Ohss

Ovarian hyperstimulation syndrome (OHSS) ni uburyo umubiri ugaragaza ububabare bwinshi bitewe n'imisemburo myinshi. Akenshi iba mu bagore bafata imiti igizwe n'imisemburo ishyirwa mu mubiri hakoreshejwe inshinge kugira ngo ishyushye intanga ngabo mu gihagararo. OHSS itera ko ibihagararo byuzuye bikaba bibabaza.

OHSS ishobora kugaragara mu bagore bakora in vitro fertilization (IVF) cyangwa bahabwa imiti igamije gutuma intanga ngabo zikura zikaba nyinshi hakoreshejwe inshinge. Gake cyane, OHSS iba mu gihe cyo kuvura ikibazo cyo kubura imbuto hakoreshejwe imiti unywa, nka clomiphene.

Uburyo bwo kuvura biterwa n'uburemere bw'uburwayi. OHSS ishobora kwikira mu gihe ari mu rwego rworoshye, mu gihe uburemere bukabije busaba kujyanwa kwa muganga no kuvurwa byihariye.

Ibimenyetso bya syndrome yo kwiyongera kw'amagi akenshi bitangira mu cyumweru kimwe nyuma yo gukoresha imiti iterwa mu mubiri yo gukangurira ovulation, nubwo rimwe na rimwe bishobora gufata ibyumweru bibiri cyangwa birenga kugira ngo ibimenyetso bigaragara. Ibimenyetso bishobora kugenda kuva ku bworoherane kugeza ku kuremereye kandi bishobora kuba bibi cyangwa bikagenda biturutse ku gihe.

Niba ufite ibibazo byo kubyara kandi ukagira ibimenyetso bya ovarian hyperstimulation syndrome, bimenyeshe umuganga wawe. Nubwo waba ufite OHSS yoroheje, umuganga wawe azakwitegereza kugira ngo arebe ko nta kibazo cyo kwiyongera k'umubyibuho cyangwa ibimenyetso bikomeye byabaho.

Hamagara umuganga wawe ako kanya niba ugize ikibazo cyo guhumeka cyangwa ububabare mu birenge igihe uri kuvurwa kugira ngo ubyare. Ibi bishobora kugaragaza ikibazo gikomeye gisaba ubuvuzi bwihuse.

Impamvu y'indwara ya hyperstimulation syndrome (OHSS) ntiyumvikana neza. Kugira urwego rwo hejuru rwa hormone ya human chorionic gonadotropin (HCG) - hormone isanzwe ikorwa mu gihe cyo gutwita - yinjijwe mu mubiri wawe, bigira uruhare. Udukoresho tw'amaraso mu gihagararo bigira imikorere idasanzwe kuri human chorionic gonadotropin (HCG) maze bigatangira gushyira hanze amazi. Aya mazi atuma amagi ababara, kandi rimwe na rimwe, ingano nyinshi yayo ijya mu nda.

Mu gihe cyo kuvura ubugumba, HCG ishobora gutangwa nk' ''igikorwa cyo gutera'' kugira ngo follicle ikure isohore intanga ngabo. OHSS isanzwe ibaho mu gihe cy'icyumweru kimwe nyuma yo guhabwa inshinge ya HCG. Niba utwite mu gihe cyo kuvura, OHSS ishobora kuba mbi cyane uko umubiri wawe utangira gukora HCG kubera gutwita.

Imiti yo kuvura ubugumba iterwa mu mubiri ifite ibyago byinshi byo gutera OHSS kurusha kuvurwa na clomiphene, imiti ifatwa mu kanwa. Rimwe na rimwe OHSS ibaho ukwayo, idafitanye isano no kuvura ubugumba.

