Ua ʻōwili ʻia ke kaula umbilical o kāu pēpē a puni kona ʻāʻī? (Nuchal Cord) Mai hopohopo, e kamaʻilio kākou e pili ana i kēia!

I kou kokoke ʻana i ka lilo ʻana i makuahine, hiki mai nā ʻano mea like ʻole e pili ana i kāu pēpē, ʻeā? I kekahi manawa, hiki i nā mea liʻiliʻi loa ke hopohopo loa. ʻO ia ke ʻano o ka lohe ʻana, 'Ua ʻōwili ʻia ke kaula umbilical a puni ka ʻāʻī o ka pēpē.' Me he mea lā he kaumaha nui ia, ʻeā? Akā he aha kēia? He mea weliweli anei kēia? E kamaʻilio kākou e pili ana i kēia lā.

He aha ke kaula Nuchal?

I ka ʻōlelo maʻalahi, ʻo ke kaula nuchal ke kaula umbilical e hoʻopuni ana a puni ka ʻāʻī o ka pēpē, i hoʻokahi manawa a i ʻole kekahi mau manawa. ʻO ke ʻano o ka huaʻōlelo 'nuchal' ʻo ia hoʻi 'e pili ana i ka ʻāʻī'. Hiki ke hana ʻia kēia i ka wā e noho ana ke pēpē i loko o ka ʻōpū, a i ʻole hiki ke hana ʻia i ka wā hānau.

I kēia manawa, ke noʻonoʻo nei paha ʻoe i ke ʻano o kēia kaula umbilical. He ʻōmole wale nō ke kaula umbilical . Ma o ia mea e loaʻa ai i ka pēpē nā mea āpau e pono ai mai ka makuahine, e like me ka oxygen, ka meaʻai, a me ke koko. I nā huaʻōlelo ʻē aʻe, ua like ia me ke kaula ola o ka pēpē. ʻO kēia kaula umbilical ka mea e hoʻopili ai i ka pēpē i ka placenta .

No laila, he mea maʻamau ke makaʻu i ka lohe ʻana ua ʻōwili ʻia ke kaula umbilical a puni ka ʻāʻī o kāu pēpē. Akā ʻo ka mea nui e pono ai ʻoe e ʻike, ʻo ia ka hapa nui o nā hihia, ʻaʻole kēia kaula umbilical e hōʻeha i ka pēpē. E haʻi hou aku kāu kauka a kahu hānai paha iā ʻoe e pili ana i kēia.

Aia kekahi mau ʻano code nukelea?

ʻAe, aia kekahi mau ala e hoʻohana ai nā kauka e wehewehe i kēia:

• Kaula Nuchal Hoʻokahi: ʻO ke ʻano kēia, hoʻokahi wale nō manawa e kāʻei ʻia ai ke kaula umbilical a puni ka ʻāʻī o ke pēpē.
• Nā Kaula Nuchal He Nui: Maanei, hiki ke hoʻopuni ʻia ke kaula umbilical a puni ka ʻāʻī o ke pēpē ma mua o hoʻokahi manawa, ʻo ia hoʻi, ʻelua a ʻekolu paha manawa.

Eia kekahi, ma muli o ke ʻano o ka hoʻopuni ʻia ʻana o ke kaula umbilical a puni ka ʻāʻī, ua ʻōlelo ʻia he 'wehe' a 'paʻa' paha.

• ʻO ke kaula nuchal wehe: ʻO kēia ke ʻano maʻamau. Maanei, ʻaʻole i ʻōwili paʻa ʻia ke kaula umbilical a puni ka ʻāʻī, akā ua ʻōwili paʻa ʻia a puni ka nipple. I kekahi manawa, hiki ke hemo ia ma kona iho i ka wā e neʻe ai ka pēpē i loko o ka ʻōpū.
• ʻO ke kaula nuchal paʻa: He mea kākaʻikahi kēia. Maanei, hiki ke hoʻopaʻa pono ʻia ke kaula umbilical a puni ka ʻāʻī o ke pēpē. ʻOi aku ka nui o kēia ʻano kaula nuchal paʻa e hoʻoulu i nā pilikia ma mua o ka mea wehe. Akā he mea kākaʻikahi loa nō hoʻi.

ʻEhia mau pēpē e ʻike i kēia kaula nuchal?

ʻOi aku ka maʻamau o kēia ma mua o kou manaʻo. Ma kahi o hoʻokahi o nā pēpē ʻehā (25%) i hānau ʻia me hoʻokahi kaula nuchal, ʻo ia hoʻi, ua ʻōwili ʻia ke kaula umbilical a puni ka ʻāʻī i hoʻokahi manawa. Ma waena o 2 a me 8 o 100 mau pēpē (2.4% - 8.3%) i hānau ʻia me ke kaula umbilical i ʻōwili ʻia a puni ka ʻāʻī i ʻelua a ʻoi aku paha, ʻo ia hoʻi he nui nā kaula nuchal . No laila hiki iā ʻoe ke ʻike ʻaʻole kēia he mea e hopohopo ai, ʻeā?

