Liteko tsa ho phatloha ha lera pele ho nako

Litaba

• Matšoao a ho phatloha ha methapo pele ho nako ke afe?
• Ho lemoha ho phatloha ha lera pele ho nako
• pH Teko
• Teko ea Nitrazine
• Ho chesa
• Liteko Tse Ling
• Na ho na le mathata ho PROM?
• Ho Etsahala'ng ka Morago?
• Libeke tse 37 ho ea holimo
• Nako e Haufi (libeke tse 34 ho isa ho tse 36)
• Pele ho nako (Libeke tse ka tlase ho 34)
• Pono ke Efe?
• Nka thibela PROM joang?

Ho Petsoha ha Lera pele ho nako: Ke eng?

Basali ba nang le bakhachane, ho robeha ha lera la pele ho nako (PROM) ho etsahala ha mokotla oa amniotic o potileng lesea (membrane) o robeha pele ho pelehi. Hangata ho thoe ke "ha metsi a hao a robeha." Ho phatloha ha lera le hlahang pele ho beke ea bo37 ea bokhachane ho bitsoa preterm PROM (PPROM). PPROM e hlaha liperesente tse ka bang 3 tsa bokhachane mme e baka karolo ea boraro ea bokhachane ba pelehi, ho latela American Family Physician. E etsahala khafetsa nakong ea bokhachane ba mafahla.

Ha lisele tsa hau li qala ho robeha, e tebile haholo ho uena le lesea la hau.

• Haeba moimana oa hau o fetile libeke tse 37 mme lera la hao le phatloha, ngoana oa hau o se a loketse ho hlaha.
• Haeba moimana oa hau o le ka tlase ho libeke tse 37 mme lera la hao le phatloha, mofani oa tlhokomelo ea bophelo o tla tlameha ho etsa qeto ea hore na o tla pepa lesea la hau hanghang kapa o leke ho tsoelapele ho ima. Mofani oa hao oa tlhokomelo ea bophelo a ka khetha ho susumetsa mosebetsi oa hau pele ho nako ka lebaka la kotsi ea tšoaetso ho lesea la hau.

Basali ba pepang nakong ea lihora tse 24 kamora ho khaoha ha metsi ha ba na tšoaetso, kahoo ho bohlokoa ho ea sepetlele kapele kamoo ho ka khonehang kamora ho phatloha ha lera. Ha u le sepetlele, liteko tse bonolo li ka tiisa hore lisele tsa hau li phatlohile.

Matšoao a ho phatloha ha methapo pele ho nako ke afe?

Letšoao le leholo ka ho fetisisa la PROM ke mokelikeli o tsoang ka botšehaling. Mokelikeli o ka 'na oa rotha butle kapa oa tsoa. Basali ka linako tse ling ba etsa phoso ea mokelikeli oa moroto.

Haeba u hlokomela maro a dutlang, sebelisa pampiri kapa pampiri ho monya mokelikeli o mong. E shebe 'me u fofonele. Amniotic fluid ha ea lokela ho fofonela joaloka moroto mme hangata ha e na 'mala.

Lipontšo tse ling li ka kenyelletsa:

• ho ikutloa eka ha u khone ho emisa ho ntša metsi
• ho tsoa hoa botshehadi kapa mongobo o fetang tloaelo e tloaelehileng
• ho tsoa madi ka hara botshehadi
• khatello ea pelvic

Haeba u nahana hore lera la hao le phatlohile, letsetsa mofani oa tlhokomelo ea bophelo hang hang.

Ho lemoha ho phatloha ha lera pele ho nako

Haeba u belaella hore metsi a hau a robehile 'me ho na le mokelikeli o tsoang ka botšehaling, mofani oa hao oa tlhokomelo ea bophelo o tla hloka ho netefatsa hore lera le sentse le phatlohile.

