Ngaba nawe wopha kakhulu emva kokuba nomntwana? Masithethe nge-Postpartum Hemorrhage (PPH)

Kuqhelekile ukopha kancinci emva kokubeleka. Kodwa kuthekani ukuba wopha kakhulu kunokuba ubucinga? Kunokuba yinto eyoyikisayo neyingozi kakhulu. Oku sikubiza ngokuba yi -postpartum hemorrhage (PPH) . Oku akusiyonto ihlekisayo, yimeko efuna unyango olukhawulezileyo.

Yintoni ukopha emva kokubeleka (PPH)? Masiqonde kakuhle?

Ngamafutshane, ukopha emva kokubeletha (PPH) kukopha kakhulu emva kokubeletha. Oku kudla ngokuvela kwiiyure ezingama-24 emva kokubeletha. Siyibiza ngokuba yi -'PPH ePhambili' . Kodwa ngamanye amaxesha, ukopha kunokubakho kwiintsuku ezimbalwa, kwiiveki ezimbalwa, okanye ukuya kuthi ga kwiiveki ezili-12 emva kokubeletha. Oku kubizwa ngokuba yi -'PPH yesibini okanye esemva kwexesha' .

Okwenzekayo koku kukuba igazi elininzi lilahleka emzimbeni wakho ngaxeshanye. Xa oku kusenzeka, uxinzelelo lwakho lwegazi lunokwehla ngequbuliso. Kwenzeka ntoni ke ngoko? Ubungakanani begazi eliya entliziyweni, engqondweni, nakwezinye izitho ezibalulekileyo buyehla. Oku kubizwa ngokuba yi -hypovolemic shock . Oku kunokuba yingozi ebomini. Ke ngoko, oogqirha kunye nabahlengikazi kufuneka bayeke ukopha ngokukhawuleza.

Khumbula, ukuba uziva ngathi wopha kakhulu emva kokuba nomntwana, kuyoyikisa. Kodwa eyona nto ibalulekileyo kukungaxhalabi, kwaye uxelele ugqirha wakho okanye umbelethisi wakho ngoko nangoko. Ukuba uqatshelwe kwangethuba kwaye unyangwa ngokukhawuleza, unokuphila ngokupheleleyo.

Ingakanani igazi elibangelwa yi-PPH?

Ngokwesiqhelo,

• Nokuba uzalela kwilungu lobufazi okanye wenze utyando lwe-C-section, ukuba ulahlekelwa litha elingaphezulu kwe-1000ml yegazi,
• Okanye, ukuba kukho utshintsho olukhulu kwisantya sentliziyo yakho kunye noxinzelelo lwegazi kunye nobungakanani begazi elilahlekileyo, kwaye ubonisa iimpawu zokulahleka kwegazi elininzi, oko kuthathwa njenge-PPH.

Le meko inokwenzeka phakathi komntwana omnye no-5 kwabayi-100 abazalwayo. Oko kuphakathi kwe-1% ne-5%. Kodwa ngonyango olukhawulezileyo, uninzi lwexesha alubeki ubomi esichengeni.

Ndingazazi njani ukuba ndine-PPH? Zithini iimpawu?

Uphawu oluphambili lwe-PPH kukopha okungapheliyo, okunamandla kwilungu lobufazi emva kokubeleka. Ngamanye amaxesha , amahlwili egazi amakhulu kunebhola yegalufa anokudlula. Ukuba oku kuyenzeka, kunokuba luphawu lwengxaki.

Ezinye iimpawu zezi:

• Iimpawu zoxinzelelo lwegazi oluphantsi: isiyezi, ukubona okufipheleyo, kunye nokuquleka.
• Ukunyuka kwesantya sentliziyo (iTachycardia).
• Ukwehla kwenani leeseli ezibomvu zegazi (ukwehla kwamanqanaba e-hematocrit).
• Ulusu oluphaphathekileyo okanye oluthambileyo, uzive ngathi ubila ngokubandayo.
• Intlungu kunye nokudumba kwindawo yesini okanye kwindawo ye-perineal.(Oku kwenzeka xa igazi liqokelelana ngaphandle komthambo)

Ukuba ufumana naziphi na kwezi mpawu zingaqhelekanga emva kokubeleka, xelela umniki-nkonzo wakho ngoko nangoko . Ngamanye amaxesha, iimpawu ze-PPH zinokuhlala zikho nasemva kokuba ubuyile ekhaya uvela esibhedlele. Ukuba oku kuyenzeka, ungoyiki kwaye ubone ugqirha wakho ngoko nangoko.

