Uhlobo lwegazi lomntwana wakho ongakazalwa aluhambisani nolwakho? (I-Erythroblastosis Fetalis) Ake sithole ukuthi lokhu kuyini ngempela!

Uma ungumama okhulelwe, kungenzeka ukuthi wesaba kancane lapho uzwa amagama athi 'i-Erythroblastosis Fetalis'. Noma mhlawumbe udokotela wakho ukusho esikhathini esidlule lapho ekhuluma ngohlobo lwegazi lakho. Kungase kwesabe kancane ukuzwa leli gama. Kodwa ungakhathazeki, namuhla sizokhuluma ngalo ngendlela elula ongayiqonda. Ake sibone ukuthi kuyini, kungani kwenzeka, nokuthi singazivikela kanjani kulesi simo.

Kuyini 'i-Erythroblastosis Fetalis'?

Kalula nje, lokhu kuyinto engavamile, okusho ukuthi akuwona wonke umuntu okutholayo, inkinga engenzeka ngesikhathi sokukhulelwa. Lokhu kwenzeka uma kukhona ukungavumelani kohlobo lwegazi phakathi kwakho nomntwana wakho ongakazalwa. Akuwona wonke umehluko wohlobo lwegazi obangela izinkinga. Kodwa-ke, le ngozi iphezulu kakhulu uma uhlobo lwegazi lakho lungu-'Rh-negative' kanti uhlobo lwegazi lomntwana wakho lungu-'Rh-positive'.

Cabanga nje, uma uke wavezwa yileli gazi eline-Rh, kungaba ngesikhathi sokukhulelwa kwangaphambilini noma ngesikhathi sokumpontshelwa igazi, isimiso somzimba wakho sokuzivikela (uhlelo olusivikela ezifweni) singaqala ukuhlasela amangqamuzana abomvu egazi lomntwana. Njengokuhlasela isitha. Lokhu kungabangela ukuthi amangqamuzana abomvu egazi lomntwana abe phansi ngendlela eyingozi. Lokhu sikubiza ngokuthi i-anemia. Uma le anemia iba nkulu, ingaba yingozi empilweni yomntwana uma ingelashwa.

Kodwa kunezindaba ezinhle! Kulezi zinsuku, ukuhlolwa okuvamile ekuqaleni kokukhulelwa kunganquma uhlobo lwegazi lakho. Uma ungenayo i-Rh, odokotela bangakunikeza imithi yokuvimbela le nkinga.

Lesi simo sibizwa nangokuthi `(isifo se-hemolytic se-alloimmune sosana olusanda kuzalwa - i-HDN)` kanye `(isifo se-hemolytic se-fetus kanye nosana olusanda kuzalwa - i-HFDN)`. Kodwa uma sikhuluma ngaso, sizosebenzisa igama elithi `(i-Erythroblastosis Fetalis)`.

Yiziphi izimpawu uma umntwana enalesi simo?

Izingane ezizalwa nalesi simo (i-Erythroblastosis Fetalis) zingase zibonise izimpawu ze-anemia. Ezinye izingane zingase zibe naso kancane, kanti ezinye zingase zibe naso kakhulu. Futhi, ingane ingase ibe ne-jaundice zingakapheli amahora angu-24 izelwe. Nazi ezinye zezimpawu:

• Ukuphuzi kwamehlo nesikhumba.
• Ukuphaphatheka kwesikhumba ngokuzumayo .
• Ingane izizwa ikhathele kakhulu futhi ingenampilo (ikhathele).
• Inhliziyo ishaya ngokushesha (i-tachycardia).
• Ukuntuleka kwesifiso sobisi.

Kwezinye izimo ezinzima kakhulu, ingane esanda kuzalwa noma umntwana osanda kuzalwa angase abe nesimo esisongela ukuphila esibizwa ngokuthi "i-hydrops fetalis." Izimpawu zaso zifaka:

• Ukuvuvukala komzimba.
• Ukuqongelela koketshezi esiswini somntwana, noma phakathi kwezitho ezibalulekile njengenhliziyo namaphaphu.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Lesi simo, esibizwa ngokuthi "i-Erythroblastosis Fetalis", senzeka ngoba, njengoba kushiwo ngaphambili, amasosha omzimba wakho ahlasela amangqamuzana egazi abomvu engane.

