Cov ntshav ntawm koj tus menyuam hauv plab tsis sib haum nrog koj li? (Erythroblastosis Fetalis) Cia peb nrhiav seb qhov no yog dab tsi!

Yog koj yog ib tug niam uas yuav yug menyuam, tej zaum koj yuav ntshai me ntsis thaum koj hnov ​​cov lus 'Erythroblastosis Fetalis'. Los yog tej zaum koj tus kws kho mob tau hais txog nws me ntsis dhau los thaum nws tab tom tham txog koj hom ntshav. Nws yuav ua rau ntshai me ntsis thaum hnov ​​lub npe no. Tab sis tsis txhob txhawj, hnub no peb yuav tham txog nws hauv txoj kev yooj yim uas koj tuaj yeem nkag siab. Cia peb saib nws yog dab tsi, vim li cas nws tshwm sim, thiab peb yuav tiv thaiv peb tus kheej li cas ntawm qhov mob no.

'Erythroblastosis Fetalis' yog dab tsi?

Hais yooj yim xwb, qhov no yog ib qho teeb meem tsis tshua muaj, txhais tau tias tsis yog txhua tus neeg yuav muaj qhov teeb meem no, uas yuav tshwm sim thaum cev xeeb tub. Qhov no tshwm sim yog tias koj thiab koj tus menyuam hauv plab tsis sib haum nrog hom ntshav. Tsis yog txhua qhov sib txawv ntawm hom ntshav ua rau muaj teeb meem. Txawm li cas los xij, qhov kev pheej hmoo no yog siab heev yog tias koj hom ntshav yog 'Rh-negative' thiab koj tus menyuam hom ntshav yog 'Rh-positive'.

Xav txog seb, yog tias koj raug cov ntshav Rh-positive no, thaum cev xeeb tub dhau los lossis thaum hloov ntshav, koj lub cev tiv thaiv kab mob (lub cev uas tiv thaiv peb ntawm cov kab mob) tuaj yeem pib tawm tsam cov qe ntshav liab ntawm tus menyuam. Zoo li tawm tsam tus yeeb ncuab. Qhov no tuaj yeem ua rau tus menyuam cov qe ntshav liab qis heev. Peb hu qhov no ua anemia. Yog tias qhov anemia no hnyav zuj zus, nws tuaj yeem ua rau tus menyuam tuag taus yog tias tsis kho.

Tiam sis muaj xov xwm zoo! Niaj hnub no, kev kuaj mob niaj hnub thaum ntxov ntawm cev xeeb tub tuaj yeem txiav txim siab koj hom ntshav. Yog tias koj Rh-negative, cov kws kho mob tuaj yeem sau tshuaj los tiv thaiv qhov teeb meem no.

Tus mob no kuj hu ua `(alloimmune hemolytic disease of the newborn - HDN)` thiab `(hemolytic disease of the fetus and newborn - HFDN)`. Tab sis thaum peb tham txog nws, peb yuav siv lo lus `(Erythroblastosis Fetalis)`.

Yog tias tus me nyuam muaj tus mob no, cov tsos mob yuav zoo li cas?

Cov menyuam mos uas yug los muaj tus mob no (Erythroblastosis Fetalis) yuav muaj cov cim qhia tias lawv tsis muaj ntshav txaus. Ib txhia menyuam mos yuav muaj mob me ntsis xwb, thaum lwm tus yuav mob hnyav heev. Tsis tas li ntawd, tus menyuam mos yuav muaj mob ntshav daj hauv 24 teev tom qab yug los. Nov yog qee cov tsos mob:

• Qhov muag thiab daim tawv nqaij daj.
• Daim tawv nqaij daj ntseg tam sim ntawd .
• Tus me nyuam mos xav tias qaug zog thiab tsis muaj sia nyob (lethargy).
• Lub plawv dhia ceev (tachycardia).
• Tsis muaj kev ntshaw mis nyuj.

Muaj tej zaum mob hnyav heev, tus menyuam hauv plab lossis tus menyuam mos yuav muaj mob hnyav hu ua "hydrops fetalis." Nws cov tsos mob muaj xws li:

• Lub cev o.
• Cov kua dej sib sau ua ke hauv lub plab ntawm tus menyuam, lossis ntawm cov kabmob tseem ceeb xws li lub plawv thiab lub ntsws.

Vim li cas qhov no thiaj tshwm sim? Yog vim li cas?

