I toto nui anō hoki koe i muri i te whānautanga o te pēpi? Me kōrero tātou mō te Toto i muri i te whānautanga (PPH)

He mea noa te whakaheke toto i muri i te whānautanga. Engari, me pēhea mēnā he nui rawa atu tō toto i tō whakaaro? He tino whakamataku, he morearea hoki. Koinei te mea e kiia nei e tātou ko te whakaheke toto i muri i te whānautanga (PPH) . Ehara tēnei i te kata, he āhuatanga e hiahia ana kia arohia tonutia e te rata.

He aha te toto muri i te whānautanga (PPH)? Kia mārama tātou?

Ki te whakarapopoto, ko te toto muri i te whānautanga (PPH) he toto nui i muri i te whānautanga. I te nuinga o te wā ka puta tēnei i roto i ngā haora 24 o te whānautanga. Ka kiia e mātou ko te 'PPH Tuatahi '. Engari i ētahi wā, ka puta te toto i roto i ētahi rā, i ētahi wiki, tae atu ki te 12 wiki i muri i te whānautanga. Ka kiia tēnei ko te 'PPH Tuarua, te PPH Whakamutunga rānei' .

Ko te mea ka tupu i roto i tēnei, he nui te toto ka ngaro i tō tinana i te wā kotahi. Ina tupu tēnei, ka heke ohorere tō toto toto . He aha te mea ka tupu i muri mai? Ka heke te nui o te toto e haere ana ki te ngākau, ki te roro, me ētahi atu okana nui. Ka kiia tēnei ko te hypovolemic shock . Ka taea e tēnei te whakararu i te ora. Nō reira, me tere tonu te whakamutu o tēnei toto e ngā tākuta me ngā nēhi.

Kia maumahara, ki te mea kei te pēhia koe e te toto nui i muri i te whānautanga o te pēpi, he mea whakamataku tēnā. Engari ko te mea nui kia kaua e mataku, me te kōrero tonu ki tō tākuta, ki tō kaiwhakawhanau rānei. Ki te kitea wawetia, ā, ka tere te rongoā, he maha ngā wā ka taea e koe te ora katoa.

E hia te nui o te toto ka puta mai i te PPH?

I te nuinga o te wā,

• Ahakoa whānau tōu tara, whānautanga rānei, ki te ngaro atu i te kotahi rita (1000ml) te toto,
• Ki te mea rānei he huringa nui kei roto i tō tere o te manawa me te toto toto me te nui o te toto i ngaro, ā, kei te whakaatu koe i ngā tohu o te nui o te toto i ngaro, e kiia ana he PPH.

Ka pā tēnei āhuatanga ki te 1 me te 5 o roto i te 100 whānautanga. Arā, kei waenganui i te 1% me te 5%. Engari ki te tere te rongoā, i te nuinga o te wā kāore e mōrearea ki te ora.

Me pēhea taku mōhio mēnā kei a au te PPH? He aha ngā tohu?

Ko te tohu matua o te PPH ko te toto toto nui, pumau i muri i te whānautanga. I ētahi wā , ka puta ngā toto toto nui atu i te pōro korowha . Ki te puta tēnei, he tohu pea tēnei nō te raruraru.

Ko ētahi atu tohu ko:

• Ngā tohu o te toto toto iti: te whanoke, te tirohanga pōuri, me te hemonga o te ngākau.
• Te pikinga o te tere o te ngakau (Tachycardia).
• Te hekenga o te maha o ngā toto toto whero (te hekenga o ngā taumata hematocrit).
• He kiri mā, he kiri mākūkū rānei, me te mea kei te puta te werawera makariri.
• Te mamae me te pupuhi i te rohe tara, i te rohe perineal rānei.(Ka puta tēnei ina kohia te toto i waho o te uaua)

Ki te pāngia koe e tētahi o ēnei tohu rerekē i muri i te whānautanga, me kōrero tonu atu ki tō kaiwhakarato hauora . I ētahi wā, ka mau tonu pea ngā tohu PPH ahakoa kua hoki koe ki te kāinga i te hōhipera. Ki te puta tēnei, kaua e mataku, me toro atu ki tō tākuta tonu.