Amangqamuzana ethu abomvu egazi anezimpawu ezikhethekile kuwo. Siwabiza ngokuthi "ama-antigen." Cabanga ngala "ma-antigen" njengamalebula anamagama kuwo. Uma isimiso sakho somzimba sokuzivikela siqaphela leli lebula, ngeke siwahlasele lawo maseli abomvu egazi.

Lokhu kungenxa yomehluko ezinhlotsheni zegazi lakho nezengane yakho. Izinhlobo zegazi zihlukaniswa ngokusekelwe kuma-"antigens" aphezu kwamaseli abomvu egazi. Kunezinhlobo ezimbili zegazi eziyinhloko esikhuluma ngazo:

• I-Rh factor: Lokhu kusho ukuthi igazi lihle (+) noma lihle (-).
• Ama-antigen e-ABO: Lokhu kusho uhlobo lwegazi lwe-A, B, AB, noma O.

Uma ukhulelwe, amasosha omzimba wakho, uma engawaqapheli ama-"antigens" emaseli egazi abomvu engane yakho, azoqala ukwenza "ama-antibodies" ngokumelene nawo. Lawa "ma-antibodies" yiwo ahlasela lawo maseli abomvu egazi. Njengalapho umzimba wethu uthola igciwane elibangela ukugula, umzimba wethu uyalwa nalo. Kodwa ukuze lokhu kwenzeke, igazi lomntwana kufanele lithintane negazi lakho. Esikhathini esiningi, lokhu kwenzeka lapho umntwana esezozalwa. Kodwa-ke, ngezinye izikhathi igazi lingaxubana nalo ngaphambi. Isibonelo:

• Uma kwenzeka ukukhipha isisu.
• Uma ukukhulelwa kuphumile phakathi nesikhathi sokukhulelwa, kubizwa ngokuthi "Ukuphuphuma Kwesisu".
• Esimweni esifana nokukhulelwa kwe-ectopic (ukukhulelwa kutholakala ngaphandle kwesibeletho, njengasepayipini le-fallopian).
• Lapho kwenziwa ``(Amniocentesis)`` (ukuhlolwa okwenziwa ngesikhathi sokukhulelwa).
• Uma wenza `(Chorionic villus sampling)` (okunye ukuhlolwa kokukhulelwa).

Uma umzimba wakho usukhiqize lawa ma-`(antibodies)`, uyawakhumbula. Uma amangqamuzana abomvu egazi lomntwana enawo lawo ma-`(antigen)` futhi ngesikhathi sokukhulelwa okulandelayo, lawa ma-`(antibodies)` azohamba abhubhise lawo maseli. Lokhu sikubiza ngokuthi ukubhujiswa kwamangqamuzana abomvu egazi `(hemolysis)`.

Imbangela eyinhloko: Ukungahambisani kwe-Rh

Imbangela enkulu neyaziwayo yalesi simo yilapho ungenayo i-Rh kanti ingane yakho ine-Rh-positive. Uma lokhu kwenzeka, amasosha omzimba wakho ahlasela amangqamuzana egazi abomvu engane yakho ane-Rh-positive. Ezweni elifana neMelika, cishe abantu abayi-15% banegazi le-Rh-negative. Ezimweni eziningi, umama nobaba, kanye nomntwana, bane-Rh-positive.

Ngokuvamile, lokhu kungahambisani kwe-Rh akubangeli izinkinga ezinkulu ngesikhathi sokukhulelwa kokuqala. Ngisho noma ungenayo i-Rh futhi ingane ine-Rh, akuvamile ukuthi igazi lakho lihlangane negazi lomntwana ngesikhathi sokukhulelwa ukuze kubangele ukusabela okubi (ama-antibodies). Kodwa-ke, uma umntwana esezelwe, igazi lakho lizosabela ngempela egazini lomntwana. Ngaleso sikhathi, uma ungazange uthathe umuthi wokuvimbela amasosha omzimba wakho ekuhlaseleni, umzimba wakho ungase wakhe ama-antibodies ngokumelene namaseli egazi abomvu ane-Rh.

