Inā he makuahine hānau ʻoe, ua lohe paha ʻoe e pili ana i ka wai e hoʻopuni ana i kāu pēpē i loko o kou ʻōpū. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia ' wai amniotic '. Ua like kēia wai me kahi uluna pale no kāu pēpē. He mea nui kēia wai e pale, hānai, a ʻae i kāu pēpē e neʻe a puni. Akā i kekahi manawa, hiki i ka nui o kēia wai ke ʻoi aku ma mua o ka maʻamau. ʻO ia ke kūlana a mākou e kapa nei ʻo Polyhydramnios. Mai makaʻu ke lohe ʻoe i kēia inoa. E kamaʻilio kākou e pili ana i ia mea me ka maopopo a me ka maʻalahi i kēia lā.
ʻO ka mea mua, e nānā kākou, he aha kēia wai amniotic?
I ka ʻōlelo maʻalahi, aia kāu pēpē i loko o kahi ʻeke piha i ka wai i loko o kou ʻōpū. Kāhea mākou i kēia ʻeke ʻo ka ʻeke amniotic. ʻO ka wai maopopo i loko ua kapa ʻia ʻo ia he wai amniotic. He mea nui kēia no ka ulu ʻana o kāu pēpē. Moni ke pēpē i kēia wai a hoʻohui hou i ka wai ma ke ʻano he mimi. Penei ke kaulike mau ʻana o nā pae wai.
Hoʻololi ka nui o kēia wai i ka wā hāpai. Ma ka awelika, aia ma kahi o 800 milliliters o ka wai ma kahi o 34 mau pule. Eia nō naʻe, i ka hoʻokokoke ʻana mai o ka hānau ʻana, ma kahi o 40 mau pule, e emi ana kēia nui i kahi o 600 milliliters. I kekahi manawa, hiki i kēia nui o ka wai ke emi ma mua o ka maʻamau (Oligohydramnios) a ʻoi aku paha ma mua o ka maʻamau (Polyhydramnios) .
No laila he aha ka Polyhydramnios?
ʻO ka Polyhydramnios, e like me ka mea i ʻōlelo ʻia ma mua, ʻo ia ka wā he nui loa ka wai amniotic i loko o ka ʻōpū. Hiki i kēia ke hoʻonui i kou ʻōpū ma mua o ka maʻamau. ʻIke pinepine ʻia kēia i ka hapa hope o ka hāpai ʻana. Eia nō naʻe, hiki ke hana ʻia i kekahi manawa ma mua o 16 mau pule.
ʻO ka mea nui, he maʻi laha ʻole kēia. Hoʻopilikia wale ia i ka 1% a i ka 2% o nā wahine hāpai. No laila, ʻaʻohe pono e hopohopo nui no ia mea.
He aha nā kumu o kēia hoʻonui ʻia ʻana o ka wai i loko o ka ʻōpū?
He mea paʻakikī ke kuhikuhi i ke kumu pololei, akā aia kekahi mau kumu maʻamau i ʻike ʻia e nā kauka.
| Kumu | He wehewehe maʻalahi |
|---|---|
| Nā kīnā hānau i loko o ka pēpē | ʻAʻole hiki paha i ka pēpē ke ale i nā wai ma muli o kahi pilikia me ka ʻōnaehana hoʻoheheʻe a ka pēpē a i ʻole ka ʻōnaehana nerve. |
| Ka maʻi diabetes o ka makuahine | ʻO ka maʻi diabetes gestational a i ʻole ka maʻi diabetes mua i kāohi ʻole ʻia. |
| Nā māhoe | ʻO ke kaulike ʻole o ke kahe koko ma waena o nā māhoe like (Twin-to-twin transfusion syndrome). |
| Anemia o ka ʻōpū | Ua emi ka helu o nā hunaola koko ʻulaʻula i loko o ke pēpē. |
| Nā pilikia placental | Aia kahi pilikia me ka placenta, ka mea e hāʻawi ana i ka meaʻai a me ka oxygen i ka pēpē. |
| Ka kūlike ʻole o ke ʻano koko | ʻO ke kūlike ʻole ma waena o nā ʻano koko o ka makuahine a me ke pēpē (ʻoi aku ka Rh factor). |
| Nā maʻi | ʻO kekahi mau maʻi e kū mai ana i ka makuahine i ka wā hāpai. |
He aha nā hōʻailona e hiki iā ʻoe ke ʻike inā loaʻa iā ʻoe ka polyhydramnios?
