Ke maneʻo nui nei kou mau poho lima a me kou mau kapuwaʻi i ka pō i ka wā hāpai? Akā ke nānā ʻoe, ʻaʻohe pōʻino i ʻike ʻia? ʻAʻole kēia he maneʻo wale nō. I nā manawa he nui, hiki i kēia ke lilo i kūlana kūikawā e pili ana i ke akepaʻa e kū mai ana i ka wā hāpai. Kāhea mākou i kēia ʻo Cholestasis o ka Hāpai. Mai hopohopo, e kamaʻilio mākou e pili ana i nā mea āpau ma nā ʻōlelo maʻalahi.
He aha ka Cholestasis o ka hāpai keiki?
I ka ʻōlelo maʻalahi, he maʻi akepaʻa kēia e kū mai ana ma ka hopena o ka hāpai ʻana. Hoʻoulu ia i ka ʻūlū nui ma ke kino holoʻokoʻa, ʻoi aku hoʻi ma nā poho lima a me nā kapuwaʻi wāwae. Ua kapa pū kekahi poʻe iā ia ʻo 'Intrahepatic Cholestasis of Pregnancy (ICP)'.
Ma kēia kūlana, emi iho ka hana o kou akepaʻa no kekahi manawa. ʻO ka hopena, hoʻomaka ka mea i kapa ʻia ʻo ka bile i hana ʻia e ke akepaʻa e hōʻiliʻili i loko o ke akepaʻa a me ke koko ma kahi o ka hoʻokuʻu pono ʻia ʻana mai ke kino.
E noʻonoʻo i ke ʻano o kēia bile. ʻO ka Bile kahi mea i hana ʻia e ke akepaʻa a mālama ʻia i loko o ka gallbladder. Ke ʻai mākou i ka meaʻai, ʻoi aku hoʻi nā meaʻai momona, ʻo kēia bile ka mea e kōkua ai i ka wāwahi ʻana i kēlā mau momona a hoʻoheheʻe iā lākou. Ua like ia me ke kopa kīʻaha. No laila, ke hōʻiliʻili kēia bile i loko o ke koko, i ka wā e ʻoi aku ai kona pae ma mua o kahi pae, hoʻomaka ʻoe e loaʻa i kēia ʻūlū hiki ʻole ke hoʻomanawanui.
Hiki i kēia kūlana ke hoʻopilikia iā ʻoe a me kāu pēpē. No laila, inā loaʻa iā ʻoe kēia mau hōʻailona, e nānā pono kāu kauka iā ʻoe a hiki i ka hopena o kou hāpai ʻana.
He aha ka mea e hana ʻia inā kū kēia kūlana?
I ka wā hāpai, hilinaʻi kāu pēpē i kou akepaʻa e wehe i nā ʻōpala mai kona koko. No laila, ke hana pono ʻole kou akepaʻa, hiki ke piʻi aʻe ka nui o ka bile i loko o kou koko, hiki ke kau i kekahi kaomi ma luna o ke akepaʻa o kāu pēpē. ʻOiai ʻo ke akepaʻa ke ʻano nui e wehe i nā ʻōpala mai ko mākou kino, ʻaʻole maikaʻi ke hoʻopilikia ʻia.
Akā, ʻaʻohe pono e hopohopo. E nānā pinepine kāu kauka iā ʻoe a me kāu pēpē a hana i nā mea āpau e pono ai e hōʻoia ʻaʻole kēia kūlana e hōʻeha.
He mea maʻamau anei kēia kūlana?
He ʻano maʻi laha ʻole kēia. Hoʻopilikia ia i hoʻokahi a ʻelua paha o kēlā me kēia 1,000 wahine hāpai. ʻOiai ʻaʻole maopopo i nā mea noiʻi ke kumu o ia mea, ʻoi aku ka maʻamau i nā mahina hoʻoilo. ʻOi aku ka maʻamau i waena o kekahi mau hui lāhui.
No ke aha lā kēia e hana nei? He aha ke kumu nui?
