Ese nawe wavuye amaraso menshi nyuma yo kubyara? Reka tuvuge ku kuva amaraso nyuma yo kubyara (PPH)

Ni ibisanzwe kuva amaraso make nyuma yo kubyara. Ariko se byagenda bite niba wavuye amaraso menshi kuruta uko wabitekerezaga? Bishobora gutera ubwoba cyane kandi bikaba akaga. Ibi nibyo twita kuva amaraso nyuma yo kubyara (PPH) . Ibi si urwenya, ni indwara isaba ubuvuzi bwihuse.

Kuva amaraso nyuma yo kubyara (PPH) ni iki? Reka dusobanukirwe neza?

Mu magambo make, kuva amaraso nyuma yo kubyara (PPH) ni ukuva amaraso menshi nyuma yo kubyara. Ibi bikunze kubaho mu masaha 24 nyuma yo kubyara. Tubyita 'PPH y'ibanze' . Ariko rimwe na rimwe, kuva amaraso bishobora kubaho iminsi mike, ibyumweru bike, cyangwa kugeza ku byumweru 12 nyuma yo kubyara. Ibi byitwa 'PPH ya kabiri cyangwa ya nyuma' .

Ikiba muri ibi ni uko amaraso menshi asohoka mu mubiri wawe icyarimwe. Iyo ibi bibaye, umuvuduko w'amaraso yawe ushobora kugabanuka mu buryo butunguranye. Hanyuma bigenda bite? Ingano y'amaraso ajya mu mutima, mu bwonko, no mu zindi ngingo z'ingenzi iragabanuka. Ibi byitwa hypovolemic shock . Ibi bishobora gushyira ubuzima mu kaga. Kubwibyo, abaganga n'abaforomo bagomba guhagarika uku kuva amaraso vuba.

Wibuke ko niba wumva urimo kuva amaraso menshi nyuma yo kubyara, biteye ubwoba. Ariko icy'ingenzi ni ukudatinya, kandi ukabibwira muganga wawe cyangwa umubyaza ako kanya. Iyo ubimenye hakiri kare kandi ukavurwa vuba, akenshi ushobora gukira neza.

PPH itera amaraso angahe?

Ubusanzwe,

• Waba warabyaye cyangwa warabyawe, niba watakaje litiro imwe (1000ml) z'amaraso,
• Cyangwa, niba hari impinduka zikomeye mu muvuduko w'umutima wawe n'umuvuduko w'amaraso hamwe n'ingano y'amaraso yatakaye, kandi ukaba ugaragaza ibimenyetso byo gutakaza amaraso menshi, bifatwa nk'indwara ya PPH.

Iyi ndwara ishobora kubaho hagati y’umwana 1 na 5 mu bana 100 bavutse. Ni hagati ya 1% na 5%. Ariko iyo habayeho kuvurwa vuba, akenshi ntabwo bibangamira ubuzima.

Namenya nte ko mfite PPH? Ni ibihe bimenyetso?

Ikimenyetso cy'ingenzi cya PPH ni ukuva amaraso menshi mu gitsina nyuma yo kubyara. Hari igihe amaraso agabanuka cyane kurusha umupira wa golf . Ibi bibaye, bishobora kuba ikimenyetso cy'ikibazo.

Ibindi bimenyetso ni ibi bikurikira:

• Ibimenyetso by'umuvuduko w'amaraso uri hasi: isereri, kutabona neza no gucika intege.
• Ukwiyongera k'umuvuduko w'umutima (Tachycardia).
• Kugabanuka kw'umubare w'uturemangingo dutukura mu maraso (kugabanuka kw'urugero rw'amaraso mu maraso).
• Uruhu rwerurutse cyangwa rusa n'urufuro, wumva umeze nk'aho urimo gushyuha ibyuya bikonje.
• Ububabare no kubyimba mu gice cy'igitsina cyangwa mu gice cy'umuyoboro w'amaraso.(Ibi bibaho iyo amaraso yikusanyije hanze y'umutsi)

Niba ubonye kimwe muri ibi bimenyetso bidasanzwe nyuma yo kubyara, bwira umuganga wawe ako kanya . Hari igihe ibimenyetso bya PPH bishobora gukomeza ndetse na nyuma yo gutaha uvuye kwa muganga. Ibi nibibaho, ntugatinye kandi uhite ubonana na muganga wawe.