He aha te take e puta ai te PPH? He aha ngā take?

He maha ngā take o te PPH.

E mōhio ana koe, i te wā e noho ana tō pēpi i roto i te kōpū, ka piri te whenua ki te pakitara o tō kōpū, ka whakarato i te kai me te hāora ki te pēpi. I muri i te whānautanga o tō pēpi, ka haere tonu te kōpiri o tō kōpū, ka pana i te whenua. Mā ēnei kōpiri ka whakawhāitihia, ka mutu te toto i roto i ngā oko toto i piri ai te whenua. Engari i ētahi wā, ki te kore e tino kaha ēnei kōpiri , kāore e mutu te toto. Koinei te take o te 80% o te PPH.

Waihoki, ka puta te PPH mēnā ka noho tonu ētahi wāhanga o te whenua i roto i te pakitara kōpū, mēnā rānei kua pakaru ngā okana o tō pūnaha whakaputa uri (te tara, te kaki, te kōpū) i te wā e whānau ana.

Ko te PPH te mea nui i waenga i te 30 me te 60 meneti i muri i te whānautanga o te pēpi.

Ko ngā "T e Whā" e pā ana ki te PPH

E whā ngā tino take o te PPH, e kiia nei ko ngā "T e Whā".

1. Tono (te āhua o te kōpū - Uterine Atony): Koinei te tino take . Ko te uterine atony ko te kore e pai te whakawhāiti o te kōpū i muri i te whānautanga, engari ka ngawari, ka ngoikore. Kātahi ka kore e whakawhāiti ngā uaua toto i noho ai te whenua, ā, ka haere tonu te toto.

2. Whara: I te wā e whānau ana, ka puta te toto nā te whara o te tara, te kaki, te kōpū, te perineum rānei. I ētahi wā ka puea ake ēnei toto ki roto i te kiko kua whara, ā, ka haere tonu te toto mō ngā hāora, ngā rā rānei i muri i te whānautanga.

3. Kiko (Kiko o te whenua e puritia ana): Ki te kore te whenua e tino wehea mai i te pakitara kōpū, ka puta te toto i ngā kiko e toe ana. Tērā pea nā te āhua rerekē o te whenua, he whenua noa rānei.

4. Thrombin (ngā raruraru toto totoka): Mena he mate totoka tōu, he mate rānei i pā ki te totoka i te wā e hapū ana, ahakoa he iti noa te toto ka waiho hei raruraru nui.

Ko wai kei te nui ake te mōrearea ki te PPH?

Ina hoki, ka pā te PPH ki te tangata e whānau ana. Ahakoa he maha ngā āhuatanga mōrearea mō te PPH, tata ki te 40% o ngā take PPH ka puta kāore he āhuatanga mōrearea . Nō reira, kāore pea e taea e ngā tākuta te ārai katoa i te PPH. Heoi, mā te mōhio ki ēnei āhuatanga mōrearea i mua i te whānautanga ka āwhina i te whakaiti i te mōrearea o te toto nui.

Ngā āhuatanga o te placenta

Ka nui ake te mōrearea o te PPH mēnā kei a koe tētahi o ngā āhuatanga e whai ake nei e pā ana ki te whenua whānau:

• (Te Wāhanga o mua o te Wāhi)(Kei raro iho te placenta i te kōpū)
• (Te pakaru o te placenta )
• (Placenta accreta) (Placenta e piri pūmau ana ki te pakitara o te kōpū)

Ngā āhuatanga e pā ana ki te whānautanga, te whānautanga rānei

Ka piki ake pea te mōrearea o te PPH mēnā ka puta ēnei āhuatanga i te wā e whānau ana:

