So wo nso wo ho yɛ wo yaw a wuntumi nnyina ano bere a wonyinsɛn no? Eyi betumi ayɛ Cholestasis of Pregnancy!

Ɛnanom pii hyia ɔhaw ahorow wɔ nyinsɛn mu. Bere a ɛyɛ ade a ɛfata sɛ ɛtɔ mmere bi a wobɛte nka sɛ wo ho yɛ wo yaw no, ɛtɔ mmere bi a ebetumi ayɛ biribi a ɛsɛ sɛ wohaw wo ho. Titiriw wɔ wo nyinsɛn no awiei no, sɛ wuhu sɛ wo ho reyɛ wo yaw a wuntumi nni so, efi ase fi wo nsateaa ne wo nan ase na afei wo nipadua nyinaa so a, ebetumi ayɛ tebea bi a wɔfrɛ no Cholestasis of Pregnancy ho sɛnkyerɛnne. So yɛbɛka eyi ho asɛm akɔ akyiri nnɛ? Mma ɛnhaw wo, ɛho hia paa sɛ wuhu eyi.

Dɛn ankasa ne Cholestasis of Pregnancy?

Sɛ yɛbɛka no tiawa a, nyinsɛn mu cholestasis yɛ tebea a ɛka mmerɛbo no . Ɛtaa ba wɔ nyinsɛn no fã a ɛto so abiɛsa mu, bɛyɛ adapɛn 28. Wɔ nnipa binom mu no, ebetumi aba ntɛm. Nnuruyɛfo nso frɛ no ``Intrahepatic Cholestasis of Pregnancy (ICP)`` anaa ``Awo mu Cholestasis``. Ebia woate saa nsɛm yi bere a wokɔ oduruyɛfo nkyɛn no.

Wɔ tebea yi mu no, mmea a wɔyem binom mmerɛbo dwumadi so tew bere tiaa bi. Afei, ade a wɔfrɛ no bile a ɛwɔ yɛn nipadua mu no nsen yiye na efi ase boaboa ano wɔ mmerɛbo ne mogya mu.

Dɛn ne bile?

Bile yɛ nsu a yɛn mmerɛbo no yɛ na ɛkora so wɔ akisikuru mu. Bere biara a yebedidi no, saa bile yi boa yɛn ma yɛyam srade a ɛwɔ aduan a yedi mu no. Enti, sɛ mogya mu bile dodow yi boro dodow a wɔhwehwɛ no so a, wufi ase nya saa ɛyaw a ɛyɛ hu no.

Saa tebea a ɛne cholestasis yi betumi de nsɛnnennen aba wo ne wo ba a ɔhyɛ yafunu mu no so. Ɛno nti na sɛ wo duruyɛfo susuw sɛ wowɔ saa tebea yi a, wɔbɛhwɛ wo ne wo ba no yiye wɔ wo nyinsɛn no bere a aka nyinaa mu no.

Sɛ mewɔ cholestasis bere a manyinsɛn a, dɛn na ɛba?

Eyi yɛ biribi a ɛsɛ sɛ yɛte ase. Wɔ nyinsɛn mu no, wo ba no de ne ho to wo mmerɛbo so ma eyi nneɛma fĩ fi ne nipadua mu. Enti, sɛ wo mmerɛbo no ntumi nyɛ adwuma yiye a, saa bile dodow a madi kan aka ho asɛm no betumi akɔ soro wɔ ɔkwan a asiane wom so. Eyi betumi de nhyɛso bi aba wo ba no mmerɛbo so nso. Mmɛn yɛ akwaa a ɛho hia paa wɔ yɛn nipadua mu no mu biako. Ɛyɛ beae titiriw a nipadua no yi nneɛma a wɔsɛe no fi hɔ. Enti sɛ ɛnyɛ adwuma yiye a, hokwan wɔ hɔ sɛ nsɛnnennen bɛba.

Nanso mma ɛnhaw wo . Wo duruyɛfo bɛhwɛ wo ne wo ba no daa ahwɛ sɛ cholestasis nsɛe mo mu biara.

Cholestasis abu so dɛn bere a wɔyem?

