Loaʻa iā ʻoe ke ʻano maneʻo hiki ʻole ke hoʻomanawanui i ka wā hāpai? ʻO Cholestasis paha kēia o ka hāpai ʻana!

He nui nā makuahine e ʻike i nā ʻano ʻoluʻolu ʻole like ʻole i ka wā hāpai. ʻOiai he mea maʻamau ka manaʻo ʻana i ka maneʻo i kekahi manawa, i kekahi manawa he mea ia e hopohopo ai. ʻOi aku hoʻi ma ka hopena o kou hāpai ʻana, inā ʻike ʻoe iā ʻoe iho e maneʻo ana me ka hiki ʻole ke kāohi ʻia, e hoʻomaka ana me kou mau poho lima a me nā kapuwaʻi a laila ma kou kino holoʻokoʻa, he hōʻailona paha ia o kahi maʻi i kapa ʻia ʻo Cholestasis of Pregnancy. E kamaʻilio kākou e pili ana i kēia i kēia lā? Mai hopohopo, he mea nui loa ka ʻike ʻana i kēia.

He aha maoli ka Cholestasis o ka hāpai ʻana?

I ka ʻōlelo maʻalahi, ʻo ka cholestasis o ka hāpai ʻana he ʻano ia e hoʻopilikia ai i ke akepaʻa . Loaʻa pinepine ia i ke kolu o ka trimester o ka hāpai ʻana, ma kahi o 28 mau pule. I kekahi poʻe, hiki ke hana mua ʻia. Ua kapa pū nā kauka iā ia he "Intrahepatic Cholestasis of Pregnancy (ICP)" a i ʻole "Obstetric Cholestasis". Ua lohe paha ʻoe i kēia mau huaʻōlelo ke ʻike ʻoe i ke kauka.

Ma kēia kūlana, ʻike kekahi mau wahine hāpai i ka emi ʻana o ka hana o ke akepaʻa no kekahi manawa. A laila, ʻaʻole e kahe pono ka mea i kapa ʻia ʻo ka bile i loko o ko mākou kino a hoʻomaka e hōʻiliʻili i loko o ke akepaʻa a me ke koko.

He aha ka ʻawaʻawa?

He wai ka ʻawaʻawa i hana ʻia e ko kākou akepaʻa a mālama ʻia i loko o ka ʻōpū. I kēlā me kēia manawa a kākou e ʻai ai, kōkua kēia ʻawaʻawa iā kākou e hoʻoheheʻe i nā momona i loko o ka meaʻai a kākou e ʻai ai. No laila, ke ʻoi aku ka nui o kēia ʻawaʻawa i loko o ke koko ma mua o ka nui i koi ʻia, hoʻomaka ʻoe e loaʻa i kēlā ʻeha weliweli.

Hiki i kēia kūlana o ka cholestasis ke hoʻoulu i nā pilikia no ʻoe a me kāu pēpē i hānau ʻole ʻia. ʻO ia ke kumu inā kānalua kāu kauka he maʻi kou, e nānā pono ʻia ʻoe a me kāu pēpē i ke koena o kou hāpai ʻana.

He aha ka mea e hana inā loaʻa iaʻu ka cholestasis i ka wā hāpai?

He mea kēia e hoʻomaopopo ai. I ka wā hāpai, hilinaʻi kāu pēpē i kou akepaʻa e wehe i nā huahana ʻōpala mai kona kino. No laila, inā ʻaʻole hana pono kou akepaʻa, hiki i kēlā pae bile aʻu i ʻōlelo ai ma mua ke lilo i mea kiʻekiʻe loa. Hiki i kēia ke kau i kekahi kaomi ma luna o ke akepaʻa o kāu pēpē. ʻO ke akepaʻa kekahi o nā ʻōkana koʻikoʻi loa i loko o ko mākou kino. ʻO ia kahi nui e hoʻopau ai ke kino i nā huahana ʻōpala. No laila inā ʻaʻole hana pono, aia kahi manawa kūpono o nā pilikia.

Akā , mai hopohopo . E nānā pinepine kāu kauka iā ʻoe a me kāu pēpē e hōʻoia ʻaʻole e hōʻino ana ka cholestasis i kekahi o ʻolua.

