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Hana Hānau Ma Mua O Ka Manawa

Nānaina

Hiki ke ulu mai ka hana hānau ma mua o ka manawa i ka wā e hoʻoulu ai nā ʻōpū maʻamau i ka wehe ʻana o kou cervix ma hope o ka hebedoma 20 a ma mua o ka hebedoma 37 o ka hāpai ʻana.

Hiki i ka hana hānau ma mua o ka manawa ke hopena i ka hānau mua. ʻO ka mua loa o ka hānau mua ʻana, ʻo ka nui aku o nā pilikia olakino no kāu pēpē. Pono ka nui o nā pēpē hānau mua (preemies) i ka mālama kūikawā ma ka ʻāpana mālama ʻana i nā pēpē hou. Hiki nō hoʻi i nā preemies ke loaʻa nā kīnā noʻonoʻo a me ke kino lōʻihi.

ʻAʻole maopopo pinepine ke kumu kūikawā o ka hana hānau ma mua o ka manawa. Hiki i kekahi mau mea pilikia ke hoʻonui i ka manawa o ka hana hānau ma mua o ka manawa, akā hiki nō hoʻi ke hana hānau ma mua o ka manawa i nā wāhine hāpai me nā mea pilikia ʻike ʻole ʻia.

Nā hōʻailona

Nā hōʻailona a me nā hōʻailona o ka hana hānau ma mua o ka manawa kūpono, e komo pū ana: Nā manaʻo maʻamau a pinepine paha o ka ʻōpū e paʻa ana (nā ʻeha) ʻEha kua haʻahaʻa mau, palupalu Manaʻo o ke kaomi o ka pelvis a i ʻole ka ʻōpū haʻahaʻa Nā ʻeha ʻōpū māmā Ka hoʻokahe koko mai ka pepeiao wahine a i ʻole ke kahe māmā Ka haki ʻana o ka membrane ma mua o ka manawa kūpono — i loko o kahi kahe nui a i ʻole kahi kahe mau o ka wai ma hope o ka haki ʻana a i ʻole ka haehae ʻana o ka membrane a puni ke keiki Loli i ke ʻano o ka hoʻokahe mai ka pepeiao wahine — wai, mucus-like a i ʻole koko Inā loaʻa iā ʻoe kēia mau hōʻailona a i ʻole nā ​​hōʻailona a i ʻole ke hopohopo nei ʻoe e pili ana i kāu mea e manaʻo nei, e kelepona koke i kāu mea mālama ola. Mai hopohopo e pili ana i ka kuhi hewa ʻana i ka hana hānau wahaheʻe no ka mea maoli. E hauʻoli nā mea a pau inā he leka hoʻomaopopo hewa ia.

ʻO ka manawa hea e ʻike ai i ke kauka

Inā ʻike ʻoe i kēia mau hōʻailona a i ʻole nā ​​hōʻailona a i ʻole ke hopohopo nei ʻoe i kāu mea e manaʻo ai, e kelepona koke i kāu mea lawelawe ola. Mai hopohopo e kuhi hewa i ka hana hānau wahaheʻe no ka mea maoli. E ʻoluʻolu nā mea a pau inā he leka hoʻomaopopo hewa ia.

Nā mea pilikia

Hiki i ka hana hānau ma mua o ka manawa i nā hāpai āpau. He nui nā kumu i pili pū ʻia me ka hoʻonui ʻana o ka pilikia o ka hana hānau ma mua o ka manawa, e like me: Ka hana hānau ma mua o ka manawa a i ʻole ka hānau mua, ʻoi aku hoʻi i ka hāpai hope loa a i ʻole ma mua o hoʻokahi hāpai ma mua Ka hāpai ʻana me nā māhoe, nā triplets a i ʻole nā ​​​​mea ʻē aʻe Ka pōkole o ka cervix Nā pilikia me ka uterus a i ʻole ka placenta Ka puhi ʻana i nā sigareta a i ʻole ka hoʻohana ʻana i nā lāʻau lapaʻau kūpono ʻole Nā maʻi maʻi, ʻoi aku hoʻi o ka wai amniotic a me ka ʻāpana genital haʻahaʻa Kekahi mau kūlana maʻi mau, e like me ke koko kiʻekiʻe, ka maʻi diabetes, ka maʻi autoimmune a me ka kaumaha Nā hanana ola kaumaha, e like me ka make ʻana o kahi mea aloha Ka nui loa o ka wai amniotic (polyhydramnios) Ke kahe koko mai ka pepeiao wahine i ka wā hāpai Ke loaʻa o kahi hemahema hānau o ka pēpē Kahi manawa emi iho ma mua o 12 mau mahina - a i ʻole ma mua o 59 mau mahina - ma waena o nā hāpai Ka makahiki o ka makuahine, ʻōpio a ʻelemakule hoʻi ʻAno ʻili ʻeleʻele, ʻaʻole Hispanic

