Naupai lai hian nu tin hian beiseina tam tak an nei a, mahse hlauhna tlemte pawh an nei bawk. Naute hriselna leh engkim a tha ang em tih te kan ngaihtuah fo thin. Chutiang hunah chuan i hriat loh pawh nise, mahse hriat hlawh tak dinhmun kan sawi a ni. Chu chu cervical insufficiency a ni a, doctor-te’n an tih angin , ‘Incompetent Cervix’ emaw ‘Cervical Insufficiency’ emaw a ni . He hming i hriat hian hlau suh, hemi chungchang hi uluk taka hriattir i nih a, enkawl dan dik i hmuh chuan a tam zawkah chuan harsatna awm lovin i enkawl thei ang.
A awlsam zawngin, serh thiam lo chu eng nge ni?
I uterus (i naute awmna bawm) chu in tlemte angin ngaihtuah rawh. Chu in kawngkhar chu serh (cervix) a ni. He kawngkhar hi i naute a lo puitlin hma loh chuan khar tlat a ngai a, chu chu kar 37-40 vel a ni. Chumi hnuah chauh chuan i naute chu i pum chhungah him takin a awm thei ang.
Mahse, ‘Incompetent Cervix’ an tih dinhmunah chuan he kawngkhar hi chhan leh natna awm lovin a inhawng tan a, naupai lai vel, naute chu a puitlin hma pawhin a inhawng tan thin. Cervix chu a chak lo va, a tawi a, a inhawng bawk.
Chuti a nih chuan engvangin nge hei hi harsatna a nih?
Ngaihtuah teh, naute kawngkhar chu hawn hma lutuk a nih chuan eng nge thleng ang? Naute chu a rawn chhuak a ngai dawn a ni. Mahse, chutih lai chuan naute taksa peng pawimawh tak tak, lung leh thinlung te chu a lo thanglian kim lo. Hei hian harsatna lian tak pahnih a thlen thei a ni:
1. Second-trimester miscarriage: Naupai kar 20 hmaa naute boral hi a ni.
2. Nau piang hma: Kar 37 hmaa nausen piang.
Hetiang dinhmun hi naupai 100 zinga 1 vel ah a awm a, chuvangin hriat a pawimawh hle.
Hetiang dinhmun hi tute nge hlauhawm ber?
Hetiang dinhmun hi tu chungah pawh a thleng thei a, mahse mi thenkhat chu an hlauhawm zawk. I doctor chuan heng risk factors te hi i neih leh neih loh en turin i health history a zawt ang che.
| Risk factor a ni | A sawifiahna awlsam tak |
|---|---|
| Tun hmaa nau pai emaw, nau piang hma emaw | Risk factor lian ber chu nau pai tawh lo, a bik takin naupai hmaa nau pai tawh, second trimester (kar 14-27 inkar)-a nau pai tawhna history a ni. |
| Cervix emaw uterus emaw a chhiat | Nau neih hmasak avanga serh a chhia a nih chuan, cervical tear, D&C emaw, thil dang vang emawa tih a nih chuan. |
| Cervical surgery neih a ni | Cervical cancer atana LLETZ emaw cone biopsy emaw ang chi procedure hnuah chuan cervix chu a tawi a, a chak lo thei bawk. |
| Nausen pum emaw, serh emaw a piansualna | Hmeichhe thenkhat chu an nausen pum emaw, an serh emaw pianziaah pianphung dik lo neiin an piang thei a, chu chuan serh chu a tichak lo thei bawk. |
| Genetic dinhmun (genetic) a awm | Taksa inzawmkhawmna tichak lo thei, Ehlers-Danlos syndrome ang chi genetic disease i neih chuan i serh pawh a chak lo thei bawk. |
| Naupai tam tak | He hlauhawmna hi naute tam tak, twins emaw triplet emaw te chu a ruala nausen pum chhunga an awm chuan a pung thei bawk a, a chhan chu nausen pum leh serh (cervix)-ah pressure a tam zawk a ni. |
A pawimawh ber chu i naupai tawhna leh i surgery tawh zawng zawng chu engmah thup lovin doctor hnenah hrilh vek tur a ni . Chu thu hriat chuan a enkawl ṭhat theih nân a ṭanpui ang che.
Hetiang natna lan chhuah dan hi engte nge ni?
Hei hi hetah hian harsatna lian ber a ni. A tam zawkah chuan ‘Incompetent Cervix’ chhinchhiahna langsar tak tak a awm lo. Nau neih dawn lai angin contraction a awm lo va, i tui pawh a chhe lo. Engkim hi ngawi rengin a thleng vek.
Mahse, mi thenkhat chuan kar 14 leh 20 inkar hian heng ang symptoms fiah lo tak tak hi an nei thei a ni:
- Pum hnuai lam pressure emaw heaviness emaw hriatna.
- Ka hnungzang na deuh ang maiin ka hria.
- Vaginal discharge inthlak danglamna (tui, mucus ang chi, thisen tlem a awm thei).
- Spotting a ni.
Heng symptoms te hi a fiah lo em em a, a chang chuan naupai laia harsatna pangngai anga ngaih theih a ni. Chuvangin thil danglam tak i hriat chuan, thil tenawm tak pawh ni se, i doctor hnenah hrilh hreh ngai suh.
Engtin nge doctor hian hei hi a hmuh theih?
He natna hi hmeichhe naupai hmasa lama harsatna nei tawh uluk taka enfiah atanga hriat theih a ni fo. A chunga kan sawi tak risk factors i neih chuan i doctor chuan a bik takin a enkawl ang che.
