Kua kite koe kua tino heke tō paheketanga ā-marama, kua mutu rānei i muri i tō D&C, i te tangohanga o te kōpū? Kei te mamae nui atu tō puku i tō paheketanga i te wā noa? Kei te moemoeā tonu koe mō te whānautanga o tētahi pēpi? He maha ngā wā ka whakaarohia ēnei mea he mea noa, he huringa homoni pea, ā, ka warewarehia. Engari he mate pea tēnei e hiahia ana kia arohia e te rata. Kei te kōrero tātou mō tētahi o aua mate i tēnei rā. Ko te Asherman's Syndrome tēnā.
He aha te mate a Asherman?
I te whakarapopototanga, ko te mate Asherman te whanaketanga o ngā kiko whara, ngā piri rānei i roto i tō kōpū me/ranei tō kaki. I ētahi wā ka karangahia tēnei e ngā tākuta he "piripiri intrauterine".
Whakaarohia tō kōpū he rite ki tētahi poihau iti. I te nuinga o te wā, ka rere noa ngā pakitara o roto o tēnei poihau, kāore e piri tetahi ki tetahi. Engari he aha te mea ka tupu mēnā ka whara ēnei pakitara o roto, ā, i te wā e ora ana aua whara, ka puta he koha, ā, ka tīmata te piri o ngā pakitara? Koinei anō te mea ka tupu i konei. Ka whakaitihia e ēnei piri te nui o te wāhi i roto i te kōpū. Ka puta pea ngā raruraru pēnei i te mamae, te paheketanga koretake, me te kore tamariki.
He pai tō āhua mō tō tinana. Ki te kite koe i tētahi panonitanga o tō huringa paheketanga, i tētahi mamae hou rānei, he pai ake te kōrero ki tētahi tākuta, kaua e whakaaro, "He mea noa tēnei."
Me pēhea koe e mōhio ai mēnā kei a koe te mate Asherman? He aha ngā tohu?
Kāore e rite ngā tohu o te mate ki te katoa. Tērā pea kāore ētahi e pāngia e te mate. Engari he iti noa ngā tohu e kitea whānuitia ana. Me titiro tātou ki ēnei tohu.
| Tohu | He whakamārama māmā |
|---|---|
| Hypomenorrhea (he iti rawa te rere o te toto i te wā paheketanga) | He aha i roa ai te paheketanga o te tangata e 4-5 ngā rā i mua, inaianei kotahi, e rua rānei ngā rā ka puta he tine? |
| Te mutunga katoa o te paheketanga (Amenorrhea) | Te ngaro ohorere o te paheketanga mō ngā marama kāore he take. |
| Te mamae nui o te puku o raro (Dysmenorrhea) | Te mamae nui e kore e taea te whakamanawanui i ngā rā i mua i te paheketanga, i te wā rānei e tata ana ki te paheketanga. |
| Te uaua ki te hapu (te kore tamariki) | Te kore e taea te hapu ahakoa te whakamātau mō te wā roa me te kore he tikanga ārai whānau. |
| Ngā Matenga Auau | Ahakoa ka hapu koe, kāore te kukune e whakatōkia, e whanake tika rānei ki roto i te kōpū, ā, ka puta he materoto. |
I ētahi wā, ahakoa kāore koe e pāngia e te paheketanga, tera pea ka pāngia tonu koe e te mamae ina tae mai tō paheketanga. Ko te tikanga tēnei kei te pāngia tonu koe e te paheketanga, engari tera pea kei te aukati te kiko whara i te ara i roto i tō kōpū, ā, kei te aukati i te toto kei puta.
He aha i puta ai ēnei momo piri? He aha ngā take matua?
Ko te tino take o te hanga o ēnei piri ko te pakaru, te whara rānei o te arai o roto o te kōpū, te "Endometrium." Ina koa mēnā ka whara ngā wāhanga e rua o te pakitara o roto o te kōpū e anga atu ana tetahi ki tetahi i te wā kotahi, he nui te tūponotanga ka piri tahi rāua i a rāua e ora ana.
E wehea ana e ngā tākuta ngā take mō tēnei mea ki ngā wāhanga matua e rua.
