Ke puka nei nā ʻōpū o kāu pēpē i waho? E kamaʻilio kākou e pili ana i kēia maʻi laha ʻole (Gastroschisis)

Inā he makuahine hānau ʻoe, hopohopo paha ʻoe no ke olakino o kāu pēpē i hānau ʻole ʻia. I kekahi manawa, ma hope o ka scan, ʻōlelo ke kauka i kahi mea koʻikoʻi, a he mea maʻamau ke manaʻo nui i ka makaʻu a me ka hopohopo. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi kīnā hānau kakaikahi loa i hopohopo iki, akā hiki ke loaʻa nā hopena maikaʻi inā mālama pono ʻia. Ua kapa ʻia kēia ʻano ʻo Gastroschisis (GAS-tro-schi-sis).

I ka ʻōlelo maʻalahi, he aha ka Gastroschisis?

ʻO Gastroschisis kahi maʻi i hānau ʻia ai kahi pēpē me kahi lua ma lalo pono o ko lākou pihi ʻōpū, kahi e puka mai ai nā ʻōpū a me kekahi manawa nā kino ʻē aʻe, e like me ke akepaʻa a me ka ʻōpū. E noʻonoʻo e pili ana i ia mea, i ka wā e ulu mua ana kahi pēpē i loko o ka ʻōpū, ʻaʻole e ulu pono nā ʻiʻo ʻōpū. ʻO kēia hakahaka liʻiliʻi e hiki ai i kēia mau kino ke puka mai.

Pono nā pēpē me kēia maʻi i ke ʻoki kino i ka wā hānau. Pono nō hoʻi lākou e noho ma ka Neonatal Intensive Care Unit no kekahi manawa pōkole ma mua a ma hope o ke ʻoki kino. Ma ke ʻano he mau mākua, hiki ke hopohopo kēia, akā ʻo ka hapa nui o nā pēpē e hoʻōla maikaʻi ma hope o ke ʻoki kino.

He aha ka ʻokoʻa ma waena o Gastroschisis a me Omphalocele?

He mau kūlana kakaikahi kēia mau kūlana ʻelua kahi e puka mai ai nā ʻōpū ma o kahi lua i loko o ka ʻōpū o ke pēpē. Akā, aia nā ʻokoʻa maopopo ma waena o nā mea ʻelua. E nānā i ka papa ma lalo nei e hoʻomaopopo i ka ʻokoʻa.

Hiki i kāu kauka hānau keiki ke nānā i kekahi o kēia mau kūlana i ka wā o kahi scan maʻamau i ka wā hāpai.

He aha nā hōʻailona o kēia maʻi?

ʻAʻole paha ʻoe e ʻike i kekahi mau hōʻailona i ka wā hāpai. ʻIke wale ʻia kēia ma o ka scan ʻana o ka pēpē. Hiki i ke kauka ke ʻike i nā mea e like me kēia i ka wā o ka scan:

• Me he mea lā e lana ana nā ʻōpū o ke pēpē, e like me nā naʻau a me ka ʻōpū, ma waho o ke kino.
• Ua pehu a wili pū paha nā ʻōpū.
• I kekahi manawa hāʻule ka mahana o ke kino o ke pēpē (Hypothermia).

He aha nā kumu o Gastroschisis?

ʻAʻohe kumu hoʻokahi no kēia. I ka hapanui o nā hihia, ʻo ia ka hopena o ka hui pū ʻana o nā kumu. Eia kekahi mau kumu i ʻike ʻia e hoʻonui ana i ka pilikia:

• Hāpai i ka wā ʻōpiopio: Kiʻekiʻe loa ka pilikia no nā makuahine ʻōpio.
• Puhipaka: Ka puhipaka ʻana i ka wā hāpai, ʻoi aku hoʻi i nā mahina mua.
• Ka inu ʻana i ka waiʻona: Ka hoʻohana ʻana i ka waiʻona i ka wā hāpai.
• Ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau a lāʻau lapaʻau paha.
• Ka helu kaumaha o ke kino o ka makuahine (BMI): Ka pohō kaumaha maʻamau ʻole o ka makuahine i ka wā hāpai.
• Nā maʻi e like me nā maʻi ʻōpū mimi: Ua loaʻa i ka makuahine nā maʻi e like me nā maʻi ʻōpū mimi 3 mau mahina ma mua o ka hāpai ʻana a i ʻole i nā mahina 3 mua o ka hāpai ʻana.
• Nā loli i nā genes a i ʻole nā ​​chromosomes o ke pēpē.

Pehea e ʻike ai i kēia maʻi?

Hiki ke ʻike pinepine ʻia kēia ʻano i ka wā o ka scan ma waena o 18 a me 20 mau pule o ka hāpai ʻana. ʻO nā hoʻāʻo nui i hoʻohana ʻia no kēia:

• Ultrasound: ʻO kēia ke ʻano nui o ka ʻike ʻana. Hiki ke ʻike maopopo ʻia nā ʻōpū o ke pēpē e lana ana i loko o ka ʻōpū.
• Ka hoʻāʻo koko o ka makuahine:I kekahi manawa, hoʻāʻo ʻia ke koko o ka makuahine no kahi protein i kapa ʻia ʻo alpha-fetoprotein (AFP). Inā kiʻekiʻe loa ke kiʻekiʻe, manaʻo ʻia ka gastroschisis. A laila hōʻoia ʻia kēia me kahi scan.
• ʻO ka Echocardiogram Fetal: He scan kūikawā nō hoʻi kēia. Hiki i kekahi mau pēpē me ka gastroschisis ke loaʻa nā pilikia puʻuwai. No laila, hana ʻia kēia scan e nānā i ka hana o ka puʻuwai o ka pēpē.

