Ukukhulelwa yisikhathi esihle kakhulu nesinethemba empilweni yabo bonke omama. Kodwa-ke, kuyinto evamile ukuba nokwesaba nokungabaza ngempilo yengane esibelethweni kanye nempilo yakho. Isikhathi esiningi, sizwile ngezimo ezifana nesifo sikashukela sokukhulelwa kanye nomfutho wegazi ophezulu (pre-eclampsia). Kodwa namuhla sizokhuluma ngesimo esingavamile kodwa esibucayi esibaluleke kakhulu ukuqashelwa kusenesikhathi. Lokhu kubizwa ngokuthi i-HELLP Syndrome.
Iyini ngempela i-HELLP syndrome?
Kalula nje, i-HELLP syndrome iyinkinga enkulu engenzeka ngesikhathi sokukhulelwa, ikakhulukazi ethinta igazi nesibindi sakho. Ivame ukwenzeka ku-trimester yesithathu yokukhulelwa, phakathi kwamasonto angama-28 nama-40. Kodwa-ke, ngezinye izikhathi ingenzeka nganoma yisiphi isikhathi phakathi nengxenye yesibili yokukhulelwa (ngemuva kwesonto lama-20). Okumangazayo ukuthi abanye omama bangaba ne-HELLP syndrome ezinsukwini eziyisikhombisa ngemva kokubeletha.
Lesi yisimo esingavamile kakhulu. Ngokuvamile sithinta owesifazane oyedwa noma ababili kwabayi-1,000 abakhulelwe. Kodwa ukuthi asivamile akufanele kuthathwe kalula. Kungaba yingozi kumama kanye nengane.
Lisho ukuthini igama elithi HELLP?
Leli akulona igama nje kuphela. Izinhlamvu ezithi HELLP zimelela izici ezintathu eziyinhloko zalesi sifo. Ake sibheke ukuthi ziyini.
| Incwadi | Incazelo | Kuchazwe kalula |
|---|---|---|
| H | I-Hemolysis | Lokhu kusho ukuthi amangqamuzana akho abomvu egazi (amangqamuzana athwala umoya-mpilo esuka emaphashini aye emzimbeni wonke) aphuka ngokushesha kunokujwayelekile. Lokhu kungaholela ezimweni ezifana ne-anemia (inani eliphansi legazi). |
| EL | Ama-enzyme esibindi aphakanyisiwe | Isibindi singesinye sezitho ezibaluleke kakhulu emzimbeni wethu. Kulesi simo, isibindi siyalimala futhi ama-enzyme esiwakhipha egazini ayanda. Lokhu kuyisibonakaliso sokuthi isibindi singaphansi kokucindezeleka. |
| I-LP | Inani eliphansi lama-platelet | Ama-platelet ayizinhlayiya ezincane egazini lethu ezisiza ekuqhekekeni kwegazi. Yizo ezimisa ukopha uma silimala. Uma lezi ziphansi, kunengozi yokungakwazi ukumisa ukopha. |
Ngakho-ke, uyaqonda? I-HELLP yisimo esithinta izinhlelo ezintathu ezinkulu emzimbeni ngesikhathi esisodwa: amangqamuzana egazi, isibindi, kanye nenqubo yokujiya kwegazi.
Ingabe i-preeclampsia kanye ne-HELLP syndrome ziyafana?
Lena inkinga abantu abaningi abanayo. I-HELLP syndrome ivame ukubhekwa njengohlobo olubi kakhulu lomfutho wegazi ophezulu ngesikhathi sokukhulelwa, noma i-preeclampsia . I-Preeclampsia yisimo ngesikhathi sokukhulelwa lapho umfutho wegazi ukhuphuka khona bese kukhishwa amaprotheni emchameni.
Omama abaningi abane-HELLP syndrome nabo bane-pre-eclampsia. Kodwa-ke, ngezinye izikhathi umuntu one-pre-eclampsia akanayo i-HELLP syndrome. Futhi, cishe umuntu oyedwa kwabahlanu abane-HELLP akanazo izimpawu ezifana nomfutho wegazi ophezulu noma amaprotheni emchameni . Yingakho ngezinye izikhathi kungaba nzima ukuxilonga.
