Preeclampsia

Preeclampsia ke khatello e phahameng ea mali le matšoao a tšenyo ea sebete kapa a liphio a hlahang ho basali kamora beke ea bo20 ea bokhachane. Le ha e le ntho e sa tloaelehang, preeclampsia le eona e ka hlaha ho mosali ka mor'a ho pepa lesea la hae, hangata nakong ea lihora tse 48. Sena se bitsoa postpartum preeclampsia.

Lebaka le tobileng la preeclampsia ha le tsejoe. E etsahala hoo e ka bang 3% ho isa ho 7% ea bokhachane bohle. Ho nahanoa hore boemo bo qala ka placenta. Lintho tse ka lebisang ho nts'etsopele ea preeclampsia li kenyelletsa:

• Mathata a ho itšireletsa mafung
• Mathata a methapo ea mali
• Lijo tsa hau
• Liphatsa tsa lefutso tsa hau

Lisosa tse kotsi tsa boemo bona li kenyelletsa:

• Boimana ba pele
• Nalane ea khale ea preeclampsia
• Ho ima hangata (mafahla kapa ho feta)
• Nalane ea lelapa ea preeclampsia
• Botenya
• Ho ba moholo ho feta lilemo tse 35
• Ho ba African American
  
• Nalane ea lefu la tsoekere, khatello e phahameng ea mali kapa lefu la liphio
• Nalane ea lefu la qoqotho

Hangata, basali ba nang le preeclampsia ha ba ikutloe ba kula.

Matšoao a preeclampsia a ka kenyelletsa:

• Ho ruruha ha matsoho le sefahleho kapa mahlo (edema)
• Ho nona ka tšohanyetso ho feta matsatsi a 1 ho isa ho a 2 kapa ho feta boima ba lik'hilograma tse 0,9 ka beke

Tlhokomeliso: Ho ruruha ha maoto le maqaqailana ho nkoa ho tloaelehile nakong ea bokhachane.

Matšoao a preeclampsia e matla a kenyelletsa:

• Ho opeloa ke hlooho ho sa foleng kapa ho mpefala.
• Ho hema ka thata.
• Bohloko ba 'mele ka lehlakoreng le letona, ka tlasa likhopo. Bohloko bo ka utluoa lehetleng le letona, 'me bo ka ferekanngoa le ho otloa ke pelo, bohloko ba sefuba, vaerase ea mpa kapa ho raha lesea.
• Ho se ntše metsi khafetsa.
• Ho nyekeloa le pelo le ho hlatsa (letšoao le tšoenyang).
• Pono ea fetoha, ho kenyeletsoa bofofu ba nakoana, ho bona mabone a phatsimang kapa matheba, kutlo ho leseli le ho fifala ha pono.
• Ho utloa o le hloohoanyana kapa o akhehile.

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele. Sena se ka bontša:

• Khatello ea mali e phahameng, hangata e phahameng ho feta 140/90 mm Hg
• Ho ruruha matsohong le sefahlehong
• Boima ba 'mele

Ho tla etsoa liteko tsa mali le moroto. Sena se ka bontša:

• Liprotheine ka morong (proteinuria)
• Li-enzyme tsa sebete tse phahameng ho feta tse tloaelehileng
• Palo ea liplatelete e tlase
• Maemo a creatinine a phahameng ho feta a tloaelehileng maling a hao
• Maemo a phahameng a uric acid

Liteko li tla etsoa hape ho:

• Bona hore na mali a hao a koetse hantle hakae
• Hlahloba bophelo bo botle ba lesea

Liphello tsa tlhahlobo ea bokhachane ea ultrasound, tlhahlobo ea khatello ea kelello le liteko tse ling li tla thusa mofani oa hau ho etsa qeto ea hore na ngoana oa hau o hloka ho pepa hang-hang.

Basali ba neng ba e-na le khatello e tlase ea mali qalong ea bokhachane, ba lateloa ke keketseho e kholo ea khatello ea mali ba hloka ho shebeloa ka hloko bakeng sa matšoao a mang a preeclampsia.

Preeclampsia hangata e rarolla kamora ho hlaha ha lesea le pepang. Leha ho le joalo, e kanna ea phehella kapa ea ba ea qala kamora ho pepa.

Hangata, libekeng tse 37, ngoana oa hau o holisoa ka ho lekana hore a phele hantle ka ntle ho popelo.

Ka lebaka leo, mofani oa hau o tla batla hore lesea la hau le pepe e le hore preeclampsia e se ke ea mpefala. U ka fumana meriana ho thusa ho qalisa mosebetsi, kapa u kanna oa hloka karolo ea C.

Haeba ngoana oa hau a sa hola ka botlalo mme o na le preeclampsia e bobebe, lefu lena le ka laoloa hae ho fihlela ngoana a se a holile. Mofani o tla khothaletsa:

• Ho etela ngaka khafetsa ho etsa bonnete ba hore uena le lesea la hao le phela hantle.
• Meriana ea ho theola khatello ea mali (ka linako tse ling).
• Boima ba preeclampsia bo ka fetoha kapele, ka hona o tla hloka tlhaiso-leseling e hlokolosi haholo.

Ho phomola ka ho felletseng ha ho sa buelloa.

Ka linako tse ling, mokhachane ea nang le preeclampsia o amoheloa sepetlele. Sena se nolofalletsa sehlopha sa tlhokomelo ea bophelo ho shebella lesea le mme haufi haufi-ufi.

