Naute i neih hnuah, i period i neih lai ang khan i pum hnuai lam ah natna tlem i nei em? Naute chu chhuak mah se, i pum chu a la lian deuh em? Ngaihtuah buai suh, mom, hei hi thil pangngai a ni vek. Hei hi i uterus chu a hmaa a size angin a lo tlem leh tan tawh vang a ni. Damdawi lam hawi chuan hei hi ‘uterus involution’ kan ti a. Vawiin hian he thil pawimawh tak, natural process chungchang hi kan sawi dawn a ni.
A awlsam zawngin, he uterine restoration hian eng nge a awmzia?
Uterine involution hi naupai laiin i naute awm theihna tura lo thanglian tawh i uterus chu nau neih hnua a hmaa a lian leh te ang lo taka a lo tlahniam lehna a ni. Ball ang maiin han ngaihtuah teh. Naute i neih hnu thla engemaw zat chhung chu i nausen pum chu a lian zauh zauh a. Nau neih hnuah a tlahniam leh tur a ni. Chuvang chuan involution kan ti a ni. Hetiang hi nau neih hnu lawkah a intan a, kar ruk vel a awh thin. Hei hi nau neih hnua thisen chhuak leh lochia an tih discharge i neih hian a ni.
Hei hi i taksa damna atana thil pawimawh tak a ni. Naupai lai hian i nausen (uterus) a lian zia leh a inthlak danglam dan ngaihtuah chuan a hmaa a lo awm leh theih nan hun engemaw chen a la ngai hi thil pangngai a ni.
Engvangin nge he kalphung hi a pawimawh?
Hei hian a tum ber chu naupai hmaa nausen pum (uterus) chu a naupai hmaa a lian zawnga a awm leh theihna tura siam leh a ni. Naupai lai hian nausen pum hi a lian zawng aiin a let tam takin a zau a. Tin, naute lo thang lian tan ei tur pe turin thisen kalna leh tissue extra a siam bawk. Naute a pian hnuah taksain he hmun dang emaw tissue emaw hi a mamawh tawh lo.
Chuvangin he ``(Involution)`` process hian a tih chu chu tissue duh loh chu paih chhuakin, nausen pum chu a ti tlem a, thla tin i thlasik hun hman tan leh turin taksa chu a buatsaih leh thin.
Engtin nge hetiang kalphung hi a lo awm?
Hetiang kalphung hi nausen (placenta) i neih hnuah a intan a, chu chu nau neihna stage pathumna a ni. Tichuan i uterus chu a inzawm leh tan a, a nih loh leh a lo tlem tan leh ta a ni. Heng contraction te hian nausen pum chhunga thisen kalna hmuna thisen kal zat a tihtlem phah a ni. Hei hi a takah chuan taksa invenna mechanism a ni. Hei hian thisen chhuah tam lutuk (Postpartum Hemorrhage) a veng thei a ni.
Heng contraction te hian nausen pum a ti tlem a, a hmaa ka sawi tawh tissue duh loh te chu taksa atanga ``Lochia'' tia a pass chhuak thin a ni. Heng contraction te hi naute pian hnu darkar 12 chhungin regular leh a chak deuh fo thin. Hetih lai hian i pum hnuai lam ah cramp i nei thei. Hengte hi "afterpains" kan ti thin.
Heng "afterpains," emaw nau neih hnua pum na lo awm te hi ni engemaw zat chauh a awm tlangpui. Mahse, i hnute i pek emaw, i pump emaw lai hian tlem an nasa zawk thei. Tin, hei hi i naute pahnihna emaw pathumna emaw a nih chuan a natna chu a hmasa ber aiin a nasa zawk thei bawk.
``Involution`` process kimchang tak hi kar ruk vel a ni. Nitin hian nausen pum rit a tlahniam a, pelvic cavity chhunga a hmun pawh a tlahniam bawk. Hei vang hian naute pian hnuah pawh i pum chu rei vak lo a la lian deuh a ni. Tunah chuan naute chu pawnah awm mahse, nausen pum hian i pum chhungah hmun tam tak a la luah reng a ni.
