E kamaʻilio kākou e pili ana i ka Fetoscopy: kahi hoʻokolokolo kūikawā o kāu pēpē i hānau ʻole ʻia!

I kēia lā, e kamaʻilio mākou e pili ana i kahi hana lapaʻau kūikawā e hiki ke kōkua iā ʻoe e aʻo hou e pili ana i kāu pēpē i ka wā hāpai, a i ʻole e mālama i kahi pilikia paʻakikī i loaʻa i kāu pēpē i loko o ka ʻōpū. Ua kapa ʻia kēia he fetoscopy . He paʻakikī iki paha ke kani ʻana o ka inoa, akā e mālama kākou i ka maʻalahi. No ka mea, he mea nui loa kēia no ʻoe a me kāu pēpē.

No laila, he aha ka fetoscopy? I ka ʻōlelo maʻalahi ...

I ka ʻōlelo maʻalahi, ʻo ka fetoscopy kahi hana i ka wā hāpai e hiki ai i kāu kauka ke nānā pololei i kāu pēpē e ulu ana i loko o kou ʻōpū. E noʻonoʻo e like me ke kau ʻana i kahi kāmela liʻiliʻi i loko o kou ʻōpū e ʻike i ke ʻano o kāu pēpē a me ke ʻano o ka ulu ʻana o kāna mau kino. Hiki i kēia ke kōkua i ka ʻike ʻana a me ka mālama ʻana i kekahi mau maʻi hānau i kāu pēpē.

Hana ʻia kēia me ka hoʻohana ʻana i kahi ʻōmole lahilahi a palupalu i kapa ʻia he fetoscope a i ʻole endoscope . Loaʻa i kēia ʻōmole kahi kāmela liʻiliʻi i hoʻopili ʻia ma kekahi ʻaoʻao. Hiki i kēia i ke kauka ke ʻike maopopo i ka mea i loko o kou ʻōpū a me ka ʻeke amniotic kahi o kāu pēpē. No ka mea he hakahaka ka fetoscope, hiki iā ia ke hoʻokomo ʻia nā mea hana ʻokiʻoki maikaʻi loa ma loko, e ʻae ana i ka pēpē e mālama ʻia ʻoiai ʻo ia i loko o ka ʻōpū, a e lawe i kahi laʻana o ka ʻiʻo no ka hoʻokolokolo ʻana ( he biopsy) .

ʻO ka hapa nui o ka manawa, hoʻokomo ʻia ka fetoscope ma o kahi ʻoki liʻiliʻi loa i loko o kou ʻōpū. Eia nō naʻe, i kekahi mau hihia kūikawā, hiki ke hoʻokomo ʻia ka mea hana ma o ka cervix.

I ka manawa hea e hana ʻia ai kēia hoʻāʻo fetoscopy?

Hana pinepine ʻia ka fetoscopy i ka trimester ʻelua a ʻekolu paha o ka hāpai ʻana, ma hope o ka ulu iki ʻana o ke pēpē. Hoʻohana ʻia ia e mālama i kekahi mau kūlana paʻakikī i loko o ka pēpē, a i kekahi manawa e lawe i kahi biopsy e hōʻoia i ka hōʻailona.

I kēia manawa, e nānā kākou i nā kūlana nui i mālama ʻia me kēia ʻano hana:

1. ʻO ka maʻi hoʻoili māhoe-a-māhoe (TTTS)

He kūlana kakaikahi kēia, akā he mea weliweli paha, e kū mai ana i ka wā ʻaʻole like ke kaʻana like ʻana o nā māhoe like i ke koko ma o ka placenta. Loaʻa i kekahi pēpē ka nui o ke koko, aʻo kekahi pēpē e loaʻa ana ka liʻiliʻi.

I kēia hihia, hoʻohana ke kauka lapaʻau i kahi fetoscope e nānā pono i ka placenta a me nā kīʻaha koko e hoʻoulu ai i kēia kahe koko like ʻole. A laila, hoʻouna ʻia kahi laser ma o ka fetoscope e pani i nā kīʻaha koko pilikia. Ua kapa ʻia kēia kaʻina hana he fetoscopic laser photocoagulation . Loaʻa i kēia kahi manawa kūpono e hoʻopakele ai i ke ola o nā māhoe ʻelua.

