Ingabe nawe wopha kakhulu ngemva kokubeletha? Ake sixoxe nge-Postpartum Hemorrhage (PPH)

Kujwayelekile ukopha kancane ngemva kokubeletha. Kodwa kuthiwani uma wopha kakhulu kunalokho obukucabanga? Kungaba yinto eyesabekayo futhi eyingozi ngempela. Lokhu yilokho esikubiza ngokuthi i-postpartum hemorrhage (PPH) . Lokhu akulona ihlaya, kuyisimo esidinga ukunakekelwa kwezokwelapha ngokushesha.

Kuyini ukopha ngemva kokubeletha (PPH)? Ake siqonde kahle?

Kalula nje, ukuphuma kwegazi ngemva kokubeletha (PPH) ukopha okukhulu ngemva kokubeletha. Lokhu kuvame ukwenzeka zingakapheli amahora angama-24 kusukela ekubelethweni. Sikubiza ngokuthi 'i-PPH Eyinhloko' . Kodwa ngezinye izikhathi, ukopha kungenzeka ezinsukwini ezimbalwa, amasonto ambalwa, noma ngisho namasonto ayi-12 ngemva kokubeletha. Lokhu kubizwa ngokuthi 'i-PPH Yesibili noma Ephuzile' .

Okwenzekayo kulokhu ukuthi igazi eliningi lilahleka emzimbeni wakho ngesikhathi esisodwa. Uma lokhu kwenzeka, umfutho wegazi lakho ungehla ngokuzumayo. Kwenzekani-ke? Inani legazi eliya enhliziyweni, ebuchosheni, nakwezinye izitho ezibalulekile liyancipha. Lokhu kubizwa ngokuthi ukushaqeka kwe-hypovolemic . Lokhu kungaba yingozi empilweni. Ngakho-ke, odokotela nabahlengikazi kudingeka bayeke lokhu kuphuma kwegazi ngokushesha.

Khumbula, uma uzizwa sengathi wopha kakhulu ngemva kokubeletha umntwana, kuyesabeka. Kodwa into ebaluleke kakhulu ukungesabi, futhi utshele udokotela wakho noma umbelethisi wakho ngokushesha. Uma uqashelwa kusenesikhathi futhi welashwa ngokushesha, ungavame ukululama ngokuphelele.

Ingakanani igazi elibangelwa yi-PPH?

Ngokuvamile,

• Kungakhathaliseki ukuthi ubeletha ngesitho sangasese sowesifazane noma uhlinzwe ngokuhlinzwa, uma ulahlekelwa igazi elingaphezu kwelitha elilodwa (1000ml) ,
• Noma, uma kukhona ushintsho olukhulu ekushayeni kwenhliziyo yakho kanye nomfutho wegazi kanye nenani legazi elilahlekile, futhi ubonisa izimpawu zokulahlekelwa igazi eliningi, kubhekwa njenge-PPH.

Lesi simo singavela phakathi kokuzalwa okungu-1 no-5 kwabangu-100. Lokho kuphakathi kuka-1% no-5%. Kodwa ngokwelashwa okusheshayo, isikhathi esiningi akusongeli impilo.

Ngingazi kanjani ukuthi ngine-PPH? Ziyini izimpawu?

Uphawu oluyinhloko lwe-PPH ukopha okungapheli, okunamandla esithweni sangasese sowesifazane ngemva kokubeletha. Ngezinye izikhathi , amahlule egazi amakhulu kunebhola legalofu angadlula. Uma lokhu kwenzeka, kungaba uphawu lwenkinga.

Ezinye izimpawu yilezi:

• Izimpawu zomfutho wegazi ophansi: isiyezi, ukubona okufiphele, kanye nokuquleka.
• Ukwanda kwesilinganiso senhliziyo (i-Tachycardia).
• Ukwehla kwenani lamaseli abomvu egazi (ukwehla kwamazinga e-hematocrit).
• Isikhumba esikhanyayo noma esithambile, uzizwa sengathi ujuluka kakhulu.
• Ubuhlungu nokuvuvukala endaweni yesitho sangasese sowesifazane noma endaweni ye-perineal.(Lokhu kwenzeka lapho igazi liqongelela ngaphandle komthambo)

Uma uhlangabezana nanoma yiziphi zalezi zimpawu ezingavamile ngemva kokubeletha, tshela umhlinzeki wakho wezempilo ngokushesha . Ngezinye izikhathi, izimpawu ze-PPH zingaqhubeka ngisho nangemva kokuba usubuyile ekhaya uvela esibhedlela. Uma lokhu kwenzeka, ungesabi futhi ubone udokotela wakho ngokushesha.

