Kua rongo kē koe i tētahi mea pēnei i muri i te pokanga tākihi? (Isthmocele / Cesarean Scar Defect)

Ina kōrero tātou mō te C-section, kāore tātou e kōrero pinepine mō ngā raruraru ka puta i muri mai. Waihoki, tera pea ētahi tāngata ka pāngia e tētahi raruraru iti i muri i te C-section mēnā kāore te tapahi o te kōpū e ora tika. Koinei te mea e kīia ana e ngā tākuta he Isthmocele, he Cesarean Scar Defect rānei. Kaua e manukanuka, kāore tēnei e pā ki te katoa, engari he mea nui kia mōhio koe ki tēnei, inā koa mēnā kua C-section koe, kei te whakamahere rānei koe kia whānau ā muri ake nei.

Nā, he aha tēnei isthmocele?

He whakarāpopototanga noa iho, he pōka iti, he kōhao rānei te isthmus i roto i te pakitara o tō kōpū i reira koe i pokaia ai. Hei whakamārama, ka puta i roto i te arai o te kōpū. Ka puta tēnei 'kokonga kōpū' ina kore e ora katoa te tapahi i mahia i te wā pokaia. I ētahi wā ka arahi tēnei ki te uauatanga o te haputanga (kore tamariki), ngā raruraru i ngā wā e hapu ana, me te maha atu o ngā raruraru.

Ko wai kei te nui ake te mōrearea ki te whakawhanake i te koha isthmus (Cesarean Scar Defect)?

Ahakoa ka pā tēnei āhuatanga ki te hunga katoa e pokaia ana te whānautanga, he nui ake te mōrearea o ētahi tāngata. Me titiro tātou ko wai rātou:

• Mena he taumaha rawa koe , he momona rawa hoki i mua atu i te wā e hapu ana rānei.
• Mena kei a koe ētahi āhuatanga hauora e whakararuraru ana i te whakaora patunga.
• I mahia te pokanga tākihi hei whakatau ohorere, i muri noa iho i te whānautanga (te pokanga tākihi kāore i whakamaheretia i te mutunga o te tukanga whānau).
• Mena he mate huka tōu, he mate huka rānei i te wā e hapu ana koe (he mate huka hāpu).
• Mena kua maha ngā wā i whānau ai koe i te whānautanga cesarean .
• Mena kei te momi hikareti koe, kei te whakamahi rānei i ētahi atu hua tupeka .

Mena ka pā tētahi, ētahi rānei o ēnei ki a koe, he mea pai kia tūpato. Engari kia maumahara, ahakoa ēnei āhuatanga mōrearea, kāore e pāngia te katoa e tēnei mate.

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He pēhea te noa o tēnei āhua whenua?

E ai ki ngā pūrongo rangahau, kei waenganui i te 24% me te 70% o ngā wāhine kua whānau i te kotahi te wā i whānau ai rātou, ka pāngia e tēnei mate. I te mea kei te piki haere te maha o ngā whānautanga puta noa i te ao, kei te piki haere te maha o ngā whānautanga puta noa i te ao. Hei tauira, tata ki te 30% o ngā pēpi i whānau i te Hononga o Amerika ka whānau mā te whānautanga. Nō reira, he mea nui kia mōhio ki tēnei mate.

He aha i puta ai tēnei koha tākihi (Isthmocele)?

Whakaarohia, i te wā e pokaia ana te kōpū, e rua ngā tapahi ka mahia. Kotahi i roto i te puku, ko tētahi i roto i te kōpū. Ki te kore te tapahi i roto i te kōpū e ora pai,Āe, mēnā ka tapahia e koe ētahi wahi i te wāhi kotahi, ka angiangi te kiko o taua wāhi. Koinei te wā ka puta he wāhi rite ki te pēke, pērā i tāu i kōrero ai, ā, ka tīmata te kī i te wai me te toto.

I ētahi wā, ka pāngia tēnei e te wāhi i tapahia ai i te wā o te pokanga whakawhānau. Mēnā he iti rawa te tapahi i roto i te kōpū, he nui ake te tūponotanga o te koha nui. I te nuinga o te wā, ka mahia tēnei momo tapahi o raro ina mahia he pokanga whakawhānau i muri roa i te whānautanga. E kīia ana hoki, mēnā kotahi noa te paparanga tuitui e whakamahia ana i te wā e kati ana i te pokanga kōpū, kaua e rua , ka piki ake te tūponotanga o te hanganga isthmus.

Ka taea e te koha o te cesarean te whakararu i te kore tamariki?

