Ua lohe paha ʻoe i kekahi mea e like me kēia ma hope o ka ʻoki ʻana i ka ʻāpana cesarean? (Isthmocele / Cesarean Scar Defect)

ʻIke ʻoe, ke kamaʻilio mākou e pili ana i ka ʻoki ʻana o ka ʻōpū (C-section), ʻaʻole mākou e kamaʻilio pinepine e pili ana i nā pilikia e hiki mai ana ma hope. Pēlā nō, hiki i kekahi poʻe ke loaʻa i kahi pilikia liʻiliʻi ma hope o ka ʻoki ʻana o ka ʻōpū inā ʻaʻole i ho'ōla pono ʻia ka ʻoki ʻana o ka ʻōpū. ʻO kēia ka mea a nā kauka e kapa nei he Isthmocele a i ʻole Cesarean Scar Defect. Mai hopohopo, ʻaʻole kēia e hana i nā kānaka a pau, akā he mea nui e makaʻala i kēia, ʻoiai inā ua loaʻa iā ʻoe kahi ʻoki ʻana o ka ʻōpū (C-section) a ke hoʻolālā nei paha e loaʻa i hoʻokahi i ka wā e hiki mai ana.

No laila, he aha kēia isthmocele?

I ka ʻōlelo maʻalahi, he ʻeke liʻiliʻi a he lua paha ka isthmus ma ka paia o kou uterus kahi i hana ʻia ai ʻoe i ka cesarean. I ka pololei, hana ʻia ia ma ka ʻili o ka uterus. Hana ʻia kēia 'uterine niche' i ka wā ʻaʻole e ho'ōla piha ʻia ka ʻoki i hana ʻia i ka wā o ka cesarean. Hiki i kēia ke alakaʻi i ka paʻakikī o ka hāpai ʻana (infertility), nā pilikia i ka wā o nā hāpai ʻana e hiki mai ana, a me nā pilikia ʻē aʻe he nui.

ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o kahi kīnā isthmus (Cesarean Scar Defect)?

ʻOiai hiki ke loaʻa kēia maʻi i kekahi mea e hana ʻia ana i ka ʻoki cesarean, aia kekahi poʻe i kahi pilikia kiʻekiʻe iki. E nānā kākou iā lākou:

• Inā kaumaha/momona ʻoe ma mua a i ka wā hāpai paha.
• Inā he mau pilikia olakino kou e hoʻopilikia ai i ka ho'ōla ʻana o nā ʻeha.
• Ua hana ʻia ke ʻoki caesarean ma ke ʻano he hoʻoholo ulia pōpilikia, ma hope loa o ka hānau ʻana (ʻoki caesarean i hoʻolālā ʻole ʻia ma hope o ke kaʻina hana hānau).
• Inā loaʻa iā ʻoe ka maʻi diabetes mellitus a inā paha ua loaʻa iā ʻoe ka maʻi diabetes i ka wā hāpai (gestational diabetes).
• Inā ua hana ʻoe i nā ʻāpana caesarean he nui .
• Inā ʻoe e puhipaka a hoʻohana paha i nā huahana paka ʻē aʻe .

Inā pili kekahi a ʻoi aku paha o kēia mau mea iā ʻoe, he manaʻo maikaʻi e akahele iki. Akā e hoʻomanaʻo, ʻoiai me kēia mau mea pilikia, ʻaʻole e loaʻa i nā kānaka a pau.

Pehea ka maʻamau o kēia ʻano isthmus?

Wahi a nā hōʻike noiʻi, ma waena o 24% a me 70% o nā wahine i loaʻa i hoʻokahi ʻoki cesarean e loaʻa i kēia maʻi. I ka piʻi ʻana o ka nui o nā ʻoki cesarean ma ka honua holoʻokoʻa, ke lilo nei kēia maʻi i mea maʻamau. No ka laʻana, ma kahi o 30% o nā pēpē i hānau ʻia ma ʻAmelika Hui Pū ʻIa i hānau ʻia ma o ka ʻoki cesarean. No laila he mea nui e makaʻala i kēia maʻi.

No ke aha e kū mai ai kēia kīnā ʻeha cesarean (Isthmocele)?

