Ububyimba bw’umubyibuho (Molar Pregnancy): Ibimenyetso, Intandaro, n’Ubuvuzi

Ububyimba bw’umubyibuho buzabaho iyo umubiri utera imbere mu buryo butari bwo mu nda yawe aho kuba umwana. Iyi ngorane idasanzwe yo gutwita ibaho ku bagore umwe kuri buri 1.000, kandi nubwo bishobora kuguhagarara, ni ingenzi kumenya ko ubufasha bw’abaganga, abenshi bagira utwitwagiheza bakagira utwite dutangaje.

Ububyimba bw’umubyibuho ni iki?

Ububyimba bw’umubyibuho ni ubwoko bwa gestational trophoblastic disease aho imyenda idasanzwe ikura mu nda yawe aho kuba gutwita bisanzwe. Tekereza ko ari nk’aho imisemburo y’umubiri wawe y’ubutwite ibonye ubutumwa butari bwo, bigatuma imyenda isa n’umwenda w’inda ikura cyane cyangwa mu buryo butari bwo.

Ibi bibaho mu gihe cyo gutwita iyo hari ikibazo ku mubiri w’umwana ukomoka ku gihimba n’intanga. Umubiri wawe ukomeza gukora imisemburo y’ubutwite, bityo uzabona ko utwite, ariko gutwita ntibishobora gukura neza cyangwa kubaho.

Ni ubuhe bwoko bw’ububyimba bw’umubyibuho?

Hari ubwoko bubiri nyamukuru bw’ububyimba bw’umubyibuho, kandi gusobanukirwa itandukaniro bishobora kugufasha kumenya icyo witeze. Ububyimba bwuzuye bw’umubyibuho buzabaho iyo intanga y’umugabo ishyize mu gihimba kidatwite kitagira imyenda, bikaba bigizwe gusa n’imyenda idasanzwe y’umwenda w’inda idafite umwana cyangwa umufuka w’amazi.

Ububyimba butuzuye bw’umubyibuho buzabaho iyo intanga ebyiri zishyize mu gihimba kimwe gisanzwe, bikaba bigizwe n’imyenda isanzwe y’umwenda w’inda hamwe n’imyenda idasanzwe. Muri ubwo bwoko, hashobora kuba hari imyenda y’umwana, ariko ntishobora gukura ikaba umwana muzima kubera ibibazo by’imiterere y’umubiri.

Ni ibihe bimenyetso by’ububyimba bw’umubyibuho?

Ibimenyetso bya mbere by’ububyimba bw’umubyibuho bikunze kumera nk’ubutwite busanzwe, niyo mpamvu bishobora gutera urujijo no guhangayika iyo hari ikintu kitameze neza. Ushobora kugira ibimenyetso bisanzwe byo gutwita nk’uko udashobora kubona imihango, ububabare bw’amabere, no kuruka mu gitondo.

Ariko kandi, bimwe mu bimenyetso bishobora kugaragaza ko hari ikintu kidasanzwe kibaho mu gutwita kwawe:

• Kuva mu gitsina cyangwa gutinda, cyane cyane amaraso atukura cyangwa umukara
• Kurwara cyane no kuruka bikabije kurusha uko bisanzwe mu gitondo
• Ukwaguka k’inda kwihuta bikugira nk’uwari utwite igihe kirekire kurusha igihe ugiye kubyara
• Umuvuduko ukabije w’amaraso mbere y’igihe mu gutwita
• Kuvamo imyenda isa n’imizabibu cyangwa ibice by’amaraso mu gitsina
• Ububabare cyangwa ububabare mu kibuno bumera bitandukanye n’ububabare busanzwe mu gihe cyo gutwita

Bamwe mu bantu bagira ibimenyetso bidakunze kugaragara ariko bikaba ingenzi kubimenya. Ibi birimo kubabara umutwe cyane, guhinduka k’ubuhanga, cyangwa kubyimba mu ntoki no mu maso mbere y’igihe ugereranyije n’uko kubyimba bisanzwe byaba mu gihe cyo gutwita.