Ziyini izimpawu zalesi simo?
Izimpawu ze-HELLP syndrome ngezinye izikhathi zingafana nezokukhulelwa okuvamile noma ezinye izifo, ngakho-ke kubalulekile ukuqaphela lezi zimpawu.
- Ubuhlungu esiswini esingaphezulu kwesokudla: Lolu uphawu oluyisici se-HELLP syndrome. Ngokukhethekile, ubuhlungu obubukhali obuvela ohlangothini lwesokudla, ngaphansi nje kwezimbambo, lapho isibindi sitholakala khona.
- Ikhanda elibuhlungu kakhulu: Hhayi njengekhanda elibuhlungu elivamile, kodwa ikhanda elibuhlungu elingapheli ngisho nangemithi yobuhlungu.
- Ukubona okufiphele: Ukuzizwa sengathi amachashazi ayantanta phambi kwamehlo, ubunzima bokubheka ukukhanya.
- Isicanucanu nokuhlanza: Nakuba lokhu kuyinto evamile ekuqaleni kokukhulelwa, kufanele ukhathazeke ngesicanucanu esinzima nokuhlanza engxenyeni yokugcina yokukhulelwa.
- Ukukhathala nokukhathala: Ukukhathala okukhulu kuzwakala ngisho nangemva kokungenzi lutho.
- Ukuvuvukala komzimba (i-edema) kanye nokukhuluphala ngokuzumayo:Ukuvuvukala, ikakhulukazi kobuso, izandla, kanye nemilenze.
- Ubuhlungu lapho uphefumula kakhulu: Ungase uzwe ubuhlungu ohlangothini lwesokudla lwesifuba.
Ezimweni ezingavamile kakhulu, lezi zimpawu zingase zivele:
- Ukopha ekhaleni okunganqandeki.
- Ukudlikizela noma ukunyakaza komzimba okungalawuleki.
Ngenxa yokuthi lezi zimpawu ngezinye izikhathi zifana nezinye izimo ezifana ne-gastritis, amatshe enyongo, kanye ne-hepatitis, ngezinye izikhathi kungaba nzima ngodokotela ukuyixilonga ngokushesha. Ngakho-ke, uma unalezi zimpawu, kubaluleke kakhulu ukutshela udokotela wakho ngokushesha, kunokucabanga ukuthi kuyinto evamile.
Yini ebangela i-HELLP syndrome? Ingabe zikhona izinto eziyingozi?
Eqinisweni, odokotela abakayazi imbangela eqondile ye-HELLP syndrome. Yilokho okwesabisayo ngakho. Kodwa-ke, bathole izici eziningana ezandisa ingozi yokuthola lesi simo kwabanye besifazane.
- Ukuba ne-preeclampsia noma i-eclampsia: Owesifazane oyedwa kwabahlanu abakhulelwe abanalezi zimo angase abe ne-HELLP syndrome.
- Ukuba ne-HELLP syndrome ekukhulelweni kwangaphambilini: Uma ube nalesi simo nomntwana odlule, kunethuba elingama-20% lokuthi kwenzeke ekukhulelweni kwakho okulandelayo.
- Ukuba neminyaka engaphezu kwengu-35 ubudala.
- Njengoba ebeletha okungenani ingane eyodwa ngaphambilini.
- Ukuba nomlando wezifo ezingamahlalakhona njengesifo sezinso, isifo sikashukela, noma umfutho wegazi ophakeme.
Yiziphi izinkinga ezingabangelwa yilokhu?
Uma i-HELLP syndrome ingelashwa ngesikhathi, ingabangela izinkinga ezinkulu kakhulu kumama nomntwana.
Izinkinga ezingaba khona kumama
- Izinkinga zokopha nokujiya kwegazi: Abanye besifazane bangaba nesimo esibizwa ngokuthi `Disseminated Intravascular Coagulation (DIC).` Lokhu kusho ukuthi amahlule egazi akheka kuwo wonke umzimba futhi aqala ukopha ngokungalawuleki. Lokhu kungaholela ekuphumeni kwegazi ngokweqile ngemva kokubeletha (`Postpartum hemorrhage`).