ʻO ke kumu nui ka piʻi ʻana o nā hormones i loko o ke kino i ka wā hāpai, ʻoiai ʻo ka estrogen a me ka progesterone.Piʻi nui nā pae o nā hormones. Ma muli o nā hopena o kēia mau hormones, ʻaʻole hiki i ke akepaʻa ke lawe pono i ka bile ma ke kino holoʻokoʻa. ʻO ke ʻano kēia ua ālai ʻia ke kahe o ka bile.
He aha ka mea e hana ʻia a laila? Hōʻiliʻili ka bile i loko o ke akepaʻa a hoʻomaka e kahe i loko o ke koko. ʻO kēia mau paʻakai bile e hōʻiliʻili ana i loko o ke koko ke kumu nui e ʻānai nui ai kou ʻili.
ʻIke pinepine ʻia kēia ʻano ma ke kolu o ka trimester o ka hāpai ʻana, ma kahi o 28 mau pule. ʻO kēia no ka mea ʻoi aku ka kiʻekiʻe o nā pae hormone i kēia manawa. I kekahi manawa hiki ke loaʻa iā ia ma muli o nā mana genetic. ʻO ke ʻano kēia inā ua loaʻa i kou makuahine a i ʻole kekahi o kou ʻohana kēia ʻano, ʻoi aku ka nui o kou pilikia o ka loaʻa ʻana iā ia.
He aha nā hōʻailona o kēia maʻi?
ʻO ka hōʻailona nui a maopopo loa, ʻo ia ka ʻūlū hiki ʻole ke hoʻomanawanui. Kāhea pū mākou i kēia ʻo 'Pruritus' ma nā ʻōlelo lapaʻau. Aia kekahi mau ʻoiaʻiʻo kūikawā e pili ana i kēia ʻūlū:
- Hoʻomaka ka maneʻo ma nā poho lima a me nā kapuwaʻi.
- A laila hiki ke laha mālie i nā ʻāpana ʻē aʻe o ke kino.
- ʻOi aku ka ʻino o ka maneʻo i ka pō. ʻOi aku ka nui o ke kahakaha ʻana o kekahi poʻe a hiki ʻole iā lākou ke hiamoe.
- ʻO ka mea nui loa, ʻaʻole ʻoe e ʻike i kekahi ʻulaʻula ma ka ʻili.
Ma waho aʻe o kēia hiʻohiʻona nui, aia kekahi mau hiʻohiʻona ʻē aʻe i ʻike pinepine ʻole ʻia. E nānā pono kākou iā lākou.
| Hōʻailona | Wehewehena |
|---|---|
| ʻO ka hōʻailona nui: ka ʻūlū nui | He ʻulaʻula maneʻo ʻole ia e hoʻomaka ana ma nā poho lima a me nā kapuwaʻi a ʻoi aku ka ʻino i ka pō. |
| Ka luaʻi | Manaʻo luaʻi. |
| Mimi ʻeleʻele | Ke lilo nei ke kala o ka mimi i melemele/ʻeleʻele ma mua o ka maʻamau. |
| Nā noho waihoʻoluʻu māmā | Lilo nā ʻōpala i hina hina a ʻeleʻele paha ke kala. |
| Luhi nui | Ka luhi nui a me ka luhi i ke kino. |
| Makemake nui | Ua emi ka makemake e ʻai. |
| ʻEha ma ka ʻaoʻao ʻākau o luna o ka ʻōpū | Ke manaʻo nei i kekahi ʻeha a ʻoluʻolu ʻole paha ma kahi o ke akepaʻa. |
| ʻĀʻī | Melemele o ka ʻili a me nā keʻokeʻo o nā maka. |
Pehea ʻoe e ʻike pono ai i kēia?
E hana nui kāu kauka i kahi hoʻāʻo koko e ʻike ai i kēia maʻi.
E lawe ʻia kahi hāpana koko mai ou aku a e nānā ʻia nā hoʻokolohua hana ate a me nā pae waikawa bile serum.