Uma-ke ukhulelwa futhi, futhi lowo mntwana ene-Rh-positive blood type, lawo ma-antibodies enziwe ngaphambilini azohlasela amangqamuzana egazi abomvu alowo mntwana. Uyaqonda?

Okunye ukungalingani kwezinhlobo zegazi okungavamile

Ngezinye izikhathi, amasosha omzimba wakho angahlasela amangqamuzana abomvu egazi lomntwana wakho noma ngabe kukhona ukungafani ne-antigen yamaseli abomvu egazi engavamile. Lokhu kwenzeka uma ingane yakho inayo leyo antigen engavamile bese uyilahlekelwa yiyo. Lokhu kwenzeka uma uke wavezwa kuleyo antigen ngesikhathi sokukhulelwa kwangaphambilini noma ukumpontshelwa igazi futhi wakha amasosha omzimba kuyo. Amanye ala ma-antigen yilawa:

• `(Colton)`
• `(Duffy)`
• `(Diego)`
• `(Ee)`
• `(Gerbich)`
• `(H)`
• `(Kell)`
• `(Kidd)`
• `(AmaLuthela)`
• `(MNS)`
• `(P)`
• `(Xg)`

Ukuhlolwa kwegazi okwenziwa ekuqaleni kokukhulelwa kungabona ukuthi wenza ama-antibodies ngokumelene nalezi zinhlobo ezingavamile zamaseli abomvu egazi.

Sivame kangakanani lesi simo?

Emhlabeni jikelele, cishe izingane ezingu-276 kwezingu-100,000 ezizalwa ziphila kubikwa ukuthi zinezinkinga zokukhulelwa ezihlobene nokungalingani kwe-Rh egazini. Ngokusho kwabacwaningi, uma zingelashwa, kunethuba elingu-50% lokuthi umntwana ongakazalwa uzoshona noma abe nezinkinga ezinkulu zempilo.

Kodwa ungakhathazeki! Ngokuhlolwa kohlobo lwegazi kanye nemithi edingekayo, imiphumela emibi kakhulu ingavinjelwa. Kwezinye izingxenye zomhlaba lapho ukunakekelwa kokubeletha kutholakala khona, cishe izingane ezingu-2.5 kwezingu-100,000 ezizalwayo zinezinkinga ngenxa yokungalingani kwe-Rh. Lokhu kuyinkinga enkulu naseSri Lanka.

Ukuthola kanjani lokhu?

Ngokuvamile, emitholampilo yangaphambi kokubeletha, uhlobo lwegazi lakho kanye nanoma yimaphi "ama-antibodies" ayahlolwa. Uma ukhulelwe futhi une-Rh-negative blood type, udokotela wakho uzohlola "ama-antibodies" ngokumelene negazi le-Rh-positive. Uma ungenawo lawo "ma-antibodies", amasosha omzimba wakho azonikezwa umuthi wokuwavimba ukuthi angakheki.

Uma ukuhlolwa kuqinisekisa ukuthi unala ma-antibodies, kusho ukuthi uma ingane ine-Rh-positive, amasosha omzimba wakho asengozini yokuhlasela amangqamuzana egazi abomvu engane. Udokotela wakho uzohlola amazinga akho e-antibody njalo emavikini ambalwa. Uma amazinga akho e-antibody ephezulu ngendlela eyingozi, kungase kwenziwe ukuhlolwa okwengeziwe ukuze kubonakale ukuthi ingane yakho ine-anemia, futhi kungadingeka ukuthi umpontshelwe igazi esibelethweni. Uma ingane yakho isengozini yokuzalwa ine-anemia enzima, udokotela wakho angase anqume ukubeletha ingane kusenesikhathi.

