Naute i neih hnuah pawh thisen a chhuak nasa em? Postpartum Hemorrhage (PPH) chungchang hi han sawi ila

Nau neih hnua thisen tlem a chhuah hi thil pangngai a ni. Mahse, i ngaihtuah aia tam thisen i chhuah chuan engtin nge ni ang? A hlauhawm tak zet a, a hlauhawm thei bawk. Hei hi postpartum hemorrhage (PPH) kan tih chu a ni. Hei hi fiamthu a ni lo, damdawi lam pan vat ngai condition a ni.

Nau neih hnua thisen chhuak (PPH) chu eng nge ni? I hrethiam chiah ang maw?

A awlsam zawngin postpartum hemorrhage (PPH) hi nau neih hnua thisen chhuak nasa tak a ni. Hei hi nau neih atanga darkar 24 chhungin a thleng tlangpui. ‘Primary PPH’ kan ti a ni. Mahse, a châng chuan, nau neih hnu ni engemaw zât emaw, kar engemaw zât emaw, a nih loh leh nau neih aṭanga kar 12 thleng pawhin thisen a chhuak thei a ni. Hei hi ‘Secondary or Late PPH’ an ti a.

Hemiah hian thil thleng chu vawi khatah i taksa atangin thisen tam tak a bo vek a ni. Chutiang a nih chuan i thisen sang chu a tlahniam nghal thei a ni. Chuti a nih chuan eng nge thleng? Thinlung, thluak leh taksa peng pawimawh dangtea thisen kal zat chu a tlahniam a ni. Hei hi hypovolemic shock an ti a . Hei hian nunna a tichhe thei a ni. Chuvangin doctor leh nurse ten he thisen chhuah hi an tihtawp vat a ngai a ni.

Naute i neih hnua thisen chhuak tam ang maia i inhriat chuan a hlauhawm hle tih hre reng ang che. Mahse a pawimawh ber chu hlauthawng lo la, i doctor emaw midwife emaw hnenah hrilh nghal mai tur a ni. Hriat hmasak a, enkawl vat a nih chuan i dam kim thei fo.

PPH hian thisen engzat nge a siam?

Atlangpuiin,

• Vaginal delivery emaw C-section emaw i neih pawhin thisen litre khat (1000ml) aia tam i hloh chuan,
• A nih loh leh, thisen hloh zat nen i heart rate leh blood pressure-ah danglamna nasa tak a awm a, thisen hloh tam tak chhinchhiahna i lantir a nih chuan PPH anga ngaih a ni.

Hetiang dinhmun hi nau piang 100 zinga 1 leh 5 inkarah a awm thei a ni. Chu chu 1% leh 5% inkar a ni. Mahse enkawl vat chuan a tam zawkah chuan nunna atana hlauhawm a ni lo.

Engtin nge PPH ka nei tih ka hriat theih ang? Eng nge a lan chhuah dan?

PPH chhinchhiahna ber chu nau neih hnua vaginal bleeding awm reng, nasa tak a ni. A châng chuan , golf ball aia lian thisen zam chu a kal tlang thei. Chutiang a nih chuan harsatna chhinchhiahna a ni thei.

A lan chhuah dan dangte chu:

• Thisen sang hniam chhinchhiahna: luak chhuak, mit hmuh fiah lo, leh muhil.
• Lung chakna (Tachycardia) a sang.
• Thisen sen (red blood cells) a tlahniam (hematocrit level tlahniam).
• Pale emaw clammy skin emaw, thawmhnaw lum takah i rawn chhuak ang maiin i hria.
• Vaginal area emaw perineal area-ah na leh hring.(Hei hi thisen kalna kawng pawn lama thisen a inkhawm hian a thleng thin)

Nau i pai hnua heng natna danglam tak takte hi i neih chuan i healthcare provider hnenah hrilh nghal rawh . A chang chuan damdawi in atanga i haw hnuah pawh PPH symptoms hi a awm reng thei. Hetiang a nih chuan hlauthawng suh la, doctor hmu nghal rawh.

Engvangin nge PPH hi a lo awm? A chhante chu engte nge ni?

PPH hi chhan hrang hrang a awm a.

I hria em, i naute chu nausen pum chhunga a awm lai hian nausen chu i nausen pum bangah a innghat a, naute chu ei tur leh oxygen a pe a ni. I naute a pian hnuah pawh i nausen chu a inzawm khawm chhunzawm zel a, nausen chu a hnawtchhuak zel bawk. Heng contraction te hian placenta a innghahna thisen kalna kawngte chu a tikhauh a, thisen chhuah chu a titawp thin. Mahse, a chang chuan, heng contraction te hi a chak tawk lo a nih chuan , thisen chhuahna chu a tawp lo. Hei hi PPH 80% awm chhan a ni.

