E makaʻala hoʻi i kēia i ka wā hāpai: He aha ka Vasa Previa?

Hauʻoli loa ʻoe i ka lilo ʻana i makuahine, akā i kekahi manawa makaʻu iki ʻoe i nā mea liʻiliʻi, ʻeā? He mea maʻamau kēlā. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi e hiki ke kū i ka wā hāpai, he mea kakaʻikahi iki ia, akā hiki ke mālama maikaʻi ʻia inā ʻike ʻoe e pili ana i ia mea ma mua. Ua kapa ʻia kēia ʻo Vasa Previa. Mai hopohopo, e kamaʻilio mākou e pili ana i nā kikoʻī.

He aha ʻo Vasa Previa? E hoʻomaopopo maʻalahi kākou!

I ka ʻōlelo maʻalahi, he pilikia ka Vasa Previa e hiki ke hana i ka wā hāpai. ʻO kēia ka manawa e hele ai kekahi o nā kīʻaha koko i loko o ke kaula umbilical, ka mea e lawe ana i nā meaʻai i kāu pēpē, me ka pale ʻole ʻia ma o ka cervix. ʻO ka maʻamau, ua pale maikaʻi ʻia kēia mau kīʻaha koko e ka placenta.

E noʻonoʻo, i ka wā e hoʻomaka ai ka hānau ʻana, i ka wā e haki ai ka ʻeke amniotic, hiki i kēia mau kīʻaha koko pale ʻole ma ka cervix ke pohā. Inā hana ʻia kēlā, hiki i ka pēpē ke kahe nui ke koko a make paha. Eia nō naʻe, inā ʻike mua ʻia kēia kūlana a mālama pono ʻia, ʻoiai inā hānau ʻia ka pēpē ma o ka ʻoki cesarean (`C-section`), hiki ke pale loa ʻia kēia pilikia. No laila he mea nui e makaʻala i kēia.

ʻElua mau ʻano nui o Vasa Previa:

Ua hoʻokaʻawale nā ​​kauka i kēia maʻi i ʻelua ʻano nui. E nānā kākou i ke ʻano o lākou.

1. ʻAno 1: Vesa Previa me ka hoʻokomo ʻana o ke kaula Velamentous

He inoa paʻakikī paha kēia, akā, ʻaʻole paʻakikī ke hoʻomaopopo. ʻO ke komo ʻana o ke kaula velamentous, ʻo ia ka wā ʻaʻole i pili pono ke kaula umbilical i ka placenta, akā, aia kona mau kīʻaha koko e holo ana ma waho o ka placenta, me ka pale ʻole ʻia. ʻO ka maʻamau, ua pili pololei ke kaula umbilical i ka placenta.

E noʻonoʻo, inā he kīʻaha koko i pale ʻole ʻia e like me kēia, aia ma lalo o ka ʻōpū, kokoke i ka cervix (ua kapa ʻia kēia he 'placenta haʻahaʻa'), i ka wā e hoʻomaka ai ka hānau ʻana a neʻe ka pēpē i ka cervix, ʻoi aku ka nui o ka manawa e kīkoʻo ai kēlā kīʻaha koko a pohā.

2. ʻAno 2: Vesa Previa me ka Bilobed Placenta

ʻO kēia ka manawa ʻaʻole hoʻokahi ʻāpana kou placenta, akā ua māhele ʻia i ʻelua lobes, e like me ʻelua māmā. A laila hiki i ke kaula umbilical ke hoʻohui i kēia mau ʻāpana ʻelua. Inā hele nā ​​​​aʻa koko pale ʻole ma waena o kēia mau ʻāpana ʻelua kokoke i ka cervix, hiki iā lākou ke haki i ka wā e hoʻomaka ai ka hānau ʻana.

He aha ka ʻokoʻa ma waena o ka Vasa Previa a me ka Placenta Previa?

