Ohss

Ko te syndrome whakapakari hua manu (OHSS) he tauhohenga nui ki te nui o nga homoni. Ka puta ke i roto i nga wahine e inu ana i nga rongoa homoni whakauru hei whakapakari i te whanaketanga o nga hua i roto i nga ovaries. Ko te syndrome whakapakari hua manu (OHSS) te take i pupuhi ai nga ovaries ka mamae.

Ka puta pea te syndrome whakapakari hua manu (OHSS) i roto i nga wahine e haere ana i te whakawhānui hua i roto i te tipu (IVF) te whakapakari ovulation me nga rongoa whakauru. Ka iti ake te puta o te OHSS i te wa e maimoatia ana te hua me nga rongoa e inu ana koe i te waha, penei i te clomiphene.

Ko te maimoatanga e whakawhirinaki ana ki te kaha o te mate. Ka pai ake pea te OHSS i a ia ano i roto i nga keehi ngawari, engari ko nga keehi kino pea ka hiahia ki te noho haumanu me te maimoatanga atu.

Ko ngā tohu o te mate pāwera hyperovulation e tīmata pinei i roto i te wiki kotahi i muri i te whakamahinga o ngā rongoā werohinga hei whakaohooho i te ovulation, ahakoa i etahi wā ka roa pea kia rua wiki, kāore rānei, kia puta mai ngā tohu. Ka rere ke ngā tohu mai i te ngawari ki te kino, ā, ka kaha ake pea, kāore rānei, i te wā.

Ki te mea kei te whakahaere koe i ngā maimoatanga whakahihiri me te pāngia e ngā tohu o te mate pāwera ovarian hyperstimulation syndrome, kī atu ki tō kaiwhakarato hauora. Ahakoa he ngawari te mate OHSS, ka hiahia tō kaiwhakarato ki te tirotiro i a koe mō te tere o te taumaha o te tinana, te kino rānei o ngā tohu.

Whakapa atu ki tō kaiwhakarato tonu mena ka puta mai ngā raruraru manawa, te mamae rānei o ō waewae i te wā o tō maimoatanga whakahihiri. Ka taea e tēnei te tohu i tētahi āhuatanga āwangawanga e hiahia ana ki te tiaki hauora tere.

E kore e tino mohiotia te take o te mate pāwera o te hyperovulation. He mea nui te nui o te homoni chorionic gonadotropin tangata (HCG) - he homoni e whakaputaina ana i te wa o te haputanga - ki roto ki to tinana. Ka rereke te mahi o nga oko toto ovarian ki te homoni chorionic gonadotropin tangata (HCG) ka timata te rerenga wai. Ka pupuhi tenei wai i nga ovaries, a, etahi wa ka neke te nui ki te kopu.

I te wa o nga maimoatanga hua, ka hoatu pea te HCG hei 'whakaohooho' kia tukuna e te follicle pakeke tona hua. Ka puta te OHSS i roto i te wiki i muri i to whiwhi i te werohanga HCG. Ki te hapu koe i te wa o te huringa maimoatanga, ka kaha ake pea te OHSS i te wa e timata ai to tinana ki te whakaputa i tona ake HCG hei whakautu ki te haputanga.

He nui ake te tupono o nga rongoa hua werohanga ki te puta mai te OHSS i te maimoatanga me te clomiphene, he rongoa e hoatu ana hei pire e inu ana koe. I etahi wa ka puta mai te OHSS noa iho, kaore e hono atu ki nga maimoatanga hua.

