Ohss

I-Ovarian hyperstimulation syndrome iwukusabela okukhulu kakhulu kumahomoni amaningi. Ngokuvamile kwenzeka kubesifazane abasebenzisa imithi yamahomoni yokutshela ukuze kuthuthukiswe amaqanda e-ovari. I-Ovarian hyperstimulation syndrome (OHSS) ibangela ukuba ama-ovari avuvuke futhi abe buhlungu.

I-OHSS ingase ibonakale kubesifazane abenza i-in vitro fertilization (IVF) noma ukuqaliswa kokukhishwa kwamaqanda ngemithi yokutshela. Ngokungavamile, i-OHSS iyenzeka ngesikhathi sokwelashwa kokuzala ngemithi oyithatha ngomlomo, njenge clomiphene.

Ukuphathwa kuxhomeke ezingeni lobunzima besimo. I-OHSS ingase iphulukane yodwa ezimweni ezilula, kuyilapho izimo ezinzima zingadinga ukungena esibhedlela nokuphathwa okwengeziwe.

Izimpawu ze-ovarian hyperstimulation syndrome zivame ukuqala ngaphakathi kweviki elilodwa ngemva kokusebenzisa imithi yokugcoba ukuvuselela ukukhishwa kweqanda, nakuba ngezinye izikhathi kungathatha amasonto amabili noma ngaphezulu ngaphambi kokuba izimpawu zivele. Izimpawu zingase zibe zibunzima obukhulu noma obuncane futhi zingase zibe zimbi noma zibe ngcono ngokuhamba kwesikhathi.

Uma unezinkinga zokukhulelwa futhi uhlushwa yizimpawu ze-ovarian hyperstimulation syndrome, tshela umhlinzeki wakho wezinsizakalo zezempilo. Ngisho noma une-OHSS emaphakathi, umhlinzeki wakho uzofuna ukukubuka ukuze abone ukuthi kukhona ukwanda kwenani lomzimba noma ukwanda kwezimpawu. Xhumana nomhlinzeki wakho ngokushesha uma uthola ubunzima bokuqeda umoya noma ubuhlungu ezinyaweni zakho ngesikhathi sokwelashwa kokukhulelwa. Lokhu kungase kubonise isimo esiphuthumayo esidinga ukunakekelwa ngokushesha kwezokwelapha.

Imbangela ye-ovarian hyperstimulation syndrome ayiqondakali ngokuphelele. Ukuba namanqanaba aphezulu e-human chorionic gonadotropin (HCG) - i-hormone evame ukukhiqizwa ngesikhathi sokukhulelwa - efakwe emzimbeni wakho, idlala indima. Izitho zegazi ze-ovari ziphendula ngokungalungile ku-human chorionic gonadotropin (HCG) bese ziqala ukuvuza amanzi. La manzi abumba ama-ovari, futhi ngezinye izikhathi inani elikhulu liya esiswini.

Phakathi nokwelashwa kokukhulelwa, i-HCG ingase inikezwe njenge "trigger" ukuze i-follicle evuthiwe ikhiphe iqanda layo. I-OHSS ngokuvamile kwenzeka ngaphakathi nesonto elilodwa ngemuva kokuthola ukugonywa kwe-HCG. Uma ukhulelwa phakathi kwesikhathi sokwelashwa, i-OHSS ingaba sibi kakhulu njengoba umzimba wakho uqala ukukhiqiza i-HCG yakho ngokuzimela njengomphendulo ekukhulelweni.

Amakhambi okukhulelwa ahlanganisiwe anethuba elikhulu lokubangela i-OHSS kunokwelashwa nge-clomiphene, i-medication enikezwa njengephilisi olithatha ngomlomo. Ngezinye izikhathi i-OHSS ivela ngokwayo, ayihlobene nokwelashwa kokukhulelwa.