Ae, i ētahi wā ka taea e tēnei koha tākihi te whakararu i te kore tamariki . Engari ko te rongo pai , mā te maimoatanga tika, ka taea e te tini o te tangata te whai haputanga hauora anō. Mena kei te whakaaro koe kei te pāngia koe e ngā tohu o te isthmus, mena kua ngana koe ki te hapu mō te tau (e ono marama rānei mena kua neke atu koe i te 35 tau) ā, kāore anō kia taea e koe te hapu, kia kite i tō tākuta me te kōrero mō tēnei.

He aha ngā tohu o tēnei āhua o te whenua tūāpapa?

Ahakoa kāore e pāngia te katoa e ngā tohu, ka pāngia pea ētahi e:

• Te paheketanga rerekē .
• Te mamae o te paheketanga (Dysmenorrhea).
• Te mamae i te wā e moe ai (Dyspareunia).
• Te mamae o te hope .
• Te toto e puta mai ana i te tara, i te kōpū rānei i waenganui i ngā huringa paheketanga e rua.
• Te rerenga rerekē o te tara .

Ki te mau tonu tētahi, ētahi rānei o ēnei tohu ki a koe, he pai ake te kōrero ki tētahi tākuta mō tēnei mea.

He aha ngā raruraru ka pā mai i te isthmus cyst?

Ki te kore tēnei mate e rongoatia tika, ka puta pea ētahi raruraru. Ko ētahi o ēnei ko:

• Te pikinga ake o te tūponotanga o ngā raruraru i te wā o ngā tikanga pokanga wahine.
• Te placenta accreta ( te placenta e piri hohonu rawa ana ki te pakitara o te kōpū ).
• Te whānautanga o mua o te whenua.
• Te hapūtanga koha - He momo hapūtanga ectopic anō hoki tēnei, ka whakatōkia te hua manu kua whakatōkia ki roto i te koha i roto i te kōpū.
• Te kore tamariki tuarua - Ko te tikanga tēnei ko te kore e taea te hapu anō i muri i te haputanga angitu o mua.
• Te pakaru o te kōpū ( te haehae, te haehae rānei o te kōpū i te wāhi i puta ai te koha o te kōpū ).

He mea whakamataku pea te rongo mō ēnei raruraru. Engari kia maumahara, kāore e pā ki te katoa. Mā te tautuhi wawe me te maimoatanga ka tino whakaiti i ēnei mōrearea.

Me pēhea te tautuhi i tēnei āhua o te whenua tūāpapa?

Tāutuhia te IsthmusKo ngā whakamātautau whakaahua motuhake te mea tino whai hua. Ko te wā pai ki te mahi i ēnei whakamātautau ko te mutunga o tō huringa paheketanga. Nā te mea kua kī tonu pea te kokoru i te toto i taua wā, ā, he māmā ake te kite i te whakamātautau.

Ka tūtohu pea tō tākuta i ngā whakamātautau penei:

• Hysteroscopy: Ko tēnei mahi he whakauru i tētahi ngongo angiangi, mārama ki roto i tō tara, ka tirotirohia te roto o tō kaki me tō kōpū. Ka taea e tēnei te tirotiro mēnā he whara, he kiko rerekē, he raruraru rānei.
• Te tātaritanga saline infusion sonohysterography: Mā tēnei ka nui ake ngā taipitopito i te tātaritanga transvaginal noa. I konei, ka whakakīia tō kōpū e te tākuta ki te saline (wai tote kua horoia) ka mahi i te tātaritanga. I te whakakīia o te 'pēke' ki te wai, ka kitea mārama ngā mea pēnei i tōna rahi me te matotoru o te pakitara i roto i ngā whakaahua.
• Te tirotiro oro-matawai whakawhiti-ira: Ko te whakaurunga o tētahi taputapu tirotiro oro-matawai mā roto i te tara hei rapu i te koha me te 'āputa' o te kōpū. Ka taea hoki te aromatawai i te matotoru o te koha.

Me pēhea te rongoā i ngā koha o te pokanga cesarean?

He maha ngā maimoatanga mō ngā whēkau isthmus. Mā tō tākuta e whakatau ko tēhea maimoatanga te mea pai mōu i runga i tō āhua, te kaha o ō tohumate, me te hiahia anō kia whānau tamariki.