Pehea ka maʻamau o ka cholestasis i ka wā hāpai?

Hoʻopilikia kēia maʻi i hoʻokahi a ʻelua paha o kēlā me kēia 1,000 wahine hāpai. ʻO ia hoʻi, ʻaʻole ia he mea maʻamau. ʻOiai ʻaʻole ʻike nā kānaka noiʻi i ke kumu pololei, hōʻike ka ʻikepili he mea maʻamau ia i ka hoʻoilo. Ua ʻōlelo ʻia hoʻi he ʻoi aku ka nui o ka poʻe o ka hanauna Hispanic a me Suedena e loaʻa iā ia.

He aha ke kumu nui o ka cholestasis?

E like me kā mākou i kūkākūkā ai ma mua, ʻo ka bile kahi mea i hana ʻia e ke akepaʻa a mālama ʻia i loko o ka gallbladder. Kōkua ia i ka wāwahi ʻana i nā momona i ka wā o ka ʻai ʻana. I ka wā hāpai, piʻi nui ka pae o nā hormones estrogen a me progesterone o kou kino. Hoʻopilikia kēia mau pae kiʻekiʻe o kēia mau hormones i ka hiki o ke akepaʻa ke lawe pono i ka bile. I ka ʻōlelo maʻalahi, ʻaʻole hele ka bile ma ke kino holoʻokoʻa, akā hōʻiliʻili i loko o ke akepaʻa a laila hoʻi i luna i loko o ke kahe koko. Ke hōʻiliʻili ka bile i loko o ke kahe koko, loaʻa iā ʻoe kēlā ʻeha hiki ʻole ke hoʻomanawanui.

ʻIke pinepine ʻia ka Cholestasis o ka hāpai ʻana i ke kolu o ka trimester, ma kahi o 28 mau pule. ʻO kēia no ka mea ʻoi aku ka kiʻekiʻe o nā pae hormone hāpai i kēia manawa. I kekahi mau hihia, hiki ke hoʻoilina ʻia . ʻO ke ʻano kēia inā loaʻa i kou mau mākua ka cholestasis, aia ʻoe i ka pilikia o ka loaʻa ʻana iā ia.

He aha nā hōʻailona o ka cholestasis i ka wā hāpai?

ʻO ka hōʻailona nui a ʻike nui ʻia o kēia ʻano, ʻo ia ka ʻūlū nui (pruritus) . Hoʻomaka mua kēia ʻūlū ma nā poho lima a me nā kapuwaʻi o nā wāwae. A laila hiki ke laha mālie i nā ʻāpana ʻē aʻe o ke kino. No nā kānaka he nui, ʻoi aku ka ʻino o kēia ʻūlū i ka pō . Hoʻowali nui lākou a hiki ʻole iā lākou ke hiamoe. ʻAʻole e like me nā ʻano ʻūlū ʻē aʻe, ʻaʻole pinepine ka cholestasis i ka ʻili . He mea nui loa kēia.

Ma waho aʻe o ka maneʻo, aia paha kekahi mau hōʻailona ʻē aʻe. Eia naʻe, ʻaʻole i ʻike nā kānaka a pau i kēia mau mea:

• Ka luaʻi
• Mimi ʻeleʻele
• ʻŌpū hina māmā a ʻeleʻele paha
• Luhi nui
• Ua emi ka makemake
• ʻEha ma ka ʻaoʻao ʻākau o luna o kou ʻōpū
• Jaundice - ʻO ke ʻano kēia e melemele ai kou ʻili a me nā keʻokeʻo o kou mau maka.

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​ʻoi aku ka maikaʻi o ka ʻimi koke ʻana i ke kōkua lapaʻau.

I ka pule hea o ka hāpai ʻana e hoʻomaka ai ka cholestasis?

Hoʻomaka pinepine ka cholestasis o ka hāpai ʻana ma hope o 28 mau pule o ka hāpai ʻana. Eia naʻe, e like me kaʻu i ʻōlelo ai ma mua, hiki i kekahi poʻe ke loaʻa i ke ʻano ma mua. No laila he mea nui e makaʻala i ka maneʻo.