Nā pilikia

ʻO nā pilikia o ka hana hānau ma mua o ka manawa kūpono e komo pū ai ka hānau ʻana i kahi pēpē ma mua o ka manawa kūpono. Hiki i kēia ke hoʻokau i ka nui o nā pilikia olakino no kāu pēpē, e like me ke kaumaha hānau haʻahaʻa, nā pilikia hanu, nā ʻōnaehana kino ʻaʻole i hoʻomohala piha a me nā pilikia ʻike. Loaʻa i nā keiki i hānau ʻia ma mua o ka manawa kūpono kahi pilikia kiʻekiʻe o ka cerebral palsy, nā pilikia aʻo a me nā pilikia ʻano.

Ka pale ʻana

ʻAʻole paha ʻoe e hiki ke pale aku i ka hānau mua ʻana—akā nui nā mea hiki iā ʻoe ke hana e hoʻoikaika i ka hāpai keiki olakino a piha. No ka laʻana:

  • E ʻimi i ka mālama hāpai maʻamau. Hiki i nā kipa hāpai ke kōkua i kāu mea mālama ola e nānā i kou olakino a me ke olakino o kāu pēpē. E haʻi i nā hōʻailona a i ʻole nā ​​hōʻailona e hopohopo ai ʻoe. Inā loaʻa iā ʻoe kahi moʻolelo o ka hānau mua ʻana a i ʻole e hoʻomohala i nā hōʻailona a i ʻole nā ​​hōʻailona o ka hānau mua ʻana, pono paha ʻoe e ʻike pinepine aku i kāu mea mālama ola i ka wā hāpai.
  • E ʻai i ka ʻai olakino. Hoʻopili pinepine ʻia nā hopena hāpai olakino me ka ʻai maikaʻi. Eia kekahi, manaʻo kekahi noiʻi e pili ana ka ʻai kiʻekiʻe i nā waikawa momona polyunsaturated (PUFAs) me ka emi ʻana o ka pilikia o ka hānau mua ʻana. Loaʻa nā PUFAs i nā nati, hua, iʻa a me nā aila hua.
  • E pale i nā mea ʻino. Inā ua puhi ʻoe, e haʻalele. E noi i kāu mea mālama ola e pili ana i kahi papahana haʻalele puhipaka. Ua pāpā ʻia nā lāʻau lapaʻau kūʻē, pēlā nō.
  • E noʻonoʻo i ka hoʻokaʻawale ʻana o ka hāpai keiki. Manaʻo kekahi noiʻi i kahi pilina ma waena o nā hāpai keiki i hoʻokaʻawale ʻia ma lalo o ʻeono mahina, a i ʻole ma mua o 59 mau mahina, a me ka hoʻonui ʻia o ka pilikia o ka hānau mua ʻana. E noʻonoʻo e kamaʻilio me kāu mea mālama ola e pili ana i ka hoʻokaʻawale ʻana o ka hāpai keiki.
  • E makaʻala i ka hoʻohana ʻana i ka ʻenehana hoʻohua kōkua (ART). Inā manaʻo ʻoe e hoʻohana i ka ART e hāpai ai, e noʻonoʻo i ka nui o nā embryo e hoʻoneʻe ʻia. ʻOi aku ka nui o ka pilikia o ka hānau mua ʻana i nā hāpai keiki he nui. Inā hoʻoholo kāu mea mālama ola ua nui ka pilikia o ka hānau mua ʻana, hiki iā ia ke ʻōlelo e lawe i nā hana hou aku e hoʻemi i kou pilikia.
ʻImi ʻike

E nānā aku kāu mea mālama ola i kou moʻolelo lapaʻau a me nā mea pilikia no ka hānau mua ʻana a loiloi i kou mau hōʻailona a me nā hōʻailona. Inā ʻoe e ʻike ana i nā ʻōhū ʻōpū maʻamau a ua hoʻomaka kāu cervix e palupalu, lahilahi a wehe (dilate) ma mua o 37 mau wiki o ka hāpai ʻana, e ʻike paha ʻia ʻoe me ka hānau mua ʻana.