Rimwe na rimwe, OHSS ibaho mu bagore badafite ibyago na mba. Ariko ibintu bizwi ko byongera ibyago bya OHSS birimo:

• Polycystic ovary syndrome — indwara ikunze kugaragara mu myanya y’ubugore itera imihango idahwitse, ubwiyongere bw’ububura bw’umubiri n’isura idasanzwe y’ovari mu isuzuma rya ultrasound
• Umubare munini w’amagi
• Imyaka iri munsi ya 35
• Kurema umubiri muke
• Ikiyiko cyane cyangwa cyiyongera cyane cya estradiol (estrogen) mbere yo gutera HCG
• Ibihe byabanje bya OHSS

Sindrome ikabije y'amagi kubera imiti itera ovulation ikunze kubaho gake, ariko ishobora guhitana. Ingaruka zishobora kuba:

• Imyanda y'amazi mu nda, rimwe na rimwe no mu kifuba
• Kugira ibibazo by'amara (sodium, potasium, n'ibindi)
• Amaraso akabana mu mitsi minini, akenshi mu birenge
• Gusinzira kw'impyiko
• Kugenda kw'igi (ovarian torsion)
• Kwatuka kw'igice mu gi, bishobora gutera kuva amaraso cyane
• Kugira ibibazo byo guhumeka
• Gutakaza imbanyi kubera gukuramo inda cyangwa kubera ingaruka z'indwara
• Mu bihe bidafite akenshi, urupfu

Kugira ngo ugabanye ibyago byo kwibasirwa na syndrome yo kwiyongera kw'amagi (ovarian hyperstimulation syndrome), uzakenera gahunda yihariye y'imiti ivura ubugumba. Tegereza ko umuganga wawe akurikirana buri gihe cyo kuvurwa, harimo gukoresha ikoranabuhanga rya ultrasound kenshi kugira ngo arebe uko amagi akura ndetse n'ibipimo by'amaraso kugira ngo arebe urwego rw'imisemburo yawe. Uburyo bwo kwirinda OHSS harimo:

• Guhindura imiti. Umuganga wawe akoresha umwanya muke ushoboka w'imiti ya gonadotropins kugira ngo akangurire amagi yawe kandi atangize ovulation.
• Kongeramo imiti. Imiti imwe isa nkaho igabanya ibyago bya OHSS idahungabanya amahirwe yo gutwita. Ibi birimo aspirine nke; imiti ya dopamine agonists nka carbergoline cyangwa quinogloide; ndetse n'imiti ya calcium. Gutanga imiti ya metformin (Glumetza) ku bagore bafite polycystic ovary syndrome mu gihe cyo gukangurira amagi bishobora gufasha kwirinda hyperstimulation.
• Guhagarara. Niba urwego rwawe rwa estrogen ruri hejuru cyangwa ufite umubare munini w'amagi akomeye, umuganga wawe ashobora kukubuza gukoresha imiti iterwa mu mubiri kandi ukategereza iminsi mike mbere yo gutanga HCG, itangiza ovulation. Ibi bizwi nka coasting.
• Kwimakaza gukoresha HCG trigger shot. Kubera ko OHSS ikunze kugaragara nyuma yo gutanga HCG trigger shot, hari ubundi buryo bwo gutangiza ovulation bukozwe hakoreshejwe imiti ya gonadotropin-releasing hormone (Gn-RH) agonists, nka leuprolide (Lupron), nk'uburyo bwo kwirinda cyangwa kugabanya OHSS.
• Gukonjesha intanga. Niba uri gukora in vitro fertilization (IVF), amagi yose (akomeye n'atacyekanye) ashobora gukurwa mu magi yawe kugira ngo hagabanywe ibyago bya OHSS. Amagi akomeye arangizwa kandi akonjeshwa, kandi amagi yawe ahabwa umwanya wo kuruhuka. Ushobora gusubukura IVF nyuma y'igihe, igihe umubiri wawe uzaba witeguye.