Pehea e ʻike ʻia ai ka cholestasis i ka wā hāpai?

E ʻike kāu kauka i kēia maʻi ma ka hana ʻana i kahi hoʻokolohua kino a me nā hoʻokolohua koko. Hiki i kēia mau hoʻokolohua ke hōʻike i ke ʻano o ka hana ʻana o kou ake. E hana pū lākou i kahi hoʻāʻo waikawa bile serum e ana i ka pae o nā waikawa bile i loko o kou koko.

Hiki i kēia mau hoʻokolohua ke hōʻoia i kēia kūlana inā he 10 micromoles i ka lita (`10 micromoles i ka lita`) a ʻoi aku paha ka nui o ka waikawa bile. ʻO nā Micromoles kahi ana i hoʻohana ʻia i kekahi mau hoʻokolohua lapaʻau. Hiki iā ʻoe ke loaʻa nā hoʻokolohua koko maʻamau e nānā i kāu mau pae waikawa bile i ke koena o kou hāpai ʻana.

Eia kekahi, hiki i kāu kauka ke ʻōlelo aku i kahi hoʻāʻo manawa prothrombin e ʻike i ke ʻano o ke koko ʻana o kou mau ʻūlū, a me kahi ultrasound e nānā i kāu mau ʻāpana bile a me ke ake.

Pehea e mālama ʻia ai ka cholestasis i ka wā hāpai?

ʻO ka lāʻau lapaʻau nui a nā kauka e hoʻohana ai e mālama i kēia maʻi ʻo ia ka Ursodeoxycholic acid (UDCA) . Ua kapa ʻia hoʻi ʻo ia he `(ursodiol)` a i ʻole `(Actigall®)`. Kōkua kēia lāʻau lapaʻau i ka hoʻomaikaʻi ʻana i ka hana o kou akepaʻa a hoʻemi i ka pae o ka bile i loko o kou koko.

Eia kekahi, aia nā lāʻau lapaʻau e kāohi i nā hōʻailona o ka cholestasis, ʻoiai ka ʻeha nui:

• Lāʻau lapaʻau no ka maneʻo: (Akā e hoʻomanaʻo, pono ʻoe e nīnau i kāu kauka ma mua o ka lawe ʻana i kekahi lāʻau lapaʻau.)
• E ʻaʻahu i nā lole palupalu a palupalu: ʻO ke ʻaʻahu ʻana i nā lole paʻa e hiki ke hoʻonui i ka maneʻo. No laila, e ʻaʻahu i nā lole palupalu i hana ʻia mai nā lole palupalu e like me ka pulupulu.
• Hoʻomaha: He mea nui loa nō hoʻi ka lawa ʻana o ka hoʻomaha.
• ʻAuʻau ʻana i ka wai mehana: ʻO ka hoʻoluʻu ʻana i ka wai mehana no kekahi manawa hiki ke hāʻawi i kahi hōʻoluʻolu mai ka maneʻo.

I kekahi manawa, inā ʻaʻole e hōʻemi ka lāʻau lapaʻau i kou pae bile, e ʻōlelo paha kāu kauka e hānau i kāu pēpē ma mua iki, ma mua o kou lā hānau. ʻO ka hoʻoulu ʻana i ka hānau ʻana, ma kahi o 37 a 38 mau pule paha, hiki ke hōʻemi i ka pilikia o nā pilikia mai ka cholestasis. E hana pū kāu kauka i nā hoʻokolohua, e like me kahi ʻikepili biophysical a i ʻole ka hoʻāʻo nonstress, e hōʻoia i ka maikaʻi o kāu pēpē.

Inā hānau mua ʻia ka pēpē, hiki ke hāʻawi ʻia i kahi steroid e kōkua i ka oʻo pono ʻana o nā māmā o ka pēpē a me kahi pākuʻi huaora K e pale ai i ke kahe ʻana o ke koko i loko.

He aha nā pilikia e hiki mai ana o ka cholestasis i ka wā hāpai?