Kuki indwara ya PPH iba? Ni izihe mpamvu?

Hari impamvu nyinshi zitera PPH.

Urabizi, iyo umwana wawe ari mu nda, placenta ifata ku rukuta rwa nyababyeyi yawe igaha umwana ibiryo n'umwuka wa ogisijeni. Nyuma y'uko umwana avutse, nyababyeyi yawe ikomeza gufunga no gusohora nyababyeyi. Uku gufungana gutuma imiyoboro y'amaraso aho nyababyeyi yari ifatanye na yo ikomeza gufungana no guhagarika kuva amaraso. Ariko rimwe na rimwe, iyo uku gufungana kudafite imbaraga zihagije , kuva amaraso ntibihagarara. Iyi ni yo mpamvu itera 80% bya PPH.

Nanone, PPH ishobora kubaho iyo ibice bya placenta bigumye mu rukuta rwa nyababyeyi, cyangwa iyo ingingo z'imyororokere yawe (igitsina gore, inkondo y'umura, nyababyeyi) zangiritse mu gihe cyo kubyara.

PPH ikunze kubaho hagati y'iminota 30 na 60 umwana avutse.

"Four Ts" zigira ingaruka ku mikorere ya PPH

Hari impamvu enye z'ingenzi zitera PPH, zitwa "Four Ts".

1. Ijwi (imiterere y'umura - Atony yo mu mura): Iyi ni yo mpamvu ikunze kugaragara . Atony yo mu mura ni igihe umura udakora neza nyuma yo kubyara, ariko ukaba woroshye kandi ugacika intege. Hanyuma imiyoboro y'amaraso aho ingobyi yari iri ntikomeza gufungana, maze amaraso agakomeza kuva.

2. Ihungabana: Mu gihe cyo kubyara, kuva amaraso bishobora guterwa n'ibikomere ku gitsina, ku mura, ku mura, cyangwa ku mubyimba. Hari igihe aya maraso ashobora kwirundanya mu ngingo zakomeretse agakomeza kuva amaraso amasaha menshi cyangwa iminsi nyuma yo kubyara.

3. Uturemangingo (Urugingo rw'ingobyi rugumanye): Iyo ingobyi idatandukanye burundu n'urukuta rw'umura, uturemangingo dusigaye dushobora gutera kuva amaraso. Ibi bishobora guterwa n'ikibazo kiri mu ngobyi, cyangwa se ikaba ingobyi isanzwe.

4. Thrombin (ibibazo byo kuvura amaraso): Niba ufite ikibazo cyo kuvura amaraso, cyangwa niba waragize ikibazo cyagize ingaruka ku kuvura amaraso mu gihe utwite, ndetse no kuva amaraso make bishobora kuba ikibazo gikomeye.

Ni nde uri mu kaga gakomeye ko kwandura PPH?

Mu by’ukuri, PPH ishobora kuba ku muntu wese ubyara. Nubwo hari ibintu byinshi bishobora gutera PPH, hafi 40% by’abarwayi ba PPH bapfa nta bintu bishobora gutera . Kubwibyo, abaganga bashobora kutabasha gukumira PPH burundu. Ariko kumenya ibi bintu mbere yo kubyara bishobora gufasha kugabanya ibyago byo kuva amaraso menshi.

