ʻAʻole hiki ke hōʻike ʻia ka hauʻoli o ka makuahine a makua paha i ka nānā ʻana i kahi pēpē hānau hou ma nā huaʻōlelo. Eia naʻe, he mea kakaikahi loa, pono kekahi mau mākua e kū i kahi pilikia nui. ʻO ia hoʻi, ʻaʻole hiki iā lākou ke hoʻoholo maopopo inā he kaikamahine a he keikikāne paha ke pēpē ma ka nānā ʻana i nā ʻāpana o ke keiki hānau hou. Ua ʻike mākou he mea koʻikoʻi loa kēia a he mea hoʻokaumaha hoʻi i ka naʻau. ʻAʻole ʻoe hoʻokahi. I kēia lā, ke kamaʻilio nei mākou e pili ana i nā mea nui loa e pono ai ʻoe e ʻike i ia manawa.
He aha ka Ambiguous Genitalia?
I ka ʻōlelo maʻalahi, he ʻano kēia i loaʻa i ka wā hānau. I kēia hihia, paʻakikī ke ʻike maopopo i nā ʻāpana kino o waho o ke keiki he kāne a he wahine paha. I kekahi manawa ʻaʻole paha e ulu pono nā ʻōpū, a i ʻole he mau ʻano kāne a wahine paha ko lākou.
ʻO ka mea nui, ʻaʻole kēia he maʻi. He ʻokoʻa kēia i ka ulu ʻana o ka moekolohe. Ma nā huaʻōlelo lapaʻau, kapa mākou i kēia he "Nā ʻokoʻa o ka ulu ʻana o ka moekolohe" ( DSD ).
I ka manawa pinepine, ʻaʻole kūlike ke ʻano o waho o ke keiki me ko lākou wahine kūloko (ʻōpū, ovaries, a i ʻole testicles) a i ʻole ko lākou wahine genetic. ʻAʻole kēia he maʻi maʻamau loa. Hoʻopilikia ia ma kahi o 1 i loko o 1,000 a 4,500 mau pēpē.
He aha nā hōʻailona e ʻike ʻia ma kēia kūlana?
ʻO ke ʻano nui, ʻaʻole like ke ʻano o nā ʻāpana kino o waho me kahi penis a vagina maʻamau. Akā hiki ke ʻokoʻa kēia mai kekahi keiki a i kekahi keiki. Aia ia i ke kumu i hoʻopilikia i ka ulu ʻana o ka moekolohe. E nānā kākou pehea e ʻike ʻia ai kēia ʻano ma nā kaikamahine a me nā keikikāne ma ke ʻano genetic.
| Nā ʻano e ʻike ʻia inā he wahine ke keiki ma ke ʻano genetic (XX) | Nā ʻano e ʻike ʻia inā he kāne ke keiki (XY) |
|---|
| Lilo ka clitoris i mea nui aʻe ma mua o ka maʻamau a ke nānā aku nei e like me ka penis liʻiliʻi. | Hiki ke liʻiliʻi loa ka penis (e like paha me ka penis liʻiliʻi) a ʻaʻole paha e ulu iki. |
| Ua pili pū nā labia, e like me ka scrotum. | Aia ka puka urethral ma ke kumu o ka penis, ma kahi o ka wēlau. (Ua kapa ʻia kēia ʻo Hypospadias) |
| Kahi ʻē o ka wehe ʻana o ka urethral. | He liʻiliʻi ka scrotum, hāmama, a ua like ke ʻano me ka labia. |
| He wahi o nā ʻiʻo i loko o ka labia i hiki ke kuhihewa ʻia me nā testicles. | ʻAʻole i iho nā testicles i loko o ka scrotum. |
Eia kekahi, hiki ke ʻike ʻia nā hemahema hormonal, ka lohi a i ʻole ka wā ʻōpiopio mua, a me nā kūlana ʻē aʻe ma hope.