Inā manaʻo kou ʻōpū e ulu nui ana i loko o kahi manawa pōkole, he hōʻailona paha ia o ka polyhydramnios, kahi kūlana e kū mai ana i ka wā e hōʻiliʻili ai ka wai a kau i ke kaomi ma ka ʻōpū a me nā ʻōpū e pili ana.
- Inā he nui iki wale nō ka nui o ka wai (nā polyhydramnios māmā): ʻAʻohe paha ou hōʻailona.
- Inā nui loa ka nui o ka wai (Polyhydramnios nui): Hiki iā ʻoe ke ʻike i hoʻokahi a ʻoi aku paha o nā hōʻailona penei:
- Paʻakikī loa ka ʻōpū .
- Paʻakikī ka hanu ʻana.
- Nā pilikia hoʻoheheʻe a me ka mumū o ka umauma.
- Ka paʻa ʻana o ka ʻōpū .
- Ka pehu ʻana o nā ʻūhā, nā wāwae, a me nā kapuwaʻi.
- ʻO ka ʻeha a i ʻole ka ʻūmiʻi o ka ʻōpū.
- Ke kūlana hewa o ka ʻōpū .
- Ua emi ka manaʻo o nā neʻe ʻana o ke pēpē.
He aha nā pilikia e hiki ke hana ma muli o kēia ʻano?
Inā piʻi nui ka nui o ka wai i nā pule mua o ka hāpai ʻana (polyhydramnios koʻikoʻi), aia kahi pilikia o nā pilikia. He mea nui e makaʻala i kēia mau mea, akā e hoʻomanaʻo ʻaʻole hiki kēia i nā kānaka a pau.
- Hānau mua ʻole: Hānau ma mua o 37 mau pule.
- Ka haki mua ʻana o nā membrane: ʻO ka haki ʻana o ka ʻeke amniotic (ʻeke wai) ma mua o ka hānau ʻana.
- Ka hoʻopau ʻana o ka placenta: Hoʻokaʻawale ka placenta mai ka paia o ka uterine ma mua o ka hānau ʻana o ke pēpē.
- Ka hemo ʻana o ke kaula umbilical: Komo ke kaula umbilical i loko o ka vagina ma mua o ka hānau ʻana o ke pēpē.
- Ka ulu wikiwiki ʻana o ka pēpē: Ke ulu nui nei ka pēpē.
- ʻO ka pono no ka ʻoki ʻoki caesarean (C-section).
- Hānau make: He mea kakaikahi loa kēia.
- Ke kahe koko nui ma hope o ka hānau ʻana.
Mai makaʻu i ka lohe ʻana i kēia mau mea. Ua ʻike pono kāu kauka i kēia mau pilikia. ʻO ia ke kumu e nānā mau ai ʻo ia iā ʻoe a me kāu pēpē a hāʻawi i ka mālama maikaʻi loa.
Pehea e ʻike ai ke kauka i kēia maʻi?
Inā loaʻa iā ʻoe nā hōʻailona i luna, e hana mua kāu kauka i kahi scan ultrasound . E ana kēia i ka nui o ka wai i loko o kou ʻōpū. Aia ʻelua mau ʻano i hoʻohana ʻia no kēia:
1. AFI (Amniotic Fluid Index): E noʻonoʻo e puʻunaue ana i kou ʻōpū i ʻehā ʻāpana, e ana ana i ke kiko hohonu loa o ka wai i kēlā me kēia ʻāpana, a e hoʻohui pū iā lākou a pau. Inā ʻoi aku ka huina ma mua o 24-25 kenimika, ua manaʻo ʻia he Polyhydramnios.
2. MPV (Maximum Vertical Pocket): Ke ana kēia i ka hohonu o ka ʻeke wai hohonu loa i loko o ka ʻōpū. Inā like kēia waiwai a ʻoi aku paha ma mua o 8 kenimika, ua ʻike ʻia hoʻi he Polyhydramnios.
Eia kekahi, hiki ke hana ʻia nā hoʻokolohua ʻē aʻe e ʻike ai i ke kumu:
- Nā hoʻāʻo koko: No ka nānā ʻana inā loaʻa i ka makuahine kekahi mau maʻi a i ʻole nā maʻi e like me ka maʻi diabetes.
