Aia nō hoʻi ʻoe i ka pilikia o ka hānau ʻana o kahi pēpē ma mua o kou lā hānau? (Preterm Labour) E makaʻala kākou…

Inā ʻoe e hāpai ana i kahi pēpē, ke manaʻo nei paha ʻoe i kahi makaʻu iki a me ka hauʻoli i kēia mau lā, ʻeā? He mea maʻamau ke noʻonoʻo inā e holo pono nā mea āpau a inā e hānau olakino ʻia ke pēpē. I kēia manawa, i kekahi manawa lohe mākou, "Auē, ua hiki mai ke pēpē ma mua o ka lā hānau!" No laila i kēia lā, e kamaʻilio kākou e pili ana i kēia kūlana o ka hoʻomākaukau ʻana no ka hānau ʻana ma mua o ka lā hānau , a i ʻole e like me ke kāhea ʻana o nā kauka , (Preterm Labor) . E kamaʻilio kākou ma nā ʻōlelo maʻalahi e pili ana i ke ʻano maoli, no ke aha e hana ʻia ai, hiki iā kākou ke pale aku, a me ka mea e hana ai inā hana ʻia.

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He aha ka hānau mua ʻana?

I ka ʻōlelo maʻalahi, ʻo ke ʻano o ka "(Preterm Labor)" ke hoʻomākaukau nei kou kino no ka hānau keiki ma mua o ka hebedoma 37 o kou hāpai ʻana. ʻO ka maʻamau, he 40 mau pule ka lōʻihi o ka hāpai ʻana. Ke pau nā hebedoma 37, ʻōlelo mākou ua "hiki ʻoe i ka manawa". Ma mua o kēlā, ʻo ia hoʻi, ma mua o 37 mau pule , inā hoʻomaka ʻoe e hōʻike i nā hōʻailona o ka hānau ʻana, ʻo ia hoʻi ka "(Preterm Labor)".

ʻO ka hānau keiki ke kaʻina hana e hoʻomākaukau ai kou kino no ka hiki ʻana mai o kāu pēpē. Pili kēia i ka hoʻopaʻa ʻana a me ka hoʻomaha ʻana o nā ʻiʻo o kou ʻōpū (contractions) a me ka haki ʻana o kou mau membrane (rupture of membranes) . I ka hānau mua ʻana, ʻo ka ʻaoʻao haʻahaʻa o kou ʻōpū, i kapa ʻia ʻo ka cervix , e hoʻomaka paha e wehe (a i ʻole e hoʻonui) ma mua o ka maʻamau.

E noʻonoʻo, i ka wā e kokoke ana ʻo Nalini e hānau i kāna pēpē ʻelua, ua hoʻomaka ʻo ia e loaʻa i nā ʻeha ʻōpū liʻiliʻi ma kahi o ka mahina 7. I ka nānā ʻana o ke kauka iā ia, ua ʻike ʻo ia ua hoʻonui iki ʻia kona cervix. Pēlā ke ʻano o kēia.

Akā, ʻaʻole kēia manaʻo e hānau mua ʻia ka pēpē. I kekahi manawa, hiki i nā kauka ke hoʻōki i ka hānau ʻana a hoʻokuʻu i ka pēpē e ulu i loko o ka ʻōpū no kekahi mau lā hou aku. Hiki ke hana ʻia kēia me ka hoʻomaha moe , nā wai intravenous (nā wai IV) , a me nā lāʻau lapaʻau e hoʻomaha ai i ka ʻōpū.

Eia kekahi, i kekahi mau hihia, no nā kumu lapaʻau e pili ana i ka pēpē a i ʻole ka makuahine, hoʻoholo nā kauka e hānau koke i ka pēpē. No ka laʻana, inā he koko kiʻekiʻe i ka wā hāpai (Preeclampsia), kahi kūlana e like me ka placental abruption, a inā ʻaʻole ulu pono ka pēpē (Fetal growth restriction).

He aha ka hānau ʻana ma mua o ka manawa? (He aha ka hānau ʻana ma mua o ka manawa?)

ʻO ka hānau mua ʻana, a i ʻole ka hānau mua ʻana, ʻo ia ka wā e hānau ʻia ai kahi pēpē ma mua o ka hebedoma 37 o ka hāpai ʻana. Hiki i nā pēpē i hānau mua ʻia i kēia wā ke loaʻa i kekahi mau pilikia olakino, e like me ka pilikia hanu a me ke kaumaha hānau haʻahaʻa. ʻO ia ke kumu e hoʻoikaika ʻia ai e mālama i ka pēpē i loko o ka ʻōpū no ka lōʻihi e like me ka hiki.

