Preeclampsia

IPreeclampsia luxinzelelo lwegazi oluphezulu kunye neempawu zesibindi okanye ukonzakala kwezintso okwenzeka kubafazi emva kweveki ye-20 yokukhulelwa. Ngelixa kunqabile, i-preeclampsia nayo inokwenzeka kumfazi emva kokubeleka umntwana wakhe, ubukhulu becala kwiiyure ezingama-48. Oku kubizwa ngokuba yi-postpartum preeclampsia.

Oyena nobangela we preeclampsia awaziwa. Kwenzeka malunga neepesenti ezi-3 ukuya kwezi-7 zokukhulelwa konke. Imeko icingelwa ukuba iqale kwi-placenta. Izinto ezinokukhokelela ekuphuhlisweni kwepreeclampsia zibandakanya:

• Ukuphazamiseka ngokuzenzekelayo
• Iingxaki zemithambo yegazi
• Ukutya kwakho
• Imfuza yakho

Imiba yomngcipheko wale meko ibandakanya:

• Ukukhulelwa kokuqala
• Imbali edlulileyo yepreeclampsia
• Ukukhulelwa okuninzi (amawele okanye nangaphezulu)
• Imbali yosapho yepreeclampsia
• Ukutyeba kakhulu
• Ukuba mdala kuneminyaka yobudala engama-35
• Ukuba ngumAfrika waseMelika
  
• Imbali yeswekile, uxinzelelo lwegazi oluphezulu, okanye isifo sezintso
• Imbali yesifo se-thyroid

Rhoqo, abasetyhini abane-preeclampsia abaziva begula.

Iimpawu zepreeclampsia zinokubandakanya:

• Ukudumba kwezandla nobuso okanye amehlo (i-edema)
• Ukufumana ubunzima ngequbuliso ngaphezulu kweentsuku ezi-1 ukuya kwezi-2 okanye ngaphezulu kweekhilogram ezi-0.9 ngeveki

Qaphela: Ukudumba kweenyawo kunye namaqatha kuthathwa njengesiqhelo ngexesha lokukhulelwa.

Iimpawu zepreeclampsia ezinzima zibandakanya:

• Intloko engapheliyo okanye iba mandundu.
• Ingxaki yokuphefumla.
• Intlungu yesisu kwicala lasekunene, ngezantsi kweembambo. Ubuhlungu bunokuvakala egxalabeni lasekunene, kwaye bunokudideka kukuqaqamba kwentliziyo, iintlungu zenyongo, intsholongwane esiswini, okanye ukukhaba umntwana.
• Ungachami rhoqo.
• Isicaphucaphu nokugabha (uphawu oluxhalabisayo).
• Umbono utshintsha, kubandakanya ukungaboni okwethutyana, ukubona izibane ezidanyazayo okanye amabala, ubuntununtunu bokukhanya, kunye nombono omfiliba.
• Ndiziva ndinentloko elula okanye ndityhafile.

Umboneleli wezempilo uya kwenza uvavanyo lomzimba. Oku kungabonisa:

• Uxinzelelo lwegazi oluphezulu, ihlala iphakamileyo kune-140/90 mm Hg
• Ukudumba ezandleni nasebusweni
• Ukutyeba kwakho

Kuya kwenziwa uvavanyo lwegazi kunye nomchamo. Oku kungabonisa:

• Iiprotheni kumchamo (proteinuria)
• Ii-enzymes zesibindi ezingaphezulu kwesiqhelo
• Ubalo lwePlatelet olusezantsi
• Amanqanaba okudala aphezulu kunesiqhelo egazini lakho
• Amanqanaba aphakamileyo e-uric acid

Iimvavanyo ziya kwenziwa kwakhona:

• Jonga ukuba igazi lakho livale kangakanani
• Jonga impilo yomntwana

Iziphumo zokukhulelwa kwe-ultrasound, uvavanyo lokungabikho koxinzelelo, kunye nezinye iimvavanyo ziya kunceda umboneleli wakho anqume ukuba ngaba umntwana wakho ufuna ukuhanjiswa kwangoko.