E noʻonoʻo, i ka wā o ka ʻoki ʻana o ka ʻōpū, ʻelua ʻoki ʻia. Hoʻokahi ma ka ʻōpū, a ʻo kekahi ma ka ʻōpū. Inā ʻaʻole e ho'ōla pono ka ʻoki ʻana ma ka ʻōpū,ʻAe, a i ʻole ke hana ʻoe i nā ʻoki he nui ma kahi hoʻokahi, hiki i ka ʻiʻo ma ia wahi ke lahilahi. ʻO ia ka manawa e hana ʻia ai kahi ʻāpana e like me ka ʻeke, e like me ka mea āu i ʻōlelo ai, a hoʻomaka ia e piha i ka wai a me ke koko.

I kekahi manawa, hiki i kahi o ka ʻoki ʻana i ka wā o ka ʻoki cesarean ke hoʻopilikia i kēia. Inā hana ʻia ka ʻoki haʻahaʻa loa i loko o ka ʻōpū, aia ka manawa kūpono o kahi ʻeha nui. ʻO ka maʻamau, hana ʻia kēia ʻano ʻoki haʻahaʻa i ka wā e hana ʻia ai ka ʻoki cesarean ma hope loa o ka hānau ʻana. Ua ʻōlelo ʻia hoʻi inā hoʻokahi wale nō papa o nā sutures e hoʻohana ʻia i ka wā e pani ai i ka ʻoki uterine ma kahi o ʻelua , hiki ke hoʻonui ʻia ka pilikia o ka hoʻokumu ʻia ʻana o ka isthmus.

Hiki i kahi ʻeha cesarean ke hoʻoulu i ka hānau ʻole?

ʻAe, i kekahi manawa hiki i kēia ʻeha cesarean ke hoʻoulu i ka hānau ʻole ʻana . Akā ʻo ka nūhou maikaʻi , me ka mālama pono ʻana, hiki i nā poʻe he nui ke hoʻomau i ka hāpai ʻana i ke olakino maikaʻi. Inā manaʻo ʻoe he mau hōʻailona o kahi isthmus, a inā paha ʻoe e hoʻāʻo nei e hāpai no hoʻokahi makahiki (a i ʻole ʻeono mahina inā ʻoi aku ʻoe ma mua o 35) a ʻaʻole hiki ke hāpai, e ʻike pono i kāu kauka a kamaʻilio e pili ana.

He aha nā hōʻailona o kēia ʻano isthmus?

ʻOiai ʻaʻole hiki i nā kānaka a pau ke ʻike i nā hōʻailona, ​​​​hiki i kekahi poʻe ke ʻike:

• Ka menstruation kūpono ʻole .
• ʻEha ka wā o ka haʻihaʻi (Dysmenorrhea).
• ʻEha i ka wā o ka moekolohe (Dyspareunia).
• ʻEha pelvic .
• Ke kahe ʻana o ke koko mai loko mai o ka vagina a i ʻole ka uterus ma waena o ʻelua mau pōʻaiapuni menstrual.
• Ka hoʻokahe ʻana o ka ʻōpū ma ke ʻano ʻē .

Inā hoʻomau ʻoe i kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me ke kauka e pili ana i ia mea.

He aha nā pilikia e hiki mai ana o ka isthmus cyst?

Inā ʻaʻole mālama pono ʻia kēia maʻi, hiki ke loaʻa kekahi mau pilikia. ʻO kēia mau mea:

• Hoʻonui ʻia ka pilikia o nā pilikia i ka wā o nā kaʻina hana gynecological.
• ʻO ka placenta accreta ( placenta e hoʻopili hohonu loa ana i ka paia o ka ʻōpū ).
• ʻO ka placenta previa.
• Hāpai ʻōpala - He ʻano hāpai ectopic kēia, kahi e hoʻokomo ʻia ai ka hua manu i loko o kahi ʻōpala ma ka ʻōpū.
• ʻO ka hānau ʻole lua - ʻO ia hoʻi ka hiki ʻole ke hāpai hou ma hope o ka hāpai holomua ma mua.
• Ka hemo ʻana o ka ʻōpū ( ka haehae ʻana a i ʻole ka haehae ʻana o ka ʻōpū ma kahi o ka ʻōpala o ka ʻōpū ).

Hiki ke hopohopo kēia mau pilikia ke lohe ʻia. Akā e hoʻomanaʻo, ʻaʻole lākou e hana i nā mea āpau. Hiki i ka ʻike mua a me ka mālama ʻana ke hōʻemi nui i kēia mau pilikia.

Pehea ʻoe e ʻike ai i kēia kūlana isthmus?

