So mogya nso tuu wo pii bere a wowoo akokoaa no? Momma yɛnka Awo Akyi Mogya (PPH) ho asɛm .

Ɛyɛ ade a ɛfata sɛ mogya bɛtɔ wo kakra wɔ awo akyi. Nanso sɛ mogya tu wo pii sen sɛnea wususuwii nso ɛ? Ebetumi ayɛ hu na asiane wom ankasa. Eyi ne nea yɛfrɛ no awo akyi mogyatɔw (PPH) . Eyi nyɛ aseresɛm, ɛyɛ tebea a ɛhwehwɛ sɛ wɔkɔ ayaresabea ntɛm ara.

Dɛn ne awo akyi mogyatɔw (PPH)? Momma yɛnte ase pɛpɛɛpɛ?

Sɛ yɛbɛka no tiawa a, awo akyi mogya (PPH) yɛ mogya a ɛtɔ kɛse wɔ awo akyi. Eyi taa ba wɔ nnɔnhwerew 24 akyi wɔ awo akyi. Yɛfrɛ no ‘Primary PPH’ . Nanso ɛtɔ mmere bi a, mogya tumi tu wɔ awo akyi nna kakraa bi, adapɛn kakraa bi, anaa adapɛn 12 mpo. Wɔfrɛ eyi sɛ ‘Secondary anaa Late PPH’ .

Nea ɛba wɔ eyi mu ne sɛ mogya pii yera fi wo nipadua mu prɛko pɛ. Sɛ eyi ba a, wo mogya mmoroso betumi akɔ fam mpofirim. Dɛn na ɛba saa bere no? Mogya dodow a ɛkɔ koma, amemene, ne akwaa afoforo a ɛho hia mu no so tew. Wɔfrɛ eyi hypovolemic shock . Eyi betumi de nkwa ato asiane mu. Enti, ɛsɛ sɛ nnuruyɛfo ne ayarehwɛfo gyae mogya a ɛretu yi ntɛm.

Kae sɛ, sɛ wote nka sɛ mogya retu wo pii bere a woawo akokoaa akyi a, ɛyɛ hu. Nanso adeɛ a ɛho hia paa ne sɛ woremmɔ hu, na wobɛka akyerɛ wo duruyɛfoɔ anaa awogyefoɔ ntɛm ara. Sɛ wohu ntɛm na wɔsa wo yare ntɛm a, mpɛn pii no wubetumi ama wo ho atɔ wo koraa.

Mogya dodow ahe na PPH de ba?

Mpɛn pii,

• Sɛ́ ebia wɔde wo awotwaa mu awo anaa C-section no, sɛ wohwere mogya bɛboro lita biako (1000ml) a , .
• Anaasɛ, sɛ nsakrae kɛse ba wo koma bɔ ne wo mogya mmoroso mu ka mogya dodow a ɛyera ho, na woda sɛnkyerɛnne ahorow a ɛkyerɛ sɛ mogya a ɛyera pii adi a, wobu no sɛ PPH.

Saa tebea yi betumi aba wɔ awo 100 biara mu 1 kosi 5 mu. Ɛno yɛ 1% ne 5% ntam. Nanso sɛ wɔsa yare ntɛm a, mpɛn pii no ɛnyɛ nea ɛde nkwa to asiane mu.

Mɛyɛ dɛn ahu sɛ mewɔ PPH? Dɛn ne sɛnkyerɛnne ahorow no?

PPH ho sɛnkyerɛnne titiriw ne mogya a ɛkɔ so daa, a emu yɛ duru wɔ ɔbea no awotwaa mu wɔ awo akyi. Ɛtɔ mmere bi a , mogya a ɛtwetwe a ɛsõ sen golf bɔɔl tumi fa mu. Sɛ eyi ba a, ebetumi ayɛ ɔhaw bi ho sɛnkyerɛnne.