Engtin nge nau hnute pek hian hei hi a nghawng?
I naute i hnute i pek chuan i nausen chu a inzawm rang zawk a ni. Hei hi a chhan chu i naute hian a hnute a hnek emaw, i pump emaw hian i taksain hormone `(Oxytocin) an tih chu a siam chhuak thin.` He hormone hian i nausen (uterus) a contract tha zawk a pui thin. Chuvang chuan hnute i pek hian tlemin a na deuh tih i hria a ni. Mahse i taksa chu a dam tha tihna a ni bawk.
Engtin nge doctor-te chuan hei hi a thawk dawn em tih an enfiah?
Damdawi ina i awm chhung hian doctor emaw nurse emaw chu he thil hi a kal tha em tih enfiah turin a lo kal fo ang.
- I pum chungah an kut an dah ang a, i uterus (fundus) chunglam en turin an press down ang. Hei hi fundal san zawng checking an ti a.
- Tin, nausen pum chu a khauh a, a lum hle tih an enfiah bawk.
- Hetih lai hian i vaginal discharge (Lochia) awm zat leh rawng pawh enfiah a ni ang.
Entirnan, i nausen pum chu beisei angin a inzawm lo a nih chuan, emaw, khawih pawhin a nem tih i hriat chuan nau neih hnua thisen chhuah theihna a sang zawk a ni. Chutiang a nih chuan i doctor chuan i pum chu a kut hmangin a massage thei a, chu chuan i uterus contract a pui thei ang. A châng chuan, Pitocin tih damdawi an pe thei bawk che a, chutah chuan hormone oxytocin a awm a, chu chuan contraction a tichak a ni.
Hetih hun chhung hian engtin nge nausen pum hi a inthlak danglam?
A tam zawkah chuan mi tin nausen pum hi hun inangah a rihna leh a lian zawng a tlahniam vek a. Mahse, i nausen pum lian leh te chu fa i neih tawh leh neih loh, fapa mal i neih leh neih loh leh i naupai laia i nau neihna hmun te a zirin a inang lo deuh thei a ni.
Hetah hian uterus hian a tlangpuiin a rihna a tihtlem dan chu kan rawn tarlang e.
| Hun | Nausen pum rit zawng (approximate) 1.1. |
|---|---|
| Nau neih zawh veleh | gram 1,000 (kilogram 1 vel) a ni. |
| Kar khat hnuah | 500 gram a ni |
| Kar hnih hnuah | gram 300 a ni |
| Kar li hnuah | gram 100 a ni |
| Kar riat hnuah | 60 grams (a zatve vel) . |
Tin, hetiang hian uterus chu pelvic cavity chhungah a kal leh a, a lo tlem leh ta a ni.
| Hun | Nausen pum dinhmun |
|---|---|
| Nau neih atanga darkar khat vel | Nausen pum (fundus) chunglam chu i serh level-ah a awm tur a ni. |
| Chumi hnuah chuan | Darkar 24 danah centimetre 1 vel a chhuk tur a ni. |
| Kar khat vel a liam hnuah | I pum hnuai chiaha awm pelvic bone chu i ``Pubic Bone'' level-ah a awm tur a ni. |
| Ni 10-14 hnuah | Nausen pum chu pelvic cavity chhungah a hniam kim tur a ni a, pum chhungah a man loh tur a ni. |
Hetiang kawngah hian eng harsatna nge lo awm thei?
Harsatna lian ber pahnih a awm thei a, chungte chu Subinvolution leh Postpartum Hemorrhage te an ni.
1. Subinvolution (Nausen pum a inzawm tha lo) .
Chumi awmzia chu i nausen pum chu kan duh angin a tlahniam rang lo tihna a ni. A châng chuan hetiang hi a awm thei a, a chhan chu nausen (placenta) inzawmna thisen kalna kawngte chu a khar ṭhat loh vang a ni.