2. ʻO ka maʻi hui Amniotic

ʻO kēia ka manawa e paʻa ai ke pēpē i loko o nā kaula lahilahi o nā membrane i loko o ka ʻeke amniotic. Hiki i kēia mau kaula ke lilo i kaula a puni nā lima a me nā manamana lima o ke pēpē. Hiki i kēia ke ʻoki i ke kahe koko i kēlā mau wahi, i kekahi manawa e hōʻino ai i kēlā mau ʻōpū a i ʻole ka stunting. Hiki i ke kauka lapaʻau ke hoʻohana i ka laser e ʻoki i nā membrane e hoʻopaʻa ana i ke pēpē me ke kūʻokoʻa ma o ka fetoscope.

3. Hernia Diaphragmatic Congenital (CDH)

Hana ʻia kēia ke hana ʻia kahi lua i loko o ka diaphragm o ka pēpē (ka ʻiʻo e hoʻokaʻawale ana i ka umauma a me ka ʻōpū). A laila, ua hoʻokuke ʻia nā ʻōpū i loko o ka ʻōpū, e like me ke akepaʻa a me nā naʻau, ma o ka lua a i loko o ka umauma. Pale kēia i ka ulu pono ʻana o nā māmā. Hiki i kēia ke hoʻopilikia i ke ola o ka pēpē.

No ka mālama ʻana i kēia, hoʻohana nā kauka ʻoki i kahi fetoscopy e hoʻokomo i kahi pōpō liʻiliʻi i loko o ka trachea o ke pēpē. Hoʻokumu kēia pōpō i ke kaomi i loko o nā māmā, e kōkua ana iā lākou e ulu. Ma hope o kekahi mau pule, wehe hou ʻia ka pōpō me ka hoʻohana ʻana i ke kaʻina hana like. Ua kapa ʻia kēia lāʻau lapaʻau ʻo Fetoscopic Endoluminal Tracheal Occlusion (FETO) .

E noʻonoʻo i ke kupaianaha o ka hiki ke hana i nā ʻokiʻoki paʻakikī i ka wā e noho ana ke pēpē i loko o ka ʻōpū! Ua hoʻopakele kēia ʻenehana i ke ola o nā pēpē he nui a hāʻawi iā lākou i kahi wā e hiki mai ana olakino.

Ma waho aʻe o kēia mau kūlana nui, hoʻohana ʻia ka fetoscopy e mālama i kekahi mau ʻano tumors e ulu ana i ka placenta a me nā kūlana congenital ʻē aʻe e like me ka spina bifida .

No laila, he aha ke kumu o ka hana ʻana i ka fetoscopy?

I ka ʻōlelo maʻalahi, ʻo ke kumu nui o ka fetoscopy ka ʻike ʻana i nā kūlana hānau i loko o ka pēpē i ka wā hāpai a mālama iā lākou inā pono. I nā hihia he nui, inā ʻaʻole hāʻawi ʻia kēia lāʻau lapaʻau, hiki ke pau ka hāpai ʻana a i ʻole hiki i ka pēpē ke loaʻa nā pilikia olakino koʻikoʻi. No laila, hoʻohana ʻia kēia ʻano hana i ka wā e pono ai nā kauka e mālama i kēlā ʻano ʻoiai e ulu ana ka pēpē i loko o ka ʻōpū.

Pehea ʻoe e hoʻomākaukau ai no kēia?

Inā ua hoʻonohonoho ʻia ʻoe e hana i kahi fetoscopy, e wehewehe pono kāu kauka iā ʻoe pehea e hoʻomākaukau ai no ia mea. Pili kēia i nā mea he nui, me ke ʻano o ka hoʻāʻo a i ʻole ke kaʻina hana e hana ʻia ana, inā paha e hoʻokomo ʻia ka fetoscope ma o ka ʻōpū a i ʻole ka vagina, ke ʻano o ka anesthesia e hāʻawi ʻia iā ʻoe (ʻo ia hoʻi, ka hoʻomaha a i ʻole ka hiamoe piha), a me ke ʻano o ka lāʻau lapaʻau e hāʻawi ʻia iā ʻoe e hōʻemi i ka neʻe ʻana o ka pēpē i ka wā o ke kaʻina hana. No laila, he mea nui e kamaʻilio me kāu kauka e pili ana i ke ʻano o ka hoʻomākaukau ʻana no kou kūlana.

Pehea e hana ʻia ai ka fetoscopy?

Hana pinepine ʻia kēia i loko o kahi lumi hana. E hāʻawi ʻia ʻoe i ka anesthesia (anesthesia kūloko a i ʻole ka anesthesia laulā) i ʻole ʻoe e ʻeha a ʻaʻole ʻoe a me kāu pēpē e neʻe i ka wā o ke kaʻina hana.