Tus mob no, hu ua "Erythroblastosis Fetalis", tshwm sim vim tias, raws li tau hais ua ntej, koj lub cev tiv thaiv kab mob tawm tsam tus menyuam cov qe ntshav liab.

Peb cov qe ntshav liab muaj cov cim tshwj xeeb rau ntawm lawv. Peb hu lawv tias "antigens." Xav txog cov "antigens" no ua cov ntawv lo nrog cov npe rau ntawm lawv. Yog tias koj lub cev tiv thaiv kab mob paub txog cov ntawv lo no, nws yuav tsis tawm tsam cov qe ntshav liab ntawd.

Qhov no yog vim muaj qhov sib txawv ntawm koj thiab koj tus menyuam cov ntshav hom. Cov hom ntshav raug faib ua pawg raws li "antigens" ntawm qhov chaw ntawm cov qe ntshav liab. Muaj ob hom ntshav tseem ceeb uas peb tab tom tham txog:

• Rh factor: Qhov no txhais tau tias seb cov ntshav puas yog positive (+) lossis negative (-).
• ABO antigens: Qhov no txhais tau tias A, B, AB, lossis O hom ntshav.

Yog tias koj cev xeeb tub, koj lub cev tiv thaiv kab mob, yog tias nws tsis paub txog "antigens" ntawm koj tus menyuam cov qe ntshav liab, yuav pib tsim "antibodies" tawm tsam lawv. Cov "antibodies" no yog cov uas tawm tsam cov qe ntshav liab ntawd. Ib yam li thaum peb lub cev tau txais cov kab mob uas ua rau muaj mob, peb lub cev tawm tsam nws. Tab sis kom qhov no tshwm sim, tus menyuam cov ntshav yuav tsum tau kov koj cov ntshav. Feem ntau, qhov no tshwm sim thaum tus menyuam yuav yug los. Txawm li cas los xij, qee zaum cov ntshav tuaj yeem sib xyaw nrog nws ua ntej. Piv txwv li:

• Yog tias muaj kev rho menyuam tshwm sim.
• Yog tias qhov kev xeeb tub poob ib nrab ntawm lub sijhawm, nws hu ua "Miscarriage".
• Hauv qhov xwm txheej zoo li cev xeeb tub ectopic (kev xeeb tub nyob sab nraum lub tsev menyuam, xws li hauv txoj hlab qe menyuam).
• Thaum ua "(Amniocentesis)" (kev kuaj mob thaum cev xeeb tub).
• Thaum ua `(Chorionic villus sampling)` (lwm qhov kev kuaj cev xeeb tub).

Thaum koj lub cev tsim cov '(antibodies)' no lawm, nws yuav nco ntsoov nws. Yog tias tus menyuam cov qe ntshav liab muaj 'antigen' ntawd dua thaum cev xeeb tub tom ntej, cov '(antibodies)' no yuav mus thiab rhuav tshem cov qe ntshav ntawd. Peb hu qhov no tias kev rhuav tshem cov qe ntshav liab '(hemolysis)'.

Qhov ua rau tseem ceeb: Rh tsis sib haum

Qhov ua rau mob no loj tshaj plaws thiab paub zoo tshaj plaws yog thaum koj yog Rh-negative thiab koj tus menyuam yog Rh-positive. Thaum qhov no tshwm sim, koj lub cev tiv thaiv kab mob tawm tsam koj tus menyuam cov ntshav liab Rh-positive. Hauv lub tebchaws zoo li Asmeskas, kwv yees li 15% ntawm cov neeg muaj ntshav Rh-negative. Feem ntau, ob leeg niam thiab txiv, nrog rau tus menyuam, yog Rh-positive.

Feem ntau, qhov kev tsis sib haum xeeb ntawm Rh no tsis ua rau muaj teeb meem loj thaum cev xeeb tub thawj zaug. Txawm tias koj yog Rh-negative thiab tus menyuam yog Rh-positive, nws tsis tshua muaj rau koj cov ntshav sib xyaw nrog tus menyuam cov ntshav thaum cev xeeb tub kom ua rau muaj kev tsis haum tshuaj loj (antibodies). Txawm li cas los xij, thaum tus menyuam yug los, koj cov ntshav yuav yeej ua rau tus menyuam cov ntshav. Lub sijhawm ntawd, yog tias koj tsis tau noj tshuaj los tiv thaiv koj lub cev tiv thaiv kab mob los ntawm kev tawm tsam nws, koj lub cev yuav tsim cov tshuaj tiv thaiv tawm tsam cov qe ntshav liab Rh-positive.