Inā loaʻa i ke pēpē ka Gastroschisis, pehea e mālama ai i ka wā hāpai?

Inā ua ʻike ʻia kāu pēpē me kēia maʻi, pono ʻoe a me kāu pēpē i ka nānā kūikawā. E kuhikuhi aku kāu kauka iā ʻoe i kahi hui o nā loea.

• Loea lapaʻau makuahine-kōpū: He kauka loea i nā hāpai keiki pilikia kiʻekiʻe.
• Neonatologist: He kauka i loea i nā pēpē hānau hou, ʻoiai ka poʻe maʻi a hānau mua paha.
• Kauka lapaʻau pediatric: He mea nui ka ʻōlelo aʻo a kēia kauka no ka mea pono ke ʻoki ʻana i ka wā e hānau ai ka pēpē.

I loko o kēia manawa, pono ʻoe e hana i nā scan pinepine e nānā i ka ulu ʻana o kāu pēpē. Hiki ke aʻo ʻia ʻoe e helu i nā neʻe ʻana o kāu pēpē (ka helu o nā neʻe ʻana) no kahi o ʻelua hola i ka lā, e hoʻomaka ana ma kahi o 26 mau pule.

Pehea e mālama ʻia ai?

ʻO ke ʻoki ʻana ke ʻano o ka mālama ʻana i ka gastroschisis.

I ka manawa pinepine, hoʻoholo nā kauka e hoʻoulu i ka hānau ʻana ma mua iki o ka maʻamau, ma waena o 35 a me 37 mau pule. ʻAʻole pono kēia ʻano maʻi i ka ʻoki ʻoki cesarean, akā he mea nui e hoʻolālā no ka hānau ʻana ma kahi haukapila me kahi keʻena mālama koʻikoʻi neonatal (NICU) no ka mea e pono ana ka pēpē i ka mālama kūikawā ke hānau ʻia.

I ka wā e hānau ai ke pēpē, hana ʻia ke ʻoki kino e hoʻokomo i nā ʻōpū i puka mai i waho i loko o ka ʻōpū a pani i ka lua. ʻElua mau ʻano hana nui no ka hana ʻana i kēia ʻoki kino.

1. Hoʻoponopono Mua (ʻoki kino hoʻokahi): Inā he liʻiliʻi ka helu o nā ʻōkana i puka mai a ʻaʻole i hōʻino nui ʻia, e hoʻihoʻi ʻia nā ʻōkana i loko o hoʻokahi ʻoki kino ma hope koke iho o ka hānau ʻana a pani ʻia ka ʻōpū.

2. Hoʻoponopono Paepae: Hoʻohana ʻia kēia kaʻina hana inā ua puka mai nā ʻāpana he nui a ua pehu paha. Ma kēia kaʻina hana, hoʻokomo ʻia nā ʻāpana o ke pēpē i loko o kahi ʻeke palakika pale kūikawā (i kapa ʻia he 'silo') ma hope koke o ka hānau ʻana. Mālama kēia i nā ʻāpana. A laila, hoʻihoʻi mālie ʻia nā ʻāpana i loko o ka ʻōpū i loko o kekahi mau lā. Ke hoʻokomo piha ʻia lākou, pani ʻia ka lua ma ke ʻoki ʻana.

Ma hope o ke ʻoki kino, e kau ʻia ke pēpē ma luna o kahi mīkini hanu e kōkua iā ia e hanu ma muli o ke kaomi kiʻekiʻe i loko o kona ʻōpū.Pono paha e hoʻopili. Eia kekahi, a hiki i ka hoʻomaka ʻana o nā ʻōpū e hana pono, pono e hānai ʻia ka pēpē ma o kahi aʻa (IV). Pono paha kēia i ka pēpē e noho ma ka haukapila no kekahi mau pule, a ʻoi aku paha ka lōʻihi.

He aha nā pilikia e hiki ke hana ma muli o kēia ʻano?

ʻO ka hōʻike ʻana i ka wai amniotic hiki ke hōʻino i nā ʻōpū. ʻO ka hopena, hiki i kekahi mau pēpē ke loaʻa nā pilikia e like me:

• Ka paʻakikī i ka hoʻopili ʻana i ka meaʻai a me ka omo ʻana i nā meaolaola.
• ʻO ka atresia ʻōpū.
• Ka wili ʻana o nā ʻōpū (Volvulus).
• Ka hōʻino ʻia ʻana o nā ʻiʻo ma muli o ke ālai ʻana o ke kahe koko i ka ʻōpū (infarction).

ʻOiai ma hope o ke ʻoki ʻana, hiki ke loaʻa nā pilikia e like me nā maʻi a me ka paʻakikī i ka ʻai ʻana. Eia nō naʻe, ke nānā pono ʻia nei kēia mau mea a pau e ka hui lapaʻau.