Ni ingenzi kumenya ko bimwe muri ibi bimenyetso bishobora kuba bifitanye isano n’izindi ngorane zo gutwita, bityo kubibona ntibisobanura ko ufite ububyimba bw’umubyibuho. Niyo mpamvu ari ingenzi kuguma uganira n’umuganga wawe ku bijyanye n’ikibazo icyo ari cyo cyose.

Ni iki gitera ububyimba bw’umubyibuho?

Ububyimba bw’umubyibuho buterwa n’ibibazo by’imiterere y’umubiri bibaho mu gihe cyo gutwita, atari ikintu wakoze cyangwa utarakora. Ibi bibazo bibaho mu buryo butunguranye iyo gihimba n’intanga bihuriye hamwe, bigatuma habaho imvange idasanzwe y’imiterere y’umubiri.

Mu bubyimba bwuzuye bw’umubyibuho, gihimba gicikaho imyenda yacyo yose mbere cyangwa mu gihe cyo gutwita. Iyo intanga y’umugabo ishyize muri icyo gihimba “gituzuye”, imyenda y’umugabo gusa iba ihari, bigatuma imyenda idasanzwe ikura aho kuba umwana akura.

Ku bubyimba butuzuye bw’umubyibuho, ikibazo cy’imiterere y’umubiri kibaho iyo intanga ebyiri zishyize mu gihimba kimwe gisanzwe icyarimwe. Ibi bituma habaho gutwita gufite imyenda myinshi, bigabuza iterambere risanzwe kandi bigatuma habaho ukura kw’imyenda idasanzwe.

Ibi bibazo by’imiterere y’umubiri ni ibyo kwisanga gusa kandi ntibishobora kwirindwa binyuze mu guhindura imibereho cyangwa ubuvuzi. Ntibitera ikintu kiri mu kirere, imirire, cyangwa amateka yawe mbere.

Ni ryari ukwiye kujya kwa muganga kubera ububyimba bw’umubyibuho?

Ukwiye guhamagara umuganga wawe ako kanya niba ufite amaraso ava mu gitsina mu gihe cyo gutwita, cyane cyane niba bifatanije no kuruka cyane cyangwa ububabare mu kibuno. Nubwo amaraso ashobora kubaho mu gutwita bisanzwe, bihora ari ingenzi kujya kwipimisha kugira ngo umenye icyabiteye.

Shaka ubufasha bw’abaganga vuba niba uvuye imyenda isa n’imizabibu cyangwa ibice bito, kuko ibyo bishobora kuba ikimenyetso cy’ububyimba bw’umubyibuho. Byongeye kandi, niba kuruka kwawe mu gitondo bikabije ku buryo udashobora kurya cyangwa kunywa amazi, ibyo bisaba ko uba uganira n’abaganga vuba.

Ibindi bimenyetso biterwa impungenge bisaba ko uba uganira n’abaganga vuba birimo kubabara umutwe cyane, guhinduka k’ubuhanga, cyangwa kubyimba mu maso no mu ntoki mu gihe cyo gutwita. Ibi bimenyetso bishobora kugaragaza ingorane zisaba ubuvuzi bw’ihutirwa.

Ni ibihe bintu byongera ibyago by’ububyimba bw’umubyibuho?

Nubwo ububyimba bw’umubyibuho buzabaho mu buryo butunguranye, ibintu bimwe bishobora kongera gato ibyago byo kubona. Imyaka igira uruhare, abagore bari munsi y’imyaka 20 n’abarengeje 35 bafite amahirwe menshi yo kugira ububyimba bw’umubyibuho.

Uko ukomokaho bishobora kandi kugira uruhare, kuko ububyimba bw’umubyibuho bukunze kubaho ku bagore bakomoka muri Aziya. Ariko rero, ni ingenzi kwibuka ko ubwo butwite bushobora kubaho kuri uwo ari we wese utabayeho.

Amateka y’ubutwite bwawe mbere agira uruhare. Niba warigeze kugira ububyimba bw’umubyibuho, ibyago byo kubona ikindi byiyongera gato, nubwo ibyago muri rusange bikomeza kuba bike. Kugira ibitwitsi byinshi bishobora kandi kongera gato ibyago.