• Mena kua tukuna he rongoā whakamoe whānui .
• Mena kua hoatu he rongoā ki a koe (tocolytics) hei whakamutu i te pupuhi o te kōpū.
• Mena ka roa te mamae , ka nui rawa rānei te hoatutanga o te rongoā hei whakaoho i te whakawhāiti o te kōpū (Oxytocin / Pitocin®) .
• Te whānautanga wawe (iti iho i te toru hāora i muri i te tīmatanga o te whānautanga).
• Mena i whakamahia he kuku , he mīhini whakakorekore rānei i te wā e whānau noa ana.
• Mena he nui ngā motu i roto i te tenetene.
• Mena i whānau te pēpi mā te mahi pokanga .

Ētahi atu āhuatanga hauora

Ka taea hoki e ētahi atu āhuatanga hauora te whakanui ake i te mōrearea o te PPH, pēnei i:

• Ngā mate toto totoka, hei tauira (te mate von Willebrand) .
• Mena kua tangohia e koe te rongoā (Magnesium sulfate) hei rongoā mō te preeclampsia kino.
• Ko ngā āhuatanga hapūtanga e pā ana ki ngā mea e whakapakeke ana i te toto, ki ngā pereti toto rānei, hei tauira: (HELLP syndrome) , (gestational thrombocytopenia) .
• He mate pāwera o te pēke amniotic (Chorioamnionitis) .
• Te momonatanga.
• Te pakeketanga o te whaea.

Waihoki, ka nui ake te mōrearea o te PPH mēnā ka nui rawa te pupuhi o te kōpū . Ka taea tēnei:

• Mena kua rima, neke atu rānei ō whānautanga o mua.
• I ngā whānautanga maha, pērā i te māhanga me te mātoru.
• Mena he pēpi nui tāu (macrosomia) .
• Mena he nui rawa te wai amniotic (polyhydramnios) .

He aha ngā pānga taha ka puta mai i te PPH?

Ina nui rawa te toto e ngaro ana i a koe, ka pāngia pea koe e ngā āhuatanga pēnei i te pikinga o te tere o te ngakau, te tere o te manawa, me te heke o te rere o te toto. Ka taea e ēnei tohu te whakaiti i te nui o te toto e rere ana ki ngā whekau pēnei i te ate, te roro, te ngākau, me ngā whatukuhu, ka puta ai te ohorere . Ko te ohorere ko te kore e whiwhi toto i ngā whekau. Ka taea e tēnei te arahi ki te ngoikore o ngā whekau , tae noa ki te mate.

Me pēhea te mōhio ki te PPH i muri i te pokanga cesarean (C-section)?

I te nuinga o te wā, he rite tonu ngā tohumate o te PPH i muri i te C-section ki te whānautanga noa. Ko ētahi o ngā tohumate ko:

• Te pikinga o te tere o te ngakau.
• Ngā ringa me ngā waewae makariri, te mākū o te kiri.
• Te uaua ki te manawa.
• Te pupuhi, te marō, te mamae rānei i tētahi atu wāhi o te puku, inā koa i te wāhi i puta ai te patunga i pokanga.
• Te toto nui o te tara me te puta o ngā toto totoka nui.

Me pēhea te tātaritanga a ngā tākuta i te PPH?

Mā ngā whakamātautau tirohanga me ngā whakamātautau tinana ka tātarihia e ngā tākuta te PPH. He mea nui anō hoki ngā whakamātautau taiwhanga me te arotake āta i tō hītori hauora hei aromatawai i te mōrearea me te pānga o te PPH.

Ko te nuinga o te wā ka kitea te PPH mā te nui o te toto kua ngaro. Ko te nui o te toto kua ngaro ka whakatauhia mā te tatau, mā te pauna rānei i ngā papa, i ngā hautai rānei i ruia ki te toto i te whānautanga o te pēpi.

