Nausen a pian hmaa tui bawm a chhe lai hi kan hriat tur em ni? (Membrane-te a hun hmaa a chheh - PROM)

Naupai lai hian thil ngaihtuah buai hi thil pangngai a ni lawm ni? "I tui a chhe" tih hi i hre tawh ngei ang, a bik takin i due date i hnaih deuh deuh chuan. A châng chuan, i due date hmaa hetiang thil hi a thlen chuan eng nge thleng ang tih ngaihtuah chu a hlauhawm deuh thei. Ngaihtuah buai suh, he thu hi chipchiar tak leh awlsam takin kan sawi dawn a ni.

Premature rupture of membranes (PROM) tih hi eng nge ni?

A awlsam zawngin, `Premature Rupture of Membranes` emaw `PROM` emaw chu i naute `labor` a ni a, chu chu nau neih tan hmain i `water bag` emaw `amniotic sac` emaw a chhe tihna a ni. Doctor thenkhat chuan hei hi `prelabor rupture of membranes` an ti bawk. Chumi awmzia chu `membrane` emaw membrane emaw chu `labor` hmain a chhe tihna a ni.

Tunah chuan en teh, he `amniotic sac` hi bag tuiin a khat ang mai a ni. He tui hi `amniotic fluid` kan tih hi a ni. Hei hian i naute chu naupai chhung zawngin a hual vel a, a venghim bawk. Naute tan chuan safety cushion tlemte ang mai a ni. He `amniotic fluid` hian naute chu natna hrik lakah a venghim a, naute chu a kal kual veleh hliam leh hliam a neih loh nan a veng a, naute taksa ruh leh ruh te pawh a lo thanglian thei bawk.

"I tui a chhe" emaw "i tui a chhe" emaw kan tih hian heng membrane te hi a chhe vek vang a ni. Heng membrane te hi a chhe chuan i naute hual vel amniotic fluid chu i vagina atang hian a chhuak tan a, zawi zawiin emaw, rang takin emaw a chhuak thin. Hei hi harsatna a ni thei. A chhan chu amniotic fluid a bo chuan nang leh i naute chu natna kai leh harsatna dang, nau piang hma ang chi te in vei theihna a sang zawk a ni .

Chuvangin i membrane a rupture nia i hriat chuan i obstetrician emaw family health worker emaw hnenah i hriattir nghal tur a ni.

Preterm PROM (PPROM) tih hi eng nge ni?

Tunah chuan `Preterm PROM` emaw `PPROM` emaw chungchang hi han sawi ila. Hei hi naupai kar 37 hmaa i `amniotic sac` a rupture lai a ni. Ngaihtuah teh, i naupai chu kar 37 pawh a tling lo a, mahse i tui chu a chhe vek. Hetih lai hian i doctor chuan naute chu `nau hrin` nghal tur nge, ni engemaw zat `nau neih` tihkhawtlai tur tih a rel ang.

Hei hi thutlukna buaithlak deuh a ni. A chhan chu, tui a chhe hnua naupai rei hian natna hrik leh harsatna dang a thlen theihna a tipung a ni. Mahse, a lehlamah chuan naute nau neih hma, chu chu a hun hmaa nau neih hian hlauhawmna engemaw zat a nei bawk. Chuvangin doctor chuan thutlukna tha ber a siam hmain heng hlauhawm pahnih hi uluk takin a ngaihtuah hmasa tur a ni.

Hetiang hian tui bawm chu a chhe ta a nih chuan eng nge thleng thei ang?

Tui bawm chu a chhe rang lutuk a nih chuan naute chu a hun hmaa nau neih a hlauhawm hle a,...Hri kai theihna a awm. I naupai chu kar 37-ah a zo tawh a nih chuan nau piang hmaa naupai avanga harsatna awm thei chu a tlem zawk. Mahse, naute hi kar 37 hmaa piang a nih chuan nau piang hmaa a pian avanga harsatna a tawh a ngai dawn a ni.

Hei hi entirnan:

• Thluak lam thil .
• Taksa lumna vawn that harsatna .
• Hei hian nausen pum chhunga nausen dinhmun pawh a tidanglam thei a, chu chuan nau neihna a nghawng thei a ni.

