Peb puas yuav tsum paub txog qhov tawg ntawm lub hnab dej ua ntej tus menyuam yug los? (Premature Rupture of Membranes - PROM)

Thaum koj cev xeeb tub, nws yog ib qho ib txwm muaj uas koj yuav ntxhov siab txog tej yam, puas yog? Tej zaum koj twb tau hnov ​​txog "koj cov kua dej tawg," tshwj xeeb tshaj yog thaum koj los txog ze rau hnub yug menyuam. Qee zaum, nws yuav ua rau koj ntshai me ntsis thaum xav txog qhov yuav tshwm sim yog tias qhov no tshwm sim ua ntej koj hnub yug menyuam. Tsis txhob txhawj, peb yuav tham txog qhov no kom meej thiab yooj yim.

Kev tawg ntawm daim nyias nyias ua ntej lub sijhawm (PROM) yog dab tsi?

Hais yooj yim xwb, 'Premature Rupture of Membranes' lossis 'PROM' yog 'kev yug me nyuam' ntawm koj tus menyuam, txhais tau tias koj lub 'hnab dej' lossis 'amniotic sac' tawg ua ntej pib yug me nyuam. Qee tus kws kho mob kuj hu qhov no tias 'prelabor rupture of membranes'. Qhov no txhais tau tias 'cov membranes' lossis cov membranes tawg ua ntej 'kev yug me nyuam'.

Tam sim no saib, lub 'amniotic sac' no zoo li lub hnab uas muaj kua dej. Cov kua no yog qhov peb hu ua 'amniotic fluid' . Qhov no yog yam uas nyob ib puag ncig thiab tiv thaiv koj tus menyuam thaum cev xeeb tub. Nws zoo li lub hauv ncoo me me rau tus menyuam. Cov 'amniotic fluid' no tiv thaiv tus menyuam ntawm cov kab mob, ua rau tus menyuam tsis txhob raug mob thiab raug mob thaum nws txav mus los, thiab tseem pab tus menyuam cov leeg thiab pob txha loj hlob.

Thaum peb hais tias "koj cov dej tawg" lossis "koj cov dej tawg," nws yog vim tias cov daim nyias nyias no tawg. Thaum cov daim nyias nyias no tawg, cov kua amniotic uas nyob ib puag ncig koj tus menyuam pib xau tawm ntawm koj lub qhov chaw mos, maj mam lossis tam sim ntawd. Qhov no tuaj yeem yog teeb meem. Vim tias thaum cov kua amniotic ploj mus, koj thiab koj tus menyuam muaj feem yuav kis kab mob thiab lwm yam teeb meem, xws li yug ntxov .

Yog li ntawd, yog tias koj xav tias koj cov ntaub so ntswg tau tawg, koj yuav tsum qhia rau koj tus kws kho mob yug menyuam lossis tus neeg ua haujlwm hauv tsev neeg tam sim ntawd.

Preterm PROM (PPROM) yog dab tsi?

Tam sim no cia peb tham txog 'Preterm PROM' lossis 'PPROM' . Qhov no yog thaum koj lub 'amniotic sac' tawg ua ntej 37 lub lis piam ntawm kev xeeb tub. Xav txog, koj cev xeeb tub tsawg dua 37 lub lis piam, tab sis koj cov dej tawg. Thaum lub sijhawm no, koj tus kws kho mob yuav txiav txim siab seb puas yuav 'yug' tus menyuam tam sim ntawd, lossis ncua qhov 'kev yug menyuam' rau ob peb hnub ntxiv.

Qhov no yog ib qho kev txiav txim siab nyuaj me ntsis. Vim tias, kev ncua sijhawm cev xeeb tub tom qab lub qhov dej tawg ua rau muaj kev pheej hmoo ntawm kev kis kab mob thiab lwm yam teeb meem. Tab sis, ntawm qhov tod tes, kuj muaj qee qhov kev pheej hmoo rau kev yug menyuam ntxov, uas yog, ua ntej lub sijhawm. Yog li tus kws kho mob yuav tsum xav txog ob qho kev pheej hmoo no ua tib zoo ua ntej txiav txim siab zoo tshaj plaws.

Yog tias lub hnab dej tawg li no ces yuav muaj dab tsi tshwm sim?

