Ukukhulelwa lixesha elihle kakhulu nelinika ithemba ebomini bomama ngamnye. Nangona kunjalo, kuqhelekile ukuba noloyiko kunye namathandabuzo malunga nempilo yomntwana osesiswini kunye nempilo yakho. Uninzi lwexesha, siye seva ngeemeko ezifana nesifo seswekile sokukhulelwa kunye noxinzelelo lwegazi oluphezulu (pre-eclampsia). Kodwa namhlanje siza kuthetha ngesimo esingaqhelekanga kodwa esinzima esibaluleke kakhulu ukuqatshelwa kwangethuba. Oku kubizwa ngokuba yi-HELLP Syndrome.

Yintoni kanye kanye i-HELLP syndrome?

Ngamafutshane, i-HELLP syndrome yingxaki enkulu enokwenzeka ngexesha lokukhulelwa, ikakhulu ichaphazela igazi nesibindi sakho. Ihlala isenzeka kwi-trimester yesithathu yokukhulelwa, phakathi kweveki yama-28 neyama-40. Nangona kunjalo, ngamanye amaxesha inokwenzeka nangaliphi na ixesha kwisiqingatha sesibini sokukhulelwa (emva kweveki yama-20). Okumangalisayo kukuba, abanye oomama banokuba ne-HELLP syndrome kwangethuba emva kweentsuku ezisixhenxe bebelekile.

Le yimeko engaqhelekanga kakhulu. Idla ngokuchaphazela umfazi omnye okanye ababini kwi-1,000 yabasetyhini abakhulelweyo. Kodwa ukuba ayiqhelekanga akufanele kuthathwe lula. Inokuba yingozi kumama nakumntwana.

Lithetha ukuthini igama elithi HELLP?

Eli asilogama nje kuphela. Oonobumba u-HELLP bamele iimpawu ezintathu eziphambili zesi sifo. Makhe sijonge ukuba zeziphi.

Ngaba i-preeclampsia kunye ne-HELLP syndrome ziyafana?

Le yingxaki abantu abaninzi abanayo. I-HELLP syndrome idla ngokuthathwa njengohlobo olubi loxinzelelo lwegazi oluphezulu ngexesha lokukhulelwa, okanye i-preeclampsia . I-Preeclampsia yimeko ngexesha lokukhulelwa apho uxinzelelo lwegazi lunyuka kwaye iiproteni zikhutshwa emchameni.

Oomama abaninzi abane-HELLP syndrome nabo bane-pre-eclampsia. Nangona kunjalo, ngamanye amaxesha umntu one-pre-eclampsia akanayo i-HELLP syndrome. Kwakhona, malunga nomntu omnye kwabahlanu abane-HELLP abanazo iimpawu ezifana noxinzelelo lwegazi oluphezulu okanye iiproteni kumchamo . Yingakho ngamanye amaxesha kunokuba nzima ukuxilonga.

Zithini iimpawu zale meko?

Iimpawu ze-HELLP syndrome ngamanye amaxesha zinokufana nezo zokukhulelwa okuqhelekileyo okanye ezinye izifo, ngoko ke kubalulekile ukuba uzazi kakuhle ezi mpawu.

• Intlungu esiswini esingaphezulu ngasekunene: Olu luphawu oluphawulekayo lwe-HELLP syndrome. Ngokukodwa, yintlungu ebukhali eyenzeka kwicala lasekunene, ngaphantsi nje kweembambo, apho isibindi sikhoyo.
• Intloko ebuhlungu kakhulu: Ayifani nentloko eqhelekileyo, kodwa intloko ebuhlungu engapheziyo nokuba isetyenziswa ngamayeza okudambisa iintlungu.
• Umbono ofipheleyo: Ukuziva ngathi amachaphaza ahamba phambi kwamehlo, ubunzima bokujonga ukukhanya.
• Isicaphucaphu nokuhlanza: Nangona oku kuqhelekile ekuqaleni kokukhulelwa, kufuneka ukhathazeke ngesicaphucaphu esinzima nokuhlanza kwisiqingatha sokugqibela sokukhulelwa.
• Ukudinwa nokudinwa: Ukudinwa kakhulu kuvakala nasemva kokuba ungenzi nto.
• Ukudumba komzimba (i-edema) kunye nokutyeba ngequbuliso:Ukudumba, ingakumbi ubuso, izandla, nemilenze.
• Intlungu xa uphefumla nzulu: Usenokuziva iintlungu kwicala lasekunene lesifuba.

