Uvavanyo lokuQhekeka kwangaphambi kweMembranes

Umxholo

• Zithini iimpawu zokuqhekeka kwembewu ngaphambi kwexesha?
• Ukuchonga ukuQhekeka kwangaphambi kweMembranes
• Uvavanyo lwe-pH
• Uvavanyo lweNitrazine
• Ukuvutha
• Olunye uvavanyo
• Ngaba kukho iingxaki kwi-PROM?
• Kwenzeka Ntoni Ngokulandelayo?
• Iiveki ezingama-37 nangaphezulu
• Kufutshane nekota (iiveki ezingama-34 ukuya kwezingama-36)
• Ngaphambi kwexesha (Ngaphantsi kweeveki ezingama-34)
• Iyintoni Imbono?
• Ndingayikhusela njani i-PROM?

Ukuqhekeka kwangaphambi kweMembranes: Yintoni le?

Kwabasetyhini abakhulelweyo, ukuqhekeka kwangaphambi kweembumba (i-PROM) kwenzeka xa ingxowa ye-amniotic ejikeleze usana (inwebu) yaphuka ngaphambi kokuqala komsebenzi. Ngokuqhelekileyo kubizwa ngokuba "xa amanzi akho ephuka." Ukuqhekeka kweMembrane okwenzeka ngaphambi kweveki yama-37 yokukhulelwa kuthiwa yi-preterm PROM (PPROM). I-PPROM yenzeka malunga neepesenti ezi-3 zokukhulelwa kwaye ibangela malunga nesinye kwisithathu sokuzalwa kwangaphambi kokubeleka, ngokwe-American Family Physician. Kwenzeka rhoqo rhoqo kumawele akhulelweyo.

Kwangoko inwebu yakho iyaqhekeka, kokukhona kubaluleke kakhulu kuwe nakumntwana wakho.

• Ukuba ukukhulelwa kwakho kudlule iiveki ezingama-37 kwaye inwebu yakho iyaqhekeka, umntwana wakho ukulungele ukuzalwa.
• Ukuba ukukhulelwa kwakho kungaphantsi kweeveki ezingama-37 kwaye inwebu yakho iyaqhekeka, umboneleli wakho wokhathalelo lwempilo kuya kufuneka athathe isigqibo sokuba angamhambisa na umntwana wakho ngokukhawuleza okanye azame ukuqhubeka nokukhulelwa. Umboneleli wakho wokhathalelo lwempilo unokukhetha ukukhuthaza umsebenzi wakho kwangethuba ngenxa yomngcipheko wosulelo kusana lwakho.

Abasetyhini abahambisa ngaphakathi kweeyure ezingama-24 emva kokuba ikhefu labo lamanzi kunqabile ukuba bafumane usulelo, ke kubalulekile ukuba uye esibhedlele ngokukhawuleza emva kokuqhekeka kweembumba. Esibhedlele, iimvavanyo ezilula zinokuqinisekisa ukuba inwebu yakho iphukile.

Zithini iimpawu zokuqhekeka kwembewu ngaphambi kwexesha?

Olona phawu lukhulu lwe-PROM kukuvuza kwamanzi kwilungu lobufazi. Ulwelo lunokuntywila kancinci okanye luphume. Abasetyhini ngamanye amaxesha benza impazamo kulwelo lomchamo.

Ukuba ubona ulwelo oluvuzayo, sebenzisa iphedi okanye iphepha ukufunxa olunye ulwelo. Jonga kwaye unuke. Amniotic fluid ayifanelanga ukunuka njengomchamo kwaye ihlala ingenawo umbala.

Ezinye iimpawu zingabandakanya:

• ukuziva ngathi awukwazi ukuyeka ukuchama
• ukukhutshwa kwilungu lobufazi okanye ubumanzi obungaphezulu kwesiqhelo
• ukopha kwilungu lobufazi
• uxinzelelo lwe-pelvic

Ukuba ucinga ukuba inwebu yakho iphukile, tsalela umnikezeli wakho wezempilo kwangoko.

Ukuchonga ukuQhekeka kwangaphambi kweMembranes

Ukuba ukrokrela ukuba amanzi akho aphukile kwaye kukho ulwelo oluvuzayo kwilungu lobufazi, umboneleli wakho wokhathalelo lwempilo kuya kufuneka aqinisekise ukuba inwebu iphume ngokwenene.

Umboneleli wakho wezempilo uyakukuvavanya kwaye ajonge ulwelo oluvela kwilungu lobufazi. Baya kuthi emva koko baodole iimvavanyo ukunceda ukuqinisekisa i-PROM okanye iPPROM. Uvavanyo lwe-PROM lubandakanya ukuhlalutya imfihlo yelungu lobufazi ukufumanisa ukuba kukho i-amniotic fluid. Kuba ulwelo lunokungcoliseka ligazi okanye ezinye izinto ezifihlakeleyo, olu vavanyo lukhangela izinto okanye iimpawu ezithile ezifumaneka kuphela kwi-amniotic fluid. Umboneleli wakho wezempilo uya kuqokelela ulwelo oluthile kwilungu lobufazi esebenzisa isixhobo sonyango esibizwa ngokuba yi-speculum ukuze enze uninzi lwezi mvavanyo. Bayakufaka i-speculum kwilungu lobufazi kwaye ngobunono basasaze iindonga zangasese. Oku kuvumela ukuba baphonononge ngaphakathi kwilungu lobufazi kwaye baqokelele ulwelo ngokuthe ngqo kwilungu lobufazi.