Hiki i ka Cholestasis o ka hāpai ʻana ke hoʻoulu i nā pilikia. Loaʻa paha iā ʻoe ka pilikia o ka omo ʻana i ka huaora K , kahi e hoʻonui ai i kou pilikia o ke kahe koko nui i loko. Hiki ke pili pū ʻia me nā kūlana e like me ka preeclampsia (ke koko kiʻekiʻe i ka wā hāpai) a me ka maʻi diabetes gestational .

ʻO nā pilikia e hiki ke kū mai i loko o ke keiki pēpē:

• Ka hānau mua ʻana
• Hānau make - He mea kēia a ka poʻe he nui e makaʻu nei. Eia nō naʻe, me ka nānā pono ʻana o ke kauka, hiki ke hoʻēmi nui ʻia kēia pilikia.
• ʻEhaeha o ka pēpē - ʻO ke ʻano kēia, ke ʻeha nei ka pēpē i loko o ka ʻōpū.
• Ka huki ʻana o ka meconium - Hoʻopau ke pēpē i loko o ka ʻōpū a hanu iā ia.

No ka hōʻemi ʻana i ka pilikia o nā pilikia e like me kēia, hoʻoholo kekahi kauka e hānau koke i ka pēpē.

Hiki ke loaʻa kahi pēpē olakino inā loaʻa iā ʻoe ka cholestasis i ka wā hāpai?

ʻAe, hiki nō iā ʻoe! ʻOiai ua loaʻa iā ʻoe ka cholestasis i ka wā hāpai, ʻaʻole ia he manaʻo ʻaʻole olakino kāu pēpē. Me ka mālama olakino kūpono a me ka nānā ʻana, hānau ka hapa nui o nā makuahine i nā pēpē olakino. No laila, mai hopohopo nui.

Aia kekahi mau meaʻai e pono iaʻu ke pale aku i ka ʻai ʻana i ka wā e loaʻa ai iaʻu ka cholestasis?

Hiki i kāu kauka ke aʻo aku iā ʻoe e kaupalena i kekahi mau meaʻai ma muli o kou kūlana. Eia nō naʻe, ʻaʻohe papaʻai kikoʻī (ʻai maʻamau) āu e pono ai e hahai inā loaʻa iā ʻoe ka cholestasis i ka wā hāpai. ʻO ka mea nui loa, ʻo ia ka ʻai ʻana i kahi meaʻai kaulike i ka wā hāpai. ʻO ia hoʻi ka ʻai ʻana i nā huaʻai, nā mea kanu, nā ʻiʻo lean a i ʻole nā ​​​​kumu ʻē aʻe o ka protein. E kamaʻilio me kāu kauka e pili ana i kēia a loaʻa hou aku ka ʻōlelo aʻoaʻo.

Hiki ke pale ʻia ka cholestasis i ka wā hāpai?

ʻO ka mea pōʻino, ʻaʻohe ala e pale aku ai i ka cholestasis i ka wā hāpai. Eia nō naʻe, hiki i ka hoʻāʻo ʻana i ka genetic ke kōkua i ka hoʻomaopopo ʻana i ka pilikia o ka hoʻoili ʻana i ke kūlana i kāu keiki.

He aha nā kumu pilikia no ka cholestasis i ka wā hāpai?

Aia ʻoe i ka pilikia kiʻekiʻe o ka hoʻomohala ʻana i ka cholestasis i ka wā hāpai inā ʻoe:

• Inā ua loaʻa i kekahi o kou ʻohana kēia maʻi ma mua (Loaʻa i kekahi lālā o ka ʻohana me kēia maʻi).
• Inā ua loaʻa iā ʻoe ka cholestasis (ICP) i ka wā hāpai mua.
• Inā ʻoe e kali ana i nā māhoe, triplets a ʻoi aku paha.
• Inā loaʻa iā ʻoe kahi mōʻaukala o nā maʻi ate a i ʻole ka hepatitis C.
• Inā he moʻolelo kou no ka hōʻino ʻia o ke akepaʻa.
• Inā he maʻi genetic kou e hoʻopilikia ai i ke ʻano o ka hana ʻana a me ka hoʻohana ʻana o kou kino i ka bile.

Inā loaʻa iā ʻoe kēia mau mea pilikia, e makaʻala loa e pili ana i nā ʻulaʻula i ka wā hāpai.