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He aha ka mea e hoʻoulu ai i ka hānau mua?

He mea paʻakikī ke ʻōlelo pololei i ke kumu o ka hānau mua ʻana. Aia kekahi mau kumu e hiki ke kōkua i ia mea. Pili kekahi o lākou i kou mōʻaukala olakino, nā hāpai mua, a me kou nohona. Akā ʻo ka mea kupanaha, i kekahi manawa hiki i ka poʻe me nā kumu pilikia ʻole ke loaʻa i kēia maʻi.

Hiki ke hoʻōki ʻia ka hānau keiki ma mua o ka manawa?

I kekahi manawa hiki, akā i ka hapa nui o ka manawa he manawa pōkole wale nō ia. Inā ʻoe i ka hānau mua ʻana, hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e hoʻōki a hoʻopaneʻe paha i ka hānau ʻana. ʻOiai ʻaʻole e hoʻōki loa kēia mau lāʻau lapaʻau, hiki iā lākou ke kōkua i ka ulu ʻana o nā māmā o kāu pēpē a me nā kino ʻē aʻe inā hānau mua lākou.

Loaʻa iā ʻoe kēia mau hōʻailona pū kekahi? E makaʻala! (Pehea ʻoe e ʻike ai inā ʻoe e hānau mua ana?)

He mea nui e ʻike i nā hōʻailona o ka hānau mua ʻana. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, a ʻaʻole lākou e hoʻomaikaʻi i loko o hoʻokahi hola, a inā he koʻikoʻi a mau ka ʻeha, e kāhea koke i kāu kauka.

Inā ʻūmiʻi ka ʻōpū a hoʻomaha i ʻehā a ʻoi aku paha manawa i loko o hoʻokahi hola (constriction) , a ʻaʻole ia e emi iho ma hope o ka hoʻololi ʻana i ke kūlana a i ʻole ka hoʻomaha ʻana.
Inā ʻike pinepine ʻoe i ka ʻeha paʻa a ʻeha paha ma kou kua haʻahaʻa e hele mai a hele aku, a inā paha e hoʻomau nei (ʻoiai ke hoʻololi ʻoe i nā kūlana a noho paha i kahi kūlana ʻoluʻolu).
He ʻehaʻeha ma ka ʻōpū lalo, e like me ka ʻōpū piha i ke kinoea (hiki ke hele pū me ka maʻi pākī a i ʻole me ka ʻole o ka maʻi pākī).
Inā ʻoe e manaʻo i ke kaomi nui i loko o kou vagina a i ʻole pelvis.
ʻO ka ʻeha ʻōpū mau, e like me ka mea e hele mai me ka menstruation.
Inā he nui ka hoʻokahe ʻana o ka ʻōpū, a inā he ʻano lahilahi a poni paha ke kahe ʻana.
Inā kahe kahi wai wai mai ka vagina, he wai amniotic paha kēia.
Inā he kahe koko o ka ʻōpū.
Nā hōʻailona e like me ke kuni, ʻo ia hoʻi nā mea e like me ka nausea a me ka luaʻi.
Ka emi ʻana o ka neʻe ʻana o ka pēpē (inā ʻaʻole neʻe ka pēpē ma ka liʻiliʻi he ʻeono manawa i ka hola).

ʻO ka mea nui loa, ʻo ia ke ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona a i ʻole kānalua paha. Mai hoʻoholo wale!

Pehea e nānā ai no nā ʻūmiʻi?

I kekahi manawa ʻaʻole paha ʻoe e manaʻo nei i nā ʻūmiʻi maoli, akā, he mau ʻūmiʻi wahaheʻe, i kapa ʻia ʻo Braxton Hicks contractions , ʻo ia kekahi ala no kou kino e maʻa ai i ka hana. Hoʻokokoke mai nā ʻūmiʻi maoli a ʻoi aku ka ʻeha. ʻAʻole lākou e pau ʻoiai ke hoʻomaha ʻoe a hoʻololi paha i nā kūlana. Inā ʻaʻole ʻoe maopopo inā he ʻūmiʻi maoli ka mea āu e manaʻo nei a ʻaʻole paha, e kamaʻilio me kāu kauka.

