He kūlana weliweli loa ia e hiki ke hana i ka wā hānau keiki! - E kamaʻilio kākou e pili ana i ka Amniotic Fluid Embolism

He manawa kūikawā loa kēia nou, he makuahine e hiki mai ana. I kou kali ʻana i ka hiki ʻana mai o kāu pēpē, ʻaʻole ia me ka hopohopo iki. I ka hapa nui o ka manawa, holo pono nā mea āpau, akā i kekahi manawa hiki ke kū mai nā pilikia i manaʻo ʻole ʻia. I kēia lā, e kamaʻilio mākou e pili ana i kahi maʻi kakaikahi akā hiki ke hoʻoweliweli i ke ola i kapa ʻia ʻo "Amniotic Fluid Embolism" (AFE). He mea nui iā ʻoe e makaʻala i kēia.

He aha ke ʻano o ka amniotic fluid embolism (AFE)?

I ka ʻōlelo maʻalahi, ʻo ka amniotic fluid embolism (AFE) he pilikia kakaikahi loa a hiki ke hoʻoweliweli i ke ola. Hana ia i ka wā e komo ai ka wai amniotic i loko o ke kino o ka makuahine i loko o kona koko i ka wā hāpai, i ka wā hānau, a i ʻole ma hope koke iho o ka hānau ʻana. I kēia manawa ke noʻonoʻo nei paha ʻoe i ke ʻano o ka wai amniotic. ʻO kēia ka wai e hoʻopuni ana i kāu pēpē i loko o ka ʻōpū. Ua like ia me kahi palekana no kāu pēpē e lana ai. ʻOiai he wai ka hapa nui o kēia wai, aia pū kekahi mau mea e like me nā pūnaewele a me nā ʻiʻo o kāu pēpē. I kekahi manawa, i ka wā e hui pū ai kēia wai amniotic me ke koko o ka makuahine, loaʻa i kekahi mau kino o nā makuahine kahi pane allergies koʻikoʻi iā ia. ʻAʻole maopopo i nā kauka ke kumu o kēia. Hiki i ka amniotic fluid embolism (AFE) ke hana i ka puʻuwai a me nā māmā o ka makuahine e hāʻule. Hiki i kēia ke alakaʻi i nā pilikia e like me ka hopu ʻana o ka puʻuwai , kahi e kū koke ai ka puʻuwai. Hiki i nā makuahine me AFE ke kahe koko me ka ʻole o ka hoʻomalu ʻia mai ka ʻōpū a i ʻole mai kahi ʻeha C-section. He kūlana koke loa a hiki ʻole ke wānana ʻia ʻo AFE. No laila, he paʻakikī loa ka mālama ʻana iā ia. He pilikia olakino nō hoʻi ia. ʻO kaʻoiaʻiʻo, he mea maʻamau ke komo ʻana o kahi wai liʻiliʻi o ka amniotic i loko o ke koko o ka makuahine i ka wā hānau. ʻAʻohe o ka hapa nui o ka poʻe i loaʻa i nā maʻi allergies i kēia. Akā, he mea pohihihi nō ke kumu o kekahi poʻe wale nō i loaʻa ai kēia maʻi ʻino. Ua kapa ʻia ʻo AFE ʻo "Anaphylactic Syndrome of Pregnancy".

Pehea ka maʻamau o kēia ʻano?

He maʻi laha ʻole ka AFE. Ma ʻAmelika Hui Pū ʻIa, loaʻa ia ma kahi o hoʻokahi i loko o 40,000 mau hānau ʻana. Ma ʻEulopa, loaʻa ia ma kahi o hoʻokahi i loko o 53,800 mau hānau ʻana. ʻO ia hoʻi, he mea laha ʻole loa ia. Akā, aia kekahi pilikia ʻē aʻe ma ʻaneʻi. Ua like loa nā hōʻailona o ka AFE me nā hōʻailona o nā pilikia ʻē aʻe e hiki ke hana i ka wā hānau, no ka laʻana, ka haki ʻana o ka ʻōpū, ka hemo ʻana o ka placenta, a i ʻole ka eclampsia. No laila, he mea paʻakikī iki ke ʻike i ke kumu pololei o kēia pilikia ʻo AFE.

