Ua ʻike anei ʻoe ua emi koke kou wā mahina a ua pau loa paha ma hope o kou hana ʻana i ka D&C, a i ʻole ka hysterectomy? Ke ʻeha nui nei kou ʻōpū ma mua o ka maʻamau i kou wā? Ke moeʻuhane nei ʻoe e pili ana i ka loaʻa ʻana o kahi pēpē? Manaʻo pinepine mākou i kēia mau mea he mea maʻamau, malia paha nā loli hormonal, a poina iā lākou. Akā he ʻano maʻi paha kēia e pono ai ke kōkua lapaʻau. Ke kamaʻilio nei mākou e pili ana i kekahi ʻano maʻi i kēia lā. ʻO ia ka Asherman's Syndrome .
I ka ʻōlelo maʻalahi, he aha ka Asherman's Syndrome?
I ka ʻōlelo maʻalahi, ʻo ka maʻi Asherman ka ulu ʻana o nā ʻiʻo ʻeha a i ʻole nā pili i loko o kou uterus a/a i ʻole cervix. I kekahi manawa kapa nā kauka i kēia "nā adhesions intrauterine".
E noʻonoʻo i kou ʻōpū e like me kahi pōpō liʻiliʻi. ʻO ka maʻamau, ua kahe wale nā pā o loko o kēia pōpō, me ka ʻole o ka pipili ʻana. Akā he aha ka mea e hana ai inā no kekahi kumu e hōʻeha ʻia kēia mau pā o loko, a i ka wā e ho'ōla ai kēlā mau ʻeha, hana ʻia nā ʻōpala, a hoʻomaka nā pā e pipili pū? ʻO ia ka mea e hana nei ma ʻaneʻi. Hoʻemi kēia mau pipili i ka nui o ka hakahaka i loko o ka ʻōpū. Hiki i kēia ke hana i nā pilikia e like me ka ʻeha, nā wā kūpono ʻole, a me ka hānau ʻole.
Manaʻo maikaʻi ʻoe i kou kino. Inā ʻike ʻoe i kahi loli i kou pōʻaiapuni menstrual a i ʻole ka ʻeha hou, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me ke kauka ma kahi o ka manaʻo ʻana, "He mea maʻamau kēia."
Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe ka maʻi Asherman? He aha nā hōʻailona?
ʻAʻole ʻike nā kānaka a pau i nā hōʻailona like. ʻAʻole paha e ʻike kekahi poʻe i kekahi mau hōʻailona. Akā, aia kekahi mau hōʻailona maʻamau. E nānā kākou i ke ʻano o ia mau mea.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| Hypomenorrhea (ka liʻiliʻi loa o ke kahe koko o ka menstrual) | No ke aha e loaʻa ai i kahi kanaka i loaʻa ka manawa he 4-5 mau lā i kēia manawa he mau ʻōpuʻu wale nō no hoʻokahi a ʻelua paha lā? |
| Ka pau ʻana o ka menstruation (Amenorrhea) | Ua hala koke ka menstruation no nā mahina me ke kumu ʻole. |
| ʻEha nui o ka ʻōpū lalo (Dysmenorrhea) | ʻEha hiki ʻole ke hoʻomanawanui i nā lā ma mua o ka menstruation a i ʻole i ka wā e hiki mai ai ka menstruation. |
| Ka paʻakikī o ka hāpai ʻana i kahi keiki (Infertility) | ʻO ka hiki ʻole ke hāpai me ka hoʻāʻo ʻole no ka manawa lōʻihi me ka ʻole o kekahi ʻano kaohi hānau. |
| Nā Hāʻule Hou | ʻOiai inā hāpai ʻoe, ʻaʻole hiki i ka embryo ke hoʻokomo a ulu pono i loko o ka ʻōpū, e hopena ai i ka hāʻule ʻana. |
I kekahi manawa, ʻoiai ʻaʻole ʻoe he wā, hiki nō iā ʻoe ke ʻeha i ka wā e hiki mai ai kou wā. ʻO ke ʻano kēia e hana maoli ana kou wā, akā hiki i ka ʻiʻo ʻeha ke ālai i ke alahele i loko o kou ʻōpū a pale i ke koko mai ka puka ʻana mai.