Abasetyhini ababenexinzelelo lwegazi olusezantsi ekuqaleni kokukhulelwa kwabo, kulandelwa kukunyuka okubonakalayo koxinzelelo lwegazi kufuneka babekwe esweni ezinye iimpawu zepreeclampsia.

I-Preeclampsia ihlala isombulula emva kokuba umntwana ezelwe kwaye i-placenta ihanjiswa. Nangona kunjalo, inokuqhubeka okanye iqale nasemva kokuhanjiswa.

Rhoqo, kwiiveki ezingama-37, umntwana wakho ukhule ngokwaneleyo ukuba abe sempilweni ngaphandle kwesibeleko.

Ngenxa yoko, umboneleli wakho uya kufuna ukuba umntwana wakho ahanjiswe ukuze i-preeclampsia ingabi mandundu. Unokufumana amayeza ukunceda ukuqala umsebenzi, okanye unokufuna icandelo le-C.

Ukuba umntwana wakho akakakhuli ngokupheleleyo kwaye une-preeclampsia emnene, esi sifo sinokuhlala silawulwa ekhaya de umntwana akhule. Umboneleli uya kucebisa:

• Ukutyelela rhoqo ugqirha ukuqinisekisa ukuba wena kunye nosana lwakho niqhuba kakuhle.
• Amayeza okwehlisa uxinzelelo lwegazi (ngamanye amaxesha).
• Ubunzima be-preeclampsia bunokutshintsha ngokukhawuleza, ke kuya kufuneka ulandele ngononophelo olukhulu.

Ukuphumla kokulala ngokugqibeleleyo akusacetyiswa.

Ngamanye amaxesha, umfazi okhulelweyo one-preeclampsia wamkelwa esibhedlele. Oku kuvumela iqela lokhathalelo lwempilo ukuba libukele usana nonina ngokusondeleyo.

Unyango esibhedlele lunokubandakanya:

• Vala ukujonga umama nosana
• Amayeza okulawula uxinzelelo lwegazi kunye nokukhusela ukuxhuzula kunye nezinye iingxaki
• Inaliti zeSteroid zokukhulelwa phantsi kweeveki ezingama-34 ukumitha ukunceda ukukhawulezisa ukukhula kwemiphunga yosana

Wena nomboneleli wakho niya kuqhubeka nixoxa elona xesha likhuselekileyo lokuhambisa umntwana wakho, ucinga:

• Usondele kangakanani kumhla obekiweyo.
• Ubungqongqo bepreeclampsia. IPreeclampsia ineengxaki ezininzi ezinokumenzakalisa umama.
• Uqhuba kakuhle umntwana esibelekweni.

Usana kufuneka luziswe ukuba kukho iimpawu zesifo sokukruqeleka komzimba. Oku kubandakanya:

• Uvavanyo olubonisa ukuba umntwana wakho akakhuli kakuhle okanye akafumani gazi laneleyo neoksijini.
• Inani elingezantsi loxinzelelo lwegazi lingaphezulu kwe-110 mm Hg okanye likhulu kune-100 mm Hg ngokungaguquguqukiyo ngaphezulu kweeyure ezingama-24.
• Iziphumo zovavanyo zesibindi ezingaqhelekanga.
• Intloko ebuhlungu.
• Intlungu kwindawo yesisu (isisu).
• Ukuxhuzula okanye utshintsho ekusebenzeni kwengqondo (eclampsia).
• Ulwakhiwo lwamanzi kwimiphunga kamama.
• I-HELLP syndrome (inqabile).
• Inani eliphantsi leplatelet okanye ukopha.
• Iziphumo eziphantsi zomchamo, iiprotheyini ezininzi kumchamo, kunye neminye imiqondiso yokuba izintso zakho azisebenzi kakuhle.