Mena kei te whakapae koe kei a koe te PPH, ka taea e koe te whakamahi i ēnei mea hei whakamātautau anō i a koe anō:

• Me aroturuki tonu i te tere o tō manawa me tō toto toto .
• Ngā whakamātautau toto e ine ana i te nui o ngā toto whero i roto i te toto (hematocrit) me ngā mea e whakapakeke ai te toto.
• He whakamātautau pelvis e tirotiro ana i te tara, te kaki pūkahukahu, me te kōpū.
• Ka tangohia e te matawai ultrasound he whakaahua taipitopito o te kōpū.

Me pēhea te rongoā mō te PPH?

He maha ngā wā ka tirohia e ngā tākuta te PPH hei āhuatanga ohorere. Ko te whāinga matua o te maimoatanga he whakamutu i te toto i te wā e taea ai.

I runga i te pūtake o tō toto me te kaha o te toto, ka tūtohu pea tō tākuta i tētahi, i ētahi rānei o ēnei maimoatanga:

• Mirimiri kōpū hei whakaū i ngā uaua o te kōpū.
• Te hoatu rongoā e whakaoho ana i te whakahekenga o te kōpū.
• Te tango i te kiko whenua e toe ana, mā te ringa, mā tētahi atu tikanga rānei.
• Te whakatika i ngā roimata i te tara, te kaki, me te kōpū.
• Te whakauru i tētahi taputapu, pērā i te catheter , i te poihau rānei, hei pēhi i ngā pakitara o te kōpū me te whakamutu i te toto.
• Ngā tikanga e aukati ana i te rere o te toto ki te kōpū.
• Me whai whakawhiti toto koe.
• Te hoatu wai mā roto i te uaua (IV) , pērā i te tote.
• Te hoatu hāora tāpiri mā te kopare.
• Te tohu i ngā tāpiringa rino .

He tino onge, mēnā rānei kāore e angitu ētahi atu tikanga, ka mahi pea te tākuta i te laparotomy (he pokanga hei whakatuwhera i te puku me te kimi i te pūtake o te toto) i te hysterectomy rānei (tango i te kōpū).

Kia pēhea te roa o te wā e ora ai i tēnei mate PPH?

He rerekē te roa o te wā whakaora i ia tangata, i ia tangata. Kei te nui o te toto i ngaro i a koe me te āhua o te maimoatanga a ō tākuta i a koe. He mea nui kia tiakina koe i ngā rā tuatahi i muri i te whānautanga o tō pēpi – kai pai, inu nui i te wai, me te okioki i ngā wā katoa e taea ana . Tērā pea ka tūtohu tō tākuta kia tangohia he tāpiringa rino hei rongoā i te mate toto kore.

Ka taea te ārai i te PPH? Ka taea e au te whānau anō i tētahi pēpi?

Ko te huarahi pai rawa atu mā ngā tākuta ki te ārai i te PPH ko te tautuhi i te hunga e nui ake ana te mōrearea ki te PPH i mua i te whānautanga. Ka taea e koe te āwhina mā te whakapuaki i tō hītori hauora katoa ki tō tākuta me te whakamōhio atu ki a rātou mō ngā tohu o te PPH i muri i te whānautanga o tō pēpi.

He haumaru te whānau anō i tētahi atu pēpi. Heoi, kōrero ki tō tākuta mō tō mōrearea ki te PPH i tō whānautanga e whai ake nei. Ahakoa he paku teitei ake tō mōrearea i te mea noa, he iti tonu te tūponotanga. Ka taea e tō tākuta te tirotiro i ō āhuatanga mōrearea me te whakatau mēnā me mahi koe i ētahi mahi ārai motuhake i tō whānautanga e whai ake nei.

Me pēhea te tiaki i a koe anō i muri i te PPH?

He uaua pea te tiaki i a koe anō i a koe e tiaki ana i tāu pēpi hou. Engari, ki te whai wā koe ki te okioki me te tiaki pai i a koe anō, ka tere ake tō ora. He mea tino nui tō oranga tinana.