I etahi wā, ka puta te OHSS ki ngā wāhine kāhore nei he take morearea. Engari, ko ngā take e mōhiotia ana e whakapiki ake ai tō morearea mō te OHSS ko ēnei:

• Te kohinga hua manu-ā-wahine - he mate tōpūtanga noa e pā ana ki ngā wā whakarereke o te marama, te tupu o te huruhuru nui me te ahua ke o ngā ovaries i te whakamātau ultrasound
• Te maha o ngā follicle
• Te pakeke i raro iho i te 35
• Te taumaha iti o te tinana
• Te taumata teitei, te piki haere rānei o te estradiol (estrogen) i mua i te whakaohooho HCG
• Ngā wāhanga o mua o te OHSS

Ko te syndrome ovarian hyperstimulation nui he mea onge, engari ka mate pea. Ko ētahi o ngā raruraru pea:

• Te kohikohi wai i roto i te kopu, ā, i etahi wā i roto i te uma
• Ngā raru o te electrolytes (sodium, potassium, me ētahi atu)
• Ngā toto kōtiti i roto i ngā oko nui, te nuinga i roto i ngā waewae
• Te kore mahi o te whatukuhu
• Te piko o te ovary (ovarian torsion)
• Te pakaru o te cyst i roto i te ovary, ka taea te arahi ki te toto nui
• Ngā raruraru o te manawa
• Te ngaro o te hapu i te mate whānau, i te mutu rānei na te raruraru
• Ko te mate, he mea onge

Hei whakaiti i ō tūmanako o te whanake i te mate hyper-stimulation ovarian, ka hiahia koe ki te mahere whaiaro mō ō rongoā huaora. Tumanakohia tō kaiwhakarato hauora kia ata tirotiro i ia huringa maimoatanga, tae atu ki ngā whakamātautau ultrasound maha hei tirotiro i te whanaketanga o ngā follicle me ngā whakamātautau toto hei tirotiro i ō taumata homoni. Nga rautaki hei awhina i te aukati i te OHSS e whai ake nei:

• Te whakarereke i te rongoā. Ka whakamahi tō kaiwhakarato i te horo iti rawa o te gonadotropins hei whakaohooho i ō ovaries me te whakaohooho i te ovulation.
• Te tāpiri i te rongoā. E hāngai ana etahi rongoā ki te whakaiti i te tūpono o te OHSS kaore e pā ana ki ngā tūpono o te hapu. Kei roto i ēnei ko te aspirin iti-horonga; ngā agonists dopamine pēnei i te carbergoline, quinogloide rānei; me ngā infusions kāratiuma. Ko te hoatu i ngā wāhine he mate polycystic ovary syndrome i te rongoā metformin (Glumetza) i te wā e whakaohooho ana i te ovarian ka āhei te āwhina i te aukati i te hyper-stimulation.
• Te whakarereke. Ki te teitei tō taumata estrogen, ki te maha rānei ō follicle kua whānuitia, ka mutu pea tō kaiwhakarato i ngā rongoā injectable ka tatari i etahi rā i mua i te hoatu i te HCG, e whakaohooho ana i te ovulation. E mohiotia ana tenei ko te whakarereke.
• Te karo i te whakamahinga o te pupuhi HCG trigger. Na te mea ka tupu pinepine te OHSS i muri i te hoatu o te pupuhi HCG trigger, kua whānuitia ngā huarahi whakakapi ki te HCG mō te whakaohooho mā te whakamahi i te gonadotropin-releasing hormone (Gn-RH) agonists, pēnei i te leuprolide (Lupron), hei huarahi hei aukati, hei whakaiti rānei i te OHSS.
• Te tio i ngā embryos. Ki te mahi koe i te whakawhānui in vitro (IVF), ka taea te tango i ngā follicle katoa (kua whānuitia me te kore i whānuitia) mai i ō ovaries hei whakaiti i te tūpono o te OHSS. Ka whakawhānuihia ngā follicle kua whānuitia ka tioretia, ā, ka tukua kia okioki ō ovaries. Ka taea e koe te whakahoki ano i te mahi IVF i tetahi rā i muri mai, ina rite tō tinana.