Ua like iki kēia mau inoa ʻelua, no laila hiki ke huikau. Akā, pili kēia mau mea ʻelua i ʻelua mau kūlana like ʻole.

• ʻO ka Placenta Previa ka wā e waiho ai ka placenta ma lalo o ka ʻōpū, e uhi ana i ka cervix āpau a i ʻole kekahi hapa, ma kahi o luna. Ke hoʻomaka ka hānau ʻana, hiki i nā kīʻaha koko e hoʻopili ana i ka placenta i ka ʻōpū ke kīkoʻo a kahe ke koko.
• ʻO ka mea nui, inā loaʻa iā ʻoe ka placenta previa a hoʻopau ʻia ma hope (placenta previa i hoʻonā ʻia) a i ʻole he placenta haʻahaʻa, piʻi ka pilikia o ka loaʻa ʻana o ka vasa previa. ʻO ke ʻano kēia he pilina paha ma waena o kēia mau kūlana ʻelua.

Pehea ke koʻikoʻi o Vasa Previa?

ʻO ka ʻoiaʻiʻo, he maʻi koʻikoʻi ka vesa previa e pono e mālama ʻia. Inā ʻaʻole i ʻike mua ʻia, hiki ke hānau ʻia ke pēpē ma ke ʻano he hānau make.

Akā, e hoʻomanaʻo i kēia: Inā ʻike ʻia kēia maʻi i ka wā hāpai (diagnosis prenatal), mālama pono ʻia, a hānau ʻia e kahi ʻoki cesarean i hoʻolālā ʻia (C-section), he 98.6% ka manawa e ola ai ka pēpē!

No laila, ma kahi o ka makaʻu, ʻo ka mea nui ka hoʻomaopopo pono ʻia a hahai i nā ʻōlelo aʻoaʻo lapaʻau.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia maʻi? (Nā kumu pilikia)

ʻO ka poʻe i ʻoi aku ka nui o ka loaʻa ʻana o Vasa Previa:

• Inā loaʻa iā ʻoe nā kūlana e like me ke 'hoʻokomo ʻana o ke kaula velamentous' (ʻaʻole i hoʻopaʻa pono ʻia ke kaula umbilical i ka placenta) a i ʻole ka 'placenta bilobed/multilobed' (ua māhele ʻia ka placenta i kekahi mau ʻāpana).
• Inā aia kou placenta ma lalo o ka ʻōpū, e uhi piha ana a hapa paha i ka cervix ('placenta previa' a i ʻole 'low-lying placenta').
• Inā ua loaʻa iā ʻoe kahi ʻāpana cesarean (C-section) ma mua.
• Inā hāpai ʻoe ma o ka hoʻoulu ʻana i loko o ka vitro (IVF - In Vitro Fertilization).
• Inā ʻoe e kali ana i nā māhoe a i ʻole nā ​​​​​​mākolu (`multiples`).
• Inā ua loaʻa iā ʻoe nā ʻoki ʻana o ka ʻōpū ma mua.

Inā loaʻa iā ʻoe kēia mau mea pilikia, e nānā nui aku kāu kauka iā lākou.

Pehea ka maʻamau o Vasa Previa?

He kūlana kākaʻikahi loa kēia. ʻIke pinepine ʻia ia ma kahi o hoʻokahi i loko o 2,500 mau hānau ʻana. Eia nō naʻe, i nā hihia o ka hoʻoulu ʻana i loko o ka vitro (IVF), ʻoi aku ka kiʻekiʻe o ka hanana, ma kahi o hoʻokahi i loko o 200 mau hānau ʻana.

He aha nā hōʻailona o Vasa Previa?

I ka manawa pinepine, ʻaʻole paha e hōʻike ka makuahine me ka vasa previa i kekahi mau hōʻailona. ʻO ia ke kumu he mea nui loa nā scan ultrasound i ka wā hāpai. Hiki i nā kauka ke ʻike i ke kūlana ma o kēia mau scan.