He aha nā kumu pilikia no ka hānau ʻana i kahi pēpē i ka wā ʻōpiopio? (He aha ke kumu o ka hānau mua ʻana?)

Nui nā kumu e hiki ai ke hānau mua ʻia. Hiki iā mākou ke kāohi i kekahi o lākou, a ʻaʻole hiki i kekahi.

ʻEkolu mau kumu pilikia nui i loaʻa ka hopena nui loa:

Inā ua hānau mua ʻoe i ka wā ʻōpiopio .
Inā hāpai ʻoe me nā māhoe, nā triplets a ʻoi aku paha .
Inā loaʻa iā ʻoe, a i ʻole ua loaʻa iā ʻoe kekahi mau pilikia me kou ʻōpū, cervix, a i ʻole vagina .

Nā mea pilikia e pili ana i ka hāpai ʻana:

Inā he kahe koko o ka ʻōpū i ka wā hāpai.
Inā ua hāpai ʻoe ma o kahi ʻano hana e like me ka (IVF) (in vitro fertilization) .
Inā he kānalua he kīnā hānau ko ka pēpē i loko o ka ʻōpū.
Inā pōkole ka manawa ma waena o kekahi hāpai ʻana a me kekahi (no ka laʻana, e hāpai hou ana ma lalo o 12-18 mau mahina).

Nā mea pilikia e pili ana i ka makahiki a me ka lāhui:

Inā ʻoe ma lalo o 17 a ʻoi aku paha ma mua o 35 mau makahiki .
Ua hōʻike kekahi mau noiʻi he mea maʻamau kēia ʻano ma waena o kekahi mau hui lāhui (he ʻike ʻepekema wale nō kēia, ʻaʻole i maʻamau i nā kānaka a pau).

Nā mea pilikia e pili ana i ke ʻano o ka nohona:

Ka nele o ka mālama ʻana i ka wā hāpai .
Ka pohō a i ʻole ka piʻi ʻana o ke kaumaha ma mua o ka hāpai ʻana.
ʻAʻole lawa ke kaumaha i ka wā hāpai.
Ma hope o kahi papaʻai maikaʻi ʻole .
Ka puhipaka, ka inu ʻana i ka waiʻona, a i ʻole ka hoʻohana ʻana i nā lāʻau lapaʻau ʻole .
Loaʻa i kahi hana koi kino (kū no nā hola o ka lā, a hana paha no nā hola).
Ke kaumaha nui nei a i ʻole ka hopohopo nui .
ʻO ka ʻike ʻana i nā mea e hōʻino ai i ka pēpē (teratogens), e like me nā kemika ʻawahia, ke kēpau, a me ka radiation .

Nā mea pilikia e kū mai ana ma muli o nā kumu olakino:

Nā maʻi ʻōpū i mālama ʻole ʻia (e.g., nā maʻi ʻōpū mimi (UTI), nā maʻi i laha ma ke moekolohe (STI), a i ʻole nā maʻi ʻōpū a i ʻole nā maʻi ʻōpū ʻē aʻe).
ʻO nā kūlana e like me nā maʻi pili o nā ʻiʻo, no ka laʻana ʻo Ehlers-Danlos syndrome (EDS) .
Nā pilikia placental, e like me ka placental abruption a i ʻole ka placenta previa .
ʻO ka wai amniotic ('Polyhydramnios') a i ʻole ka wai amniotic ('Oligohydramnios') .
ʻO ka pūpū pōkole a i ʻole ka ʻōpū ʻano like ʻole (e laʻa.
Ma hope o ka hana ʻoki kino mua ʻana ma ka cervix a i ʻole ka uterus .
Loaʻa iā ʻoe nā maʻi e like me ka maʻi diabetes mellitus, ke koko kiʻekiʻe, a i ʻole nā maʻi ʻaʻai koko .
Loaʻa i ke ʻano i kapa ʻia ʻo "Intrahepatic cholestasis of pregnancy (ICP)", he maʻi akepaʻa e kū mai ana i ka wā hāpai.

Pehea e ʻike ai ke kauka i kēia? (Pehea e ʻike ʻia ai ka hānau mua ʻana?)

