Isifo seHELLP

I-HELLP syndrome liqela leempawu ezenzeka kubasetyhini abakhulelweyo abane:

• H: i-hemolysis (ukuphazamiseka kweeseli ezibomvu zegazi)
• EL: ii-enzymes zesibindi eziphakanyisiweyo
• LP: ubalo lweplatelet ephantsi

Unobangela we-HELLP syndrome akafumaneki. Kucatshangelwa njengokwahluka kwepreeclampsia. Ngamanye amaxesha ubukho be-HELLP syndrome bubangelwa sisifo esisisiseko njenge-antiphospholipid syndrome.

I-HELLP syndrome yenzeka malunga noku-1 ukuya ku-2 kwabakhulelweyo abali-1 000. Kwabasetyhini abane-preeclampsia okanye i-eclampsia, imeko ikhula nge-10% ukuya kwi-20% yokukhulelwa.

Rhoqo iHELLP ikhula ngexesha lesithathu lokukhulelwa (phakathi kweeveki ezingama-26 ukuya kwezingama-40 zokumitha). Ngamanye amaxesha ikhula kwiveki emva kokuba umntwana ezelwe.

Abasetyhini abaninzi banexinzelelo lwegazi kwaye bafunyaniswe benesifo sepreeclampsia ngaphambi kokuba bafumane isifo se-HELLP. Ngamanye amaxesha, iimpawu ze-HELLP sisilumkiso sokuqala se-preeclampsia. Le meko ngamanye amaxesha ichazwa gwenxa njenge:

• Umkhuhlane okanye esinye isifo
• Isifo senyongo
• Hepatitis
• Idiopathic thrombocytopenic purpura (ITP)
• ILupus flare
• Thrombotic thrombocytopenic purpura

Iimpawu zibandakanya:

• Ukudinwa okanye ukuziva ungaphilanga
• Ukugcinwa kwamanzi kunye nokuzuza ubunzima obuninzi
• Intloko ebuhlungu
• Isihlunu nokuhlanza okuqhubeka kusiba mandundu
• Ubuhlungu kwilungelo elingaphezulu okanye embindini wesisu
• Umbono ongenangqondo
• Ukuphuma ngeempumlo okanye ukuphuma kwegazi okungayi kuyeka ngokulula (kunqabile)
• Ukuxhuzula okanye ukuxhuzula (kunqabile)

Ngexesha lovavanyo lomzimba, umboneleli wezempilo unokufumanisa:

• Ukuthamba kwesisu, ngakumbi kwicala lasekunene eliphezulu
• Ukwandiswa kwesibindi
• Igazi elonyukayo
• Ukudumba emilenzeni

Uvavanyo lomsebenzi wesibindi (ii-enzyme zesibindi) zinokuphakama. Ubalo lweplatelet lunokuba sezantsi. Ukuskena i-CT kunokubonisa ukopha esibindini. Iprotein egqithisileyo inokufumaneka kumchamo.

Uvavanyo lwempilo yosana luya kwenziwa. Uvavanyo lubandakanya uvavanyo lokungabikho koxinzelelo lomntwana kunye ne-ultrasound, phakathi kwabanye.

Olona nyango luphambili kukuhambisa umntwana ngokukhawuleza, nokuba umntwana ulibele ngaphambi kwexesha. Iingxaki zesibindi kunye nezinye iingxaki ze-HELLP syndrome zinokukhula ngokukhawuleza kwaye zibe yingozi kubo bobabini umama nomntwana.

Umboneleli wakho unokunyanzelisa abasebenzi ukuba bakunike amayeza okuba uqale, okanye enze icandelo le-C.

Unokufumana:

• Igazi xa iingxaki zokopha ziba nzima
• Amayeza e-Corticosteroid ukunceda imiphunga yomntwana ukuba ikhule ngokukhawuleza
• Amayeza anyanga uxinzelelo lwegazi oluphezulu
• Ukufakwa kwe-Magnesium sulfate ukuthintela ukuxhuzula

Iziphumo zihlala zilungile ukuba ingxaki ifunyenwe kwangoko. Kubaluleke kakhulu ukuba uhlolwe rhoqo ngaphambi kokubeleka. Kuya kufuneka ukwazise umboneleli wakho kwangoko ukuba uneempawu zeli meko.

Xa imeko inganyangwa kwangethuba, ukuya kuthi ga kwabasetyhini kwaba-4 baba nengxaki enkulu. Ngaphandle konyango, inani elincinci labasetyhini liyasweleka.

Izinga lokufa kweentsana ezizelwe ngoomama abane-HELLP syndrome lixhomekeke kubunzima bokuzalwa kunye nokukhula kwamalungu omntwana, ngakumbi imiphunga. Uninzi lweentsana luzalwa ngaphambi kwexesha (luzalwe ngaphambi kweeveki ezingama-37 zokukhulelwa).

I-HELLP syndrome inokubuyela kwi-1 kwaba-4 yokukhulelwa kwixa elizayo.

Kunokubakho iingxaki ngaphambi nasemva kokuba umntwana ezelwe, kubandakanya:

• Isasazwe i-intravascular coagulation (DIC). Ingxaki yokujiya ekhokelela kukopha okungaphezulu (ukopha).
• Ulwelo kwimiphunga (i-edema yemiphunga)
• Ukungaphumeleli kwezintso
• Ukopha kwesibindi kunye nokusilela
• Ukwahlula kwe-placenta kuludonga lwesibeleko (ukuphazamiseka kweplacenta)

Emva kokuba umntwana ezelwe, i-HELLP syndrome iyahamba kwiimeko ezininzi.

Ukuba iimpawu zesifo se-HELLP zenzeka ngexesha lokukhulelwa:

• Jonga umboneleli wakho kwangoko.
• Fowunela inombolo yongxamiseko yendawo (enje ngo-911).
• Yiya kwigumbi likaxakeka esibhedlele okanye icandelo labasebenzi kunye nokuhanjiswa.

Akukho ndlela yaziwayo yokuthintela isifo se-HELLP. Bonke abasetyhini abakhulelweyo kufuneka baqale ngononophelo lwangaphambi kokubeleka kwaye baqhubeke nokukhulelwa. Oku kuvumela umboneleli ukuba afumane kwaye anyange iimeko ezinje ngesifo se-HELLP kwangoko.

• Preeclampsia

I-Esposti SD, i-Reinus JF. Ukuphazamiseka kwesisu kunye nokuphazamiseka kwesibindi kwisigulana esikhulelweyo. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Amathumbu kunye nezifo zesibindi: iPathophysiology / Diagnosis / Management. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 39.

Sibai BM. I-Preeclampsia kunye nokuphazamiseka koxinzelelo lwegazi. Ku: Gabbe SG, Niebyl JR, Simpson JL, et al, ii-eds. I-Obstetrics: Ukukhulelwa okuqhelekileyo kunye neengxaki. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 31.