Imiterere y'imyanya

Ingaruka zo kurwara PPH ziba nyinshi iyo ufite imwe muri izi ndwara zikurikira zijyanye n'ingobyi:

• (Placenta previa)(Placenta iherereye hepfo mu mura)
• (Guhagarara kw'inyuma y'inyuma )
• (Placenta accreta) (Placenta ifatanye cyane n'urukuta rw'inda ibyara)

Ibihe bifitanye isano no kubyara cyangwa kubyara

Ibyago byo kurwara PPH bishobora kwiyongera iyo ibintu bikurikira bibaye mu gihe cyo kubyara:

• Niba hari ikinya rusange cyatanzwe.
• Niba warahawe imiti (tocolytics) yo guhagarika kubyimba kw'inda yo mu mura.
• Iyo ububabare bumaze igihe kirekire cyangwa umuti ukoreshwa mu gutera ibise byo mu mura (Oxytocin / Pitocin®) utanzwe cyane igihe kirekire.
• Kubyara umwana hakiri kare (mu gihe kitarenze amasaha atatu nyuma yo kubyara).
• Niba hakoreshejwe forceps cyangwa vacuum mu gihe cyo gutanga intanga bisanzwe.
• Iyo hari ibisebe binini mu gitsina.
• Niba umwana yaravutse hakoreshejwe uburyo bwo kubagwa .

Izindi ndwara

Izindi ndwara zishobora kongera ibyago byo kwandura PPH, nko:

• Indwara zo kuvura amaraso, urugero (indwara ya von Willebrand) .
• Niba warafashe umuti (Magnesium sulfate) kugira ngo uvure preeclampsia ikomeye.
• Indwara zo gutwita zigira ingaruka ku maraso cyangwa platelets, urugero: (syndrome ya HELLP) , (thrombocytopenia yo mu gihe cyo gutwita) .
• Ubwivumbure bw'agasabo k'imyororokere (Chorioamnionitis) .
• Umubyibuho ukabije.
• Imyaka yo kubyara igeze mu zabukuru.

Nanone, ibyago byo kurwara PPH biri hejuru iyo nyababyeyi ivunitse cyane . Ibi bishobora kubaho:

• Niba warigeze kubyara abana batanu cyangwa barenga mbere.
• Mu kubyara abana benshi, nko kubyara impanga n'abana batatu.
• Niba ufite umwana munini (macrosomia) .
• Iyo hari amazi menshi ya amniotic (polyhydramnios) .

Ni izihe ngaruka mbi zishobora guterwa na PPH?

Iyo utakaje amaraso menshi cyane, ushobora guhura n'ibintu nko kwiyongera k'umutima, kwiyongera k'umuvuduko wo guhumeka, no kugabanuka k'amaraso atembera neza. Ibi bimenyetso bishobora kugabanya ingano y'amaraso atembera mu ngingo nk'umwijima, ubwonko, umutima, n'impyiko, bigatera shock . Shock ni igihe ingingo zitabona amaraso ahagije. Ibi bishobora gutera impanuka ku ngingo cyangwa ndetse no gupfa.

Ni gute wamenya PPH nyuma yo kubagwa (C-bection)?

Kenshi na kenshi, ibimenyetso bya PPH nyuma yo kubagwa mu kibuno ni bimwe n'ibyo umuntu ahura na byo mu gihe cyo kubyara bisanzwe. Bimwe mu bimenyetso birimo:

• Umutima utera cyane.
• Amaboko n'ibirenge bikonje, numva bishyushye.
• Kugorwa no guhumeka.
• Kubyimba, gukomereka, cyangwa kubabara ahandi mu nda, cyane cyane aho igikomere cyakorewe.
• Kuva amaraso menshi mu gitsina no kubyimba kw'amaraso menshi.

Ni gute abaganga bapima indwara ya PPH?

Abaganga bapima PPH binyuze mu gusuzuma amaso n'umubiri. Ibizamini byo muri laboratwari no gusuzuma neza amateka y'ubuzima bwawe nabyo ni ingenzi kugira ngo hamenyekane ingaruka n'ingaruka za PPH.

Indwara ya PPH ipimwa ahanini bitewe n'ingano y'amaraso watakaje. Ingano y'amaraso watakaje ikunze kubarwa hakoreshejwe kubara cyangwa gupima udupira twatose amaraso igihe umwana yavukaga.

Niba ukeka ko PPH itera indwara, ushobora gukoresha ibi bintu kugira ngo wipimishe neza:

• Komeza kugenzura umuvuduko w'amaraso n'umuvuduko w'amaraso .
• Ibizamini by'amaraso bipima ingano y'uturemangingo dutukura mu maraso (hematocrit) n'ibipimo by'amaraso agwa.
• Isuzuma ry'ikibuno risuzuma igitsina gore, inkondo y'umura n'umura.
• Isuzuma rya ultrasound rifata ishusho irambuye y'umura.

