻau e kōkua i ka ulu ʻana o nā māmā o kāu pēpē a e pale aku i ka lolo o ka pēpē, inā pono ka hānau mua.

• Kokoke ka pēpē i ka wā piha. Ma ke ʻano laulā ma hope o 34 mau wiki o ka hāpai ʻana, inā he liʻiliʻi ka placental abruption, hiki paha ke hānau ʻia ma ke ʻano vaginal me ka nānā pono. Inā ʻino ka abruption a hoʻoweliweli paha i kou olakino a i ʻole ke olakino o kāu pēpē, pono ʻoe i ka hānau koke — ma ke ʻano maʻamau ma o ka C-section.