Chu bâkah, amniotic fluid leh amniotic sac chu venhim loha dah a nih chuan naute leh i nausen pum chu natna kai theihna a sang zâwk a ni . Heng infection te hi a chang chuan a hlauhawm thei hle.

Hetiang dinhmun hi engtiang chiahin nge a awm?

`PROM` tih hi naupai zinga 10% vel ah a awm thin. `PROM` hi term-ah (kar 37-ah) a awm chuan darkar 28 chhungin naute hi 95% a piang a ni.

PPROM hi thil awm lo tak a ni a, naupai zinga 3% velin a awm thin. Zirna hrang hrangah PPROM hi naupai tam tak neiah a awm tam zawk tih hmuhchhuah a ni .

Engvangin nge hetiang hi a lo awm? `PROM` leh `PPROM` awm chhan berte chu engte nge ni?

`PROM` leh `PPROM` awm chhan hi a inang lo thei.

• I tui chu a hun takah a chhe a nih chuan, chu chu kar 37 hnuah a chhe a nih chuan, a chhan ber chu nau neih laiin i amniotic membranes te chu a chak lo zauh zauh a, chu chu nau neih laiin a contractions te pressure vang a ni. Membrane te hi a takin a chhe vek hi thil pangngai a ni a, mahse nau neih tan hnuah a thleng fo thin.

A pawimawh ber chu Contraction i hre lo a nih pawhin i taksa hian nau neih a inbuatsaih mai thei. Chumi awmzia chu i hriat lohvin i nausen pum chu a inzawm khawm thei a, i serh chu a hring (effacing) a, i serh chu a inhawng (dilating) thei tihna a ni. Hei hian amniotic sac a tichak lo thei a, a tawpah chuan a ti chhe thei bawk.

• Preterm PROM (PPROM) hi naupai laiin damdawi lam thil emaw, harsatna emaw avanga lo awm a ni tlangpui a, mahse a chhan hriat lohvin a thleng thei bawk.

A chhan lian ber thenkhat chu:

• Vaginal atanga thisen chhuak .
• I nausen pum chhunga pianpui natna ( Ehlers-Danlos syndrome ang chi ).
• Cervical insufficiency a awm a .

Hei hi eng symptoms nge ni? Engtin nge i hriat chian?

I membrane a chhe tih chhinchhiahna langsar ber chu i vagina atang hian tui tam tak a chhuak nghal mai ang tih i hriat hi a ni. Mahse, tam tak angin a lang ngai lo. Mi thenkhat chuan an leak deuh niin an hria a, trickle ang maiin an inhria. I tui chhe lutuk hi i thunun theih loh thil a ni. I zun i chawlhsan thei lo ang mai a ni .

A châng chuan amniotic fluid, vaginal discharge, emaw urine emaw a ni em tih hriat a harsa ṭhin . Chutiang hunah chuan white paper towel la la, fluid chhungah i dip thei bawk.

• A sen a nih chuan, a rimchhia a nih chuan , zun a ni mai thei.
• If it is colorless and odorless , doctor pan nghal tur a ni.

Mahse, i vagina atanga thil lo chhuak tur chungchangah rinhlelhna tlemte i neih chuan doctor hnenah hriattir ngei ang che.

Engtin nge doctor-te hian hei hi an hriat chian?

I doctor chuan PROM chu sterile speculum exam hmangin a confirm ang . Hei hian i vagina chhungah speculum dah a huam a ni. Hei hian doctor chuan i serh bangte chu a inthlau thei a, i serh (cervix) chu a hmu thei a ni. Chumi hnuah chuan fluid sample lak a ni a, test a ni. A châng chuan, he exam-naah hian doctor-in i vagina chunglam a amniotic fluid a pung tih a hmuh chuan, a membrane-te chu a chhe tawh mai thei.

Tin, naute dinhmun leh nausen pum chhunga amniotic fluid awm zat enfiah nan ultrasound scan pawh tih theih a ni bawk.

Test dang eng nge awm?