Nsɛnkyerɛnne afoforo ne:

• Mogya mmoroso a ɛba fam ho sɛnkyerɛnne: adwenemhaw, nhumu a ɛyɛ kusuu, na ɔtotɔ piti.
• Koma a ɛbɔ kɛse (Tachycardia).
• Mogya mu nkwammoaa kɔkɔɔ dodow a ɛso tew (hematocrit dodow a ɛso tew).
• Wora a ɛyɛ mmerɛw anaasɛ ɛyɛ nwunu, a ɛte sɛ nea worepae wɔ fifiri a ɛyɛ nwini mu.
• Ɛyaw ne ɔfe a ɛwɔ ɔbea no awotwaa mu anaa akyi berɛmo no fã.(Eyi ba bere a mogya boaboa ano wɔ ntini bi akyi) .

Sɛ wuhu saa sɛnkyerɛnne ahorow a ɛyɛ soronko yi bi wɔ awo akyi a, ka kyerɛ w’akwahosan ho ɔyaresafo ntɛm ara . Ɛtɔ da bi a, PPH ho sɛnkyerɛnne betumi akɔ so atra hɔ bere a woafi ayaresabea akɔ fie mpo no. Sɛ eyi ba a, mma wo ho nnpopo na kɔ wo duruyɛfo nkyɛn ntɛm ara.

Dɛn nti na PPH ba? Dɛn na ɛde ba?

Nneɛma pii na ɛde PPH ba.

Wunim, sɛ wo ba no wɔ awotwaa mu a, awotwaa no bata w’awotwaa no fasu ho na ɛma akokoaa no nya aduan ne mframa pa. Sɛ wowo wo ba wie a, w’awotwaa no kɔ so twetwe awotwaa no na ɛpam awotwaa no. Saa ntini a ɛtwetwe yi ma mogya ntini a na awotwaa no abata ho no mu yɛ den na ɛma mogya no gyae. Nanso ɛtɔ mmere bi a, sɛ saa ntini a ɛtwetwe yi mu nyɛ den sɛnea ɛsɛ a , mogya no rennyae. Eyi na ɛde PPH 80% ba.

Afei nso, sɛ awotwaa no afã horow da so ara wɔ awotwaa no fasu mu, anaasɛ w’awo akwaa (awotwaa, awotwaa, awotwaa) sɛe bere a worewo no a, PPH betumi aba.

PPH taa ba wɔ akokoaa no awo akyi simma 30 kosi 60 .

"Ts Anan" a ɛka PPH no

Nneɛma atitiriw anan na ɛde PPH ba, a wɔfrɛ no "Ts Anan".

1. Tone (awotwaa no tebea - Uterine Atony): Eyi ne ade a ɛtaa de ba . Uterine atony yɛ bere a awotwaa no ntumi ntwetwe yiye wɔ awo akyi, na mmom ɛbɛyɛ mmerɛw na ɛyɛ mmerɛw. Afei mogya ntini a na awotwaa no wɔ no mu no mu nyɛ den, na mogya kɔ so tu.

2. Ahodwiriw: Wɔ awo mu no, mogya betumi atu esiane apirakuru a ɛba ɔbea awotwaa, awotwaa, awotwaa, anaa akyi berɛmo mu nti. Ɛtɔ mmere bi a, mogya yi tumi boaboa ano wɔ ntini a apira no mu na ɛkɔ so mogya tu nnɔnhwerew anaa nna pii wɔ awo akyi.

3. Ntini (Retained placental tissue): Sɛ awotwaa no ntew ne ho mfi awotwaa no fasu no ho koraa a, ntini a aka no betumi ama mogya atu. Eyi betumi afi biribi a ɛnteɛ wɔ awotwaa no mu, anaasɛ ebetumi ayɛ awotwaa a ɛteɛ.

4. Thrombin (mogya a ɛtwetwe ho haw): Sɛ wowɔ ɔyare bi a ɛma mogya tu, anaasɛ na wowɔ tebea bi a ɛka mogya a ɛtwetwe bere a wonyinsɛn no a, mogya kakraa bi mpo betumi ayɛ ɔhaw kɛse.

Henanom na wɔwɔ asiane kɛse mu sɛ wobenya PPH?

