E makaʻala kākou i ka HELLP Syndrome, kahi maʻi kakaikahi akā koʻikoʻi hiki ke loaʻa i ka wā hāpai.

He wā nani a me ka manaʻolana ka hāpai ʻana i ke ola o kēlā me kēia makuahine. Eia nō naʻe, he mea maʻamau nō hoʻi ke loaʻa kekahi mau makaʻu a me nā kānalua e pili ana i ke olakino o ka pēpē i loko o ka ʻōpū a me kou olakino ponoʻī. I ka hapa nui o ka manawa, ua lohe mākou e pili ana i nā maʻi e like me ka maʻi diabetes gestational a me ke koko kiʻekiʻe (pre-eclampsia). Akā i kēia lā e kamaʻilio mākou e pili ana i kahi maʻi kakaʻikahi akā koʻikoʻi he mea nui loa e ʻike mua. Ua kapa ʻia kēia ʻo HELLP Syndrome.

He aha maoli ka maʻi HELLP?

I ka ʻōlelo maʻalahi, he pilikia koʻikoʻi ka maʻi HELLP e hiki ke hana i ka wā hāpai, e hoʻopilikia nui ana i kou koko a me ke ake. Loaʻa pinepine ia i ke kolu o ka trimester o ka hāpai ʻana, ma waena o nā pule 28 a me 40. Eia nō naʻe, hiki ke hana ʻia i kekahi manawa i kēlā me kēia manawa i ka hapa lua o ka hāpai ʻana (ma hope o ka pule 20). ʻO ka mea kupanaha, hiki i kekahi mau makuahine ke loaʻa i ka maʻi HELLP i ʻehiku mau lā ma hope o ka hānau ʻana.

He maʻi laha ʻole kēia. Hoʻopilikia pinepine ia i hoʻokahi a ʻelua paha o kēlā me kēia 1,000 wahine hāpai. Akā, ʻaʻole pono e lawe māmā ʻia no ka mea he laha ʻole. Hiki ke lilo i mea weliweli no ka makuahine a me ke pēpē.

He aha ke ʻano o ka inoa HELLP?

ʻAʻole kēia he inoa wale nō. Hōʻike nā leka HELLP i ʻekolu mau hiʻohiʻona nui o kēia maʻi. E nānā kākou i ko lākou ʻano.

He like anei ka preeclampsia a me ka HELLP syndrome?

He pilikia kēia i loaʻa i nā poʻe he nui. Manaʻo pinepine ʻia ka maʻi HELLP he ʻano koʻikoʻi o ke koko kiʻekiʻe i ka wā hāpai, a i ʻole preeclampsia . ʻO ka preeclampsia kahi kūlana i ka wā hāpai kahi e piʻi ai ke koko a hoʻokuʻu ʻia ka protein i loko o ka mimi.

He nui nā makuahine me ka maʻi HELLP i loaʻa i ka pre-eclampsia. Eia nō naʻe, i kekahi manawa ʻaʻole i loaʻa i ka mea me ka pre-eclampsia ka maʻi HELLP. Eia kekahi, ma kahi o hoʻokahi o ka ʻelima mau kānaka me HELLP ʻaʻohe o lākou mau hōʻailona e like me ke koko kiʻekiʻe a i ʻole ka protein i loko o ka mimi . ʻO ia ke kumu e paʻakikī ai ke ʻike i kekahi manawa.

He aha nā hōʻailona o kēia maʻi?

Hiki i nā hōʻailona o ka maʻi HELLP ke like me nā hōʻailona o ka hāpai maʻamau a i ʻole nā ​​​​maʻi ʻē aʻe, no laila he mea nui e makaʻala pono i kēia mau hōʻailona.

• ʻEha ma ka ʻōpū ʻākau o luna: He hōʻailona maʻamau kēia o ka maʻi HELLP. ʻO ke kikoʻī, he ʻeha ʻoi ia e kū mai ana ma ka ʻaoʻao ʻākau, ma lalo pono o nā iwi ʻaoʻao, kahi i loaʻa ai ke akepaʻa.
• ʻEha poʻo nui: ʻAʻole like me ka ʻeha poʻo maʻamau, akā he ʻeha poʻo nui ʻaʻole i emi iho me nā lāʻau ʻeha.
• ʻIke pōwehiwehi: Manaʻo e like me nā kiko e lana ana i mua o nā maka, paʻakikī ke nānā aku i ka mālamalama.
• Ka luaʻi a me ka luaʻi: ​​ʻOiai he mea maʻamau kēia i ka wā hāpai mua, pono ʻoe e hopohopo e pili ana i ka luaʻi nui a me ka luaʻi ʻana i ka hapalua hope o ka hāpai ʻana.
• Luhi a me ka luhi: Luhi nui i manaʻo ʻia ʻoiai ma hope o ka hana ʻole ʻana.
• Pehu kino (edema) a me ka piʻi koke ʻana o ke kaumaha:Ka pehu ʻana, ʻoiai hoʻi o ka maka, nā lima, a me nā wāwae.
• ʻEha i ka wā e hanu hohonu ai: Hiki paha iā ʻoe ke manaʻo i ka ʻeha ma ka ʻaoʻao ʻākau o ka umauma.