Yog tias lub hnab dej tawg sai dhau, tus menyuam yuav muaj feem yug ntxov thiabMuaj kev pheej hmoo ntawm kev kis kab mob. Yog tias koj cev xeeb tub tiav thaum 37 lub lis piam, cov teeb meem los ntawm kev yug ntxov ntxov yuav tsis tshua muaj. Txawm li cas los xij, yog tias tus menyuam yug ua ntej 37 lub lis piam, nws yuav tsum ntsib teeb meem los ntawm kev yug ntxov ntxov.

Piv txwv ntawm qhov no yog:

• Teeb meem ua pa .
• Nyuaj tswj qhov kub ntawm lub cev .
• Qhov no tuaj yeem hloov tus menyuam hauv plab txoj haujlwm, uas tuaj yeem cuam tshuam rau kev yug menyuam.

Tsis tas li ntawd xwb, thaum cov kua dej amniotic thiab lub hnab amniotic tsis muaj kev tiv thaiv, tus menyuam thiab koj lub tsev menyuam muaj feem yuav kis tau kab mob ntau dua. Cov kab mob no qee zaum tuaj yeem ua rau muaj kev phom sij.

Tus mob no feem ntau tshwm sim li cas?

Muaj ib qho mob hu ua 'PROM' tshwm sim rau kwv yees li 10% ntawm cov poj niam cev xeeb tub. Yog tias 'PROM' tshwm sim thaum lub sijhawm (thaum muaj 37 lub lis piam), 95% ntawm lub sijhawm tus menyuam yug los hauv 28 teev.

PPROM yog ib qho mob tsis tshua muaj, tshwm sim rau kwv yees li 3% ntawm cov cev xeeb tub. Cov kev tshawb fawb tau qhia tias PPROM yuav tshwm sim ntau dua rau cov cev xeeb tub uas muaj ntau tus menyuam .

Vim li cas qhov no thiaj tshwm sim? Cov laj thawj tseem ceeb ntawm `PROM` thiab `PPROM` yog dab tsi?

Qhov ua rau muaj `PROM` thiab `PPROM` tej zaum yuav txawv.

• Yog tias koj cov dej ntws tawm thaum lub sijhawm zoo, uas yog, tom qab 37 lub lis piam , qhov laj thawj tseem ceeb yog tias koj cov kua amniotic maj mam qaug zog vim yog lub zog ntawm cov leeg nqaij thaum lub sijhawm yug menyuam. Nws yog ib txwm rau cov kua amniotic tawg yam tsis muaj kev cuam tshuam, tab sis nws feem ntau tshwm sim tom qab yug menyuam tau pib.

Qhov tseem ceeb yog tias txawm tias koj tsis hnov ​​​​​​qhov mob plab los xij, koj lub cev tej zaum yuav npaj rau kev yug menyuam. Qhov no txhais tau tias yam tsis tau koj paub, koj lub tsev menyuam tej zaum yuav mob plab, koj lub qhov ncauj tsev menyuam tej zaum yuav nyias nyias (effacing), thiab koj lub qhov ncauj tsev menyuam tej zaum yuav qhib (dilating). Qhov no tuaj yeem ua rau lub hnab amniotic tsis muaj zog thiab thaum kawg tawg.

• Feem ntau, tus menyuam yug ua ntej lub sijhawm PROM (PPROM) yog tshwm sim los ntawm ib qho mob lossis teeb meem thaum cev xeeb tub , tab sis qee zaum nws tuaj yeem tshwm sim yam tsis muaj laj thawj pom tseeb.

Qee qhov laj thawj tseem ceeb yog:

• Los ntshav ntawm qhov chaw mos .
• Cov mob uas muaj nyob hauv koj lub tsev menyuam (xws li Ehlers-Danlos syndrome ).
• Tsis txaus ntawm lub caj dab.

Cov tsos mob ntawm qhov no yog dab tsi? Koj paub nws li cas?

Qhov cim qhia meej tshaj plaws uas qhia tias koj cov kua qaub ncaug tawg yog koj xav tias koj tam sim ntawd ntws ntau cov kua los ntawm koj lub qhov chaw mos. Tab sis nws tsis yog ib txwm zoo li ntau heev. Ib txhia neeg xav tias lawv ntws me ntsis, zoo li dej ntws. Koj cov dej tawg yog ib yam dab tsi uas koj tswj tsis tau. Nws zoo li koj tsis tuaj yeem tso zis tsis tau.

Qee zaum nws nyuaj rau qhia seb nws yog kua amniotic, cov kua tawm ntawm qhov chaw mos, lossis zis . Hauv cov xwm txheej zoo li no, koj tuaj yeem siv daim ntawv phuam dawb thiab muab nws tso rau hauv cov kua ntawd.

