So ɛsɛ sɛ yehu sɛnea nsu kotoku no mu paapae ansa na wɔawo akokoaa no? (Ntini a Ɛpae Ntɛmntɛm - PROM) .

Ɛyɛ ade a ɛfata sɛ wo ho yeraw wo wɔ nneɛma ho bere a woanyinsɛn no, ɛnte saa? Ebia woate "wo nsu a ɛrebubu" ho asɛm, titiriw bere a worebɛn da a ɛsɛ sɛ wotɔ no. Ɛtɔ da bi a, ebetumi ayɛ hu kakra sɛ wubesusuw nea ɛbɛba sɛ eyi si ansa na da a ɛsɛ sɛ woyɛ no adu ho. Mma ɛnhaw wo, yɛbɛka eyi ho asɛm akɔ akyiri na ɛnyɛ den.

Dɛn ne ntini a ɛpaapae ntɛm (PROM)?

Sɛ yɛbɛka no tiawa a, `Premature Rupture of Membranes` anaa `PROM` yɛ wo ba no `awoɔ`, a ɛkyerɛ sɛ wo `nsu kotoku` anaa `amniotic sac` no bubu ansa na awo no afi ase. Nnuruyɛfo binom nso frɛ eyi `prelabor rupture of membranes`. Wei kyerε sε `membranes` anaa membranes no bubu ansa na `labor` aba.

Afei hwɛ, saa `amniotic sac` yi te sɛ bag a nsu ahyɛ mu ma. Saa nsu yi ne nea yɛfrɛ no `amniotic fluid` . Eyi ne nea atwa wo ba ho ahyia na ɛbɔ ne ho ban wɔ nyinsɛn no nyinaa mu. Ɛte sɛ ahobammɔ cushion ketewaa bi ma akokoaa no. Saa `amniotic fluid` yi bɔ akokoaa no ho ban fi mmoawa ho, ɛmma akokoaa no nnya akuru ne opira bere a ɔredi akɔneaba no, na ɛboa nso ma akokoaa no ntini ne nnompe nyin.

Sɛ yɛka sɛ "wo nsuo bubu" anaa "wo nsuo bubu" a, ɛyɛ sɛ saa ntini yi bubu. Sɛ saa ntini ahorow yi bubu a, awotwaa mu nsu a atwa wo ba no ho ahyia no fi ase pue fi wo awotwaa mu, nkakrankakra anaasɛ mpofirim. Eyi betumi ayɛ ɔhaw. Efisɛ sɛ awotwaa mu nsu no kɔ a, wo ne wo ba no wɔ asiane kɛse mu sɛ wobenya ɔyare mmoawa ne nsɛnnennen afoforo te sɛ awo a ɛba ntɛm .

Enti, sɛ wususuw sɛ wo ntini ahorow no mu apaapae a, ɛsɛ sɛ wobɔ wo awo ho oduruyɛfo anaa abusua akwahosan ho ɔbenfo amanneɛ ntɛm ara.

Dɛn ne Preterm PROM (PPROM)?

Afei momma yɛnka `Preterm PROM` anaa `PPROM` ho asɛm. Eyi ne bere a wo `amniotic sac` no mu paapae ansa na nyinsɛn no adi adapɛn 37 . Fa no sɛ, wo nyinsɛn no nnu adapɛn 37, nanso wo nsu no bubu. Saa bere yi de, wo duruyɛfo no besi gyinae sɛ `ɔbɛwo` akokoaa no ntɛm ara, anaasɛ ɔbɛtwentwɛn `awo` no ase nna kakraa bi bio.

Eyi yɛ gyinaesi a ɛyɛ den kakra. Efisɛ, nyinsɛn no a wɔkyɛ bere a nsu no abubu akyi no ma asiane a ɛwɔ hɔ sɛ wobenya ɔyare mmoawa ne nsɛnnennen afoforo no yɛ kɛse. Nanso, ɔkwan foforo so no, asiane ahorow bi nso wɔ akokoaa no a wɔbɛwo no ntɛm, kyerɛ sɛ, ntɛm. Enti ɛsɛ sɛ oduruyɛfo no susuw asiane abien yi nyinaa ho yiye ansa na wasi gyinae a eye sen biara.

Sɛ nsu kotoku no bubu saa a, dɛn na ebetumi asi?

