Isimo esiyingozi kakhulu esingase senzeke ngesikhathi sokubeletha! - Ake sixoxe nge-Amniotic Fluid Embolism

Lesi yisikhathi esikhethekile kakhulu kuwe, umama okhulelwe. Njengoba ulinde ingane yakho ukuba ifike, akusikho ngaphandle kokwesaba okuncane. Esikhathini esiningi, konke kuhamba kahle, kodwa ngezinye izikhathi kungavela izinkinga ezingalindelekile. Namuhla, sizokhuluma ngesimo esingavamile kodwa esingasongela ukuphila esibizwa ngokuthi "i-Amniotic Fluid Embolism" (AFE). Kubalulekile ukuthi uqaphele lokhu.

Kuyini ngempela i-amniotic fluid embolism (AFE)?

Kalula nje, i-amniotic fluid embolism (AFE) iyisimo esiphuthumayo esingavamile kakhulu futhi esingasongela impilo. Kwenzeka lapho uketshezi lwe-amniotic emzimbeni kamama lungena egazini lakhe ngesikhathi sokukhulelwa, ngesikhathi sokubeletha, noma ngokushesha nje ngemva kokuzalwa. Manje ungase uzibuze ukuthi luyini uketshezi lwe-amniotic. Lolu uketshezi oluzungeze ingane yakho ngaphakathi kwesibeletho. Kufana nendawo ephephile lapho ingane yakho ingantanta khona. Nakuba lolu ketshezi luyimanzi kakhulu, luqukethe nezinto ezifana namaseli nezicubu zengane yakho. Ngezinye izikhathi, lapho lolu ketshezi lwe-amniotic luhlangana negazi likamama, eminye imizimba yomama iba nempendulo enkulu yokungezwani nalo. Odokotela abasazi kahle ukuthi kungani lokhu kwenzeka. I-amniotic fluid embolism (AFE) ingabangela inhliziyo namaphaphu kamama ukuthi ahluleke. Lokhu kungaholela ezinkingeni ezifana nokuma kwenhliziyo , lapho inhliziyo ima ngokuzumayo. Omama abane-AFE nabo bangopha igazi ngendlela engalawuleki esibelethweni noma esilondeni se-C-section. I-AFE iyisimo esiphuthumayo kakhulu nesingenakubikezelwa . Ngakho-ke, ukuyelapha kuyinselele kakhulu. Futhi kuyisimo esiphuthumayo sezokwelapha. Eqinisweni, kuyinto evamile ukuthi inani elincane loketshezi lwe-amniotic lingene egazini likamama ngesikhathi sokubeletha. Iningi labantu alinazo izimpendulo zokungezwani nalokhu. Kodwa ukuthi kungani abanye abantu kuphela abasabela ngendlela enzima kangaka kuseyimfihlakalo. I-AFE yaziwa nangokuthi "i-Anaphylactic Syndrome of Pregnancy".

Sivame kangakanani lesi simo?

Empeleni i-AFE iyisimo esingavamile kakhulu. E-United States, yenzeka cishe koyedwa kwabazelwe abangu-40,000. EYurophu, yenzeka cishe koyedwa kwabazelwe abangu-53,800. Lokho kusho ukuthi ayivamile kakhulu. Kodwa kukhona enye inkinga lapha. Izimpawu ze-AFE zifana kakhulu nezimpawu zezinye izinkinga ezingase zenzeke ngesikhathi sokubeletha, isibonelo, ukuqhuma kwesibeletho, ukushaqeka kwe-placenta, noma i-eclampsia. Ngakho-ke, kunzima kancane ukuhlonza imbangela eqondile yale nkinga njenge-AFE.

Yiziphi izinto ezibangela ingozi ye-AFE?

Ngenxa yokuthi i-AFE ayivamile futhi kunzima ukuyicwaninga, kunzima ukubikezela ngqo ukuthi yiziphi izici eziyingozi ezingaba nomthelela kuyo. Kodwa-ke, ngokusekelwe ocwaningweni lwamanje, kunezinto ezimbalwa okucatshangwa ukuthi zingaba nomthelela kulesi simo:

