Naawe wavaamu omusaayi mungi ng’omaze okuzaala omwana? Ka twogere ku kuvaamu omusaayi oluvannyuma lw'okuzaala (PPH) .

Kya bulijjo okuvaamu omusaayi katono ng’omaze okuzaala. Naye watya singa ovaamu omusaayi mungi okusinga bwe wali olowooza? Ddala kiyinza okuba eky’entiisa era eky’akabi. Kino kye tuyita okuvaamu omusaayi oluvannyuma lw’okuzaala (PPH) . Kino si kya kusaaga, mbeera eyeetaaga okujjanjabibwa amangu.

Okuvaamu omusaayi oluvannyuma lw’okuzaala (PPH) kye ki? Tutegeere ddala?

Mu ngeri ennyangu, okuvaamu omusaayi oluvannyuma lw’okuzaala (PPH) kwe kuvaamu omusaayi omungi oluvannyuma lw’okuzaala. Kino kitera okubaawo mu ssaawa 24 nga bamaze okuzaala. Tukiyita ‘Primary PPH’ . Naye oluusi, omusaayi guyinza okuvaamu ennaku ntono, wiiki ntono oba n’okutuuka ku wiiki 12 oluvannyuma lw’okuzaala. Kino kiyitibwa ‘Secondary oba Late PPH’ .

Ekibaawo mu kino omusaayi mungi gubula mu mubiri gwo omulundi gumu. Kino bwe kibaawo, puleesa yo eyinza okukka mu bwangu. Kiki ekibaawo olwo? Omuwendo gw’omusaayi ogugenda mu mutima, ku bwongo, n’ebitundu ebirala ebikulu gukendeera. Kino kiyitibwa hypovolemic shock . Kino kiyinza okutta omuntu. N’olwekyo abasawo ne ba nurse balina okukomya amangu omusaayi guno.

Jjukira nti bw’owulira ng’ovaamu omusaayi mungi ng’omaze okuzaala omwana, kikutiisa. Naye ekisinga obukulu si kutya, n’okubuulira omusawo wo oba omuzaalisa amangu ago. Singa okitegeera nga bukyali era n’ojjanjabwa mangu, emirundi mingi osobola okuwona mu bujjuvu.

PPH ereeta omusaayi mmeka?

Buli kaseera,

• Oba ozaala mu bukyala oba C-section, singa ofiirwa omusaayi ogusukka mu liita emu (1000ml) , .
• Oba, singa wabaawo enkyukakyuka ey’amaanyi mu kukuba kw’omutima gwo ne puleesa wamu n’omuwendo gw’omusaayi ogufiiriddwa, era ng’olaga obubonero bw’okufiirwa omusaayi mungi, kitwalibwa nga PPH.

Embeera eno esobola okubaawo mu baana abazaalibwa wakati wa 1 ne 5 ku 100. Ekyo kiri wakati wa 1% ne 5%. Naye bw’ofuna obujjanjabi obw’amangu, ebiseera ebisinga tekiba kya bulabe eri obulamu.

Ntegeera ntya oba nnina PPH? Obubonero bwe buliwa?

Akabonero akakulu aka PPH kwe kuvaamu omusaayi omungi mu bukyala obutasalako, oluvannyuma lw’okuzaala. Oluusi , ebizimba by’omusaayi ebinene okusinga omupiira gwa golf bisobola okuyitamu. Kino bwe kibaawo, kiyinza okuba akabonero akalaga nti waliwo ekizibu.

Obubonero obulala bwe buno:

• Obubonero bwa puleesa okukka: okuziyira, obutalaba bulungi, n’okuzirika.
• Omutima gweyongera okukuba (Tachycardia).
• Okukendeera kw’obutoffaali obumyufu (okukendeera kw’emiwendo gya hematocrit).
• Olususu oluddugavu oba olunyirira, ng’owulira ng’okutuse mu ntuuyo ennyogovu.
• Obulumi n’okuzimba mu kitundu ky’obukyala oba mu kitundu ky’obukyala.(Kino kibaawo ng’omusaayi gukuŋŋaanyiziddwa ebweru w’omusuwa)

Bw’ofuna obubonero buno obutali bwa bulijjo oluvannyuma lw’okuzaala, tegeeza omusawo wo amangu ago . Oluusi, obubonero bwa PPH busobola okusigalawo ne bw’omala okudda eka okuva mu ddwaaliro. Kino bwe kibaawo, tosattira era olabe omusawo amangu ago.