Saa tebea yi ka mmea a wɔyem 1,000 biara mu biako kosi baanu. Ɛno kyerɛ sɛ ɛnyɛ nea abu so saa. Ɛwom sɛ nhwehwɛmufo da so ara nnim nea ɛde ba ankasa de, nanso nsɛm a wɔanya kyerɛ sɛ ɛtaa ba awɔw bere mu. Wɔsan nso ka sɛ nnipa a wofi Hispanic ne Sweden abusua mu no taa nya bi.

Dɛn ne ade titiriw a ɛde cholestasis ba?

Sɛnea yɛadi kan aka ho asɛm no, bile yɛ ade a mmerɛbo no yɛ na wɔkora so wɔ akisikuru mu. Ɛboa ma srade mu paapae bere a wɔreyɛ aduan no. Wɔ nyinsɛn mu no, wo nipadua mu nkwaadɔm a wɔfrɛ no estrogen ne progesterone dodow kɔ soro kɛse. Saa nkwaadɔm yi dodow a ɛkɔ soro yi ka sɛnea mmerɛbo no tumi de bile kɔ baabiara yiye. Sɛ yɛbɛka no tiawa a, bile ntumi nkɔ nipadua no nyinaa mu, na mmom ɛboaboa ano wɔ mmerɛbo no mu na afei ɛsan kɔ mogya no mu. Sɛ bile boaboa ano wɔ mogya no mu a, wunya saa ɛyaw a wuntumi nnyina ano no.

Nyinsɛn mu cholestasis taa ba wɔ ɔsram abiɛsa a ɛto so abiɛsa mu, bɛyɛ adapɛn 28. Nea enti a ɛte saa ne sɛ nyinsɛn mu hormone dodow kɔ soro sen biara wɔ saa bere yi mu. Wɔ tebea horow bi mu no, ebetumi afi awosu mu . Eyi kyerɛ sɛ sɛ na w’awofo wɔ cholestasis a, wo nso wowɔ asiane mu sɛ wubenya bi.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya cholestasis bere a ɔyem?

Tebea yi ho sɛnkyerɛnne titiriw a ɛda adi kɛse ne ɛyaw a emu yɛ den (a ɛyɛ akisikuru) . Saa ɛyaw yi di kan fi ase wɔ nsateaa ne nan ase. Afei etumi trɛw nkakrankakra kɔ nipadua no afã afoforo. Wɔ nnipa pii fam no, saa akisikuru yi yɛ kɛse anadwo . Wɔkeka wɔn ho araa ma wontumi nna. Nea ɛnte sɛ tebea afoforo a ɛma obi ho yɛ no yaw no, cholestasis ntaa mma honam ani akisikuru . Eyi ho hia paa.

Wɔ ɛyaw akyi no, ebia sɛnkyerɛnne afoforo pii bɛba. Nanso, ɛnyɛ obiara na onya eyinom mu osuahu:

• Abofono
• Nsu a ɛyɛ sum
• Poop a ɛyɛ fitaa a ɛyɛ hare anaasɛ ɛyɛ bruu a ɛyɛ mmerɛw
• Ɔbrɛ a ɛtra so
• Aduan ho akɔnnɔ a ɛso tew
• Ɛyaw a ɛba wo yafunu nifa so atifi
• Jaundice - Wei kyere se wo honam ani ne w'ani fitaa dane kɔkɔɔ.

Sɛ wowɔ saa sɛnkyerɛnne yi mu biako anaa nea ɛboro saa a, ɛbɛyɛ papa sɛ wobɛhwehwɛ aduruyɛfo afotu ntɛm ara.

Nyinsɛn dapɛn bɛn mu na cholestasis fi ase?

Mpɛn pii no, nyinsɛn mu cholestasis fi ase wɔ nyinsɛn no adapɛn 28 akyi . Nanso, sɛnea madi kan aka no, nnipa binom tumi nya tebea no ntɛm. Enti ɛho hia sɛ wohu sɛnea ɛyɛ wo yaw no.

Ɔkwan bɛn so na wohu cholestasis bere a wɔyem?

