Ubwoko bw'amaraso y'umwana wawe utaravuka ntibuhuye n'ayawe? (Erythroblastosis Fetalis) Reka turebe neza icyo ari cyo!

Niba uri umubyeyi utwite, ushobora kuba waragize ubwoba gato ubwo wumvise amagambo 'Erythroblastosis Fetalis'. Cyangwa se wenda muganga wawe yabivuzeho igihe gito gishize ubwo yavugaga ku bwoko bw'amaraso yawe. Bishobora gutera ubwoba kumva iri zina. Ariko ntugahangayike, uyu munsi turabivugaho mu buryo bworoshye ushobora gusobanukirwa. Reka turebe icyo ari cyo, impamvu kibaho, n'uko twakwirinda iki kibazo.

'Erythroblastosis Fetalis' ni iki?

Mu magambo make, iki ni ikibazo kidasanzwe, bivuze ko atari buri wese ubibona, gishobora kubaho mu gihe utwite. Ibi bibaho iyo hari ukudahuza kw'ubwoko bw'amaraso hagati yawe n'umwana wawe ukiri mu nda. Si itandukaniro ryose ry'ubwoko bw'amaraso ritera ibibazo. Ariko, ibi byago biba byinshi cyane cyane iyo ubwoko bw'amaraso yawe ari 'Rh-negative' naho ubwoko bw'amaraso y'umwana wawe bukaba ari 'Rh-positive'.

Tekereza, uramutse wahuye n'aya maraso ya Rh-positive, haba mu gihe wari utwite mbere cyangwa mu gihe cyo guterwa amaraso, ubudahangarwa bw'umubiri wawe (uburyo buturinda indwara) bushobora gutangira kwibasira uturemangingo dutukura tw'umwana. Nk'aho ari ukwibasira umwanzi. Ibi bishobora gutuma uturemangingo dutukura tw'umwana tuba duke cyane. Ibi tubyita anemia. Iyo iyi anemia ibaye ikomeye, ishobora gushyira ubuzima bw'umwana mu kaga iyo idavuwe.

Ariko hari inkuru nziza! Muri iyi minsi, ibizamini bisanzwe mu ntangiriro z'umubyeyi wawe bishobora kugaragaza ubwoko bw'amaraso yawe. Niba udafite Rh-negative, abaganga bashobora kukwandikira imiti yo kwirinda iki kibazo.

Iyi ndwara yitwa kandi `(indwara ya hemolytic y'umwana ukiri mu nda - HDN)` na `(indwara ya hemolytic y'umwana uri mu nda n'umwana ukiri mu nda - HFDN)`. Ariko iyo tuyivuzeho, tuzakoresha ijambo `(Erythroblastosis Fetalis)`.

Ni ibihe bimenyetso umwana aramutse afite iyi ndwara?

Abana bavutse bafite iyi ndwara (Erythroblastosis Fetalis) bashobora kugaragaza ibimenyetso byo kubura amaraso. Bamwe mu bana bashobora kuyirwara byoroheje, abandi bakayirwara cyane. Nanone, umwana ashobora kurwara umuhondo mu masaha 24 nyuma yo kuvuka. Dore bimwe mu bimenyetso:

• Ibara ry'umuhondo ry'amaso n'uruhu.
• Uruhu ruhinduka ubururu butunguranye .
• Uruhinja rugira umunaniro mwinshi kandi nta buzima rufite (umunaniro).
• Umutima utera cyane (tachycardia).
• Kubura ubushake bwo kurya amata.

Mu bihe bimwe na bimwe bikomeye, umwana uri mu nda cyangwa umwana ukiri muto ashobora kugira indwara ishobora gushyira ubuzima mu kaga yitwa "hydrops fetalis." Ibimenyetso byayo birimo:

• Kubyimba umubiri.
• Amazi yiyongera mu nda y'umwana, cyangwa hagati y'ingingo z'ingenzi nk'umutima n'ibihaha.

Kuki ibi bibaho? Impamvu ni izihe?