Anei ētahi mea hei āwhina i a koe:

• Okiokinga: Me whai wā tō tinana ki te whakaora. Kaua e wehi ki te tono āwhina, ā, me whiwhi i te okiokinga e hiahiatia ana e koe.
• Kai i ngā kai whai kiko: Ko ngā kai whai kiko rino pērā i te mīti whero, ngā huawhenua matomato, me ngā pata parakuihi whai kiko ka āwhina i te hanga i ngā toto whero. Ka taea e ngā kai whai kiko te āwhina i a koe ki te ora.
• Inumia he wai: Inumia he nui te wai i muri i te whānautanga hei ārai i te matewai.
• Whāia ngā tohutohu a tō tākuta: Tērā pea ka tohua e tō tākuta he rongoā, he whakarerekētanga rānei mō tō noho hei āwhina i a koe ki te ora. Āta whāia aua tohutohu.
• Kia mataara ki te nui o te toto e rere ana: Mauria he paraikete horoi. Kia mataara ki te roa o te wā e kī ana. Me heke haere te toto i roto i ētahi wiki. Ki te kore, tirohia tō tākuta.

He tino mamae te toto nui. He mea noa te roa o te wā ki te whakaora i te wairua i muri i te whānautanga. Tērā pea me tautoko koe e tō whānau, e ō hoa, e ngā tākuta, e ētahi atu rānei. Kōrerohia ō kare ā-roto, ā, tonoa he āwhina ina hiahiatia.

Āhea koe me toro atu ki te tākuta?

I te nuinga o te wā, ka puta te PPH i muri i te whānautanga, i a koe rānei i te hōhipera. Heoi, ki te nui te toto e puta mai ana i muri i tō taenga ki te kāinga, ki te puta rānei ētahi tohu o te PPH, me toro atu ki tō tākuta tonu . Mena kua kati te tari o tō tākuta, kāore rānei e taea e koe te toro atu ki a rātou, haere ki te rūma whawhati tata ki tō hōhipera.

Ki te pāngia koe e te toto nui i muri i te whānautanga, me toro atu ki te tākuta tonu. Ko ētahi atu tohu o te PPH ko te whanoke, te ngoikore, me te uaua ki te manawa. He mate kino te PPH e hiahia ana kia arohia tonutia e te rata.

Mena kei a koe, kei tētahi rānei o tō whānau te PPH, he mea noa te ohorere me te mataku i te wheako. Engari kia maumahara, mā te kitenga wawe me te maimoatanga tere ka ārai i ngā raruraru nui. Koia te mea nui kia tuwhera, kia pono hoki ki tō tākuta mō tō hītori hauora. Mā tēnei koe e āwhina ki te whakatau mena kei te mōrearea koe ki te PPH.

Karere Whakamutunga mō te Tango ki te Kāinga

• He mate kino te PPH (Postbirth Hemorrhage) e hiahia ana kia aro wawe atu ki te hauora, ā, ko tōna āhuatanga he nui te toto i muri i te whānautanga.
• Ki te pāngia koe e ngā tohu pēnei i te toto nui, te pupuhi toto nui, te whanoke, te hemo, te tere haere rānei o te manawa , rapua tonutia he tohutohu hauora .
• Ko te tino take o te PPH ko te uterine atony, arā, ko te kore e taea e te kōpū te whakapūmau tika. Ko ētahi atu take ko ngā whara, te pupuri i te whenua, me ngā raruraru totoka.
• Ahakoa ētahi āhuatanga mōrearea, ka pā te PPH ki te katoa .
• Ki te kitea wawetia, ā, ka rongoātia wawetia, he maha ngā wā ka taea te whakaora katoa.
• Ka taea e te wheako PPH te tino mamae i te hinengaro. Kaua e mangere ki te tiki i te tautoko e hiahiatia ana e koe.

He mea tino nui te tiaki i tō hauora, inā koa i ēnei wā. Kāore koe i te mokemoke, tonoa he āwhina.

` Te toto i muri i te whānautanga, PPH, whānautanga, toto, kōpū, whenua whānau, hauora o ngā wāhine