Ibintu by’imirire, cyane cyane urwego ruke rwa vitamine A na poroteyine mu mirire yawe, byahujwe n’ibyago byinshi mu bindi byanditswe. Ariko kandi, isano ntiirasobanutse neza, kandi ububyimba bwinshi bw’umubyibuho buzabaho ku bagore bafite imirire isanzwe.

Ni izihe ngorane zishoboka z’ububyimba bw’umubyibuho?

Ingorane ya mbere y’ububyimba bw’umubyibuho ni indwara y’umubyibuho idakira, aho imyenda idasanzwe ikomeza gukura na nyuma yo kuvurwa. Ibi bibaho kuri 15-20% by’ububyimba bwuzuye bw’umubyibuho kandi bisaba ubuvuzi bundi bwakozwe na chimiothérapie.

Kuva amaraso cyane ni indi ngorane ikomeye ishobora kubaho mu gihe cyo gukuraho imyenda cyangwa nyuma yacyo. Ikipe yawe y’abaganga izakurinda neza ibimenyetso byo kuva amaraso menshi kandi izaba yiteguye kubivura vuba niba bibaye.

Mu bihe bidasanzwe, ububyimba bw’umubyibuho bushobora gutera ingorane zikomeye:

• Choriocarcinome, ubwoko bwa kanseri bushobora guturuka ku myenda idasanzwe
• Ingorane zo guhumeka niba imyenda ikwirakwira mu bihaha
• Anemie ikomeye kubera kuva amaraso gahoraho
• Ibibazo bya thyroid kubera urwego rwo hejuru cyane rw’imisemburo y’ubutwite
• Ibimenyetso bisa na preeclampsia birimo umuvuduko ukabije w’amaraso na poroteyine mu mwanya

Nubwo izi ngorane zisa n’iziteye ubwoba, ni ingenzi kumenya ko ubufasha bw’abaganga, gukurikirana, n’ubufasha, abenshi bakira neza. Ikintu nyamukuru ni ukuguma uganira n’ikipe yawe y’abaganga no gukurikiza gahunda yabo yo gukurikirana.

Ububyimba bw’umubyibuho bumenyekana gute?

Kumenya ububyimba bw’umubyibuho bisanzwe bitangira hakoreshejwe isuzuma ry’inda n’ubuvuzi bw’amajwi iyo utangaje ibimenyetso biterwa impungenge. Ubuvuzi bw’amajwi buzerekana imiterere isanzwe itandukanye n’ubutwite busanzwe, ikunze kwitwa “imvura y’ubuki” ku ibaraza.

Umuganga wawe azareba kandi urwego rw’amaraso yawe rwa hCG (human chorionic gonadotropin), imisemburo y’ubutwite. Mu bubyimba bw’umubyibuho, urwo rwego rukunze kuba rwo hejuru kurusha ibyo witeze ukurikije igihe ugiye kubyara, ibyo bikaba ari ikimenyetso cy’ingenzi cyo kumenya indwara.

Ibizamini byongeyeho bishobora kuba harimo igipimo cyuzuye cy’amaraso kugira ngo harebwe anemie, ibizamini bya thyroid kuko hCG nyinshi ishobora kugira ingaruka kuri thyroid yawe, n’ama rayons X yo mu gituza kugira ngo harebwe niba imyenda idasanzwe itarakwirakwira mu bihaha byawe.

Rimwe na rimwe kumenya indwara ntibiraba neza kugeza nyuma y’ubuvuzi bwitwa dilation and curettage (D&C), iyo imyenda yakuwe isuzumwe kuri mikoroskopi. Iyo isuzuma ry’imyenda rihamye rihamya indwara kandi rifasha kumenya ubwoko bw’ububyimba bw’umubyibuho.

Ni ubuhe buvuzi bw’ububyimba bw’umubyibuho?