Uvavanyo lwe-pH

Olu vavanyo lubandakanya ukuvavanywa kwe-pH yesampulu yolwelo lobufazi. I-pH eqhelekileyo yelungu lobufazi iphakathi ko-4.5 no-6.0. Amniotic fluid ine-pH ephezulu ye-7.1 ukuya kwi-7.3. Ke ngoko, ukuba inwebu iqhekekile, i-pH yesampulu yolwelo lobufazi iya kuba phezulu kunesiqhelo.

Uvavanyo lweNitrazine

Olu vavanyo lubandakanya ukubeka ithontsi lolwelo olufunyenwe kwilungu lobufazi kwimicu yamaphepha aqukethe idayi yeNitrazine. Imicu itshintsha umbala ngokuxhomekeke kwi-pH yencindi. Imicu iya kujika ibe luhlaza okwesibhakabhaka ukuba i-pH inkulu kuno-6.0. Umtya oluhlaza okwesibhakabhaka kuthetha ukuba kunokwenzeka ukuba inwebu iqhume.

Olu vavanyo, nangona kunjalo, lunokuvelisa iziphumo ezingalunganga. Ukuba igazi lingena kwisampuli okanye ukuba kukho usulelo olukhoyo, i-pH yencindi yelungu lobufazi inokuba phezulu kunesiqhelo. Isidoda sinayo ne-pH ephezulu, ngenxa yoko ukwabelana ngesondo kwilungu lobufazi kutshanje kunokuvelisa ukufunda okungachananga.

Ukuvutha

Ukuba amanzi akho aphukile, ulwelo oluxutywe kunye ne-estrogen luza kwenza ipateni "efana ne-fern" phantsi kwemicroscope ngenxa yetyalstallization yetyuwa. Amaconsi ambalwa olwelo aya kubekwa kwisilayidi semicroscope kwaye abonwe phantsi kwemicroscope.

Olunye uvavanyo

Olunye uvavanyo lokufumanisa i-PROM lubandakanya:

• Uvavanyo lweDayi: Inaliti yedayi kwisitya se-amniotic ngesisu. Ukuba inwebu iqhekekile, ulwelo olunombala luya kufunyanwa kwilungu lobufazi ngaphakathi kwemizuzu engama-30.
• Uvavanyo olulinganisa amanqanaba eekhemikhali ezaziwayo ukuba zibakhona kulwelo lwe-amniotic kodwa hayi kulwelo lwelungu lobufazi. Oku kubandakanya iprolactin, i-alpha-fetoprotein, i-glucose, kunye ne-diamine oxidase. Amanqanaba aphezulu ezi zinto athetha ukuba inwebu yaphukile.
• Uvavanyo olutsha olungafunekiyo njengovavanyo lwe-AmniSure ROM kwiiNzululwazi ze-QIAGEN. Olu vavanyo aludingi kuviwo lwe-speculum. Isebenza ngokufumanisa i-alpha microglobulin-1 biomarker ye-placenta kwi-amniotic fluid.

Nje ukuba i-PROM iqinisekiswe, iimvavanyo ezongezelelweyo zokuvavanya oku kulandelayo ziya kuthi zenziwe ukuvavanya oku kulandelayo:

• ubukho bosulelo ngokuvavanya i-amniotic fluid
• inqanaba lokukhula kwemiphunga yosana olungekazalwa, ukumisela ukuba ingaba imiphunga yomntwana ikhule ngokwaneleyo ukuba ingasebenza ngaphandle kwesibeleko
• ubume kunye nempilo yomntwana, kubandakanya ukumamela ukubetha kwentliziyo yosana

Ukuba ukwixesha (ngaphezulu kweeveki ezingama-37 ukhulelwe), unokuya emsebenzini ngokwemvelo okanye umboneleli wakho wokhathalelo lwempilo unokubangela abasebenzi ukuba banciphise umngcipheko wosulelo.

Ukuba umboneleli wakho wezempilo uthatha isigqibo sokulibazisa ukuhanjiswa, kufuneka baqhubeke nokubeka iliso kuwe kunye nosana lwakho ukuze baqiniseke ukuba esi sigqibo sihlala siyindlela elungileyo. Ukuba ukubetha kwentliziyo yomntwana kuyehla, ukuhanjiswa kwangoko kubalulekile.

Ngaba kukho iingxaki kwi-PROM?