No ke aha e kū mai ai kēia ʻano pipili? He aha nā kumu nui?
ʻO ke kumu nui o kēia mau pipili ʻana, ʻo ia kekahi hōʻino a ʻeha paha i ka uhi o loko o ka ʻōpū, ʻo ia hoʻi ka "Endometrium." ʻOiai inā ʻeha nā ʻāpana ʻelua o ka paia o loko o ka ʻōpū e kū pono ana kekahi i kekahi i ka manawa like, kiʻekiʻe ka likelika o ko lākou pipili ʻana i ka wā e ho'ōla ai.
Ua hoʻokaʻawale nā kauka i nā kumu no kēia i ʻelua mau ʻāpana nui.
1. Nā kumu e pili ana i ka hāpai ʻana
Ua ʻike ʻia ma ka noiʻi ʻana ua ʻoi aku ma mua o 90% o nā hihia o ka maʻi Asherman i hana ʻia e kahi kaʻina hana D&C (Dilation and Curettage) i hana ʻia i ka wā hāpai. ʻO ka D&C he kaʻina hana wale nō ia e wehe a hoʻomaʻemaʻe i loko o ka ʻōpū. Eia nā kūlana e hiki ai ke hana ʻia kahi D&C:
- E hoʻopau i ka hāpai ʻana.
- E wehe i nā ʻāpana i koe o ka ʻōpū ma hope o ka hāʻule ʻana o ka hāpai keiki.
- Inā koe kekahi mau ʻāpana o ka placenta i loko o ka ʻōpū ma hope o ka hānau ʻana o ke pēpē, e wehe iā lākou.
He ʻano koʻikoʻi loa ka ʻōpū ma hope o ka hāpai ʻana. I ia mau manawa, ʻoiai he liʻiliʻi wale nō ka hōʻino ʻana i ka "endometrium" hiki ke alakaʻi i ka hoʻokumu ʻia ʻana o nā ʻiʻo ʻeha nui. He mea kākaʻikahi loa, hiki ke loaʻa kēia ʻano ma hope o ka ʻoki ʻana i ka ʻōpū (C-section).
2. Nā kumu i pili ʻole i ka hāpai ʻana
ʻOiai ua hana pinepine ʻia kahi D&C no nā kumu pili i ka hāpai ʻana, hana ʻia nā D&C a me nā hana ʻē aʻe no nā kumu ʻē aʻe.
- Inā kānalua ʻia ka maʻi ʻaʻai ʻōpū, e kiʻi i kahi hāpana ʻiʻo (biopsy).
- E wehe i nā polyps i loko o ka ʻōpū.
- ʻO ka Hysteroscopy kahi hana ʻokiʻoki e wehe i nā fibroids uterine.
- ʻO ke ʻoki kino e wehe ai i kahi uterus septate.
Ma waho aʻe o kēia,
- Nā maʻi pelvic koʻikoʻi
- Hiki i nā mea e like me ka radiation therapy i ka ʻāpana pelvic ke hana i kēia.
Pehea e ʻike ʻia ai kēia maʻi? He aha nā hoʻokolohua e hana ʻia ai?
Ke haʻi aku ʻoe i kāu kauka e pili ana i kāu mau hōʻailona, e nīnau ʻo ia e pili ana i kou mōʻaukala olakino, ʻoiai kekahi mau ʻoki kino ma mua (e like me ka D&C). A laila, e paipai lākou i kekahi mau hoʻokolohua e hōʻoia i ke kūlana.