Lwaki PPH ebaawo? Biki ebivaako?

Waliwo ebintu ebiwerako ebivaako PPH.

Omanyi omwana bw’aba mu lubuto, enseke yeekwata ku bbugwe wa nnabaana wo n’awa omwana emmere n’omukka gwa oxygen. Omwana bw’amala okuzaalibwa, nnabaana wo yeeyongera okukonziba n’okugoba enseke. Okukonziba kuno kuleetera emisuwa gy’omusaayi omwabadde nnabaana okunywezebwa n’okuyimiriza okuvaamu omusaayi. Naye oluusi, singa okukonziba kuno tekuba kwa maanyi kimala , omusaayi tegujja kukoma. Kino kye kivaako ebitundu 80% ebya PPH.

Ate era, PPH esobola okubaawo singa ebitundu by’omumwa gwa nnabaana bisigala mu bbugwe wa nnabaana, oba singa ebitundu by’enkola yo ey’okuzaala (obukyala, omumwa gwa nnabaana, nnabaana) byonooneddwa ng’ozaala.

PPH esinga kubaawo wakati w’eddakiika 30 ne 60 ng’omwana amaze okuzaalibwa.

"Four Ts" ezikosa PPH

Waliwo ebintu bina ebikulu ebivaako PPH, ebiyitibwa "Four Ts".

1. Tone (embeera ya nnabaana - Uterine Atony): Kino kye kisinga okuvaako . Uterine atony bwe buba nga nnabaana takonziba bulungi oluvannyuma lw’okuzaala, wabula n’afuuka omugonvu era nga munafu. Olwo emisuwa gy’omusaayi omuli nnabaana teginyweza, era omusaayi ne gugenda mu maaso.

2. Obuvune: Mu kiseera ky’okuzaala, omusaayi guyinza okuvaamu olw’obuvune mu bukyala, omumwa gwa nnabaana, nnabaana oba mu bitundu by’omubiri ebiyitibwa perineum. Oluusi omusaayi guno gusobola okukuŋŋaana munda mu bitundu ebifunye obuvune ne gusigala nga guvaamu omusaayi okumala essaawa oba ennaku oluvannyuma lw’okuzaala.

3. Tissue (Retained placental tissue): Singa enseke teyawukana ddala ku bbugwe wa nnabaana, ebitundu ebisigaddewo bisobola okuvaamu omusaayi. Kino kiyinza okuba nga kiva ku butabeera bulungi mu nnabaana, oba kiyinza okuba nga kya bulijjo.

4. Thrombin (obuzibu mu kuzimba omusaayi): Bw’oba ​​olina obuzibu bw’okuzimba omusaayi, oba ng’olina embeera eyakosa omusaayi okuzimba ng’oli lubuto, ne bw’ovaamu omusaayi omutono kiyinza okuba ekizibu ekinene.

Ani ali mu bulabe obw’amaanyi obw’okulwala PPH?

Mu butuufu, PPH esobola okutuuka ku muntu yenna azaala omwana. Wadde nga waliwo ensonga nnyingi ez’akabi eri PPH, nga 40% ku misango gya PPH gibaawo awatali nsonga yonna ya bulabe . N’olwekyo, abasawo bayinza obutasobola kuziyiza ddala PPH. Kyokka okumanya ebintu bino eby’akabi nga tonnazaala kiyinza okuyamba okukendeeza ku bulabe bw’okuvaamu omusaayi omungi.

Embeera z’omu lubuto

Obulabe bwa PPH buba bungi singa oba olina emu ku mbeera zino wammanga ezikwata ku nnabaana:

• (Placenta eyasooka)(Placenta esangibwa wansi mu nnabaana)
• (Okugwa mu nseke ) .
• (Placenta accreta) (Placenta enywedde bulungi ku bbugwe wa nnabaana) .