Kutheni i-PPH isenzeka? Zithini izizathu?

Kukho izizathu ezahlukeneyo ze-PPH.

Uyazi, xa umntwana wakho esesibelekweni, i-placenta inamathela eludongeni lwesibeleko sakho kwaye inika umntwana ukutya kunye neoksijini. Emva kokuba umntwana wakho ezelwe, isibeleko sakho siyaqhubeka nokufinyela kwaye sikhuphe i-placenta. Oku kufinyela kubangela ukuba imithambo yegazi apho i-placenta yayinamathele khona iqine kwaye iyeke ukopha. Kodwa ngamanye amaxesha, ukuba oku kufinyela akunamandla ngokwaneleyo , ukopha akupheli. Le yimbangela ye-80% ye-PPH.

Kwakhona, i-PPH inokwenzeka ukuba iindawo ezithile ze-placenta zihlala eludongeni lwesibeleko, okanye ukuba amalungu enkqubo yakho yokuzala (i-vagina, i-cervix, i-uterus) onakele ngexesha lokubeleka.

I-PPH idla ngokuvela phakathi kwemizuzu engama-30 ukuya kwengama-60 emva kokuba umntwana ezelwe.

"Ii-T ezine" ezichaphazela i-PPH

Kukho izizathu ezine eziphambili ze-PPH, ezibizwa ngokuba yi-"Four Ts".

1. Ithoni (imeko yesibeleko - I-Uterine Atony): Le yeyona nto ixhaphakileyo . I-Uterine Atony kuxa isibeleko singanciphi kakuhle emva kokuzalwa, kodwa sibe buthathaka kwaye sithambe. Emva koko imithambo yegazi apho i-placenta yayikhona ayiqini, kwaye ukopha kuyaqhubeka.

2. Ukonzakala: Ngexesha lokubeleka, ukopha kunokubakho ngenxa yokwenzakala kwilungu lobufazi, umlomo wesibeleko, isibeleko, okanye iperineum. Ngamanye amaxesha eli gazi linokubuthana ngaphakathi kwizicubu ezonakeleyo lize liqhubeke nokopha kangangeeyure okanye iintsuku emva kokubeleka.

3. Izicubu (Izicubu ze-placenta ezigciniweyo): Ukuba i-placenta ayihlukani ngokupheleleyo nodonga lwesibeleko, izicubu eziseleyo zinokubangela ukopha. Oku kunokubangelwa kukungasebenzi kakuhle kwe-placenta, okanye kunokuba yi-placenta eqhelekileyo.

4. I-Thrombin (iingxaki zokujiya kwegazi): Ukuba unengxaki yokujiya kwegazi, okanye ukuba ubunemeko echaphazele ukujiya kwegazi ngexesha lokukhulelwa, nokuba kuncinci ukopha igazi kunokuba yingxaki enkulu.

Ngubani osengozini enkulu ye-PPH?

Enyanisweni, i-PPH inokwenzeka nakubani na ofumana umntwana. Nangona kukho izinto ezininzi ezibangela i-PPH, malunga ne-40% yeemeko ze-PPH zenzeka ngaphandle kwezinto ezibangela umngcipheko . Ke ngoko, oogqirha basenokungakwazi ukuyithintela ngokupheleleyo i-PPH. Nangona kunjalo, ukwazi ukuba zeziphi ezi zinto zibangela umngcipheko ngaphambi kokubeletha kunokunceda ukunciphisa umngcipheko wokopha kakhulu.