Hana ke kauka lapaʻau i kēia mau hana:

1. Inā hana ʻia mai ka ʻōpū:

• ʻO ka mea mua, hana ʻia kahi ʻoki liʻiliʻi loa i loko o kou ʻōpū.
• A laila, ma o kēlā ʻoki ʻana, ua hoʻokomo ʻia kahi fetoscope i loko o ka ʻōpū a i loko o ka ʻeke amniotic kahi o ke pēpē.
• Hōʻike ʻia nā kiʻi mai ke kāmela ma ka fetoscope ma kahi pale, e ʻae ana i ke kauka ʻoki e ʻike maopopo i ke pēpē a me ka placenta.
• Ma muli o ke ʻano o ke ʻoki ʻana e hana ʻia, e hoʻouna ke kauka ʻoki i nā mea hana ʻoki maikaʻi ma o ka fetoscope a hana i ka lāʻau e pono ai a lawe paha i kahi hāpana ʻiʻo (biopsy).

2. Inā hana ʻia ma o ka cervix:

• ʻO ka mea mua, hoʻokomo ʻia kahi mea i kapa ʻia he speculum i loko o ka vagina e hohola i nā paia o ka vagina a ʻike maopopo ʻia ka cervix.
• A laila, ua hoʻokomo ʻia kahi fetoscope ma o ka cervix a komo i loko o ka ʻōpū.

He ʻoki ʻoki nui anei kēia fetoscopy?

ʻAʻole. He hana hoʻopilikia iki ka Fetoscopy. ʻO ia hoʻi, hana ʻia ia ma o kahi ʻoki liʻiliʻi loa a i ʻole ka puka kūlohelohe, me ka ʻole o ka hōʻino nui ʻana i ke kino. Ke hoʻohālikelike ʻia me nā ʻano hana ʻē aʻe o ka hana ʻoki ʻana i ka wā e noho ana ke pēpē i loko o ka ʻōpū (no ka laʻana, nā kaʻina hana ʻōpū hāmama), ʻoi aku ka liʻiliʻi o ka hopena o kēia kaʻina hana i ke kino a me ka emi ʻana o ka pilikia o nā pilikia.

Aia kekahi mau pilikia me ka fetoscopy?

E like me nā hana ʻoki kino āpau, loaʻa i ka fetoscopy kekahi mau pilikia. Eia naʻe, ua haʻahaʻa kēia mau pilikia. ʻO nā pilikia nui:

• Ka hānau mua ʻana .
• Ka hānau mua ʻana .
• ʻO ka haki mua ʻana o nā membrane (PPROM) .
• Ka nalowale ʻana o ka hāpai ʻana (he mea kākaʻikahi loa kēia).
• Ka maʻi ʻana .
• Ke kahe koko nui ʻana.

E wehewehe kāu kauka i kēia mau pilikia a pau iā ʻoe, a e hana lākou i nā hana āpau e pono ai e hōʻemi i kēia mau pilikia.

He aha kā mākou e aʻo ai mai kahi fetoscopy?

He mea hana a he kaʻina hana ka Fetoscopy i hoʻohana ʻia no ka ʻike a me ka mālama ʻana i nā maʻi. No laila, ʻo ka ʻike āu e loaʻa ai mai ia mea e pili ana i ke kumu e hana ʻia ai ʻoe.

Hāʻawi kēia i nā kauka o kāu pēpē i ka ʻike koʻikoʻi e pili ana i ke kūlana o ka pēpē. Kōkua nō hoʻi ia i ka mālama ʻana i nā kūlana e hiki ai ke hoʻopilikia i ke koena o kou hāpai ʻana a i ʻole ke hānau ʻana o kāu pēpē.

Ma hope o ka fetoscopy, e noʻonoʻo nā kauka i kēia mau mea:

• Ke ʻano hānau: Ma muli o ke kūlana o ka pēpē, hiki i nā kauka ke hoʻoholo he ʻoki caesarean (C-section) ke ala palekana loa.
• Kahi hānau: Ma muli o ke kūlana o ka pēpē, e hoʻoholo nā kauka inā pono nā lako kūikawā a i ʻole ka mālama kūikawā i ka wā hānau. No laila, hiki ke koho ʻia kahi haukapila kūpono.
• Ka manawa hānau: Na nā kauka e hoʻoholo inā hiki ke hoʻomau ʻia ka hāpai ʻana a i ʻole pono e hānau mua ʻia ke pēpē.