Wo duruyɛfo no behu tebea yi denam nipadua mu nhwehwɛmu ne mogya mu nhwehwɛmu a ɔbɛyɛ so. Saa nhwehwɛmu ahorow yi betumi akyerɛ sɛnea wo mmerɛbo no reyɛ adwuma. Wɔbɛyɛ serum bile acid nhwehwɛmu nso de ahwɛ sɛnea bile acid dodow a ɛwɔ wo mogya mu no te.

Saa nhwehwɛmu ahorow yi betumi asi tebea yi so dua sɛ bile acid dodow nyinaa yɛ micromoles 10 wɔ lita biara mu (`micromoles 10 wɔ lita biara mu`) anaa nea ɛboro saa a. Micromoles yɛ ade a wɔde susuw nneɛma a wɔde di dwuma wɔ aduruyɛ mu nhwehwɛmu ahorow bi mu. Ebia wobɛyɛ mogya mu nhwehwɛmu daa nso de ahwɛ wo bile acid dodow wɔ wo nyinsɛn no bere a aka nyinaa mu.

Bio nso, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ prothrombin bere mu nhwehwɛmu mfa nhu sɛnea wo mogya no tu yiye, ne ultrasound mfa nhwɛ wo bile ntini ne wo mmerɛbo mu.

Ɔkwan bɛn so na wɔsa cholestasis bere a wɔyem?

Nnuru titiriw a nnuruyɛfo de sa tebea yi ne Ursodeoxycholic acid (UDCA) . Wɔsan frɛ no `(ursodiol)` anaa `(Actigall®)`. Saa aduru yi boa ma wo mmerɛbo no yɛ adwuma yiye na ɛtew bile dodow a ɛwɔ wo mogya mu no so.

Bio nso, ayaresa ahorow bi wɔ hɔ a wɔde siw cholestasis ho sɛnkyerɛnne ahorow ano, titiriw no, ɛyaw a emu yɛ den no:

• Aduru a wɔde sa ɛyaw: (Nanso kae sɛ akyinnye biara nni ho sɛ ɛsɛ sɛ wubisa wo duruyɛfo ansa na woanom aduru biara.)
• Hyɛ ntade a ɛyɛ mmerɛw na ɛnyɛ den: Sɛ wohyɛ ntade a ɛyɛ den a, ebetumi ama ɛyaw no ayɛ kɛse. Enti, hyɛ ntade a ɛnyɛ den a wɔde ntama a ɛyɛ mmerɛw te sɛ kotoku ayɛ.
• Ahomegye: Ahomegye a ɛsɛ a wubenya nso ho hia yiye.
• Nsu a ɛyɛ hyew a wobɛguare: Sɛ wode wo ho bɛhyɛ nsu a ɛyɛ nwini mu kakra a, ebetumi ama woanya ahotɔ kakra afi ɛyaw mu.

Ɛtɔ mmere bi a, sɛ nnuru mma wo bile dodow so ntew a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ fa wo ba no ntɛm kakra, ansa na bere a ɛsɛ sɛ wowo no adu. Awo a wɔma wɔma ɛba, mpɛn pii no bɛyɛ adapɛn 37 anaa 38 no betumi atew asiane a ɛwɔ hɔ sɛ ɔhaw ahorow a efi cholestasis mu ba no so. Wo duruyɛfo nso bɛyɛ nhwehwɛmu te sɛ biophysical profile anaa nonstress test de ahwɛ ahu sɛ wo ba no ho ye.

Sɛ wɔwo akokoaa no ntɛm a, wobetumi ama akokoaa no aduru bi a wɔfrɛ no steroid na aboa akokoaa no ahurututu ma wanyin yiye ne vitamin K a wɔde bɛma no na wɔasiw mogya a ɛbɛtu wɔ ne mu no ano.

Dɛn ne nsɛnnennen a ebetumi afi cholestasis mu aba bere a wɔyem no?

Nyinsɛn mu cholestasis betumi de nsɛnnennen aba. Ebia ɛbɛyɛ den ama wo sɛ wobɛtwe vitamin K , a ɛma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ wo mu dodo no yɛ kɛse. Wobetumi de abata tebea horow te sɛ preeclampsia (mogya mmoroso bere a wɔyem) ne asikreyare a ɛba wɔ nyinsɛn mu nso ho .