Kalafo sepetlele e ka kenyelletsa:

• Koala tlhokomelo ea mme le lesea
• Meriana ea ho laola khatello ea mali le ho thibela ho oela le mathata a mang
• Liente tsa steroid bakeng sa bokhachane bo ka tlase ho libeke tse 34 boimana ho thusa ho akofisa kholo ea matšoafo a ngoana

Uena le mofani oa hau le tla tsoelapele ho bua ka nako e sireletsehileng ea ho pepa lesea la hau, u ntse u nahana ka:

• U haufi hakae le letsatsi la hau la ho qetela.
• Boima ba preeclampsia. Preeclampsia e na le mathata a mangata a matla a ka lematsang mme.
• Lesea le sebetsa hantle hakae ka popelong.

Lesea le lokela ho pepa haeba ho na le matšoao a preeclampsia e matla. Tsena li kenyelletsa:

• Liteko tse bontšang ngoana oa hau ha a hōle hantle kapa ha a fumane mali le oksijene tse lekaneng.
• Palo e tlase ea khatello ea mali e feta 110 mm Hg kapa e kholo ho feta 100 mm Hg ka linako tsohle ho feta nako ea lihora tse 24.
• Liphello tse sa tloaelehang tsa tlhahlobo ea sebete.
• Ho opeloa ke hlooho haholo.
• Bohloko bo ka mpeng (mpa).
• Ho oa kapa ho fetoha ha ts'ebetso ea kelello (eclampsia).
• Mokelikeli o kenang matšoafong a 'mè.
• HELLP syndrome (e sa tloaelehang).
• Palo e tlase ea platelet kapa ho tsoa mali.
• Ho tsoa ha moroto o tlase, liprotheine tse ngata morotong, le matšoao a mang a bontšang hore liphio tsa hau ha li sebetse hantle.

Matšoao le matšoao a preeclampsia hangata a ea fela ka mor'a libeke tse 6 ka mor'a ho pepa. Leha ho le joalo, khatello e phahameng ea mali ka linako tse ling e ba mpe le ho feta matsatsing a pele ka mor'a ho pepa. U ntse u le kotsing ea preeclampsia ho fihlela libeke tse 6 ka mor'a ho pepa. Preeclampsia ena ea kamora 'pelehi e na le kotsi e kholo ea lefu. Haeba u hlokomela matšoao a preeclampsia, ikopanye le mofani oa tlhokomelo ea bophelo hang hang.

Haeba u kile ua ba le preeclampsia, u na le monyetla oa ho e hlahisa hape nakong ea bokhachane bo bong. Maemong a mangata, ha e matla joalo ka lekhetlo la pele.

Haeba u na le khatello e phahameng ea mali nakong ea bokhachane bo fetang o le mong, u ka ba le khatello e phahameng ea mali ha u tsofala.

Mathata a sa tloaelehang empa a bohloko hang hang a mme a ka kenyelletsa:

• Mathata a ho tsoa mali
• Ho tsieleha (eclampsia)
• Kholofalo ea kholo ea lesea
• Ho aroloa pele ho nako ha lesea ho tsoa popelong pele lesea le hlaha
• Ho phatloha ha sebete
• Leqeba
• Lefu (ka seoelo)

Ho ba le nalane ea preeclampsia ho etsa hore mosali a be kotsing e kholo ea mathata a kamoso a joalo ka:

• Lefu la pelo
• Lefu la tsoekere
• Lefu la liphio
• Khatello ea mali e sa foleng e sa foleng

Bitsa mofani oa hau haeba u na le matšoao a preeclampsia nakong ea bokhachane kapa kamora ho pepa.

Ha ho na mokhoa o tiileng oa ho thibela preeclampsia.

• Haeba ngaka ea hau e nahana hore u kotsing e kholo ea ho ba le preeclampsia, ba ka fana ka maikutlo a hore u qale aspirin ea ngoana (81 mg) letsatsi le letsatsi qetellong ea trimester ea pele kapa mathoasong a trimester ea bobeli ea bokhachane. Leha ho le joalo, U SE KE UA qala aspirin ea masea ntle le haeba u kile ua buisana le ngaka ea hau pele.
• Haeba ngaka ea hau e nahana hore khalsiamo ea hau e tlase, ba kanna ba fana ka tlhahiso ea hore u nke tlatsetso ea calcium letsatsi le leng le le leng.
• Ha ho na mehato e meng e ikhethang ea thibelo ea preeclampsia.

Ho bohlokoa hore bakhachane bohle ba qale ho fumana tlhokomelo ea bakhachane pele ho nako le ho e tsoala nakong ea bokhachane le kamora 'pelehi.

Toxemia; Matšoenyeho a bakoang ke bokhachane (PIH); Khatello ea meriana ea bokhachane; Khatello ea mali e phahameng - preeclampsia

• Preeclampsia

K'holejeng ea Amerika ea Litsebi tsa Ngaka le Lingaka tsa Gynecologists; Task Force on Hypertension nakong ea Bokhachane. Hypertension nakong ea bokhachane. Tlaleho ea American College of Obstetricians and Gynecologists 'Task Force on Hypertension in bokhachane. Gynecol e thibelang. 2013; 122 (5): 1122-1131. PMID: 24150027 phatlalalitsoeng.ncbi.nlm.nih.gov/24150027/.

Harper LM, Tita A, Karumanchi SA. Matšoenyeho a amanang le bokhachane. Ka: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, li-eds. Creasy le Resnik's Maternal-Fetal Medicine: Melao-motheo le Tloaelo. La 8th. Philadelphia, PA: Elsevier; 2019: khaolo ea 48.

Sibai BM. Preeclampsia le mathata a khatello ea mali. Landon MB, Galan HL, Jauniaux ERM, le al, eds. Li-Obstetrics tsa Gabbe: Bokhachane bo Tloaelehileng le Bothata. La 7th. Philadelphia, PA: Elsevier; 2021: khaolo ea 38.