Sɛ nsu kotoku no bubu ntɛmntɛm dodo a, akokoaa no wɔ asiane mu sɛ wɔbɛwo no ntɛm naAsiane wɔ hɔ sɛ obi benya ɔyare mmoawa. Sɛ wo nyinsɛn no wie wɔ adapɛn 37 mu a, nsɛnnennen a efi awo a ɛba ntɛm mu no ntaa mma. Nanso, sɛ wɔwo akokoaa no ansa na adapɛn 37 adu a, ɛsɛ sɛ ohyia ɔhaw ahorow a efi awo a ɛba ntɛm mu.

Eyi ho nhwɛso ne:

• Ɔhome ho nsɛm .
• Ɛyɛ den sɛ wobɛkɔ so akura nipadua mu hyew mu .
• Eyi betumi asakra akokoaa no gyinabea wɔ awotwaa no mu mpo , na ebetumi aka awo.

Bio nso, sɛ wɔannyaw awotwaa mu nsu ne awotwaa kotoku no a wɔmmɔ ho ban a, akokoaa no ne w’awotwaa no wɔ asiane kɛse mu sɛ wobenya ɔyare mmoawa . Ɛtɔ mmere bi a, saa nyarewa yi betumi ayɛ nea asiane wom.

Saa tebea yi abu so dɛn?

Tebea bi a wɔfrɛ no `PROM` ba wɔ nyinsɛn bɛyɛ 10% mu. Sɛ `PROM` ba wɔ akokoaa no bere mu (wɔ adapɛn 37 mu) a, bere no mu 95% na wɔwo akokoaa no wɔ nnɔnhwerew 28 mu.

PPROM yɛ tebea a ɛntaa nsi, ɛba wɔ nyinsɛn bɛyɛ 3% mu. Nhwehwɛmu ahorow ada no adi sɛ PPROM taa ba wɔ nyinsɛn a wɔwo mpɛn pii no mu .

Dɛn nti na eyi ba? Dɛn ne nneɛma atitiriw a ɛde `PROM` ne `PPROM` ba?

Ebia nea ɛde `PROM` ne `PPROM` ba no yɛ soronko.

• Sɛ wo nsu no bubu wɔ bere a ɛfata mu, kyerɛ sɛ, adapɛn 37 akyi a, nea enti titiriw ne sɛ wo amniotic membranes no reyɛ mmerɛw nkakrankakra esiane nhyɛso a ɛwɔ ntini a ɛtwetwe no mu bere a worewo nti. Ɛyɛ ade a ɛfata sɛ ntini no ankasa bubu, nanso ɛtaa ba bere a awo afi ase akyi.

Nea ɛho hia ne sɛ, sɛ woante nka sɛ wo ho ayɛ wo hyew mpo a, ebia wo nipadua no resiesie ne ho ama awo. Eyi kyerɛ sɛ, sɛ wunnim a, ebia w’awotwaa no reyɛ ketewaa, ebia w’awotwaa no reyɛ teateaa (ɛrepopa), na w’awotwaa no betumi abue (atrɛw). Eyi betumi ama amniotic kotoku no ayɛ mmerɛw na awiei koraa no apaapae.

• Mpɛn pii no, aduruyɛ mu tebea anaa ɔhaw bi a ɛba bere a wɔyem no na ɛde PROM a ɛba ansa na bere aso (PPROM) ba , nanso ɛtɔ mmere bi a ebetumi aba a ntease biara nnim.

Nneɛma atitiriw a enti ɛte saa no bi ne:

• Mogya a ɛba ɔbea no awotwaa mu .
• Tebea horow a wowo wo wɔ w’awotwaa mu (te sɛ Ehlers-Danlos syndrome ).
• Awotwaa mu a ɛnyɛ adwuma yiye .

Dɛn ne eyi ho sɛnkyerɛnne? Woyɛ dɛn hu no?

Nsɛnkyerɛnne a ɛda adi kɛse a ɛkyerɛ sɛ wo ntini ahorow no rebubu ne sɛ wote nka sɛ nsu pii retu afi wo awotwaa mu mpofirim. Nanso ɛnyɛ bere nyinaa na ɛte sɛ nea ɛdɔɔso. Nnipa binom te nka sɛ wɔretu kakra, te sɛ nsu a ɛreworo so. Wo nsu a ɛrebubu no yɛ biribi a wuntumi nni so. Ɛte sɛ nea wuntumi nnyae nsu a wobɛtow .

Ɛtɔ mmere bi a ɛyɛ den sɛ wubehu sɛ ɛyɛ nsu a efi awotwaa mu, nsu a efi ɔbea no awotwaa mu, anaa nsu a ɛba . Wɔ tebea horow a ɛtete saa mu no, wubetumi afa krataa fitaa mpopaho de ahyɛ nsu no mu.