Nokwarem no, PPH betumi ato obiara a ɔrewo akokoaa. Ɛwom sɛ asiane pii wɔ hɔ a ɛde PPH ba de, nanso PPH nsɛm no mu bɛyɛ 40% ba a asiane biara nni ho . Enti, ebia nnuruyɛfo rentumi nsiw PPH ano koraa. Nanso, sɛ wuhu nea asiane ahorow yi yɛ ansa na woawo a, ebetumi aboa ma asiane a ɛwɔ hɔ sɛ mogya bɛtu kɛse no so atew.

Tebea horow a ɛwɔ awotwaa mu

Asiane a ɛwɔ hɔ sɛ wubenya PPH no yɛ kɛse sɛ wowɔ tebea horow a edidi so yi mu biara a ɛfa awotwaa no ho a:

• (Placenta a edi kan)(Placenta wɔ awotwaa no ase) .
• (Placental a ɛba mpofirim ) .
• (Placenta accreta) (Placenta a ɛbata awotwaa no fasu ho denneennen) .

Tebea horow a ɛfa awo anaa awo ho

Asiane a ɛwɔ hɔ sɛ obi benya PPH no betumi ayɛ kɛse sɛ nneɛma a edidi so yi si bere a wɔrewo a:

• Sɛ wɔde aduru a wɔde kum nipadua no nyinaa ama a.
• Sɛ wɔama wo nnuru (tocolytics) a wode begyae awotwaa no mu akisikuru a.
• Sɛ ɛyaw no kyɛ anaasɛ wɔde aduru a wɔde ma awotwaa no twetwe (Oxytocin / Pitocin®) no ma dodo bere tenten dodo a.
• Akokoaa a wobɛwo no ntɛm (annu nnɔnhwerew abiɛsa wɔ awo no mfiase akyi).
• Sɛ wɔde forceps anaa vacuum dii dwuma bere a na wɔrewo no sɛnea ɛsɛ a.
• Sɛ mpaapaemu akɛse wɔ ɔbea awotwaa no mu a.
• Sɛ wɔde oprehyɛn a wɔde twa akokoaa no woo akokoaa no a .

Akwahosan tebea afoforo

Akwahosan tebea afoforo nso betumi ama asiane a ɛwɔ hɔ sɛ obi benya PPH no ayɛ kɛse, te sɛ:

• Sɛ nhwɛso no, nyarewa a ɛma mogya tu (von Willebrand yare) .
• Sɛ woanom aduru (Magnesium sulfate) a wɔde sa preeclampsia a emu yɛ den a .
• Nyinsɛn tebea horow a ɛka nneɛma a ɛma mogya tu anaa mogya nkwammoaa a ɛma mogya tu, sɛ nhwɛso no: (HELLP syndrome) , (gestational thrombocytopenia) .
• Nyarewa a ɛba awotwaa kotoku mu (Chorioamnionitis) .
• Obolo.
• Ɛnanom mfe a wɔadi a ɛkɔ anim.

Afei nso, asiane a ɛwɔ hɔ sɛ obi benya PPH no yɛ kɛse sɛ awotwaa no trɛw dodo a . Eyi betumi asi:

• Sɛ woadi kan awo anum anaa nea ɛboro saa a.
• Wɔ awo pii mu, te sɛ mmanoma ne mma abiɛsa.
• Sɛ wowɔ akokoaa kɛse (macrosomia) a .
• Sɛ nsu a ɛwɔ awotwaa mu (polyhydramnios) dɔɔso dodo a .

Dɛn ne nneɛma bɔne a ebetumi afi PPH mu aba?

Sɛ wohwere mogya pii a, ebia wubehu nneɛma te sɛ koma a ɛbɔ kɛse, ɔhome a ɛkɔ soro, ne mogya a ɛkɔ nipadua no mu a ɛso tew. Saa sɛnkyerɛnne ahorow yi betumi atew mogya a ɛkɔ akwaa ahorow te sɛ mmerɛbo, amemene, koma, ne asaabo mu no so, na ɛde ahodwiriw aba . Shock yɛ bere a akwaa no nnya mogya a ɛdɔɔso. Eyi betumi ama akwaa ahorow adi huammɔ anaasɛ owu mpo.