Ubuvuzi bw’ububyimba bw’umubyibuho burimo gukuraho imyenda yose idasanzwe mu nda yawe binyuze mu buvuzi bwitwa suction curettage cyangwa dilation and curettage (D&C). Ubu buvuzi bwo hanze bugirwa hakoreshejwe anesthésie kandi busanzwe bumaramo iminota 15-30.

Nyuma yo gukuraho imyenda, uzakenera ubufasha bwo gukurikirana kugira ngo harebwe urwego rwa hCG. Umuganga wawe azareba urwo rwego rw’imisemburo buri cyumweru mbere, hanyuma buri kwezi, kugira ngo arebe niba rugarutse mu buryo busanzwe kandi ruguma rutyo.

Igihe cyo gukurikirana ni ingenzi kandi gisanzwe kiba ari amezi 6-12. Muri icyo gihe, uzakenera kwirinda gutwita kugira ngo harebwe neza urwego rw’imisemburo yawe. Ikipe yawe y’abaganga izakugira inama ku buryo bwo kwirinda gutwita muri icyo gihe.

Niba urwego rwa hCG rutamanuka nk’uko byari biteganyijwe cyangwa rugatangira kuzamuka ukundi, ushobora kuba ukeneye ubuvuzi bundi bwakozwe na chimiothérapie. Nubwo ibyo bishobora gutera ubwoba, imiti ikoreshwa ifite akamaro cyane kuri iyi ndwara, kandi abenshi barayikira neza.

Uko wakwitaho mu rugo

Kwitaho mu rugo nyuma yo kuvurwa ububyimba bw’umubyibuho byibanda ku gukira ku mubiri no ku mubiri. Ushobora kwitega kuva amaraso mu gitsina no kubabara mu nda igihe cy’icyumweru kimwe nyuma y’ubuvuzi, bisa n’uko imihango yaba ikomeye.

Witondere umubiri wawe binyuze mu kuruhuka bihagije, kurya ibiryo biringaniye, no kunywa amazi ahagije. Irinde gukoresha tampon, douching, cyangwa imibonano mpuzabitsina igihe cy’ibyumweru bibiri cyangwa kugeza umuganga wawe aguhaye uburenganzira kugira ngo wirinde kwandura.

Kwita ku mubiri mu buryo bw’amarangamutima ni ingenzi cyane. Ni ibisanzwe kumva agahinda, intimba, cyangwa urujijo nyuma yo kubura gutwita muri ubu buryo. Abantu benshi basanga ari ingirakamaro kuvugana n’umujyanama, kwinjira mu itsinda ry’ubufasha, cyangwa kuvugana n’abandi banyuze mu bibazo nk’ibyo.

Komeza gukurikiza gahunda yawe yose yo kujya kwa muganga, nubwo wumva umeze neza. Izo ngendo ni ingenzi mu gukurikirana uko ukomeza gukira no kubona ingorane zishoboka hakiri kare. Ntuzuzagira ikibazo cyo guhamagara umuganga wawe niba ufite impungenge hagati y’ingendo.

Uko wakwitegura kujya kwa muganga

Mbere yo kujya kwa muganga, andika ibimenyetso byawe byose, harimo igihe byatangiye n’uburemere bwabyo. Garagazamo amakuru yerekeye imihango yawe, igihe wabonye imihango bwa nyuma, n’ibizamini byo gutwita wakoze.

Tegura urutonde rw’ibibazo ushaka kubabaza umuganga wawe. Ushobora kwifuza kumenya ibijyanye n’ubuvuzi, icyo witeze mu gihe cyo gukira, igihe ushobora kongera kugerageza gutwita, n’ubufasha bwo gukurikirana ukeneye.

Zana umuntu ubakubera umufasha niba bishoboka, kuko ushobora kubona amakuru menshi kandi kugira umuntu uri aho bishobora kugufasha kwibuka amakuru y’ingenzi. Ni ingenzi kandi kugira ubufasha mu gihe cy’ibibazo.

Menyesha umuganga wawe imiti yose ufata, harimo imiti yo hanze n’ibindi byongewemo. Menyesha kandi ibyo uri allergique cyangwa uko warigeze ugira reaction ku miti cyangwa anesthésie.