Nā hoʻokolohua a me nā kaʻina hana e ʻike ai i ka hānau mua ʻana:

  • Nānā Pelvic. Hiki i kāu mea mālama ola ke loiloi i ka paʻa a me ka ʻeha o kou ʻōpū a me ka nui a me ke kūlana o ke pēpē. Inā ʻaʻole i haki kou wai a ʻaʻohe pilikia e uhi ana ka placenta i ka cervix (placenta previa), hiki iā ia ke hana i kahi nānā pelvic e hoʻoholo ai inā ua hoʻomaka kāu cervix e wehe. Hiki i kāu mea mālama ola ke nānā pū no ke kahe koko o ka ʻōpū.
  • Ultrasound. Hiki ke hoʻohana ʻia kahi ultrasound transvaginal e ana i ka lōʻihi o kāu cervix. Hiki ke hana ʻia kahi ultrasound e nānā i nā pilikia me ke pēpē a i ʻole ka placenta, e hōʻoia i ke kūlana o ke pēpē, e loiloi i ka nui o ka wai amniotic, a e kuhikuhi i ke kaumaha o ke pēpē.
  • Nānā ʻōpū. Hiki i kāu mea mālama ola ke hoʻohana i kahi mīkini nānā ʻōpū e ana i ka lōʻihi a me ka mamao o kou mau ʻōhū.
  • Nā hoʻokolohua Lab. Hiki i kāu mea mālama ola ke lawe i kahi swab o kāu mau wai vaginal e nānā i ke alo o kekahi mau maʻi a me ka fetal fibronectin - kahi mea e hana like me ka glue ma waena o ka ʻeke fetal a me ka lining o ka ʻōpū a ua hoʻokuʻu ʻia i ka wā hānau. E nānā ʻia kēia mau hopena me nā mea pilikia ʻē aʻe. E hāʻawi pū ʻoe i kahi laʻana mimi, kahi e hoʻokolohua ʻia ai no ke alo o kekahi mau bacteria.
Ka mālama ʻana

Ke hele mai ʻoe i ka hānau keiki, ʻaʻohe lāʻau lapaʻau a i ʻole nā ​​kaʻina hana ʻokiʻoki e hoʻōki ai i ka hānau keiki, koe wale nō no ke manawa pōkole. Eia naʻe, hiki i kāu kauka ke ʻōlelo aku i nā lāʻau lapaʻau penei:

  • Corticosteroids. Hiki i nā Corticosteroids ke kōkua i ka hoʻoulu ʻana i ka makua o ka māmā o kāu pēpē. Inā ʻoe ma waena o 23 a me 34 mau wiki, e ʻōlelo paha kāu kauka i nā corticosteroids inā manaʻo ʻia ʻoe i ka pilikia nui o ka hānau ʻana i loko o hoʻokahi a ʻehiku mau lā. Hiki nō hoʻi i kāu kauka ke ʻōlelo aku i nā steroids inā pilikia ʻoe i ka hānau ʻana ma waena o 34 mau wiki a me 37 mau wiki.

Hiki paha ke hāʻawi ʻia iā ʻoe i kahi papa hana hou o nā corticosteroids inā ʻoi aku ʻoe ma lalo o 34 mau wiki hapai, pilikia i ka hānau ʻana i loko o ʻehiku mau lā, a loaʻa iā ʻoe kahi papa hana mua o nā corticosteroids ma mua o 14 mau lā ma mua.

  • Magnesium sulfate. Hiki i kāu kauka ke hāʻawi i ka magnesium sulfate inā loaʻa iā ʻoe kahi pilikia nui o ka hānau ʻana ma waena o 24 a me 32 mau wiki o ka hapai. Ua hōʻike kekahi noiʻi ua hiki ke hoʻemi i ka pilikia o kahi ʻano hōʻino kikoʻī i ka lolo (cerebral palsy) no nā pēpē i hānau ʻia ma mua o 32 mau wiki o ka hāpai.

Corticosteroids. Hiki i nā Corticosteroids ke kōkua i ka hoʻoulu ʻana i ka makua o ka māmā o kāu pēpē. Inā ʻoe ma waena o 23 a me 34 mau wiki, e ʻōlelo paha kāu kauka i nā corticosteroids inā manaʻo ʻia ʻoe i ka pilikia nui o ka hānau ʻana i loko o hoʻokahi a ʻehiku mau lā. Hiki nō hoʻi i kāu kauka ke ʻōlelo aku i nā steroids inā pilikia ʻoe i ka hānau ʻana ma waena o 34 mau wiki a me 37 mau wiki.