Hei hi kawng lian pahnih hmangin hriat theih a ni:
1. Hriselna chanchin: Doctor chuan a hmaa i naupai te, i nau pai te, i surgery te chipchiar takin a zawt ang che.
2. Transvaginal Ultrasound: Hei hi he natna hi hriat chian dan tha ber a ni. Chutah chuan instrument te tak te chu vagina kaltlangin dahin cervical sei zawng chiang takin an teh thin. He scan hian naupai lai hian cervix a tawi emaw, a inhawng emaw tih chiang takin a hmu thei. Hlauhawm nei tan chuan doctor chuan naupai kar 16-na atanga kar khat emaw kar hnih emaw hnuah he scan hi tih leh a rawt thei a, kar 24-na hnuah pawh tih leh a rawt thei bawk.
Hei hi eng enkawl dan leh enkawl dan nge ni?
Hetiang dinhmun hi hriat chhuah a nih chuan naute pum chhunga hun rei zawk hman theih tur enkawlna chi hrang hrang a awm a, chu chuan nau piang hmasa tur venna kawngah a pui thei a ni. I doctor chuan i dinhmun leh i hriselna chanchin a zirin i tana enkawlna tha ber tur a ruat ang.
| Enkawl dan tur | Hrilhfiahna |
|---|---|
| Cervical Cerclage tih a ni | Hei hi hmanraw hman tlanglawn ber leh hlawhtling ber a ni. A awlsam zawngin, serh chak lo tak vel chu suture nghet tak dahin, khar turin an khar tlat a ni. Bag pakhatin cervix a khar tlat ang mai a ni. He surgery hi kar 12 leh kar 14 inkarah tih a ni tlangpui. Tichuan, naute pian hnaih tawh, kar 37 vel a nih chuan suture te chu an tan a, an la chhuak thin. |
| Progesterone hormone hmanga enkawlna (Progesterone supplement) hmanga enkawlna . | Progesterone hi hormone a ni a, naupai reng rengin a pui a ni. Preterm birth history nei tan chuan he hormone hi second trimester atang hian pill angin emaw vaginal suppository angin emaw pek theih a ni. Hei hian uterine contraction a tihziaawm bakah cervix a tichak bawk. |
| Monitoring neih reng a ni | Risk a awm a, mahse a natna chu a na lutuk lo a, stitches a ngai lo a nih chuan, i doctor chuan i cervix chu a sei zawng a inthlak leh awm loh enfiah turin scan a nei fo ang. Hrilhfiahna eng emaw hmuh a nih chuan a tul anga enkawl tan nghal theih a ni. |
Mi zawng zawng hian cerclage kan nei thei ang em?
No. Hetiang surgery hi tih loh tur thenkhat a awm. Entir nan:
- Twins emaw a aia tam emaw i neih chuan.
- Cervix chu centimetre 4 aia tam a dilated tawh chuan.
- Membrane te chu a rupture tawh a nih chuan.
- Nausen pum chhungah natna hrik a awm chuan.
Hetiang hunah hian i doctor chuan duhthlan tur dang a sawipui ang che.
I naupai leh tur chu i ngaihtuah thei ang em?
Ni e, a theih ngei ang. Mahse naupai pakhatah ‘Incompetent Cervix’ i nei a nih chuan i naupai leh hunah pawh hetiang dinhmun hi i nei thei tihna a ni. Chuvangin, naute dang neih i ngaihtuah hmain i gynecologist nen inhmu la, hei hi sawipui hmasa phawt ang che. Tichuan, i naupai leh tur tan tirh atang khan uluk takin i enkawl thei a, a tul chuan stitch (cerclage) dah hmasak ang chi te pawh i la thei bawk.
Thu lawmawm tak chu cerclage hi 90% velin a hlawhtling a ni. Chumi awmzia chu i naute chu a pian hun thlenga enkawl theihna chance tha tak i nei tihna a ni. Chuvangin lungngai suh.
Doctor i hmuh nghal tur hunah
Hetiang natna hi enkawl i ni emaw, i dawng lo emaw, naupai laiin thil danglam tak i tawk a nih chuan damdawi lam thurawn lak nghal a pawimawh hle. A bik takin a hnuaia symptoms te hi i neih chuan doctor ko nghal la, damdawi in hnai ber Emergency Department (ETU) pan la.
- Vagina atanga thisen emaw tui ang chi tui lo chhuak a awm chuan.
- I pum hnuai lam natna emaw, i inzawmna (contraction) emaw i hriat chuan.
- Back pain danglam tak i neih chuan.
- I pum hnuai lam pressure i hriat chuan.
Take-Home Thuchah a ni
- ‘Incompetent Cervix’ tih hi naute a puitlin hmaa serh a chak lo a, a inhawng tan a ni. Hei hi nau piang hmaa awm chhan lian tak a ni.
- A tam zawkah chuan he natna hi a lan chhuah dan chiang tak a awm lo va, chuvangin i nau pai tawhna leh i surgery tawh zawng zawng kha doctor hnenah hrilh vek a pawimawh hle.
- Transvaginal ultrasound scan hian cervical dilation chu a hmu hmasa thei a ni.
- Chumi atan chuan Cervical cerclage hi a tha hle.
- Hemi chungchangah hian rinhlelhna leh ngaihtuahna i neih chuan i doctor nen sawiho hreh suh. I himna leh i naute himna hi a pawimawh ber a ni.
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