Ngesinye isikhathi, i-OHSS kwenzeka kwabesifazane abangenazo nhlobo izimbangela ezingozi. Kodwa izimbangela ezibonakala zanda amathuba okuthola i-OHSS zihlanganisa:

• I-Polycystic ovary syndrome — isifo esivamile sokuzala esibangela ukuqina okungajwayelekile kwesikhathi, ukukhula okukhulu kwezinwele kanye nokuvela okungajwayelekile kwama-ovari ekuhlolweni kwe-ultrasound
• Inani elikhulu lama-follicles
• Ubudala obungaphansi kweminyaka engu-35
• Isisindo somzimba esincane
• Izinga eliphezulu noma elikhuphuka ngokushesha le-estradiol (i-estrogen) ngaphambi kokudubula kwe-HCG
• Izimo zangaphambili ze-OHSS

I-sindroma enamandla yokukhuluphala kwama-ovari ayindabuko, kodwa ingaba yingozi eyingozi. Izinkinga ezingase zenzeke zihlanganisa:

• Ukubuthana kwamanzi esiswini, ngezinye izikhathi nasesifubeni
• Ukuphazamiseka kwama-electrolyte (isodium, i-potassium, nabanye)
• Ama-blood clots ezinsimini ezinkulu, ngokuvamile ezinyaweni
• Ukwehluleka kwempilo yokukhuluphala
• Ukuphefumula kwe-ovari (i-ovarian torsion)
• Ukuphazamiseka kwe-cyst e-ovari, okungabangela ukuphulukana negazi elibi kakhulu
• Izinkinga zokuphefumula
• Ukukhulelwa kokukhulelwa ngenxa yokukhulelwa noma ukupheliswa ngenxa yezinkinga
• Ngokungaqondakali, ukufa

Ukuze unciphise amathuba akho okukhula i-ovarian hyperstimulation syndrome, uzodinga uhlelo oluqondene nawe lwemiyekezo yakho yokuzala. Lindela umhlinzeki wakho wezempilo ukuthi alandelele ngokucophelela yonke imijikelezo yokwelashwa, kuhlanganise ne-ultrasounds ejwayelekile ukuhlola ukuthuthukiswa kwama-follicles kanye nokuphehla igazi ukuhlola amazinga akho ehormone. Izindlela zokusiza ukuvimbela i-OHSS zihlanganisa:

• Ukulungisa imithi. Umhlinzeki wakho usebenzisa umthamo ophansi kakhulu we-gonadotropins ukukhuthaza ama-ovari akho futhi uqalise ukukhishwa kweqanda.
• Ukuwengeza imithi. Eminye imithi ibonakala inciphise ingozi ye-OHSS ngaphandle kokuthinta amathuba okukhulelwa. Lezi zihlanganisa i-aspirin ephansi; i-dopamine agonists efana ne-carbergoline noma i-quinogloide; kanye ne-calcium infusions. Ukupha abesifazane abane-polycystic ovary syndrome imithi i-metformin (Glumetza) ngesikhathi sokusheshisa ama-ovari kungasiza ukuvimbela ukukhuluphala kakhulu.
• Ukuhamba kancane. Uma amazinga akho e-estrogen aphezulu noma unezinombolo ezinkulu zama-follicles athuthukisiwe, umhlinzeki wakho angase akuyeke ukusebenzisa imithi ehlanganisiwe futhi ulinde izinsuku ezimbalwa ngaphambi kokunika i-HCG, okuqalisa ukukhishwa kweqanda. Lokhu kuyaziwa ngokuthi ukuhamba kancane.
• Ukugwema ukusetshenziswa kwe-HCG trigger shot. Ngoba i-OHSS ivame ukuthuthuka ngemuva kokunikezwa kwe-HCG trigger shot, ezinye izindlela ze-HCG zokuthinta seziye zakhiwa usebenzisa i-gonadotropin-releasing hormone (Gn-RH) agonists, efana ne-leuprolide (Lupron), njengendlela yokuvimbela noma ukulinganisela i-OHSS.
• Ukubandisa ama-embryos. Uma uqala i-in vitro fertilization (IVF), wonke ama-follicles (afuthiwe nangafuthiwe) angasuswa kuma-ovari akho ukuze kunciphise amathuba e-OHSS. Ama-follicles afuthiwe ahlanganiswa futhi abandiswe, futhi ama-ovari akho avunyelwe ukuphumula. Ungaqala kabusha inqubo ye-IVF ngesikhathi esizayo, lapho umzimba wakho ulungile.