He aha nā hōʻailona e loaʻa paha iā ʻoe kahi code nukelea?

ʻO kahi hōʻailona e ʻike ʻia i kekahi manawa i ka wā e komo ana ke pēpē i loko o ka ʻōpū a i ʻole kokoke i ka hānau ʻana, ʻo ia ka loaʻa ʻana o ke kaula nuchal.Hiki i ka nānā ʻana i ka helu o ka puʻuwai o ka pēpē ke hōʻike i nā loli o ka helu o ka puʻuwai. ʻOi aku ka ʻike ʻia ʻana o kahi kūlana i kapa ʻia ʻo 'variable decelerations' . I ka ʻōlelo maʻalahi, ʻo ia ka manawa e emi koke ai ka helu o ka puʻuwai o ka pēpē, ʻo ia hoʻi ka wikiwiki o ka puʻuwai, a laila hoʻi i ka maʻamau.

ʻO kēia mau loli i ka helu o ka puʻuwai e hōʻike pinepine ana aia kekahi keʻakeʻa i ke kahe koko ma o ke kaula umbilical. Hiki paha kēia ma muli o ke kaomi ʻana o nā kīʻaha koko i loko o ke kaula umbilical. Hiki paha kēia ma muli o ke kaula nuchal. Eia nō naʻe, ʻo nā kumu ʻē aʻe e like me kahi puʻupuʻu i ke kaula a i ʻole ka prolapse o ke kaula umbilical hiki ke hana i kēia mau loli i ka helu o ka puʻuwai.

Akā ʻo ka mea nui loa, inā ʻike ʻoe i kahi loli e like me kēia i ka helu o ka puʻuwai o kāu pēpē, e hana koke kāu mau kauka a me nā kahu maʻi a hana i nā mea āpau e hiki ai iā lākou ke pale aku iā ʻoe a me kāu pēpē. No laila, mai hopohopo.

He aha nā kumu o kahi code nukelea?

ʻIke ʻia nā kaula nuchal ma ke ʻano he mea maʻamau ʻole. ʻO ia hoʻi, he mea paʻakikī i kekahi ke ʻōlelo pololei i ke kumu o ia mau mea. Eia nō naʻe, ua ʻike ʻia e hiki i kēia mau mea ke hoʻonui iki i ka pilikia o ka loaʻa ʻana o kahi kaula nuchal:

• Neʻe nui ʻana o ka pēpē: Inā ʻeleu loa ke pēpē, hiki ke hihia ke kaula umbilical i ka ʻāʻī i kona ʻōwili ʻana i mua a i mua.
• He kaula piko lōʻihi: Inā ʻoi aku ka lōʻihi o ke kaula piko ma mua o 27 ʻīniha (ma kahi o 70 kenimika), ʻoi aku ka nui o ka hiki ke hihia.
• Ka nui o ka wai amniotic i loko o ka ʻōpū (Polyhydramnios): Inā nui loa ka wai a puni ka pēpē, hiki ke hihia ke kaula umbilical no ka mea he nui ka lumi o ka pēpē e neʻe ai.

ʻAʻohe mea hiki iā ʻoe ke hana e kāohi i kēia mau mea pilikia. Inā he kaula nuchal ko kāu pēpē, ʻaʻole ia kou hewa. No laila, mai hopohopo no ia mea.

He aha nā pilikia e hiki mai ana ma muli o ke kaula nuchal?

E like me kaʻu i ʻōlelo ai ma mua, he mea kakaikahi loa nā kaula nuchal wehe. Ke hānau ʻia ka pēpē, hiki i ke kauka a kahu maʻi paha ke huki mālie i ke apo o ke kaula ma luna o ke poʻo o ka pēpē i kona puka ʻana mai ke kahawai hānau.

Eia nō naʻe, ʻo nā pēpē me ke kaula nuchal paʻa - ʻaʻole nā ​​​​mea āpau, akā i kekahi manawa - hiki ke loaʻa i kēia mau pilikia liʻiliʻi ma hope o ka hānau ʻana:

• ʻO ke kahe koko subconjunctival (kahi kīʻaha koko liʻiliʻi i loko o ka maka i pohā)
• Ke koko haʻahaʻa (Hypotension )
• Ka emi ʻana o ka nui o ke koko i loko o ke kino ( Hypovolemia )
• Ka pilikia hanu iki
• Nā kiko ʻulaʻula liʻiliʻi o ke kahe koko ma lalo o ka ʻili o ka maka ( Facial petechiae )
• Nā ʻōpala liʻiliʻi ma ka ʻili a puni ka ʻāʻī
• Ka loli manawa pōkole i ke kala o ka maka

Akā e hoʻomanaʻo, ʻaʻole koʻikoʻi kēia mau pilikia a ʻaʻole hoʻi e hoʻopilikia i ke olakino no ka wā lōʻihi.