• Ukukhula kweminyaka yomama: Le ngozi ingase ikhuphuke kancane komama abakhulelwa beneminyaka engaphezu kwengu-35.
• Ukuba namawele noma ngaphezulu: Kwabomama abakhulelwe izingane ezingaphezu kweyodwa, njengamawele noma amawele amathathu.
• Ukucindezeleka kwengane esanda kuzalwa: Izinto ezifana nokushintsha kwenhliziyo yengane.
• Izinkinga ze-placenta : Isibonelo, izimo ezifana nokuqhekeka kwe-placenta.
• Ukuba ne-preeclampsia noma i-eclampsia: Lezi yizinkinga ezihlobene nomfutho wegazi ophezulu ngesikhathi sokukhulelwa.
• Ama-Polyhydramnios: Lokhu kusho inani eliningi kakhulu loketshezi lwe-amniotic esibelethweni.
• Izinyembezi zomlomo wesibeletho .
• Ukuqaliswa Kwemisebenzi: Yilapho ukuqaliswa kwemisebenzi kwenziwa ngokwenziwa ukuze kuqalwe umsebenzi.
• Ukubeletha umntwana ngokuhlinzwa (ukubeletha ngokuhlinzwa ).
• Ukubeletha okusizwa ngokuhlinzwa: Lezi yizimo lapho umntwana ezalwa khona kusetshenziswa i-forceps delivery noma i-vacuum extraction.

Khumbula, akuwona wonke umuntu onalezi zici eziyingozi ozothola i-AFE. Lezi yizinto nje ezingandisa amathuba okuba nalesi simo .

Ziyini izimpawu ze-amniotic fluid embolism?

Izimpawu ze-AFE zivele ngokuzumayo nangokushesha.Njengoba kushiwo ngaphambili, kungaba nzima ukuxilonga ngokunembile ngoba lezi zimpawu zifana nezezinye izinkinga ngesikhathi sokukhulelwa nokubeletha. Lezi zimpawu ezilandelayo zingaba khona:

• Ubunzima bokuphefumula : Kungazelelwe kuba nzima ukuphefumula, uzizwe sengathi uyacinana.
• Ukwehla kwengcindezi yegazi ngokuzumayo: Umfutho wegazi wehla ngokuzumayo kakhulu.
• Ukuvuvukala kwamaphaphu: Ukusebenza kwamaphaphu kuyaphazamiseka, njengokungathi kucwiliswe emanzini.
• Isilinganiso senhliziyo esingavamile: Isilinganiso senhliziyo siyashintsha ngokuzumayo, ngezinye izikhathi siqala ukushaya ngokushesha okukhulu, noma sishaya kancane kakhulu.
• Ukopha ngokweqile okuvela esibelethweni, inxeba lokuhlinzwa, noma indawo yokuzala: Ukopha okungenakuvinjelwa.
• Ukucindezeleka kwengane: Ukushaya kwenhliziyo kwengane kuyashintsha.
• Ukungahlaliseki okungazelelwe, ukudideka, noma ukukhathazeka okukhulu: Ngokungazelelwe uqala ukuzizwa ukhathazekile kakhulu, ungahlaliseki, ungakwazi ukuqonda okwenzekayo, futhi ungase uzizwe wesaba kakhulu.
• Ukuzizwa ubanda futhi uqhaqhazela (Ukugodola).

Uma kuvela uphawu olulodwa noma ngaphezulu kwalezi ngokuzumayo, kungaba yisimo esiphuthumayo.

Yiziphi izinkinga ezingaba khona ngenxa ye-AFE?

I-AFE iyisimo esibi kakhulu. Ingabangela izinkinga ezinkulu kumama kanye nengane.

Izinkinga ezingaba khona kumama:

• Ukwehluleka kwenhliziyo namaphaphu.
• Ukulahlekelwa ukwazi.
• Ukuquleka.
• Ukopha ngokweqile.
• Izinkinga zokujiya kwegazi (Disseminated Intravascular Coagulation - DIC): Lokhu kwenzeka lapho inkinga ohlelweni lokujiya kwegazi ibangela ukuba igazi lijiye kolunye uhlangothi bese liphuma igazi ngokweqile kolunye uhlangothi.
• Isifo sohlangothi.
• Ukuma kwenhliziyo: Lokhu kusho ukuthi inhliziyo iyayeka ukushaya ngokuphelele.
• Ukulimala kobuchopho.
• Ngisho nokufa kungenzeka. Lena yinto edabukisa kakhulu.

Izingozi ezingaba khona enganeni esibelethweni:

Ingozi enganeni incike ekutheni i-amniotic fluid embolism ivele nini. Uma umama eba nalezi zimpawu ngaphambi kokuba umntwana azalwe, kungase kudingeke ukuba abelethe ngokuphuthumayo . Uma i-AFE isiqalile kakade, umntwana usengozini yokungatholi umoya-mpilo owanele. Uma kungekho umoya-mpilo owanele, kungalimaza isimiso sezinzwa noma ubuchopho bomntwana.