Embeera ezikwata ku kuzaala oba okuzaala

Obulabe bwa PPH buyinza okweyongera singa ebintu bino wammanga bibaawo ng’ozaala:

• Singa eddagala eribudamya abantu bonna liweereddwa.
• Bw’oba ​​oweereddwa eddagala (tocolytics) okukomya okukonziba kwa nnabaana.
• Singa obulumi buba buwanvu oba eddagala erikozesebwa okuleetera nnabaana okukonziba (Oxytocin / Pitocin®) liweebwa nnyo okumala ebbanga eddene.
• Okuzaala omwana amangu (nga tewannayita ssaawa ssatu ng’okuzaala kutandise).
• Singa forceps oba vacuum yakozesebwa mu kiseera ky’okuzaala okwa bulijjo.
• Singa wabaawo ebikutuka ebinene mu bukyala.
• Singa omwana yazaalibwa mu ngeri ya cesarean .

Embeera z’obulamu endala

Embeera endala ez‟obulamu nazo zisobola okwongera ku bulabe bw‟okulwala PPH, gamba nga:

• Endwadde z’okuzimba omusaayi, okugeza (obulwadde bwa von Willebrand) .
• Bw’oba ​​omaze okumira eddagala (Magnesium sulfate) okujjanjaba obulwadde bw’okuzaala obw’amaanyi .
• Embeera z’olubuto ezikosa ensonga z’okuzimba omusaayi oba obutoffaali obukola omusaayi, okugeza: (HELLP syndrome) , (gestational thrombocytopenia) .
• Obulwadde bw’ensawo y’omu lubuto (Chorioamnionitis) .
• Obunene.
• Emyaka gya maama egy’obukulu.

Ate era, obulabe bwa PPH buba bungi singa nnabaana agaziwa ekisusse . Kino kiyinza okubaawo:

• Bw’oba ​​omaze okuzaala abaana bataano oba okusingawo.
• Mu kuzaala emirundi mingi, gamba ng’abalongo n’abaana basatu.
• Bw’oba ​​olina omwana omunene (macrosomia) .
• Singa wabaawo amazzi g’omu lubuto amangi ennyo (polyhydramnios) .

Biki ebiyinza okuva mu PPH?

Bw’ofiirwa omusaayi omungi, oyinza okufuna ebintu ng’omutima okweyongera, okussa okweyongera, n’okukendeera kw’omusaayi. Obubonero buno busobola okukendeeza ku muwendo gw’omusaayi ogukulukuta mu bitundu by’omubiri ng’ekibumba, obwongo, omutima, n’ensigo, ekivaako okuwuniikirira . Okusannyalala kwe kuba nti ebitundu by’omubiri tebifuna musaayi gumala. Kino kiyinza okuvaako ebitundu by’omubiri okulemererwa oba n’okufa.

Otegeera otya PPH oluvannyuma lw’okulongoosebwa (C-section)?

Ebiseera ebisinga, obubonero bwa PPH oluvannyuma lw’okulongoosebwa C-section bwe bumu n’obw’okuzaala okwa bulijjo. Obumu ku bubonero buno mulimu:

• Omutima gweyongera okukuba.
• Emikono n’ebigere binyogoga, nga biwulira nga biwunya.
• Okukaluubirirwa okussa.
• Okuzimba, okunyiga oba okulumwa awalala mu lubuto naddala mu kifo ekiwundu we kyalongoosebwa.
• Okuvaamu omusaayi oguyitiridde mu bukyala n’okuyisa omusaayi omunene.

Abasawo bazuula batya obulwadde bwa PPH?

Abasawo bazuula PPH nga bayita mu kukeberebwa okulaba n’omubiri. Okukebera mu laabu n’okwekenneenya n’obwegendereza ebyafaayo by’obulamu bwo nabyo bikulu okwekenneenya akabi n’enkosa ya PPH.

PPH ezuulibwa okusinga okusinziira ku bungi bw’omusaayi gw’ofiiriddwa. Omuwendo gw’omusaayi ogubula gutera okubalirirwa nga babala oba okupima paadi oba sipongi ezaali zinyikiddwamu omusaayi ng’omwana azaaliddwa.

Bw’oba ​​oteebereza PPH, osobola okukozesa ebintu bino okwongera okwekebera:

• Weeyongere okulondoola omukka gwo ne puleesa .
• Okukebera omusaayi okupima obungi bw’obutoffaali obumyufu mu musaayi (hematocrit) n’ebintu ebizimba omusaayi.
• Okukebera ekisambi nga kwekebejja obukyala, omumwa gwa nnabaana ne nnabaana.
• Sikaani ya ultrasound ekwata ekifaananyi kya nnabaana mu bujjuvu.