He mea kākaʻikahi loa, ʻo ia hoʻi i nā hihia kakaʻikahi loa, hiki i kahi kaula nuchal paʻa ke hana i nā mea e like me kēia:

• Ka nalowale koko nui
• Hoʻonui ʻia ka waikawa i loko o ke koko (Acidosis )
• Anemia (nele i ke koko)

Inā hana ʻia kekahi mea e like me kēia, ua ʻike maikaʻi nā kauka a me nā kahu maʻi e mālama ana i kāu pēpē pehea e hoʻokele ai i kēlā mau kūlana. No laila, mai hopohopo pū kekahi.

Pehea ʻoe e ʻike pono ai inā he code nukelea kāu?

E ʻike paha kāu kauka i kahi kaula nuchal i ka wā o ka ultrasound scan i kou wā hāpai. Eia nō naʻe, i kekahi manawa ʻaʻole paha lākou e haʻi iā ʻoe e pili ana i ia mea. ʻO kēia no ka mea he mea maʻamau loa nā kaula nuchal a manaʻo ʻia he mea maʻamau. Inā maʻamau ke kahe ʻana o ke koko ma o ke kaula umbilical, ʻaʻohe mea e hopohopo ai. Hiki i kāu kauka ke hoʻohana i kahi ultrasound Doppler e nānā inā maʻamau kēia kahe koko.

Ke kokoke aku nei kāu pēpē i ka hānau ʻana, e hana paha kāu kauka i kahi hoʻāʻo kino e nānā i ke kaula nuchal. Pili kēia i ke kaomi mālie ʻana i ka ʻāʻī o kāu pēpē, ma luna pono o kou ʻōpū. Inā lohi ka puʻuwai o kāu pēpē, hiki ke hōʻike he pilikia ke kaomi ʻia ke kaula umbilical. Inā hana ʻia kēia, e hoʻomau kāu kauka i ka nānā ʻana i ka puʻuwai o kāu pēpē a hana i nā hana inā he pilikia.

He aha ka hana a nā kauka inā he nuchal cord ko ke pēpē i kona wā hānau?

Inā he kaula umbilical ko ka pēpē i ka wā hānau, ʻaʻohe ala e wehe ai a hoʻoponopono paha. E nānā nā kauka a me nā kahu maʻi i ka helu o ka puʻuwai o ka pēpē ma mua a i ka wā hānau e nānā i nā pilikia me ke kaula umbilical. Inā haʻahaʻa ka helu o ka puʻuwai o ka pēpē, e hana ke kime lapaʻau i nā hana e pono ai. ʻO ka maʻamau, ʻo ia hoʻi:

• Ke hoʻololi nei i kou kūlana (no ka laʻana, ke huli ʻana mai kekahi ʻaoʻao a i kekahi ʻaoʻao)
• Ka hāʻawi ʻana i ka saline (IV fluids) inā pono
• Ke hāʻawi nei i ka lāʻau lapaʻau oxygen

Ke hānau ʻia kahi pēpē, ma hope o ka puka ʻana o ke poʻo o ka pēpē mai loko mai o ka vagina, e kau ke kauka a kahu maʻi paha i ko lākou mau lima a puni ka ʻāʻī o ka pēpē e nānā i ke kaula umbilical. Inā he kaula nuchal palupalu , hiki iā lākou ke wehe maʻamau ma ka huki mālie ʻana ma luna o ke poʻo o ka pēpē.

Inā paʻa koke ke kaula umbilical (paʻa ke kaula nuchal), hiki i ke kauka ke hana i ka 'Somersault maneuver'.E hānau i kāu pēpē ma ke ʻano i kapa ʻia ʻo "breech delivery." ʻO kēia ka mālama ʻana i ke poʻo o ke pēpē kokoke i kou pelvis a me ka wehe pono ʻana i ke pēpē i ʻole e ʻūmiʻi ʻia ke kaula umbilical a puni ka ʻāʻī i ka wā e puka ai ke koena o ke kino o ke pēpē mai loko mai o ka vagina.

Hiki ke hānau maʻamau ʻia kahi pēpē me ke kaula umbilical?

I ka hapanui o nā hihia, ʻaʻole hoʻopilikia ke kaula nuchal i ka hānau ʻana, ʻo ia hoʻi hiki iā ʻoe ke loaʻa kahi hānau maʻamau e like me ka hoʻolālā.