Kwiimeko ezinqabileyo kakhulu, ezi mpawu zinokwenzeka:

• Ukopha okungapheliyo.
• Ukuxhuzula okanye iintshukumo zomzimba ezingalawulekiyo.

Yintoni ebangela i-HELLP syndrome? Ngaba kukho izinto ezinokubangela umngcipheko?

Enyanisweni, oogqirha abakayazi eyona nto ibangela i-HELLP syndrome. Yiyo loo nto yoyikisayo ngayo. Nangona kunjalo, bachonge izinto ezininzi ezibangela umngcipheko wokuba nale meko kwabanye abafazi.

• Ukuba ne-preeclampsia okanye i-eclampsia: Omnye kubafazi abahlanu abakhulelweyo abanezi meko unokufumana i-HELLP syndrome.
• Ukuba ne-HELLP syndrome kukukhulelwa kwangaphambili: Ukuba ubunale meko nomntwana wangaphambili, kukho umngcipheko we-20% wokuba ivele kukukhulelwa kwakho okulandelayo.
• Ukuba uneminyaka engaphezu kwama-35 ubudala.
• Ukuba sele ezele umntwana omnye ubuncinane ngaphambili.
• Ukuba nembali yezifo ezingapheliyo ezifana nesifo sezintso, isifo seswekile, okanye uxinzelelo lwegazi oluphezulu.

Zeziphi iingxaki ezinokubangela oku?

Ukuba i-HELLP syndrome ayinyangwa ngexesha, inokubangela iingxaki ezinkulu kumama nakumntwana.

Iingxaki ezinokwenzeka kumama

• Iingxaki zokopha nokugabha igazi: Abanye abafazi banokuba nesifo esibizwa ngokuba yi-'Disseminated Intravascular Coagulation (DIC).' Oku kuthetha ukuba amahlwili egazi ayenzeka emzimbeni wonke aze aqale ukopha ngokungalawulekiyo. Oku kunokukhokelela ekuphumeni kwegazi elininzi emva kokubeleka ('Postpartum hemorrhage').
• Ukungasebenzi kakuhle kwezintso: Izintso zinokonakala zize ziyeke ukusebenza.
• Ukopha ngenxa yesibindi okanye ukungasebenzi kakuhle kwesibindi: Isibindi siyadumba, siqale ukopha ngaphakathi, kwaye isibindi sinokuphelelwa ngumsebenzi ngokupheleleyo.
• Ukudumba kwemithambo yegazi: Oku kubangela ubunzima bokuphefumla.
• Ukuqhawuka kwe-placenta: I-placenta iyahlukana nodonga lwesibeleko ngaphambi kokuba umntwana azalwe. Oku kuyingozi kakhulu kuba kuthintela i-oksijini kunye nesondlo kumntwana.
• I-Eclampsia: Eli lelona nqanaba linzima le-pre-eclampsia. Libangela ukuxhuzula.

Iingxaki ezinokwenzeka kumntwana osesiswini

• Ukuzalwa kwangaphambi kwexesha: Ekubeni unyango olulodwa lwe-HELLP syndrome kukubeleka umntwana, kudla ngokuba yimfuneko ukubeleka umntwana ngexesha lokuzala.
• Uthintelo lokukhula ngaphakathi kwesibeleko (IUGR): Umntwana akakhuli kakuhle esibelekweni.
• Ukuzalwa une-platelet counts ephantsi, i-anemia, okanye ezinye iingxaki zegazi.
• Uxinzelelo lokuphefumla.

Ugqirha uyifumanisa njani le nto?

Xa uxelela ugqirha wakho ukuba uneempawu ze-HELLP syndrome, uza kuqala akuhlole ngokwasemzimbeni. Ngokukodwa,

• Ingaba kukho intlungu esiswini esingaphezulu ngasekunene?
• Ingaba imilenze yakho idumbile?

Emva koko uxinzelelo lwakho lwegazi luya kulinganiswa, kuhlolwe umchamo ukuze kuhlolwe iiproteni. Kuza kwenziwa uvavanyo lwegazi oluninzi ukuqinisekisa oku.

• Ubalo lwegazi olupheleleyo (i-CBC) : Lujonga inani leeseli ezibomvu zegazi, iiseli ezimhlophe zegazi, kunye neeplatelets.
• Uvavanyo lokusebenza kwesibindi : Jonga amanqanaba eeenzyme zesibindi.
• Uvavanyo lokusebenza kwezintso : Lujonga ukuba izintso zisebenza kakuhle na.

Ukuba imeko imbi kakhulu, kunokwenziwa i-ultrasound okanye i-CT scan ukujonga ukudumba okanye ukopha esibindini.