1. Ngā take e pā ana ki te hapūtanga
Kua kitea e ngā rangahau neke atu i te 90% o ngā mate Asherman i puta mai i te tikanga D&C (Dilation and Curettage) i mahia i te wā e hapu ana. Ko te D&C he tikanga noa iho e tango ana, e horoi ana hoki i te roto o te kōpū. Koinei ngā āhuatanga ka taea te mahi i te D&C:
- Hei whakamutu i te haputanga.
- Tangohia ngā toenga o te kōpū i muri i te whānautanga kore i oti.
- Mena kei te toe tonu ētahi wāhanga o te whenua i roto i te kōpū i muri i te whānautanga o te pēpi, tangohia atu.
He tino tairongo te kōpū i muri i te hapūtanga. I ēnei wā, ahakoa he iti noa te pakaru o te "endometrium" ka arahi pea ki te hanganga o te kiko whara nui. He tino onge, ka puta anō hoki tēnei āhuatanga i muri i te pokanga cesarean (C-section).
2. Ngā take kāore e pā ana ki te haputanga
Ahakoa e mahia ana te D&C mō ngā take e pā ana ki te hāputanga, ka mahia hoki ngā D&C me ētahi atu pokanga mō ētahi atu take.
- Ki te whakapae koe he mate pukupuku kōpū koe, tikina he tauira kiko (biopsy).
- Tangohia ngā polyp i roto i te kōpū.
- Ko te Hysteroscopy he tikanga pokanga hei tango i ngā pūtau kikokore o te uterine.
- He pokanga hei tango i te kōpū septate.
Hei tāpiri atu ki tēnei,
- Ngā mate pukupuku nui o te hope
- Ka taea hoki tēnei e ngā mahi pēnei i te rongoā irahiko ki te rohe hope.
Me pēhea te tautuhi i tēnei mate? He aha ngā whakamātautau e mahia ana?
Ina kōrero koe ki tō tākuta mō ō tohumate, ka pātai ia mō tō hītori hauora, inā koa ngā pokanga o mua (pēnei i te D&C). Kātahi ka tūtohu ia i ētahi whakamātautau hei whakaū i te mate.
Ko te whakamātautau tino tika, tino pai hoki mō tēnei ko te hysteroscopy tātaritanga. Ko te whakauru i tētahi ngongo tino angiangi me tētahi kāmera e piri ana ki roto i tō tenetene me te cervix, me te tirotiro i te roto o tō kōpū. Mā tēnei ka taea e te tākuta te kite mārama i te maha o ngā piri kei roto i te kōpū, me tōna āhua.
Hei tāpiritanga, ka taea hoki te mahi i te "Matawai Ultrasound Transvaginal". I ētahi wā, i roto i tēnei matawai, ka werohia he iti o te wai tote ki roto i te kōpū, ka pupuhi te kōpū i mua i te matawai. Mā tēnei ka taea te tiki pikitia pai ake o roto o te kōpū me ngā piri, mēnā he mea kei roto.
He wāhanga o te kaha o te mate Asherman?
Āe, ka taea te wehewehe i tēnei āhuatanga kia maha ngā wāhanga i runga i te kaha o te mate. Mā tēnei koe me tō tākuta e āwhina kia mārama ake ai ki te āhuatanga.
| Atamira | Whakaahuatanga |
|---|---|
| Mate Ngāwari | He iti noa ngā piri angiangi, rite tonu ki te kiriuhi, kei roto i te iti iho i te hautoru o te kōpū. Tērā pea he noa te paheketanga, he iti noa iho rānei. |
| Mate Waenga | Kei waenganui i te kotahi hautoru me te rua hautoru o te kōpū he ranunga o ngā piri angiangi me ngā piri matotoru. Ka tino heke te paheketanga. |
| Mate kino | Neke atu i te rua hautoru o te kōpū kua kapi i ngā piri matotoru. He maha ngā wā kua mutu katoa te paheketanga. |
He aha ngā maimoatanga mō tēnei?
He maimoatanga kei reira mō tēnei. Ko te whāinga matua o te maimoatanga he tango i te kiko whara me te whakahoki i te kōpū ki tōna āhua noa. Mena kāore koe e mamae ana, ā, kāore hoki koe e hiahia ki te whānau tamariki, kāore pea koe e hiahia ki tētahi maimoatanga. Heoi, ki te whai tohu koe, ko te maimoatanga pea ko:
- Ka taea te whakamamae i te mamae.