Hiki paha ke hāʻawi ʻia iā ʻoe i kahi papa hana hou o nā corticosteroids inā ʻoi aku ʻoe ma lalo o 34 mau wiki hapai, pilikia i ka hānau ʻana i loko o ʻehiku mau lā, a loaʻa iā ʻoe kahi papa hana mua o nā corticosteroids ma mua o 14 mau lā ma mua.

Tocolytics. Hiki i kāu mea mālama ola ke hāʻawi iā ʻoe i kahi lāʻau i kapa ʻia ʻo ka tocolytic e hoʻōhīhie i kou mau ʻeha no kekahi manawa. Hiki ke hoʻohana ʻia nā Tocolytics no 48 mau hola e hoʻopaneʻe i ka hānau keiki ma mua o ka manawa e hāʻawi ai i nā corticosteroids i ka pono nui loa a i ʻole, inā pono, no ka lawe ʻia ʻana i kahi haukapila e hiki ke hāʻawi i ka mālama kūikawā no kāu pēpē ma mua o ka manawa.

Inā ʻaʻole ʻoe i hoʻokomo ʻia i ka haukapila, pono paha ʻoe e hoʻonohonoho i nā kipa pule a i ʻole nā ​​kipa pinepine me kāu mea mālama ola i hiki iā ia ke nānā i nā hōʻailona a me nā hōʻailona o ka hānau keiki ma mua o ka manawa.

Inā pilikia ʻoe i ka hānau keiki ma mua o ka manawa ma muli o ka pōkole o ka cervix, hiki i kāu kauka ke ʻōlelo aku i kahi hana ʻokiʻoki i ʻike ʻia ʻo cervical cerclage. I loko o kēia kaʻina hana, ua kāʻei ʻia ka cervix me nā mea kāʻei ikaika. Ma ke ʻano maʻamau, ua wehe ʻia nā mea kāʻei ma hope o 36 mau wiki piha o ka hapai. Inā pono, hiki ke wehe ʻia nā mea kāʻei ma mua.

Hiki ke ʻōlelo ʻia ka Cervical cerclage inā ʻoi aku ʻoe ma lalo o 24 mau wiki hapai, loaʻa iā ʻoe kahi moʻolelo o ka hānau keiki ma mua o ka manawa, a hōʻike ka ultrasound i kou cervix e wehe ana a i ʻole ka lōʻihi o kou cervix he emi iho ma mua o 25 mau milimita.

Inā loaʻa iā ʻoe kahi moʻolelo o ka hānau keiki ma mua o ka manawa, hiki i kāu mea mālama ola ke ʻōlelo aku i nā pana pule o kahi ʻano o ka hormone progesterone i kapa ʻia ʻo hydroxyprogesterone caproate, e hoʻomaka ana i kou trimester ʻelua a hoʻomau a hiki i ka wiki 37 o ka hapai.

Eia kekahi, hiki i kāu mea mālama ola ke hāʻawi i ka progesterone, kahi i hoʻokomo ʻia i loko o ka vagina, ma ke ʻano he hana palekana e kūʻē i ka hānau keiki ma mua o ka manawa. Inā ʻike ʻia ʻoe me ka pōkole o ka cervix ma mua o ka wiki 24 o ka hapai, hiki i kāu mea mālama ola ke ʻōlelo aku i ka hoʻohana ʻana i ka progesterone a hiki i ka wiki 37 o ka hapai.

Hōʻike nā noiʻi hou i ka progesterone vaginal e like me ka maikaʻi o ka cervical cerclage i ka pale ʻana i ka hānau keiki ma mua o ka manawa no kekahi mau wahine i pilikia. Loaʻa i ka lāʻau lapaʻau ka pono o ka ʻole o ka ʻokiʻoki a i ʻole ka anesthesia. Hiki i kāu kauka ke hāʻawi iā ʻoe i ka lāʻau lapaʻau ma ke ʻano he koho i ka cervical cerclage.

Inā loaʻa iā ʻoe kahi moʻolelo o ka hānau keiki ma mua o ka manawa a i ʻole ka hānau keiki ma mua o ka manawa, pilikia ʻoe i ka hānau keiki ma hope o ka manawa. E hana pū me kāu mea mālama ola e hoʻokele i nā kumu pilikia a pane i nā hōʻailona a me nā hōʻailona hoʻomaopopo mua.

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Hōʻole: He kahua ʻike olakino ʻo ʻAukake a ʻaʻole hōʻike kāna mau pane i ka ʻōlelo aʻoaʻo lapaʻau. E kūkākūkā mau me kahi ʻoihana lapaʻau laikini kokoke iā ʻoe ma mua o ka hana ʻana i nā hoʻololi.

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