Iimeko ze-placental

Umngcipheko we-PPH uphezulu ukuba unenye yezi meko zilandelayo ezinxulumene ne-placenta:

• (I-Placenta previa)(I-Placenta isezantsi kwesibeleko)
• (Ukuphazamiseka kwe-placenta )
• (I-Placenta accreta) (I-Placenta inamathele ngokuqinileyo eludongeni lwesibeleko)

Iimeko ezinxulumene nokuzala okanye ukuzala

Umngcipheko we-PPH unokwanda ukuba ezi zinto zilandelayo zenzeka ngexesha lokubeleka:

• Ukuba unikwe i-anesthesia jikelele .
• Ukuba unikwe amayeza (tocolytics) okuthintela ukubhitya kwesibeleko.
• Ukuba intlungu ihlala ixesha elide okanye iyeza elisetyenziselwa ukukhawulezisa isibeleko (i-Oxytocin / Pitocin®) linikwa kakhulu ixesha elide.
• Ukuzalwa komntwana kwangethuba (ngaphantsi kweeyure ezintathu emva kokuqala kokubeleka).
• Ukuba kusetyenziswe i-forceps okanye i- vacuum ngexesha lokuhanjiswa okuqhelekileyo.
• Ukuba kukho imikrwelo emikhulu kwilungu lobufazi.
• Ukuba umntwana ubelekwe nge-cesarean section .

Ezinye iimeko zempilo

Ezinye iimeko zempilo zinokunyusa umngcipheko we-PPH, ezifana nezi:

• Izifo zokuqunjelwa kwegazi, umzekelo (isifo sikaVol Willebrand) .
• Ukuba ukhe wasebenzisa iyeza (iMagnesium sulfate) ukunyanga i-preeclampsia enzulu.
• Iimeko zokukhulelwa ezichaphazela izinto ezibangela ukujiya kwegazi okanye iiplatelets, umzekelo: (i-HELLP syndrome) , (i-gestational thrombocytopenia) .
• Usulelo lwe-amniotic sac (iChorioamnionitis) .
• Ukutyeba kakhulu.
• Ubudala obuphezulu bomama.

Kwakhona, umngcipheko we-PPH uphezulu ukuba isibeleko sivuleke kakhulu . Oku kunokwenzeka:

• Ukuba ukhe wazala abantwana abahlanu okanye ngaphezulu ngaphambili.
• Kubantwana abazalwa ngeendlela ezahlukeneyo, njengamawele namawele amathathu.
• Ukuba unomntwana omkhulu (i-macrosomia) .
• Ukuba kukho ulwelo lwe-amniotic oluninzi kakhulu (i-polyhydramnios) .

Zithini iziphumo ebezingalindelekanga ze-PPH?

Xa ulahlekelwa ligazi elininzi, unokufumana izinto ezifana nokunyuka kwesantya sentliziyo, ukunyuka kwesantya sokuphefumla, kunye nokwehla kokujikeleza kwegazi. Ezi mpawu zinokunciphisa inani legazi elihamba liye kwizitho ezifana nesibindi, ingqondo, intliziyo, kunye nezintso, nto leyo ekhokelela ekuthukeni . Ukothuka kuxa amalungu engafumani gazi laneleyo. Oku kunokukhokelela ekusileleni kwamalungu okanye ekufeni.

Ungayiqaphela njani i-PPH emva kotyando lwe-cesarean (C-section)?

Kwiimeko ezininzi, iimpawu ze-PPH emva kotyando lwe-C-section ziyafana nezo zexesha lokuzala okuqhelekileyo. Ezinye zeempawu ziquka:

• Ukunyuka kwesantya sentliziyo.
• Izandla neenyawo ezibandayo, uzive ngathi zithambile.
• Ubunzima bokuphefumla.
• Ukudumba, ukukrweleka, okanye iintlungu kwenye indawo esiswini, ingakumbi kwindawo yenxeba lotyando.
• Ukopha kakhulu kwilungu lobufazi kunye nokuphuma kwamahlwili egazi amakhulu.

Oogqirha bayixilonga njani i-PPH?

Oogqirha baxilonga i-PPH ngokuhlolwa ngamehlo nangokwasemzimbeni. Uvavanyo lwelabhoratri kunye nokuphononongwa ngononophelo kwembali yakho yempilo kubalulekile ukuvavanya umngcipheko kunye nempembelelo ye-PPH.

I-PPH ifunyaniswa ikakhulu bubungakanani begazi olahlekileyo. Ubungakanani begazi olahlekileyo budla ngokuqikelelwa ngokubala okanye ukulinganisa ii-pad okanye iisponji ezazimanziswe ligazi xa umntwana wayezalwa.