E ʻike i ka IsthmusʻO nā hoʻokolohua kiʻi kūikawā ka mea kūpono loa. ʻO ka manawa kūpono loa e hana ai i kēia mau hoʻokolohua ma hope koke o ka pau ʻana o kāu pōʻaiapuni menstrual. ʻO kēia no ka mea ua piha paha ka niche i ke koko i kēlā manawa, e maʻalahi ai ke ʻike ʻia ma ka hoʻokolohua.

Hiki i kāu kauka ke kuhikuhi i nā hoʻokolohua e like me kēia:

• Hysteroscopy: Pili kēia i ke kauka e hoʻokomo i kahi ʻōmole lahilahi a hoʻomālamalama ʻia ma o kou vagina a nānā i loko o kou cervix a me ka uterus. Hiki i kēia ke nānā i kekahi ʻeha, nā ʻiʻo ʻē aʻe, a i ʻole nā ​​​​pilikia ʻē aʻe.
• ʻO ka sonohysterography hoʻokomo saline: Hāʻawi kēia i nā kikoʻī hou aku ma mua o ka ultrasound transvaginal maʻamau. Maanei, hoʻopiha ke kauka i kou ʻōpū me ka saline (wai paʻakai sterilized) a hana i ka ultrasound. I ka piha ʻana o ka 'ʻeke' me ka wai, hiki ke ʻike maopopo ʻia nā mea e like me kona nui a me ka mānoanoa o ka paia i nā kiʻi.
• ʻO ka ultrasound transvaginal: Pili kēia i ke komo ʻana i kahi probe ultrasound ma o ka vagina e nānā i ka scar a me ka 'niche' i loko o ka uterus. Hiki iā ia ke loiloi i ka mānoanoa o ka scar.

Pehea e mālama ʻia ai nā ʻōpala ma ka ʻoki ʻoki caesarean?

Aia kekahi mau lāʻau lapaʻau no nā cysts isthmus. Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa iā ʻoe ma muli o kou kūlana, ke koʻikoʻi o kāu mau hōʻailona, ​​a inā makemake ʻoe e loaʻa hou nā keiki.

• Nā lāʻau pale hānau waha: He mau lāʻau hoʻomalu hānau kēia. Hāʻawi lākou i nā lāʻau haʻahaʻa o nā hormones. Hiki i kēia mau hormones ke hoʻoponopono i kāu pōʻaiapuni menstrual a hōʻemi i ke kahe ʻana o ke koko menstrual. I kekahi manawa hiki i kēia lāʻau ke hoʻemi i ka nui o ka 'niche' a ʻaʻole pono ke ʻoki kino.
• ʻO ka Hysteroscopic resection (HR): I ka wā o ka hysteroscopy, hiki i ke kauka ke wehe i nā ʻiʻo ʻeha mai ka ʻōpū. Hiki iā ia ke wehe i nā ʻaoʻao o ka 'niche' e ʻae i ke koko a me ka wai e kahe i waho. ʻAʻole pono kēia i kekahi ʻoki ʻana i loko o ka ʻōpū.
• Hoʻoponopono Laparoscopic: Ma kēia kaʻina hana, hana ke kauka i hoʻokahi a ʻoi aku paha mau ʻoki liʻiliʻi i loko o kou ʻōpū a hoʻokomo i kahi ʻōmole lahilahi a hoʻomālamalama ʻia (laparoscope) ma o lākou e nānā i loko o kou uterus. A laila wehe ʻia ka ʻiʻo ʻeha a me nā ʻiʻo keu a puni ka 'niche'. He ʻoki kino minimally invasive kēia no nā ʻeha cesarean. Hiki i kēia ke kōkua iā ʻoe e hoʻōla wikiwiki a ʻike i ka ʻeha liʻiliʻi.
• Hoʻopau ʻana i ka ʻōpū:ʻO ke ʻano kēia o ka wehe ʻana i ka ʻōpū holoʻokoʻa. Hana pinepine ʻia kēia no ka poʻe me nā hōʻailona isthmus koʻikoʻi loa a ʻaʻole makemake e loaʻa hou nā keiki. Hiki paha iā ʻoe ke loaʻa i kahi hysterectomy laparoscopic. He hana hoʻopilikia iki kēia, ʻo ia hoʻi hiki iā ʻoe ke ho'ōla koke a loaʻa ka ʻeha liʻiliʻi me ka ʻole o ka hana ʻana i nā ʻoki nui.

Pehea mākou e pale ai i ka hoʻokumu ʻia ʻana o nā isthmuses?