ʻO ka hoʻāʻo maikaʻi loa a pololei loa no kēia he hysteroscopy diagnostic. Pili kēia i ke komo ʻana i kahi ʻōmole lahilahi loa me kahi kāmela i hoʻopili ʻia ma o kou vagina a me ka cervix a me ka nānā ʻana i loko o kou uterus. Hiki i ke kauka ke ʻike maopopo i ka nui o nā mea hoʻopili i loko o ka uterus a me ko lākou ʻano.
Eia kekahi, hiki ke hana ʻia kahi "Transvaginal Ultrasound Scan". I kekahi manawa, i loko o kēia scan, ua hoʻokomo ʻia kahi liʻiliʻi o ka wai saline i loko o ka ʻōpū, e hoʻoulu ai i ka ʻōpū e pehu iki ma mua o ke scan. ʻAe kēia i kahi kiʻi maikaʻi aʻe o loko o ka ʻōpū a me nā mea hoʻopili, inā he.
Aia kekahi mau pae o ke koʻikoʻi no ka maʻi Asherman?
ʻAe, hiki ke hoʻokaʻawale ʻia kēia maʻi i kekahi mau pae ma muli o ke koʻikoʻi. E kōkua kēia iā ʻoe a me kāu kauka e hoʻomaopopo maikaʻi i ke ʻano.
| Kahua | Wehewehena |
|---|---|
| Maʻi ʻoluʻolu | Aia kekahi mau mea pipili lahilahi e like me ka membrane ma lalo o ka hapakolu o ka ʻōpū. Hiki ke maʻamau a emi iki paha ka maʻi ʻōpū. |
| Maʻi Kaulike | Ma waena o hoʻokahi hapakolu a me ʻelua hapakolu o ka ʻōpū he hui ʻana o nā mea pipili lahilahi a mānoanoa. Ua emi nui ka maʻi ʻōpū. |
| Maʻi koʻikoʻi | Ua uhi ʻia ma mua o ʻelua hapakolu o ka ʻōpū me nā mea hoʻopili mānoanoa. I ka manawa pinepine, ua pau loa ka menstruation. |
He aha nā lāʻau lapaʻau no kēia?
Aia nā lāʻau lapaʻau no kēia. ʻO ka pahuhopu nui o ka lāʻau lapaʻau, ʻo ia ka wehe ʻana i nā ʻiʻo ʻeha a hoʻihoʻi i ka ʻōpū i kona ʻano maʻamau. Inā ʻaʻole ʻoe e ʻeha a ʻaʻole makemake e loaʻa nā keiki, ʻaʻole paha ʻoe e pono i kekahi lāʻau lapaʻau. Eia nō naʻe, inā loaʻa iā ʻoe nā hōʻailona, hiki i ka lāʻau lapaʻau ke komo pū me:
- Hiki ke hoʻomaha ʻia ka ʻeha.
- Hiki ke hoʻihoʻi hou ʻia ke kaʻina hana menstrual.
- Hiki ke hoʻihoʻi ʻia ka hiki ke hāpai i kahi keiki.
ʻO ka lāʻau lapaʻau nui, ʻo ia ka Operative Hysteroscopy. Ua like kēia me ka diagnostic hysteroscopy. Eia nō naʻe, ma kēia kaʻina hana, hoʻokomo ʻia kahi kāmela a me kahi ʻokiʻoki lahilahi a i ʻole ka laser i loko o ka ʻōpū a ʻoki pono ʻia nā mea i hoʻopili ʻia. Pono paha e hana ʻia kēia kaʻina hana ma mua o hoʻokahi manawa, ma muli o ke koʻikoʻi o ke kūlana.
Nā mea e mālama ai ma hope o ke ʻoki kino
ʻO ka pilikia nui loa ma hope o kēia ʻoki kino, ʻo ia ka pilikia o ka hoʻi hou ʻana mai o nā pipili. E hana kāu kauka i kekahi mau hana e pale aku ai i kēia.
- Ke hāʻawi ʻana i nā lāʻau hormonal: ʻO ka hāʻawi ʻana i ka hormone estrogen e kōkua i ka ulu wikiwiki a maikaʻi o ka uhi o ka ʻōpū (endometrium).