Tin, PPH hi placenta hmun thenkhat chu uterine wall-ah a awm reng a nih chuan, emaw, nau neih laiin i reproductive system organs (vagina, cervix, uterus) a chhiat chuan a awm thei bawk.

PPH hi naute pian hnu minute 30 leh 60 inkarah a thleng tam ber.

PPH nghawngtu "Four Ts" te hi

PPH hi a chhan lian ber pali a awm a, chungte chu "Four Ts" an ti.

1. Tone (uterus dinhmun - Uterine Atony): Hei hi a chhan tam ber a ni . Uterine atony chu nau neih hnua uterus a contract tha lo a, a nem leh chak lo a nih chuan a ni. Tichuan, nausen awmna thisen kalna kawngte chu a khauh lo va, thisen a chhuak chhunzawm zel a ni.

2. Trauma: Nau neih lai hian vagina, cervix, uterus, perineum-a hliam vangin thisen a chhuak thei. A châng chuan he thisen hi hliam tuar tissue chhungah a inzawm khawm thei a, nau neih hnu darkar emaw ni emaw chhung chu thisen a chhuak chhunzawm zel thei bawk.

3. Tissue (Retained placental tissue): Nausen chu uterine wall atanga a inthen kim loh chuan a la awm chu thisen a chhuah tir thei a ni. Hei hi nausen chhunga thil danglam vang a ni thei a, a nih loh leh nausen pangngai a ni thei bawk.

4. Thrombin (thisen zawrh harsatna): Coagulation disorder i neih chuan, emaw, naupai laia thisen zam tichhe thei khawpa natna i neih chuan thisen chhuak tlemte pawh hi harsatna lian tak a ni thei.

Tute nge PPH vei theihna sang zawk?

Dik tak chuan PPH hi naute nei mek apiangah a thleng thei a ni. PPH vei theihna tur risk factor tam tak awm mahse, PPH vei zinga 40% vel chu risk factors awm lovin an thleng thin . Chuvangin Doctor ten PPH hi an veng kim thei lo mai thei. Mahse, nau neih hmaa heng risk factors te hi eng nge ni tih hriat hian thisen chhuahna nasa tak awm theihna a ti tlem thei a ni.

Nausen awmna (placental) dinhmun

PPH vei theihna a sang zawk a, a hnuaia thil awmte hi placenta nena inzawm i neih chuan a sang zawk a ni:

• (Placenta hmasa ber)(Placenta hi nausen pum hnuai lamah a awm) .
• (Placental atanga lo chhuak ) .
• (Placenta accreta) (Placenta chu nausen pum chhunga nghet taka inzawm) .

Nau neih emaw, nau neih emaw nena inzawm dinhmun

Nau neih laiin a hnuaia thilte hi a thlen chuan PPH vei theihna a sang thei a ni:

• General anesthesia pek a nih chuan.
• Uterine contraction tihtawp nan damdawi (tocolytics) pek i nih chuan.
• Natna a rei emaw, nausen hnute tichhe thei damdawi (Oxytocin / Pitocin®) chu rei lutuk pek a nih chuan.
• Naute neih hma (nau neih tan atanga darkar thum aia rei lo).
• Nau neih pangngai laiin forceps emaw vacuum emaw hman a nih chuan.
• Vagina chhungah lacerations lian tak tak a awm chuan.
• Naute chu cesarean section hmanga nau a nih chuan .

Hriselna lama harsatna dangte

Hriselna dang pawh hian PPH vei theihna a tipung thei a, chungte chu:

• Thisen zam natna, entirnan (von Willebrand natna) .
• Preeclampsia na tak enkawlna atana damdawi (Magnesium sulfate) i ei tawh chuan .
• Naupai lai hian thisen zam thei thil emaw platelet emaw nghawng thei, entirnan: (HELLP syndrome) , (gestational thrombocytopenia) .
• Amniotic sac-a natna hrik (Chorioamnionitis) .
• Thau lutuk.
• Nu kum upa lam.

Tin, nausen pum hi a zau lutuk chuan PPH vei theihna a sang zawk bawk . Hei hi a thleng thei a ni:

• Nau piang hmasa panga emaw a aia tam emaw i neih tawh chuan.
• Nau piang tam takah, twins leh triplets-ah te.
• Naute lian tak (macrosomia) i neih chuan .
• Amniotic fluid (polyhydramnios) a tam lutuk chuan .

PPH hian eng side effect nge a neih theih?