Eia nō naʻe, he mea kākaʻikahi loa, hiki i kekahi poʻe ke ʻike i kahi kahe koko liʻiliʻi o ka ʻōpū i ka wā o ka trimester ʻelua a ʻekolu paha o ka hāpai ʻana me ka ʻole o ka ʻeha. Hiki i kēia koko ke ʻulaʻula iki ma mua o ka maʻamau. ʻAʻole paha ia kou koko, akā he hōʻailona ia o ke koko fetal. Inā ʻike ʻoe i ke kahe koko ʻana o ka ʻōpū i kēlā me kēia manawa i ka wā hāpai, inā me ka ʻeha a ʻaʻohe paha, e ʻike koke i kāu kauka, ʻaʻohe mea liʻiliʻi.

He aha ke kumu o ka Vasa Previa?

ʻO ke kumu nui o kēia, e like me ka mea i ʻōlelo ʻia ma mua, ʻo ia ka hele ʻana o nā kīʻaha koko o ke kaula umbilical e hoʻopili ana iā ʻoe a me kāu pēpē me ka pale ʻole ma kahi kokoke i ka cervix. ʻO ka maʻamau, pili pololei ke kaula umbilical i ka placenta, a ua pale maikaʻi ʻia nā kīʻaha koko. Eia nō naʻe, ma ka vesa previa, ʻaʻole wale kēia kīʻaha koko e puka mai ana, akā aia pū kekahi kokoke i ka cervix, ʻo ia kahi e ʻomi nui ʻia i ka wā hānau.

Pehea e ʻike ʻia ai ka Vasa Previa?

ʻIke pinepine ʻia ka Vesa previa i ka wā o ka ultrasound scan ma waena o 18 a me 26 mau pule o ka hāpai ʻana. Inā hōʻike kāu scan i nā kumu pilikia no ka vasa previa, e like me ka bilobed placenta a i ʻole ka hoʻokomo ʻana o ke kaula velamentous, hiki i kāu kauka ke hana i kahi ultrasound scan kūikawā ma o kou vagina (transvaginal ultrasound) . Hiki i kēia ke ʻike maopopo inā he mau kīʻaha koko i loko o ke kaula umbilical kokoke i ka cervix (cervical os). I kekahi manawa hoʻohana pū nā kauka i kahi ʻenehana ultrasound i kapa ʻia ʻo Color Doppler . Hōʻike kēia i ke kahe koko i nā kala, e maʻalahi ai ka ʻike ʻana i kahi o nā kīʻaha koko.

E nānā pono ke kauka i kēia mau mea:

• Aia ma hea ka placenta e pili ana i ka cervix?
• Inā he nui nā lobes o ka placenta.
• Kahi e loaʻa ai ke kaula umbilical.

He aha nā lāʻau lapaʻau no ka Vasa Previa?

Inā ua ʻike ʻia ʻoe me ka vasa previa, e hoʻoholo paha kāu kauka e hānau i kāu pēpē ma o ka ʻoki cesarean i hoʻolālā ʻia (C-section). E nānā pono lākou iā ʻoe a me kāu pēpē i kou wā hāpai. ʻO ka pahuhopu nui o nā kauka ma ʻaneʻi, ʻo ia ka mālama ʻana i ka pēpē i loko o ka ʻōpū no ka lōʻihi e hiki ai, akā e hoʻomaka koke i ka hānau ʻana a hānau palekana i ka pēpē ma mua o ka hōʻino ʻia ʻana o nā kīʻaha koko.