Nsɛnnennen a ebetumi aba akokoaa no so ne:

• Awo a ɛba ntɛm
• Stillbirth - Wei ye biribi a nnipa bebree suro. Nanso, sɛ nnuruyɛfo hwɛ wɔn so yiye a, asiane yi betumi atew kɛse.
• Fetal distress - Wei kyerε sε akokoaa no rehyia ɔhaw wɔ awotwaa no mu.
• Meconium aspiration - Akokoaa bi to ne ho fi ne yafunu mu na ɔhome.

Nea ɛbɛyɛ na asiane a ɛwɔ hɔ sɛ ɔhaw ahorow a ɛte sɛ eyinom benya no so atew no, ɛtɔ mmere bi a wo duruyɛfo si gyinae sɛ ɔbɛwo akokoaa no ntɛm kakra.

So ebetumi aba sɛ wobɛwo akokoaa a ɔwɔ apɔwmuden sɛ wowɔ cholestasis bere a wonyinsɛn a?

Yiw, akyinnye biara nni ho sɛ wubetumi! Esiane sɛ na wowɔ cholestasis bere a na wonyinsɛn nti, ɛnkyerɛ sɛ wo ba no rennya apɔwmuden. Sɛ ɛnanom dodow no ara hwɛ ayarehwɛ na wɔhwɛ wɔn yiye a, wɔwo nkokoaa a wɔwɔ apɔwmuden. Enti mma ɛnhaw wo a ɛho nhia.

So nneɛma bi wɔ hɔ a ɛsɛ sɛ mekwati sɛ medi bere a mewɔ cholestasis no?

Ebia wo duruyɛfo betu wo fo sɛ to nnuan bi ano hye a egyina wo tebea no so. Nanso, aduan ho nhyehyɛe pɔtee biara nni hɔ (aduan a wɔde di dwuma daa) a ɛsɛ sɛ wudi akyi sɛ wowɔ cholestasis bere a wonyinsɛn a. Ade a ɛho hia sen biara ne sɛ wubedi aduan a ɛkari pɛ bere a wonyinsɛn no. Eyi kyerɛ sɛ wubedi nnuaba, nhabannuru, nam a ɛnyɛ den anaa protein fibea afoforo. Wo ne wo duruyɛfo nka eyi ho asɛm na nya afotu pii.

So wobetumi asiw cholestasis ano bere a wɔyem no?

Nea ɛyɛ awerɛhow no, ɔkwan biara nni hɔ a wɔbɛfa so asiw cholestasis ano bere a wɔyem no. Nanso, awosu mu nhwehwɛmu betumi aboa ma woate asiane a ɛwɔ tebea no mu a wɔde bɛma wo ba no ase.

Dɛn ne asiane ahorow a ɛde cholestasis ba bere a wɔyem no?

Ɛwɔ asiane kɛse mu sɛ wubenya cholestasis bere a woanyinsɛn sɛ:

• Sɛ obi a ɔwɔ w’abusua mu anya saa tebea yi pɛn a (Ma abusua muni bi a ɔwɔ tebea no).
• Sɛ woanya cholestasis (ICP) wɔ nyinsɛn a atwam mu a.
• Sɛ worehwɛ mmanoma, mma mmiɛnsa anaa nea ɛboro saa kwan a.
• Sɛ wowɔ mmerɛbo mu yare anaa hepatitis C ho abakɔsɛm a.
• Sɛ wowɔ abakɔsɛm a ɛkyerɛ sɛ wo mmerɛbo asɛe a.
• Sɛ wowɔ awosu mu tebea bi a ɛka sɛnea wo nipadua yɛ bile na ɛde di dwuma a.

Sɛ wowɔ asiane ahorow yi a, hwɛ yiye titiriw wɔ akisikuru a ɛbɛba bere a wonyinsɛn no ho.

Dɛn ne nkɔmhyɛ a ɛwɔ hɔ ma wɔn a wɔwɔ nyinsɛn mu cholestasis?