- Ka taea te whakahoki mai i te huringa paheketanga.
- Ka taea te whakahoki mai i te kaha ki te hapu i te tamaiti.
Ko te maimoatanga matua ko te Hysteroscopy Whakahaere. He rite tēnei ki te hysteroscopy tātaritanga. Heoi, i roto i tēnei tikanga, ka whakauruhia he kāmera me tētahi kutikuti angiangi rawa, he laser rānei ki roto i te kōpū, ā, ka tapahia marietia ngā piri. Me mahi pea tēnei tikanga neke atu i te kotahi, i runga i te kaha o te mate.
Ngā mea hei tiaki i muri i te pokanga
Ko te wero nui rawa atu i muri i tēnei pokanga ko te mōrearea o te hoki mai o ngā piri. Ka mahi tō tākuta i ētahi mahi hei ārai i tēnei.
- Te hoatu rongoā homoni: Mā te hoatu i te homoni estrogen ka āwhina i te arai o te kōpū (endometrium) kia tere, kia pai hoki te tipu.
- Te whakaurunga o tētahi ārai ki roto i te kōpū: Tērā pea ka whakanohoia he poihau iti (poihau intrauterine) he catheter rānei ki roto i te kōpū mō ētahi rā i muri i te pokanga hei ārai i te piri o ngā pakitara kōpū.
- Te hoatutanga o ngā paturopi: Ka hoatu ēnei hei ārai i te mate i te wā e whakatakotoria ana tētahi mea pērā i te poihau.
Tērā pea ka tirotirohia anō koe i te wiki, i ngā wiki e rua rānei i muri i te pokanga kia kite ai mēnā kua tīmata te hanga o ētahi piri hou.
Ka taea te whānau i tētahi tamaiti me te mate Asherman?
He pātai nui tēnei mā te tini o te tangata. He uaua ki te kī tika "āe, ka taea e koe" me "kāo, kāore e taea e koe". Kei te kaha o tō mate me te angitu o tō maimoatanga.
I te nuinga o te wā, he iti ake te tūponotanga o te hunga e pāngia ana e te mate Asherman āhua-waenga ki te kino ki te hapu me te pupuri i te hauora o te hāputanga ahakoa kua rongoatia.
E ai ki tētahi rangahau:
- O te hunga he ngawari noa te piri, 60.7% i hapu i muri i te maimoatanga.
- O te hunga he paku piri te kiri , 53.4% i hapu i muri i te maimoatanga.
- E 25% o te hunga he nui ngā piripono kua hapu i muri i te maimoatanga.
Kaua e mataku i ēnei tatauranga. Mā tō tākuta koe e mārama ki tō āhuatanga. Ko te mea nui ko te tuwhera me te pono ki tō tākuta mō ō whāinga momona.
Ki te hapu te wahine e pāngia ana e te mate Asherman, ka kiia he haputanga mōrearea nui. Ka tirotirohia koe me tō pēpi e tō tākuta nā te mea he iti noa te tūponotanga o ngā raruraru pēnei i te whānautanga o mua me te whānautanga o mua o te whānautanga.
Karere Tangohia ki te Kāinga
- Ko te mate Asherman te hanganga o ngā kiko koha (ngā piri) ki roto i te kōpū.
- Ka puta pinepine tēnei āhuatanga i muri i tētahi pokanga pērā i te D&C (whakawhanui me te curettage).
- Ko ngā tohu matua ko te whakaiti, te kore rānei o te paheketanga, te mamae nui, me te uaua ki te hapu.
- Ka taea te tautuhi tika i tēnei mate mā te whakamahi i te hysteroscopy.
- Ka taea te rongoā i ēnei piri mā te pokanga hei tango atu. Heoi anō, tera pea ka hoki anō mai ngā piri.
- Ka pā pea tēnei āhuatanga ki tō momonatanga, nō reira he mea nui kia kōrero noa koe ki tō tākuta mō ō mahere ā meake nei.
- Kāore koe i te mokemoke. Ka taea te whakahaere i tēnei āhuatanga mā te maimoatanga hauora me te aratohu tika.
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