Ingabe nawe unakho ukulunywa okungabekezeleleki ngesikhathi sokukhulelwa? Lokhu kungaba yi-Cholestasis yokukhulelwa!

Omama abaningi babhekana nokungakhululeki okuhlukahlukene ngesikhathi sokukhulelwa. Nakuba kujwayelekile ukuzizwa uluma ngezinye izikhathi, ngezinye izikhathi kungaba yinto okufanele uyikhathazeke. Ikakhulukazi ngasekupheleni kokukhulelwa kwakho, uma uzithola uluma ngokungalawuleki, uqala ngezintende zakho nasematheni bese kuba umzimba wakho wonke, kungaba uphawu lwesimo esibizwa ngokuthi i-Cholestasis of Pregnancy. Ingabe singakhuluma ngalokhu ngokuningiliziwe namuhla? Ungakhathazeki, kubaluleke kakhulu ukuqaphela lokhu.

Iyini ngempela i-Cholestasis yokukhulelwa?

Kalula nje, i-cholestasis yokukhulelwa yisimo esithinta isibindi . Sivame ukwenzeka ku-trimester yesithathu yokukhulelwa, cishe amasonto angama-28. Kwabanye abantu, singase sivele kusenesikhathi. Odokotela baphinde bakubize ngokuthi ``Intrahepatic Cholestasis of Pregnancy (ICP)`` noma ``Obstetric Cholestasis``. Kungenzeka ukuthi uke wezwa la magama lapho ubona udokotela.

Kulesi simo, abanye besifazane abakhulelwe babhekana nokwehla kwesikhashana kokusebenza kwesibindi. Ngemuva kwalokho, into ebizwa ngokuthi i-bile emzimbeni wethu ayihambi kahle bese iqala ukunqwabelana esibindini nasegazini.

Kuyini inyongo?

Inyongo iwuketshezi olukhiqizwa yisibindi sethu futhi lugcinwe enyongweni. Njalo lapho sidla, lenyongo isisiza ukugaya amafutha ekudleni esikudlayo. Ngakho-ke, lapho leli zinga lenyongo egazini lidlula izinga elidingekayo, uqala ukuthola ukulunywa okubi.

Lesi simo se-cholestasis singadala izinkinga kuwe nakumntwana wakho ongakazalwa. Yingakho uma udokotela wakho esola ukuthi unalesi simo, wena nomntwana wakho nizoqashwa eduze phakathi nesikhathi esisele sokukhulelwa kwenu.

Kwenzekani uma ngine-cholestasis ngesikhathi sokukhulelwa?

Lokhu kuyinto okufanele uyiqonde. Ngesikhathi sokukhulelwa, ingane yakho ithembele esibindini sakho ukuze isuse udoti emzimbeni wayo. Ngakho-ke, uma isibindi sakho singasebenzi kahle, lelo zinga lenyongo engikhulume ngalo ekuqaleni lingaba phezulu ngendlela eyingozi. Lokhu kungabeka ingcindezi esibindini somntwana wakho. Isibindi singesinye sezitho ezibaluleke kakhulu emzimbeni wethu. Yindawo eyinhloko lapho umzimba ulahla khona udoti. Ngakho-ke uma ungasebenzi kahle, kunethuba lezinkinga.

Kodwa ungakhathazeki . Udokotela wakho uzokuhlola wena nomntwana wakho njalo ukuqinisekisa ukuthi i-cholestasis ayilimazi nobabili kini.

I-cholestasis ivame kangakanani ngesikhathi sokukhulelwa?

Lesi simo sithinta owesifazane oyedwa kuya kwababili kwabesifazane abayi-1,000 abakhulelwe. Lokho kusho ukuthi asivamile kangako. Nakuba abacwaningi bengakayazi imbangela eqondile, idatha ikhombisa ukuthi sivame kakhulu ebusika. Kuthiwa futhi abantu bozalo lwamaHispanic namaSweden banamathuba amaningi okuba naso.

Iyini imbangela eyinhloko ye-cholestasis?

Njengoba sesixoxile ngaphambili, i-bile yinto ekhiqizwa yisibindi futhi egcinwe enyongweni. Isiza ekugayeni amafutha ngesikhathi sokugaya ukudla. Ngesikhathi sokukhulelwa, amazinga omzimba wakho ama-hormone i-estrogen ne -progesterone anda kakhulu. Lawa mazinga akhuphukile ala ma-hormone athinta ikhono lesibindi lokuthutha i-bile ngendlela efanele. Kalula nje, i-bile ayihambi emzimbeni wonke, kodwa kunalokho iqoqana esibindini bese ibuyela egazini. Lapho i-bile iqoqana egazini, uthola lokho kuluma okungabekezeleleki.

