Ua pili loa anei kou placenta i ka uterus? E kamaʻilio kākou e pili ana iā Placenta Accreta!

Ma ke ʻano he makuahine, i kekahi manawa he mau makaʻu iki kou e pili ana i nā mea, ʻeā? ʻOi loa aku hoʻi i ka wā e kokoke ana ʻoe e hānau i kahi pēpē, e pili ana i ka placenta. I kēia lā e kamaʻilio mākou e pili ana i kahi kūlana e loaʻa paha i kekahi mau makuahine i ka wā hāpai, akā pono ʻoe e makaʻala iki, a hiki ke lilo i mea weliweli. He kūlana i kapa ʻia ʻo (Placenta Accreta) .

He aha ka (Placenta Accreta)? I ka ʻōlelo maʻalahi...

I ka ʻōlelo maʻalahi, ʻo Placenta Accreta ka wā e hoʻopili hohonu loa ai ka placenta, ka mea e hāʻawi ana i kāu pēpē i nā meaʻai a me ka oxygen, i ka paia o kou uterus. I ka hāpai ʻana maʻamau, hemo maʻalahi kēia placenta mai ka paia o ka uterine ma hope o ka hānau ʻana o ke pēpē. Eia nō naʻe, i ke ʻano o Placenta Accreta, ua pili loa ka placenta i ka paia o ka uterine ʻaʻole hiki ke hemo maʻalahi ma hope o ka hānau ʻana o ke pēpē.

E noʻonoʻo i kēia ʻano, e like me ke kanu ʻia ʻana o kahi mea kanu i ka lepo, ua pālahalaha maʻamau kona mau aʻa, i ka hāpai ʻana olakino, pili ka placenta i ka paia o ka ʻōpū. Eia nō naʻe, ma Placenta Accreta, ʻoi aku ka hohonu o ke aʻa o kēlā mea kanu ma mua o ka mea i manaʻo ʻia, me he mea lā ua komo pololei lākou i loko o kahi mea paʻakikī e like me ka sima, a ua komo ka placenta i loko o ka papa ʻiʻo o ka paia o ka ʻōpū a ua paʻa pono.

I nā hihia koʻikoʻi, hiki i kēia ke alakaʻi i ke kahe koko nui o ka ʻōpū. Hiki ke hoʻoweliweli i ke ola. I kēia hihia, pono paha ʻoe i kahi hoʻoili koko (ʻo ia hoʻi, kahi hoʻoili koko) a me kahi hysterectomy. Hoʻomaopopo pinepine nā kauka e hāʻawi ana i ka mālama prenatal i ke kūlana i ka wā hāpai, a i kekahi manawa i ka wā hānau. ʻO ka maʻamau, ʻo ka mālama ʻana e pili ana i ka hānau ʻana o ka pēpē ma o ka hānau ʻana cesarean i hoʻolālā ʻia (C-section) e hōʻemi i ka pilikia o nā pilikia koʻikoʻi, a ukali ʻia e kahi hysterectomy.

Aia kekahi mau ʻano like ʻole o ka Placenta Accreta?

ʻAe, ʻekolu ʻano nui o ka Placenta Accreta. Hoʻoholo nā kauka i kēia mau ʻano ma muli o ka hohonu o ka hoʻopili ʻana o ka placenta i kou ʻōpū.

1. Placenta Accreta: ʻO kēia ke ʻano maʻamau. Maanei, pili pono ka placenta i ka paia o ka ʻōpū, akā ʻaʻole e hoʻolōʻihi ma waena o ka paia a ʻaʻole ia e hoʻopilikia nui i nā ʻiʻo o ka ʻōpū.

2. Placenta Increta: Ma kēia ʻano, hoʻopili hohonu ka placenta i loko o ka paia o ka ʻōpū, i loko o ka papa ʻiʻo. ʻAʻole i komo piha i loko o ka paia, akā ua paʻa pono ia i nā ʻiʻo o ka ʻōpū. Hana ʻia kēia ma kahi o 15% o nā hihia Placenta Accreta āpau.

3. Placenta Percreta: ʻO kēia ka hihia koʻikoʻi loa a weliweli hoʻi. Maanei, komo loa ka placenta i loko o ka paia o ka ʻōpū. Hiki iā ia ke hele ma ʻō aku o ka ʻōpū a hoʻopilikia i nā ʻāpana ʻē aʻe o kou kino, e like me ka ʻōpū mimi a me nā ʻōpū, a i ʻole e pili iā lākou. Hana wale kēia i kahi poʻe liʻiliʻi, ma kahi o 5%.

ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o ka Placenta Accreta?