Ngemva kokuzalwa komntwana, udokotela angakwazi ukuthola uhlobo lwegazi lomntwana. Lokhu kungasiza ekunqumeni ukuthi i-anemia yomntwana ibangelwa yini ukungahambelani kohlobo lwegazi.

Ezinye izivivinyo ezenziwe yilezi:

• Ukubalwa Kwegazi Okuphelele (i-CBC): Lokhu kuhlolwa kungahlola ukuthi amangqamuzana abomvu egazi lomntwana aphansi kangakanani. Uma izinga liphansi, kulapho i-anemia iba nzima khona.
• Ukuskena Kwegazi Okuseduze (i-PBS): Lokhu kuhilela ukuhlola isampula yegazi ngaphansi kwe-microscope. Lokhu kunganikeza umbono wokuthi ukwehla kungenxa yokubhujiswa kwamangqamuzana abomvu egazi ngaphambi kwesikhathi (i-hemolysis).
• Ukuhlolwa kwe-Bilirubin:Lokhu kulinganisa amazinga e-bilirubin. I-Bilirubin ingumkhiqizo obangelwa ukuwohloka kwamaseli abomvu egazi. Amazinga aphezulu e-bilirubin (i-hyperbilirubinemia) angase abonise ukuthi amaseli abomvu egazi ayabhujiswa.
• Ukuhlolwa Okuqondile Kwe-Antiglobulin (DAT): Lokhu kuhlolwa kukhombisa ukuthi ama-antibodies akhona yini ebusweni bamaseli abomvu egazi lomntwana. Lokhu kusho ukuthi amasosha omzimba kamama ahlasela amaseli omntwana.

Yiziphi izindlela zokwelapha?

Ukwelashwa kuncike ekutheni ukhulelwe noma usanda kubeletha umntwana.

Ukwelashwa ngesikhathi sokukhulelwa

Uma une-antibodies ezikubeka engozini ye-Erythroblastosis Fetalis, udokotela wakho uzoqapha amazinga akho e-antibody njalo emavikini ambalwa. Uma amazinga akho e-antibody ephezulu, kungadingeka ukuthi wenze ezinye izikena ze-ultrasound ukuze ubone ukuthi ingane yakho ayinayo yini i-anemia. Uma i-anemia inzima, ingane yakho ingadinga ukumpontshelwa igazi.

Ukwelashwa ngemva kokuzalwa komntwana

Odokotela belapha izinsana ezisanda kuzalwa ezine-"Erythroblastosis Fetalis" ngokwelapha i-anemia kanye ne-"hyperbilirubinemia" (i-jaundice). Izinketho zokwelapha yilezi:

• Ukwelashwa nge-Phototherapy: Lokhu kusebenzisa ukukhanya ukwelapha i-hyperbilirubinemia. Lokhu kukhanya kuguqula i-bilirubin ibe izinto ezikhishwa kalula emzimbeni wengane.
• Ukumpontshelwa igazi: Ngemva kokuzalwa kwengane, ingane ingadinga ukumpontshelwa igazi ukuqinisekisa ukuthi inamaseli abomvu egazi anele.
• Ama-Erythropoiesis Stimulating Agents (ESA): Lawa angaba yindlela yokwelapha i-anemia engenkulu ngokwanele ukuthi ingadinga ukumpontshelwa igazi. Kungadingeka ukuthi anikezwe kanye nezithasiselo zensimbi ukusiza ingane ukuthi yakhe amangqamuzana egazi abomvu aphilile.

Ezimweni ezimbi kakhulu, ingane ingadinga ukunakekelwa okusekelwayo, njengomshini wokuphefumula kanye noketshezi lwe-IV.

Kwenzekani enganeni ngemva kwalesi simo?

Imiphumela incike ekutheni izimpawu zomntwana wakho zimbi kangakanani. I-anemia enkulu kanye ne-hyperbilirubinemia kungaba yingozi uma ingelashwa.