PPH ejjanjabwa etya?

Abasawo batera okutwala PPH ng’embeera ey’amangu. Ekigendererwa ekikulu eky’obujjanjabi kwe kuyimiriza okuvaamu omusaayi mu bwangu nga bwe kisoboka.

Okusinziira ku kikuviiriddeko okuvaamu omusaayi n’obuzibu bw’omusaayi, omusawo ayinza okukuwa amagezi ku bujjanjabi bumu oba obusingawo ku buno:

• Okusiiga nnabaana okukonziba ebinywa bya nnabaana.
• Okuwa eddagala erisitula nnabaana okukonziba.
• Okuggyawo ebitundu by’omu lubuto ebikuumiddwa, oba mu ngalo oba mu nkola endala.
• Okuddaabiriza amaziga mu bukyala, omumwa gwa nnabaana ne nnabaana.
• Okuyingiza ekyuma, gamba nga ekituli oba bbaatule, okussa puleesa ku bisenge bya nnabaana n’okukomya okuvaamu omusaayi.
• Enkola eziyimiriza omusaayi okugenda mu nnabaana.
• Okwetaaga okuteekebwamu omusaayi .
• Okuwa amazzi okuyita mu musuwa (intravenous - IV fluids) , ekitegeeza ebintu nga saline.
• Okuwa omukka gwa oxygen ogw’okugatta nga oyita mu masiki.
• Okuwandiika eddagala eriweweeza ku kyuma .

Tekitera nnyo, oba singa enkola endala zigaana, omusawo ayinza okukola laparotomy (okulongoosa okuggulawo olubuto n’okuzuula ensibuko y’omusaayi) oba okuggyamu nnabaana (okuggyawo nnabaana).

Kitwala bbanga ki okuwona embeera eno eya PPH?

Ebiseera by’okuwona byawukana okusinziira ku muntu. Kisinziira ku musaayi gwe wafiirwa n’engeri abasawo gye baakujjanjaba. Kikulu okwerabirira obulungi mu nnaku ezisooka ng’omwana amaze okuzaalibwa – lya bulungi, nywa amazzi mangi, era ofune ekiwummulo ekinene nga bwe kisoboka . Omusawo ayinza n’okukuwa amagezi okumira eddagala eriweweeza ku kyuma okujjanjaba okukendeeza ku musaayi.

PPH esobola okuziyizibwa? Nsobola okuddamu okuzaala omwana?

Engeri esinga obulungi abasawo gye bayinza okuziyiza PPH kwe kuzuula abo abali mu bulabe obw’amaanyi obwa PPH nga tebannazaala. Osobola okuyamba ng’ogabana ebyafaayo byo byonna eby’obujjanjabi n’omusawo wo n’okubategeeza ku bubonero bwonna obwa PPH ng’omaze okuzaala omwana wo.

Ebiseera ebisinga tekiba kya bulabe okuzaala omwana omulala. Wabula yogerako n’omusawo wo ku bulabe bw’olina okufuna PPH mu kuzaala kwo okuddako. Ne bwe kiba nti akabi kwo kasingako katono ku ka bulijjo, kakyayinza okuba nga katono. Omusawo asobola okutunuulira ebikuleetera akabi n’asalawo oba olina okwegendereza okw’enjawulo mu kuzaala kwo okuddako.

Weerabirira otya oluvannyuma lw’okukola PPH?

Kiyinza okukuzibuwalira okwerabirira ng’olabirira omwana wo omuwere. Naye, bw’ofuna obudde okuwummula n’okwerabirira obulungi, ojja kusobola okudda engulu amangu. Obulamu bwo kikulu nnyo.