Pehea e ʻike ʻia ai kēia maʻi? (Diagnosis)
Hoʻomaopopo pinepine ka hui lapaʻau i ke kūlana i ka wā hānau. I kekahi manawa, hiki i nā scan i ka wā hāpai ke hāʻawi i kahi kuhi, akā ʻaʻole i hōʻoia ʻia a hiki i ka hānau ʻana o ka pēpē. E nīnau mua kāu
kauka a me ka hui lapaʻau e pili ana i ka mōʻaukala olakino o kou ʻohana. A laila, pono lākou e hana i kekahi mau hoʻokolohua e hoʻoholo ai i ke kāne maoli o ka pēpē a me ke kumu pololei o ke kūlana.
- Nā hoʻāʻo koko : E nānā i nā chromosomes o ka pēpē (XX a i ʻole XY) a me nā pae hormone .
- Nā hoʻāʻo kiʻi : ʻO nā hoʻāʻo e like me nā scan ultrasound, X-ray , a i ʻole MRI scan e nānā i nā ʻōpū i loko o ke kino o ke pēpē, e like me ka uterus , ovaries, a i ʻole testicles .
- Nā hoʻokolohua kūikawā: I kekahi mau hihia, hiki ke lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai nā ʻōpū no ka hoʻokolokolo ʻana (`Biopsy`) a i ʻole e hoʻohana ʻia kahi kāmela liʻiliʻi e nānā i loko o ke kino (`Laparoscopy`).
He aha ke kumu o kēia?
Hiki mai kēia kūlana ke ālai ʻia ka ulu ʻana o nā ʻōpū i nā wā mua o ka ulu ʻana o ka pēpē i loko o ka ʻōpū. Aia kekahi mau kumu nui:
- Nā pilikia hormonal:ʻAʻole loaʻa i kahi fetus kāne (XY) nā hormones kāne lawa e hoʻomohala ai i nā ʻāpana kāne, a i ʻole ua hōʻike ʻia kahi fetus wahine (XX) i nā hormones kāne.
- Nā loli hoʻoilina: Nā loli ʻana i loko o kekahi mau genes e hoʻopilikia i ka ulu ʻana o ka moekolohe ('nā genes i hoʻololi ʻia').
- Nā ʻano ʻē o ka Chromosomal: He ʻano ʻē i nā chromosomes o ke pēpē, e like me ka nalowale a i ʻole ka loaʻa ʻana o kahi chromosome.
Nā kumu pilikia
Hiki i ka mōʻaukala ʻohana ke pāʻani i kahi kuleana. Inā loaʻa i kekahi o kou ʻohana nā kūlana ma lalo nei, ʻoi aku paha kou pilikia:
- Ka make ʻana o nā pēpē me ke kumu i ʻike ʻole ʻia.
- Hiki i nā wāhine o ka ʻohana ke pilikia i ka hānau ʻana i nā keiki, ka pau ʻana o ka menstruation, a i ʻole ka ulu nui ʻana o ka lauoho maka.
- Aia kekahi o ka ʻohana me nā ʻano ʻē o ka ʻōpū.
- Nā ʻano ʻē i ka wā ʻōpio.
- Nā maʻi hoʻoilina e hoʻopilikia ana i nā kelepa adrenal, e like me Congenital Adrenal Hyperplasia (CAH) .
Inā ʻoe e hoʻolālā ana e loaʻa kahi keiki a he moʻolelo ʻohana kou no kēia, he mea nui loa
e ʻike i kahi loea a kamaʻilio e pili ana.
Pehea e hana ʻia ai ka lāʻau lapaʻau a he aha ka mea e hana ai ma hope?
No ka mea he pilikia paʻakikī a koʻikoʻi kēia, ʻaʻole hoʻokahi kauka wale nō e hana i nā hoʻoholo. E kōkua
kahi hui o nā loea iā ʻoe a me kāu keiki. ʻO ka maʻamau, hiki i kēia hui ke komo pū me:
- Neonatologist: He kauka i loea i nā pēpē hānau hou.
- Endocrinologist: He kauka i loea i nā hormones.
- He loea i nā genes a me nā chromosomes: He loea i nā genes a me nā chromosomes.