• Nitrazine paper test: Hei hi i vagina pH (thil pakhat acidity tehna) tehna atan hman a ni. I vaginal discharge drop khat chu he paper-ah hian dah la, paper chu a blue a ni em tih enfiah a ni. A blue a nih chuan a tui pH chu 6.0 aia tam a nih avangin amniotic fluid a nih a rinawm zawk. (Vaginal discharge pangngai hian amniotic fluid aiin pH a hniam zawk.)
• Fern test: Fern hnah ang chi amniotic fluid hring (dried amniotic fluid) hming vuah a ni. Hetah pawh hian tui sample lak a ni a, microscope hmangin an enfiah leh a.

Hei hi eng enkawlna nge ni?

Enkawlna chu naupai kum , naute hriselna leh i dinhmun nasat danah a innghat a ni .

A tlangpuiin duhthlan tur pahnih a awm a, pakhat chu naute `nau hrin` a ni a, pakhat chu `expectant management` a ni. `Expectant management` tih hi `labor` tihkhawtlai thei enkawlna a ni. Hei hian khumah chawlh te, damdawi ei te, leh natna hrik emaw, nausen harsatna emaw a awm leh awm loh enfiah reng a huam a ni.

Kar 37 hnuah PROM enkawl

Kar 37 leh 40 inkar i naupai a, i tui a chhe a nih chuan darkar 24 chhungin hmeichhia 90% vel chu anmahniin nau pai an ni ang. I doctor chuan nau neih tir turin damdawi a pe thei che a, a nih loh leh nau neih chu a pianphung anga kalpui turin an phalsak thei bawk.A tlangpuiin darkar 24 chhunga naute hrin hi a him ber a ni.

`PROM` hi kar 34 leh kar 37 inkar a awm chuan enkawl tur a ni

Chutiang a nih chuan, i doctor chuan naute piang hmaa neih theihna chu natna kai leh harsatna dangte a thlen theihna tur a teh ang . Doctor chuan naute hrin a tum a nih chuan, naute chu a pian veleh enkawlna bik eng pawh ( NICU - Neonatal Intensive Care Unit -a enkawlna ang chi) dawng turin ruahmanna a siam ang.

Kar 34 hmaa Preterm PROM (PPROM) enkawl

I naute chu kar 34 hnuai lam a nih chuan nau piang hmaa harsatna a thlen theihna a sang zawk. Hetih lai hian i doctor chuan damdawi inah awmtir che a tum ang a, khum chawlhtir che a tum ang a, i naupai chu rei vak lo sei a tum ang.

Damdawi an pe thei bawk che a, chungte chu:

• Corticosteroids: Naute lung (lungs) a lo thanglian theih nan a pui thin.
• Antibiotics: Infection a veng a, naupai a ti rei bawk.
• Tocolytics: Nau neih tihtawp nan damdawi pek thin.
• Magnesium sulfate: Naute thluak thanna atan a pui thin.

I doctor chuan natna kai chhinchhiahna a awm leh awm loh a enfiah fo ang che. I naute thinlung thawk leh che vel pawh a enfiah ang a, naute chu harsatna a tawk lo tih a chiang ang. Heng enkawlnate beiseina chu i naupai chhung chu kar 34 tal thleng sei a ni.

A pawimawh ber chu, i tui a chhe lai chiaha natna i neih chuan, a nih loh leh a hnua natna i neih chuan naute i hrin ngei a ngai dawn a ni.

Hei hi ven dan tur a awm em?

PROM ven dan tur bik a awm lo. I tih theih tha ber chu meizuk khap vek a, naupai hrisel tak neih a, nau neih hmaa i checkup zawng zawngte tel vek hi a ni. Zuk leh hmuam hman hi PROM (leh naupai laiin harsatna dang tam tak) vei theihna tur risk factor a ni.

`PROM` leh `PPROM` vei tur hian tute nge risk sang zawk? (Risk Factor hrang hrang) 1.1.

I chorioamniotic membrane (amniotic sac pawn lam layer) tichak lo thei natna i neih chuan, tun hnaia lo awm a nih chuan PPROM emaw PROM emaw i vei theihna a sang hle. Hei hi entirnan:

• Infection: Sexually transmitted infection (STI) hi bacterial vaginosis ang chi infection a ni.
• Cervical sei zawng tawi .
• Tun hmaa `PROM` lo awm tawhna history a awm chuan .
• Naute twins emaw triplets (`Expecting multiples`) ang chi i beisei a nih chuan.
• Polyhydramnios (chu chu amniotic fluid tam lutuk tihna a ni).
• Vaginal atanga thisen chhuak.
• `Amniocentesis` tih a ni(Tui test) tih a nih chuan.
• Preterm labor history a awm chuan .