Mofani oa hao oa tlhokomelo ea bophelo o tla u hlahloba le ho bona mokelikeli o tsoang ka botšehaling. Joale ba tla odara liteko ho thusa ho netefatsa PROM kapa PPROM. Liteko tsa PROM li kenyelletsa ho sekaseka liphiri tsa ka botšehaling ho bona hore na amniotic fluid e teng. Kaha maro a ka silafatsoa ke mali kapa liphiri tse ling, liteko tsena li sheba lintho kapa litšobotsi tse itseng tse atisang ho fumanoa ka amniotic fluid. Mofani oa hao oa tlhokomelo ea bophelo o tla bokella metsi a mang ka hara botshehadi a sebelisa sesebelisoa sa bongaka se bitsoang speculum molemong oa ho etsa liteko tse ngata. Ba tla kenya speculum ka hara botshehadi mme ka bonolo ba phatlalatse mabota a botshehadi. Sena se ba lumella ho lekola bokahare ba botšehali le ho bokella mokelikeli ka kotloloho ka hara botshehadi.

pH Teko

Teko ena e kenyelletsa ho leka pH ea sampole ea mokelikeli oa botšehali. PH e tloaelehileng ea botšehaling e pakeng tsa 4.5 le 6.0. Amniotic fluid e na le pH e phahameng ea 7.1 ho isa ho 7.3. Ka hona, haeba lera le phatlohile, pH ea sampole ea mokelikeli oa botšehaling e tla ba holimo ho feta e tloaelehileng.

Teko ea Nitrazine

Teko ena e kenyelletsa ho beha lerotholi la mokelikeli le fumanoang ka hara botshehadi liphateng tsa pampiri tse nang le dae ea Nitrazine. Mekhabiso e fetola mmala ho latela pH ea mokelikeli. Lihlopha li tla fetoha putsoa haeba pH e kholo ho feta 6.0. Letlapa le leputsoa le bolela hore ho ka etsahala hore lera le phatlohile.

Teko ena, leha ho le joalo, e ka hlahisa melemo ea bohata. Haeba mali a kena sampoleng kapa haeba ho na le tšoaetso, pH ea mokelikeli oa botšehali e ka ba holimo ho feta e tloaelehileng. Peo ea botona le eona e na le pH e phahameng, ka hona thobalano ea haufinyane ea botšehali e ka hlahisa palo e fosahetseng.

Ho chesa

Haeba metsi a hau a robehile, mokelikeli o kopantsoeng le estrogen o tla etsa mohlala oa "fern-like" tlasa microscope ka lebaka la kristale ea letsoai. Marotholi a 'maloa a mokelikeli a tla beoa holim'a microscope slide mme a hlokomeloe tlasa microscope.

Liteko Tse Ling

Liteko tse ling tsa ho fumana PROM li kenyelletsa:

• Teko ea dae: Ho kenya dae ka mokotleng oa amniotic ka mpeng. Haeba lera le phatlohile, mokelikeli o 'mala o tla fumanoa ka hara botshehadi nakong ea metsotso e 30.
• Liteko tse lekanyang maemo a lik'hemik'hale tse tsejoang hore li teng ka har'a mokelikeli oa amniotic empa eseng ka mokelikeli oa botšehali. Tsena li kenyelletsa prolactin, alpha-fetoprotein, tsoekere le diamine oxidase. Maemo a phahameng a lintho tsena a bolela hore lera le robehile.
• Liteko tse ncha tse sa hlaseleng tse kang teko ea AmniSure ROM e tsoang ho QIAGEN Sciences. Teko ena ha e hloke tlhahlobo ea speculum. E sebetsa ka ho lemoha biomarker ea alpha microglobulin-1 ka har'a amniotic fluid.

Hang ha PROM e netefalitsoe, liteko tse ling tsa ho lekola tse latelang li kanna tsa etsoa ho lekola tse latelang:

• boteng ba tšoaetso ka ho hlahloba mokelikeli oa amniotic
• boemo ba nts'etsopele ea matšoafo a lesea, ho bona hore na matšoafo a lesea a holile ka ho lekana hore a sebetse kantle ho popelo
• boemo le bophelo bo botle ba lesea le ka popelong, ho kenyeletsoa ho mamela ho otla ha pelo ea lesea

Haeba u le nakong, (u ka ima libeke tse fetang tse 37), u ka ea bohlokong ka tlhaho kapa mofani oa hao oa tlhokomelo ea bophelo a ka etsa hore basebetsi ba fokolise tšoaetso.