Aia ʻoe i ka pilikia kiʻekiʻe o ka loaʻa ʻana o ka Placenta Accreta inā loaʻa iā ʻoe kekahi o kēia mau kūlana:

• Inā ua loaʻa iā ʻoe nā hānau cesarean ma mua: ʻOi aku ke kiʻekiʻe o ka pilikia, ʻoiai inā ua loaʻa iā ʻoe nā hānau cesarean he nui, no ka mea, hiki ke hana ʻia ka ʻeha o ka ʻōpū ma kahi o ke ʻoki ʻana.
• Inā aia ka placenta i kahi kūlana ʻē i loko o kou ʻōpū: Eia kekahi laʻana, inā he maʻi kou i kapa ʻia ʻo "Placenta Previa", kahi i noho ai ka placenta ma ka ʻaoʻao haʻahaʻa o ka ʻōpū, e uhi ana i ka cervix.
• Inā ua loaʻa iā ʻoe ke ʻoki ʻana i ka ʻōpū ma mua: Inā ua loaʻa iā ʻoe nā ʻoki ʻana e like me ka wehe ʻana i nā fibroids uterine a i ʻole D&C (dilation a me ka curettage), hiki ke kū mai kēia ʻano ma muli o ka ʻeha ma kēlā mau wahi.
• Inā ua loaʻa iā ʻoe nā hāpai he nui ("ʻoi aku ma mua o hoʻokahi hāpai ʻana") ma mua.
• Inā ua hāpai ʻoe ma o IVF (artificial insemination).

E noʻonoʻo, he hoaaloha kāu, e ʻōlelo kākou ʻo Nimali. Ua loaʻa iā Nimali ʻelua mau pēpē ma mua ma o ka ʻoki ʻoki cesarean. I kēia manawa ua hāpai ʻo ia i kāna pēpē ʻekolu, ua haʻi aku ke kauka iā ia e pono ʻo ia e makaʻala iki e pili ana i ke kūlana o ka placenta. No ka mea, ua loaʻa iā ia kahi ʻoki cesarean ma mua, aia paha he mau ʻeha liʻiliʻi ma ka ʻōpū kahi i hana ʻia ai ke ʻoki. ʻO ia ke kumu e piʻi ai ka pilikia o ka Placenta Accreta.

E hōʻeha anei ka Placenta Accreta i ka pēpē?

ʻAʻole hōʻeha pololei ka Placenta Accreta i ka pēpē. Eia nō naʻe, hiki i kēia kūlana ke alakaʻi pinepine i ka hānau mua ʻana (hānau mua). ʻO ke ʻano kēia hiki ke hānau ʻia ka pēpē ma mua o 37 mau pule. Loaʻa i nā pēpē i hānau mua ʻia nā pilikia e like me nā pilikia hanu a me nā pilikia e piʻi ai ke kaumaha. Eia kekahi, ʻoi aku ka nui o ka manawa e hoʻokomo ʻia ai ka pēpē i ka Neonatal Intensive Care Unit (NICU) no ka mālama kūikawā.

He aha nā pilikia i ka makuahine ma muli o ka Placenta Accreta?

He mea weliweli iki paha kēia, akā he mea nui e ʻike. Hiki i kahi makuahine me Placenta Accreta ke kū i kēia mau pilikia:

• Ka hānau mua ʻana.
• Ka hōʻino ʻana i ka ʻōpū a me nā ʻōpū e pili ana e like me ka ʻōpū mimi a me nā naʻau.
• Ka nalowale o ka hānau keiki ma muli o ka hysterectomy.
• ʻO ke kahe koko nui, e hopena ana i ka pono no ke kahe koko.
• Nā pilikia o ke kāpili ʻana o ke koko.
• Ka hemahema o ka māmā a i ʻole ka puʻupaʻa.
• I nā hihia kakaikahi loa, hiki ke make. ʻO ia ke kumu i manaʻo ʻia ai kēia maʻi he mea koʻikoʻi loa.

Pehea ka maʻamau o ka Placenta Accreta?

Ua ʻōlelo ʻia ʻo Placenta Accreta e hoʻopilikia i kahi 1 i loko o 533 mau hāpai keiki. Eia naʻe,Ua piʻi aʻe ka nui o kēia maʻi i nā makahiki i hala iho nei, ma muli nui o ka piʻi ʻana o ka nui o nā ʻāpana cesarean (C-sections).

He aha nā kumu o ka Placenta Accreta?