Bino bye bimu ku bintu ebiyinza okukuyamba:

• Okuwummula: Omubiri gwo gwetaaga obudde okuwona. Totya kusaba buyambi, era ofune ebisigadde bye weetaaga.
• Lya emmere erimu ebiriisa: Emmere erimu ekyuma ng’ennyama emmyufu, enva endiirwa, n’emmere ey’empeke ey’oku makya erimu ebirungo biyamba okukola obutoffaali obumyufu. Emmere erimu ebiriisa esobola okukuyamba okuwona.
• Nywa amazzi: Nywa amazzi amangi ng’omaze okuzaala okutangira okuggwaamu amazzi mu mubiri.
• Goberera ebiragiro by’omusawo: Omusawo ayinza okukuwa eddagala oba okukyusa mu bulamu bwo okukuyamba okudda engulu. Goberera n’obwegendereza ebiragiro ebyo.
• Kuuma eriiso ku bungi bw’omusaayi oguvaamu: Yambala ‘sanitary pad’. Laba ebbanga lye kitwala okujjula. Okuvaamu omusaayi kulina okukendeera mpolampola mu wiiki ntono. Bwe kitaba bwe kityo, laba omusawo wo.

Okuvaamu omusaayi omungi kiyinza okuba ekizibu ennyo. Kya bulijjo okutwala ekiseera okudda engulu mu nneewulira okuva mu bumanyirivu bwo mu kuzaala. Oyinza okwetaaga obuyambi okuva mu b’omu maka go, mikwano gyo, abasawo, oba abalala. Yogera ku ngeri gy’owuliramu, era saba obuyambi nga bw’oba ​​weetaaga.

Ddi lw’osaanidde okulaba omusawo?

Ebiseera ebisinga, PPH ebaawo ng’omaze okuzaala oba ng’oli mu ddwaaliro. Kyokka bw’oba ​​ovaamu omusaayi mungi ng’omaze okutuuka awaka oba ng’ofuna obubonero bwonna obwa PPH, laba omusawo amangu ago . Ofiisi y’omusawo wo bw’eba eggaddwa oba nga tosobola kubatuukako, genda mu kisenge ky’abalwadde ab’amangu mu ddwaaliro erikuli okumpi.

Bw’ofuna omusaayi omungi ng’omaze okuzaala, laba omusawo mu bwangu. Obubonero obulala obwa PPH mulimu okuziyira, okuzirika, n’okukaluubirirwa okussa. PPH mbeera ya maanyi era nga yeetaaga okujjanjabibwa mu bwangu.

Bw’oba ​​ggwe oba omwagalwa wo olina PPH, kya bulijjo okuwulira ng’owuniikirira era ng’otya olw’ebyo by’oyitamu. Naye jjukira nti okuzuula amangu n’okujjanjabibwa amangu kiyinza okuziyiza ebizibu eby’amaanyi. Eno y’ensonga lwaki kikulu okubeera omuggule era omwesimbu eri omusawo wo ku byafaayo byo eby’obujjanjabi. Kino kijja kukuyamba okuzuula oba oli mu bulabe bwa PPH.

Obubaka Obusembayo Okutwala Awaka

• PPH (Postpartum Hemorrhage) mbeera ya maanyi eyeetaaga okujjanjabibwa amangu, emanyiddwa ng’okuvaamu omusaayi omungi oluvannyuma lw’okuzaala.
• Bw’ofuna obubonero ng’okuvaamu omusaayi omungi, okuyita mu bitundu by’omusaayi ebinene, okuziyira, okuzirika, oba omutima okweyongera , funa amagezi mu bwangu omusawo .
• Ekisinga okuvaako PPH ye nnabaana atony, nga eno ye nnabaana obutasobola kukwatagana bulungi. Ebirala ebivaako mulimu obuvune, enseke okusigala n’obuzibu mu kuzimba omusaayi.
• Wadde nga waliwo ebintu ebimu ebiyinza okuleeta akabi, PPH esobola okutuuka ku muntu yenna .
• Singa kizuulibwa nga bukyali ne kijjanjabwa mangu, emirundi mingi kisobola okuwona ddala.
• Obumanyirivu bwa PPH buyinza okukumalamu amaanyi mu nneewulira. Tolwawo okufuna obuwagizi bwe weetaaga.

Okufaayo ku bulamu bwo kikulu nnyo naddala mu biseera nga bino. Toli wekka, saba obuyambi.

` Okuvaamu omusaayi oluvannyuma lw'okuzaala, PPH, okuzaala, okuvaamu omusaayi, nnabaana, nnabaana, obulamu bw'abakyala