Thisen i hloh tam lutuk hian thinlung chakna sang, thawk chakna sang, thisen kal chak lohna ang chi thil i tawng thei a ni. Heng chhinchhiahnate hian thisen kal zat chu liver, thluak, thinlung, leh kal ang chi taksa peng hrang hrangah a tihtlem thei a, chu chuan shock a thlen thei a ni . Shock chu taksa peng hrang hrangin thisen an dawn tlem hian a ni. Hei hian taksa peng hrang hrang a tichhe thei a , thihna pawh a thlen thei a ni.

Cesarean section (C-section) hnuah PPH hi engtin nge kan hriat theih ang?

A tam zawkah chuan C-section hnua PPH symptoms hi nau neih pangngai lai nen a inang tlangpui. A lan chhuah dan thenkhat chu:

• Heart rate a sang chho zel.
• Kut leh ke lum, clammy tih hriat.
• Thâwk harsa.
• Pum chhung hmun dangah, a bik takin surgery hliam awmna hmunah chuan a hring, a hliam emaw, a na emaw a awm.
• Vaginal bleeding tam lutuk leh thisen zam lian tak tak pass.

Doctor-te hian engtin nge PPH hi an hriat theih?

Doctor-te chuan PPH hi mit leh taksa enfiahna hmangin an hmuchhuak thin. Lab test leh i hriselna chanchin uluk taka enfiah pawh hi PPH hlauhawmna leh nghawng dan tehna atan a pawimawh hle.

PPH hi thisen i hloh zat atanga hriat theih a ni ber. Thisen hloh zat hi naute piang laia thisen chhuak pad emaw sponge emaw chhiar emaw, rit emaw atanga chhut a ni tlangpui.

PPH i rinhlelh chuan heng thilte hi i test belh leh theih nan i hmang thei ang:

• I pulse rate leh blood pressure te chu enfiah chhunzawm zel ang che .
• Thisen test , thisen a thisen sen (hematocrit) awm zat leh thisen zam (blood clotting factors) tehna a ni.
• Pelvic exam, vagina, cervix leh uterus enfiahna.
• Ultrasound scan hmangin nausen pum chu chipchiar takin a la a.

PPH hi engtin nge enkawl a nih?

Doctor-te chuan PPH hi emergency angin an enkawl fo thin. Enkawlna tum ber chu thisen chhuah chu a rang thei ang bera tihtawp a ni.

I thisen chhuah chhan leh thisen chhuahna nasat dan azirin i doctor chuan heng zinga pakhat emaw, a aia tam emaw a rawt thei ang:

• Uterine massage hmangin nausen pum ruh (muscles) te chu a tikhawlo thei a ni.
• Uterine contractions tichaktu damdawi pek.
• Retained placental tissue lakchhuah, kut hmanga emaw, kawng dang emaw hmanga lak chhuah .
• Vagina, cervix, leh uterus-a mittui tlak dan siamthat .
• Uterine wall-a pressure pek leh thisen chhuah tihtawp nan hmanrua, catheter emaw balloon emaw dah luh.
• Nausen pum chhunga thisen kalna titawptu kalphung .
• Thisen pek i mamawh a ni .
• Vein hmanga tui pek (intravenous - IV fluids) , chu chu saline ang chi thil tihna a ni.
• Mask hmanga supplemental oxygen pek.
• Iron supplement pek dan tur .

A tlem hle a, a nih loh leh kawng dang a hlawhchham chuan doctor chuan laparotomy (a pum hawn a, thisen chhuahna hmun zawn chhuahna operation) emaw, hysterectomy (uterus lakchhuah) emaw a ti thei a ni.

He PPH natna atanga dam leh theih nan hian eng chen nge hun a duh?

Dam leh hun chhung hi mi hrang hrangah a inang lo. Thisen i hloh zat leh i doctor ten an enkawl danah a innghat a ni. I naute pian hnu ni hmasa berah hian i in enkawl tha a pawimawh – ei tha la, tui in tam la, a theih ang anga chawlh hahdam rawh . I doctor pawhin thisen tlakchhamna enkawlna atan iron supplement ei a rawt thei bawk.

PPH hi ven theih a ni em? Naute ka nei leh thei ang em?

Doctor-te tan PPH laka invenna tha ber chu nau neih hmaa PPH vei theihna sang zawkte hriatchhuah hi a ni. I doctor hnenah i medical history kimchang hrilhin i naute i neih hnua PPH chhinchhiahna awm apiang hriattirna hmangin i pui thei ang.