ʻO ke kumu nui o ka Placenta Accreta ʻo ia kekahi mau ʻano ʻē i loko o ka uhi o kou ʻōpū. Ua hōʻino ʻia a ua ʻeha paha kou uhi ʻōpū e nā ʻoki hysterectomy ma mua. Akā i kekahi manawa hiki ke loaʻa kēia ʻano i nā poʻe i loaʻa ʻole i kekahi hysterectomy, ʻeā?

ʻO nā kumu pilikia nui no ka Placenta Accreta:

• Nā ʻoki Cesarean ma mua ('Nui nā ʻoki Cesarean'): ʻOi aku ka nui o ka pilikia o ka loaʻa ʻana o ka Placenta Accreta i nā wahine i loaʻa i nā ʻoki Cesarean he nui. ʻO kēia no ka mea hiki ke koʻikoʻi nā ʻeha e kū mai ana ma ka ʻōpū mai kēlā mau ʻoki. Hoʻonui ka pilikia me ka helu o nā ʻoki Cesarean i hana ʻia i ka hala ʻana o ka manawa. ʻOi aku ma mua o 60% o nā hihia Placenta Accreta i loaʻa i kahi ʻoki Cesarean ma mua.
• Nā ʻoki ʻana o ka ʻōpū ma mua: Inā ua hana ʻia ʻoe i ke ʻoki ʻana e wehe i nā fibroids uterine (ʻo ia hoʻi nā puʻupuʻu ʻaʻole cancerous), hiki i ka scarring ke alakaʻi i ka placenta accreta. Eia kekahi, hiki i nā ʻoki ʻana e like me ka curettage (D&C) a i ʻole ka endometrial ablation ke hana i ka scarring, e alakaʻi ana i kēia kūlana.
• Placenta Previa: Ma kēia kūlana, aia ka placenta e uhi ana i ka cervix. No ka poʻe me Placenta Previa a me ka poʻe i hana mua i nā ʻoki cesarean, piʻi ka pilikia o ka loaʻa ʻana o Placenta Accreta me ka helu o nā ʻoki cesarean i hana ʻia.

He aha nā hōʻailona o ka Placenta Accreta?

ʻO ka hapa nui o ka manawa, ʻaʻole hōʻike ka poʻe me Placenta Accreta i kekahi mau hōʻailona kikoʻī. He mea ia e noʻonoʻo ai. Eia nō naʻe, hiki i kekahi poʻe ke loaʻa i kekahi kahe koko ʻana i ka wā o ke kolu o ka trimester o ka hāpai ʻana (ʻo ia hoʻi, mai nā pule 28 a 40), a i ʻole e loaʻa paha iā lākou ka ʻeha o ka ʻōpū haʻahaʻa i ka wā e kaomi ai ka placenta i ka ʻōpū mimi a i ʻole nā ​​​​​​kikona ʻē aʻe.

Pehea e ʻike ai i ka Placenta Accreta (Placenta Accreta)?

Hiki ke ʻike ʻia ka Placenta Accreta me kahi scan ultrasound i ka wā hāpai. I kekahi manawa , hiki ke hana ʻia kahi hoʻāʻo Magnetic Resonance Imaging (MRI) e ʻike pono i ka hohonu o ke komo ʻana o ka placenta iā ia iho i loko o ka paia o ka ʻōpū.

I nā hihia ʻē aʻe, ʻike wale nā ​​kauka iā Placenta Accreta ma hope o ka hānau ʻana o ka pēpē. ʻO ka maʻamau, ʻūlū ka ʻōpū a puka mai ka placenta i loko o 30 mau minuke o ka hānau ʻana o ka pēpē. Inā ʻaʻole kēia e hana, kānalua paha ke kauka iā Placenta Accreta.

Pehea ke koʻikoʻi o ka ʻike mua ʻana i ka Placenta Accreta?

He mea nui loa ka ʻike ʻana i kēia maʻi i ka wā mua.

No ka mea, a laila, i kou wā hāpai a ma hope o ka hānau ʻana o kāu pēpē, hiki i nā mea lawelawe mālama ola like ʻole, ʻo ia hoʻi, nā loea like ʻole, ke hui pū e hoʻolālā i ka lāʻau maikaʻi loa nou a me kāu pēpē. No ka laʻana, hiki i kahi neonatologist ke komo i ka mālama ʻana i kāu pēpē, a i ʻole he perinatologist ke komo i kāu mālama ʻana. E nānā pono kāu kauka iā ʻoe a hana e hāʻawi i ka hopena maikaʻi loa nou a me kāu pēpē.