• Yog tias nws daj, lossis nws tsw phem , tej zaum nws yog zis .
• Yog tias nws tsis muaj xim thiab tsis muaj ntxhiab , koj yuav tsum mus ntsib kws kho mob tam sim ntawd.

Txawm li cas los xij, yog tias koj muaj kev tsis ntseeg me ntsis txog dab tsi tawm hauv koj lub qhov chaw mos, nco ntsoov qhia rau koj tus kws kho mob.

Cov kws kho mob kuaj mob li cas?

Koj tus kws kho mob yuav kuaj xyuas PROM los ntawm kev siv lub tshuab kuaj mob sterile speculum . Qhov no suav nrog kev ntxig lub tshuab kuaj mob rau hauv koj lub qhov chaw mos. Qhov no tso cai rau tus kws kho mob txav cov phab ntsa ntawm koj lub qhov chaw mos kom pom koj lub qhov chaw mos. Tom qab ntawd coj ib qho qauv ntawm cov kua dej thiab kuaj. Qee zaum, yog tias tus kws kho mob pom cov kua amniotic sib sau ua ke hauv qhov chaw sab saud ntawm koj lub qhov chaw mos thaum lub sijhawm kuaj xyuas no, cov membranes yuav tawg lawm.

Tsis tas li ntawd xwb, yuav muaj kev kuaj ultrasound los xyuas seb tus menyuam nyob qhov twg thiab seb cov kua amniotic hauv lub tsev menyuam muaj pes tsawg.

Muaj lwm yam kev ntsuam xyuas dab tsi ntxiv?

• Kev kuaj ntawv Nitrazine: Qhov no yog siv los ntsuas pH (kev ntsuas qhov acidity ntawm ib yam dab tsi) ntawm koj lub qhov chaw mos. Muab ib tee ntawm koj cov kua qaub ncaug tso rau ntawm daim ntawv no thiab daim ntawv raug kuaj xyuas seb nws puas hloov xiav. Yog tias nws hloov xiav, pH ntawm cov kua dej ntau dua 6.0, yog li nws yuav yog cov kua amniotic. (Cov kua qaub ncaug ib txwm muaj pH qis dua li cov kua amniotic.)
• Kev kuaj Fern: Ferning yog lub npe muab rau cov kua amniotic qhuav uas zoo li nplooj fern. Qhov no kuj suav nrog kev coj cov qauv ntawm cov kua thiab kuaj nws hauv qab lub tshuab microscope.

Cov kev kho mob rau qhov no yog dab tsi?

Kev kho mob nyob ntawm lub hnub nyoog cev xeeb tub , kev noj qab haus huv ntawm tus menyuam , thiab qhov hnyav ntawm koj tus mob .

Feem ntau muaj ob txoj kev xaiv: ib qho yog 'yug' tus menyuam, thiab qhov thib ob yog 'kev tswj xyuas kev xeeb tub'. 'Kev tswj xyuas kev xeeb tub' yog ib txoj kev kho mob uas ncua 'kev yug menyuam'. Qhov no suav nrog kev so hauv txaj, tshuaj, thiab kev saib xyuas tas li rau kev kis kab mob lossis kev nyuaj siab ntawm tus menyuam hauv plab.

Kev kho mob rau PROM tom qab 37 lub lis piam

Yog koj cev xeeb tub li ntawm 37 thiab 40 lub lis piam thiab koj lub kua dej tawg, kwv yees li 90% ntawm cov poj niam yuav yug menyuam yam tsis tau npaj tseg hauv 24 teev. Koj tus kws kho mob yuav muab tshuaj rau koj kom pab koj yug menyuam, lossis lawv yuav cia koj yug menyuam yam tsis tau npaj tseg.Feem ntau, kev yug menyuam hauv 24 teev yog qhov kev xaiv zoo tshaj plaws.

Kev kho mob yog tias 'PROM' tshwm sim ntawm 34 thiab 37 lub lis piam

Hauv qhov no, koj tus kws kho mob yuav ntsuas qhov kev pheej hmoo ntawm kev muaj menyuam yug ntxov piv rau qhov kev pheej hmoo ntawm kev kis kab mob thiab lwm yam teeb meem . Yog tias tus kws kho mob txiav txim siab yug menyuam, nws yuav npaj rau tus menyuam kom tau txais kev saib xyuas tshwj xeeb (xws li kev saib xyuas hauv NICU - Neonatal Intensive Care Unit ) thaum nws yug los.