Kodwa-ke, izingane ezine-Erythroblastosis Fetalis zingasinda kulesi simo uma zelashwa kahle. Zingadinga ukumpontshelwa igazi ukuze zigcwalise amangqamuzana azo abomvu egazi ngesikhathi sokukhulelwa kanye/noma ngemva kokuzalwa. Udokotela kuzodingeka aziqaphe izinyanga eziningana ukuze aqinisekise ukuthi azikho izinkinga.

Lokhu akunakuvinjelwa?

Kungenzeka ngempela! I-Erythroblastosis I-Fetalis ingavinjelwa kakhulu ngokuhlolwa kohlobo lwegazi kanye nemithi yokuvimbela ngesikhathi sokukhulelwa.Isimo. Uma ungenayo i-Rh-negative, ungathatha i-Rh immune globulin (i-Rh immune globulin - i-RhIg noma i-RhoGAM®) ukuvimbela umzimba wakho ekwenzeni ama-antibodies ngokumelene negazi le-Rh-positive. Udinga ukuthatha lo muthi emavikini angama-28 okukhulelwa, zingakapheli amahora angama-72 kusukela ekupheleni kokukhulelwa (ngemuva kokubeletha, ukuphuphuma kwesisu), futhi uma uphuma igazi eliningi ngesikhathi sokukhulelwa (ngisho nase-trimester yokuqala).

Lokhu kusebenza kuphela uma uthatha lo muthi ngaphambi kokuba igazi lakho livezwe egazini eline-Rh. Yingakho ubhekwa ikakhulukazi emitholampilo yokukhulelwa.

Izinto okufanele uzibuze udokotela wakho

Uma uneminye imibuzo mayelana nalokhu, ungesabi ukubuza udokotela wakho noma umhlengikazi. Nazi ezinye izibonelo:

• Luyini uhlobo lwegazi lami?
• Ingabe kukhona "ama-antibodies" okufanele ngikhathazeke ngawo?
• Ingabe kufanele ngikhathazeke ngokuthi `(i-Erythroblastosis Fetalis)`?
• Ingabe ngizodinga ukubhekwa okwengeziwe noma ukuvakashelwa njalo emtholampilo?
• Ingabe kuzodingeka ngithathe i-Rh immune globulin (RhIg)?
• Kufanele ngenze nini i-aphoyintimenti noma ngifune usizo oluphuthumayo?

Kwenzekani uma umama ene-Rh-positive kanti ingane ine-Rh-negative?

Lokhu akuvamile ukuba kube ukungavumelani kohlobo lwegazi okufanele kukhathazeke ngakho. Ingane engena-Rh ayinayo i-Rh-antigen engahlaselwa amasosha omzimba kamama. Ngaphandle kokuthi kukhona okunye ukungavumelani okungavamile kohlobo lwegazi, lokhu akufanele kube yinkinga.

Izinto ezibaluleke kakhulu okufanele uzikhumbule

Umbono wokuthi amasosha omzimba wakho angahlasela ingane yakho engakazalwa uyesabeka. Kodwa izindaba ezinhle ukuthi lokhu kungalingani kwegazi okuyingozi akuvamile. Futhi, odokotela benza konke okusemandleni abo ukuvimbela lezi zinkinga ukuthi zenzeke. Ukuhlolwa kohlobo lwegazi kuyingxenye ebalulekile yokunakekelwa kwangaphambi kokubeletha. Futhi, ukuqapha nokwelapha ukungalingani kohlobo lwegazi okungaba yingozi enganeni yakho kuyingxenye eqinisekisiwe yokunakekelwa kwangaphambi kokubeletha. Udokotela wakho uzoba nawe zonke izinyathelo zendlela ukuze akugcine wena nomntwana wakho niphephile. Ngakho-ke, ungesabi ngokungadingekile, futhi ulandele imiyalelo kadokotela ngokucophelela. Khona-ke wena nomntwana wakho ningahlala niphilile!

I- Erythroblastosis yengane esanda kuzalwa, ukungavumelani kwe-Rh, izinkinga zokukhulelwa, uhlobo lwegazi lomntwana, uhlobo lwegazi lomama, i-anemia, i-jaundice, i-RhoGAM