Yini ebangela i-amniotic fluid embolism?

Imbangela eqondile ye-AFE ayaziwa okwamanje. Kucatshangwa ukuthi kungenzeka ukuthi ibangelwa impendulo yomzimba kwabanye omama ekwandeni kwe-placenta ngesikhathi sokubeletha. Kodwa-ke, akucaci ukuthi kungani kwenzeka kwabanye abantu kuphela hhayi kwabanye.

Ingabe i-AFE ingenzeka ngesikhathi sokuhlinzwa (ukuhlinzwa kwe-C-section)?

Yebo, kungenzeka. I-amniotic fluid embolism ingenzeka ngesikhathi sokubeletha okuvamile kanye nokuhlinzwa (C-section).

Odokotela bakuthola kanjani ukusha kwe-amniotic fluid embolism?

I-Amniotic fluid embolism ingaba nzima ukuyixilonga. Njengoba kushiwo ngaphambili, izimpawu zifana nezezinye izimo eziningi zezokwelapha ezimbi. Ngakho-ke, lapho odokotela besola i-AFE, baqale bakhiphe ezinye izimbangela ezingaba khona. I-Amniotic fluid embolism ivame ukwenzeka ngesikhathi sokubeletha noma kungakapheli imizuzu engama-30 yokubeletha. Uma une-AFE, udinga ukuthola ukwelashwa ngokushesha ukuze ugweme izinkinga ezisongela impilo. Udokotela wakho angase asole i-AFE uma unezinye zalezi zimpawu:

• Ukwehla okuzumayo komfutho wegazi.
• Ubunzima bokuphefumula.
• Ukushaya kwenhliziyo okungajwayelekile noma ukumiswa kwenhliziyo ngokuphelele.
• Ukopha ngokweqile ngaphandle kwesizathu.

Izigaba ezimbili zokutholwa kwe-AFE

Odokotela bahlukanisa i-amniotic fluid embolism ngezigaba ezimbili:

• Isigaba sokuqala: Lesi sigaba sibonakala ngokwehluleka kokuphefumula okusheshayo (ukuntuleka komoya-mpilo kanye nokungakwazi ukuphefumula) kanye nokuma kwenhliziyo. Inani elikhulu kakhulu lokufa libikwa phakathi nalesi sigaba.
• Isigaba sesibili: Lesi yisigaba sokopha. Kulesi sigaba, kungase kube nokopha ngokweqile okungalawuleki, kungaba yinxeba lokuhlinzwa noma esibelethweni (lapho i-placenta yayinamathele khona).

Ukuhlolwa okufanele kwenziwe uma usinda

Ngenxa yokuthi i-AFE iyisimo esiphuthumayo sezokwelapha, odokotela abanaso isikhathi sokuthembela ekuhlolweni kwezithombe noma ekuhlolweni kwegazi ukuze bathole isifo. Kunalokho, bangakunikeza ukwelashwa okusindisa impilo ngokushesha. Kodwa-ke, uma usinda ekushayweni yi-amniotic fluid embolism, udokotela wakho angase akucele ukuhlolwa okufana nalokhu:

• I-Electrocardiogram (EKG): Ihlola ukusebenza kwenhliziyo kanye nesigqi sayo.
• I-pulse oximeter: Hlola izinga lomoya-mpilo egazini.
• I-X-ray yesifuba: Ukubona ukuthi kukhona yini uketshezi oluzungeze inhliziyo.
• I-Echocardiogram: Bona ukuthi inhliziyo isebenza kanjani.

Iphathwa kanjani i-amniotic fluid embolism?

Ukuminyana koketshezi oluphuma ku-amniotic kuyisimo esiphuthumayo. Kudingeka kwelashwe ngokushesha okukhulu.Nansi indlela ongavikela ngayo wena nomntwana wakho. Nazi ezinye izindlela odokotela abangazisebenzisa ukwenza lokhu:

• Ukubeletha umntwana ngokushesha.
• Ukumpontshelwa igazi okuningi, i-plasma kanye nama-platelet.
• Ukususwa kwesisu ukuze kumiswe ukopha (lokhu kwenziwa kuphela uma kungekho enye indlela yokuvimba ukopha etholakalayo).
• Ukunikeza ama-steroid noma eminye imithi yokulawula umfutho wegazi noma ukusebenza kwenhliziyo.
• Ukuhlinzeka ngokuvuselelwa kwenhliziyo namaphaphu (i-CPR).
• Ukunikeza umoya-mpilo ngepayipi lomgudu wokuphefumula noma ngosizo lomshini (umoya wokuphefumula owenziwe ngomshini).
• Gada umfutho wegazi ngokufaka i-catheter yemithambo yamaphaphu noma i-catheter yemithambo ephakathi.