He aha nā kumu pilikia no ka AFE?

Ma muli o ka laha ʻole o ka AFE a he paʻakikī ke noiʻi ʻana, he paʻakikī ke wānana pololei i nā mea pilikia e hiki ke kōkua iā ia. Eia nō naʻe, ma muli o ka noiʻi o kēia manawa, aia kekahi mau mea i manaʻo ʻia e kōkua paha i ke kūlana:

• Ka hoʻonui ʻana i ka makahiki makuahine: Hiki ke hoʻonui iki ʻia kēia pilikia no nā makuahine i hāpai i ka makahiki ma luna o 35.
• Loaʻa nā māhoe a ʻoi aku paha: No nā makuahine e manaʻo ana i nā keiki he nui ma mua o hoʻokahi, e like me nā māhoe a i ʻole nā ​​​​māhoe ʻekolu.
• ʻEhaeha o ka ʻōpū: Nā mea e like me nā loli i ka helu o ka puʻuwai o ka pēpē.
• Nā pilikia placental : No ka laʻana, nā kūlana e like me ka placental abruption.
• Loaʻa ka preeclampsia a i ʻole eclampsia: He mau pilikia kēia e pili ana i ke koko kiʻekiʻe i ka wā hāpai.
• Polyhydramnios: ʻO ke ʻano o kēia ka nui o ka wai amniotic i loko o ka ʻōpū.
• Nā waimaka o ka ʻāʻī .
• Hoʻoulu hana: ʻO kēia ka manawa e hoʻoulu ʻia ai ka hana e hoʻoulu i ka hana.
• Ka hānau ʻana i kahi pēpē ma o ka ʻoki caesarean (hanau ʻoki C ).
• Nā hānau keiki kōkua ʻoki kino: ʻO kēia nā hihia kahi e hānau ʻia ai ke pēpē me ka hoʻohana ʻana i nā forceps a i ʻole ka vacuum extracting.

E hoʻomanaʻo, ʻaʻole nā ​​​​kānaka a pau me kēia mau mea pilikia e loaʻa iā AFE. He mau mea wale nō kēia e hiki ke hoʻonui iki i ka likelika o ka loaʻa ʻana o ke kūlana .

He aha nā hōʻailona o ka embolism wai amniotic?

ʻIke koke ʻia nā hōʻailona o AFE a me ka wikiwiki loa.E like me ka mea i ʻōlelo ʻia ma mua, hiki ke paʻakikī ke ʻike pololei no ka mea ua like kēia mau hōʻailona me nā pilikia ʻē aʻe i ka wā hāpai a me ka hānau keiki ʻana. Eia nā hōʻailona hiki ke loaʻa:

• Paʻakikī ka hanu ʻana : Ua lilo koke ia i mea paʻakikī ke hanu, me he mea lā ua pau kou hanu.
• Ka hāʻule koke ʻana o ke koko : Hāʻule koke ke koko i ka nui.
• ʻEdema pulmonary: Ua pilikia ka hana o ka māmā, me he mea lā ua piholo i loko o ka wai.
• Ka helu o ka puʻuwai maʻamau ʻole: Loli koke ka helu o ka puʻuwai , i kekahi manawa e hoʻomaka ana e kuʻi wikiwiki loa, a i ʻole e kuʻi lohi loa.
• Ke kahe koko nui mai ka ʻōpū, ka ʻeha cesarean, a i ʻole ka wahi IV: Ke kahe koko ʻana hiki ʻole ke hoʻōki.
• ʻEhaeha o ka ʻōpū: Loli ka puʻuwai o ka pēpē.
• Ka hoʻomaha koke, ka huikau, a i ʻole ka hopohopo nui: Hoʻomaka koke ʻoe e hopohopo nui, hoʻomaha ʻole, hiki ʻole ke hoʻomaopopo i ka mea e hana nei, a makaʻu paha.
• Ke anu nei a me ka haʻalulu (Chills).