Iyi ndwara yitwa "Erythroblastosis Fetalis", iterwa nuko, nk'uko byavuzwe mbere, ubudahangarwa bw'umubiri wawe bwibasira uturemangingo tw'amaraso dutukura tw'umwana.

Uturemangingo dutukura dufite ibimenyetso byihariye kuri two. Tutwita "antigens." Tekereza kuri "antigens" nk'ibirango biriho amazina. Niba ubudahangarwa bw'umubiri bwawe bumenye iki kirango, ntibuzibasira uturemangingo dutukura.

Ibi biterwa n'itandukaniro riri hagati y'amaraso yawe n'ay'umwana wawe. Ubwoko bw'amaraso bushyirwa mu byiciro hashingiwe ku "antigens" ziri ku buso bw'uturemangingo dutukura tw'amaraso. Hari ubwoko bubiri bw'ingenzi bw'amaraso tuvuga:

• Igipimo cya Rh: Ibi bivuze niba amaraso ari meza (+) cyangwa ari mabi (-).
• Antigen za ABO: Ibi bivuze ubwoko bw'amaraso bwa A, B, AB, cyangwa O.

Niba utwite, ubudahangarwa bw'umubiri bwawe, niba butazi "antigens" ku tunyangingo tw'amaraso dutukura tw'umwana wawe, buzatangira gukora "antibodys" zo kubarwanya. Izi "antibodys" ni zo zitera utwo tunyangingo tw'amaraso dutukura. Nk'uko umubiri wacu uhura n'umugera utera indwara, umubiri wacu urawurwanya. Ariko kugira ngo ibi bishoboke, amaraso y'umwana agomba guhura n'amaraso yawe. Akenshi, ibi bibaho iyo umwana agiye kuvuka. Ariko, rimwe na rimwe amaraso ashobora kuvanga na yo mbere. Urugero:

• Iyo gukuramo inda bibayeho.
• Iyo inda ibuze hagati mu gihe cyo gutwita, byitwa "Gukuramo inda".
• Mu gihe cyo gutwita hanze y'umura (gutwita biba biri hanze y'umura, nko mu muyoboro w'inda).
• Mu gihe cyo gukora ``(Amniocentesis)`` (ikizamini cyakozwe mu gihe cyo gutwita).
• Mu gihe cyo gukora `(Chorionic villus sampling)` (ikindi gipimo cyo gutwita).

Iyo umubiri wawe umaze gukora izi `(antibodies)`, urabyibuka. Iyo uturemangingo dutukura tw'umwana twongeye kugira iyo `(antigen)` mu gihe cyo gutwita, izi `(antibodies)` zizagenda zisenya utwo turemangingo. Ibi tubyita isenya ry'uturemangingo dutukura tw'amaraso `(hemolysis)`.

Impamvu nyamukuru: Kudahuza kwa Rh

Impamvu ikomeye kandi izwi cyane itera iyi ndwara ni iyo ufite Rh-negative kandi umwana wawe akaba afite Rh-positive. Iyo ibi bibaye, ubudahangarwa bw'umubiri bwawe bwibasiye uturemangingo tw'amaraso dutukura tw'umwana wawe dufite Rh-positive. Mu gihugu nka Amerika, abantu bagera kuri 15% bafite amaraso ya Rh-negative. Kenshi na kenshi, umubyeyi na se, ndetse n'umwana, baba bafite Rh-positive.

Ubusanzwe, uku kudahuza kwa Rh ntabwo bitera ibibazo bikomeye mu gihe cyo gutwita kwa mbere. Nubwo waba ufite Rh-negative kandi umwana akaba afite Rh-positive, ni gake cyane amaraso yawe yivanga n'amaraso y'umwana mu gihe atwite bigatuma habaho ingaruka zikomeye (antibodys). Ariko, umwana amaze kuvuka, amaraso yawe azahura n'amaraso y'umwana. Muri icyo gihe, niba utarafata imiti yo gukumira ubudahangarwa bw'umubiri wawe kubwibasira, umubiri wawe ushobora kugira antibody barwanya uturemangingo tw'amaraso dutukura twa Rh-positive.

