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 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.
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.
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
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.
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 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:
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:
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.
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.
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.
Hana ʻia i India, no ka honua