Ua hānau wale ʻoe i kahi pēpē? A i ʻole ua hele ʻoe i kahi ʻike ʻeha e like me ka hāʻule ʻana o ka hāpai keiki? Ma hope o ia hanana, lōʻihi ka manawa e hoʻōla ai ke kino. No laila, he mea maʻamau ke loaʻa kekahi kahe koko o ka ʻōpū a me ka ʻeha iki no kekahi mau lā. Eia nō naʻe, inā ʻoi aku ke kaumaha o kēia kahe koko ma mua o ka maʻamau, inā ʻoe e hele ana i nā clots nui, a inā ʻaʻohe hoʻomaikaʻi ma hope o kekahi mau lā, ʻaʻole ia he manaʻo maikaʻi e haʻalele wale. Malia paha ma muli o kahi kūlana i kapa ʻia ʻo "retained uterine tissue," a mākou e kamaʻilio nei i kēia lā.
I ka ʻōlelo maʻalahi, he aha ka ʻāpana i mālama ʻia o ka ʻōpū (RPOC)?
He mea paʻakikī paha kēia ke lohe ʻoe i ka inoa, akā he mea maʻalahi loa ia.
Ma hope o ka pau ʻana o ka wā hāpai, ʻo ia hoʻi, ma hope o ka hānau ʻana o kahi pēpē, ma hope o ka hāʻule ʻana o ka hāpai keiki, a i ʻole ma hope o ka hoʻopau ʻana i ka hāpai keiki, aia nā ʻāpana ʻiʻo i koe i loko o ka ʻōpū e pili ana i kēlā wā hāpai, ʻo ia ka mea a mākou e kapa nei ma ke ʻano lapaʻau he `(Retained Products of Conception - RPOC)`. E noʻonoʻo e pili ana i ia mea, i ka wā hāpai, ʻo kekahi mea nui i kapa ʻia ʻo ka placenta e ulu ana i loko o ka ʻōpū me ka pēpē, ʻeā? Loaʻa i ka pēpē ka meaʻai a me ka oxygen e pono ai ma o kēia placenta. Ma hope o ka hānau ʻana o ka pēpē, pono e haʻalele loa kēia placenta i ka ʻōpū a puka i waho. Akā i kekahi manawa, ʻaʻole paha e wehe loa ʻia nā ʻāpana liʻiliʻi o kēia placenta, nā ʻāpana ʻiʻo o ka embryo a i ʻole ka fetus, a i ʻole nā ʻāpana ʻiʻo ʻē aʻe e pili ana i ka wā hāpai a paʻa mau i loko o ka ʻōpū. ʻO ia ke kumu e kapa ai mākou i kēia ʻano.
No laila, ua like kēia me ka "Retained Placenta"?
ʻAʻole, he ʻokoʻa iki lākou. Kāhea mākou iā "Retained Placenta" ke puka ʻole ka placenta holoʻokoʻa mai loko mai o ka ʻōpū i loko o 30-60 mau minuke o ka hānau ʻana. I kēlā hihia, ke kamaʻilio nei mākou e pili ana i
ka placenta holoʻokoʻa . Akā ʻo ka `(RPOC)` he ʻano ākea iki. Maanei, ʻaʻole ia ka placenta holoʻokoʻa, akā
he ʻāpana liʻiliʻi o ka placenta, kahi ʻāpana o ka ʻiʻo fetal, a i ʻole kekahi mea ʻē aʻe i waiho ʻia i loko o ka ʻōpū. I ka ʻōlelo maʻalahi, hiki ke manaʻo ʻia ʻo `(Retained Placenta)` he ʻano `(RPOC)`.
He aha nā hōʻailona o kēia maʻi? Pehea ʻoe e ʻike ai?
Ma muli o ka nui o nā loli i kou kino ma hope o ka hānau ʻana i kahi pēpē, he mea maʻalahi i kekahi manawa ke kuhihewa i kēia mau hōʻailona no kahi mea maʻamau. Akā he mea nui e makaʻala i kēia.
E hoʻomanaʻo, he mea maʻamau ke kahe iki ke koko no kekahi mau pule ma hope o ka hānau ʻana o kahi pēpē a i ʻole ka hāʻule ʻana o ka hāpai keiki. Akā pono e emi mālie. Inā ʻaʻole, he mea ia e makaʻala ai.
ʻO ka hōʻailona nui a maʻamau
ka kahe koko ʻana o ka ʻōpū ma ke ʻano maʻamau ʻole a nui paha. E wehewehe hou aku kākou i kēia:
- Ke kahe koko nui : Inā lawa kou kahe ʻana e hoʻomaʻū loa i kahi pale i kēlā me kēia ʻelua hola.