I doctor-in pum enfiah laiin hei hi a rinhlelh chuan ultrasound scan neih a rawt mai thei. Tin, nau neih hnu kar khat aia rei dark red bleeding i neih chuan hei pawh hi he natna chhinchhiahna a ni thei bawk. Hei hi chhan hrang hrang a awm a:
- Nausen pum chhunga natna hrik, entirnan `(Endometritis)`.
- Nausen pum chhunga placenta chi hrang hrang la awm ang chi thil.
- Nau neih hrehawmna chu a nasa lutuk ta.
- Cesarean section (C-section) a neih tawh avangin.
2. Nau neih hnua thisen chhuak - PPH (Nau neih hnua thisen chhuak) .
Hei hi natna khirh tak, nunna atana hlauhawm tak a ni. PPH hi nau neih hnua nausen pum atanga thisen chhuak tam lutuk a ni. Nau neih hnua uterine contractions a chak tawk loh chuan a thleng fo thin.
PPH hi nau neih hnu darkar 24 hmasa berah a awm tlangpui a, mahse a chang chuan kar 12 chhung vel pawh a awm thei.
Damdawi ina i awm chhung hian doctor leh nurse ten i thisen tlakchham dan an enfiah fo ang. Mahse in i thlen hnua a pangngai aia tam thisen chhuak a nih chuan (entir nan darkar khata pad pakhat aia tam i hnim chuan), thisen zam lian tak tak i paltlang a nih chuan, emaw, i luak chhuak a nih chuan, damdawi in hnai ber Emergency Department (ETU)-ah kal nghal rawh. Hei hi tihkhawtlai tur thil a ni lo.
Hetih hun chhung hian engtin nge i in enkawl ang?
Naute i neih hnu hun, chu chu nau neih hnu hun chhung hi i naute ang bawkin nangmah i enkawl a ngai a ni. Chawlh hahdam tam rawh. Naute enkawl turin i chhungte leh i pasal hnen atangin tanpuina la rawh.
Ka sawi tawh "afterpains" te kha a chang chuan a na deuh thei a, a bik takin naupai laiin. Minute 5 vel chhung chu natna nasa tak i nei thei a, chutah chuan a reh zauh zauh ang maiin a awm thei. He natna hi enkawl dan tur i tih theih thenkhat chu hetiang hi a ni:
- Nau neihna atana hman tur thawk leh chawlh hahdamna exercise te ti thin ang che.
- I pum hnuaiah pillow dah la, i hnungzang chungah muhil rawh.
- Kal chhuak rawh.
- I doctor-in a rawt angin natna tidamtu damdawi ei rawh. Ibuprofen ang chi hian paracetamol aiin hna a thawk tha zawk mai thei a, mahse eng thil pawh i ei hmain doctor nen inbiakna neih hmasak phawt ang che.
Uterus a pianzia pangngaia a lo kir leh hi thil pawimawh tak, natural process a ni. Mahse a chang chuan, nausen pum hian he zinkawngah hian tanpuina tlem a mamawh thin. Chuvangin i naute i neih hnuah medical team te chuan damdawi inah an check reng ang che. Heng check te hi i tan chuan harsatna ang maiin a lang thei a, a chhan chu i chhungkaw member thar nen zalen taka awm i duh vang a ni. Mahse heng check te hi PPH ang chi complication te hriat hmasak nan a pawimawh hle.
Take-Home Thuchah a ni
- Uterine involution hi nau neih hnua thil awm dan pangngai leh thil awm dan pangngai tak a ni.
- Naute neih hnu ni engemaw zat chhung chu pum na ("afterpains") neih hi thil awmze nei tak a ni. Hei hi nau hnute pek lai hian a langsar zual thei hle.
- Hetiang zawng zawng hi a tlangpuiin kar ruk vel a ni.
- A pangngai aia tam thisen chhuak emaw, thisen zam lian tak tak i neih emaw, in lama awm laiin luak chhuak i tih chuan damdawi in Emergency Department (ETU) pan nghal tur a ni.
- Hemi chungchangah hian zawhna emaw rinhlelhna emaw i neih chuan i doctor nen inbiakna neih hi hlau ngai suh.
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