Ces yog koj cev xeeb tub dua, thiab tus menyuam ntawd kuj muaj hom ntshav Rh-positive, cov tshuaj tiv thaiv kab mob uas tau tsim ua ntej yuav mus tua tus menyuam cov qe ntshav liab. Koj puas nkag siab?

Lwm yam kev tsis sib haum xeeb ntawm cov ntshav hom tsis tshua muaj

Qee zaum, koj lub cev tiv thaiv kab mob tuaj yeem tawm tsam koj tus menyuam cov qe ntshav liab txawm tias muaj qhov tsis sib xws nrog cov qe ntshav liab antigen tsawg. Qhov no tshwm sim yog tias koj tus menyuam muaj cov antigen tsawg ntawd thiab koj poob nws. Qhov no tshwm sim yog tias koj tau raug cov antigen ntawd los ntawm kev cev xeeb tub yav dhau los lossis kev hloov ntshav thiab tau tsim cov tshuaj tiv thaiv rau nws. Ib txhia ntawm cov antigens no yog:

• `(Colton)`
• `(Duffy)`
• `(Diego)`
• `(Ee)`
• `(Gerbich)`
• `(H)`
• `(Kell)`
• `(Kidd)`
• `(Lutheran)`
• `(MNS)`
• `(P)`
• `(Xg)`

Cov kev kuaj ntshav ua thaum ntxov ntawm cev xeeb tub tuaj yeem ntes tau seb koj puas tsim cov tshuaj tiv thaiv kab mob tawm tsam cov qe ntshav liab tsawg tsawg no.

Tus mob no feem ntau tshwm sim li cas?

Thoob ntiaj teb, muaj li ntawm 276 ntawm 100,000 tus menyuam yug los muaj teeb meem thaum cev xeeb tub uas cuam tshuam nrog Rh ntshav tsis sib xws. Raws li cov kws tshawb fawb, yog tias tsis kho, muaj 50% feem pua ​​uas tus menyuam hauv plab yuav tuag lossis muaj teeb meem kev noj qab haus huv loj.

Tiam sis tsis txhob txhawj! Nrog kev kuaj ntshav hom thiab cov tshuaj tsim nyog, qhov tshwm sim phem tshaj plaws tuaj yeem tiv thaiv tau. Hauv qee qhov chaw ntawm lub ntiaj teb uas muaj kev saib xyuas ua ntej yug menyuam, tsuas yog li ntawm 2.5 ntawm 100,000 tus menyuam yug muaj teeb meem vim Rh tsis sib xws. Qhov no yog qhov kev txhawj xeeb loj hauv Sri Lanka thiab.

Koj nrhiav tau qhov no li cas?

Feem ntau, ntawm cov chaw kho mob ua ntej yug menyuam, koj cov ntshav hom thiab cov "antibodies" raug kuaj xyuas. Yog tias koj cev xeeb tub thiab muaj cov ntshav hom Rh-negative, koj tus kws kho mob yuav kuaj xyuas "antibodies" tiv thaiv cov ntshav Rh-positive. Yog tias koj tsis muaj cov "antibodies" ntawd, koj lub cev tiv thaiv kab mob yuav tau txais tshuaj los tiv thaiv lawv kom tsis txhob tsim.

Yog tias qhov kev kuaj ntawd lees paub tias koj muaj cov tshuaj tiv thaiv no, nws txhais tau tias yog tias tus menyuam yog Rh-positive, koj lub cev tiv thaiv kab mob muaj feem yuav tawm tsam tus menyuam cov qe ntshav liab. Koj tus kws kho mob mam li kuaj xyuas koj cov tshuaj tiv thaiv kab mob txhua ob peb lub lis piam. Yog tias koj cov tshuaj tiv thaiv kab mob siab heev, tej zaum yuav muaj kev kuaj ntxiv kom pom tias koj tus menyuam puas muaj ntshav tsis txaus, thiab koj yuav tsum tau hloov ntshav hauv plab. Yog tias koj tus menyuam muaj feem yuav yug los muaj ntshav tsis txaus, koj tus kws kho mob yuav txiav txim siab yug tus menyuam ntxov.

Tom qab tus me nyuam yug los, tus kws kho mob tuaj yeem txiav txim siab seb tus me nyuam muaj hom ntshav twg. Qhov no tuaj yeem pab txiav txim siab seb tus me nyuam puas muaj ntshav tsis txaus vim yog hom ntshav tsis sib xws.