• Sɛ ɛyɛ kɔkɔɔ, anaasɛ ɛyɛ huam a , ebia ɛyɛ nsu a wɔde gu mu .
• Sɛ enni kɔla na enni huam a , ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara.

Nanso, sɛ w’adwene mu yɛ wo naa kakra wɔ nea ɛrefi wo awotwaa mu aba no ho a, hwɛ hu sɛ wobɛbɔ wo duruyɛfo amanneɛ.

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Wo duruyɛfo de sterile speculum nhwehwɛmu besi PROM so dua . Eyi hwehwɛ sɛ wode speculum bi bɛhyɛ wo awotwaa mu. Eyi ma oduruyɛfo no tumi tu wo honam ani afasu no mu ma ohu wo awotwaa no. Afei wɔfa nsu no bi na wɔsɔ hwɛ. Ɛtɔ mmere bi a, sɛ oduruyɛfo no hu sɛ awotwaa mu nsu aboaboa ano wɔ wo awotwaa no atifi wɔ nhwehwɛmu yi mu a, ebia ntini no mu apaapae.

Nea ɛka ho no, wobetumi ayɛ ultrasound scan de ahwɛ baabi a akokoaa no wɔ ne nsu dodow a ɛwɔ awotwaa no mu.

Sɔhwɛ afoforo bɛn na ɛwɔ hɔ?

• Nitrazine krataa sɔhwɛ: Wɔde eyi susuw wo awotwaa no pH (a ɛkyerɛ sɛnea biribi yɛ acid). Wɔde wo awotwaa mu nsu a ɛtɔ gu krataa yi so na wɔhwɛ krataa no mu hwɛ sɛ ɛbɛyɛ bruu anaa. Sɛ ɛdan bruu a, nsu no pH boro 6.0, enti ɛda adi sɛ ɛyɛ amniotic nsu. (Nsu a ɛba ɔbea awotwaa mu a ɛtaa ba no pH sua sen awotwaa mu nsu.)
• Fern sɔhwɛ: Ferning ne din a wɔde frɛ amniotic nsu a ayow a ɛte sɛ fern ahaban. Eyi nso hwehwɛ sɛ wɔfa nsu no bi na wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ mu.

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Ayaresa no gyina mfe a nyinsɛn no adi , akokoaa no akwahosan ne sɛnea wo tebea no mu yɛ den so .

Mpɛn pii no, akwan abien na ɛwɔ hɔ: biako ne sɛ `wobɛwo` akokoaa no, na biako nso ne `hwɛ kwan sɛ wɔbɛhwɛ no`. `Expectant management` yɛ ayaresa a ɛtwentwɛn `adwumayɛ` ase. Nea ɛka eyi ho ne mpa so home, nnuru a wɔde ma, ne hwɛ a wɔbɛhwɛ bere nyinaa sɛ ebia ɔyare mmoawa anaa awotwaa no haw no.

Ayaresa a wɔde sa PROM wɔ adapɛn 37 akyi

Sɛ wo nyinsɛn adapɛn 37 kosi 40 na wo nsu no bubu a, mmea bɛyɛ 90% bɛkɔ awo mu wɔ wɔn ankasa mu wɔ nnɔnhwerew 24 mu. Ebia wo duruyɛfo betumi ama wo nnuru a ɛbɛma woawo, anaasɛ wɔbɛma awo akɔ so wɔ awosu mu.Mpɛn pii no, akokoaa no a wɔbɛwo no wɔ nnɔnhwerew 24 ntam no ne ɔkwan a ahobammɔ wom sen biara.

Ayaresa sɛ `PROM` ba wɔ adapɛn 34 ne 37 ntam a

Sɛ ɛba saa a, wo duruyɛfo no bɛkari asiane ahorow a ɛwɔ akokoaa a wɔawo no ntɛm mu ne asiane a ɛwɔ ɔyare mmoawa ne nsɛnnennen afoforo mu no ahwɛ . Sɛ oduruyɛfo no si gyinae sɛ ɔbɛwo akokoaa no a, ɔbɛyɛ nhyehyɛe ama akokoaa no anya ɔhwɛ titiriw biara (te sɛ ɔhwɛ wɔ NICU - Neonatal Intensive Care Unit ) bere a wɔawo no pɛn.