Inā ʻo ka nui o ka waikawa bile i loko o ke koko he 10 micromoles i ka lita a ʻoi aku paha, hōʻoia ia i ka loaʻa ʻana o ka cholestasis.
Ke hōʻoia ʻia ka hōʻailona, e nānā mau kāu kauka i kou pae bile me kēia mau hoʻāʻo koko i kou wā hāpai. I kekahi manawa, pono paha ʻoe e loaʻa i kahi scan ultrasound e nānā i kou hiki ke hoʻopaʻa koko (hoʻāʻo manawa prothrombin) a i ʻole e nānā i kou ake a me nā ʻauwai bile.
He aha ka lāʻau lapaʻau a me ka hoʻokele no kēia?
ʻO ka lāʻau lapaʻau nui a nā kauka e hoʻohana ai e mālama i kēia maʻi ʻo ia ka Ursodeoxycholic acid (UDCA) . Kōkua kēia lāʻau lapaʻau i ka hoʻihoʻi ʻana i ka hana o kou akepaʻa a hoʻemi i ka pae o ka bile i loko o kou koko.
Eia nō naʻe, aia kekahi mau mea hiki iā ʻoe ke hana e mālama i nā hōʻailona e like me ka ʻūlū:
- Lāʻau lapaʻau no ka maneʻo: E nīnau i kāu kauka a hoʻohana i ka ʻaila poni a lāʻau lapaʻau paha āna i kuhikuhi mai ai. Mai hoʻohana i kekahi lāʻau lapaʻau āu e makemake ai e hoʻohana.
- E ʻaʻahu i nā lole palupalu a palupalu: E ʻaʻahu i nā lole omo hou, ʻaʻole paʻa e like me ka pulupulu.
- E hoʻomaha maikaʻi: He mea nui e hoʻomaha i ke kino.
- ʻAuʻau ʻana i ka wai mehana: Hiki i kēia ke kōkua i ka hōʻemi iki ʻana i ka maneʻo i ka wā e hoʻomaʻalili ai i ke kino.
I kekahi mau hihia, inā ʻaʻole hiki i ka lāʻau lapaʻau ke kāohi i nā pae bile, hiki i ke kauka ke hoʻoholo e hānau i ka pēpē ma mua iki, ma kahi o 37 a 38 mau pule . ʻO ke kumu o kēia, ʻo ka hana ʻana pēlā hiki ke hōʻemi i ka pilikia o nā pilikia no ka pēpē.
Inā hānau mua ʻia ka pēpē, hiki ke hāʻawi ʻia kahi inikini steroid e kōkua i ka oʻo pono ʻana o nā māmā o ka pēpē a me kahi pākuʻi huaora K e pale aku i ke kahe nui ʻana o ke koko.
He aha nā pilikia e hiki ke hana ma muli o kēia ʻano?
Inā ʻaʻole i kaohi ʻia kēia kūlana, hiki i ka makuahine a me ke pēpē ke loaʻa i kekahi mau pilikia.
| ʻO wai ka mea i hoʻopilikia ʻia? | Nā pilikia hiki ke loaʻa |
|---|---|
| I kou makuahine |
|
| I ke pēpē i loko o ka ʻōpū |
|
Mai makaʻu i kēia mau mea. ʻO kēia nā pilikia e hiki ke kū mai. Ua ʻike kāu kauka i kēia mau pilikia a e hana i nā hana e pono ai e pale aku iā lākou. ʻO ka hoʻoholo ʻana e hānau koke i ka pēpē, ʻo ia hoʻi ka hōʻemi ʻana i kēia mau pilikia.
Hiki ke loaʻa kahi pēpē olakino me kēia maʻi?
ʻAe, hiki nō iā ʻoe! ʻOiai he cholestasis kou, ʻaʻole ia he manaʻo ua maikaʻi ʻole kāu pēpē. Me ka nānā pono ʻana a me ka mālama ʻana o ke kauka, hānau ka hapa nui o nā makuahine i nā pēpē olakino.