Ubwoko bw'indwara ya Ovarian hyperstimulation syndrome bushobora gushingirwa kuri ibi bikurikira:

• Isuzumwa ry'umubiri. Umuganga azashakisha ibimenyetso by'uburyo uburemere bw'umubiri bwiyongereye, ukuguruka kw'inda n'ububabare bw'inda ushobora kuba ufite.
• Amashusho y'inyo y'umubiri (échographie). Niba ufite indwara ya ovarian hyperstimulation syndrome (OHSS), amashusho y'inyo y'umubiri ashobora kwerekana ko ibiheri byawe ari binini ugereranyije n'ibisanzwe, bikaba birimo amazi menshi aho igihe cy'intanga cyateye imbere. Mu gihe cyo kuvurwa hakoreshejwe imiti yongerera ubushobozi bw'imyororokere, umuganga wawe azahora asuzuma ibiheri byawe akoresheje amashusho y'inyo y'umubiri akoreshwa mu gitsina.
• Isuzumwa ry'amaraso. Ibizamini bimwe by'amaraso bituma umuganga wawe ashobora kureba niba hari ikibazo mu maraso yawe ndetse niba imikorere y'impyiko yawe itangira guhungabana kubera OHSS.

Sindrome ya hyperstimulation y'ovari ikunda kwikemura yonyine mu cyumweru kimwe cyangwa bibiri, cyangwa igihe kirekire gato niba utwite. Ivuriro rigamije kugutuma wumva utekanye, kugabanya imikorere y'ovari no kwirinda ingaruka mbi.

OHSS ya hato hamwe ikunda kwikemura yonyine. Ivuriro rya OHSS iciye icyuho rishobora kuba ririmo:

Ku OHSS ikomeye, bishobora kuba ngombwa ko ujyanwa mu bitaro kugira ngo ugenzurwe kandi uvurwe cyane, harimo amazi ya IV. Umuganga wawe ashobora kuguha imiti yitwa cabergoline kugira ngo igabanye ibimenyetso byawe. Rimwe na rimwe, umuganga wawe ashobora kandi kuguha imiti indi, nka antagonist ya gonadotropin-releasing hormone (Gn-RH) cyangwa letrozole (Femara) - kugira ngo afashe mu kugabanya imikorere y'ovari.

Ingaruka mbi zikomeye zishobora gusaba ubundi buryo bwo kuvura, nko kubaga imyeyo yavunitse cyangwa kwitabwaho cyane kubera ingaruka mbi ku mwijima cyangwa ku mpyiko. Ushobora kandi gukenera imiti igabanya ubusembwa kugira ngo ugabanye ibyago by'amaraso mu birenge byawe.

• Kugira amazi menshi
• Kusuzuma umubiri kenshi no gukoresha ultrasound
• Kupima ibiro buri munsi no gupima ingano y'ibitugu kugira ngo harebwe impinduka zikomeye
• Gupima umusaruro w'umushishi buri munsi
• Ibizamini by'amaraso kugira ngo hagenzurwe kuzimangana, kudahuza kwa electrolytes n'ibindi bibazo
• Gusohora amazi y'umubiri arenze urugero hakoreshejwe umugozi ushyirwa mu kibuno
• Imiti ibuza amaraso gukomera (anticoagulants)

Niba ufite syndrome yoroheje yo gukangurira amagi cyane, urashobora gukomeza gahunda yawe ya buri munsi. Kurikiza inama z'abaganga bawe, zishobora kuba zirimo ibi bikurikira:

• Gerageza imiti igabanya ububabare iboneka mu maduka, nka acetaminophen (Tylenol, izindi), kugirango ugabanye ububabare mu nda, ariko wirinda ibuprofen (Advil, Motrin IB, izindi) cyangwa naproxen sodium (Aleve, izindi) niba uherutse kubagwa, kuko iyo miti ishobora kubangamira gutera kw'umunembwe.
• Irinde imibonano mpuzabitsina, kuko bishobora kubabaza kandi bikaba byatuma igice cy'igi cyuzuye cyavuka.
• Komeza umubiri wawe ukorere utuje, wirinda imikino ikomeye cyangwa ikubita cyane.
• Pima ibiro byawe kuri metero imwe kandi upime ingano y'inda yawe buri munsi, utangaze ibyiyongere bitunguranye ku muganga wawe.
• Hamagara muganga wawe niba ibimenyetso byawe bikomeye.