He Rh maikaʻi ʻole anei ka makuahine, he Rh maikaʻi anei ka makuakāne? Aia kekahi hopena i ka pēpē? (Rh Incompatibility)

Hauʻoli nui nā mākuahine a me nā makuakāne a pau i ka wā e ʻike ai lākou e hāpai ana lākou i kahi pēpē . Akā i ka manawa like, hiki mai kahi makaʻu iki i ka noʻonoʻo, ʻeā? Ke holo nei nā nīnau e like me 'E ola kino anei ke pēpē?', 'E maikaʻi anei nā mea a pau?' i loko o kou noʻonoʻo. ʻOiai inā he 'Negative' kou ʻano koko a he 'Positive' ke ʻano koko o kāu kāne, ua lohe paha ʻoe i kahi mea i kapa ʻia ʻo 'Rh incompatibility'. ʻO ka lohe ʻana i kēia e hoʻoweliweli iki paha iā ʻoe. Akā, mai hopohopo iki. E kamaʻilio kākou e pili ana i nā mea āpau i kēia lā me ka maʻalahi a me ka maopopo.

He aha ka mea Rh?

ʻAe, e nānā mua kākou i ke ʻano o kēia kumu Rh. He maʻalahi loa ia. He protein kūikawā ia ma ka ʻili o ko kākou mau hunaola koko ʻulaʻula.

• Inā loaʻa kēia protein i loko o kou mau hunaola koko ʻulaʻula , ʻo kou ʻano koko he Rh Positive (+) . E like me ka hapa nui o ka poʻe ma Sri Lanka, ʻo ke ʻano koko o ka hapa nui o ka honua he Rh Positive.
• Inā ʻaʻohe ou protein i loko o kou mau ʻulaʻula koko, ʻo kou ʻano koko he Rh maikaʻi ʻole (-) .

Hiki ke kū mai kahi pilikia inā he Rh Negative ka makuahine a he Rh Positive ka pēpē . Inā he Rh Positive ka makuahine, ʻaʻohe pilikia me ka nānā ʻole i ke ʻano koko o ka pēpē. Pēlā nō, inā he Rh Negative ka makuahine a me ka pēpē, ʻaʻohe pilikia ma laila. ʻAʻole kēia kūlana e hōʻeha i ke olakino o ka makuahine. Aia ka hopena i ka pēpē.

Pehea e hoʻoulu ai ka pilikia i ka launa ʻole?

He mea maʻalahi loa kēia e hoʻomaopopo. ʻO ka maʻamau, i ka wā hāpai, ʻaʻole hui pū ke koko o ka makuahine a me ke koko o ke pēpē. Hoʻokaʻawale ʻia lākou e ka placenta.

Eia nō naʻe, i ka wā hānau keiki, ʻoiai ke kaʻawale ka placenta , hiki i kahi liʻiliʻi o ke koko o ka pēpē ke komo i loko o ke kahe koko o ka makuahine. E noʻonoʻo i kēia: he Rh Negative ka makuahine. ʻO ia hoʻi, ʻaʻohe ona protein Rh i loko o kona kino. Ua hānau ʻia ka pēpē me ka Rh Positive. ʻO ia hoʻi, aia ka protein Rh i loko o ke koko o ka pēpē.

I kēia manawa, ke komo kekahi o ke koko Rh maikaʻi o ke pēpē i ke kino o ka makuahine, ʻike ka ʻōnaehana pale o ka makuahine i kēia protein Rh ma ke ʻano he mea hoʻouka kaua haole a weliweli. E like me kahi maʻi e hoʻoulu ai i ka maʻi. A laila hoʻomaka ke kino o ka makuahine e hana i nā koa kūikawā, i kapa ʻia ʻo 'antibodies', e hakakā me kēia 'mea hoʻouka kaua'.

Ma muli o ka lōʻihi o ka manawa e ulu ai kēia mau antibodies, ʻaʻole i hōʻeha ʻia ka pēpē mua no ka mea hoʻomaka kēia kaʻina hana ma hope o kona hānau ʻana.

Eia nō naʻe, kū mai ka pilikia i ka hāpai ʻana aʻe. I kēia manawa, loaʻa i ke kino o ka makuahine nā antibodies e kūʻē i ke koko Rh maikaʻi. Hiki i kēia mau antibodies ke hele ma waena o ka placenta a komo i loko o ke kino o ka pēpē aʻe.

Inā he Rh Positive ka lua o ka pēpē, hoʻouka kēia mau antibodies mai ke kino o ka makuahine i nā hunaola koko ʻulaʻula o ka pēpē a hoʻomaka e luku iā lākou. Kāhea mākou i kēia maʻi ʻo 'Hemolytic Disease of the Newborn'.

He aha nā hopena e hiki ke loaʻa i ka pēpē?

Ma muli o ka luku ʻana o nā antibodies o ka makuahine i nā hunaola koko ʻulaʻula o ka pēpē, hiki i ka pēpē ke loaʻa i nā pilikia olakino like ʻole.

• Anemia : Ua emi ka nui o ke koko o ke pēpē ma muli o ka luku ʻia ʻana o nā hunaola koko ʻulaʻula.
• Jaundice: Huli ka ʻili a me nā maka o kahi pēpē i melemele ma muli o kahi mea i kapa ʻia ʻo bilirubin, kahi i hoʻokuʻu ʻia mai nā hunaola koko ʻulaʻula i luku ʻia.
• Nā kūlana koʻikoʻi: I nā hihia koʻikoʻi loa, hiki ke hōʻino ʻia nā ʻōpū o ka pēpē, e like me ka puʻuwai a me ke akepaʻa, a hiki ke make ka pēpē i loko o ka ʻōpū.