Hanyuma niba wongeye gutwita, kandi uwo mwana afite ubwoko bw'amaraso bwa Rh-positive, utwo tunyangingo twakozwe mbere tuzagenda twibasira uturemangingo tw'amaraso dutukura tw'uwo mwana. Urabyumva?

Ibindi bintu bidasanzwe bidashobora guhuza ubwoko bw'amaraso

Hari igihe ubudahangarwa bw'umubiri wawe bushobora kwibasira uturemangingo tw'amaraso dutukura tw'umwana wawe nubwo hari aho bihurira na antigen y'uturemangingo tw'amaraso dutukura. Ibi bibaho iyo umwana wawe afite iyo antigen idasanzwe hanyuma ukayitakaza. Ibi bibaho iyo wahuye n'iyo antigen mu gihe cyo gutwita cyangwa guterwa amaraso mbere kandi ukaba warabonye uturemangingo tuyirwanya. Zimwe muri izi antigen ni:

• `(Colton)`
• `(Duffy)`
• `(Diego)`
• `(Ee)`
• `(Gerbich)`
• `(H)`
• `(Kell)`
• `(Kidd)`
• `(Abaluteriyani)`
• `(MNS)`
• `(P)`
• `(Xg)`

Ibizamini by'amaraso bikozwe mu ntangiriro z'umubyeyi utwite bishobora kugaragaza niba urimo gukora ubudahangarwa bw'umubiri burwanya ubwo bwoko bw'uturemangingo dutukura tudasanzwe.

Iyi ndwara ikunze kugaragara gute?

Ku isi yose, abagera kuri 276 mu bana 100.000 bavutse ari bazima bivugwa ko bafite ibibazo byo gutwita bijyanye no kudahuza kw'amaraso ya Rh. Nk'uko abashakashatsi babivuga, iyo bitavuwe, hari amahirwe angana na 50% ko umwana uri mu nda yapfa cyangwa akarwara ibibazo bikomeye by'ubuzima.

Ariko ntugahangayike! Hamwe no gupima ubwoko bw'amaraso n'imiti ikenewe, ingaruka mbi zishobora kwirindwa. Mu bice bimwe na bimwe by'isi aho ubuvuzi bw'ababyeyi buboneka, abana bagera kuri 2.5 mu 100.000 ni bo bonyine bafite ibibazo bitewe no kudahuza kwa Rh. Iki ni ikibazo gikomeye muri Sri Lanka.

Ubibona ute?

Ubusanzwe, ku mavuriro y’abatarabyara, amaraso yawe n’andi yose arwanya indwara ya “antibodies” arasuzumwa. Niba utwite kandi ufite ubwoko bw’amaraso ya “Rh-negative”, muganga wawe azasuzuma “antibodies” zirwanya amaraso ya “Rh-positive”. Niba udafite izo “antibodies”, ubudahangarwa bw’umubiri bwawe buzahabwa umuti wo kubuhagarika.

Iyo ikizamini cyemeza ko ufite izi antibodies, bivuze ko niba umwana afite Rh-positive, ubudahangarwa bw'umubiri bwawe buba buri mu kaga ko kwibasira uturemangingo tw'amaraso dutukura tw'umwana. Muganga wawe azasuzuma urugero rw'uturemangingo tw'umubiri wawe buri byumweru bike. Niba urugero rw'uturemangingo tw'umubiri wawe ruri hejuru cyane, hashobora gukorwa ibindi bipimo kugira ngo barebe niba umwana wawe afite amaraso make, kandi ushobora gukenera guterwa amaraso mu nda. Niba umwana wawe afite ibyago byo kuvuka afite amaraso make cyane, muganga wawe ashobora gufata icyemezo cyo kubyara umwana hakiri kare.