I nā hihia kakaikahi loa, hiki ke ʻike ʻia kēia mau hōʻailona:

• Ke kahe koko ihu hiki ʻole ke hoʻōki.
• Nā ʻōhūhū a i ʻole nā ​​neʻe kino i kāohi ʻole ʻia.

He aha ke kumu o ka maʻi HELLP? Aia kekahi mau mea pilikia?

ʻO kaʻoiaʻiʻo, ʻaʻole ʻike nā kauka i ke kumu pololei o ka maʻi HELLP. ʻO ia ka mea weliweli e pili ana i ia mea. Eia nō naʻe, ua ʻike lākou i kekahi mau mea e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i ke ʻano i kekahi mau wahine.

• Loaʻa ka preeclampsia a i ʻole eclampsia: Hoʻokahi i loko o ʻelima mau wahine hāpai me kēia mau kūlana e loaʻa paha ka maʻi HELLP.
• Loaʻa ka maʻi HELLP i ka hāpai mua ʻana: Inā loaʻa kēia ʻano iā ʻoe me kahi pēpē ma mua, aia ma kahi o 20% ka pilikia o ia mea i kāu hāpai hou ʻana.
• ʻOiai ma luna o 35 mau makahiki.
• Ma hope o ka hānau ʻana i hoʻokahi keiki ma mua.
• Loaʻa kahi moʻolelo o nā maʻi mau loa e like me ka maʻi puʻupaʻa, ka maʻi diabetes, a i ʻole ke koko kiʻekiʻe.

He aha nā pilikia e hiki ai i kēia ke hana?

Inā ʻaʻole mālama ʻia ka maʻi HELLP i ka manawa kūpono, hiki iā ia ke hana i nā pilikia koʻikoʻi loa no ka makuahine a me ke pēpē.

Nā pilikia hiki ke loaʻa no ka makuahine

• Nā pilikia koko a me ke kāpili ʻana o ke koko: Hiki i kekahi mau wahine ke loaʻa i kahi maʻi i kapa ʻia ʻo 'Disseminated Intravascular Coagulation (DIC).' ʻO ia hoʻi, hana ʻia nā ʻōpū koko ma ke kino holoʻokoʻa a hoʻomaka lākou e kahe koko me ke kāohi ʻole. Hiki i kēia ke alakaʻi i ke kahe koko nui ma hope o ka hānau ʻana ('Postpartum hemorrhage').
• Ka hāʻule ʻana o nā puʻupaʻa: Hiki i nā puʻupaʻa ke hōʻino ʻia a oki ka hana.
• Ke kahe ʻana o ke koko mai ke akepaʻa a i ʻole ka hāʻule ʻana o ke akepaʻa: Pehu ke akepaʻa, hoʻomaka ke kahe ʻana o ke koko mai loko mai, a hiki i ke akepaʻa ke nalowale loa i ka hana.
• ʻEdema pulmonary: Hoʻopilikia kēia i ka hanu ʻana.
• Ka hoʻopau ʻana o ka placenta: Hoʻokaʻawale ka placenta mai ka paia o ka ʻōpū ma mua o ka hānau ʻana o ke pēpē. He mea weliweli loa kēia no ka mea e ʻoki ana i ka oxygen a me ka meaʻai i ka pēpē.
• Eclampsia: ʻO kēia ke kahua koʻikoʻi loa o ka pre-eclampsia. Hoʻoulu ia i nā hopu ʻana.

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

• Hānau mua: ʻOiai ʻo ka lāʻau wale nō no ka maʻi HELLP ka hānau ʻana i ka pēpē, pono pinepine ka hānau ʻana i ka pēpē i ka manawa.
• Kaohi ulu ʻana o ka pēpē i loko o ka ʻōpū (IUGR): ʻAʻole ulu pono ka pēpē i loko o ka ʻōpū.
• ʻO ka hānau ʻia ʻana me ka helu platelet haʻahaʻa, anemia, a i ʻole nā ​​​​maʻi koko ʻē aʻe.
• Ka pilikia hanu.

Pehea e ʻike ai ke kauka i kēia?

Ke haʻi aku ʻoe i kāu kauka he mau hōʻailona kou o ka maʻi HELLP, e nānā mua ʻo ia iā ʻoe ma ke kino. ʻO ke kikoʻī,

• Aia ka ʻeha ma ka ʻōpū ʻākau o luna?
• Ua pehu kou mau wāwae?

A laila e ana ʻia kou koko, e hana ʻia kahi hoʻāʻo mimi e nānā i ka protein. E hana ʻia kekahi mau hoʻāʻo koko e hōʻoia i kēia.

• Helu koko piha (CBC) : Nānā i ka helu o nā hunaola koko ʻulaʻula, nā hunaola koko keʻokeʻo, a me nā platelets.
• Hoʻāʻo hana o ke akepaʻa : E nānā i nā pae enzyme o ke akepaʻa.
• Hoʻāʻo hana puʻupaʻa : Nānā inā e hana pono ana nā puʻupaʻa.

