Ukungahambelani kweRh

Ukungahambelani kwe-Rh yimeko ethi ikhule xa umfazi okhulelweyo enegazi eline-Rh kwaye umntwana osesibelekweni sakhe enegazi eline-Rh.

Ngexesha lokukhulelwa, iiseli ezibomvu zegazi ezisuka kumntwana ongekazalwa zinokuwela kwigazi likamama ngeplasenta.

Ukuba umama une-Rh-negative, amajoni akhe omzimba aphatha iiseli zemveku ezinesifo i-Rh ngokungathi zizinto zangaphandle. Umzimba kamama wenza izilwa-buhlungu ngokuchasene neeseli zegazi olungekazalwa. Ezi antibodies zinokuwela zibuyele emva kwi-placenta ziye kusana olukhulayo. Batshabalalisa iiseli ezibomvu zegazi lomntwana.

Xa iiseli ezibomvu zegazi ziqhekeka, zenza i-bilirubin. Oku kubangela ukuba usana lube tyheli (jaundiced). Inqanaba le-bilirubin egazini losana lisenokusuka kubumnene ukuya kwinqanaba eliyingozi.

Iintsana zamazibulo zihlala zingachaphazeleki ngaphandle kokuba umama ebekhe waphunyelwa sisisu ngaphambili okanye wakhupha izisu. Oku kuya kuqinisa amajoni akhe omzimba. Kungenxa yokuba kuthatha ixesha ukuba umama avelise izilwa-buhlungu. Bonke abantwana anabo kamva abane-Rh banokuchaphazeleka.

Ukungahambelani kwe-Rh kukhula kuphela xa umama ene-Rh-kwaye usana lune-Rh. Le ngxaki iye yaxhaphaka kwiindawo ezinikezela ngononophelo olulungileyo ngaphambi kokubeleka. Kungenxa yokuba iiglobulin ezikhethekileyo zomzimba ezibizwa ngokuba yiRhoGAM zisetyenziswa rhoqo.

Ukungahambelani kweRh kunokubangela iimpawu ezisusela komoya omnene kakhulu ziye ekufeni. Ngendlela yayo enobulali, ukungahambelani kwe-Rh kubangela ukutshatyalaliswa kweeseli ezibomvu zegazi. Akukho ziphumo zimbi.

Emva kokuzalwa, umntwana usenokuba:

• Ukuluhlaza kwesikhumba kunye nabamhlophe bamehlo (i-jaundice)
• Ithoni yezihlunu ephantsi (hypotonia) kunye nokudinwa

Ngaphambi kokubeleka, umama unokuba ne-amniotic fluid engaphezulu kosana olungekazalwa (i-polyhydramnios).

Kunokubakho:

• Iziphumo zovavanyo zeCoombs ezichanekileyo
• Amanqanaba aphezulu kunalawo aqhelekileyo ebilirubin egazini lomntwana eline-umbilical cord
• Iimpawu zokutshatyalaliswa kweeseli ezibomvu kwigazi lomntwana

Ukungahambelani kwe-Rh kunokuthintelwa ngokusetyenziswa kweRhoGAM. Ke ngoko, uthintelo luhlala lunyango olulungileyo. Unyango losana esele luchaphazelekayo luxhomekeke kubukrakra bale meko.

Iintsana ezinobunzima bokungahambelani kwe-Rh zinokuphathwa nge-phototherapy kusetyenziswa izibane zebilirubin. I-immune globulin ingasetyenziswa. Kwiintsana ezichaphazeleke ngamandla, ukutshintshwa kwegazi kunokufuneka. Oku ukunciphisa amanqanaba e-bilirubin egazini.

Ukubuyiswa ngokupheleleyo kulindelwe ukungahambelani kakuhle kwe-Rh.

Iingxaki zinokubandakanya:

• Umonakalo wobuchopho ngenxa yamanqanaba aphezulu ebilirubin (kernicterus)
• Ulwakhiwo lwamanzi kunye nokudumba kusana (hydrops fetalis)
• Iingxaki ngokusebenza kwengqondo, ukuhamba, ukuva, intetho, kunye nokuhlutha

Fowunela umboneleli wakho wezempilo ukuba ucinga okanye uyazi ukuba ukhulelwe kwaye awukamboni umboneleli.

Ukungahambelani kweRh kuphantse kuthintelwe ngokupheleleyo. Oomama abangenayo i-Rh kufuneka balandelwe ngokusondeleyo ngababoneleli babo ngexesha lokukhulelwa.

Ii-globulin ezikhethekileyo zomzimba, ezibizwa ngokuba yiRhoGAM, ngoku zisetyenziselwa ukuthintela ukungahambelani kwe-RH koomama abangenayo i-Rh.

Ukuba utata wosana une-Rh-positive okanye ukuba uhlobo lwegazi lakhe alwaziwa, umama unikwa inaliti yeRhoGAM kwikota yesibini yesibini. Ukuba umntwana une-Rh, umama uza kufumana inaliti yesibini kwiintsuku nje ezimbalwa emva kokubeleka.

Ezi zitofu zithintela ukukhula kweentsholongwane ezichasene negazi eline-Rh. Nangona kunjalo, abasetyhini abanoluhlobo lwegazi olungena-Rh kufuneka bafumane iinaliti:

• Ngethuba lokukhulelwa konke
• Emva kokuphuma kwesisu okanye ukukhupha isisu
• Emva kovavanyo lwangaphambi kokubeleka olufana ne-amniocentesis kunye ne-chorionic villus biopsy
• Emva kokulimala kwesisu ngexesha lokukhulelwa

Isifo se-hemolytic esibangelwa yi-Rh sosana olusandul 'ukuzalwa; I-Erythroblastosis fetalis

• Isifo senyongo esanda kuzalwa - ukubhobhoza

• I-Erythroblastosis fetalis - ifotomicomic
• Usana olugqityiweyo
• Iintsholongwane
• Utshintshiselwano lotshintshiselwano- uthotho
• Ukungahambelani kwe-Rh - uthotho

UKaplan M, uWong RJ, uSibley E, uStevenson DK. Izifo ze-jaundice kunye nezifo zesibindi. Ku: UMartin RJ, uFanaroff AA, uWalsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 100.

IKliegman RM, iSt. Geme JW, iBlum NJ, i-Shah SS, iTasker RC, uWilson KM. Ukuphazamiseka kwegazi. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 124.

Ukuhambisa KJ. Ukudityaniswa kweeseli ebomvu. 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 34.