Usuzobeletha? Noma ingabe othile emndenini wakho ulungiselela ukuba ngumama? Ukukhulelwa yisikhathi esimnandi esigcwele ithemba elikhulu, kodwa namuhla sizokhuluma ngesimo esingavamile, kodwa esiyingozi kakhulu, esisongela ukuphila esingaba khona ngalesi sikhathi. Lokhu kubizwa ngokuthi i-amniotic fluid embolism . Ungakhathazeki ngegama, lesi yisimo esingavamile kakhulu. Kodwa kubaluleke kakhulu ukuqaphela.
Kuyini ngempela i-amniotic fluid embolism (AFE)?
Kalula nje, lokhu kwenzeka lapho uketshezi lwe-amniotic oluzungeze umntwana ngesikhathi esesibelethweni, noma amaseli omntwana, izinwele, njll., lungena egazini likamama. Cabanga ngakho, ngokuvamile kuba nomgoqo wemvelo phakathi kwezinhlelo zegazi likamama nelomntwana. Kulesi simo, ngandlela-thile lowo mgoqo uyaphuka, futhi igazi lomntwana lixubana negazi likamama.
Lokhu kubangela ukusabela okukhulu kokungezwani komzimba emzimbeni kamama. Ngokungazelelwe, ngaphandle kwesixwayiso , izinhlelo eziningi zomzimba ziqala ukungasebenzi kahle. Lesi simo singavela ngaphambi nje kokuzalwa komntwana, ngesikhathi, noma ngemva kokuzalwa kwakhe.
Lesi simo asivamile kakhulu, sithinta phakathi koyedwa no-12 kwabangu-100,000 abazalwa bephila. Kodwa uma kwenzeka, kuyingozi enkulu empilweni kamama futhi kudinga ukwelashwa ngokushesha.
Yiziphi izimbangela kanye nezici eziyingozi zalesi simo?
Eqinisweni, odokotela abakazi kahle ukuthi yini ebangela lokhu. Ngenxa yokuthi kuvela ngokuzumayo, kunzima ukusho ngokuqinisekile ukuthi yini ebangela lokhu. Kodwa-ke, ezinye izifundo zikhombe izici eziningana eziyingozi ezandisa amathuba okuba nalesi simo.
Ake sibone ukuthi kuyini.
| Isici Sengozi | Incazelo Elula |
|---|---|
| Ubudala | Ubudala bomama ngesikhathi sokubeletha buyiminyaka engama-35 noma ngaphezulu. |
| Ukulethwa Komsebenzi | Ezimweni lapho umntwana ebelethwa ngokuhlinzwa, nge-forceps, noma nge-vacuum, umgoqo phakathi kukamama nomntwana ungathinteka. |
| Ukukhuthaza abasebenzi (Ukukhuthaza abasebenzi) | Nakuba kunenkolelo yokuthi ezinye izindlela ezisetshenziswa ukuvusa ukubeletha ngokwenziwa zingandisa ingozi, ucwaningo ngalokhu lusaqhubeka. |
| Ukukhubazeka Kwe-Placental | Izimo ezifana nokuthi i-placenta ibekwe phansi esibelethweni, imboze umlomo wesibeletho (i-placenta previa) noma i-placenta isuka odongeni lwesibeletho ngesikhathi sokubeletha (ukuphazamiseka kwe-placental). |
| I-Preeclampsia | Isimo esenzeka ngesikhathi sokukhulelwa kwangemva kwesikhathi futhi esibonakala ngezimpawu ezifana nomfutho wegazi ophakeme, iphrotheni emchameni, kanye nokuvuvukala kwemilenze. |
| Ukwanda koketshezi lwe-amniotic (i-Polyhydramnios) | Inani le-amniotic fluid elizungeze umntwana liphakeme kakhulu kunejwayelekile. |
Ziyini izimpawu zalokhu?
Into eyingozi kakhulu ngalesi simo ukuthi izimpawu zivela ngokuzumayo, ngaphandle kokuba nesikhathi sokucabanga. Izimpawu eziyinhloko yilezi:
- Ukuqala ngokuzumayo kobunzima obukhulu bokuphefumula .
- Ukwehla okungazelelwe nokuyingozi komfutho wegazi (Hypotension).
- Ukopha ngokweqile nokungalawuleki okuvela esibelethweni noma enxebeni lokuhlinza .
- Ukuzizwa ukhathazekile kakhulu, wesaba , noma ukhathazekile.
- Ukushaya kwenhliziyo kwengane kuhamba kancane ngendlela engavamile noma kuyashintsha.