Inā ʻike koke ʻia kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​he pilikia paha ia.

He aha nā pilikia e hiki ke hana ma muli o ka AFE?

He maʻi koʻikoʻi loa ka AFE. Hiki iā ia ke hana i nā pilikia koʻikoʻi no ka makuahine a me ka pēpē.

Nā pilikia e hiki ke loaʻa i ka makuahine:

• Ka hāʻule ʻana o ka puʻuwai a me ka māmā.
• Ka nalowale o ka ʻike.
• Nā ʻōʻili.
• Ke kahe koko nui ʻana.
• Nā pilikia me ke kāpili ʻana o ke koko (Disseminated Intravascular Coagulation - DIC): Hana ʻia kēia i ka wā e paʻa ai ke koko ma kekahi ʻaoʻao a kahe nui ke koko ma kekahi ʻaoʻao kahi pilikia me ka ʻōnaehana kāpili koko.
• Hahau.
• Hopu ka puʻuwai: ʻO ke ʻano kēia ua pau loa ke kuʻi ʻana o ka puʻuwai.
• Ka pōʻino o ka lolo.
• Hiki ke make. ʻO kēia ka mea kaumaha loa.

Nā pilikia hiki ke loaʻa i ka pēpē i loko o ka ʻōpū:

Aia ka pilikia i ka pēpē i ka wā e hana ʻia ai ka embolism wai amniotic. Inā loaʻa i ka makuahine kēia mau hōʻailona ma mua o ka hānau ʻana o ka pēpē, pono paha ʻo ia e hānau koke . Inā ua hoʻomaka mua ʻo AFE, ua pilikia ka pēpē i ka loaʻa ʻole o ka oxygen lawa. Inā ʻaʻole lawa ka oxygen, hiki iā ia ke hōʻino i ka ʻōnaehana nerve a i ʻole ka lolo o ka pēpē.

He aha ke kumu o ka embolism wai amniotic?

ʻAʻole ʻike ʻia ke kumu kikoʻī o AFE. Ua manaʻo ʻia he kumu ia o ka pane ʻana o ka pale ʻana o kekahi mau makuahine i ka haki ʻana o ka placenta i ka wā hānau. Eia naʻe, ʻaʻole maopopo ke kumu e hiki ai i kekahi poʻe wale nō a ʻaʻole i kekahi.

Hiki ke hana ʻia ka AFE i ka wā o ka ʻoki ʻoki cesarean (C-section)?

ʻAe, hiki nō. Hiki ke hana ʻia ka embolism wai amniotic i ka wā hānau maʻamau a me ka ʻoki cesarean (C-section).

Pehea e ʻike ai nā kauka i ka embolism wai amniotic?

Hiki ke paʻakikī ke ʻike i ka embolism wai amniotic. E like me ka mea i ʻōlelo ʻia ma mua, ua like nā hōʻailona me nā ʻano maʻi koʻikoʻi ʻē aʻe. No laila, ke kānalua nā kauka i ka AFE, kāpae mua lākou i nā kumu ʻē aʻe. ʻO ka maʻamau, hana ka embolism wai amniotic i ka wā hānau a i ʻole i loko o 30 mau minuke o ka hānau ʻana. Inā loaʻa iā ʻoe ka AFE, pono ʻoe e loaʻa koke i ka lāʻau lapaʻau e pale aku i nā pilikia e hoʻoweliweli i ke ola. Hiki i kāu kauka ke kānalua i ka AFE inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona:

• Ka hāʻule koke ʻana o ke koko.
• Paʻakikī ka hanu ʻana.
• Ka puʻuwai kūpono ʻole a i ʻole ka hopu piha ʻana o ka puʻuwai.
• Ke kahe koko nui ʻana me ke kumu ʻole.