Eia nō naʻe, he mea kakaikahi loa, hiki i kahi kaula umbilical paʻa ke ālai i ke kahe koko ma o ke kaula umbilical, e hōʻeha ai i ka fetal. Inā hana ʻia kēia, pono paha ʻoe e hana i kahi ʻoki C-section ulia pōpilikia .

Eia kekahi, inā aia ke pēpē i ke kūlana breech a aia kahi kaula nuchal, ʻaʻole e ʻōlelo pinepine ke kauka i kahi mana cephalic waho (ECV ) a i ʻole ka hānau ʻana ma ke ʻano vaginal. ʻOiai i kēlā manawa, ʻoi aku ka maikaʻi o ka ʻoki ʻana i ka cesarean.

No laila, pono anei iaʻu e makaʻu i kahi code nukelea?

ʻO kaʻoiaʻiʻo, i ka hapanui o nā hihia, ʻaʻohe mea e hopohopo ai ke kaula nuchal. ʻAʻole i ʻike ʻia he kumu ia o ka hānau make ʻana a i ʻole nā ​​​​pilikia olakino koʻikoʻi. E ʻike kāu kauka pehea e mālama ai i ke kaula nuchal. Inā hoʻoulu ia i kekahi ʻeha i ka pēpē ( fetal distress), e haʻi lākou iā ʻoe. No laila, mai hopohopo pono ʻole.

Aia kekahi mea e hiki iaʻu ke hana e pale aku ai i ke kaula umbilical mai ke kāʻei ʻana a puni ka ʻāʻī?

ʻAʻohe mea hiki iā ʻoe ke hana e pale aku ai i ke kaula nuchal mai ka hoʻokumu ʻana. ʻAʻole hiki iā ʻoe ke kāohi i ke ʻano o ka neʻe ʻana o kāu pēpē i loko o ka ʻōpū a i ʻole ke ʻano o ka neʻe ʻana o ke kaula umbilical. Eia kekahi, inā ua hihia ke kaula umbilical, ʻaʻohe mea hiki iā ʻoe ke hana e wehe ai. E ʻike pono kāu hui lapaʻau i ka mea e hana ai inā he kaula nuchal ko kāu pēpē i ka wā hānau.

ʻOiai paha he mea weliweli ke lohe ʻana ua kāʻei ʻia ke kaula umbilical o kāu pēpē a puni ko lākou ʻāʻī, hiki iā ʻoe ke hilinaʻi he mea kakaikahi loa nā pilikia mai ke kaula nuchal. ʻAʻole ia e hoʻopilikia pinepine i ke olakino o kāu pēpē. I ka hanana i manaʻo ʻole ʻia e loaʻa ana i kāu pēpē ka ʻeha ma muli o ke kaula nuchal, ua mākaukau kāu hui lapaʻau e hānau i kāu pēpē me ka palekana.

ʻO nā mea nui loa e pono ai ʻoe e hoʻomanaʻo

ʻAe, no laila, mai nā mea a mākou i kamaʻilio ai, eia nā mea nui e pono ai ʻoe e hoʻomanaʻo:

• ʻO ke kaula nuchal ke kaula umbilical e wahī ana a puni ka ʻāʻī o ke pēpē. He mea maʻamau loa kēia.
• I ka hapa nui o ka manawa, ʻaʻole kēia he kūlana weliweli. Loaʻa i ka pēpē kahi manawa kiʻekiʻe loa e hānau ʻia me ka ʻole o kahi pōʻino.
• Hana wale ʻia kēia, ʻaʻole na ʻoe ka hewa. No laila, mai hopohopo no ia mea.
• Nā KaukaKe nānā nei mākou i kēia ma o nā scan a me ka nānā ʻana i ka puʻuwai o ka pēpē.
• I ka hapa nui o ka manawa, hiki ke hānau ʻia ke pēpē ma ke ʻano maʻamau. Pono ka ʻoki cesarean i ka wā pilikia wale nō.
• He mea kākaʻikahi loa nā pilikia, akā inā loaʻa, ʻaʻole lākou he mea koʻikoʻi.
• ʻAʻohe mea hiki iā ʻoe ke hana e pale aku i kēia. Akā ua mākaukau kāu mau kauka a me nā kahu maʻi no kekahi kūlana.

No laila, inā haʻi aku ke kauka iā ʻoe e pili ana i ke kaula nuchal, mai hopohopo, e nīnau wale iā lākou i kāu mau nīnau. E wehewehe lākou i nā mea āpau iā ʻoe. ʻO nā mea maikaʻi loa no ʻoe a me kāu pēpē!

ʻO ke kaula nuchal, ka hihia ʻana o ke kaula piko, hāpai keiki, hānau keiki, olakino o ka pēpē, ke kaula piko, ka puʻuwai o ka pēpē