Lwm cov kev ntsuam xyuas uas tau ua yog:

• Kev suav cov ntshav tag nrho (CBC): Qhov kev kuaj no tuaj yeem xyuas seb tus menyuam cov qe ntshav liab qis npaum li cas. Qhov qis dua, qhov ntshav tsis txaus yuav hnyav dua.
• Kev Ntsuas Ntshav Ntawm Ib Sab (PBS): Qhov no suav nrog kev kuaj xyuas cov ntshav hauv qab lub tshuab tsom iav. Qhov no tuaj yeem muab lub tswv yim seb qhov kev txo qis puas yog vim muaj kev puas tsuaj ntawm cov qe ntshav liab ua ntej lub sijhawm (hemolysis).
• Kev kuaj Bilirubin:Qhov no ntsuas cov bilirubin. Bilirubin yog ib yam khoom seem ntawm kev tawg ntawm cov qe ntshav liab. Cov bilirubin ntau (hyperbilirubinemia) tej zaum yuav qhia tau tias cov qe ntshav liab tab tom raug rhuav tshem.
• Kev Ntsuas Antiglobulin Ncaj Qha (DAT): Qhov kev kuaj no qhia seb puas muaj cov tshuaj tiv thaiv kab mob nyob rau ntawm qhov chaw ntawm cov qe ntshav liab ntawm tus menyuam. Qhov no txhais tau tias tus niam lub cev tiv thaiv kab mob tab tom tawm tsam cov qe ntshav ntawm tus menyuam.

Cov kev kho mob yog dab tsi?

Kev kho mob nyob ntawm seb koj cev xeeb tub lossis nyuam qhuav muaj menyuam.

Kev kho mob thaum cev xeeb tub

Yog tias koj muaj cov tshuaj tiv thaiv kab mob uas ua rau koj muaj feem yuav mob Erythroblastosis Fetalis, koj tus kws kho mob yuav saib xyuas koj cov tshuaj tiv thaiv kab mob txhua ob peb lub lis piam. Yog tias koj cov tshuaj tiv thaiv kab mob siab, koj yuav tsum tau kuaj ultrasound ntxiv kom pom tias koj tus menyuam puas muaj ntshav tsis txaus. Yog tias qhov ntshav tsis txaus hnyav, koj tus menyuam yuav xav tau kev hloov ntshav.

Kev kho mob tom qab yug tus menyuam

Cov kws kho mob kho cov menyuam mos uas muaj "Erythroblastosis Fetalis" los ntawm kev kho cov ntshav tsis txaus thiab "hyperbilirubinemia" (jaundice). Cov kev xaiv kho mob yog:

• Kev Kho Mob Los Ntawm Duab: Qhov no siv lub teeb los kho cov ntshav bilirubin ntau dhau. Lub teeb no hloov cov bilirubin mus ua cov tshuaj uas yooj yim tso tawm ntawm lub cev ntawm tus menyuam.
• Kev ntxiv ntshav: Tom qab tus menyuam yug los, tus menyuam yuav xav tau kev ntxiv ntshav kom paub tseeb tias nws muaj cov qe ntshav liab txaus.
• Cov Tshuaj Erythropoiesis Stimulating Agents (ESA): Cov no yuav yog ib txoj kev xaiv rau kev kho cov ntshav tsis txaus uas tsis hnyav txaus kom yuav tsum tau hloov ntshav. Tej zaum yuav tsum tau muab lawv nrog rau cov tshuaj ntxiv hlau kom pab tus menyuam tsim cov qe ntshav liab noj qab haus huv.

Thaum mob hnyav, tus menyuam yuav xav tau kev saib xyuas txhawb nqa, xws li lub tshuab ua pa thiab cov kua IV.

Tom qab qhov xwm txheej no, tus menyuam yuav ua li cas?

Cov txiaj ntsig nyob ntawm seb koj tus menyuam cov tsos mob hnyav npaum li cas. Kev tsis muaj ntshav txaus thiab hyperbilirubinemia tuaj yeem ua rau tuag taus yog tias tsis kho.

Txawm li cas los xij, cov menyuam mos uas muaj tus kab mob Erythroblastosis Fetalis tuaj yeem dim ntawm tus mob no yog tias kho kom zoo. Lawv yuav tsum tau hloov ntshav kom rov qab muaj zog rau lawv cov qe ntshav liab thaum cev xeeb tub thiab/lossis tom qab yug los. Tus kws kho mob yuav tsum tau saib xyuas lawv ob peb lub hlis kom paub tseeb tias tsis muaj teeb meem.