ʻElua pae o ka ʻike ʻana o AFE

Hoʻokaʻawale nā ​​​​kauka i ka embolism wai amniotic i ʻelua mau pae:

• Pae ʻekahi: Hōʻike ʻia kēia pae e ka hāʻule wikiwiki o ka hanu (nele i ka oxygen a me ka hiki ʻole ke hanu) a me ka hopu ʻana o ka puʻuwai. ʻO ka nui o nā make i hōʻike ʻia i kēia pae.
• Kahua ʻelua: ʻO kēia ka pae hemorrhagic. I kēia pae, aia paha ke kahe koko nui hiki ʻole ke kāohi ʻia, mai ka ʻeha caesarean a i ʻole mai ka uterus (kahi i hoʻopili ʻia ai ka placenta).

Nā hoʻāʻo e hana ʻia inā ola ʻoe

No ka mea he pilikia olakino ʻo AFE, ʻaʻohe manawa o nā kauka e hilinaʻi ai i nā hoʻokolohua kiʻi a i ʻole nā ​​​​hoʻokolohua koko e hana i kahi hōʻailona. Akā, hiki iā lākou ke hāʻawi koke i ka lāʻau lapaʻau e hoʻōla ola ai. Eia nō naʻe, inā ola ʻoe i kahi embolism wai amniotic, hiki i kāu kauka ke kauoha i nā hoʻokolohua e like me kēia:

• Electrocardiogram (EKG): Nānā i ka hana a me ke ʻano o ka puʻuwai.
• ʻO ka oximeter pulse: E nānā i ka pae oxygen i loko o ke koko.
• X-ray o ka umauma: No ka ʻike ʻana inā he wai a puni ka puʻuwai.
• Echocardiogram: E nānā pehea e hana ai ka puʻuwai.

Pehea e mālama ʻia ai ka embolism wai amniotic?

He pilikia ka amniotic fluid embolism. Pono e mālama koke ʻia.Penei e hiki ai iā ʻoe ke pale aku iā ʻoe a me kāu pēpē. Eia kekahi mau ʻano hana e hiki ai i nā kauka ke hoʻohana e hana i kēia:

• Ka hānau koke ʻana i ka pēpē.
• Nā hoʻoili koko he nui, plasma a me nā platelet.
• ʻO ka hysterectomy e hoʻōki i ke kahe ʻana o ke koko (hana ʻia kēia inā ʻaʻohe ala ʻē aʻe e hoʻōki ai i ke kahe ʻana o ke koko).
• Ke lawelawe ʻana i nā steroids a i ʻole nā ​​​​lāʻau lapaʻau ʻē aʻe e kaohi i ke koko a i ʻole ka hana puʻuwai.
• Ke hāʻawi nei i ka Cardiopulmonary Resuscitation (CPR).
• Hāʻawi ʻia ka oxygen ma o kahi paipu tracheal a i ʻole ma o kahi mīkini (mechanical ventilation).
• E hoʻopaʻa i ke kaomi koko ma ke hoʻokomo ʻana i kahi catheter artery pulmonary a i ʻole kahi catheter venous waena.

Hana ʻia kēia mau mea a pau e hoʻopakele i ke ola o ka makuahine a me ka pēpē. No laila, hoʻoholo ka hui lapaʻau ma muli o ke kūlana i kēlā manawa.

Aia kekahi ala e hiki ai iā kākou ke pale aku i kēia?