- Ukwehluleka kwezinso: Izinso zingalimala futhi ziyeke ukusebenza.
- Ukopha okuvela esibindini noma ukwehluleka kwesibindi: Isibindi siyavuvukala, siqale ukopha ngaphakathi, futhi isibindi singalahlekelwa ukusebenza ngokuphelele.
- Ukuvuvukala kwamaphaphu: Lokhu kubangela ubunzima bokuphefumula.
- Ukuphazamiseka kwe-placenta: I-placenta iyahlukana nodonga lwesibeletho ngaphambi kokuba umntwana azalwe. Lokhu kuyingozi kakhulu ngoba kunciphisa umoya-mpilo kanye nokudla okunomsoco enganeni.
- I-Eclampsia: Lesi yisigaba esibi kakhulu se-pre-eclampsia. Sibangela ukuxhuzula.
Izinkinga ezingase zenzeke enganeni esibelethweni
- Ukuzalwa ngaphambi kwesikhathi: Njengoba ukwelashwa kwe-HELLP syndrome kuphela ukubeletha umntwana, kuvame ukudingeka ukubeletha umntwana ngesikhathi sokubeletha.
- Umkhawulo wokukhula kwesisu (IUGR): Ingane ayikhuli kahle esibelethweni.
- Ukuzalwa unenani eliphansi lama-platelet, i-anemia, noma ezinye izinkinga zegazi.
- Ukucindezeleka kokuphefumula.
Udokotela ukuxilonga kanjani lokhu?
Uma utshela udokotela wakho ukuthi unezimpawu ze-HELLP syndrome, uzokuhlola kuqala ngokomzimba. Ngokukhethekile,
- Ingabe kukhona ubuhlungu esiswini esingaphezulu kwesokudla?
- Ingabe imilenze yakho ivuvukele?
Ngemuva kwalokho kuzolinganiswa umfutho wegazi lakho, kuzokwenziwa ukuhlolwa komchamo ukuze kuhlolwe amaprotheni. Kuzokwenziwa ukuhlolwa kwegazi okuningana ukuqinisekisa lokhu.
- Inani eliphelele legazi (i-CBC) : Lihlola inani lamaseli abomvu egazi, amaseli amhlophe egazi, nama-platelet.
- Ukuhlolwa kokusebenza kwesibindi : Hlola amazinga e-enzyme yesibindi.
- Ukuhlolwa kokusebenza kwezinso : Kuhlola ukuthi izinso zisebenza kahle yini.
Uma isimo sibi kakhulu, kungenziwa i-ultrasound noma i-CT scan ukuze kuhlolwe ukuvuvukala noma ukopha esibindini.
Iphathwa kanjani i-HELLP syndrome?
Ukwelashwa okuwukuphela futhi okungcono kakhulu kokwelapha ngokuphelele i-HELLP syndrome ukubeletha umntwana .
Uma unezinsuku ezingu-34 ukhulelwe noma ngaphezulu, noma uma izimpawu zakho zinzima kakhulu, odokotela bangase batuse ukubeletha ingane yakho ngokushesha okukhulu. Lokhu kungabangela ukuthi ingane izalwe ngaphambi kwesikhathi. I-HELLP syndrome ivame ukuphela zingakapheli izinsuku ezimbalwa ingane izelwe.
Kodwa-ke, uma ukukhulelwa kungaphansi kwamasonto angu-34 futhi umama nomntwana bezinzile, odokotela bazozama ukuthenga isikhathi sokuba amaphaphu omntwana akhule kancane. Phakathi naleso sikhathi, uzogcinwa esibhedlela futhi unikezwe ukwelashwa okufana nalokhu:
- Imithi yokwehlisa umfutho wegazi.
- Ukumpontshelwa igazi uma inani lama-platelet liphansi.
- Ukunikeza i-magnesium sulfate ukuvimbela ukuquleka.
- Ukujova nge-corticosteroids ukusiza amaphaphu engane akhule ngokushesha.
- Ukuhlolwa kwegazi ukuze kuqashwe njalo ukusebenza kwesibindi sakho kanye namazinga e-platelet.
Phakathi nalesi sikhathi, odokotela bahlala beqapha impilo yengane ngokusebenzisa izivivinyo ezifana ne-'biophysical profile', 'nonstress test', kanye ne-'ultrasound'.