I-Cholestasis yokukhulelwa ivame ukwenzeka ku-trimester yesithathu, cishe emavikini angama-28. Lokhu kungenxa yokuthi amazinga ama-hormone okukhulelwa aphezulu kakhulu ngalesi sikhathi. Kwezinye izimo, kungaba yizakhi zofuzo . Lokhu kusho ukuthi uma abazali bakho babene-cholestasis, nawe usengozini yokuba nayo.

Ziyini izimpawu ze-cholestasis ngesikhathi sokukhulelwa?

Uphawu oluyinhloko nolusobala kakhulu lwalesi simo ukulunywa okukhulu (pruritus) . Lokhu kulunywa kuqala ezintendeni nasematheni ezinyawo. Bese kungasakazeka kancane kancane kwezinye izingxenye zomzimba. Kwabaningi, lokhu kulunywa kubi kakhulu ebusuku . Kuklwebha kakhulu kangangokuthi abakwazi ukulala. Ngokungafani nezinye izimo zokulunywa, i-cholestasis ayivamisile ukubangela ukuqubuka kwesikhumba . Lokhu kubaluleke kakhulu.

Ngaphezu kokulunywa, kungase kube nezinye izimpawu eziningana. Kodwa-ke, akuwona wonke umuntu obhekana nalezi:

• Isicanucanu
• Umchamo omnyama
• Indle empunga noma ensundu ngokukhanyayo
• Ukukhathala okukhulu
• Ukuncipha kwesifiso sokudla
• Ubuhlungu ohlangothini oluphezulu kwesokudla lwesisu sakho
• I-Jaundice - Lokhu kusho ukuthi isikhumba sakho kanye namehlo akho amhlophe aphenduka aphuzi.

Uma unesinye noma ngaphezulu salezi zimpawu, kungcono ukufuna iseluleko sezokwelapha ngokushesha.

I-cholestasis iqala nini isonto lokukhulelwa?

I-Cholestasis yokukhulelwa ivame ukuqala ngemva kwamasonto angama-28 okukhulelwa. Kodwa-ke, njengoba ngishilo ekuqaleni, abanye abantu bangaba nalesi simo kusenesikhathi. Ngakho-ke kubalulekile ukuqaphela ukulunywa.

I-cholestasis itholakala kanjani ngesikhathi sokukhulelwa?

Udokotela wakho uzohlonza lesi simo ngokwenza ukuhlolwa ngokomzimba kanye nokuhlolwa kwegazi. Lokhu kuhlolwa kungabonisa ukuthi isibindi sakho sisebenza kanjani. Bazokwenza nokuhlolwa kwe-serum bile acid ukuze balinganise izinga lama-bile acid egazini lakho.

Lezi zivivinyo zingaqinisekisa lesi simo uma izinga le-bile acid liyi-10 micromoles ngelitha (`10 micromoles ngelitha`) noma ngaphezulu. Ama-Micromoles ayiyunithi yokulinganisa esetshenziswa kwezinye izivivinyo zezokwelapha. Ungase futhi ube nokuhlolwa kwegazi okuvamile ukuze uqaphe amazinga akho e-bile acid phakathi nokukhulelwa kwakho konke.

Ngaphezu kwalokho, udokotela wakho angase ancome ukuhlolwa kwesikhathi se-prothrombin ukuze abone ukuthi igazi lakho ligobile kangakanani, kanye ne-ultrasound ukuze kubhekwe imigudu ye-bile nesibindi sakho.

I-cholestasis iphathwa kanjani ngesikhathi sokukhulelwa?

Imithi eyinhloko odokotela abayisebenzisayo ukwelapha lesi simo yi -Ursodeoxycholic acid (UDCA) . Yaziwa nangokuthi `(ursodiol)` noma `(Actigall®)`. Lo muthi usiza ekuthuthukiseni ukusebenza kwesibindi sakho futhi wehlise izinga le-bile egazini lakho.