Umngcipheko omkhulu we-PROM usulelo. Ukuba isibeleko siyosuleleka (chorioamnionitis), umntwana kufuneka aziswe kwangoko. Usulelo lunokubangela iingxaki ezinkulu emntwaneni.

Kwi-PROM yangaphambi kwexesha, umngcipheko omkhulu kukuhanjiswa kwangaphambi kwexesha, okwandisa umngcipheko weengxaki zomntwana. Ezi ngxaki zibandakanya:

• ukukhubazeka ekufundeni
• iingxaki zemithambo-luvo
• isifo sokuphefumla

Enye ingxaki enzulu kukucinezelwa kwentambo. Ngaphandle kwe-amniotic fluid, intambo ye-umbilical isengozini yomonakalo. Umtya we-umbilical uhambisa ioksijini kunye nezondlo emntwaneni kwaye uhlala ukhuselwe yi-amniotic fluid. Ukuba ulwelo luyavuza, umbilical cord unokucinezeleka phakathi kosana kunye nesibeleko okanye kwezinye iimeko, uwe kwisibeleko uye kwilungu lobufazi. Oku kunokukhokelela kukonzakala kwengqondo okungathethekiyo kunye nokufa.

Ngaphambi kwexesha PROM phambi kweveki ye-24 kunqabile. Nangona kunjalo, ihlala ikhokelela ekufeni komntwana ngenxa yokuba imiphunga yosana ayinakho ukukhula kakuhle. Ukuba umntwana uyaphila, baya kuhlala benengxaki zexesha elide, kubandakanya:

• isifo esinganyangekiyo semiphunga
• iingxaki zophuhliso
• haycecephalusi
• umvakalelo yokitazo

Kwenzeka Ntoni Ngokulandelayo?

Yintoni eyenzekayo ngokulandelayo ixhomekeke kwinqanaba lokukhulelwa kwakho.

Iiveki ezingama-37 nangaphezulu

Umboneleli wakho wezempilo uya kuqhubeka nokuhambisa umntwana wakho. Umsebenzi unokwenzeka ngokwawo (ngokuzenzekelayo) okanye umboneleli wakho wezempilo unokubangela abasebenzi basebenzise amayeza athile.

Kufutshane nekota (iiveki ezingama-34 ukuya kwezingama-36)

Umboneleli wakho wokhathalelo lwempilo uya kuqhubeka nokuhambisa usana ukuba isibhedlele sinononophelo lwasemva kokubeleka. Ngokwe-Sanford Health, isibini kwisibini sabasetyhini kweli nqanaba bazakusa umntwana kungekapheli neveki. Uninzi luya kuzisa zingadlulanga iiyure ezingama-48.

Ngaphambi kwexesha (Ngaphantsi kweeveki ezingama-34)

Ngaphandle kokuba imiphunga yomntwana ikhule ngokupheleleyo, umboneleli wezempilo uya kufuna ukulinda ukuze enze abasebenzi. Uya kuthetha ngemeko yakho kunye nomngcipheko kunye nokhetho lonyango olufumanekayo kuwe nakumntwana wakho.

Amachiza anokubandakanya:

• antibiotics ukuthintela usulelo
• Inaliti ye-steroid ukukhawulezisa ukukhula kwemiphunga yosana
• iziyobisi zokuthintela ukusikwa

Umboneleli wakho wokhathalelo lwempilo uya kujonga ngononophelo wena kunye nosana lwakho ngezixhobo eziqhelekileyo kunye nokujonga usulelo. Kusenokufuneka uhlale ebhedini ngeli xesha.

Iyintoni Imbono?

Umbono uxhomekeke kwinqanaba lokukhulelwa kwakho. Iintsana ezizalwe kwangoko zisemngciphekweni omkhulu wokuba neengxaki. Ngaphandle kwemizamo yokwandisa ixesha lokukhulelwa emva kwe-PPROM, uninzi lwabasetyhini luya kuzisa kwiveki enye. Iziphumo ze-PPROM kukusweleka kosana olungekazalwa kwiipesenti ezi-1 ukuya kwezi-2 zamatyala, ngokukaGqirha wosapho waseMelika.

Ndingayikhusela njani i-PROM?

Awunakuhlala uthintela i-PROM, kodwa utshintsho oluthile kwindlela yokuphila lunokunciphisa umngcipheko. Imbali yezifo ezidluliselwa ngeentlobano zesini kunye nokutshaya ngexesha lokukhulelwa kungonyusa umngcipheko wokuba ne-PROM (ukutshaya kufanele kuthintelwe).

Thetha nomboneleli wakho wezempilo ukuba uthatha amayeza e-steroid. Banokucebisa ukuba uyeke ukuzithatha ukuba akukho mfuneko yokunyanga enye ingxaki

Ukuzivocavoca ngexesha lokukhulelwa kulungile, kodwa kuya kufuneka uthethe nomboneleli wakho wezempilo malunga nenqanaba lomsebenzi onokuyenza ngokukhuselekileyo ngexesha lokukhulelwa kwakho. Umsebenzi onzima womzimba unokubangela i-PROM.