ʻO ka hāpai ʻana he manawa ia e loaʻa ai i kēlā me kēia makuahine ka manaʻolana nui, akā he makaʻu iki hoʻi. Manaʻo mau mākou i ke olakino o ka pēpē a inā e maikaʻi nā mea āpau. I kēlā manawa, ke kamaʻilio nei mākou e pili ana i kahi kūlana āu i lohe ʻole ai, akā he mea pono ke ʻike. ʻO ia ka cervical insufficiency, a i ʻole e like me ka kapa ʻana a nā kauka , 'Incompetent Cervix' a i ʻole 'Cervical Insufficiency' . Mai makaʻu i kou lohe ʻana i kēia inoa, inā ua hoʻomaopopo pono ʻia ʻoe e pili ana i kēia a loaʻa ka lāʻau kūpono, hiki iā ʻoe ke hoʻokele me ka ʻole o nā pilikia i ka hapa nui o nā hihia.
I ka ʻōlelo maʻalahi, he aha ka cervix incompetent?
E noʻonoʻo i kou ʻōpū (ka ʻeke kahi o kāu pēpē) me he hale liʻiliʻi lā. ʻO ka cervix ka puka i kēlā hale. Pono e pani paʻa ʻia kēia puka a hiki i ka wā e ulu piha ai kāu pēpē, ʻo ia hoʻi ma kahi o 37-40 mau pule. A laila wale nō e hiki ai i kāu pēpē ke noho palekana i loko o kou ʻōpū.
Eia nō naʻe, ma ke ʻano i kapa ʻia ʻo 'Incompetent Cervix', hoʻomaka kēia puka e wehe me ke kumu ʻole a ʻeha paha, ma kahi o ka hapai ʻana, ma mua o ka ulu piha ʻana o ka pēpē. Lilo ka cervix i nāwaliwali, pōkole, a wehe.
No ke aha he pilikia kēia?
E noʻonoʻo, he aha ka mea e hana ʻia inā e wehe koke ʻia ka puka o ka pēpē? Pono ke pēpē e puka i waho. Akā i kēlā manawa, ʻaʻole i ulu pono nā ʻōpū koʻikoʻi o ka pēpē, e like me nā māmā a me ka puʻuwai. Hiki i kēia ke hana i ʻelua mau pilikia nui:
1. Ka hāʻule ʻana o ka pēpē i ka lua o ka trimester: Ka nalowale ʻana o kahi pēpē ma mua o 20 mau pule o ka hāpai ʻana.
2. Hānau mua ʻole: Ka hānau ʻana o kahi pēpē ma mua o 37 mau pule.
ʻIke ʻia kēia maʻi ma kahi o 1 i loko o 100 mau hāpai ʻana, no laila he mea nui e makaʻala i kēia.
ʻO wai ka mea i pilikia nui no kēia maʻi?
Hiki i kēia maʻi ke hiki i kekahi, akā ʻoi aku ka nui o ka pilikia o kekahi poʻe. E nīnau kāu kauka iā ʻoe e pili ana i kou mōʻaukala olakino e ʻike inā loaʻa iā ʻoe kekahi o kēia mau mea pilikia.
| Kumu pilikia | He wehewehe maʻalahi |
|---|---|
| Nā hāʻule mua a i ʻole nā hānau mua ʻana | ʻO kahi kumu pilikia nui ka moʻolelo o ka hāʻule ʻana o ka hāpai keiki me ka ʻeha ʻole, ʻoiai hoʻi i ka lua o ka trimester (ma waena o nā pule 14-27) i ka hāpai mua. |
| Ka hōʻino ʻana i ka cervix a i ʻole ka uterus | Inā ua hōʻino ʻia ka ʻōpū o ka ʻāʻī ma muli o ka hānau keiki ʻana ma mua, he hana e like me ka haehae ʻana o ka ʻāʻī, D&C, a i ʻole kekahi kumu ʻē aʻe. |
| Nā ʻoki kino ʻōpū | Ma hope o ke kaʻina hana e like me LLETZ a i ʻole ka biopsy cone no ka maʻi ʻaʻai cervical, hiki i ka cervix ke lilo i pōkole a nāwaliwali. |
| Nā kīnā hānau o ka ʻōpū a i ʻole ka cervix | Hiki ke hānau ʻia kekahi mau wahine me nā ʻano ʻē i ke ʻano o ko lākou ʻōpū a i ʻole ka cervix, a hiki nō hoʻi ke hoʻonāwaliwali i ka cervix. |
| Nā kūlana hoʻoilina | Inā loaʻa iā ʻoe nā maʻi genetic e hoʻonāwaliwali i nā ʻiʻo pili o ke kino, e like me ka Ehlers-Danlos syndrome , hiki ke hoʻonāwaliwali ʻia kou cervix. |
| Nā hāpai keiki he nui | Hiki ke hoʻonui ʻia kēia pilikia i ka wā e hānau ʻia ai nā pēpē he nui, e like me nā māhoe a i ʻole nā triplets, i loko o ka ʻōpū i ka manawa like, no ka mea, ʻoi aku ka nui o ke kaomi ma ka uterus a me ka cervix. |
ʻO ka mea nui loa, ʻo ia ke haʻi aku i kāu kauka i nā kikoʻī āpau e pili ana i kāu hāpai ʻana a me nā ʻoki kino ma mua me ka hūnā ʻole i kekahi mea . E kōkua kēlā ʻike iā ia e mālama pono iā ʻoe.