He aha ka wānana no ka poʻe me ka cholestasis o ka hāpai ʻana?

ʻO kēia ka nūhou maikaʻi loa! ʻO ka maʻamau, e nalowale ana ka cholestasis o ka hāpai ʻana i loko o kekahi mau lā ma hope o ka hānau ʻana o ke pēpē . E hoʻi hou ana kou pae bile koko i ka maʻamau. Ke hoʻi hou kou pae bile i ka maʻamau, hiki iā ʻoe ke hoʻōki i ka lawe ʻana i kāu lāʻau lapaʻau.

ʻAʻole loaʻa i ka hapa nui o ka poʻe kekahi pilikia o ke akepaʻa ma hope mai kēia maʻi, ke ʻole lākou e hāpai hou. Inā loaʻa iā ʻoe ka cholestasis i hoʻokahi manawa,Aia he 60% ka manawa e hiki hou mai ai i nā hāpai ʻana ma hope. Eia nō naʻe, inā loaʻa iā ʻoe kahi hihia koʻikoʻi o ka cholestasis, hiki ke piʻi aʻe ka manawa e hiki hou mai ai i nā hāpai ʻana ma hope i 90%.

Āhea wau e ʻike ai i kaʻu kauka?

Inā ʻike ʻoe i ka maneʻo hiki ʻole ke hoʻomanawanui i ka wā hāpai ʻaʻole e nalo, a inā ʻike ʻia kou ʻili a i ʻole ke keʻokeʻo o kou mau maka he melemele (nā hōʻailona o ka jaundice), e ʻike koke i kāu kauka. ʻAʻole paha kēia mau hōʻailona ma muli o ka cholestasis, akā ʻoi aku ka maikaʻi o ka nānā ʻana.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Inā ua ʻike ʻia ʻoe me ka cholestasis o ka hāpai ʻana, makemake paha ʻoe e nīnau i kāu kauka i nā nīnau e like me kēia:

• Pehea ke koʻikoʻi o ka cholestasis o ka hāpai ʻana?
• He aha nā koho lapaʻau e loaʻa iaʻu?
• He aha kaʻu e hana ai e pale aku iaʻu iho a me kaʻu pēpē?
• Inā ua loaʻa iaʻu ka cholestasis (ICP) ma mua, he aha kaʻu e ʻike ai e pili ana i nā hāpai ʻana i ka wā e hiki mai ana?

Mai makaʻu e nīnau i nā nīnau e like me kēia. Aia kāu kauka ma laila e kōkua iā ʻoe a e hoʻomaʻemaʻe i nā kānalua āu e loaʻa ai.

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

ʻO ke Kolestasis o ka hāpai ʻana he ʻano ia e hoʻoulu ai i ka ʻānai nui i ka wā hāpai. Mai hopohopo ke lohe ʻoe i kēia. E nānā pono kāu kauka iā ʻoe a me kāu pēpē a hāʻawi i ka lāʻau lapaʻau e pono ai. Hoʻopau loa kēia ʻano ma hope o ka hānau ʻana o ke pēpē a ʻaʻole ia he mea hoʻoweliweli i ke ola. I kekahi manawa, hoʻoholo paha kāu kauka e hānau koke i kāu pēpē no ka palekana o ʻolua ʻelua.

ʻO ka mea nui loa, inā he mau nīnau kāu, kānalua, a makaʻu paha e pili ana i kēia, e kamaʻilio me kāu kauka e pili ana iā lākou. Aia lākou ma laila e hoʻolohe iā ʻoe a hana i nā mea e pono ai e mālama iā ʻoe a me kāu pēpē. ʻAʻole ʻoe hoʻokahi, a aia nā kauka e hiki ke kōkua iā ʻoe ma kēia huakaʻi.

No laila, ke lana nei koʻu manaʻo he mea kōkua kēia ʻike iā ʻoe. Ke makemake nei iā ʻoe i kahi hāpai olakino a me kahi hānau olakino!

ʻO ke kōlea o ka hāpai ʻana, ka maneʻo i ka wā hāpai, ka maʻi akepaʻa, ICP, ke olakino o ka hāpai ʻana, ka hōʻiliʻili ʻana o ka bile, ke olakino o ka pēpē