Eyi ne asɛmpa a eye sen biara! Mpɛn pii no nyinsɛn mu cholestasis no fi hɔ wɔ nna kakraa bi mu wɔ akokoaa no awo akyi . Wo mogya mu nsu a ɛwɔ wo mogya mu no bɛsan ayɛ sɛnea na ɛte kan no. Sɛ wo bile dodow san kɔ sɛnea na ɛte kan no a, wubetumi agyae w’aduru no nom.

Nnipa dodow no ara nnya mmerɛbo mu haw biara akyiri yi mfi tebea yi mu, gye sɛ wonyinsɛn bio. Sɛ wowɔ cholestasis pɛnkoro a, .60% wɔ hɔ sɛ ɛbɛsan asi bio wɔ nyinsɛn a edi hɔ no mu. Nanso, sɛ wowɔ cholestasis a emu yɛ den a, hokwan a ɛwɔ hɔ sɛ ɛbɛsan asi bio wɔ nyinsɛn a edi hɔ mu no betumi akɔ soro akodu 90%.

Bere bɛn na ɛsɛ sɛ mekɔ me duruyɛfo nkyɛn?

Sɛ wo ho yɛ wo yaw a wuntumi nnyina ano wɔ nyinsɛn mu a ɛrenkɔ, anaasɛ wo honam ani anaa w’ani fitaa no yɛ kɔkɔɔ (jaundice ho sɛnkyerɛnne) a, kɔ wo duruyɛfo nkyɛn ntɛm ara. Ebia ɛnyɛ nea efi cholestasis mu na saa sɛnkyerɛnne ahorow yi ba, nanso eye sɛ wobɛkɔ akɔhwɛ.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wohu sɛ wowɔ nyinsɛn mu cholestasis a, ebia wobɛpɛ sɛ wubisa wo duruyɛfo nsɛm te sɛ eyinom:

• Nyinsɛn mu cholestasis yɛ aniberesɛm dɛn?
• Ayaresa ahorow bɛn na mewɔ?
• Dɛn na metumi ayɛ de abɔ me ho ne me ba no ho ban?
• Sɛ manya cholestasis (ICP) pɛn a, dɛn na ɛsɛ sɛ mihu fa nyinsɛn a ɛbɛba daakye ho?

Nsuro sɛ wubebisa nsɛm te sɛ eyinom. Wo duruyɛfo wɔ hɔ sɛ ɔbɛboa wo na wasiesie adwenem naayɛ biara a ebia wowɔ.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Cholestasis of pregnancy yɛ tebea a ɛma ɛyɛ yaw kɛse bere a nyinsɛn no. Mma wo ho nnpopo bere a wote eyi no. Wo duruyɛfo bɛhwɛ wo ne wo ba no yiye na wama wo ayaresa a ɛho hia. Saa tebea yi fi hɔ koraa bere a wɔawo akokoaa no akyi na mpɛn pii no ɛnyɛ nea ɛde ne nkwa to asiane mu. Ɛtɔ da bi a, ebia wo duruyɛfo besi gyinae sɛ ɔbɛwo wo ba no ntɛm kakra na ama mo baanu nyinaa anya ahobammɔ.

Nea ɛho hia sen biara ne sɛ, sɛ wowɔ nsɛmmisa, adwenem naayɛ, anaa ehu bi wɔ eyi ho a, wo ne wo duruyɛfo nka ho asɛm. Wɔwɔ hɔ sɛ wobetie wo na wɔayɛ nea ɛho hia na ama wo ne wo ba no akɔ so ayɛ dwoodwoo. Ɛnyɛ wo nko ara, na nnuruyɛfo bi wɔ hɔ a wobetumi aboa wo wɔ akwantu yi mu.

Enti, mewɔ anidaso sɛ saa nsɛm yi bɛboa wo. Yɛpɛ sɛ wunya nyinsɛn a ahoɔden wom ne awo a ahoɔden wom!

` Cholestasis a nyinsɛn, ɛyaw bere a nyinsɛn, mmerɛbo mu yare, ICP, nyinsɛn akwahosan, bile a ɛboaboa ano, akokoaa akwahosan