He aha nā hōʻailona o kēia maʻi?
ʻO kēia ka pilikia nui loa ma ʻaneʻi. ʻO ka hapa nui o ka manawa, ʻaʻohe hōʻailona maopopo o ka 'Incompetent Cervix'. ʻAʻohe ʻūlū e like me kou wā e hānau ai, a ʻaʻole e haki kou wai. Hana mālie nā mea āpau.
Eia nō naʻe, hiki i kekahi poʻe ke ʻike i nā hōʻailona maalea e like me kēia ma waena o nā pule 14 a me 20:
- Ka manaʻo o ke kaomi a i ʻole ke kaumaha ma ka ʻōpū lalo.
- Me he ʻeha iki lā ma kuʻu kua.
- He loli i ke kahe ʻana o ka ʻōpū (hiki ke wai, like me ka mucus, a i ʻole he koko iki).
- Ke ʻike ʻana.
He palupalu loa kēia mau hōʻailona a hiki ke nānā ʻole ʻia i kekahi manawa he mau ʻeha maʻamau o ka hāpai ʻana. No laila, inā manaʻo ʻoe i kekahi mea ʻē, ʻoiai inā he mea liʻiliʻi wale nō, mai kānalua e haʻi i kāu kauka.
Pehea e ʻike ai ke kauka i kēia?
Hoʻomaopopo pinepine ʻia kēia maʻi ma ka nānā pono ʻana i kahi wahine i loaʻa kahi pilikia i ka hāpai ʻana ma mua. Inā loaʻa iā ʻoe kekahi o nā mea pilikia i ʻōlelo ʻia ma luna, e mālama pono kāu kauka iā ʻoe.
Hiki ke ʻike ʻia kēia ma nā ʻano nui ʻelua:
1. Mōʻaukala olakino: E nīnau aku ke kauka iā ʻoe i nā kikoʻī e pili ana i kāu mau hāpai ʻana ma mua, nā hāʻule ʻana o nā keiki, a me nā ʻoki kino.
2. Ultrasound Transvaginal: ʻO kēia ke ala maikaʻi loa e ʻike ai i kēia kūlana. Ma kēia, hoʻokomo ʻia kahi mea liʻiliʻi ma o ka vagina a ana pololei ʻia ka lōʻihi o ka cervical. Hiki i kēia scan ke ʻike maopopo inā e pōkole ana a wehe paha ka cervix i ka wā e holomua ai ka hāpai ʻana. No ka poʻe i pilikia, hiki i ke kauka ke ʻōlelo e hana hou i kēia scan i hoʻokahi a ʻelua paha pule ma hope o ka pule 16 o ka hāpai ʻana a ma hope o ka pule 24.
He aha nā lāʻau lapaʻau a me ka hoʻokele no kēia?
Inā ʻike ʻia kēia maʻi, aia kekahi mau lāʻau lapaʻau e hiki ke hoʻohana ʻia e hoʻolōʻihi i ka manawa o ka pēpē i loko o ka ʻōpū, hiki ke kōkua i ka pale ʻana i ka hānau mua ʻana. Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa nāu ma muli o kou kūlana a me kou mōʻaukala olakino.