Kungani i-PPH yenzeka? Ziyini izimbangela?

Kunezimbangela eziningana ze-PPH.

Uyazi, uma ingane yakho isesibelethweni, i-placenta inamathela odongeni lwesibeletho sakho futhi inikeze ingane ukudla nomoya-mpilo. Ngemva kokuzalwa kwengane yakho, isibeletho sakho siyaqhubeka nokufinyela futhi sikhiphe i-placenta. Lokhu kufinyela kubangela ukuthi imithambo yegazi lapho i-placenta yayinamathele khona iqine futhi iyeke ukuphuma kwegazi. Kodwa ngezinye izikhathi, uma lokhu kufinyela kungaqinile ngokwanele , ukuphuma kwegazi ngeke kume. Lesi yimbangela ye-80% ye-PPH.

Futhi, i-PPH ingenzeka uma izingxenye ze-placenta zihlala odongeni lwesibeletho, noma uma izitho zohlelo lwakho lokuzala (isitho sangasese sowesifazane, umlomo wesibeletho, isibeletho) zonakele ngesikhathi sokubeletha.

I-PPH ivame ukwenzeka phakathi kwemizuzu engama-30 nengama-60 ngemva kokuzalwa komntwana.

"Ama-T amane" athinta i-PPH

Kunezimbangela ezine eziyinhloko ze-PPH, ezibizwa ngokuthi "ama-T amane".

1. Ithoni (isimo sesibeletho - I-Uterine Atony): Lena imbangela evame kakhulu . I-Uterine Atony yilapho isibeletho singanciphi kahle ngemva kokubeletha, kodwa siba buthakathaka futhi sithambe. Ngemuva kwalokho imithambo yegazi lapho i-placenta yayikhona ayiqini, bese ukuphuma kwegazi kuyaqhubeka.

2. Ukulimala: Ngesikhathi sokubeletha, ukopha kungenzeka ngenxa yokulimala kwesitho sangasese sowesifazane, umlomo wesibeletho, isibeletho, noma i-perineum. Ngezinye izikhathi leli gazi lingahlangana ngaphakathi kwezicubu ezilimele futhi liqhubeke nokopha amahora noma izinsuku ngemva kokubeletha.

3. Izicubu (Izicubu ze-placenta ezigciniwe): Uma i-placenta ingahlukani ngokuphelele nodonga lwesibeletho, izicubu ezisele zingabangela ukopha. Lokhu kungaba ngenxa yokungajwayelekile kwe-placenta, noma kungaba yi-placenta evamile.

4. I-Thrombin (izinkinga zokujiya kwegazi): Uma unesifo sokujiya kwegazi, noma uma unesifo esithinte ukujiya kwegazi ngesikhathi sokukhulelwa, ngisho nokopha okuncane kungaba yinkinga enkulu.

Ubani osengozini enkulu yokuthola i-PPH?

Eqinisweni, i-PPH ingenzeka kunoma ubani othola umntwana. Nakuba kunezici eziningi eziyingozi ze-PPH, cishe u-40% wamacala e-PPH ayenzeka ngaphandle kwezizathu eziyingozi . Ngakho-ke, odokotela bangase bangakwazi ukuvimbela ngokuphelele i-PPH. Kodwa-ke, ukwazi ukuthi ziyini lezi zinto eziyingozi ngaphambi kokubeletha kungasiza ekunciphiseni ingozi yokopha kakhulu.