Kev Kho Mob Rau Preterm PROM (PPROM) ua ntej 34 lub lis piam

Yog koj tus menyuam cev xeeb tub tsis tau 34 lub lis piam, muaj feem yuav muaj teeb meem ntau dua los ntawm kev yug ntxov. Thaum lub sijhawm no, koj tus kws kho mob yuav sim kom koj nyob hauv tsev kho mob, muab koj pw tsaug zog, thiab sim ua kom koj cev xeeb tub ntev me ntsis.

Lawv kuj tseem yuav muab cov tshuaj rau koj xws li:

• Cov tshuaj Corticosteroids: Pab kom tus menyuam lub ntsws loj hlob.
• Cov Tshuaj Tua Kab Mob: Tiv thaiv kev kis kab mob thiab ua kom cev xeeb tub ntev dua.
• Cov tshuaj tocolytics: Cov tshuaj uas muab los pab kom tsis txhob yug menyuam.
• Magnesium sulfate: Pab txhawb kev loj hlob ntawm lub hlwb ntawm tus menyuam.

Koj tus kws kho mob yuav kuaj xyuas koj tsis tu ncua seb puas muaj cov cim qhia tias muaj kab mob. Nws kuj tseem yuav saib xyuas koj tus menyuam lub plawv dhia thiab kev txav mus los kom paub tseeb tias tus menyuam tsis raug kev nyuaj siab. Kev cia siab ntawm cov kev kho mob no yog kom ncua koj cev xeeb tub mus txog tsawg kawg 34 lub lis piam.

Qhov tseem ceeb tshaj plaws yog, yog tias koj muaj kev kis kab mob thaum koj cov dej tawg, lossis yog tias koj muaj kev kis kab mob tom qab, koj yuav tsum yug tus menyuam.

Puas muaj ib txoj kev los tiv thaiv qhov no?

Tsis muaj ib txoj kev tshwj xeeb los tiv thaiv PROM. Qhov zoo tshaj plaws uas koj ua tau yog tsum tsis txhob haus luam yeeb kiag li, muaj lub cev xeeb tub noj qab nyob zoo, thiab mus kuaj mob ua ntej yug menyuam. Kev haus luam yeeb yog ib qho ua rau muaj PROM (thiab ntau yam teeb meem thaum cev xeeb tub).

Leej twg muaj feem yuav kis tau tus kab mob `PROM` thiab `PPROM` ntau dua? (Cov Yam Uas Yuav Kis Tau)

Koj muaj feem yuav mob PPROM lossis PROM ntau dua yog tias koj muaj mob uas ua rau koj daim nyias nyias chorioamniotic (txheej sab nraud ntawm lub hnab amniotic tsis muaj zog), lossis yog tias nws nyuam qhuav tshwm sim. Piv txwv li ntawm qhov no suav nrog:

• Cov kab mob: Cov kab mob sib kis los ntawm kev sib deev (STIs) yog cov kab mob zoo li kab mob bacterial vaginosis.
• Lub caj dab luv luv .
• Yog tias muaj keeb kwm ntawm kev tau ua 'PROM' ua ntej .
• Yog tias koj tab tom yuav muaj menyuam xws li menyuam ntxaib lossis menyuam peb ('Xav tias yuav muaj ntau tus menyuam').
• Polyhydramnios (uas txhais tau tias muaj kua amniotic ntau dhau).
• Los ntshav ntawm qhov chaw mos.
• `Kev kuaj amniocentesis`Yog tias (kev sim dej) tau ua tiav lawm.
• Yog tias muaj keeb kwm ntawm kev yug menyuam ua ntej lub sijhawm .

Thaum lub hnab dej tawg, tej yam txaus ntshai tshaj plaws yog dab tsi?

Qhov kev pheej hmoo loj tshaj plaws nrog PROM yog yug ntxov. Yug ntxov yog thaum koj tus menyuam yug ua ntej 37 lub lis piam. Cov teeb meem ntawm kev yug ntxov suav nrog teeb meem ua pa, qhov kub ntawm lub cev qis, thiab teeb meem kev loj hlob. Qee tus menyuam yug ntxov kuj tseem yuav muaj kev loj hlob qeeb tom qab hauv lub neej.