| ʻAno lapaʻau | Wehewehena |
|---|---|
| Ka ʻōpū o ka ʻōpū | ʻO kēia ke ʻano hana i hoʻohana pinepine ʻia a kūleʻa loa. I ka ʻōlelo maʻalahi, ua kau ʻia kahi humuhumu ikaika a puni ka cervix nāwaliwali a hoʻopaʻa ʻia e pani iā ia. Ua like ia me kahi ʻeke e nakinaki ana i ka cervix. Hana pinepine ʻia kēia ʻoki ma waena o 12 a me 14 mau pule. A laila, i ka wā e kokoke ana ka pēpē e hānau ʻia, ma kahi o 37 mau pule, ʻoki ʻia a wehe ʻia nā humuhumu. |
| ʻO ka lāʻau lapaʻau hormone Progesterone (nā mea hoʻohui Progesterone) | He hormone ka Progesterone e kōkua ana i ka mālama ʻana i ka hāpai ʻana. No ka poʻe i loaʻa ka mōʻaukala o ka hānau mua ʻana, hiki ke hāʻawi ʻia kēia hormone ma ke ʻano he pila a i ʻole he suppository vaginal e hoʻomaka ana i ka trimester ʻelua. Kōkua kēia i ka hōʻemi ʻana i nā ʻūlū o ka ʻōpū a mālama i ka cervix ikaika. |
| Ka nānā mau ʻana | Inā he pilikia, akā ʻaʻole i koʻikoʻi ke kūlana e pono ai ke humuhumu, e hana kāu kauka i nā scan maʻamau e nānā i kou cervix no nā loli o ka lōʻihi. Inā ʻike ʻia kekahi mau loli, hiki ke hoʻomaka koke ʻia ka lāʻau lapaʻau e pono ai. |
Hiki i nā kānaka a pau ke loaʻa kahi cerclage?
ʻAʻole. Aia kekahi mau hihia kahi i ʻōlelo ʻole ʻia ai kēia ʻoki kino. Eia kekahi laʻana:
- Inā he mau māhoe a ʻoi aku paha kāu.
- Inā ua ʻoi aku ka nui o ka cervix ma mua o 4 kenimika.
- Inā ua haki nā membrane.
- Inā he maʻi i loko o ka ʻōpū.
I nā manawa e like me kēia, e kamaʻilio kāu kauka me ʻoe e pili ana i nā koho ʻē aʻe.
Hiki iā ʻoe ke noʻonoʻo e pili ana i kou hāpai ʻana e hiki mai ana?
ʻAe, hiki nō ia. Akā inā loaʻa iā ʻoe kahi 'Incompetent Cervix' i hoʻokahi hāpai ʻana, aia ʻoe i ka pilikia o ka loaʻa ʻana o ke ʻano like i kāu hāpai ʻana aʻe. No laila, ma mua o kou noʻonoʻo ʻana e loaʻa hou kahi pēpē, e hālāwai me kāu gynecologist a kūkākūkā i kēia. A laila, hiki ke nānā pono ʻia ʻoe mai ka hoʻomaka ʻana o kāu hāpai ʻana aʻe, a inā pono, e hana i nā hana e like me ke kau ʻana i kahi humuhumu (cerclage) i ka wā mua.
ʻO ka nūhou maikaʻi, ua holomua ka cerclage ma kahi o 90%. ʻO ia hoʻi, he manawa kūpono kou e mālama ai i kāu pēpē a hiki i ka lā hānau. No laila, mai hopohopo.
I ka manawa e pono ai ʻoe e ʻike koke i ke kauka
Inā paha e loaʻa ana iā ʻoe ka lāʻau lapaʻau no kēia ʻano maʻi, he mea nui e ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe kekahi mea ʻē i ka wā hāpai. ʻOi loa aku inā loaʻa iā ʻoe nā hōʻailona ma lalo nei, e kelepona koke i kāu kauka a i ʻole e hele i ka haukapila kokoke loa i ka Emergency Department (ETU).
- Inā he wai e like me ke koko a i ʻole ka wai e puka mai ana mai loko mai o ka ʻōpū.
- Inā ʻoe e ʻeha ma kou ʻōpū lalo a i ʻole nā ʻūmiʻi.
- Inā loaʻa iā ʻoe ka ʻeha hope i ʻokoʻa.
- Inā ʻoe e manaʻo ana i ke kaomi ma kou ʻōpū lalo.
Leka Lawe-Home
- ʻO ke ʻano o ka "Incompetent Cervix" ka wā e nāwaliwali ai ka cervix a hoʻomaka e wehe ma mua o ka ulu piha ʻana o ka pēpē. He kumu nui kēia o ka hānau mua ʻana.
- ʻO ka hapa nui o ka manawa, ʻaʻohe hōʻailona maopopo o kēia ʻano, no laila he mea nui loa e haʻi i kāu kauka i nā kikoʻī āpau e pili ana i kāu mau hāʻule ʻana a me nā ʻoki kino ma mua.
- Hiki i ka ultrasound transvaginal ke ʻike i ka hoʻonui ʻana o ka cervical i ka wā mua.
- He lāʻau lapaʻau kūpono loa ka cervical cerclage no kēia.
- Inā he kānalua a hopohopo paha kāu e pili ana i kēia, mai kānalua e kūkākūkā me kāu kauka. ʻO kou palekana a me ka palekana o kāu pēpē ka mea nui loa.
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