Qhov no puas tiv thaiv tsis tau?

Yeej ua tau tiag! Kab mob Erythroblastosis Fetalis yog ib yam kab mob uas tiv thaiv tau yooj yim los ntawm kev kuaj ntshav thiab tshuaj tiv thaiv thaum cev xeeb tub.Qhov Xwm Txheej. Yog tias koj yog Rh-negative, koj tuaj yeem noj Rh immune globulin (Rh immune globulin - RhIg lossis RhoGAM®) los tiv thaiv koj lub cev kom tsis txhob tsim cov tshuaj tiv thaiv kab mob tiv thaiv cov ntshav Rh-positive. Koj yuav tsum noj cov tshuaj no thaum 28 lub lis piam ntawm kev xeeb tub, tsis pub dhau 72 teev ntawm qhov kawg ntawm kev xeeb tub (tom qab yug menyuam, rho menyuam), thiab yog tias koj muaj ntshav ntau thaum cev xeeb tub (txawm tias nyob rau hauv thawj peb lub hlis).

Qhov no tsuas ua haujlwm yog tias koj noj cov tshuaj no ua ntej koj cov ntshav raug rau cov ntshav Rh-positive. Yog vim li ntawd nws thiaj li raug saib xyuas tshwj xeeb hauv cov chaw kho mob cev xeeb tub.

Tej yam uas yuav tsum nug koj tus kws kho mob

Yog koj muaj lus nug ntxiv txog qhov no, tsis txhob ntshai nug koj tus kws kho mob lossis tus nais maum. Nov yog qee cov piv txwv:

• Kuv cov ntshav yog hom twg?
• Puas muaj cov "antibodies" uas kuv yuav tsum txhawj txog?
• Kuv puas yuav tsum txhawj xeeb txog '(Erythroblastosis Fetalis)'?
• Puas yog kuv yuav tsum tau saib xyuas ntxiv lossis mus ntsib kws kho mob ntau zaus?
• Kuv puas yuav tsum tau noj tshuaj Rh immune globulin (RhIg)?
• Thaum twg kuv yuav tsum teem caij lossis nrhiav kev kho mob thaum muaj xwm txheej ceev?

Yuav ua li cas yog tias leej niam yog Rh-positive thiab tus menyuam yog Rh-negative?

Qhov no feem ntau tsis yog qhov tsis sib xws ntawm cov ntshav hom uas yuav tsum txhawj xeeb. Tus menyuam hauv plab Rh-negative tsis muaj Rh-antigen uas lub cev tiv thaiv kab mob ntawm leej niam tuaj yeem tawm tsam. Tshwj tsis yog tias muaj lwm yam tsis sib xws ntawm cov ntshav hom, qhov no yuav tsum tsis yog teeb meem.

Tej yam tseem ceeb tshaj plaws uas yuav tsum nco ntsoov

Lub tswv yim hais tias koj lub cev tiv thaiv kab mob tuaj yeem tawm tsam koj tus menyuam hauv plab yog qhov txaus ntshai heev. Tab sis qhov xov xwm zoo yog tias cov ntshav tsis sib xws no tsis tshua muaj. Thiab, cov kws kho mob ua qhov zoo tshaj plaws los tiv thaiv cov teeb meem no kom tsis txhob tshwm sim. Kev kuaj ntshav hom yog ib feem tseem ceeb ntawm kev saib xyuas ua ntej yug menyuam. Tsis tas li ntawd, kev saib xyuas thiab kho cov ntshav tsis sib xws uas tuaj yeem ua rau koj tus menyuam muaj kev pheej hmoo yog ib feem ntawm kev saib xyuas ua ntej yug menyuam. Koj tus kws kho mob yuav nrog koj txhua kauj ruam ntawm txoj kev kom koj thiab koj tus menyuam muaj kev nyab xeeb. Yog li, tsis txhob ntshai tsis tsim nyog, thiab ua raws li cov lus qhia ntawm tus kws kho mob kom zoo. Ces koj thiab koj tus menyuam tuaj yeem noj qab nyob zoo!

` Kab mob Erythroblastosis Fetalis, Rh tsis sib xws, teeb meem cev xeeb tub, hom ntshav ntawm tus menyuam, hom ntshav ntawm niam, ntshav tsis txaus, mob daj ntseg, RhoGAM