Izimo ze-placenta

Ingozi ye-PPH iphakeme uma unezinye zezimo ezilandelayo ezihlobene ne-placenta:

• (I-Placenta previa)(I-Placenta itholakala ngaphansi kwesibeletho)
• (Ukuphazamiseka kwe-placenta )
• (I-Placenta accreta) (I-Placenta inamathele ngokuqinile odongeni lwesibeletho)

Izimo ezihlobene nokubeletha noma ukubeletha

Ingozi ye-PPH inganda uma kwenzeka izinto ezilandelayo ngesikhathi sokubeletha:

• Uma kunikezwe i-anesthesia ejwayelekile .
• Uma unikezwe imithi (i-tocolytics) yokuvimba ukuminyana kwesibeletho.
• Uma ubuhlungu buqhubeka isikhathi eside noma umuthi osetshenziselwa ukubangela ukufinyela kwesibeletho (i-Oxytocin / Pitocin®) unikezwa omningi kakhulu isikhathi eside kakhulu.
• Ukubeletha umntwana kusenesikhathi (ngaphansi kwamahora amathathu ngemuva kokuqala kokubeletha).
• Uma kusetshenziswe i-forceps noma i- vacuum ngesikhathi sokulethwa okuvamile.
• Uma kukhona imihuzuko emikhulu esithweni sangasese sowesifazane.
• Uma umntwana ebelethwe ngokuhlinzwa .

Ezinye izimo zempilo

Ezinye izimo zezempilo nazo zingandisa ingozi ye-PPH, njenge:

• Izifo zokujiya kwegazi, isibonelo (isifo sika-von Willebrand) .
• Uma uke wathatha umuthi (i-Magnesium sulfate) ukwelapha i-preeclampsia enzima.
• Izimo zokukhulelwa ezithinta izici zokujiya kwegazi noma ama-platelet, isibonelo: (i-HELLP syndrome) , (i-gestational thrombocytopenia) .
• Ukutheleleka kwe-amniotic sac (i-Chorioamnionitis) .
• Ukukhuluphala ngokweqile.
• Ubudala obuphezulu bomama.

Futhi, ingozi ye-PPH iphakeme uma isibeletho sivuvukele kakhulu . Lokhu kungenzeka:

• Uma uke wabeletha izingane ezinhlanu noma ngaphezulu ngaphambilini.
• Ekuzalweni okuhlukahlukene, njengamawele namawele amathathu.
• Uma unengane enkulu (i-macrosomia) .
• Uma kukhona uketshezi oluningi kakhulu lwe-amniotic (polyhydramnios) .

Yimiphi imiphumela emibi engaba khona ye-PPH?

Uma ulahlekelwa igazi eliningi kakhulu, ungase ubhekane nezinto ezifana nokushaya kwenhliziyo okukhuphukile, ukuphefumula okukhuphukile, kanye nokwehla kokujikeleza kwegazi. Lezi zimpawu zinganciphisa inani legazi eligeleza ezithweni ezifana nesibindi, ubuchopho, inhliziyo, nezinso, okuholela ekushaqekeni . Ukushaqeka kwenzeka lapho izitho zingatholi igazi elanele. Lokhu kungaholela ekuhlulekeni kwezitho noma ngisho nasekufeni.

Ungayibona kanjani i-PPH ngemva kokuhlinzwa (ukuhlinzwa kwe-C-section)?

Ezimweni eziningi, izimpawu ze-PPH ngemva kokuhlinzwa kwe-C-section ziyafana nezangesikhathi sokubeletha okuvamile. Ezinye zezimpawu zifaka:

• Ukwanda kwesilinganiso senhliziyo.
• Izandla nezinyawo ezibandayo, uzizwa umanzi.
• Ubunzima bokuphefumula.
• Ukuvuvukala, ukuphuka, noma ubuhlungu kwenye indawo esiswini, ikakhulukazi endaweni lapho kuhlinzwe khona inxeba.
• Ukopha kakhulu kwesitho sangasese sowesifazane kanye nokuphuma kwamahlule amakhulu egazi.

Odokotela bayixilonga kanjani i-PPH?

Odokotela baxilonga i-PPH ngokuhlolwa kwamehlo nangokomzimba. Ukuhlolwa kwelebhu kanye nokubuyekezwa ngokucophelela komlando wempilo yakho nakho kubalulekile ukuhlola ubungozi kanye nomthelela we-PPH.

I-PPH ihlolwa kakhulu ngenani legazi olilahlile. Inani legazi elilahlekile livame ukulinganiselwa ngokubala noma ukukala ama-pad noma iziponji ezazimanziswe ngegazi lapho umntwana ezalwa.