Nyuma yo kuvuka k'umwana, muganga ashobora kumenya ubwoko bw'amaraso y'umwana. Ibi bishobora gufasha kumenya niba amaraso y'umwana aterwa no kudahuza kw'ubwoko bw'amaraso.

Ibindi bizamini byakozwe ni ibi bikurikira:

• Umubare wuzuye w'amaraso (CBC): Iki kizamini gishobora kugenzura uburyo uturemangingo dutukura tw'umwana turi hasi. Uko urugero rugabanuka, niko amaraso agabanuka cyane.
• Gupima amaraso mu maraso (PBS): Ibi bikubiyemo gusuzuma amaraso hakoreshejwe mikorosikopi. Ibi bishobora gutanga igitekerezo cy'uko igabanuka ryabyo riterwa no kwangirika kw'uturemangingo dutukura tw'amaraso (hemolysis).
• Ikizamini cya Bilirubin:Ibi bipima urugero rwa bilirubin. Bilirubin ni umusaruro ukomoka ku gusenyuka kw'uturemangingo dutukura tw'amaraso. Urugero rwinshi rwa bilirubin (hyperbilirubinemia) rushobora kugaragaza ko uturemangingo dutukura tw'amaraso turimo kwangirika.
• Ikizamini cya Antiglobulin kitaziguye (DAT): Iki kizamini kigaragaza niba uturemangingo tw’umubiri turi ku buso bw’uturemangingo dutukura tw’amaraso y’umwana. Ibi bivuze ko ubudahangarwa bw’umubiri bw’umubyeyi bwibasiye uturemangingo tw’umwana.

Ni ubuhe buryo bwo kuvura?

Uburyo bwo kuvura buterwa n'uko utwite cyangwa umaze kubyara.

Uburyo bwo kuvura mu gihe cyo gutwita

Niba ufite uturemangingo tw’umubiri dushobora kugushyira mu kaga ko kwandura Erythroblastosis Fetalis, muganga wawe azakurikirana urugero rw’uturemangingo tw’umubiri wawe buri byumweru bike. Niba urugero rw’uturemangingo tw’umubiri wawe ruri hejuru, ushobora gukenera gukorerwa isuzuma ry’inyongera rya ultrasound kugira ngo urebe niba umwana wawe afite ikibazo cyo kubura amaraso. Niba ikibazo cyo kubura amaraso ari kinini, umwana wawe ashobora gukenera guterwa amaraso.

Uburyo bwo kuvura umwana nyuma yo kuvuka

Abaganga bavura abana bavutse bafite ``Erythroblastosis Fetalis'' bavura amaraso make na ``hyperbilirubinemia'' (jaundice). Uburyo bwo kuvura ni ubu:

• Ubuvuzi bw'izuba: Ubu buryo bukoresha urumuri mu kuvura hyperbilirubinemia. Ubu mucyo uhindura bilirubine mo ibintu byoroshye gusohoka mu mubiri w'umwana.
• Guterwa amaraso: Nyuma yo kuvuka k'umwana, umwana ashobora gukenera guterwa amaraso kugira ngo amenye neza ko afite uturemangingo dutukura duhagije.
• Ibikoresho bitera imbaraga mu mikurire y'amaraso (ESA): Ibi bishobora kuba amahitamo yo kuvura amaraso make adahagije ku buryo bisaba guterwa amaraso. Bishobora gukenerwa guhabwa hamwe n'inyongeramusaruro za feri kugira ngo bifashe umwana gukora uturemangingo tw'amaraso dutukura dufite ubuzima bwiza.

Mu bihe bikomeye, umwana ashobora gukenera ubufasha, nk'icyuma gifasha guhumeka n'amazi yo mu nda.

Ni iki kigendekera umwana nyuma y'iki kibazo?

Ibisubizo biterwa n'uburemere bw'ibimenyetso by'umwana wawe. Kubura amaraso menshi no kugabanuka kwa bilirubinemiya bishobora kwica iyo bitavuwe.