Preterm PROM (PPROM) ayaresa ansa na adapɛn 34 adu

Sɛ wo ba no nyinsɛn nnu adapɛn 34 a, asiane kɛse wɔ hɔ sɛ obenya nsɛnnennen afi awo a ɛba ntɛm mu. Saa bere yi de, wo duruyɛfo no bɛbɔ mmɔden sɛ ɔbɛma woatra ayaresabea, de wo akɔda mpa so, na wabɔ mmɔden sɛ ɔbɛma wo nyinsɛn no akyɛ kakra.

Ebia wɔbɛma wo nnuru te sɛ:

• Corticosteroids: Boa ma akokoaa no ahurututu nyin.
• Nnuru a ekum ɔyare mmoawa: Siw nyarewa ano na ɛma nyinsɛn no kyɛ.
• Tocolytics: Nnuru a wɔde ma de gyae awo.
• Magnesium sulfate: Ɛboa ma akokoaa amemene nyin.

Wo duruyɛfo bɛhwɛ wo daa sɛ ebia wowɔ ɔyare no ho sɛnkyerɛnne bi anaa. Ɔbɛhwɛ wo ba no koma bɔ ne sɛnea ɔkeka ne ho nso de ahwɛ ahu sɛ akokoaa no nni ahokyere mu. Anidaso a ɛwɔ saa ayaresa ahorow yi mu ne sɛ anyɛ yiye koraa no, ɛbɛtrɛw wo nyinsɛn no mu akodu adapɛn 34.

Nea ɛho hia sen biara ne sɛ, sɛ wowɔ ɔyare mmoawa bere a wo nsu no bubu no ara pɛ, anaasɛ akyiri yi wunya ɔyare mmoawa a, akyinnye biara nni ho sɛ ɛsɛ sɛ wowo akokoaa no.

So ɔkwan bi wɔ hɔ a wɔbɛfa so asiw eyi ano?

Ɔkwan pɔtee biara nni hɔ a wobɛfa so asiw PROM ano. Ade a eye sen biara a wubetumi ayɛ ne sɛ wubegyae sigaretnom koraa, anya nyinsɛn a ɛfata, na woakɔ wo nhwehwɛmu a wɔyɛ ansa na woawo no nyinaa ase. Tawa a wɔnom yɛ asiane a ɛde PROM (ne nsɛnnennen afoforo pii a ɛba bere a wɔyem) ba.

Hena na ɔwɔ asiane kɛse mu ma `PROM` ne `PPROM`? (Nneɛma a Ɛma Asiane) .

Wowɔ asiane kɛse mu sɛ wubenya PPROM anaa PROM sɛ wowɔ tebea bi a ɛma wo chorioamniotic membrane (amniotic kotoku no akyi fã) yɛ mmerɛw a, anaasɛ sɛ ɛba nnansa yi ara a. Eyi ho nhwɛso ahorow bi ne:

• Nyarewa: Nyarewa a wonya fi nna mu (STIs) yɛ nyarewa te sɛ ɔyare mmoawa a ɛma obi nya ɔbea awotwaa mu yare.
• Awotwaa no tenten tiawa.
• Sɛ abakɔsɛm bi wɔ hɔ a ɛkyerɛ sɛ na ɔyɛ `PROM` ansa na .
• Sɛ worehwɛ nkokoaa te sɛ mmanoma anaa mma mmiɛnsa kwan a (`Expecting multiples`).
• Polyhydramnios (a ɛkyerɛ sɛ nsu a ɛwɔ awotwaa mu a ɛboro so).
• Mogya a ɛba ɔbea no awotwaa mu.
• `Amniocentesis a ɛwɔ nipadua no mu`Sɛ wɔayɛ (nsuo sɔhwɛ) a.
• Sɛ abakɔsɛm bi wɔ hɔ a ɛkyerɛ sɛ wɔwo awo ansa na bere aso a .

Asiane atitiriw bɛn na ɛwɔ mu bere a nsu kotoku no mu abubu no?

Asiane kɛse a ɛwɔ PROM mu ne awo a ɛba ntɛm. Awo a ɛba ntɛm ne bere a wɔwo wo ba no ansa na wadi adapɛn 37. Nsɛnnennen a ɛba bere a wɔwo awo ntɛm no bi ne ɔhome mu haw, nipadua mu hyew a ɛba fam, ne onyin ho haw. Nkokoaa bi a wɔawo wɔn ntɛm nso betumi akyɛ wɔ wɔn nkɔso mu akyiri yi.