Hiki i kāu hoʻolālā hāpai ke komo pū me:

• Nā hoʻāʻo ʻaʻole pilikia: Hana ʻia kēia mau hoʻāʻo ma kahi o ʻelua manawa i ka pule e nānā i ka puʻuwai o ka pēpē. He palekana loa lākou no ʻoe a me kāu pēpē.
• Corticosteroids: Hiki ke hāʻawi ʻia kēia mau lāʻau lapaʻau ma mua o ka ʻoki ʻana i ka cesarean e kōkua i ka ulu pono ʻana o nā māmā o ka pēpē. ʻO kēia no ka mea, ʻoiai e pono paha ke hānau ʻia ka pēpē i ka wā mua, he mea nui ka oʻo ʻana o ka māmā.
• Ka mālama ʻana i ka maʻi ma loko: Hiki i kāu kauka ke hoʻoholo e mālama iā ʻoe i loko o ka haukapila no ka nānā pono ʻana no kekahi mau lā ma mua o ka hānau ʻana o kāu pēpē. E hana ʻia kēia hoʻoholo ma muli o nā mea e like me kou mau kūlana olakino mua, ka hiki ke hānau mua ʻana, a me ka mamao o kou wahi noho mai ka haukapila.
• ʻO ka ʻoki caesarean i hoʻolālā ʻia (ma waena o 34 a me 37 mau pule):I mea e hōʻemi ai i nā pilikia e pili ana me ka vesa previa, e kamaʻilio kāu kauka me ʻoe e pili ana i ka manawa kūpono e hānau ai i kāu pēpē. ʻOiai ua hānau pinepine ʻia i ka wā mua, pono paha e mālama ʻia kāu pēpē ma ka Neonatal Intensive Care Unit (NICU) ma hope o ka hānau ʻana.

E hoʻoholo ʻia kāu hoʻolālā hāpai kikoʻī e kou kūlana, no laila he mea nui e hahai pololei i nā ʻōlelo a kāu kauka.

Hiki ke "hoʻoponopono" ʻia ka Vasa Previa?

ʻOiaʻiʻo, ʻaʻohe ala e "hoʻoponopono" ai i kahi kūlana i kapa ʻia ʻo vesa previa. ʻO ia hoʻi, ʻaʻole hiki iā ʻoe ke hoʻololi i ke ʻano o nā kīʻaha koko. Akā hiki iā ʻoe ke hoʻokele i ke kūlana a hana i kahi hoʻolālā e hānau pono ai i kahi pēpē olakino. E kamaʻilio me kāu kauka e pili ana i ka manawa kūpono e hānau ai i kāu pēpē me ka palekana no ʻoe a me kāu pēpē, a me ka wā e hana ai i kahi ʻoki cesarean.

Hiki ke hoʻemi ʻia ka pilikia o ka Vasa Previa?

ʻAʻole hiki iā ʻoe ke hōʻemi i ka pilikia o ka loaʻa ʻana o ka vesa previa. ʻAʻole ia he mea hiki iā mākou ke kaohi. Akā, hiki iā ʻoe ke hōʻemi i ka pilikia o nā pilikia koʻikoʻi loa e hiki mai ana mai ia mea. Pehea ʻoe e hana ai i kēlā? Ma ke hele ʻana i nā keʻena prenatal maʻamau a me ka hahai ʻana i nā ʻōlelo aʻoaʻo a kāu kauka. ʻO ka ʻike mua ʻana i kēia kūlana ke kī i ka hoʻokō ʻana i nā hopena maikaʻi loa.

Inā loaʻa iaʻu kahi vasa previa, he aha kaʻu e manaʻo ai?

Inā loaʻa iā ʻoe ka vasa previa, pono ʻoe e manaʻo i ka ʻoki cesarean (C-section) ma kahi o ka hānau ʻana ma ke ʻano vaginal. Pono nō hoʻi ʻoe e hana i nā hoʻokolohua nānā hou aʻe i kou wā hāpai. E kōkua kēia mālama keu iā ʻoe e hānau i kahi pēpē olakino.

Ke hoʻopilikia nei anei ka Vasa Previa i kahi pēpē?