Konke lokhu kwenzelwa ukusindisa izimpilo zikamama nomntwana. Ngakho-ke, ithimba lezokwelapha lenza izinqumo ngokusekelwe esimweni saleso sikhathi.

Ingabe ikhona indlela esingakuvimbela ngayo lokhu?

Ngeshwa, okwamanje ayikho indlela yokuvimbela i-amniotic fluid embolism. Odokotela abakaqondi ngokugcwele ukuthi kungani i-AFE yenzeka noma ukuthi yini ebangela lokho. Kodwa-ke, enye indlela yokulungiselela noma yisiphi isimo esiphuthumayo sezokwelapha ukusebenzisana nomndeni wakho nodokotela ukuthuthukisa uhlelo. Buza udokotela wakho ngezimo eziphuthumayo nokuthi ithimba lakho lezokwelapha lizosabela kanjani kuzo. Lokhu kungaba yingxenye "yohlelo lwakho lokuzalwa," uhlelo olwenzile ngaphambi kokuba ingane yakho izalwe. Kodwa khumbula, uhlelo lwakho lokuzalwa lumelela isimo esingcono kakhulu. Uma kwenzeka isimo esiphuthumayo, ithimba lakho lezokwelapha kuzodingeka lithathe isinyathelo ngokufanele ukuze livikele wena nengane yakho.

Angakanani amathuba okusinda ku-AFE?

Ngenxa yokuthi i-AFE kunzima ukuyixilonga futhi incike ezintweni eziningi, kunzima ukunikeza iphesenti eliqondile lokuthi bangaki abantu abafayo ngenxa yalesi simo. Nakuba izifundo ziyahlukahluka kuye ngokuthi idatha iqoqwa kanjani, eminye imibiko iphakamisa ukuthi izinga lokufa lingafinyelela ku-60%. Lokhu kukhombisa ukuthi lesi simo sibi kangakanani.

Yimiphi imiphumela engaba khona yesikhathi eside kwabasindile?

Lokhu kuncike ekutheni uphendule kanzima kangakanani ku-AFE, kanye nomlando wakho wezempilo jikelele. I-amniotic fluid embolism ingabangela imiphumela emibi yomzimba neyengqondo. Eminye yemiphumela yesikhathi eside engase ivele ihlanganisa:

• Ukulimala kwemizwa okuthinta inkumbulo noma ikhono lokukhumbula amagama.
• Ukulimala okungapheli enhliziyweni.
• Uma kwenzeka isifo sohlangothi, izinkinga ezingase zivele.
• Izinkinga zezinso.
• Ukukhathazeka, ukucindezeleka, kanye nemizwa yecala.
• Isifo Sokucindezeleka Ngemva Kokuhlukumezeka (PTSD). Ngenxa yokuthi lokhu kuyinto ebuhlungu kakhulu, kungathatha isikhathi ukululama engqondweni.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Amniotic fluid embolism (AFE) iyinkinga esongela ukuphila engenzeka ngesikhathi sokubeletha kanye naseduze nako. Akuvamile kakhulu, futhi kungenzeka ngokuzumayo nangokushesha. Ngenxa yokuthi lesi simo asiqondakali ngokugcwele, akukho ongakwenza ukusivimbela. Abacwaningi bezokwelapha abakaqiniseki ukuthi kungani kwenzeka kwabanye abantu kuphela.

Uma ukhulelwe, amathuba okuba ube ne-AFE aphansi kakhulu . Ngakho-ke ungakhathazeki ngokungadingekile. Kodwa-ke, khuluma nomhlinzeki wakho wokunakekelwa kwangaphambi kokubeletha nganoma yikuphi ukukhathazeka noma imibuzo ongase ube nayo ngalesi simo esingavamile. Bazokwazi ukukusiza ukunciphisa ukwesaba kwakho.

Uma ungumuntu osindile ku-AFE, ungase ube nezinkinga zempilo yomzimba noma yengqondo zesikhathi eside. Khuluma nodokotela wakho, umlingani wakho, noma abangane ngalokhu. Bangakunikeza ukwesekwa okudingayo ukuze ululame kulesi simo. Khumbula, awuwedwa.