Indwara ya PPH ivurwa ite?

Abaganga bakunze gufata PPH nk'ikibazo cyihutirwa. Intego nyamukuru yo kuvura ni uguhagarika kuva amaraso vuba bishoboka.

Bitewe n'impamvu yaguteye kuva amaraso n'uburemere bw'amaraso, muganga wawe ashobora kukugira inama imwe cyangwa nyinshi muri izi nzira:

• Massage yo mu mura kugira ngo imitsi y'umura ihute.
• Gutanga imiti itera kubyimba kw'inda yo mu mura.
• Gukuraho ingirabuzimafatizo zasigaye, haba mu buryo bw'intoki cyangwa ubundi buryo.
• Gusana amarira mu gitsina, mu nkondo y'umura no mu mura.
• Gushyiramo igikoresho, nka catheter cyangwa balloon, kugira ngo ushyire igitutu ku nkuta z'inda no guhagarika kuva amaraso.
• Uburyo bwo guhagarika amaraso ajya mu mura.
• Ukeneye guterwa amaraso .
• Gutanga amazi binyuze mu mitsi (ikoreshwa mu mitsi - IV fluids) , bivuze ibintu nk'umunyu.
• Gutanga umwuka wa ogisijeni w'inyongera binyuze mu gapfukamunwa.
• Kumpa imiti igabanya ubushyuhe mu mubiri.

Ni gake cyane, cyangwa ubundi buryo bunaniranye, muganga ashobora kubaga laparotomy (kubaga kugira ngo afungure inda maze amenye aho amaraso yaturutse) cyangwa kubaga hysterectomy (gukuramo nyababyeyi).

Bifata igihe kingana iki kugira ngo umuntu akire iyi ndwara ya PPH?

Igihe cyo gukira kiratandukanye bitewe n'umuntu ku giti cye. Biterwa n'ingano y'amaraso watakaje n'uburyo abaganga bawe bagufashe. Ni ngombwa kwiyitaho neza mu minsi mike ya mbere umwana wawe avutse - jya urya neza, unywe amazi menshi, kandi uruhuke uko bishoboka kose . Muganga wawe ashobora kandi kukugira inama yo gufata inyunganiramirire ya feri mu kuvura amaraso make.

Ese indwara ya PPH ishobora kwirindwa? Ese nshobora kongera kubyara umwana?

Uburyo bwiza bwo kwirinda PPH ni ukumenya abafite ibyago byinshi byo kurwara PPH mbere yo kubyara. Ushobora gufasha ubwira muganga wawe amateka yawe yose y’ubuzima no kumumenyesha ibimenyetso byose bya PPH nyuma yo kubyara umwana.

Ubusanzwe nta kibazo kirimo kubyara undi mwana. Ariko, ganira na muganga wawe ku byago byawe byo kurwara PPH mu gihe cyo kubyara kwawe gutaha. Nubwo ibyago byawe byaba biri hejuru gato ugereranyije n'ibisanzwe, birashoboka ko byaba biri hasi. Muganga wawe ashobora kureba ibintu bishobora kugutera ibyago maze agafata icyemezo niba ukeneye gufata ingamba zidasanzwe mu gihe cyo kubyara kwawe gutaha.

Ni gute wiyitaho nyuma yo kugira PPH?

Bishobora kugorana kwiyitaho mu gihe wita ku mwana wawe ukiri mu nda. Ariko, nufata umwanya wo kuruhuka no kwiyitaho neza, uzashobora gukira vuba. Imibereho myiza yawe ni ingenzi cyane.