ʻEhia ka manawa e hiki ai ke ʻike i nā hopena o ka fetoscopy?

Aia nō hoʻi kēia i ke kumu i hana ʻia ai ka fetoscopy. ʻAʻole kēia he hoʻāʻo maoli, akā he ʻano hana i hoʻohana ʻia e nā kauka e ʻike a mālama i nā maʻi i ka wā e noho ana ke pēpē i loko o ka ʻōpū.

Eia kekahi laʻana, inā ua hana ʻia kahi fetoscopy e lawe i kahi ʻāpana o ka ʻiʻo no ka hoʻokolokolo ʻana (biopsy), hiki ke hala kekahi mau lā no ka hoʻi ʻana mai o nā hopena. Eia nō naʻe, inā ua hoʻohana ke kauka lapaʻau o kāu pēpē i kahi mea e like me ka laser e sila ai i nā kīʻaha koko kūpono ʻole, ʻaʻole ʻoe e ʻike pono a hiki i ka wā ma hope o ke ʻoki ʻana inā ua holomua ke kaʻina hana.

ʻEhia ka lōʻihi e hoʻōla ai ma hope o ka fetoscopy?

ʻOiai he hana hoʻopilikia iki kēia, inā he ʻoki ʻia kou ʻōpū, e lōʻihi ka manawa e ho'ōla ai. Hiki i ka hapa nui o ka poʻe ke hoʻi i kā lākou hana maʻamau i ka lā hoʻokahi, akā pono ʻoe e mālama pono i ka wahi i hana ʻia ai ka ʻoki ʻana, a inā paha i hana ʻia ma ke ʻano vaginal. E hāʻawi kāu hui lapaʻau iā ʻoe i nā ʻōlelo kikoʻī e pili ana i ka pehea e ho'ōla koke ai, nā mea e hana ai, a me nā mea ʻaʻole e hana. No laila he mea nui e hahai pololei i kēlā mau ʻōlelo kuhikuhi.

He hana lapaʻau waiwai nui ka Fetoscopy e hiki ai i nā kauka ke ʻike, loiloi, a mālama i nā maʻi hānau ʻoiai ke ulu nei ka pēpē i loko o ka ʻōpū. Hana pinepine ʻia ma hope o 18 mau pule o ka hāpai ʻana, i ka wā e hiki ai ke ʻike ʻia nā kīnā hānau he nui. Hiki ke mālama ʻia kekahi mau maʻi, hoʻoponopono ʻia, a hoʻopakele paha i ke ola o ka pēpē.

He mea maʻamau ka makaʻu a me ka hopohopo e pili ana i kēia ʻano hoʻāʻo. Akā e hoʻomanaʻo, ke hana nei kāu kauka a me ka hui lapaʻau i nā mea āpau e hiki ai iā lākou ke mālama iā ʻoe i ke olakino i kou wā hāpai a e hāʻawi i kāu pēpē i ka mālama maikaʻi loa. E kamaʻilio me lākou e pili ana i nā nīnau a hopohopo paha āu e loaʻa ai. E hāʻawi lākou iā ʻoe i ke kākoʻo a me ka ʻike āu e pono ai.

Nā mea nui loa āu e hoʻomanaʻo ai (Leka Lawe-Home)

• ʻO ka Fetoscopy kahi hana kūikawā e hiki ai iā ʻoe ke ʻike i ke pēpē i loko o ka ʻōpū a mālama i kekahi mau kūlana olakino.
• I loko o kēia, ua hoʻokomo ʻia kahi ʻōmole lahilahi me kahi kāmela liʻiliʻi (fetoscope) ma o kahi ʻoki liʻiliʻi ma ka ʻōpū a i ʻole ma o ka cervix.
• Hoʻōla ia i nā kūlana e like me ka twin-to-twin transfusion syndrome (TTTS), amniotic band syndrome, a me ka congenital diaphragmatic hernia (CDH).
• Ma muli o ke kaʻina hana minimally invasive kēia, ʻaʻohe ʻoki nui i hana ʻia.
• ʻOiai he mau pilikia liʻiliʻi, e like me nā ʻoki kino āpau, ua hoʻopakele kēia ʻano hana i ke ola o nā pēpē he nui a hoʻomaikaʻi i ko lākou olakino.
• Inā he mau nīnau a hopohopo paha kāu e pili ana i kēia, e ʻoluʻolu e kamaʻilio me kāu kauka.

Makemake mākou iā ʻoe a me kāu pēpē i ke ola olakino a hauʻoli!

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