Ukuba ukrokrela i-PPH, ungasebenzisa ezi zinto ukuze uzivavanye ngakumbi:

• Qhubeka ujonga izinga lokubetha kwentliziyo yakho kunye noxinzelelo lwegazi .
• Uvavanyo lwegazi olulinganisa ubungakanani beeseli ezibomvu zegazi egazini (i-hematocrit) kunye nezinto ezibangela ukujiya kwegazi.
• Uvavanyo lwe-pelvic oluhlola i-vagina, umlomo wesibeleko kunye ne-uterus.
• I-ultrasound scan ithatha umfanekiso oneenkcukacha zesibeleko.

Inyangwa njani i-PPH?

Oogqirha badla ngokuyiphatha i-PPH njengengxamiseko. Injongo ephambili yonyango kukuyeka ukopha ngokukhawuleza.

Ngokuxhomekeke kwisizathu sokopha kwakho kunye nobunzima bokopha, ugqirha wakho unokucebisa olunye okanye ngaphezulu kwezi ndlela zonyango:

• Ukuphulula isibeleko ukuze kuncitshiswe izihlunu zesibeleko.
• Ukunika amayeza avuselela ukudumba kwesibeleko.
• Ukususa izicubu ze-placenta ezigciniweyo, nokuba ngesandla okanye ngenye indlela.
• Ukulungisa ukukrazuka kwilungu lobufazi, umlomo wesibeleko, kunye nesibeleko.
• Ukufaka isixhobo, esifana ne -catheter okanye ibhaluni, ukuze kufakwe uxinzelelo eludongeni lwesibeleko kwaye kumiswe ukopha.
• Iinkqubo ezithintela ukuhanjiswa kwegazi esibelekweni.
• Udinga utofelo-gazi .
• Ukunika ulwelo ngomthambo (i-intravenous - IV fluids) , oko kuthetha izinto ezifana ne-saline.
• Ukunika ioksijini eyongezelelweyo ngemaski.
• Ukunika amayeza okongeza isinyithi .

Amaxesha amaninzi, okanye ukuba ezinye iindlela ziyasilela, ugqirha angenza i-laparotomy (utyando lokuvula isisu nokufumanisa umthombo wokopha) okanye i- hysterectomy (ukususwa kwesibeleko).

Kuthatha ixesha elingakanani ukuchacha kule meko ye-PPH?

Ixesha lokuchacha liyahluka kumntu nomntu. Kuxhomekeke ekubeni ulahlekelwe ligazi elingakanani kwaye oogqirha bakho bakunyange njani. Kubalulekile ukuzinyamekela kakuhle kwiintsuku zokuqala emva kokuba umntwana wakho ezelwe – yitya kakuhle, usele amanzi amaninzi, kwaye uphumle kangangoko unako . Ugqirha wakho unokucebisa nokuba uthathe izongezo zesinyithi ukunyanga i-anemia.

Ngaba i-PPH ingathintelwa? Ndingaphinda ndibe nomntwana?

Eyona ndlela ilungileyo oogqirha yokuthintela i-PPH kukubona abo basengozini enkulu ye-PPH ngaphambi kokuba babeleke. Unganceda ngokwabelana ngembali yakho epheleleyo yezonyango nogqirha wakho kwaye ubazise ngazo naziphi na iimpawu ze-PPH emva kokuba ufumene umntwana.

Kuqhelekile ukuba kukhuselekile ukuba nomntwana omnye. Nangona kunjalo, thetha nogqirha wakho malunga nomngcipheko wakho we-PPH ekuzalweni kwakho okulandelayo. Nokuba umngcipheko wakho uphezulu kancinci kunesiqhelo, kusenokwenzeka ukuba uphantsi. Ugqirha wakho unokujonga izinto ezikubangela umngcipheko aze agqibe ukuba ufuna ukuthatha naziphi na izilumkiso ezikhethekileyo ekuzalweni kwakho okulandelayo.

Uzinyamekela njani emva kokuba une-PPH?

Kunokuba nzima ukuzinyamekela ngelixa unyamekela umntwana wakho osandul’ ukuzalwa. Kodwa, ukuba uzinika ixesha lokuphumla nokuzinyamekela kakuhle, uya kukwazi ukuchacha ngokukhawuleza. Impilo-ntle yakho ibaluleke kakhulu.