- Ke kahe ʻana o nā ʻōpū koko nui: Inā ʻoe e kahe i nā ʻōpū koko i ʻoi aku ka nui ma mua o ka maʻamau.
- Ke kahe koko manawa ʻole: Inā pau ke kahe koko no kekahi mau lā a laila hoʻomaka koke ke kahe nui hou.
- Ka hoʻokahe ʻala ʻino: Inā he ʻala ʻino ka hoʻokahe ʻana o ka vagina, he hōʻailona paha ia o kahi maʻi.
Ma waho aʻe o kēia hōʻailona nui, hiki ke ʻike ʻia kekahi mau hōʻailona ʻē aʻe.
| Hōʻailona | Wehewehena |
|---|
| Kuni a me nā anu | Inā loaʻa kahi maʻi ma muli o nā ʻāpana i koe i loko o ka ʻōpū, hiki ke kuni. |
| ʻEha ʻōpū haʻahaʻa | Hiki ke manaʻo ʻia e like me ka ʻeha ʻoi a mau paha a i ʻole ka ʻūmiʻi ma ka ʻōpū lalo. |
| ʻO ka ʻōpū i hoʻonui ʻia a koʻikoʻi | I ka wā o ka hoʻokolokolo ʻana, ʻike paha ke kauka he ʻoi aku ka nui o ka ʻōpū ma mua o ka mea i manaʻo ʻia a ʻeha hoʻi ke hoʻopā aku. |
| ʻAʻole hiki ke hoʻomaka hou i ka menstruation o kēlā me kēia mahina | Inā ʻaʻole ʻoe e hānai waiū ana i kāu pēpē, pono e hoʻomaka hou kou wā i loko o 6-8 mau pule. Inā ʻaʻole, he hōʻailona paha ia o kēia maʻi. |
No ke aha lā kēia e hana nei? Aia kekahi kumu kikoʻī no kēia?
He mea paʻakikī pinepine ke kuhikuhi i hoʻokahi kumu. Eia nō naʻe, ua ʻike nā kauka i kekahi mau kumu e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i kēia maʻi.
ʻO ke kumu pilikia nui inā ua loaʻa iā ʻoe kēia maʻi (RPOC) i ka hāpai ʻana ma mua,He kiʻekiʻe nō hoʻi ka pilikia o kēia e hana hou ʻia i nā hāpai ʻana ma hope. Eia kekahi, hiki i nā kūlana ma lalo nei ke hoʻonui i ka pilikia.
| Kumu pilikia | He wehewehe maʻalahi |
|---|
| ʻO ka Placenta Accreta | He kūlana kēia kahi e pili pono ai ka placenta i ka paia o ka ʻōpū. A laila, ma hope o ka hānau ʻana o ke pēpē, ʻaʻole ia e hemo maʻalahi. Nui ka manawa e koe ai nā ʻāpana. |
| ʻOi aku ma mua o 35 mau makahiki | Hoʻonui iki ʻia ka pilikia inā ʻoi aku ka nui o ka makuahine ma mua o 35 mau makahiki i ka wā hāpai. |
| Kōkua Hoʻouna | Inā pono ʻoe e hoʻohana i nā mea hana e like me ka forceps a i ʻole ka vacuum e wehe ai i ka pēpē. |
| Ka hāʻule ʻana o ka pēpē a i ʻole ka hānau make ʻana i ka wā o ka lua o ka trimester o ka hāpai ʻana (nā pule 13-26) | I loko o kēia manawa, nui ka manawa kūpono ʻaʻole e wehe loa ʻia ka placenta a e waiho ʻia nā ʻāpana. |
| ʻAʻole e holomua i ka hānau keiki ʻana | I ka holomua ʻana o ka hānau ʻana, luhi paha ka ʻōpū a ʻaʻole i loaʻa nā ʻūlū e pono ai e kipaku loa i ka placenta. |
| ʻO ke ʻoki ʻana o ka ʻōpū ma mua | Inā ua loaʻa iā ʻoe nā ʻoki cesarean (C-sections) a i ʻole D&C ma mua, hiki i ka ʻiʻo ʻeha i loko o ka ʻōpū ke hoʻopili hohonu i ka placenta. |
| Loaʻa kahi ʻōpū i ke ʻano kūpono ʻole | He ʻokoʻa iki ke ʻano o nā ʻōpū o kekahi mau wahine mai ka hānau ʻana mai, a ʻoiai pēlā, hiki ke noho mau nā ʻāpana. |
He aha ka mea e hana ʻia inā ʻaʻole e wehe ʻia kēia mau ʻāpana? E loaʻa anei nā pilikia koʻikoʻi?