- Amniocentesis: Pili kēia i ka hoʻohana ʻana i kahi nila lahilahi loa e lawe i kahi wai liʻiliʻi mai ka ʻōpū a hoʻāʻo iā ia. Hiki i kēia ke hāʻawi i ka ʻike e pili ana i nā mea e like me nā pilikia genetic i loko o ka pēpē.
Ke ʻike ʻia kēia maʻi, e nānā mau kāu kauka iā ʻoe a me kāu pēpē. No kēia, pono ʻoe e hana i kahi hoʻāʻo nonstress .Nā hoʻāʻo e like me ka echocardiogram fetal (e nānā ana i ka puʻuwai o ka pēpē) a me kahi ʻikepili biophysical (kahi scan e nānā pinepine ai i ka neʻe ʻana o ka pēpē, ka hanu ʻana, a me nā pae wai).
He aha nā lāʻau lapaʻau no ka polyhydramnios?
ʻO ka nūhou maikaʻi, ʻo ka hapa nui o nā hihia o ka paʻa ʻana o ka wai liʻiliʻi ʻaʻole pono i kekahi lāʻau lapaʻau . E hoʻopau wale ʻia ke kūlana i ka hala ʻana o ka manawa. Hiki nō hoʻi ke hoʻomaikaʻi ke mālama ʻia kahi kumu kumu, e like me ka maʻi diabetes.
Eia nō naʻe, inā kiʻekiʻe loa ka wai (koʻikoʻi) a pilikia ʻoe i ka hanu ʻana, ʻeha ka ʻōpū, a i ʻole nā hōʻailona o ka hānau mua ʻana, pono paha ʻoe i ka lāʻau lapaʻau. Pono paha ʻoe e lawe ʻia i ka haukapila.
Ma ke ʻano he mau ʻano lapaʻau:
- Ka wehe ʻana i ka wai: E like me ka amniocentesis, hoʻohana ʻia kahi nila e wehe i ka wai keu mai ka ʻōpū. Eia nō naʻe, no ka mea, he liʻiliʻi ka pilikia o ka haki ʻana o nā membrane i ka wā mua o kēia kaʻina hana, e hana wale kāu kauka i kēia inā pono loa.
- Lāʻau lapaʻau: Hiki ke kuhikuhi ʻia nā lāʻau lapaʻau e like me Indomethacin. Hoʻemi kēia i ka nui o ka mimi a ka pēpē e hana ai a hoʻemi i nā pae wai. Eia nō naʻe, hāʻawi ʻia kēia mau lāʻau lapaʻau ma mua o 31 mau pule o ka hāpai ʻana. No ka mea hiki i kēia mau lāʻau lapaʻau ke loaʻa kekahi mau hopena i ka puʻuwai o ka pēpē, e nānā mau ke kauka i ka puʻuwai o ka pēpē.
ʻO ka mea nui loa, ʻo ia ka hana ʻana o kēia mau hoʻoholo a pau e kāu kauka. Na ia e hoʻoholo i ka mea maikaʻi loa iā ʻoe, me ka noʻonoʻo ʻana i kou kūlana a me ke olakino o kāu pēpē.
Leka Lawe-Home
- ʻO ka Polyhydramnios kahi nui loa o ka wai amniotic i loko o ka ʻōpū. He maʻi laha ʻole kēia.
- He mea paʻakikī pinepine ka loaʻa ʻana o ke kumu maopopo no kēia, akā ʻo ka maʻi diabetes, nā hānau keiki he nui, a me kekahi mau pilikia me ka pēpē hiki ke lilo i mau kumu kōkua.
- ʻAʻole pinepine nā hihia maʻalahi i nā hōʻailona. Hiki i nā hihia koʻikoʻi ke hana i nā hōʻailona e like me ka paʻakikī o ka hanu ʻana a me ka ʻeha o ka ʻōpū.
- Hoʻomaopopo ʻia kēia maʻi me ka ultrasound.
- Inā he nui iki wale nō ka wai, ʻaʻole pono ka lāʻau lapaʻau a e ho'ōla ponoʻī ia.
- Inā wale nō koʻikoʻi ke kūlana e mālama ʻia me ka wehe ʻana i ka wai a i ʻole ka lāʻau lapaʻau.
- Mai makaʻu e noʻonoʻo i kekahi mea ma kāu iho. E kamaʻilio me kāu kauka e pili ana i nā mea āpau. Nāna e hāʻawi i ka mālama maikaʻi loa nou a me kāu pēpē.
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