- Urologist: He loea i nā ʻōnaehana mimi a me ka hānau keiki.
- Kauka Lapaʻau: He kauka nāna e hana i ke ʻoki kino inā pono.
- Kauka Noʻonoʻo: He loea e hāʻawi i ke kākoʻo noʻonoʻo iā ʻoe a me kāu keiki.
E kōkua pū kēia hui iā ʻoe e hoʻoholo i ka hoʻokaʻawale ʻana i ke kāne kūpono loa no kāu keiki ma muli o nā hopena o ka hoʻāʻo. Hiki i ka lāʻau lapaʻau ke komo pū me
ka lāʻau hoʻololi hormone a i ʻole
ke ʻoki hana hou . Hiki ke hana ʻia nā ʻoki kino e pono ai ke olakino, e like me ka hoʻoponopono ʻana i kahi wehe ʻana o ke ala mimi, i ka wā kamaliʻi. Eia nō naʻe, hiki ke hoʻopanee ʻia nā ʻoki kino hoʻonani a hiki i ka wā e lawa ai ke keiki e hoʻomaopopo ai, a hiki i nā mākua a me ke hui lapaʻau ke hoʻoholo pū inā e hoʻopanee i ke kaʻina hana ma muli o ko lākou makemake.
Ka wā e hiki mai ana o ke keiki
He mea maʻamau iā ʻoe ke loaʻa nā nīnau e like me, "E hiki anei i kaʻu keiki ke hānau keiki i ka wā e hiki mai ana?" a "E loaʻa anei nā pilikia e pili ana i kona ʻano moekolohe?"
- Ka loaʻa ʻana o nā keiki:Ma muli o ke kumu o ke kūlana, hiki paha i kekahi poʻe ke loaʻa nā keiki i ka wā e hiki mai ana. No ka laʻana, hiki i nā kaikamahine me Congenital Adrenal Hyperplasia ke hāpai ma hope o ka mālama ʻana i ka hormone.
- ʻIke Wahine: ʻAʻole nā chromosome wale nō e hoʻoholo i ka ʻike wahine o ke kanaka. He kuleana ko ka hana o ka lolo a me nā mea pili kaiaulu. No laila, he mea nui e kūkākūkā i kēia me kahi hui lapaʻau akamai a hana i kahi hoʻoholo e hāʻawi i ke keiki i ka wā e hiki mai ana maikaʻi loa.
ʻO ka mea nui loa, ʻo ia ka mālama mau ʻana i ke olakino noʻonoʻo o kāu keiki i ko lākou ulu ʻana. Aia mau nā kauka a me nā kākāʻōlelo akamai e hāʻawi iā ʻoe a me kāu keiki i ke kākoʻo e pono ai lākou ma kēia huakaʻi.
Leka Lawe-Home
- He maʻi laha ʻole ka Ambiguous Genitalia a ʻaʻole ia i hana ʻia e ka hewa o nā mākua.
- I ka wā e ʻike ʻia ai kēia maʻi, he mea nui e ʻimi i ke kōkua o kahi hui lapaʻau loea. Mai hoʻoholo hoʻokahi.
- He hoʻoholo paʻakikī loa ka hāʻawi ʻana i kahi ʻike kāne a wahine i kahi keiki. Pono e noʻonoʻo i nā hōʻike lapaʻau a me nā ʻōlelo aʻoaʻo a pau.
- ʻOi aku ka mea nui ma mua o ka mālama ʻana, ʻo ia ke kākoʻo naʻau a me ke aloha i hāʻawi ʻia i ke keiki a me ka ʻohana holoʻokoʻa.
- E kamaʻilio ākea me kāu kauka e pili ana i nā nīnau, nā makaʻu, a i ʻole nā kānalua āu e loaʻa ai.
ʻO nā Genitalia Ambiguous, DSD, Kāne a ka Pēpē, Nā Hormones, Nā Chromosomes, Nā Maʻi Genetic, Congenital Adrenal Hyperplasia
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