Inā koʻikoʻi ke kūlana, hiki ke hana ʻia kahi ultrasound a i ʻole CT scan e nānā i ka pehu ʻana a i ʻole ke kahe ʻana o ke koko i loko o ke ake.

Pehea e mālama ʻia ai ka maʻi HELLP?

Inā he 34 pule kou hāpai ʻana a ʻoi aku paha, a inā he koʻikoʻi loa kou mau hōʻailona, ​​​​​​e ʻōlelo paha nā kauka e hānau koke i kāu pēpē. Hiki i kēia ke hana i ka hānau mua ʻole ʻana o ka pēpē. ʻO ka maʻamau, nalo ka maʻi HELLP i loko o kekahi mau lā ma hope o ka hānau ʻana o ka pēpē.

Eia nō naʻe, inā ʻaʻole i hala ka hāpai ʻana ma mua o 34 mau pule a ua paʻa ka makuahine a me ka pēpē, e hoʻāʻo nā kauka e kūʻai i ka manawa no ka oʻo ʻana o nā māmā o ka pēpē. I loko o ia manawa, e mālama ʻia ʻoe i ka haukapila a hāʻawi ʻia i nā lāʻau lapaʻau e like me:

• Nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke koko.
• Ka hoʻoili koko inā haʻahaʻa ka helu platelet.
• ʻO ka hāʻawi ʻana i ka magnesium sulfate e pale aku ai i nā hopu ʻana.
• Ke hāʻawi ʻana i nā inikini corticosteroids e kōkua i ka ulu koke ʻana o nā māmā o ke pēpē.
• Nā hoʻāʻo koko e nānā mau i kāu hana ate a me nā pae platelet.

I loko o kēia manawa, nānā mau nā kauka i ke olakino o ke pēpē ma o nā hoʻokolohua e like me ka 'biophysical profile', 'nonstress test', a me ka 'ultrasound'.

Pehea ka hopena o kēia kūlana i ka makuahine a me ke pēpē?

He maʻi koʻikoʻi ka maʻi HELLP, akā hiki ke ho'ōla ʻia inā ʻike mua ʻia a mālama pono ʻia . Inā ʻaʻole mālama ʻia, hiki ke hoʻoweliweli i ke ola.

Mai ka manaʻo o ka makuahine, ʻoi aku ka liʻiliʻi o ka make ma mua o 1% inā loaʻa ka mālama kūpono. Hoʻōla piha ka hapa nui o nā makuahine i loko o kekahi mau lā ma hope o ka hānau ʻana.

Mai ka manaʻo o ka pēpē, hilinaʻi nui ke ola ʻana i ka makahiki hāpai i ka wā hānau. ʻO ka lōʻihi o ke pēpē i loko o ka ʻōpū, ʻoi aku ka maikaʻi o ke olakino o ka pēpē. Hiki i ka hānau mua ʻana ke hana i nā pilikia e like me ka pilikia o ka hanu ʻana, nā pilikia ʻike, a i ʻole ka lohi o ka ulu ʻana.

Hiki ke pale ʻia ka maʻi HELLP?

ʻO ka mea pōʻino, ʻaʻohe ala maopopo e pale aku ai i ka maʻi HELLP. Eia nō naʻe, ʻo ka mea maikaʻi loa hiki iā ʻoe ke hana e hōʻemi i kou pilikia o nā pilikia i ka wā hāpai, ʻo ia ke hele i ka mālama maʻamau no ka wā hāpai . E nānā ana kāu kauka i kou koko a me nā hōʻailona ʻē aʻe, i hiki ke ʻike mua ʻia nā pilikia.

Inā hoʻoholo kāu kauka he kiʻekiʻe kou pilikia o ka hoʻomohala ʻana i kēia ʻano, hiki iā ia ke ʻōlelo aku iā ʻoe e lawe i ka aspirin haʻahaʻa ma hope o ka trimester mua (ma kahi o 12 mau pule).

Eia kekahi, e kōkua kēia mau mea iā ʻoe e loaʻa kahi hāpai olakino:

• ʻAi ʻana i ka meaʻai momona (nā mea kanu, nā protein, nā huaʻai, a me nā mea ʻai palai).
• Hoʻoikaika kino mau.
• E hiamoe maikaʻi no ka liʻiliʻi he 8 mau hola i kēlā me kēia lā.
• Ke kamaʻilio ʻana me kāu kauka e pili ana i nā pilikia olakino i ka wā hāpai.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe ka preeclampsia a i ʻole ke koko kiʻekiʻe, e makaʻala loa i nā hōʻailona o ka maʻi HELLP. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e kāhea koke aku i kāu kauka.

• ʻEha ka ʻōpū ma ka ʻaoʻao ʻākau.
• Ka luaʻi a me ka luaʻi.
• ʻEha poʻo a i ʻole ka ʻike pohihihi.

He maʻi weliweli ka maʻi HELLP. Akā e hoʻomanaʻo, ke hana nei kāu hui lapaʻau i nā mea āpau e hiki ai iā lākou ke mālama iā ʻoe a me kāu pēpē. He mea nui ka ʻike mua ʻana.