ʻO ka ʻoiaʻiʻo, ʻo ke ala wale nō e pale loa ai i ka isthmus, ʻo ia ka pale ʻana i ka hana ʻoki cesarean. Akā, ʻaʻole hiki i nā kānaka a pau ke hana pēlā. Inā hāpai ʻoe a ke hoʻolālā nei i kahi ʻoki cesarean, e kamaʻilio me kāu kauka e pili ana i kou pilikia o ka loaʻa ʻana o kahi ʻeha cesarean (isthmus). Hiki iā ʻoe ke hōʻemi i kou pilikia ma ka hana ʻana i kēia mau mea:

• E mālama i ke kaumaha olakino ma mua a i ka wā hāpai.
• Ke kāohi nei i ka maʻi diabetes .
• Ke pale ʻana i ka puhipaka a me ka hoʻohana ʻana i nā huahana paka ʻē aʻe .

He aha ke kūlana olakino o ka poʻe me nā ʻeha cesarean?

ʻO ka nūhou maikaʻi, he maʻi hiki ke mālama ʻia ka ʻeha cesarean (isthmus). Hiki i ka hapa nui o ka poʻe ke hāpai hou ma hope o ka mālama ʻana, no laila mai hoʻopau i ka manaʻolana.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe kahi isthmus i ka wā hāpai, aia ʻoe i ka pilikia o ka haki ʻana o ka ʻōpū . He pilikia olakino kēia. Hana ʻia kēia i ka wā e hemo ai ka ʻōpala o ka ʻōpū a haehae ka ʻōpū. Hiki i kēia ke hoʻopilikia nui i ke olakino iā ʻoe a me kāu pēpē.

Inā loaʻa iā ʻoe ka ʻeha nui o ka pelvic, ka ʻeha ma kahi o kou ʻeha cesarean, a i ʻole ke kahe nui ʻana o ke koko i loko o ka ʻōpū , he mau hōʻailona paha kēia o ka haki ʻana o ka ʻōpū. Inā hana ʻia kēia, e ʻimi koke i ke kōkua lapaʻau.

He ʻeke liʻiliʻi ka isthmus, a i ʻole 'niche,' e hana ʻia ana ma ka paia o kou ʻōpū. Hoʻokumu ʻia ia e kahi ʻoki cesarean i hoʻōla pono ʻole ʻia. Hiki i kēia ke hana i ke kahe koko ʻano ʻole o ka vaginal, ka ʻeha pelvic, a me nā pilikia menstrual. Hiki iā ia ke hana i ka hānau ʻole ʻana a i ʻole nā ​​​​pilikia me nā hāpai ʻana i ka wā e hiki mai ana. ʻO ka lāʻau lapaʻau maʻamau ka ʻoki kino minimally invasive e wehe i ka ʻiʻo scar keu a hana i ka 'niche.' Hiki i ka hapa nui o ka poʻe ke loaʻa nā hāpai olakino ma hope o ka lāʻau lapaʻau.

E hoʻomanaʻo i ka mea nui loa (Leka Lawe-Home)

• He ʻeke liʻiliʻi ka isthmocele i hana ʻia ke ho'ōla pono ʻole ʻia ka ʻoki ʻana o ka ʻōpū ma hope o ka ʻoki cesarean.
• ʻOiai ʻaʻole loaʻa i nā kānaka a pau kēia, hiki i kekahi poʻe ke loaʻa i ka hānau ʻole ʻana, nā pilikia menstrual, a me nā pilikia i ka wā hāpai e hiki mai ana.
• Inā loaʻa iā ʻoe nā hōʻailona e like me ke kahe koko ʻole a i ʻole ka ʻeha pelvic, e ʻike i ke kauka.
• Hiki ke ʻike ʻia a mālama ʻia kēia maʻi. I ka hapanui o nā hihia, hiki ke hoʻokō ʻia nā hāpai holomua ma hope o ka mālama ʻana.
• Inā ua hana ʻoe i kahi ʻoki cesarean, he mea nui loa ia e makaʻala i kēia. ʻAʻohe mea e makaʻu ai, e kamaʻilio mau me kāu kauka e pili ana i kēia.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai makaʻu e nīnau i kāu kauka wahine. E kōkua lākou iā ʻoe.

ʻIsthmocele , Cesarean Scar Defect, ʻoki ʻia ʻana, uterus, olakino wahine, hānau ʻole, ʻoki ʻia ʻana