Nazi ezinye izinto ezinokukunceda:

• Ukuphumla: Umzimba wakho udinga ixesha lokuphiliswa. Ungoyiki ukucela uncedo, kwaye ufumane ukuphumla okufunayo.
• Yitya ukutya okunesondlo: Ukutya okutyebileyo nge-iron efana nenyama ebomvu, imifuno eluhlaza, kunye neenkozo zesidlo sakusasa eziqinisiweyo kunceda ekwenzeni iiseli ezibomvu zegazi. Ukutya okunesondlo kunokukunceda uphile.
• Sela amanzi: Sela amanzi amaninzi emva kokubeleka ukuze uthintele ukuphelelwa ngamanzi emzimbeni.
• Landela imiyalelo kagqirha wakho: Ugqirha wakho unokukunika amayeza okanye utshintsho kwindlela ophila ngayo ukuze akuncede uchache. Landela loo miyalelo ngononophelo.
• Jonga ubungakanani bokopha: Nxiba i-sanitary pad. Jonga ukuba kuthatha ixesha elingakanani ukuba izaliseke. Ukopha kufuneka kwehle kancinci kancinci kwiiveki ezimbalwa. Ukuba akunjalo, bona ugqirha wakho.

Ukopha kakhulu kunokuba ngamava abuhlungu kakhulu. Kuqhelekile ukuba uthabathe ixesha elithile ukuze uphile ngokweemvakalelo emva kokuzalwa kwakho. Ungadinga inkxaso kusapho lwakho, abahlobo, oogqirha, okanye abanye. Thetha ngendlela oziva ngayo, kwaye ucele uncedo xa ulufuna.

Ufanele uye nini kugqirha?

I-PPH idla ngokubakho emva kokuba ubelethile okanye xa usesibhedlele. Nangona kunjalo, ukuba wopha kakhulu emva kokuba ufikile ekhaya okanye ukuba ubonakalisa iimpawu ze-PPH, bona ugqirha wakho ngoko nangoko . Ukuba iofisi kagqirha wakho ivaliwe okanye awukwazi ukufikelela kuye, yiya kwigumbi likaxakeka kwisibhedlele esikufutshane nawe.

Ukuba ufumana ukopha okukhulu emva kokubeleka, bonana nogqirha ngokukhawuleza. Ezinye iimpawu ze-PPH ziquka isiyezi, ukuquleka, kunye nobunzima bokuphefumla. I-PPH yimeko enzima efuna unyango olukhawulezileyo.

Ukuba wena okanye umntu omthandayo une-PPH, kuyinto eqhelekileyo ukuziva wothukile kwaye usoyika yile nto. Kodwa khumbula, ukubhaqwa kwangoko kunye nonyango olukhawulezileyo kunokuthintela iingxaki ezinkulu. Yiyo loo nto kubalulekile ukuba ukhululeke kwaye unyaniseke kugqirha wakho malunga nembali yakho yezonyango. Oku kuya kukunceda ubone ukuba usemngciphekweni we-PPH.

Umyalezo Wokugqibela Wokuya Ekhaya

• I-PPH (Postpartum Hemorrhage) yimeko enzima efuna unyango olukhawulezileyo, ebonakala ngokuphuma igazi elininzi emva kokubeletha.
• Ukuba ufumana iimpawu ezinje ngokopha kakhulu, ukuphuma kwegazi elininzi, isiyezi, ukuquleka, okanye ukunyuka kwesantya sentliziyo , funa ingcebiso kagqirha ngoko nangoko .
• Eyona nto ibangela i-PPH yi-uterine atony, oku kukungakwazi kwesibeleko ukufinyela kakuhle. Ezinye izizathu ziquka ukwenzakala, i-placenta egciniweyo, kunye neengxaki zokugalela igazi.
• Nangona kukho izinto ezinobungozi, i-PPH inokwenzeka nakubani na .
• Ukuba ifunyenwe kwangethuba kwaye inyangwa ngokukhawuleza, inokuhlala inyangeka ngokupheleleyo.
• Amava e-PPH anokubangela ukudinwa ngokweemvakalelo. Musa ukuthandabuza ukufumana inkxaso oyifunayo.

Ukunyamekela impilo yakho kubaluleke kakhulu, ingakumbi ngamaxesha anje. Awuwedwa, cela uncedo.

Ukopha emva kokubeletha, i-PPH, ukuzala, ukopha, isibeleko, i-placenta, impilo yabasetyhini