Lesi simo simthinta kanjani umama nomntwana?
I-HELLP syndrome iyisifo esibi kakhulu, kodwa ingelapheka uma itholakale kusenesikhathi futhi yelashwa kahle . Uma ingelashwa, ingaba yingozi empilweni.
Ngokombono kamama, ingozi yokufa ingaphansi kuka-1% uma kutholwa ukwelashwa okufanele. Iningi lomama liyalulama ngokuphelele ezinsukwini ezimbalwa ngemva kokubeletha.
Ngokombono womntwana, ukusinda kuncike kakhulu eminyakeni yokukhulelwa lapho ezalwa. Uma umntwana ehlala isikhathi eside esibelethweni, kulapho impilo yakhe izoba ngcono khona. Ukubeletha ngaphambi kwesikhathi kungabangela izinkinga ezifana nobunzima bokuphefumula, izinkinga zokubona, noma ukubambezeleka kokukhula.
Ingabe i-HELLP syndrome ingavinjelwa?
Ngeshwa, ayikho indlela eqinisekile yokuvimbela i-HELLP syndrome. Kodwa-ke, into engcono kakhulu ongayenza ukunciphisa ingozi yakho yezinkinga ngesikhathi sokukhulelwa ukuya ekunakekelweni okuvamile kokubeletha . Udokotela wakho uzobe eqapha umfutho wegazi lakho nezinye izimpawu, ukuze noma yiziphi izinkinga zitholakale kusenesikhathi.
Uma udokotela wakho ethola ukuthi usengozini enkulu yokuthola lesi simo, angase akuncome ukuthi uthathe i-aspirin ephansi ngemva kwe-trimester yokuqala (cishe amasonto ayi-12).
Ngaphezu kwalokho, lezi zinto zizokusiza ukuthi ukhulelwe kahle:
- Ukudla ukudla okunomsoco (okusanhlamvu, amaprotheni angenamafutha, izithelo nemifino).
- Ukuzivocavoca njalo.
- Lala kahle okungenani amahora angu-8 nsuku zonke.
- Ukukhuluma nodokotela wakho ngezingozi ezingaba khona empilweni ngesikhathi sokukhulelwa.
Kufanele ngimbone nini udokotela?
Uma une-preeclampsia noma umfutho wegazi ophakeme, qaphela kakhulu izimpawu ze-HELLP syndrome. Uma unezinye zezimpawu ezilandelayo, shayela udokotela wakho ngokushesha.
- Ubuhlungu besisu ohlangothini lwesokudla.
- Isicanucanu nokuhlanza.
- Ikhanda elibuhlungu noma umbono ofiphele.
Uma uhlangabezana nezimpawu ezinzima njengokopha kakhulu noma ukuquleka, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha . Kungaba yisinqumo sokuphila noma ukufa.
I-HELLP syndrome iyisimo esesabekayo. Kodwa khumbula, ithimba lakho lezokwelapha lenza konke okusemandleni alo ukugcina wena nomntwana wakho niphephile. Ukutholwa kusenesikhathi kubalulekile.
Umlayezo Wokuya Nawe Ekhaya
- I-HELLP syndrome iyisimo esingavamile kodwa esibi kakhulu esingaba khona ngesikhathi sokukhulelwa.
- Izimpawu eziyinhloko zifaka phakathi ubuhlungu esiswini esingaphezulu kwesokudla, ikhanda elibuhlungu kakhulu, isicanucanu, nokuhlanza. Ungakushayi indiva lokhu njengokungakhululeki okuvamile kokukhulelwa.
- Ukuphela kokwelashwa okuhlala njalo kwalesi simo ukubeletha umntwana, okungaholela ekuzalweni ngaphambi kwesikhathi.
- Ngokuya emitholampilo efanele yokukhulelwa, ikhono lokubona izimo ezinjalo kusenesikhathi liyakhula.
- Uma unezinye zezimpawu ezishiwo kulesi sihloko, yazisa udokotela wakho ngokushesha. Uma izimpawu zinzima, iya ekamelweni lezimo eziphuthumayo (ETU) ngokushesha.
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