Ma ka hoʻokomo ʻana i ka hui lapaʻau kūpono, hiki paha iā ʻoe ke pale aku i kahi hysterectomy a pale aku paha i ke kahe koko nui e hoʻoweliweli ana i ke ola. I kekahi mau hihia koʻikoʻi, ʻaʻole paha e pale aku ka ʻike mua ʻana i ka hysterectomy a i ʻole ke kahe koko. Eia nō naʻe, hiki i ka ʻike mua ʻana ke hōʻemi nui i ka pilikia o nā pilikia ʻē aʻe.

Pehea e mālama ʻia ai ka Placenta Accreta?

Hiki ke ʻokoʻa ka lāʻau no kēia mai kēlā kanaka a kēia kanaka. Inā ʻike kāu kauka ma mua o ka hānau ʻana o kāu pēpē, e nānā pono lākou iā ʻoe i kou wā hāpai. Hiki ke noi ʻia ʻoe e noho i ka haukapila a i ʻole e hoʻomaha moe ma ka home e kōkua i ka pale ʻana i ka hānau mua ʻana.

E hoʻonohonoho kāu kauka i kahi ʻoki C (ʻoki caesarean) e hānau ai i kāu pēpē, ma waena o 34 a me 37 mau pule o ka hāpai ʻana. ʻO kēia ke pale aku i ke kahe nui ʻana o ke koko e hiki mai ana mai nā ʻūlū ʻōpū a i ʻole ka hānau ʻana. Inā ʻoe e hoʻolālā ana e loaʻa nā keiki hou aku, e hoʻāʻo kāu kauka e mālama i kou ʻōpū.

Eia nō naʻe, i nā hihia koʻikoʻi kahi i hohonu loa ai ka placenta, pili loa, a i ʻole ua hoʻopilikia i nā ʻōpū ʻē aʻe, ʻo ka hysterectomy ka koho palekana loa. ʻO ka cesarean hysterectomy kahi hana e wehe ʻia ai ka uterus i ka manawa like me ka hānau ʻana o ka pēpē ma o C-section. Ma kēia hana, wehe ke kauka i ka pēpē a me ka uterus a me ka placenta i ka manawa like. ʻO ka wehe ʻana i ka uterus ʻoiai e pili ana ka placenta hiki ke hōʻemi nui i ka pilikia o ke kahe nui ʻana o ke koko.

Koho kekahi mau kauka e waiho i nā ʻāpana liʻiliʻi o ka placenta i loko o ka ʻōpū, no ka mea, e heheʻe ka placenta i ka hala ʻana o ka manawa. Eia nō naʻe, he mau pilikia nō hoʻi kēia e like me ke kahe koko nui o ka ʻōpū, ka maʻi, a me nā ʻūpā koko. Hiki iā ia ke paʻakikī i ka hāpai ʻana i ka wā e hiki mai ana.

ʻEhia ka wā e hānau ai ʻoe i ka pēpē ke loaʻa iā ʻoe (Placenta Accreta)?

ʻO ka hapa nui o nā kauka e paipai i ka ʻoki C-section ma waena o 34 a me 37 mau pule o ka hāpai ʻana , ke ʻole he mau pilikia ʻē aʻe. ʻO kēia ke pale aku iā ʻoe mai ka loaʻa ʻana o nā ʻūlū a i ʻole ka hoʻomaka ʻana o ka hānau ʻana, kahi e hiki ai ke kahe nui ke koko. Hiki i kāu kauka ke hāʻawi iā ʻoe i kahi lāʻau i kapa ʻia ʻo corticosteroids e kōkua i ka ulu ʻana o nā māmā o kāu pēpē.

Hiki ke pale ʻia ka Placenta Accreta?

ʻAʻohe ala maoli e pale loa ai i ke kūlana (Placenta Accreta).Eia nō naʻe, inā ua loaʻa iā ʻoe nā ʻoki C-sections he nui i ka wā ma mua, a inā he placenta previa kou (placenta previa), ʻoi aku ka kiʻekiʻe o kou pilikia. E kamaʻilio me kāu kauka e pili ana i kou mōʻaukala olakino a me kou pilikia no ka loaʻa ʻana o ka placenta accreta.

He aha ka wā e hiki mai ana no ka poʻe me (Placenta Accreta)?

ʻO ka Placenta Accreta, inā ʻike ʻia i ka wā hāpai mua, he hopena maikaʻi ka maʻamau. Eia nō naʻe, hiki iā ia ke alakaʻi i nā pilikia e like me ka hānau mua ʻana a me ka hysterectomy. Inā wehe kāu kauka i kou ʻōpū, ʻaʻole hiki iā ʻoe ke hāpai hou. Hiki i kēia kūlana ke hoʻoulu i ke kahe koko nui, ka hōʻino ʻana i kou ʻōpū a i ʻole ka ʻōpū mimi, a me ka make. ʻO ia ke kumu he kūlana ia e pono ai ka mālama nui.