ʻO ka mea pōʻino, ʻaʻohe ala e pale aku ai i ka embolism wai amniotic i kēia manawa . ʻAʻole maopopo loa i nā kauka ke kumu o ka AFE a i ʻole ke kumu. Eia nō naʻe, ʻo kekahi ala e hoʻomākaukau ai no kekahi pilikia olakino, ʻo ia ka hana pū ʻana me kou ʻohana a me nā kauka e hoʻomohala i kahi hoʻolālā. E nīnau i kāu kauka e pili ana i nā pilikia a pehea e pane ai kāu hui lapaʻau iā lākou. He ʻāpana paha kēia o kāu "hoʻolālā hānau," kahi hoʻolālā āu i hana ai ma mua o ka hānau ʻana o kāu pēpē. Akā e hoʻomanaʻo, ʻo kāu hoʻolālā hānau ke kūlana maikaʻi loa. Inā loaʻa kahi pilikia, pono kāu hui lapaʻau e hana e like me ia e pale aku iā ʻoe a me kāu pēpē.

He aha nā kūlana e ola ai i ka AFE?

Ma muli o ka paʻakikī o ka ʻike ʻana i ka AFE a hilinaʻi ia i nā kumu he nui, he paʻakikī ke hāʻawi i ka pakeneka pololei o ka nui o ka poʻe e make ana mai kēia maʻi. ʻOiai ke ʻokoʻa nā haʻawina ma muli o ke ʻano o ka hōʻiliʻili ʻana o ka ʻikepili, hōʻike kekahi mau hōʻike e hiki ke piʻi ka nui o ka make i ka 60%. Hōʻike kēia i ke koʻikoʻi o kēia maʻi.

He aha nā hopena lōʻihi e hiki ke loaʻa i ka poʻe i pakele?

Aia kēia i ke koʻikoʻi o kāu pane ʻana i ka AFE, a me kou mōʻaukala olakino holoʻokoʻa. Hiki i ka amniotic fluid embolism ke hana i nā hopena kino a me ka noʻonoʻo. ʻO kekahi o nā hopena lōʻihi e hiki mai ana:

• ʻO ka hōʻino ʻana o ka lolo e hoʻopilikia ai i ka hoʻomanaʻo a i ʻole ka hiki ke hoʻomanaʻo i nā huaʻōlelo.
• Ka hōʻino mau loa i ka puʻuwai.
• Inā loaʻa kahi hahau, hiki ke kū mai nā pilikia.
• Nā pilikia puʻupaʻa.
• Hopohopo, kaumaha, a me nā manaʻo hewa.
• Maʻi Hopohopo Ma hope o ka Trauma (PTSD). No ka mea he ʻike ʻeha loa kēia, hiki ke lōʻihi ka manawa e hoʻōla ai i ka noʻonoʻo.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

ʻO ka amniotic fluid embolism (AFE) kahi pilikia e hoʻoweliweli ana i ke ola e kū mai ana i ka wā hānau keiki a ma kahi o ka hānau keiki ʻana. He mea kākaʻikahi loa ia, a hiki ke hana koke a wikiwiki. No ka mea, ʻaʻole maopopo loa ke ʻano, ʻaʻohe mea hiki iā ʻoe ke hana e pale aku ai. ʻAʻole maopopo i nā kānaka noiʻi lapaʻau ke kumu e hana wale ai i kekahi poʻe.

Inā hāpai ʻoe, haʻahaʻa loa ka manawa e loaʻa ai iā ʻoe ka AFE. No laila, mai hopohopo pono ʻole. Eia nō naʻe, e kamaʻilio me kāu mea mālama maʻi hāpai e pili ana i nā hopohopo a i ʻole nā ​​nīnau āu e pili ana i kēia maʻi laha ʻole. E hiki iā lākou ke kōkua iā ʻoe e hōʻoluʻolu i kou mau makaʻu.

Inā he mea ola ʻoe no ka AFE, loaʻa paha iā ʻoe nā pilikia olakino kino a noʻonoʻo paha no ka wā lōʻihi. E kamaʻilio me kāu kauka, hoa, a i ʻole nā ​​hoaaloha e pili ana i kēia. Hiki iā lākou ke hāʻawi iā ʻoe i ke kākoʻo āu e pono ai e hoʻōla mai kēia maʻi. E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi.