Ingabe kufanele sazi ngokuqhekeka kwesikhwama samanzi ngaphambi kokuba umntwana azalwe? (Ukuqhekeka Kwama-Membranes Ngaphambi Kwesikhathi - I-PROM)

Kuvamile ukuzizwa ukhathazekile ngezinto uma ukhulelwe, akunjalo? Cishe uke wezwa "ngokuphazamiseka kwakho kwamanzi," ikakhulukazi njengoba usondela osukwini lwakho lokuzalwa. Ngezinye izikhathi, kungaba yinto eyesabekayo ukucabanga ngokuthi kuzokwenzekani uma lokhu kwenzeka ngaphambi kosuku lwakho lokuzalwa. Ungakhathazeki, sizoxoxa ngalokhu ngokuningiliziwe nangokulula.

Kuyini ukuqhekeka kwangaphambi kwesikhathi kwama-membrane (i-PROM)?

Kalula nje, 'Ukuqhuma Kwama-Membranes Ngaphambi Kwesikhathi' noma 'i-PROM' ' ukubeletha' kwengane yakho, okusho ukuthi 'isikhwama sakho samanzi' noma 'isikhwama se-amniotic' siyaphuka ngaphambi kokuqala kokubeletha. Abanye odokotela babiza lokhu ngokuthi 'ukuqhuma kwama-membranes ngaphambi kokubeletha'. Lokhu kusho ukuthi 'ama-membrane' noma ama-membrane ayaphuka ngaphambi 'kokubeletha'.

Manje bheka, lesi sikhwama se-amniotic sifana nesikhwama esigcwele uketshezi. Lolu ketshezi yilokho esikubiza ngokuthi i-'amniotic fluid' . Yilokhu okuzungezile nokuvikela ingane yakho phakathi nokukhulelwa. Kufana nomqamelo omncane wokuphepha wengane. Lolu ketshezi lwe-'amniotic' luvikela ingane emagciwaneni, luvikela ingane ekutholeni imihuzuko nokulimala lapho ihambahamba, futhi lusiza nemisipha namathambo engane ukukhula.

Uma sithi “amanzi akho ayaphuka” noma “amanzi akho ayaphuka,” kungenxa yokuthi la ma-membrane ayaphuka. Lapho la ma-membrane ephuka, uketshezi lwe-amniotic oluzungeze ingane yakho luqala ukuvuza esithweni sakho sangasese, kungaba kancane noma ngokuzumayo. Lokhu kungaba yinkinga. Ngoba lapho uketshezi lwe-amniotic seluhambile, wena nomntwana wakho nisengozini enkulu yokutheleleka kanye nezinye izinkinga, njengokuzalwa ngaphambi kwesikhathi .

Ngakho-ke, uma ucabanga ukuthi ulwelwesi lwakho luqhumile, kufanele wazise ngokushesha udokotela wakho wezifo zabesifazane noma isisebenzi sezempilo somndeni wakho.

Kuyini i-Preterm PROM (PPROM)?

Manje ake sixoxe nge -'Preterm PROM' noma i-'PPROM' . Yilapho i-'amniotic sac' yakho iqhuma khona ngaphambi kwamasonto angu-37 okukhulelwa. Cabanga nje, ukukhulelwa kwakho kungaphansi kwamasonto angu-37, kodwa amanzi akho ayaqhuma. Kuleli qophelo, udokotela wakho uzonquma ukuthi 'uzobeletha' umntwana ngokushesha, noma abambezele 'ukubeletha' izinsuku ezimbalwa ezengeziwe.

Lesi yisinqumo esiyinkimbinkimbi kancane. Ngoba, ukwelula isikhathi sokukhulelwa ngemva kokuphuma kwamanzi kwandisa ingozi yokutheleleka kanye nezinye izinkinga. Kodwa, ngakolunye uhlangothi, kunezinye izingozi zokubeletha umntwana kusenesikhathi, okungukuthi, ngaphambi kwesikhathi. Ngakho udokotela kumele ahlole zombili lezi zingozi ngokucophelela ngaphambi kokwenza isinqumo esingcono kakhulu.

Yini engenzeka uma isikhwama samanzi siphuka kanje?

Uma isikhwama samanzi siphuka ngokushesha kakhulu, umntwana usengozini yokuzalwa ngaphambi kwesikhathi futhiKukhona ingozi yokutheleleka. Uma ukukhulelwa kwakho kuqediwe emavikini angu-37, izinkinga zokuzalwa ngaphambi kwesikhathi azivamile. Kodwa-ke, uma umntwana ezalwa ngaphambi kwamasonto angu-37, kuzodingeka abhekane nezinkinga zokuzalwa ngaphambi kwesikhathi.

Izibonelo zalokhu yilezi:

• Izinkinga zokuphefumula .
• Ubunzima bokugcina izinga lokushisa lomzimba .
• Lokhu kungashintsha ngisho nendawo yengane esibelethweni , okungathinta ukubeletha.

Ngaphezu kwalokho, uma uketshezi lwe-amniotic kanye nesikhwama se-amniotic kushiywe kungavikelekile, umntwana kanye nesibeletho sakho basengozini enkulu yokuthola izifo . Lezi zifo ngezinye izikhathi zingaba yingozi.

Sivame kangakanani lesi simo?

Isimo esibizwa ngokuthi 'i-PROM' senzeka cishe ku -10% wokukhulelwa. Uma 'i-PROM' isenzeka ngesikhathi sokubeletha (emasontweni angu-37), u-95% wesikhathi umntwana ezalwa zingakapheli amahora angu-28.

I-PPROM iyisimo esingavamile, esenzeka cishe ku- 3% wokukhulelwa. Izifundo zikhombisile ukuthi i-PPROM ingenzeka kakhulu ekukhulelweni okune -multiples .

Kungani lokhu kwenzeka? Yiziphi izimbangela eziyinhloko ze-'PROM' kanye ne-'PPROM'?

Izimbangela ze-'PROM' kanye ne-'PPROM' zingase zihluke.

• Uma amanzi akho ephuka ngesikhathi esifanele, okungukuthi, ngemva kwamasonto angu-37 , isizathu esiyinhloko ukuthi ulwelwesi lwakho lwe-amniotic luya ngokuya luba buthaka ngenxa yokucindezela kokuncipha ngesikhathi sokubeletha. Kuvamile ukuthi ulwelwesi luqhekeke ngokuzenzakalelayo, kodwa kuvame ukwenzeka ngemva kokuqala kokubeletha.

Into ebalulekile ukuthi noma ungazizwa ukufinyela, umzimba wakho ungase ulungiselele ukubeletha. Lokhu kusho ukuthi ngaphandle kokuqaphela, isibeletho sakho singase sifinyele, umlomo wesibeletho sakho ungase unciphe (uphume), kanti umlomo wesibeletho sakho ungase uvuleke (uvuleke). Lokhu kungabangela ukuba isikhwama se-amniotic sibe buthaka futhi ekugcineni siqhume.

• I-PROM yangaphambi kwesikhathi (PPROM) ivame ukubangelwa yisimo sezokwelapha noma izinkinga ngesikhathi sokukhulelwa , kodwa ngezinye izikhathi kungenzeka ngaphandle kwesizathu esicacile.

Ezinye zezizathu eziyinhloko yilezi:

• Ukopha kwesitho sangasese sowesifazane .
• Izimo zokuzalwa esibelethweni sakho (njenge- Ehlers-Danlos syndrome ).
• Ukungasebenzi kahle komlomo wesibeletho.

Ziyini izimpawu zalokhu? Ukubona kanjani?

Isibonakaliso esisobala kakhulu sokuthi ulwelwesi lwakho luyaphuka ukuthi uzizwa sengathi uvuza uketshezi oluningi ngokuzumayo esithweni sakho sangasese sowesifazane. Kodwa akuhlali kuzwakala sengathi kuningi. Abanye abantu bazizwa sengathi bavuza kancane, njengokuconsa. Ukuvuza kwamanzi akho kuyinto ongeke ukwazi ukuyilawula. Kufana nokuthi awukwazi ukuyeka ukuchama .

Ngezinye izikhathi kunzima ukubona ukuthi uketshezi lwe-amniotic, uketshezi oluphuma esithweni sangasese sowesifazane, noma umchamo . Ezimweni ezinjalo, ungathatha ithawula elimhlophe bese ulicwilisa oketshezini.

• Uma kuphuzi, noma uma kunuka kabi , kungenzeka ukuthi umchamo .
• Uma ingenambala futhi ingenaphunga , kufanele ubonane nodokotela ngokushesha.

Kodwa-ke, uma unokungabaza okuncane ngalokho okuphuma esithweni sakho sangasese sowesifazane, qiniseka ukuthi wazisa udokotela wakho.

Odokotela bakuthola kanjani lokhu?

Udokotela wakho uzoqinisekisa i-PROM ngokuhlolwa kwe-speculum engenamagciwane . Lokhu kuhilela ukufaka i-speculum esithweni sakho sangasese sowesifazane. Lokhu kuvumela udokotela ukuthi ahlukanise izindonga zesitho sakho sangasese sowesifazane ukuze abone umlomo wesibeletho sakho. Bese kuthathwa isampula yoketshezi bese ihlolwa. Ngezinye izikhathi, uma udokotela ebona ukunqwabelana koketshezi lwe-amniotic engxenyeni engenhla yesitho sakho sangasese sowesifazane ngesikhathi salokhu kuhlolwa, ulwelwesi kungenzeka ukuthi luqhumile.

Ngaphezu kwalokho, kungenziwa i -ultrasound scan ukuze kuhlolwe indawo yomntwana kanye nenani loketshezi lwe-amniotic ngaphakathi kwesibeletho.

Yiziphi ezinye izivivinyo ezikhona?

• Ukuhlolwa kwephepha le-Nitrazine: Lokhu kusetshenziselwa ukukala i-pH (isilinganiso se-asidi yento ethile) yesitho sakho sangasese sowesifazane. Iconsi loketshezi lwakho lwesitho sangasese sowesifazane lubekwa kuleli phepha bese iphepha lihlolwa ukuze kubonakale ukuthi luphenduka lube luhlaza okwesibhakabhaka yini. Uma luphenduka lube luhlaza okwesibhakabhaka, i-pH yoketshezi ingaphezu kuka-6.0, ngakho-ke kungenzeka kakhulu ukuthi lube uketshezi lwe-amniotic. (Uketshezi olujwayelekile lwesitho sangasese sowesifazane lune-pH ephansi kunoketshezi lwe-amniotic.)
• Ukuhlolwa kwe-Fern: I-Ferning yigama elinikezwe uketshezi lwe-amniotic olomisiwe olufana neqabunga le-fern. Futhi, isampula yoketshezi iyathathwa bese ihlolwa ngaphansi kwe-microscope.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kuncike eminyakeni yokukhulelwa , impilo yengane , kanye nobunzima besimo sakho .

Ngokuvamile kunezindlela ezimbili ongakhetha kuzo: enye iwukuba 'ubelethe' umntwana, kanti enye iwukuba 'ukuphathwa okulindelwe'. 'Ukuphathwa okulindelwe' kuyindlela yokwelapha ebambezela 'ukubeletha'. Lokhu kuhlanganisa ukuphumula embhedeni, imithi, kanye nokuqapha njalo ukutheleleka noma ukucindezeleka kombungu.

Ukwelashwa kwe-PROM ngemva kwamasonto angu-37

Uma ukhulelwe phakathi kwamasonto angu-37 kuya kwangu-40 futhi amanzi ephuma, cishe abesifazane abangu-90% bazoqala ukubeletha ngokuzenzekelayo zingakapheli amahora angu-24. Udokotela wakho angase akwazi ukukunika imithi yokubangela ukubeletha, noma angase avumele ukubeletha kuqhubeke ngokwemvelo.Ngokuvamile, ukubeletha umntwana zingakapheli amahora angu-24 kuyindlela ephephile kakhulu.

Ukwelashwa uma i-'PROM' isenzeka phakathi kwamasonto angu-34 no-37

Kulesi simo, udokotela wakho uzolinganisa izingozi zokuthola umntwana ngaphambi kwesikhathi ngokumelene nezingozi zokutheleleka nezinye izinkinga . Uma udokotela enquma ukubeletha umntwana, uzohlela ukuthi umntwana athole noma yiluphi ukunakekelwa okukhethekile (njengokunakekelwa e -NICU - Iyunithi Yokunakekelwa Okujulile Kwezingane Ezisanda Kuzalwa) uma esezelwe.

Ukwelashwa kwe-Preterm PROM (PPROM) ngaphambi kwamasonto angu-34

Uma ingane yakho ingaphansi kwamasonto angu-34 ikhulelwe, kunengozi enkulu yezinkinga zokuzalwa ngaphambi kwesikhathi. Kuleli qophelo, udokotela wakho uzozama ukukugcina esibhedlela, akubeke embhedeni, futhi azame ukwandisa isikhathi sokukhulelwa kwakho.

Bangase bakunike nemithi efana nalokhu:

• Ama-Corticosteroids: Siza amaphaphu engane akhule.
• Ama-antibiotic: Vimbela izifo futhi ukhulise isikhathi sokukhulelwa.
• Imithi Yokwelapha Ukubeletha: Imithi enikezwa ukuvimba ukubeletha.
• I-Magnesium sulfate: Isiza ekukhuleni kobuchopho bomntwana.

Udokotela wakho uzokukuhlola njalo ukuthola izimpawu zokutheleleka. Uzophinde aqaphe ukushaya kwenhliziyo kwengane yakho kanye nokunyakaza kwayo ukuqinisekisa ukuthi ingane ayikho esimeni esibucayi. Ithemba lalezi zindlela zokwelapha liwukwandisa ukukhulelwa kwakho kube okungenani amasonto angu-34.

Into ebaluleke kakhulu ukuthi, uma unesifo lapho amanzi akho eqhuma, noma uma unesifo kamuva, kuzodingeka nakanjani ubelethe umntwana.

Ingabe ikhona indlela yokuvimbela lokhu?

Ayikho indlela eqondile yokuvimbela i-PROM. Into engcono kakhulu ongayenza ukuyeka ngokuphelele ukubhema, ukukhulelwa okunempilo, nokuya kuzo zonke izivivinyo zakho zokukhulelwa. Ukusebenzisa ugwayi kuyisici esiyingozi se-PROM (nezinye izinkinga eziningi ngesikhathi sokukhulelwa).

Ubani osengozini enkulu yokuthola i-'PROM' kanye ne-'PPROM'? (Izici Zengozi)

Usengozini enkulu yokuthola i-PPROM noma i-PROM uma unesifo esenza ulwelwesi lwakho lwe-chorioamniotic lube buthaka (ungqimba lwangaphandle lwesikhwama se-amniotic), noma uma lusanda kukhula. Izibonelo zalokhu zifaka:

• Izifo: Izifo ezithathelwana ngocansi (ama-STI) ziyizifo ezifana ne-bacterial vaginosis.
• Ubude bomlomo wesibeletho obufushane.
• Uma kukhona umlando wokuba `i-PROM` ngaphambili .
• Uma ulindele izingane ezifana namawele noma amawele amathathu (`Ukulindela ukuphindaphinda`).
• Ama-Polyhydramnios (okusho inani eliningi kakhulu le-amniotic fluid).
• Ukopha kwangasese.
• `I-Amniocentesis`Uma (ukuhlolwa kwamanzi) kwenziwe.
• Uma kukhona umlando wokubeletha ngaphambi kwesikhathi .

Yiziphi izingozi ezinkulu lapho isikhwama samanzi siphuka?

Ingozi enkulu nge-PROM ukuzalwa ngaphambi kwesikhathi. Ukuzalwa ngaphambi kwesikhathi yilapho ingane yakho izalwa ngaphambi kwamasonto angu-37. Izinkinga zokuzalwa ngaphambi kwesikhathi zifaka phakathi izinkinga zokuphefumula, izinga lokushisa eliphansi lomzimba, kanye nezinkinga zokukhula. Ezinye izingane ezizalwa ngaphambi kwesikhathi nazo zingase zibe nokubambezeleka kokukhula kamuva ekuphileni.

Uma uketshezi lwe-amniotic lungavikelwe, kungase kube nezinkinga ezengeziwe ngesikhathi sokukhulelwa, isibonelo:

• Izifo ezifana ne -Chorioamnionitis (ukutheleleka kwe-membrane kanye ne-amniotic fluid).
• Ukuphazamiseka kwe-placenta .
• Ukucindezelwa kwentambo yesisu noma ukuwohloka kwentambo yesisu .

Udokotela wakho uzocabangela kokubili ingozi yokuthola umntwana ngaphambi kwesikhathi kanye nengozi yokutheleleka kanye nezinye izinkinga ukuze anqume isikhathi esingcono kakhulu sokubeletha umntwana wakho.

Kufanele ngibelethe umntwana ngokushesha kangakanani ngemva kokuphuza amanzi?

Ucwaningo lubonise ukuthi abesifazane ababeletha zingakapheli amahora angama-24 kusukela kwaqhekeka ulwelwesi banengozi ephansi yokutheleleka kunalabo ababeletha ngemva kwamahora angama-24 . Kodwa-ke, le ngozi kumele ilinganiswe nengozi yokuthola umntwana ngaphambi kwesikhathi. Udokotela wakho uzokusiza ukuthi wenze isinqumo esingcono kakhulu kuwe kanye nengane yakho.

Ungahlala isikhathi esingakanani ukhulelwe ngemva kokuphuza amanzi?

Lokhu kuzohluka kuye ngesimo sakho nokuthi ukhulelwe amasonto amangaki lapho amanzi akho ephuma. Uma amanzi akho ephuma ngaphambi kwamasonto angu-37, udokotela wakho uzokusiza ukuthi wenze isinqumo esiphephile. Kwezinye izimo, ingozi yokutheleleka nezinkinga iphezulu kakhulu, ngakho-ke kungadingeka ukuthi umntwana abelethwe.

Ingabe ingane ingasinda uma isikhwama samanzi siphuka kusenesikhathi?

Yebo, kungenzeka. Ngisho noma isikhwama samanzi siphuka ngokushesha, umntwana angasinda. Kuncike ezintweni eziningi, njengokuthi ukukhulelwa kukude kangakanani nokuthi kusele uketshezi olungakanani lwe-amniotic. Udokotela wakho uzovame ukuqapha ingane ukuze abone izimpawu zokucindezeleka kombungu kanye nokutheleleka, futhi uzonquma ukuthi uzoyibeletha nini ingane.

Khumbula into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

Ngesikhathi sokukhulelwa, isikhwama esigcwele uketshezi, esibizwa ngokuthi i-amniotic sac , sizungeza futhi sivikele umntwana. Ngokuvamile, lesi sikhwama siyaphuka ngesikhathi sokubeletha. Kodwa-ke, ngezinye izikhathi singaphuka ngaphambi kokuqala kokubeletha, noma ngisho namasonto ngaphambi kokuqala kokubeletha. Lokhu kubizwa ngokuthi i-Premature Rupture of Membranes (PROM) .

• Uma lokhu kwenzeka ngemva kwamasonto angu-37 , udokotela uzobeletha umntwana.
• Lokhu kungaphambi kwamasonto angu-37.Uma kwenzeka i-"Preterm PROM", udokotela uzohlola izingozi zokuthola umntwana ngaphambi kwesikhathi kanye nezingozi zezinkinga ezifana nokutheleleka kanye nokucindezelwa kwe-umbilical cord ngaphambi kokwenza isinqumo.

Kungakwethusa ukuzwa ukuphuza kwakho amanzi kusenesikhathi. Kodwa khumbula, udokotela wakho wenza konke angakwenza ukuze akugcine uphephile futhi uphilile wena nomntwana wakho. Uma unemibuzo noma ukukhathazeka, khuluma nodokotela wakho ngakho. Kubaluleke kakhulu.

I- PROM, i-PPROM, ukuqhekeka kwesikhwama samanzi, izinkinga zokukhulelwa, ukubeletha ngaphambi kwesikhathi, uketshezi lwe-amniotic, impilo yokukhulelwa