Ɔkwan bɛn so na wobehu PPH bere a wɔayɛ oprehyɛn (C-section) akyi?

Mpɛn pii no, PPH ho sɛnkyerɛnne wɔ C-section akyi no te sɛ bere a wɔawo no sɛnea ɛsɛ. Nsɛnkyerɛnne no bi ne:

• Koma a ɛbɔ a ɛkɔ soro.
• Nsa ne anan a ɛyɛ nwini, a ɛte nka sɛ ɛyɛ mmerɛw.
• Ɔhome a ɛyɛ den.
• Ɔhonhon, akuru, anaa ɛyaw a ɛba yafunu no mu baabi foforo, titiriw wɔ baabi a wɔyɛɛ kuru no oprehyɛn no.
• Mogya a ɛtɔ dodo wɔ ɔbea no awotwaa mu ne mogya a ɛtwetwe kɛse a ɛtwam.

Ɔkwan bɛn so na nnuruyɛfo hu PPH?

Nnuruyɛfo nam aniwa ne nipadua mu nhwehwɛmu so hu PPH. Lab nhwehwɛmu ne w’akwahosan ho abakɔsɛm a wobɛsan ahwɛ yiye nso ho hia na ama woatumi ahwɛ asiane ne nkɛntɛnso a ɛwɔ PPH so.

Mogya dodow a woahwere no titiriw na ɛkyerɛ sɛ wowɔ PPH. Wɔtaa bu mogya dodow a ɛyera denam ntama anaa sponge a wɔde mogya guu mu bere a wɔwoo akokoaa no a wɔkan anaa wɔkari no so.

Sɛ wususuw sɛ PPH a, wubetumi de saa nneɛma yi asɔ wo ho ahwɛ bio:

• Kɔ so hwɛ sɛnea wo koma bɔ ne wo mogya mmoroso .
• Mogya mu nhwehwɛmu a ɛkyerɛ mogya mu nkwammoaa kɔkɔɔ dodow a ɛwɔ mogya no mu (hematocrit) ne nneɛma a ɛma mogya tu.
• Pelvic nhwehwɛmu a wɔde hwehwɛ awotwaa, awotwaa, ne awotwaa mu.
• Ultrasound scan twa awotwaa no mfonini a ɛkɔ akyiri.

Ɔkwan bɛn so na wɔsa PPH?

Nnuruyɛfo taa di PPH ho dwuma sɛ ade a egye ntɛmpɛ. Botae titiriw a ɛwɔ ayaresa mu ne sɛ wobegyae mogya a ɛretu no ntɛm ara sɛnea wobetumi.

Ɛdenam nea ɛde mogya a ɛretu wo ne sɛnea mogya no mu yɛ den so no, wo duruyɛfo betumi akamfo ayaresa yi mu biako anaa nea ɛboro saa akyerɛ:

• Awotwaa mu aduru a wɔde twitwiw awotwaa no mu ntini ahorow.
• Nnuru a ɛkanyan awotwaa no twetwe a wɔde ma.
• Awotwaa mu ntini a wɔakora so a wobeyi afi hɔ, sɛ́ wɔde nsa anaa ɔkwan foforo bi so.
• Nsuo a ɛwɔ awotwaa, awotwaa, ne awotwaa mu a wosiesie .
• Afiri bi te sɛ catheter anaa balloon a wɔde bɛhyɛ awotwaa no afasu so na ama mogya atɔ no agyae.
• Nneɛma a ɛma mogya a ɛkɔ awotwaa no mu no gyae.
• Ɛsɛ sɛ wɔde mogya ma .
• Nsu a wɔde fa ntini bi mu ma (intravenous - IV fluids) , a ɛkyerɛ nneɛma te sɛ nkyene.
• Oxygen foforo a wɔde ma denam akataso so.
• Nnuru a wɔde dade ma a wɔkyerɛw ma obi .