Sɛ wɔmmɔ awotwaa mu nsu no ho ban a, nsɛnnennen foforo betumi aba wɔ nyinsɛn mu, sɛ nhwɛso no:

• Nyarewa , te sɛ Chorioamnionitis (nyarewa a ɛba ntini ne awotwaa mu nsu mu).
• Awotwaa mu a ɛba mpofirim .
• Awotwaa mu hama a wɔde mia anaasɛ awotwaa mu hama a ɛhwe ase .

Wo duruyɛfo besusuw asiane a ɛwɔ hɔ sɛ wobɛwo akokoaa ntɛm ne asiane a ɛwɔ hɔ sɛ wobɛnya ɔyare mmoawa ne nsɛnnennen afoforo nyinaa ho de ahu bere a eye sen biara a wode bɛwo wo ba no.

Bere a me nsu abubu awie no, ɛsɛ sɛ mewo akokoaa no ntɛm ahe?

Nhwehwɛmu ahorow ada no adi sɛ mmea a wɔwo wɔ nnɔnhwerew 24 akyi bere a wɔn ntini no mu apaapae no sua sɛ wobenya ɔyare mmoawa sen wɔn a wɔwo wɔ nnɔnhwerew 24 akyi no . Nanso, ɛsɛ sɛ wɔde asiane yi toto asiane a ɛwɔ hɔ sɛ wɔbɛwo akokoaa ntɛm no ho. Wo duruyɛfo bɛboa wo ma woasi gyinae a eye sen biara ama wo ne wo ba no.

Bere tenten ahe na wubetumi anyinsɛn bere a wo nsu abubu akyi?

Eyi bɛyɛ soronko a egyina wo tebea ne adapɛn dodow a wunyinsɛn bere a wo nsu no mu no so. Sɛ wo nsu no bubu ansa na adapɛn 37 adu a, wo duruyɛfo bɛboa wo ma woasi gyinae a ahobammɔ wom sen biara. Wɔ tebea horow bi mu no, asiane a ɛwɔ hɔ sɛ obenya ɔyare mmoawa ne nsɛnnennen no dɔɔso dodo, enti ebia ebehia sɛ wɔwo akokoaa no.

Sɛ nsu kotoku no bubu ntɛm a, so akokoaa no betumi anya nkwa?

Yiw, ebetumi aba. Sɛ nsu kotoku no bubu ntɛmntɛm mpo a, akokoaa no da so ara tumi tra ase. Egyina nneɛma pii so, te sɛ baabi a nyinsɛn no kɔ akyiri ne nsu dodow a aka wɔ awotwaa mu. Mpɛn pii no, wo duruyɛfo bɛhwɛ akokoaa no so ahwɛ sɛ ebia awotwaa no mu ahokyere ne ɔyare mmoawa ho sɛnkyerɛnne bi wɔ hɔ anaa, na obesi bere a ɔbɛwo akokoaa no ho gyinae.

Kae ade a ɛho hia sen biara (Take-Home Message) .

Wɔ nyinsɛn mu no, kotoku bi a nsu ahyɛ mu ma, a wɔfrɛ no amniotic sac , twa akokoaa no ho hyia na ɛbɔ ho ban. Mpɛn pii no, saa kotoku yi bubu bere a wɔrewo no. Nanso, ɛtɔ mmere bi a, ebetumi abubu ansa na awo afi ase, anaasɛ adapɛn bi mpo ansa na awo afi ase. Wɔfrɛ eyi Premature Rupture of Membranes (PROM) .

• Sɛ eyi ba wɔ adapɛn 37 akyi a , oduruyɛfo no bɛwo akokoaa no.
• Eyi yɛ ansa na adapɛn 37 adu.Wɔ ``Preterm PROM'' fam no, oduruyɛfo no bɛkari asiane a ɛwɔ akokoaa a wɔawo no ntɛm ne asiane a ɛwɔ nsɛnnennen te sɛ ɔyare mmoawa ne awotwaa mu nhama a wɔde mia mu mu ansa na wasi gyinae.

Ebetumi ayɛ ahodwiriw sɛ wobɛte sɛ wo nsu no abubu ntɛm. Nanso kae sɛ wo duruyɛfo no reyɛ nea obetumi biara na ama wo ne wo ba no anya ahobammɔ na apɔwmuden. Sɛ wowɔ nsɛmmisa anaa nsɛm bi a ɛhaw wo a, wo ne wo duruyɛfo nka ho asɛm. Ɛho hia paa.

` PROM, PPROM, nsu kotoku a ɛpaapae, nyinsɛn mu nsɛnnennen, awo a ɛba ntɛm, awotwaa mu nsu, nyinsɛn akwahosan