Uma usola i-PPH, ungasebenzisa lezi zinto ukuze uzihlole ngokwengeziwe:

• Qhubeka nokuqapha izinga lokushaya kwenhliziyo yakho kanye nomfutho wegazi .
• Ukuhlolwa kwegazi okulinganisa inani lamaseli abomvu egazini (i-hematocrit) kanye nezinto ezibangela ukujiya kwegazi.
• Ukuhlolwa kwesinqe okuhlola isitho sangasese sowesifazane, umlomo wesibeletho kanye nesibeletho.
• I-ultrasound scan ithatha isithombe esiningiliziwe sesibeletho.

Iphathwa kanjani i-PPH?

Odokotela bavame ukuphatha i-PPH njengesimo esiphuthumayo. Umgomo oyinhloko wokwelashwa ukuvimba ukopha ngokushesha okukhulu.

Kuye ngokuthi imbangela yokopha kwakho ingakanani kanye nobukhulu bokopha, udokotela wakho angase ancome okukodwa noma ngaphezulu kwalokhu kwelashwa:

• Ukuhlikihla kwesibeletho ukuze kufinyezwe imisipha yesibeletho.
• Ukunikeza imithi evuselela ukufinyela kwesibeletho.
• Ukususa izicubu ze-placenta ezigciniwe, kungaba ngesandla noma ngenye indlela.
• Ukulungisa ukudabuka esithweni sangasese sowesifazane, emlonyeni wesibeletho kanye nasesibelethweni.
• Ukufaka idivayisi, njenge -catheter noma ibhaluni, ukuze kucindezelwe odongeni lwesibeletho futhi kumiswe ukopha.
• Izinqubo ezivimba ukugeleza kwegazi esibelethweni.
• Udinga ukumpontshelwa igazi .
• Ukunikeza uketshezi ngomthambo (ongena emthanjeni - uketshezi lwe-IV) , okusho izinto ezifana nosawoti.
• Ukunikeza umoya-mpilo owengeziwe ngemaski.
• Ukunikeza imithi yokwengeza insimbi .

Akuvamile kakhulu, noma uma ezinye izindlela zingaphumeleli, udokotela angenza i-laparotomy (ukuhlinzwa kokuvula isisu nokuthola umthombo wokopha) noma i- hysterectomy (ukususwa kwesibeletho).

Kuthatha isikhathi esingakanani ukululama kulesi simo se-PPH?

Isikhathi sokululama siyahlukahluka kuye ngomuntu nomuntu. Kuncike ekutheni ulahlekelwe yigazi elingakanani nokuthi odokotela bakho bakuphathe kanjani. Kubalulekile ukuzinakekela kahle ezinsukwini ezimbalwa zokuqala ngemva kokuzalwa komntwana wakho - yidla kahle, uphuze amanzi amaningi, futhi uthole ukuphumula ngangokunokwenzeka . Udokotela wakho angase futhi ancome ukuthatha izithasiselo zensimbi ukuze welaphe i-anemia.

Ingabe i-PPH ingavinjelwa? Ngingaba nomntwana futhi?

Indlela engcono kakhulu yodokotela yokuvimbela i-PPH ukuhlonza labo abasengozini enkulu ye-PPH ngaphambi kokubeletha. Ungasiza ngokwabelana ngomlando wakho wezokwelapha ogcwele nodokotela wakho futhi ubazise nganoma yiziphi izimpawu ze-PPH ngemva kokuthola umntwana wakho.

Ngokuvamile kuphephile ukuba nomntwana omunye. Kodwa-ke, khuluma nodokotela wakho ngengozi yakho ye-PPH ekuzalweni kwakho okulandelayo. Ngisho noma ingozi yakho iphakeme kancane kunejwayelekile, kungenzeka ukuthi iphansi. Udokotela wakho angabheka izici zakho eziyingozi futhi anqume ukuthi udinga ukuthatha noma yiziphi izinyathelo zokuphepha ezikhethekile ekuzalweni kwakho okulandelayo.

Uzinakekela kanjani ngemva kokuthola i-PPH?

Kungaba nzima ukuzinakekela ngenkathi unakekela usana lwakho olusanda kuzalwa. Kodwa, uma uzinika isikhathi sokuphumula futhi uzinakekela kahle, uzokwazi ukululama ngokushesha. Inhlalakahle yakho ibaluleke kakhulu.