Ariko, abana barwaye Erythroblastosis Fetalis bashobora kurokoka iyo bavuwe neza. Bashobora gukenera guterwa amaraso kugira ngo bongere uturemangingo tw’amaraso dutukura mu gihe batwite na/cyangwa nyuma yo kubyara. Muganga azakenera kubakurikirana mu gihe cy’amezi menshi kugira ngo arebe neza ko nta kibazo kirimo.

Ese ibi ntibishobora kwirindwa?

Birashoboka rwose! Erythroblastosis Fetalis ishobora kwirindwa cyane binyuze mu gupima ubwoko bw'amaraso no gukoresha imiti yo kuyirinda mu gihe cyo gutwita.Ingorane. Niba ufite Rh-negative, ushobora gufata Rh immune globulin (Rh immune globulin - RhIg cyangwa RhoGAM®) kugira ngo wirinde ko umubiri wawe ukora ubudahangarwa bw’amaraso ya Rh-positive. Ugomba gufata uyu muti mu byumweru 28 utwite, mu masaha 72 nyuma yo gutwita (nyuma yo kubyara, gukuramo inda), kandi niba uva amaraso menshi mu gihe utwite (ndetse no mu gihembwe cya mbere cy’umubyigano).

Ibi bikora gusa iyo ufashe uyu muti mbere yuko amaraso yawe ahura n'amaraso ya Rh-positive. Niyo mpamvu witabwaho cyane cyane mu mavuriro atwite.

Ibintu ugomba kubaza muganga wawe

Niba ufite ibindi bibazo kuri ibi, ntutinye kubaza muganga wawe cyangwa umuforomo. Dore ingero zimwe na zimwe:

• Ubwoko bw'amaraso yanjye ni ubuhe?
• Ese hari "antibodies" nkwiye guhangayikishwa nazo?
• Ese nkwiye guhangayikishwa n'indwara ya `(Erythroblastosis Fetalis)`?
• Ese nkeneye gukurikiranwa by'inyongera cyangwa kujya kwa muganga kenshi?
• Ese nkeneye gufata Rh immune globulin (RhIg)?
• Ni ryari nkwiye gufata gahunda cyangwa gushaka ubuvuzi bwihutirwa?

Bigenda bite iyo umubyeyi afite Rh-positive naho umwana akaba nta Rh-negative?

Ibi akenshi si ukudahuza kw'ubwoko bw'amaraso. Umwana uri mu nda udafite Rh nta antigen ya Rh afite ubudahangarwa bw'umubiri bw'umubyeyi bushobora kwibasira. Keretse niba hari ibindi bintu bidahuye by'ubwoko bw'amaraso, ibi ntibikwiye kuba ikibazo.

Ibintu by'ingenzi cyane ugomba kuzirikana

Igitekerezo cy'uko ubudahangarwa bw'umubiri bwawe bushobora kwibasira umwana wawe uri mu nda ni ikintu giteye ubwoba. Ariko inkuru nziza ni uko uku kudahuza kw'amaraso mu buryo buteye ubwoba atari ibintu bisanzwe. Kandi, abaganga bakora uko bashoboye kose kugira ngo birinde ibi bibazo. Gupima ubwoko bw'amaraso ni igice cy'ingenzi mu kwita ku mwana utwite. Nanone, gukurikirana no kuvura kudahuza kw'ubwoko bw'amaraso bishobora guteza akaga ku mwana wawe ni igice cy'ingenzi mu kwita ku mwana utwite. Muganga wawe azaba ari kumwe nawe mu ntambwe zose kugira ngo akurinde wowe n'umwana wawe. Rero, ntugatinye bitari ngombwa, kandi ukurikize amabwiriza ya muganga witonze. Hanyuma wowe n'umwana wawe mushobora gukomeza kugira ubuzima bwiza!

Erythroblastosis Fetal, Kudahuza kwa Rh, ingorane zo gutwita, ubwoko bw'amaraso y'umwana, ubwoko bw'amaraso ya nyina, kubura amaraso, umuhondo w'umuhondo, RhoGAM