Ko te taatai o te mate hyper-stimulation o te ovaries e taea ana te whakawhirinaki ki:

• Te whakamatautau tinana. Ka titiro to kaiwhakarato ki tetahi atu taumaha, te nui ake o te rahi o to hope me te mamae o te kopu pea kei a koe.
• He ultrasound. Ki te mate koe i te ovarian hyperstimulation syndrome (OHSS), ka taea e te ultrasound te whakaatu kei te nui ake i te noa o ou ovaries, me nga cysts nui kapi i te wai kei hea nga follicles i whanau mai. I te wa e maimoatia ana me nga rongoa huaora, ka arotake tonu to kaiwhakarato i ou ovaries me te ultrasound waha.
• Te whakamatautau toto. Ka taea e etahi whakamatautau toto to kaiwhakarato te tirotiro i nga rereketanga i roto i to toto me te mea kei te ngoikore to mahi whatukuhu na te OHSS.

Ko te mate hyper-stimulation o te ovaries e ngāwari ana te whakaora i roto i te wiki, rua rānei, ā, ka roa ake pea mēnā kei te hapu koe. Ko te whakaora he whakaaro kia pai ai koe, kia whakaitihia te mahi o te ovaries, ā, kia kore ai ngā raruraru.

Ka ngāwari te whakaora i te OHSS ngawari. Ko te rongoā mō te OHSS tūturu pea ka whai:

Ki te OHSS nui, pea ka hiahia koe ki te whakauru ki te hōhipera mō te tirotiro me te whakaora kaha, tae atu ki ngā wai IV. Pea ka hoatu e tō kaiwhakarato he rongoā e kiia nei ko te cabergoline hei whakaiti i ō tohu. I etahi wā, pea ka hoatu ano e tō kaiwhakarato ētahi atu rongoā, pēnei i te antagonist gonadotropin-releasing hormone (Gn-RH) te letrozole rānei (Femara) — hei āwhina i te whakaiti i te mahi o te ovaries.

Ko ngā raruraru kino pea ka hiahia ki ētahi atu whakaora, pēnei i te pokanga mō te ovarian cyst pakaru, te tiaki matatau rānei mō ngā raruraru ate, ngā pūkahukahu rānei. Pea ka hiahia koe ki ngā rongoā anticoagulant hei whakaiti i te tūpono o ngā toto i ō waewae.

• Te whakahaere nui o te wai
• Ngā whakamātautau tinana me ngā whakamātautau ultrasound
• Ngā taumaha o ia rā me ngā ine o te hope hei tirotiro i ngā huringa nui
• Ngā ine o te nui o te mimi e puta ana i ia rā
• Ngā whakamātautau toto hei tirotiro i te mate wai, te koretake o te electrolyte me ētahi atu raruraru
• Te tango i te wai nui o te kopu mā te ngira e whakauruhia ana ki roto i tō kopu
• Ngā rongoā hei ārai i ngā toto (anticoagulants)

Ki te whanake koe i te mate pāwera o te hyperovulation ngāwari, pea ka taea e koe te haere tonu i ō mahi o ia rā. Whai i ngā tohutohu a tō kaiwhakarato, ā, pea ka uru atu ēnei whakaaro:

• Whakamātauria he rongoā mamae kore-whakahaunga penei i te acetaminophen (Tylenol, ētahi atu) mō te mamae o te kopu, engari kaua e whakamahi i te ibuprofen (Advil, Motrin IB, ētahi atu) rānei i te naproxen sodium (Aleve, ētahi atu) ki te tata nei kua nekehia tētahi ira ki a koe, nā te mea ka taea e ēnei rongoā te whakaroa i te whakatō i te ira.
• Kaua e moe tahi, nā te mea pea ka mamae, ā, ka taea te pakaru o te whekau i roto i tō ovaries.
• Kia mau ki te taumata mahi tinana māmā, kia kaua e mahi kaha, te mahi kaha rānei.
• Whakapaua tō taumaha i runga i te taumaha kotahi, ā, me whakatau te whānuitanga o tō kopu i ia rā, ā, whakamōhio atu ki tō kaiwhakarato mō ngā pikinga koretake.
• Karangatia tō kaiwhakarato ki te kino ake ō tohu me ō tohu.