Dore bimwe mu bintu bishobora kugufasha:

• Kuruhuka: Umubiri wawe ukeneye igihe cyo gukira. Ntutinye gusaba ubufasha, kandi ubone ikiruhuko ukeneye.
• Kurya ibiryo bifite intungamubiri: Ibiryo bikungahaye kuri feri nk'inyama zitukura, imboga mbisi, n'ibinyampeke byo mu gitondo bifasha mu gukora uturemangingo dutukura tw'amaraso. Ibiryo bifite intungamubiri bishobora kugufasha gukira.
• Nywa amazi: Nywa amazi menshi nyuma yo kubyara kugira ngo wirinde amazi menshi.
• Kurikiza amabwiriza ya muganga wawe: Muganga wawe ashobora kukwandikira imiti cyangwa guhindura imibereho yawe kugira ngo bigufashe gukira. Kurikiza ayo mabwiriza witonze.
• Reba ingano y'amaraso ava: Ambara agatambaro ko mu isuku. Reba igihe bifata kugira ngo yuzure. Amaraso agomba kugabanuka buhoro buhoro mu byumweru bike. Niba bitagenze bityo, reba muganga wawe.

Kuva amaraso menshi bishobora kuba ikintu giteye ishozi cyane. Ni ibisanzwe gufata umwanya kugira ngo wongere gukira mu buryo bw'amarangamutima nyuma yo kubyara. Ushobora gukenera inkunga y'umuryango wawe, inshuti, abaganga, cyangwa abandi. Vugana uko umerewe, kandi usabe ubufasha igihe ubukeneye.

Ni ryari ukwiye kujya kwa muganga?

Akenshi, PPH ibaho nyuma yo kubyara cyangwa uri mu bitaro. Ariko, niba urimo kuva amaraso menshi nyuma yo kugera mu rugo cyangwa niba ugaragaje ibimenyetso bya PPH, jya kwa muganga wawe ako kanya . Niba ibiro bya muganga bifunze cyangwa udashobora kubageraho, jya mu cyumba cy’ubutabazi bw’ibanze ku bitaro biri hafi yawe.

Niba ugize kuva amaraso menshi nyuma yo kubyara, hita ubonana na muganga. Ibindi bimenyetso bya PPH birimo kuzerera, gucika intege no guhumeka bigoranye. PPH ni indwara ikomeye isaba ubuvuzi bwihuse.

Niba wowe cyangwa uwo ukunda afite PPH, ni ibisanzwe kumva utangaye kandi utewe ubwoba n'ibyabaye. Ariko ibuka ko kuyimenya hakiri kare no kuyivura vuba bishobora gukumira ingorane zikomeye. Niyo mpamvu ari ngombwa kuvugisha ukuri no kuvugisha ukuri muganga wawe ku bijyanye n'amateka yawe y'ubuzima. Ibi bizagufasha kumenya niba uri mu kaga ko kurwara PPH.

Ubutumwa bwa nyuma bwo kujyana mu rugo

• Kuva amaraso nyuma yo kubyara (PPH) ni indwara ikomeye isaba ubuvuzi bwihuse, irangwa no kuva amaraso menshi nyuma yo kubyara.
• Niba ugize ibimenyetso nko kuva amaraso menshi, kubyimba amaraso menshi, kuzungera, gucika intege, cyangwa gutera k'umutima cyane , shaka ubufasha bwa muganga vuba .
• Impamvu nyamukuru itera PPH ni ukudakora neza kw'umura, ari na ko umura udashobora kwifata neza. Izindi mpamvu zirimo imvune, placenta igumana, n'ibibazo byo kuvura amaraso.
• Nubwo hari ibintu bimwe na bimwe bishobora gutera ibyago, PPH ishobora kugera kuri buri wese .
• Iyo igaragaye hakiri kare kandi igavurwa vuba, akenshi ishobora gukira burundu.
• Ubunararibonye bwo kwitabwaho n'abaganga (PPH) bushobora kugutera agahinda kenshi. Ntugatinye kubona ubufasha ukeneye.

Kwita ku buzima bwawe ni ingenzi cyane, cyane cyane mu bihe nk'ibi. Ntabwo uri wenyine, saba ubufasha.

Kuva amaraso nyuma yo kubyara, PPH, kubyara, kuva amaraso, nyababyeyi, nyababyeyi, ubuzima bw'abagore