• Ngā ārai hapūtanga ā-waha: He pire ārai whānau ēnei. He iti noa ngā homoni e tukuna ana. Ka taea e ēnei homoni te whakahaere i tō huringa paheketanga me te whakaiti i te toto paheketanga. I ētahi wā ka taea e tēnei maimoatanga te whakaiti i te rahi o te 'wāhi' kia kore ai e hiahiatia he pokanga.
• Te tango i te kiko kiriuhi (Hysteroscopy): I te wā o te hysteroscopy, ka taea e te tākuta te tango i te kiko whara mai i te kōpū. Ka taea hoki e ia te whakatuwhera i ngā taha o te 'āputa' kia rere ai te toto me te wai. Kāore e hiahiatia he tapahi i te puku.
• Te whakatikatika laparoscopic: I tēnei tikanga, ka tapahia e te tākuta tētahi, neke atu rānei, ngā tapahi iti ki roto i tō puku, ka whakaurua he ngongo angiangi, he mārama (laparoscope) mā roto i aua tapahi hei tirotiro i roto i tō kōpū. Kātahi ka tangohia te kiko whara me te kiko taikaha huri noa i te 'āputa'. He pokanga iti rawa te whakaekenga mō ngā whara o te pokanga cesarean. Ka taea e tēnei te āwhina i a koe kia tere ake te ora, kia iti ake hoki te mamae.
• Te tango i te tākihi:Ko te tikanga o tēnei ko te tango i te kōpū katoa. He tikanga tēnei mā te hunga he tino kino ngā tohu o te isthmus, ā, kāore e hiahia ana ki te whānau tamariki anō. Tērā pea ka taea e koe te tango i te hysterectomy laparoscopic. He tikanga iti rawa te whakaekenga tēnei, arā, ka taea e koe te ora wawe me te iti ake o te mamae me te kore e tapahia he nui.

Me pēhea te aukati i te hanganga o ngā whenua pukepuke?

Ina hoki, ko te huarahi anake hei ārai i te isthmus ko te karo i te pokanga cesarean. Engari kāore e taea e te katoa te mahi i tēnā. Mena kei te hapu koe, ā, kei te whakamahere koe i te pokanga cesarean, kōrero ki tō tākuta mō tō tūponotanga ki te whakawhanake i te koha cesarean (isthmus). Ka taea e koe te whakaiti i tō tūponotanga mā te mahi i ēnei e whai ake nei:

• Kia mau tonu te taumaha hauora i mua atu me te wā e hapu ana.
• Te whakahaere i te mate huka .
• Te karo i te momi hikareti me te whakamahi i ētahi atu hua tupeka .

He aha te āhua hauora o te hunga he koha tā te pokanga whānau?

Ko te rongo pai , he mate ka taea te rongoā i te koha o te pokanga tākihi (isthmus). Ka taea e te nuinga o te tangata te hapu anō i muri i te maimoatanga, nō reira kaua e mutu te tumanako.

Āhea ahau me toro atu ki te tākuta?

Mena he isthmus tōu i te wā e hapu ana, kei te tūpono koe ki te pakaru o te kōpū . He āhuatanga ohorere hauora tēnei. Ka puta tēnei ina wehea te koha o te kōpū, ā, ka pakaru te kōpū. Ka tūpono pea tēnei ki te hauora o koe me tō pēpi.

Mena ka pāngia koe e te mamae nui o te hope, te mamae i te wāhi i whara ai tō kōiwi whakawhānau, te toto nui rānei o te tara , he tohu pea ēnei o te pakaru o te kōpū. Mena ka puta tēnei, rapua tonutia he tohutohu hauora.

He pute iti te isthmus, he 'niche' rānei, e puta ana i roto i te pakitara o tō kōpū. Nā te tapahi cesarean kāore i te ora tika. Ka puta pea he toto tara rerekē, he mamae pelvic, me ngā raruraru paheketanga. Ka puta hoki he kore tamariki, he raruraru rānei ki ngā hāputanga a muri ake nei. Ko te maimoatanga tino noa ko te pokanga iti rawa te whakaekenga hei tango i te kiko whara tāpiri me te hanga i te 'niche'. Ka taea e te nuinga o te tangata te whai hāputanga hauora i muri i te maimoatanga.

Kia maumahara ki te mea tino nui (Karere hei kawe ki te kāinga)

• He 'pēke' iti te isthmocele ka puta ina kore e ora tika te tapahi o te kōpū i muri i te pokanga cesarean.
• Ahakoa kāore e pāngia te katoa e tēnei mate, tera pea ētahi tāngata ka pāngia e te kore tamariki, ngā raruraru paheketanga, me ngā raruraru i ngā wā e hapu ana.
• Mena ka puta mai ngā tohu pēnei i te toto rerekē, te mamae rānei o te hope, me toro atu ki te tākuta.
• Ka taea te tātaritanga me te rongoā i tēnei mate. I te nuinga o te wā, ka angitu te hāputanga i muri i te maimoatanga.
• Mena kua whānau kē koe i tētahi tākuta, he mea nui kia mōhio koe ki tēnei. Kāore he mea e wehi ai koe, me kōrero tonu ki tō tākuta mō tēnei.

Mena he pātai anō āu mō tēnei, kaua e wehi ki te pātai atu ki tō tākuta wahine. Mā rātou koe e āwhina.