Ɛntaa mma koraa, anaasɛ sɛ akwan afoforo di nkogu a, oduruyɛfo no betumi ayɛ laparotomy (oprehyɛn a wɔde bebue yafunu no na wɔahu faako a mogya no fi) anaasɛ hysterectomy (woyi awotwaa no).

Bere tenten ahe na egye na obi ho atɔ no afi PPH tebea yi mu?

Ɛsono bere a wɔde ma obi ho tɔ no wɔ onipa biara mu. Egyina mogya dodow a wohweree ne sɛnea wo nnuruyɛfo saa wo yare no so. Ɛho hia sɛ wohwɛ wo ho yiye wɔ nna kakraa a edi kan wɔ wo ba no awo akyi – di yiye, nom nsu pii, na gye w’ahome sɛnea wubetumi . Ebia wo duruyɛfo nso bɛkamfo akyerɛ sɛ fa nnuru a wɔde yɛ iron mfa sa mogya a ɛtɔ kɔ nipadua mu.

So wobetumi asiw PPH ano? So metumi awo akokoaa bio?

Ɔkwan pa a nnuruyɛfo betumi afa so asiw PPH ano ne sɛ wobehu wɔn a asiane kɛse wom sɛ wobenya PPH ansa na wɔawo. Wubetumi aboa denam w’aduruyɛ ho abakɔsɛm nyinaa a wobɛka akyerɛ wo duruyɛfo na sɛ wowɔ PPH ho sɛnkyerɛnne bi wɔ wo ba akyi a wobɛbɔ wɔn amanneɛ no so.

Mpɛn pii no, asiane biara nni ho sɛ wobɛwo akokoaa foforo. Nanso, wo ne wo duruyɛfo nka asiane a ɛwɔ hɔ sɛ wubenya PPH wɔ w’awo a edi hɔ no mu ho asɛm. Sɛ asiane a ɛwɔ wo mu no dɔɔso kakra sen sɛnea ɛte daa mpo a, ɛda so ara yɛ nea ɛba fam. Wo duruyɛfo betumi ahwɛ nneɛma a ɛde asiane ba wo so na wasi gyinae sɛ ebia ɛsɛ sɛ woyɛ ahwɛyiye titiriw biara wɔ w’awo a edi hɔ no mu anaa.

Wobɛyɛ dɛn ahwɛ wo ho wɔ PPH akyi?

Ebetumi ayɛ den sɛ wobɛhwɛ wo ho bere a worehwɛ wo ba a wɔawo no foforo no. Nanso, sɛ wugye bere gye w’ahome na wohwɛ wo ho yiye a, wubetumi ho atɔ wo ntɛmntɛm. Wo yiyedi ho hia paa.

Nneɛma bi a ebetumi aboa wo ni:

• Ahomegye: Wo nipadua hia bere na ama asa. Nsuro sɛ wobɛsrɛ mmoa, na nya ahomegye a wuhia.
• Di nnuan a ahoɔden wom: Nnuan a dade wom te sɛ nam kɔkɔɔ, nhabannuru a ɛyɛ ahabammono, ne anɔpaduan mu aburow a wɔahyɛ no den boa ma mogya mu nkwammoaa kɔkɔɔ. Nnuan a ahoɔden wom betumi aboa wo ma woasa yare.
• Nom nsu: Nom nsu pii bere a woawo akyi na amma wo ho atɔ wo.
• Di wo duruyɛfo akwankyerɛ akyi: Ebia wo duruyɛfo bɛkyerɛw nnuru anaa asetra mu nsakrae a ɛbɛboa wo ma wo ho atɔ wo. Di saa akwankyerɛ ahorow no akyi yiye.
• Hwɛ mogya dodow a ɛbɛtɔ no yiye: Hyɛ aduru a wɔde tew nneɛma ho. Hwɛ bere tenten a egye ansa na ayɛ ma. Ɛsɛ sɛ mogya a ɛretu no so tew nkakrankakra wɔ adapɛn kakraa bi mu. Sɛ ɛnte saa a, kɔ wo duruyɛfo nkyɛn.