ʻAe. Inā ʻaʻole mālama ʻia kēia maʻi, hiki i kekahi manawa ke alakaʻi i nā pilikia koʻikoʻi. ʻO ia ke kumu e ʻōlelo ai mākou e makaʻala i kēia mau hōʻailona.
- Anemia : Hiki i ke kahe koko nui ke hoʻemi i ka nui o ke koko i loko o ke kino, e alakaʻi ana i nā hōʻailona e like me ka luhi a me ka poniuniu .
- Nā maʻi: ʻO ke koena o ka ʻiʻo i loko o ka ʻōpū he wahi kūpono ia no ka ulu ʻana o ka bacteria . Hiki i kēia maʻi ke laha i nā ʻōpū fallopian a me nā ovaries , e hoʻopilikia ana i kou hiki ke loaʻa nā keiki i ka wā e hiki mai ana. I kekahi manawa, hiki i kēia maʻi ke laha ma ke kino a hoʻoulu i nā kūlana hoʻoweliweli ola e like me sepsis .
- ʻEha Pelvic Mau Loa: Loaʻa paha iā ʻoe ka ʻeha o ka ʻōpū lalo no ka manawa lōʻihi.
- ʻO ka Asherman's Syndrome: He maʻi laha ʻole kēia. ʻO kahi maʻi a i ʻole ka lāʻau lapaʻau i loko o ka ʻōpū (ʻoi aku ka D&C) hiki ke hoʻopili i nā paia o ka ʻōpū. Hiki i kēia ke alakaʻi i nā wā kūpono ʻole, nā hāʻule ʻana o ka hāpai keiki, a me ka paʻakikī o ka hāpai ʻana i ka wā e hiki mai ana.
Pehea e ʻike ai nā kauka i kēia maʻi?
He mea paʻakikī ke maopopo 100% ua loaʻa iā ʻoe kēia maʻi ma muli o nā hōʻailona wale nō. Hiki ke ʻike ʻia kēia mau hōʻailona i nā kūlana olakino ʻē aʻe. No laila, hiki i kāu kauka ke hana i kekahi mau hoʻokolohua e hōʻoia i kēia.
| ʻAno hoʻāʻo | He aha kāu e aʻo ai mai ia mea? |
|---|
| ʻO ke kiʻi ʻana o ka Ultrasound Transvaginal | ʻO kēia scan, ʻo ia hoʻi ke hoʻokomo ʻana i kahi probe liʻiliʻi ma o ka vagina, hiki ke ʻike maopopo inā ua mānoanoa ka paia o loko o ka uterus a i ʻole he mau puʻupuʻu o nā ʻiʻo. |
| Ultrasound Doppler Waihoʻoluʻu | He ʻano scan nō hoʻi kēia. Hiki iā ia ke ʻike inā loaʻa ke koko i ke koena o nā ʻiʻo i loko o ka ʻōpū. Inā he koko, ʻo ia paha kekahi hapa o ka placenta. |
| Hoʻāʻo koko HCG (Human Chorionic Gonadotropin Test) | He hormone ka HCG i hana ʻia e ka placenta i ka wā hāpai. Inā kiʻekiʻe mau ka pae o kēia hormone i loko o ke koko i kekahi mau pule ma hope o ka pau ʻana o ka hāpai ʻana, hōʻike ia aia nō paha kekahi mau ʻāpana o ka placenta i loko o ka ʻōpū. |
| Hysteroscopy | Ma kēia, ua hoʻokomo ʻia kahi ʻōmole lahilahi me kahi kāmela i hoʻopili ʻia ma o ka vagina i loko o ka uterus a ʻike pololei ʻia ke ʻano o loko ma kahi pale. Hiki iā ʻoe ke ʻike pono i nā ʻāpana i koe. |
He aha nā lāʻau lapaʻau no kēia?
Inā ua hōʻoia ʻia kēia kūlana, pono e wehe ʻia nā ʻāpana i koe. ʻElua mau koho lapaʻau nui no kēia. Na kāu kauka e hoʻoholo i ka lāʻau kūpono loa nou ma muli o kou kūlana, ke koʻikoʻi o kou mau hōʻailona, a me ka nui o nā ʻiʻo i koe. 1.
Hoʻokele Lapaʻau:- Misoprostol: He lāʻau lapaʻau kēia i lawe ʻia ma ke ʻano he pila a i ʻole e kau ʻia i loko o ka vagina. Hoʻoulu ia i ka ʻōpū e ʻūlū (dilate). Ke ʻūlū ka ʻōpū, hoʻokuke ia i waho i nā mea i koe.
2.