Tui bawm a chhiat chuan eng hlauhawm ber nge a awm?

PROM avanga hlauhawm ber chu nau piang hmasa a ni. Premature birth chu i naute chu kar 37 hmaa a pian chuan a ni. Nau piang hmaa harsatna awmte chu thawk lama harsatna, taksa lumna hniam, leh thanlenna lama harsatna te a ni. Nausen piang hmasa thenkhatte pawhin an naupan laiin an thanlenna a tikhawtlai thei bawk.

Amniotic fluid hi venhim a nih loh chuan naupai laiin harsatna dang a awm thei a, entirnan:

• Infection , Chorioamnionitis (membrane leh amniotic fluid-a infection) ang chi te.
• Nausen hnute (placental abruption) a awm .
• Umbilical cord compression emaw umbilical cord prolapse emaw a awm thei .

I doctor chuan naute piang hmaa i neih theihna tur leh natna kai leh harsatna dang awm theihna te chu a ngaihtuah vek ang a, chu chuan i naute nau neih hun tha ber a ruat ang.

Ka tui a chhiat hnuah eng chen nge naute ka neih ang?

Zirna hrang hrangah chuan hmeichhia membrane rupture atanga darkar 24 chhunga nau neih chuan darkar 24 hnua nau neihte aiin natna kai an tlem zawk tih hmuhchhuah a ni Mahse, he hlauhawmna hi naute piang hmaa neih theihna nen tehkhin a ngai a ni. I doctor chuan nang leh i naute tan thutlukna tha ber siam turin a pui ang che.

I tui a chhe hnuah eng chen nge nau i pai theih ang?

Hei hi i dinhmun leh i tui a chhiat hunah kar engzat nge i naupai tih a zirin a danglam ang. Kar 37 hmaa i tui a chhe a nih chuan i doctor chuan thutlukna him ber siam turin a pui ang che. A \henah chuan hri kai leh harsatna a thlen theihna a sang lutuk a, chuvangin naute hi nau neih a ngai mai thei.

Tui bawm chu a chhe hma chuan naute chu a dam thei ang em?

Ni e, a theih. Tui bawm chu a chhe thuai a nih pawhin naute chu a la dam thei tho a ni. Thil tam takah a innghat a, naupai lai hian eng chen nge a hlat tih leh amniotic fluid engzat nge a la awm tih te hi a ni. I doctor chuan nausen chu nausen harsatna leh hri kai chhinchhiahna a awm leh awm loh a enfiah fo ang a, naute hrin hun tur a rel ang.

Thil pawimawh ber (Take-Home Message) hre reng ang che .

Naupai lai hian tuiin a khat sac, amniotic sac , an tih chuan naute chu a hual vel a, a humhim bawk. A tlangpuiin he bawm hi nau neih laiin a chhe thin. Mahse, a châng chuan nau neih ṭan hmain a chhe thei a, nau neih ṭan hma kar tam takah pawh a chhe thei bawk. Hei hi Premature Rupture of Membranes (PROM) tih a ni.

• Kar 37 hnuah hetiang hi a thleng a nih chuan doctor chuan naute chu a hrin ang.
• Hei hi kar 37 hma lam a ni.``Preterm PROM'' chungchangah chuan doctor chuan thutlukna a siam hmain naute piang hmaa neih theihna tur leh natna hrik leh umbilical cord compression ang chi harsatna awm thei te chu a ngaihtuah hmasa ang.

I tui a chhe hma tih hriat chu thil mak tak a ni thei. Mahse, i doctor hian nang leh i naute hi him leh hrisel taka awm theih nan theihtawp a chhuah tih hre reng ang che. Zawhna emaw, ngaihtuahna emaw i neih chuan i doctor nen sawiho rawh. A pawimawh hle mai.

` PROM, PPROM, tui bag rupture, naupai harsatna, nau piang hma, amniotic fluid, naupai hriselna