Naute dang neih hi a him tlangpui. Mahse, i nau neih leh hunah PPH i vei theihna tur chu i doctor nen sawiho rawh. I risk chu a tlangpui aia sang deuh pawh nise, a hniam mai thei. I doctor chuan i risk factors te chu a en thei a, i nau neih leh hunah fimkhur bik i neih a ngai em tih a rel thei bawk.

PPH i tih hnuah engtin nge i in enkawl?

Nau piang thar i enkawl lai hian mahni in enkawl chu a harsa thei hle. Mahse, chawlh hahdamna hun i hman a, i in enkawl tha chuan i dam thuai thei ang. I damna hi a pawimawh hle.

I tanpui thei tur thil thenkhat chu hetiang hi a ni:

• Chawlh hahdam: I taksa hian dam nan hun a mamawh a. Ṭanpuina dil hlau suh la, i mamawh bak chu la rawh.
• Chaw tha ei: Iron tamna ei tur, sa sen, thlai hring, leh chawhmeh chi hrang hrang (fortified breakfast cereals) te hian thisen sen (red blood cells) siam nan a pui thin. Chaw tha tak takte hian damna kawngah a pui thei che a ni.
• Tui in tur: Nau neih hnuah tui tam tak in la, chu chuan dehydration a veng ang.
• I doctor thupek zawm rawh: I doctor chuan i dam leh theih nan damdawi emaw, nunphung tihdanglam emaw a pe thei che a ni. Chu thupekte chu ngun takin zawm rawh.
• Thisen chhuah zat hi en reng ang che: Sanitary pad vuah tur a ni. Eng chen nge a fill up theih tih hi en rawh. Kar tlemte chhungin thisen chhuah hi a tlahniam zauh zauh tur a ni. A awm lo a nih chuan doctor rawn rawh.

Thisen chhuah nasa lutuk hi thil lungchhiatthlak tak a ni thei. I nau neih aṭanga i rilru lama harh leh theih nan hun engemaw chen i hman chu thil pangngai a ni. I chhungte, i ṭhiante, doctor, a nih loh leh mi dangte ṭanpuina i mamawh mai thei. I rilru put hmang sawi la, i mamawh hunah ṭanpuina dîl bawk ang che.

Engtikah nge doctor i hmuh ang?

A tam zawkah chuan PPH hi nau i neih hnuah emaw, damdawi ina i awm laiin emaw a thleng thin. Mahse, in i thlen hnua thisen chhuak nasa tak i neih emaw, PPH symptom i neih emaw chuan doctor pan nghal rawh . I doctor office khar emaw, i thlen theih loh emaw chuan i damdawi in hnai ber emergency room-ah kal rawh.

Nau i neih hnua thisen chhuak nasa tak i neih chuan Doctor pan nghal tur a ni. PPH chhinchhiahna dangte chu luak chhuak, muhil, leh thawk harsa te a ni. PPH hi natna khirh tak a ni a, damdawi lam pan vat a ngai a ni.

Nangmah emaw, i hmangaih tak emaw hian PPH i nei a nih chuan, chu thil tawn avanga mangang leh hlauhna awm chu thil pangngai tak a ni. Mahse, hriat hmasak leh enkawl vat chuan harsatna lian tham a veng thei tih hre reng ang che. Chuvangin i doctor hnenah i medical history chungchangah inhawng leh dik taka sawi a pawimawh hle. Hei hian PPH vei theihna tur i nih leh nih loh a hriat theih nan a pui ang che.

Take-Home Thuchah hnuhnung ber

• PPH (Postpartum Hemorrhage) hi natna khirh tak a ni a, damdawi lam pan vat a ngai a, nau neih hnua thisen chhuak tam lutuk a ni.
• Thisen chhuah tam lutuk, thisen zam lian tak tak kal tlang, luak chhuak, muhil, emaw thinlung chakna sang lutuk ang chi symptoms i neih chuan doctor thurawn zawng nghal rawh .
• PPH thlentu ber chu uterine atony a ni a, chu chu nausen pum (uterus) in contract tha thei lo hi a ni. A chhan dangte chu hliam, nausen retained, leh thisen zam lama harsatna te a ni.
• Risk factor engemaw zat awm mahse, PPH hi tu chungah pawh a thleng thei .
• A hmaa hmuhchhuah a nih a, enkawl vat a nih chuan a dam vek thei fo.
• PPH experience hi emotionally draining tak a ni thei. I mamawh support chu dawng hreh suh.

I hriselna enkawl hi a pawimawh hle a, a bik takin hetiang hun lai hian. Nangmah chauh i ni lo, tanpuina dil rawh.

` Nau neih hnua thisen chhuak, PPH, nau neih, thisen chhuah, nausen pum, nausen, hmeichhe hriselna