Icyo ukwiye kumenya cyane ku bubyimba bw’umubyibuho

Ikintu cyingenzi cyo kumenya ku bubyimba bw’umubyibuho ni uko ari indwara ivurwa ifite ibyiza byinshi iyo ivuwe neza. Nubwo ari ibintu bitoroshye kubura gutwita muri ubu buryo, abenshi bagira utwite dutangaje mu gihe kizaza.

Kumenya indwara hakiri kare no kuvurwa ni ingenzi mu kwirinda ingorane. Niba ufite ibimenyetso bidasanzwe mu gihe cyo gutwita, cyane cyane kuruka cyane, amaraso, cyangwa gukura kwihuta, ntutinye guhamagara umuganga wawe ako kanya.

Wibuke ko ububyimba bw’umubyibuho atari amakosa yawe kandi ntibishobora kwirindwa. Ni ikibazo cy’imiterere y’umubiri kibaho mu gihe cyo gutwita, kandi nta kintu wakora kugira ngo ubikureho.

Ubufasha bw’abaganga, gukurikirana, n’ubufasha, ushobora gukira neza ububyimba bw’umubyibuho. Gukomeza kuvugana n’ikipe yawe y’abaganga, kwita ku mubiri wawe, no kumenya ko hari icyizere cyo gutwita neza mu gihe kizaza.

Ibibazo bikunze kubaho ku bubyimba bw’umubyibuho

Nshobora kongera gutwita nyuma y’ububyimba bw’umubyibuho?

Yego, abenshi bashobora kugira utwite twiza nyuma y’ububyimba bw’umubyibuho. Ariko rero, uzakenera gutegereza kugeza urwego rwa hCG rugarutse mu buryo busanzwe kandi umuganga wawe akaguha uburenganzira, ibyo bisanzwe bimamara amezi 6-12. Icyo gihe cyo gutegereza ni ingenzi mu gukurikirana neza no kugira ngo harebwe uko ukomeza gukira.

Nzagira ibyago byinshi by’ububyimba bw’umubyibuho mu gihe cy’ubutwite buzaza?

Nubwo kugira ububyimba bw’umubyibuho bumwe byongera gato ibyago byo kubona ikindi, ibyago muri rusange bikomeza kuba bike cyane kuri 1-2%. Abenshi mu bantu bagize ububyimba bw’umubyibuho bagira utwite twiza. Umuganga wawe azakukurikirana cyane mu gihe cy’ubutwite bwawe bwa mbere nk’uburyo bwo kwirinda.

Nzakenera gukurikiranwa igihe kingana gute nyuma yo kuvurwa?

Gukurikirana bisanzwe bikomeza amezi 6-12 nyuma yo kuvurwa, bitewe n’uburyo urwego rwa hCG rugaruka mu buryo busanzwe. Uzaba ufite ibizamini by’amaraso buri cyumweru mbere, hanyuma buri kwezi. Icyo gukurikirana ni ingenzi mu kugira ngo harebwe uko ukomeza gukira no kubona ingorane zishoboka hakiri kare.

Ububyimba bw’umubyibuho ni ubwoko bwa kanseri?

Ububyimba bw’umubyibuho ubwo bwonyine si kanseri, ariko ni kimwe mu bintu byitwa gestational trophoblastic disease. Mu bihe bidasanzwe, niba bitavuwe cyangwa ntibikurikiranwe, bishobora kuba kanseri yitwa choriocarcinome. Ariko rero, ubufasha bw’abaganga, ibyo bishobora kwirindwa kandi bikavurwa.

Ni iki nakora niba ntekereza ko mfite ububyimba bw’umubyibuho?

Hamagara umuganga wawe ako kanya niba ufite ibimenyetso biterwa impungenge nk’amaraso ava mu gitsina, kuruka cyane, cyangwa kuvamo imyenda isa n’imizabibu mu gihe cyo gutwita. Kumenya indwara hakiri kare no kuvurwa ni ingenzi kugira ngo harebwe ibyiza.