- Ukugodola nokuthuthumela kanye nokuxhuzulaIsenzakalo.
- Ukwehluleka kwenhliziyo noma ukulahlekelwa ingqondo ngokuzumayo (Ukuboshwa Kwenhliziyo).
Imbangela yalokhu kuphuma kwegazi ngokweqile ukuwohloka kwesistimu yonke esiza umzimba ukuthi uvale igazi. Lokhu kubizwa ngokuthi i-Disseminated Intravascular Coagulation (DIC) kwezokwelapha. Okwenzekayo kulokhu ukuthi igazi lilahlekelwa amandla alo okuvaleka. Ngenxa yalokho, ukuphuma kwegazi kuba kubi kakhulu kangangokuthi akukwazi ukumiswa. Futhi, ukuphefumula okunzima, ukulimala kwamaphaphu kanye nokungakwazi ukuphefumula kungenzeka, okubizwa ngokuthi i-Acute Respiratory Failure .
Lesi simo selashwa kanjani?
Njengoba lesi kuyisimo sokuphila noma ukufa, ukwelashwa kuqala ngemizuzwana. Kuphathwa egunjini lokunakekela abagula kakhulu esibhedlela (ICU) noma egumbini lokuhlinza. Lapha, akuyona ukwelashwa okukodwa, kodwa inhlanganisela yezindlela zokwelapha eziningana kuye ngesimo sesiguli.
- Ukubeletha Ngokushesha: Odokotela banquma ukubeletha umntwana ngokushesha okukhulu, becabangela impilo kamama neyomntwana.
- Ukwelashwa okusindisa impilo (Ukuvuselela): Uma umama equlekile, kunikezwa umoya-mpilo ngenkathi kwenziwa i-Cardiopulmonary Resuscitation (CPR) .
- Ukuphefumula Okwenziwa Ngomshini: Uma unenkinga yokuphefumula, uxhunywe emshinini obizwa ngokuthi i-ventilator ukuze ikusize uphefumule.
- Ukuqapha umfutho wegazi kanye nokuqapha inhliziyo: Ama-catheter akhethekile afakwa emithanjeni emikhulu yomzimba kanye nasemithanjeni yegazi ukuze kuqashwe ngokucophelela izinto ezifana nomfutho wegazi kanye nokusebenza kwenhliziyo, okwesibili ngomzuzwana.
- Ukumpontshelwa Igazi: Ngenxa yokulahlekelwa igazi ngokweqile, kunikezwa igazi eliningi kanye nezingxenye zegazi ukuze kuthathelwe indawo igazi elilahlekile futhi kuhlinzekwe ngamaprotheni (izici zokugoba) adingekayo ukuze igazi ligobe.
- Imithi ekhethekile: Kunikezwa imithi ehlukahlukene ukuze kubuyiselwe umfutho wegazi ophansi, kuthuthukiswe ukusebenza kwenhliziyo, futhi kumiswe ukopha ngokwenza isibeletho sifinyele.
Konke lokhu kwenziwa ngenhloso eyinhloko yokusindisa impilo kamama. Nakuba izinga lokusinda komama kulesi simo liphansi, ukwelashwa kusenesikhathi kungandisa amathuba okusinda. Izinga lokusinda komntwana liphezulu kakhulu (cishe ngo-70%).
Umlayezo Wokuya Nawe Ekhaya
- I-Amniotic fluid embolism (AFE) iyisimo esingavamile kodwa esiyingozi kakhulu esingase senzeke ngesikhathi sokukhulelwa.
- Yilapho uketshezi lwe-amniotic oluzungeze umntwana lungena egazini likanina. Imbangela yangempela yalokhu ayikatholakali.
- Izimpawu ezinzima ezifana nobunzima bokuphefumula, umfutho wegazi ophansi, ukopha ngokweqile, kanye nokulahlekelwa ukwazi kuvela ngokuzumayo.
- Lesi yisimo esiphuthumayo sezokwelapha. Ukungeniswa ngokushesha eYunithi Yokunakekelwa Okujulile (ICU) noma eYunithi Yokwelashwa Okuphuthumayo (ETU) yesibhedlela kuyadingeka ukuze uthole ukwelashwa, futhi ukwelashwa okusindisa impilo kufanele kuqalwe ngokushesha.
- Ungakhathazeki ngalesi simo, ngoba asivamile kakhulu. Kodwa-ke, kubalulekile ukwazisa udokotela wakho nganoma yiziphi izimpawu ezingavamile ozizwayo ngesikhathi sokukhulelwa.
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