Hoʻokele ʻoki kino:- Dilation a me Curettage (D&C): He hana ʻoki liʻiliʻi kēia. Ma Sinhala, kapa mākou ia he "holoi ʻana i ka uterus." Maanei, wehe iki ʻia ka cervix, hoʻokomo ʻia kahi mea hana kūikawā (pinepine he paipu omo), a hoʻomaʻemaʻe ʻia a wehe ʻia nā ʻōpala i koe i hoʻopili ʻia i nā paia o ka uterus. Hana pinepine ʻia kēia ma lalo o ka anesthesia.
Aia kekahi mau pilikia me kēia mau lāʻau lapaʻau?
E like me nā hana lapaʻau a pau, he liʻiliʻi loa nā pilikia me kēia mau kaʻina hana. Hiki i nā mea e like me ke kahe koko nui a me ka maʻi ke hana me nā mea ʻelua, akā haʻahaʻa loa nā manawa kūpono. He mea kākaʻikahi loa ka D&C.
Hiki ke loaʻa ka perforation uterine, akā ho'ōla pinepine ia iā ia iho. ʻO ka mea nui loa, ʻo ia ke kamaʻilio ākea me kāu kauka e pili ana i kēia mau lāʻau lapaʻau a me ko lākou mau pono a me nā pōʻino. A laila hiki iā ʻoe ke hoʻoholo i kahi hoʻoholo naʻauao.
He aha nā pilikia e pono ai ke ʻike ʻana i ke kauka?
Ma hope o ka pau ʻana o kou hāpai ʻana, inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, e hele koke i ka ʻOihana Hoʻopilikia (ETU) o ka haukapila a i ʻole e hoʻomaopopo i kāu kauka.- Paʻakikī ka hanu ʻana
- Ke kahe koko nui loa o ka ʻōpū (ka pulu ʻana ma mua o hoʻokahi pad i kēlā me kēia hola)
- kuni kiʻekiʻe
- Ka luaʻi a me ka luaʻi
- ʻEha nui o ka ʻōpū lalo hiki ʻole ke hoʻomanawanui
I loko o ia ʻano kūlana, mai kali ma ka home. ʻO ka mea palekana loa e hana ai, ʻo ia ke ʻimi koke i ke kōkua lapaʻau. Ua ʻike au he mea paʻakikī loa ke alo ʻana i ia ʻano kūlana, ʻoiai ma ka noʻonoʻo. Ke makemake ʻoe e ʻike i ka hauʻoli o ka loaʻa ʻana o kahi pēpē, a i ʻole ke hoʻāʻo nei ʻoe e hoʻopau i ka ʻeha o ka hāʻule ʻana o ka hāpai keiki, he mea maʻamau ke manaʻo i kahi kaumaha nui ke haʻi ʻia iā ʻoe e pono ʻoe e hana i kahi lāʻau ʻē aʻe. Akā e hoʻomanaʻo, he ʻano kēia e hiki ke ho'ōla loa ʻia me ka lāʻau. Hiki i nā wahine he nui ke hāpai hou me ka ʻole o nā pilikia ma hope o kēia lāʻau a loaʻa nā keiki olakino. E kamaʻilio ākea me kāu kauka, kāu kāne, a me kou ʻohana e pili ana i kāu mau nīnau, makaʻu, a me nā manaʻo. He mea hōʻoluʻolu nui ia nou. Leka Lawe-Home
- ʻO ke alo ʻana o nā koena o ka ʻiʻo uterine ma hope o ka pau ʻana o ka hāpai ʻana (hānau keiki, hoʻopau ʻana) ua kapa ʻia ʻo ke koena o ka ʻiʻo uterine (RPOC) .
- ʻO nā hōʻailona nui ka kahe koko nui, ke kuni, a me ka ʻeha o ka ʻōpū lalo .
- Inā ʻaʻole e emi mālie ke kahe ʻana o ke koko ma hope o ka hānau ʻana a i ʻole ka hoʻopau ʻana i ka hāpai keiki, akā e piʻi a hoʻomaka hou paha, e ʻike koke i ke kauka.
- Inā waiho ʻole ʻia kēia kūlana, hiki iā ia ke alakaʻi i ka anemia a me nā maʻi koʻikoʻi.
- Hiki ke ʻike ʻia kēia ma o nā scan ultrasound a me nā hoʻāʻo koko, a hiki ke ho'ōla piha ʻia me ka lāʻau lapaʻau a i ʻole kahi ʻoki kino liʻiliʻi (D&C).
- Ma hope o ka loaʻa ʻana o ka mālama kūpono, ʻaʻohe hopena i nā hāpai olakino i ka wā e hiki mai ana.
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