Ngaphezu kwalokho, kunezindlela zokwelapha zokulawula izimpawu ze-cholestasis, ikakhulukazi ukulunywa okukhulu:

• Umuthi wokuluma: (Kodwa khumbula, kufanele ubuze udokotela wakho ngaphambi kokuthatha noma yimuphi umuthi.)
• Gqoka izingubo ezithambile nezikhululekile: Ukugqoka izingubo eziqinile kungenza ukulunywa kube kubi nakakhulu. Ngakho-ke, gqoka izingubo ezikhululekile ezenziwe ngezindwangu ezithambile njengokotini.
• Ukuphumula: Ukuphumula okwanele nakho kubaluleke kakhulu.
• Ukugeza emanzini afudumele: Ukucwilisa emanzini afudumele isikhashana kunganikeza impumuzo ethile ekulumeni.

Ngezinye izikhathi, uma imithi inganciphisi amazinga akho enyongo, udokotela wakho angase akuncomele ukubeletha ingane yakho kusenesikhathi, ngaphambi kosuku lwakho lokuzalwa. Ukubeletha okubangela ukubeletha, ngokuvamile cishe amasonto angu-37 noma angu-38, kunganciphisa ingozi yezinkinga ezivela ku-cholestasis. Udokotela wakho uzokwenza nokuhlolwa, njengephrofayili ye-biophysical noma ukuhlolwa okungenakucindezeleka, ukuqinisekisa ukuthi ingane yakho iphilile.

Uma umntwana ebelethwe kusenesikhathi, i-steroid inganikezwa ukusiza amaphaphu omntwana akhule kahle kanye nesengezo se-vitamin K ukuvimbela ukopha kwangaphakathi.

Yiziphi izinkinga ezingaba khona ze-cholestasis ngesikhathi sokukhulelwa?

I-Cholestasis yokukhulelwa ingabangela izinkinga. Ungase ube nenkinga yokumunca i-vitamin K , okwandisa ingozi yakho yokopha kakhulu kwangaphakathi. Kungaxhunyaniswa nezimo ezifana ne -preeclampsia (umfutho wegazi ophezulu ngesikhathi sokukhulelwa) kanye nesifo sikashukela sokukhulelwa .

Izinkinga ezingase zenzeke enganeni yilezi:

• Ukuzalwa ngaphambi kwesikhathi
• Ukuzalwa Kwengane Ifile - Lokhu kuyinto abantu abaningi abayesabayo. Kodwa-ke, ngokuqashwa okufanele kwezokwelapha, le ngozi ingancishiswa kakhulu.
• Ukucindezeleka kwengane esibelethweni - Lokhu kusho ukuthi ingane izwa ubuhlungu esibelethweni.
• Ukufuthwa kwe-Meconium - Ingane iyakhipha indle esibelethweni bese iyiphefumula.

Ukuze kuncishiswe ingozi yezinkinga ezinjengalezi, udokotela wakho ngezinye izikhathi unquma ukubeletha umntwana kusenesikhathi.

Kungenzeka yini ukuba nomntwana onempilo uma une-cholestasis ngesikhathi sokukhulelwa?

Yebo, ungakwenza nakanjani! Ukuthi nje ube ne-cholestasis ngesikhathi sokukhulelwa akusho ukuthi ingane yakho ngeke ibe nempilo enhle. Ngokunakekelwa okufanele kwezokwelapha kanye nokuqashwa, omama abaningi bazala izingane ezinempilo. Ngakho ungakhathazeki ngokungadingekile.

Ingabe kukhona izinto okufanele ngizigweme ukuzidla uma ngine-cholestasis?

Udokotela wakho angase akucebise ukuthi unciphise ukudla okuthile kuye ngesimo sakho. Kodwa-ke, akukho uhlelo lokudla oluthile (ukudla okujwayelekile) okufanele ulandele uma une-cholestasis ngesikhathi sokukhulelwa. Into ebaluleke kakhulu ukudla ukudla okulinganiselayo ngesikhathi sokukhulelwa. Lokhu kusho ukudla izithelo, imifino, inyama engenamafutha noma eminye imithombo yamaprotheni. Khuluma nodokotela wakho ngalokhu bese uthola iseluleko esengeziwe.

Ingabe i-cholestasis ingavinjelwa ngesikhathi sokukhulelwa?

Ngeshwa, ayikho indlela yokuvimbela i-cholestasis ngesikhathi sokukhulelwa. Kodwa-ke, ukuhlolwa kofuzo kungasiza ekuqondeni ingozi yokudlulisela lesi simo enganeni yakho.