He mea weliweli kēia ke lohe ʻia. Akā, ʻo ka nūhou maikaʻi, hiki ke pale ʻia kēia kūlana me ka holomua nui.

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Hoʻonā: Ka lāʻau pale Anti-D (RhoGAM)

Me ka holomua o ka ʻepekema lapaʻau, aia i kēia manawa kahi hopena kūpono loa no kēia pilikia Rh incompatibility. ʻO ia ka Anti-D immunoglobulin.Ua ʻike nui ʻia ka lāʻau pale ma ka inoa inoa ʻo 'RhoGAM'.

I ka ʻōlelo maʻalahi, hoʻopau ka lāʻau pale Anti-D a 'holoi' aku i nā hunaola koko ʻulaʻula Rh-positive i komo paha i loko o ke kino o ka makuahine mai ka pēpē i loko o ka ʻōpū ma mua o ka 'ala ʻana' o ka ʻōnaehana pale o ka makuahine. Pale kēia i ka makuahine mai ka hoʻomohala ʻana i nā antibodies weliweli.

Hāʻawi ʻia kēia lāʻau pale e like me kahi papa hana kikoʻī.

1. Ma kahi o 28 mau pule o ka hāpai ʻana: Ua hāʻawi ʻia ka hapa nui o nā makuahine Rh maikaʻi ʻole i kahi lāʻau pale Anti-D i kēia manawa. ʻO kēia ke pale aku i ka manawa liʻiliʻi loa o ka hui ʻana o ke koko ma kekahi ʻano i ka wā hāpai.

2. I loko o 72 mau hola o ka hānau ʻana: Inā ua hōʻoia ʻia ke ʻano koko o ke pēpē hānau hou he Rh Positive, e hāʻawi ʻia ka makuahine i kahi inikini Anti-D ʻē aʻe.

3. I nā hihia ʻē aʻe: He mea koi kēia lāʻau pale ma hope o kekahi hanana kahi e komo ai ke koko o ka pēpē i ke kino o ka makuahine, e like me ka hāʻule ʻana o ka ʻōpū, ka hāpai ʻana o ka tuba, ka hoʻopau ʻana i ka ʻōpū, a i ʻole ka amniocentesis.

ʻAʻole hele nā ​​antibodies i loko o kēia lāʻau pale i ka placenta a ʻaʻole hoʻi e hōʻeha i ka pēpē. No laila, palekana loa ia.

He mau mea hou aʻe e hoʻomanaʻo ai

Pehea e hoʻoholo ʻia ai ke ʻano koko o kahi pēpē?

Inā he Rh Negative ʻoe, e hoʻoilina maoli kāu pēpē i kahi gene Rh Negative mai iā ʻoe. ʻO ka Rh Positive a i ʻole ka Negative o ke pēpē, aia nō ia i ka gene i hoʻoilina ʻia mai ka makuakāne mai.

• Inā he Homozygous Positive ka makuakāne (ʻo ia hoʻi, ua loaʻa iā ia nā genes Rh Positive mai kona mau mākua ʻelua), e loaʻa pū i ke pēpē kahi gene maikaʻi mai iā ia. No laila , e 100% Rh Positive ka pēpē.
• Inā he Heterozygous Positive ka makuakāne (ʻo ia hoʻi, he hoʻokahi gene maikaʻi a hoʻokahi gene maikaʻi ʻole kāna), he 50% ka manawa kūpono o ka pēpē e loaʻa ai kahi gene maikaʻi a he 50% ka manawa kūpono o ka loaʻa ʻana o kahi gene maikaʻi ʻole. ʻO ia hoʻi, he 50% ka manawa kūpono o ka pēpē e lilo i Rh Positive.

ʻOiai he paʻakikī iki kēia mau pilikia hoʻoilina, hiki iā ʻoe ke kamaʻilio me kāu kauka e wehewehe hou aku i kēia.

Nā manaʻo kuhihewa a me ka ʻoiaʻiʻo

Makaʻu paha kekahi poʻe i ka lāʻau pale Anti-D no ka mea ua hana ʻia ia mai ke koko. Akā, hana ʻia kēia mau mea ma hope o ka hoʻomaʻemaʻe pono ʻia ʻana a hōʻoia ʻia he palekana. Eia kekahi, lohe paha ʻoe i nā moʻolelo e like me, "Ua loaʻa i kuʻu hoaaloha ʻelua mau pēpē Rh Positive olakino me ka ʻole o ka lawe ʻana i ka Anti-D." ʻAe, hiki ke hana pinepine ʻia. Akā, ua like ia me ka lawe ʻana i kahi pilikia pono ʻole, e like me ka lele ʻana i ke alanui me ka ʻole o ka nānā ʻana i nā kaʻa e hiki mai ana.

ʻO ka mea nui loa, ʻo ia ka hahai ʻana i nā ʻōlelo aʻoaʻo lapaʻau kūpono me ka ʻole o ka hoʻokumu ʻana i ka makaʻu pono ʻole e pili ana i kēia.Na kāu kauka e hana i nā hoʻokolohua a pau e pono ai nāu, hāʻawi iā ʻoe i ka lāʻau pale Anti-D i ka wā e pono ai, a alakaʻi iā ʻoe e mālama pono iā ʻoe a me kāu pēpē.