- Ke hoʻokomo ʻana i kahi pale i loko o ka ʻōpū: Hiki ke waiho ʻia kahi pōpō liʻiliʻi (intrauterine balloon) a i ʻole catheter i loko o ka ʻōpū no kekahi mau lā ma hope o ke ʻoki ʻana e pale ai i nā paia o ka ʻōpū mai ka pipili ʻana.
- Ke hāʻawi ʻana i nā lāʻau antibiotic: Hāʻawi ʻia kēia mau mea e pale aku i ka maʻi ʻoiai e kau ana kekahi mea e like me ka pōpō.
Hiki ke nānā hou ʻia ʻoe ma kahi o hoʻokahi a ʻelua paha pule ma hope o ke ʻoki ʻana e ʻike ai inā ua hoʻomaka nā hoʻopili hou e hana.
Hiki iaʻu ke hānau keiki me ka maʻi Asherman?
He nīnau nui kēia no nā kānaka he nui. He paʻakikī ke hāʻawi pololei i kahi "ʻae, hiki iā ʻoe" a i ʻole "ʻaʻole, ʻaʻole hiki iā ʻoe." Aia ia i ke koʻikoʻi o kou kūlana a me ka holomua o kāu lāʻau lapaʻau.
Ma keʻano laulā, ʻoi aku ka haʻahaʻa o ka manawa o ka poʻe me ka maʻi Asherman maʻamau a koʻikoʻi paha e hāpai a mālama i ka hāpai olakino ma hope o ka mālama ʻana.
Wahi a kekahi noiʻi:
- No ka poʻe me nā mea hoʻopili iki, 60.7% i hāpai ma hope o ka mālama ʻana.
- No ka poʻe me nā hoʻopili kaulike , 53.4% ua hāpai ma hope o ka mālama ʻana.
- He 25% o ka poʻe me nā pipili koʻikoʻi ua hāpai ma hope o ka mālama ʻana.
Mai hopohopo i kēia mau helu helu. E hāʻawi kāu kauka iā ʻoe i ka ʻike maikaʻi loa o kou kūlana. ʻO ka mea nui loa, ʻo ia ke wehe a me ka ʻoiaʻiʻo me kāu kauka e pili ana i kāu mau pahuhopu hānau keiki.
Inā hāpai kahi wahine me ka maʻi Asherman, ua manaʻo ʻia he hāpai pilikia kiʻekiʻe. E nānā pono kāu kauka iā ʻoe a me kāu pēpē no ka mea he liʻiliʻi ka manawa kūpono o nā pilikia e like me ka hānau mua ʻana a me ka placenta previa.
Leka Lawe-Home
- ʻO ka maʻi Asherman ka hoʻokumu ʻia ʻana o nā ʻiʻo scar (adhesions) i loko o ka ʻōpū.
- Hoʻomaʻamaʻa pinepine ʻia kēia ʻano ma hope o kahi hana ʻoki e like me ka D&C (dilation a me ka curettage).
- ʻO nā hōʻailona nui ka emi ʻana a i ʻole ka hala ʻole o ka menstruation, ka ʻeha nui, a me ka paʻakikī o ka hāpai ʻana.
- Hiki ke ʻike pololei ʻia kēia maʻi ma o ka hysteroscopy.
- Hiki ke mālama ʻia kēia mau mea pipili me ke ʻoki ʻana e wehe iā lākou. Eia nō naʻe, aia kahi pilikia o ka hoʻi hou ʻana o nā mea pipili.
- Hiki i kēia kūlana ke hoʻopilikia i kou momona, no laila he mea nui e kamaʻilio ākea me kāu kauka e pili ana i kāu mau hoʻolālā e hiki mai ana.
- ʻAʻole ʻoe hoʻokahi. Hiki ke mālama ʻia kēia kūlana me ka mālama lapaʻau kūpono a me ke alakaʻi.
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