E nānā mua kāu kauka i kou cervix e ʻike inā ʻoe e hānau mua ana. Inā ua hoʻopau ʻia a hoʻonui ʻia kou cervix, aia paha ʻoe i ka hānau mua ʻana. Ma waho aʻe o kēia hoʻokolokolo kūloko, hiki i kāu kauka ke:

ʻO ke scan Ultrasound: Hiki i kēia ke nānā i ka nui o ke pēpē, kona kūlana i loko o ka ʻōpū, a inā he mau pilikia me ka placenta a i ʻole ka wai amniotic.
E nānā i nā ʻūmiʻi: Hiki ke hoʻopili ʻia ʻoe i kahi mīkini e ana i ke ʻano o kāu mau ʻūmiʻi.
Hoʻāʻo fibronectin fetal: Lawe ʻia kahi laʻana o kou wai vaginal a nānā ʻia no ke alo o kahi protein i kapa ʻia ʻo fetal fibronectin. He protein kēia e kōkua i ka ʻeke amniotic e hoʻopili i ka uterus. ʻO kona alo ʻana i loko o ka wai vaginal ʻo ia hoʻi ua hoʻomaka paha ka hānau ʻana.

He aha ka hana a nā kauka no kēia? / He aha nā lāʻau lapaʻau? (Pehea e mālama ai nā kauka i ka hānau mua ʻana?)

Inā ʻoe e hānau mua ana, pono paha ʻoe i ka lāʻau lapaʻau e hoʻolohi a hoʻōki paha i nā ʻūlū. Inā ua lōʻihi loa nā ʻūlū a ʻaʻole hiki ke hoʻōki ʻia, pono paha i kāu kauka ke hānau koke i kāu pēpē. Aia kekahi mau lāʻau lapaʻau e hiki ke kōkua i ka ulu ʻana o nā māmā o kāu pēpē a me nā ʻōpū ʻē aʻe inā hānau mua ʻia lākou. E noʻonoʻo kāu kauka i kēia mau mea:

ʻEhia pule o kou hāpai ʻana?
He palekana anei ka hānau ʻana o kahi pēpē ?
He aha ke kumu o kou hāʻule mua ʻana (e.g., kahi maʻi, kahi pilikia placental, kahi maʻi).

He aha nā lāʻau lapaʻau i hoʻohana ʻia no ka hānau mua ʻana?

ʻO ka pahuhopu nui o ka lāʻau lapaʻau, ʻo ia ke kāohi i ka holomua o ka hānau ʻana a ʻae i ka pēpē e ulu i loko o ka ʻōpū no ka lōʻihi e hiki ai. ʻO nā ʻano lāʻau lapaʻau nui i hoʻohana ʻia no ka (Preterm Labor):

Tocolytics: Hiki i kēia mau lāʻau lapaʻau ke hoʻōki i ka hana a hiki i 48 mau hola a hoʻopaneʻe i ka hānau mua ʻana. Ma hope o ka hoʻopaneʻe ʻia ʻana o ka hana, hiki i kāu kauka ke hāʻawi iā ʻoe i ka magnesium sulfate a i ʻole corticosteroids . Hiki ke hoʻoneʻe ʻia ʻoe i kahi haukapila me kahi Neonatal Intensive Care Unit (NICU) i kēia manawa.
Magnesium sulfate: He lāʻau lapaʻau kēia i hāʻawi ʻia ma ke kino. Kōkua ia i ka hōʻemi ʻana i ka pilikia o ka lolo lolo a me nā maʻi neʻe i loko o ka pēpē. Hāʻawi ʻia inā ʻaʻole ʻoe ma mua o 32 mau pule hāpai a aia kahi pilikia o ka hānau ʻana i loko o nā hola 24 e hiki mai ana.
Corticosteroids: Kōkua kēia mau steroids i ka ulu ʻana o nā māmā o ka pēpē, ka ʻōnaehana hoʻoheheʻe, a me ka lolo ma mua o ka hānau ʻana. Hāʻawi pinepine ʻia lākou ma waena o 24 a me 34 mau pule o ka hāpai ʻana.

Inā ua hānau mua ʻoe ma mua o ka hānau ʻana, hiki i kāu kauka hānau keiki ke ʻōlelo aku i ka lāʻau lapaʻau e pale aku i ka hānau mua ʻana. ʻO ka mea maʻamau ka progesterone . Pili kēia i ka hoʻokomo ʻana i kahi suppository progesterone (e like me ka pila) i loko o ka vagina. I kekahi mau hihia, hiki i kāu kauka ke ʻōlelo aku i kahi kaʻina hana i kapa ʻia he cerclage cervical. Pili kēia i ka humuhumu ʻana i ka cervix a pani ʻia e pale aku ai i ka wehe ʻana.