Iimpawu kunye neempawu zepreeclampsia zihlala zihamba kwiiveki ezi-6 emva kokubeleka. Nangona kunjalo, uxinzelelo lwegazi oluphezulu ngamanye amaxesha luba mandundu kwiintsuku zokuqala emva kokubeleka. Usesemngciphekweni wepreeclampsia ukuya kuthi ga kwiiveki ezi-6 emva kokubeleka. Le postpartum preeclampsia inomngcipheko ophezulu wokufa. Ukuba uqaphela naziphi na iimpawu zepreeclampsia, nxibelelana nomboneleli wakho wezempilo kwangoko.

Ukuba unayo i-preeclampsia, kunokwenzeka ukuba uyiphinde uyenze kwakhona ngexesha lokukhulelwa. Kwiimeko ezininzi, ayinzima njengesihlandlo sokuqala.

Ukuba unoxinzelelo lwegazi oluphezulu ngexesha lokukhulelwa okungaphezulu kwesinye, kunokwenzeka ukuba ube noxinzelelo lwegazi xa usiba mdala.

Rare kodwa iingxaki ezinzima kwangoko kumama zinokubandakanya:

• Iingxaki zokopha
• Ukuhlutha (eclampsia)
• Ukudodobala kokukhula komntwana
• Ukwahlula kwangaphambili i-placenta kwisibeleko ngaphambi kokuba umntwana azalwe
• Ukuqhekeka kwesibindi
• Ukubetha
• Ukufa (kunqabile)

Ukuba nembali ye-preeclampsia kwenza ukuba umfazi abe semngciphekweni omkhulu kwiingxaki ezizayo ezinje:

• Isifo sentliziyo
• Seswekile
• Isifo sezintso
• Uxinzelelo oluphezulu lwegazi

Fowunela umboneleli wakho ukuba uneempawu zepreeclampsia ngexesha lokukhulelwa kwakho okanye emva kokubeleka.

Akukho ndlela iqinisekileyo yokuthintela i-preeclampsia.

• Ukuba ugqirha wakho ucinga ukuba usemngciphekweni omkhulu wokuba ne-preeclampsia, banokucebisa ukuba uqale i-aspirin yomntwana (i-81 mg) yonke imihla emva kwexesha kwikota yokuqala yokuqala okanye ekuqaleni kwekota yesibini yokukhulelwa kwakho. Nangona kunjalo, SUKUQALA i-aspirin yomntwana ngaphandle kokuba uthethe nogqirha wakho kuqala.
• Ukuba ugqirha wakho ucinga ukuba ukutya kwakho kwe-calcium kuphantsi, banokucebisa ukuba uthathe isongezo se-calcium yonke imihla.
• Akukho manyathelo athile othintelo lwepreeclampsia.

Kubalulekile ukuba bonke abasetyhini abakhulelweyo baqale ukukhulelwa ngaphambi kokubeleka kwaye baqhubeke nokukhulelwa nasemva kokubeleka.

Toxemia; Uxinzelelo lwexinzelelo lokukhulelwa (PIH); Uxinzelelo lwegazi; Uxinzelelo lwegazi oluphezulu- preeclampsia

• Preeclampsia

Ikholeji yaseMelika yoNyango kunye neeGynecologists; Umsebenzi kwi-Hypertension xa ukhulelwe. Uxinzelelo lwegazi xa ukhulelwe. Ingxelo yeAmerican College of Obstetricians kunye neGynecologists 'Task Force on Hypertension in Pregnancy. IGynecol ebambekayo. Ngo-2013; 122 (5): 1122-1131. IINKCUKACHA: 24150027 pubmed.ncbi.nlm.nih.gov/24150027/.

IHarper LM, Tita A, Karumanchi SA. Uxinzelelo lwexinzelelo lokukhulelwa. Ku: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Isilivere RM, ii-eds. I-Creasy kunye neResnik's Maternal-Fetal Medicine: Imigaqo kunye nokuziqhelanisa. Ngomhla we-8. IPhiladelphia, PA: Elsevier; I-2019: isahluko 48.

Sibai BM. I-Preeclampsia kunye nokuphazamiseka koxinzelelo lwegazi. I-Landon MB, i-Galan HL, iJauniaux ERM, et al, ii-eds. Ii-Obstetrics zikaGabbe: Ukukhulelwa okuqhelekileyo kunye neengxaki. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahluko 38.