Ukuxilongwa kwe-ovarian hyperstimulation syndrome kungaqaleka ngokusebenzisa okuhlangenwe nakho okulandelayo:

• Ukuhlolwa komzimba. Umhlinzeki wakho wezempilo uzobheka noma ikhona inzuzo yobunzima bomzimba, ukwanda komthamo wesisu, kanye nobuhlungu besisu obunokuba khona.
• I-ultrasound. Uma une-ovarian hyperstimulation syndrome (OHSS), i-ultrasound ingabonisa ukuthi ama-ovari akho amakhulu kunokujwayelekile, ane-cysts eziningi ezigcwele amanzi lapho ama-follicles akhule khona. Phakathi nokwelashwa ngemithi yokuzala, umhlinzeki wakho wezempilo uhlola njalo ama-ovari akho nge-ultrasound ye-vaginal.
• Ivivinyo legazi. Izivivinyo ezithile zegazi zivumela umhlinzeki wakho wezempilo ukuthi ahlole ukungapheleli kwegazi lakho nokuthi umsebenzi wempilo yengculazi yakho uyancipha yini ngenxa ye-OHSS.

I-Ovarian hyperstimulation syndrome (OHSS) ngokuvamile iyaphela yodwa ngaphakathi kweviki noma ezimbili noma isikhathi eside kakhulu uma ukhulelwe. Ukwelashwa kugxilwe ekukwenzeni ukhululeke, ukunciphisa umsebenzi we-ovary nokuvimba izinkinga.

I-OHSS emaphakathi ngokuvamile iyaphela yodwa. Ukwelashwa kwe-OHSS ephakathi kungabandakanya:

Ngokuqina kwe-OHSS, kungase kudingeke ukwamukelwa esibhedlela ukuze kulandelelwe futhi kunikezwe ukwelashwa okuqine kakhulu, okuhlanganisa ne-IV fluids. Umhlinzeki wakho angakunika imithi ebizwa nge-cabergoline ukuze unciphise izimpawu zakho. Ngezinye izikhathi, umhlinzeki wakho angakunika nezinye izidakamizwa, njenge-gonadotropin-releasing hormone (Gn-RH) antagonist noma i-letrozole (Femara) - ukusiza ekuvinjeni umsebenzi we-ovary.

Izinkinga ezingathi sína zingadinga ukwelashwa okwengeziwe, njengokuhlinzwa kwe-ovarian cyst ephukile noma ukunakekelwa okuqine kakhulu kwezinkinga zesibindi noma emaphaphwini. Ungase futhi udinga imithi ye-anticoagulant ukuze unciphise ingozi ye-blood clots ezinyaweni zakho.

• Ukusetshenziswa okwandisiwe kwamanzi
• Ukuhlolwa komzimba njalo kanye ne-ultrasounds
• Ukulinganiswa kwesisindo nsuku zonke kanye nokulinganiswa komthamo ukuhlola izinguquko ezinkulu
• Ukulinganiswa kokuthi ukhupha kangakanani umchamo nsuku zonke
• Izivivinyo zegazi ukuqapha ukuphelelwa amanzi, ukungalingani kwe-electrolyte nezinye izinkinga
• Ukususa amanzi amaningi esiswini usebenzisa unhlangothi olufakwe esiswini sakho
• Imithi yokuvimbela i-blood clots (i-anticoagulants)

Uma uthuthukisa i-ovarian hyperstimulation syndrome emaphakathi, cishe uzokwazi ukuqhubeka nomkhuba wakho wansuku zonke. Landela iseluleko somhlinzeki wakho, okungafaka lezi zikhuthazo:

• Zama umhluzi wokunciphisa ubuhlungu oqhutshwa ngaphandle kokubhalwa kwelungu, njenge-acetaminophen (Tylenol, nabanye) ukuze unciphise ubuhlungu esiswini, kodwa gwema i-ibuprofen (Advil, Motrin IB, nabanye) noma i-naproxen sodium (Aleve, nabanye) uma usanda kuthola ukudluliswa kwembrio, njengoba lezi zidakamizwa zingaphazamisa ukufakwa kwembrio.
• Gwema ucansi, njengoba kungaba buhlungu futhi kungabangela ukuba i-cyst esiqwini sakho iqhekeke.
• Gcina izinga lokusebenza komzimba olukhanyayo, ugweme imisebenzi enzima noma enkulu.
• Zinzisa ngesikali esifanayo futhi ulinganise ngokuphahlazeka kwesisu sakho nsuku zonke, ubike ukwanda okungavamile kumhlinzeki wakho.
• Shaya umhlinzeki wakho uma izimpawu zakho nezimpawu ziya ziba zimbi.