Pono anei ka mea me kēia maʻi e makaʻala i kā lākou meaʻai?
ʻAʻohe papaʻai kikoʻī no kēia maʻi. Eia nō naʻe, ma muli o kou kūlana, hiki i kāu kauka ke aʻo aku iā ʻoe e kaupalena i kekahi mau meaʻai. E like me nā hāpai ʻana a pau, he mea nui e ʻai i ka papaʻai kaulike. E hoʻāʻo i ka papaʻai momona i nā huaʻai, nā mea kanu, nā ʻiʻo momona, a me ka protein.
E nalo anei kēia maʻi ma hope o ka hānau ʻana?
ʻAe. ʻO kēia ka nūhou maikaʻi loa. E nalowale loa kēia maʻi i loko o kekahi mau lā ma hope o ka hānau ʻana o ke pēpē. E hoʻi hou kou pae bile koko i ka maʻamau. Ma hope o kēlā, ʻaʻole pono ʻoe e lawe i kekahi lāʻau lapaʻau.
Akā, aia kekahi mea e hoʻomanaʻo ai. Loaʻa iā ʻoe ma kahi o 60% ka manawa e loaʻa hou ai kēia maʻi i kāu hāpai ʻana aʻe. Inā loaʻa iā ʻoe kahi hihia ʻoi aku ka koʻikoʻi i kēia manawa, hiki ke piʻi aʻe ka manawa e loaʻa hou ai i ka manawa aʻe i 90%.
Hiki ke pale ʻia kēia? He aha nā kumu pilikia?
ʻO ka mea pōʻino, ʻaʻohe ala e pale aku ai i kēia maʻi mai ka hanana ʻana. Akā aia kekahi mau mea pilikia. Inā loaʻa iā ʻoe kēia mau pilikia, pono ʻoe e akahele iki.
- Inā ua loaʻa i kekahi o ka ʻohana kēia maʻi.
- Inā ua loaʻa kēia ʻano i ka wā hāpai mua.
- Inā ʻoe e hāpai ana i nā māhoe a i ʻole nā māhoe ʻekolu.
- Inā ua loaʻa iā ʻoe kahi maʻi ate ma mua a i ʻole ke ʻano e like me ka Hepatitis C.
- Inā ua hōʻino ʻia ke akepaʻa.
- Inā he maʻi genetic kou e hoʻopilikia ai i ka hana ʻana a i ʻole ka hoʻohana ʻana i ka bile.
Āhea wau e ʻike ai i ke kauka?
Ke hāpai ʻoe,
- Inā loaʻa iā ʻoe ka maneʻo nui ʻaʻole e nalo, ʻoiai ma nā poho lima a me nā kapuwaʻi o kou mau wāwae,
- Inā he melemele kou ʻili a i ʻole kou mau maka,
E ʻike koke i kāu kauka. Mai hoʻowahāwahā i kēia mau hōʻailona. He mea nui ka ʻimi ʻana i ke kōkua lapaʻau i ka wā hikiwawe no kou palekana a me kāu pēpē.
Leka Lawe-Home
- ʻAʻole pono e manaʻo ʻia he mea maʻamau ka ʻāʻī nui i ka wā hāpai, ʻoiai ma nā poho lima a me nā kapuwaʻi. He hōʻailona paha ia o ka Cholestasis of Pregnancy.
- ʻO ke kumu o kēia kūlana, ʻo ia ke keakea nei nā hormones hāpai i ka neʻe ʻana o ka bile i loko o ke ake.
- Me ka mālama pono ʻana a me ka nānā ʻana, hiki ke kaohi ʻia nā pilikia he nui i ka makuahine a me ke pēpē.
- E ho'ōla loa kēia maʻi i loko o kekahi mau lā ma hope o ka hānau ʻana o ke pēpē.
- Inā he kānalua kou no kēia, mai hoʻokaʻulua a nīnau aku i kāu kauka no ka ʻōlelo aʻo.
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