Thaum cov kua dej amniotic tsis raug tiv thaiv, lwm yam teeb meem tuaj yeem tshwm sim thaum cev xeeb tub, piv txwv li:

• Cov kab mob , xws li Chorioamnionitis (kev kis kab mob ntawm daim nyias nyias thiab cov kua dej amniotic).
• Kev tawg ntawm placental .
• Kev sib txhuam ntawm txoj hlab ntaws los yog txoj hlab ntaws prolapse .

Koj tus kws kho mob yuav xav txog ob qho kev pheej hmoo ntawm kev muaj menyuam yug ntxov thiab kev pheej hmoo ntawm kev kis kab mob thiab lwm yam teeb meem kom txiav txim siab lub sijhawm zoo tshaj plaws los yug koj tus menyuam.

Kuv yuav tsum yug tus menyuam sai npaum li cas tom qab kuv lub cev dej tawg?

Cov kev tshawb fawb tau qhia tias cov poj niam uas yug menyuam hauv 24 teev tom qab lub cev tawg muaj kev pheej hmoo tsawg dua ntawm kev kis kab mob dua li cov neeg uas yug menyuam tom qab 24 teev . Txawm li cas los xij, qhov kev pheej hmoo no yuav tsum tau muab piv rau qhov kev pheej hmoo ntawm kev muaj menyuam yug ntxov. Koj tus kws kho mob yuav pab koj txiav txim siab zoo tshaj plaws rau koj thiab koj tus menyuam.

Koj tuaj yeem cev xeeb tub tau ntev npaum li cas tom qab koj lub cev tsis muaj dej lawm?

Qhov no yuav txawv nyob ntawm koj qhov xwm txheej thiab koj cev xeeb tub tau pes tsawg lub lis piam thaum koj cov kua dej tawg. Yog tias koj cov kua dej tawg ua ntej 37 lub lis piam, koj tus kws kho mob yuav pab koj txiav txim siab zoo tshaj plaws. Qee zaum, qhov kev pheej hmoo ntawm kev kis kab mob thiab teeb meem siab dhau, yog li ntawd tus menyuam yuav tsum tau yug los.

Tus me nyuam puas yuav muaj sia nyob yog tias lub hnab dej tawg ua ntej?

Yog, nws ua tau. Txawm tias lub hnab dej tawg sai sai los, tus menyuam tseem muaj sia nyob. Nws nyob ntawm ntau yam, xws li lub sijhawm cev xeeb tub ntev npaum li cas thiab cov kua amniotic tshuav ntau npaum li cas. Koj tus kws kho mob feem ntau yuav saib xyuas tus menyuam kom paub txog cov cim qhia tias tus menyuam hauv plab muaj kev nyuaj siab thiab kev kis kab mob, thiab yuav txiav txim siab thaum twg yuav yug tus menyuam.

Nco ntsoov qhov tseem ceeb tshaj plaws (Cov Lus Coj Mus Tsev)

Thaum cev xeeb tub, ib lub hnab uas muaj kua dej, hu ua lub hnab amniotic , nyob ib puag ncig thiab tiv thaiv tus menyuam. Feem ntau, lub hnab no tawg thaum lub sijhawm yug menyuam. Txawm li cas los xij, qee zaum nws tuaj yeem tawg ua ntej pib yug menyuam, lossis txawm tias ob peb lub lis piam ua ntej yug menyuam pib. Qhov no hu ua Premature Rupture of Membranes (PROM) .

• Yog qhov no tshwm sim tom qab 37 lub lis piam , tus kws kho mob yuav yug tus menyuam.
• Qhov no yog ua ntej 37 lub lis piam.Yog tias muaj tus mob "Preterm PROM", tus kws kho mob yuav ntsuas qhov kev pheej hmoo ntawm kev muaj menyuam tsis tau yug ua ntej thiab qhov kev pheej hmoo ntawm cov teeb meem xws li kev kis kab mob thiab kev nias ntawm txoj hlab ntaws ua ntej txiav txim siab.

Nws yuav ua rau koj xav tsis thoob thaum hnov ​​​​​​tias koj cov dej tawg ntxov. Tab sis nco ntsoov, koj tus kws kho mob tab tom ua txhua yam uas nws ua tau kom koj thiab koj tus menyuam muaj kev nyab xeeb thiab noj qab haus huv. Yog tias koj muaj lus nug lossis kev txhawj xeeb, nrog koj tus kws kho mob tham txog lawv. Nws yog ib qho tseem ceeb heev.

PROM , PPROM, lub hnab dej tawg, teeb meem cev xeeb tub, yug ntxov, kua amniotic, kev noj qab haus huv cev xeeb tub