ʻO ke ʻano o ka hopena o ke kūlana i ka pēpē ma muli o ka ʻike mua ʻia ʻana. Inā ʻaʻole ʻike ʻia ka vasa previa, hiki i ka nui o ka make ʻana o ka fetal ke piʻi a hiki i ka 56% a i ka 60%. Eia nō naʻe, inā ʻike ʻia i ka wā hāpai mua, mālama pono ʻia, a hānau ʻia ma o ka ʻoki cesarean, he 97% ka manawa e ola ai ka pēpē. I kekahi mau hihia, pono paha ka pēpē i ka mālama hou aku ma ka NICU ma hope o ka hānau ʻana, ʻoiai inā hānau mua ʻia ka pēpē. Eia nō naʻe, maikaʻi loa nā hopena o nā ʻoki cesarean me ka vasa previa.

Āhea wau e ʻike ai i kaʻu kauka?

E ʻike i kāu kauka i kēlā me kēia manawa i kou wā hāpai. Eia kekahi, e hele i nā scan ultrasound āpau i ʻōlelo ʻia. Inā ua ʻike ʻia ʻoe me ka vesa previa, pono paha ʻoe e ʻike pinepine i kāu kauka.

Inā ʻike ʻoe i ke kahe ʻana o ke koko i ka wā o ka trimester ʻelua a ʻekolu paha o kou hāpai ʻana, e ʻike koke i kāu kauka. Inā nui ke kahe ʻana o ke koko, e hele koke i ka keʻena pilikia o ka haukapila kokoke loa.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Inā loaʻa iā ʻoe ka reflux vesicoureteral, e nīnau i kāu kauka pehea e hōʻemi ai i ka pilikia o nā pilikia koʻikoʻi. Eia kekahi laʻana:

• "ʻOi aku ka maikaʻi iaʻu ke kāpae i ka moekolohe (hoʻomaha pelvic)?"
• "He aha nā ʻano maʻamau e hiki iaʻu ke hoʻokō e loaʻa ai kahi hāpai olakino?"

He mea weliweli ka loaʻa ʻana o nā pilikia i ka wā hāpai. Akā, ʻaʻole ia he manaʻo ʻaʻole hiki iā ʻoe ke loaʻa kahi hāpai olakino, ka hānau ʻana, a me ka pēpē. ʻO ka ʻike ʻana he vasa previa kou ka hana mua i ka hoʻolālā ʻana i kahi ʻoki cesarean holomua. E kamaʻilio me kāu kauka e pili ana i ka hopena o kāu hōʻailona i kāu mau hoʻolālā hānau.

Leka Lawe-Home

He maʻi kakaikahi akā koʻikoʻi ka Vasa Previa e hiki ke hana i ka wā hāpai.

• ʻO ka mea e hana ʻia ma kēia hihia , ʻo ia ke hele ʻana o nā kīʻaha koko o ke kaula umbilical o ke pēpē ma o ka cervix me ka pale ʻole ʻia.
• He mea nui loa ka ʻike mua ʻana. No ka mea, ʻaʻohe pinepine nā hōʻailona, ​​​​he mea nui e hana i nā scan maʻamau.
• ʻO ka lāʻau nui e mālama ai, ʻo ia ka hānau ʻana i ka pēpē ma o ka ʻoki caesarean i hoʻolālā ʻia (C-section).
• Me ka ʻike mua ʻana a me ka mālama pono ʻana, kiʻekiʻe loa ka manawa e hoʻopakele ai i ke ola o ke pēpē (ʻoi aku ma mua o 97%).
• E kamaʻilio mau me kāu kauka a e hahai i kā lākou ʻōlelo aʻo. Mai hopohopo, ʻaʻole ʻoe hoʻokahi. Me ka ʻike kūpono a me ke kākoʻo lapaʻau, hiki iā ʻoe ke hoʻoponopono i kēia kūlana me ka holomua.

ʻO Vasa Previa, hāpai keiki, nā pilikia hāpai keiki, ke kaula umbilical, placenta, ʻoki cesarean, olakino fetal, ʻike maʻi prenatal