Mogya a ɛtɔ kɛse betumi ayɛ osuahu a ɛyɛ awerɛhow kɛse. Ɛyɛ ade a ɛfata sɛ wubegye bere kakra ansa na wo ho atɔ wo wɔ nkate fam afi wo awo mu osuahu no mu. Ebia wubehia mmoa afi w’abusua, wo nnamfo, nnuruyɛfo, anaa afoforo hɔ. Ka sɛnea wote nka ho asɛm, na srɛ mmoa bere a wuhia no.

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn?

Mpɛn pii no, PPH ba bere a woawo akyi anaa bere a wowɔ ayaresabea. Nanso, sɛ mogya retu wo kɛse bere a woadu fie akyi anaasɛ wunya PPH ho sɛnkyerɛnne biara a, kɔ wo duruyɛfo nkyɛn ntɛm ara . Sɛ wɔato wo duruyɛfo adwumayɛbea mu anaasɛ wuntumi nkɔ wɔn nkyɛn a, kɔ baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ wɔ ayaresabea a ɛbɛn wo.

Sɛ mogya tu wo kɛse wɔ awo akyi a, kɔ oduruyɛfo nkyɛn ntɛm ara. PPH ho sɛnkyerɛnne afoforo ne adwenemhaw, ɔtopae, ne ɔhome a ɛyɛ den. PPH yɛ tebea a emu yɛ den a ɛsɛ sɛ wɔde kɔ ayaresabea ntɛm ara.

Sɛ wo anaa wo dɔfo bi wɔ PPH a, ɛyɛ ade a ɛfata sɛ wobɛte nka sɛ wo ho dwiriw wo na wosuro wɔ osuahu no ho. Nanso kae sɛ, sɛ wohu ntɛm na wɔsa yare ntɛm a, ebetumi asiw nsɛnnennen a emu yɛ den ano. Ɛno nti na ɛho hia sɛ wubue w’adwene mu na woka nokware kyerɛ wo duruyɛfo wɔ w’ayaresa ho abakɔsɛm ho no. Eyi bɛboa wo ma woahu sɛ ebia wowɔ asiane mu sɛ wobenya PPH anaa.

Nkrasɛm a Etwa To a Wɔde Kɔ Fie

• PPH (Postpartum Hemorrhage) yɛ tebea a emu yɛ den a ɛsɛ sɛ wɔde kɔ ayaresabea ntɛm ara, a nea ɛda nsow ne sɛ mogya tu dodo wɔ awo akyi.
• Sɛ wuhu sɛnkyerɛnne ahorow te sɛ mogya a ɛtɔ dodo, mogya a ɛtɔ kɛse a ɛtwam, w’adwene tu fra, wo totɔ piti, anaa koma bɔ kɛse a , hwehwɛ aduruyɛfo afotu ntɛm ara .
• Nea ɛde PPH ba titiriw ne awotwaa mu atony, a ɛyɛ awotwaa no a entumi ntwetwe no yiye. Nneɛma afoforo a ɛde ba ne opira, awotwaa a ɛkɔ so tra hɔ, ne mogya a ɛtwetwe ho haw.
• Ɛwom sɛ asiane ahorow bi wɔ hɔ de, nanso PPH betumi ato obiara .
• Sɛ wohu ntɛm na wɔsa no ntɛm a, mpɛn pii no wobetumi asa no koraa.
• PPH osuahu no betumi ayɛ nea ɛma nkate mu yɛ den. Mma ntwentwɛn wo nan ase sɛ wubenya mmoa a wuhia no.

W’akwahosan a wobɛhwɛ so yiye no ho hia yiye, titiriw wɔ mmere a ɛte sɛɛ mu. Ɛnyɛ wo nko ara, srɛ mmoa.

` Awo akyi mogyatɔw, PPH, awo, mogya a ɛtɔ, awotwaa, awotwaa, mmea akwahosan