Iphathwa njani i-HELLP syndrome?

Ukuba uneeveki ezingama-34 ukhulelwe okanye ngaphezulu, okanye ukuba iimpawu zakho zinzima kakhulu, oogqirha banokucebisa ukuba ubelethe umntwana wakho ngokukhawuleza. Oku kunokubangela ukuba umntwana azalwe ngaphambi kwexesha. I-HELLP syndrome idla ngokuphela kwiintsuku ezimbalwa emva kokuba umntwana ezelwe.

Nangona kunjalo, ukuba ukukhulelwa kungaphantsi kweeveki ezingama-34 kwaye umama nomntwana bezinzile, oogqirha baya kuzama ukuthenga ixesha lokuba imiphunga yomntwana ikhule kancinci. Ngeli xesha, uya kugcinwa esibhedlele kwaye unikwe unyango olufana nolu:

• Amayeza okunciphisa uxinzelelo lwegazi.
• Utofelo-gazi ukuba inani leeplatelet liphantsi.
• Ukunika i-magnesium sulfate ukuthintela ukuxhuzula.
• Ukunika inaliti ye-corticosteroids ukunceda amaphaphu omntwana akhule ngokukhawuleza.
• Uvavanyo lwegazi ukuze kuhlolwe rhoqo ukusebenza kwesibindi sakho kunye namanqanaba eeplatelet.

Kulo lonke eli xesha, oogqirha bahlala bejonga impilo yomntwana ngokusebenzisa iimvavanyo ezifana ne-'biophysical profile', 'nonstress test', kunye ne-'ultrasound'.

Le meko imchaphazela njani umama nomntwana?

I-HELLP syndrome yimeko enzima kakhulu, kodwa inokunyangeka ukuba ifunyaniswe kwangethuba kwaye inyangwe ngokufanelekileyo . Ukuba ayinyangwa, inokuba yingozi ebomini.

Ngokwembono kamama, umngcipheko wokufa ungaphantsi kwe-1% ukuba ufumana unyango olufanelekileyo. Uninzi loomama luyaphila ngokupheleleyo kwiintsuku ezimbalwa emva kokubeleka.

Ngokwembono yomntwana, ukusinda kuxhomekeke kakhulu kwiminyaka yokukhulelwa ekuzalweni kwakhe. Okukhona umntwana ehlala esibelekweni ixesha elide, kokukhona impilo yomntwana ingcono. Ukuzalwa ngaphambi kwexesha kunokubangela iingxaki ezifana nobunzima bokuphefumla, iingxaki zokubona, okanye ukulibaziseka kokukhula.

Ngaba i-HELLP syndrome ingathintelwa?

Ngelishwa, akukho ndlela iqinisekileyo yokuthintela i-HELLP syndrome. Nangona kunjalo, eyona nto ingcono onokuyenza ukunciphisa umngcipheko weengxaki ngexesha lokukhulelwa kukuya kunyango oluqhelekileyo lokubeleka . Ugqirha wakho uza kujonga uxinzelelo lwakho lwegazi kunye nezinye iimpawu, ukuze naziphi na iingxaki zibonwe kwangethuba.

Ukuba ugqirha wakho ufumanisa ukuba usemngciphekweni omkhulu wokufumana esi sifo, unokucebisa ukuba uthathe i-aspirin encinci emva kwekota yokuqala (malunga neeveki ezili-12).

Ukongeza, ezi zinto ziya kukunceda ukuba ukhulelwe kakuhle:

• Ukutya ukutya okunesondlo (iinkozo, iiproteni ezingenamafutha, iziqhamo kunye nemifuno).
• Ukuzilolonga rhoqo.
• Lala kakuhle ubuncinane iiyure ezisi-8 yonke imihla.
• Ukuthetha nogqirha wakho malunga neengozi ezinokubakho kwimpilo ngexesha lokukhulelwa.

Ndifanele ndimbone nini ugqirha?

Ukuba une-preeclampsia okanye uxinzelelo lwegazi oluphezulu, lumka kakhulu malunga neempawu ze-HELLP syndrome. Ukuba unezinye zezi mpawu zilandelayo, fowunela ugqirha wakho ngokukhawuleza.

• Intlungu yesisu kwicala lasekunene.
• Isicaphucaphu nokuhlanza.
• Intloko ebuhlungu okanye umbono ofipheleyo.

I-HELLP syndrome yimeko eyoyikisayo. Kodwa khumbula, iqela lakho lezonyango lenza konke okusemandleni alo ukugcina wena nomntwana wakho nikhuselekile. Ukufunyanwa kwangoko kubalulekile.