Yiziphi izinto ezibangela i-cholestasis ngesikhathi sokukhulelwa?

Usengozini enkulu yokuthola i-cholestasis ngesikhathi sokukhulelwa uma:

• Uma othile emndenini wakho eke waba nalesi simo ngaphambili (Ube nelungu lomndeni elinalesi simo).
• Uma uke waba ne-cholestasis (ICP) ngesikhathi sokukhulelwa kwangaphambilini.
• Uma ulindele amawele, amawele amathathu noma ngaphezulu.
• Uma unomlando wesifo sesibindi noma i-hepatitis C.
• Uma unomlando wokulimala kwesibindi.
• Uma unesifo sofuzo esithinta indlela umzimba wakho okhiqiza futhi osebenzisa ngayo i-bile.

Uma unalezi zici eziyingozi, qaphela kakhulu ngamaqhubu ngesikhathi sokukhulelwa.

Kuyini ukubikezela kulabo abane-cholestasis yokukhulelwa?

Lezi yizindaba ezinhle kakhulu! I-Cholestasis yokukhulelwa ivame ukuphela zingakapheli izinsuku ezimbalwa umntwana ezelwe . Amazinga e-bile egazini lakho azobuyela esimweni sawo esijwayelekile. Uma amazinga e-bile akho ebuyela esimweni sawo esijwayelekile, ungayeka ukuphuza imithi yakho.

Iningi labantu alibi nezinkinga zesibindi kamuva ngenxa yalesi simo, ngaphandle kokuthi baphinde bakhulelwe. Uma une-cholestasis kanye,Kunamathuba angu-60% okuthi lokhu kuphinde kwenzeke ekukhulelweni okulandelayo. Kodwa-ke, uma unesimo esibi se-cholestasis, amathuba okuthi lokhu kuphinde kwenzeke ekukhulelweni okulandelayo anganda afike ku-90%.

Kufanele ngimbone nini udokotela wami?

Uma uzwa ukulunywa okungabekezeleleki ngesikhathi sokukhulelwa okungapheli, noma uma isikhumba sakho noma amhlophe amehlo akho ebonakala ephuzi (izimpawu ze-jaundice), bona udokotela wakho ngokushesha. Lezi zimpawu kungenzeka zingabangelwa yi-cholestasis, kodwa kungcono ukuya kohlolwa.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma kutholakala ukuthi une-cholestasis yokukhulelwa, ungase ufune ukubuza udokotela wakho imibuzo efana nale:

• Ingakanani i-cholestasis yokukhulelwa?
• Yiziphi izindlela zokwelapha enginazo?
• Yini engingayenza ukuze ngizivikele mina kanye nomntanami?
• Uma ngike ngaba ne-cholestasis (ICP) ngaphambili, yini okufanele ngiyazi ngokukhulelwa kwesikhathi esizayo?

Ungesabi ukubuza imibuzo efana nale. Udokotela wakho ukhona ukukusiza nokususa noma yikuphi ukungabaza ongase ube nakho.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Cholestasis yokukhulelwa yisimo esibangela ukulunywa okukhulu ngesikhathi sokukhulelwa. Ungakhathazeki ngalokhu. Udokotela wakho uzokuqapha wena nomntwana wakho eduze futhi anikeze ukwelashwa okudingekayo. Lesi simo siphela ngokuphelele ngemva kokubeletha futhi ngokuvamile asisongeli impilo. Kwezinye izimo, udokotela wakho angase anqume ukubeletha ingane yakho kusenesikhathi ukuze niphephe nobabili.

Into ebaluleke kakhulu ukuthi uma unemibuzo, ukungabaza, noma ukwesaba ngalokhu, khuluma nodokotela wakho ngakho. Bakhona ukukulalela nokwenza okudingekayo ukuze wena nomntwana wakho niphephe. ​​Awuwedwa, futhi kukhona odokotela abangakusiza kulolu hambo.

Ngakho-ke, ngithemba ukuthi lolu lwazi luzokusiza. Ngikufisela ukukhulelwa okunempilo kanye nokubeletha okunempilo!

I- Cholestasis yokukhulelwa, ukulunywa ngesikhathi sokukhulelwa, isifo sesibindi, i-ICP, impilo yokukhulelwa, ukuqongelela kwe-bile, impilo yomntwana