Hiki ke hānau hou i kahi pēpē ma hope o ka Placenta Accreta?

Aia kēia i ka mea inā ua hana ʻia ʻoe i kahi hysterectomy (ʻoki e wehe i kou ʻōpū). Inā makemake ʻoe e loaʻa nā keiki hou aʻe i ka wā e hiki mai ana, e kamaʻilio me kāu kauka e pili ana i ia mea. Hiki paha iā ia ke pale aku i kahi hysterectomy e mālama i kou momona (hiki ke loaʻa nā keiki).

He aha ka manawa kūpono e ola ai mai ka Placenta Accreta?

Ma keʻano laulā, maikaʻi ka nui o ke ola no ka Placenta Accreta. I nā hihia he nui, pono ka hysterectomy e pale i ke kahe koko postpartum a i ʻole nā ​​​​pilikia koʻikoʻi ʻē aʻe.

Āhea wau e kāhea aku ai i kaʻu kauka?

He maʻi hāpai pilikia kiʻekiʻe ka Placenta Accreta. E nānā pono kāu kauka iā ʻoe a e hoʻomaopopo iā ʻoe e pili ana i ke koena o kou hāpai ʻana, ka hānau ʻana, a me ka hoʻōla ʻana. Inā he mau nīnau kāu e pili ana i kēia hōʻailona, ​​e nīnau iā lākou. Aia lākou ma laila e kōkua iā ʻoe.

Inā hoʻomaka koke ʻoe e kahe nui ke koko (nui loa a pulu ʻoe i kahi pale i loko o hoʻokahi hola) a inā ʻike ʻoe i ka ʻeha nui ma kou ʻōpū lalo, e kāhea koke i ka 911 a i ʻole e hele koke i ka haukapila kokoke loa.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka hānau a me ka gynecologist?

He mea maʻamau ka loaʻa ʻana o nā nīnau he nui ke ʻike ʻoe he Placenta Accreta kou. Eia kekahi mau nīnau maʻamau hiki iā ʻoe ke nīnau i kāu kauka:

• Pono anei au e hānau i ke pēpē i ka wā mua?
• Pehea e mālama ʻia ai kēia maʻi?
• Pono anei au e hoʻomaha i kahi moe a hoʻololi paha i kaʻu hana maʻamau i kēlā me kēia lā?
• Pehea e ʻike ai au i ka wā e pono ai iaʻu e hele i ka haukapila?
• Hiki ke hānau maʻamau i ka pēpē (ma ke ʻano vaginal)?
• E hiki anei iaʻu ke loaʻa hou kahi pēpē i ka wā e hiki mai ana?
• Pono anei iaʻu e hana i kahi hysterectomy?

Pono anei ka hysterectomy ma muli o ka Placenta Accreta?

E hana ke kauka i kāna mea maikaʻi loa e hoʻopakele i kou ʻōpū, akā ʻoi aku ka nui o nā pilikia o ka hana ʻana pēlā.(Placenta Accreta) Pono ka nui o ka poʻe me nā maʻi koʻikoʻi e wehe i ka ʻōpū e pale aku i ke kahe koko e hoʻoweliweli ana i ke ola. E kamaʻilio me kāu kauka e pili ana inā pono ka hysterectomy no kou kūlana.

He aha kā kākou e aʻo ai mai kēia? (Leka Lawe-Home)

ʻO ka Placenta Accreta kahi maʻi i ʻole e hōʻike i kekahi mau hōʻailona i ka wā hāpai, akā hiki ke hoʻoweliweli i ke ola. Eia nō naʻe, ʻo ka ʻike mua ʻana a me ka nānā pono ʻana me kahi ultrasound scan hiki ke hōʻemi i ka pilikia o nā pilikia. I kekahi manawa ʻike ʻia ke ʻano ma hope o ka hānau ʻana o ka pēpē. Inā loaʻa iā ʻoe ka Placenta Accreta, e kamaʻilio me kāu kauka e pili ana i ka mea e manaʻo ai. E hoʻomanaʻo, aia lākou ma laila e mālama iā ʻoe a me kāu pēpē i palekana a olakino. No laila, mai makaʻu e kamaʻilio me lākou e pili ana i kou mau hopohopo a me nā mea e noʻonoʻo nei.

ʻO ka Placenta, ka ʻōpū, ka hāpai ʻana, ka ʻoki Cesarean, ka hānau keiki ʻana, ke kahe koko ʻana, ka Placenta Accreta, ke olakino wahine, nā pilikia o ka hāpai ʻana