Nazi ezinye izinto ezingakusiza:

• Ukuphumula: Umzimba wakho udinga isikhathi sokululama. Ungesabi ukucela usizo, futhi uthole ukuphumula okudingayo.
• Yidla ukudla okunomsoco: Ukudla okune-iron eningi njengenyama ebomvu, imifino eluhlaza, kanye nokudla kwasekuseni okunongiwe kusiza ekwakheni amangqamuzana abomvu egazi. Ukudla okunomsoco kungakusiza ukuthi ululame.
• Phuza amanzi: Phuza amanzi amaningi ngemva kokubeletha ukuze uvimbele ukuphelelwa amanzi emzimbeni.
• Landela imiyalelo kadokotela wakho: Udokotela wakho angase akunike imithi noma izinguquko zendlela yokuphila ukuze akusize ululame. Landela leyo miyalelo ngokucophelela.
• Qaphela inani lokopha: Gqoka i-sanitary pad. Qaphela ukuthi kuthatha isikhathi esingakanani ukuthi igcwale. Ukopha kufanele kwehle kancane kancane emavikini ambalwa. Uma kungenjalo, bona udokotela wakho.

Ukopha kakhulu kungaba yinto ebuhlungu kakhulu. Kuvamile ukuthatha isikhathi ukuze ululame ngokomzwelo ngenxa yokuhlangenwe nakho kwakho kokubeletha. Ungase udinge ukwesekwa ngumndeni wakho, abangane, odokotela, noma abanye. Khuluma ngendlela ozizwa ngayo, futhi ucele usizo uma uludinga.

Kufanele ubonane nini nodokotela?

Ngokuvamile, i-PPH yenzeka ngemva kokubeletha noma ngenkathi usesibhedlela. Kodwa-ke, uma wopha kakhulu ngemva kokufika ekhaya noma uma uba nanoma yiziphi izimpawu ze-PPH, bona udokotela wakho ngokushesha . Uma ihhovisi likadokotela wakho livaliwe noma ungakwazi ukufinyelela kubo, iya ekamelweni lezimo eziphuthumayo esibhedlela esiseduze nawe.

Uma uzwa ukopha okukhulu ngemva kokubeletha, bona udokotela ngokushesha. Ezinye izimpawu ze-PPH zifaka phakathi isiyezi, ukuquleka, kanye nobunzima bokuphefumula. I-PPH yisimo esibi esidinga ukunakekelwa kwezokwelapha ngokushesha.

Uma wena noma othandekayo wakho ene-PPH, kuyinto evamile ukuzizwa ushaqekile futhi wesaba ngalokho okwenzekile. Kodwa khumbula, ukutholakala kusenesikhathi kanye nokwelashwa okusheshayo kungavimbela izinkinga ezinkulu. Yingakho kubalulekile ukuvuleleka nokwethembeka kudokotela wakho mayelana nomlando wakho wezokwelapha. Lokhu kuzokusiza ukuthi unqume ukuthi usengozini yini ye-PPH.

Umyalezo Wokugcina Wokuya Nasekhaya

• I-PPH (Postpartum Hemorrhage) yisimo esibi esidinga ukunakekelwa kwezokwelapha okusheshayo, esibonakala ngokopha ngokweqile ngemva kokubeletha.
• Uma uhlangabezana nezimpawu ezifana nokopha ngokweqile, ukuphuma amahlule amakhulu egazi, isiyezi, ukuquleka, noma ukushaya kwenhliziyo okwandayo , funa iseluleko sikadokotela ngokushesha .
• Imbangela eyinhloko ye-PPH ukuvaleka kwesibeletho, okuwukungakwazi kwesibeletho ukuncipha kahle. Ezinye izimbangela zifaka phakathi ukulimala, i-placenta egciniwe, kanye nezinkinga zokujiya kwegazi.
• Nakuba kunezinye izinto eziyingozi, i-PPH ingenzeka kunoma ubani .
• Uma kutholakala kusenesikhathi futhi kwelashwa ngokushesha, ngokuvamile kungalapheka ngokuphelele.
• Ukuhlangenwe nakho kwe-PPH kungaba yinto ekhathazayo ngokomzwelo. Ungangabazi ukuthola ukwesekwa okudingayo.

Ukunakekela impilo yakho kubaluleke kakhulu, ikakhulukazi ngezikhathi ezinjengalezi. Awuwedwa, cela usizo.

Ukopha ngemva kokubeletha, i-PPH, ukubeletha, ukopha, isibeletho, i-placenta, impilo yabesifazane