He aha kā mākou e hana ai e pale aku i ka hānau mua ʻana? (Pehea e hiki ai iaʻu ke pale aku i ka hānau mua ʻana?)

ʻOiai he paʻakikī ke pale loa i ka hānau mua ʻana, aia kekahi mau mea hiki iā mākou ke hana e hōʻemi i ka pilikia o ka hānau mua ʻana:

E hōʻalo i ka puhipaka, inu waiʻona, hoʻohana i nā lāʻau lapaʻau ʻole, a i ʻole ka hoʻohana ʻana i nā lāʻau lapaʻau ʻino.
E hoʻonui i ke kaumaha olakino ma mua o ka hāpai ʻana, a e loaʻa i ka nui kūpono o ke kaumaha i ka wā hāpai.
E ʻai i nā meaʻai olakino a lawe i nā huaora prenatal i ʻōlelo ʻia e kāu kauka.
E ʻimi i nā ala e hōʻemi ai a hoʻokele paha i kou kaumaha. E noho hana, e hele wāwae, e heluhelu i nā puke, a e hoʻokaʻawale i ka manawa e hoʻomaha ai i kēlā me kēia lā.
E hele i nā keʻena hoʻomaʻamaʻa hāpai mua a pau. E ʻike i ke kauka niho a hoʻomaʻemaʻe i kou mau niho. Aia kahi pilina ma waena o ke olakino o kou mau ʻāʻī a me ka (Preterm Labor).
E kiʻi i ka lāʻau lapaʻau a mālama paha i kekahi mau kūlana olakino āu e loaʻa ai, e like me ke koko kiʻekiʻe (hypertension), ka maʻi diabetes gestational diabetes), ke kaumaha, a i ʻole nā maʻi vaginal.
E mālama i kahi kaʻawale ma ka liʻiliʻi he 12 a 18 mau mahina ma waena o nā hāpai ʻana.

Āhea ʻoe e ʻike pono ai i ke kauka? (Āhea ʻoe e hoʻokaʻaʻike aku ai i kāu mea mālama ola e pili ana i ka hānau mua ʻana?)

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona o ka hānau mua ʻana, e hoʻomaopopo koke i kāu kauka:

Ke kahe ʻana o ka wai ma ka ʻōpū (ka liki ʻana o ka wai) a i ʻole ke kahe ʻana o ke koko.
Ka luaʻi a ʻeha paha o ka ʻōpū (me ka maʻi diarrhea a i ʻole me ka ʻole).
ʻEha mau o ke kua i lalo.
Ke manaʻo o ke kaomi i loko o ka lua pelvic a i ʻole ka ʻōpū.
"Ke haki nei kou wai."

Leka Hoʻihoʻi Hope Loa

ʻO ka hānau mua ʻana, a i ʻole ka hānau mua ʻana, hiki ke hana i kāu pēpē i ka wā ʻōpiopio. No laila, inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻūlū ʻana, ka nui o ke kahe ʻana o ka wahine, ke kahe ʻana o ke koko, a i ʻole ka ʻeha pelvic, e kāhea koke i kāu kauka. ʻO ka mea pōmaikaʻi, aia nā mea hiki i kāu kauka ke hana e kōkua i ka mālama ʻana i kou ʻūlū ʻana. ʻO ka lōʻihi o ka noho ʻana o kāu pēpē i loko o kou ʻōpū, ʻo ka liʻiliʻi o ka loaʻa ʻana o nā pilikia olakino. Inā ʻoe e hāpai ana i nā māhoe a i ʻole ua loaʻa mua kahi hānau mua a hānau mua paha, hiki iā ʻoe ke kiʻekiʻe iki aʻe ka pilikia.

ʻO ke ala maikaʻi loa e pale aku ai i ka hānau mua ʻana, ʻo ia ke noho olakino i kou wā hāpai a mālama pono i kou mau kūlana olakino. E kamaʻilio mau me kāu kauka a hahai i kā lākou ʻōlelo aʻo. Mai hopohopo, ʻo ka mea nui ka ʻike!

hānau mua ʻana, hānau mua ʻana, hāpai keiki, hana, pēpē, olakino, hānau keiki

Aia nō hoʻi ʻoe i ka pilikia o ka hānau ʻana o kahi pēpē ma mua o kou lā hānau? (Preterm Labour) E makaʻala kākou i kēia!