Haeba mofani oa tlhokomelo ea bophelo a nka qeto ea ho lieha ho pepa, ba lokela ho tsoelapele ho beha leihlo uena le lesea la hau ho etsa bonnete ba hore qeto ena e lula e le tsela e ntle ka ho fetesisa. Haeba lebelo la pelo la lesea le theoha, ho pepa kapele ho bohlokoa.

Na ho na le mathata ho PROM?

Kotsi e kholo ea PROM ke tšoaetso. Haeba popelo e tšoaetsoa (chorioamnionitis), ngoana o lokela ho pepa hang-hang. Tšoaetso e ka baka mathata a tebileng ho lesea.

Bakeng sa pele ho nako PROM, kotsi e kholo ke ho pepa pele ho nako, e leng ho eketsang likotsi tsa mathata bakeng sa lesea. Mathata ana a kenyelletsa:

• bokooa ba ho ithuta
• mathata a methapo
• lefu la khatello ea maikutlo

Bothata bo bong bo tebileng ke khatello ea mokhubu. Ntle le amniotic fluid, mokhubu o kotsing ea ho senyeha. Khoele e isa oksijene le limatlafatsi ho lesea mme ka tloaelo e sirelelitsoe ke mokelikeli oa amniotic. Haeba mokelikeli o tsoa, ​​mokokotlo oa mokokotlo o ka hatelloa pakeng tsa lesea le popelo kapa maemong a mang, o ka tsoa ka popelong o kene ka botšehaling. Sena se ka baka likotsi tse mpe tsa boko esita le lefu.

Preterm PROM pele ho beke ea 24 ha e fumanehe hangata. Leha ho le joalo, hangata ho fella ka lefu la lesea le ka popelong hobane matšoafo a lesea ha a khone ho hola hantle. Haeba lesea le phela, hangata le tla ba le mathata a nako e telele, ho kenyelletsa:

• lefu le sa foleng la matšoafo
• mathata a nts'etsopele
• hydrocephalus
• Bokooa ba boko

Ho Etsahala'ng ka Morago?

Se etsahalang kamora moo se latela sethaleng sa bokhachane ba hau.

Libeke tse 37 ho ea holimo

Mofani oa hao oa tlhokomelo ea bophelo o tla tsoelapele ho pepa ngoana oa hau. Mosebetsi o ka iketsahalla o le mong (ka boithatelo) kapa mofani oa tlhokomelo ea bophelo a ka etsa hore basebetsi ba sebelise meriana e itseng.

Nako e Haufi (libeke tse 34 ho isa ho tse 36)

Mofani oa hao oa tlhokomelo ea bophelo o tla tsoelapele ho pepa ngoana haeba sepetlele se na le tlhokomelo ea masea pelehi. Ho ea ka Sanford Health, basali ba babeli ho ba bahlano mothating ona ba tla pepa lesea pele ho beke. Bongata bo tla fana ka thepa nakong ea lihora tse 48.

Pele ho nako (Libeke tse ka tlase ho 34)

Ntle le ha matšoafo a lesea a se a holile ka botlalo, mofani oa tlhokomelo ea bophelo o tla batla ho emela ho hlahisa mosebetsi. U tla bua ka boemo ba hau le likotsi le likhetho tsa kalafo tse fumanehang ho uena le ho lesea la hau.

Meriana e ka kenyelletsa:

• lithibela-mafu ho thibela tšoaetso
• liente tsa steroid ho potlakisa nts'etsopele ea matšoafo a lesea
• lithethefatsi ho thibela pelehi

Mofani oa hao oa tlhokomelo ea bophelo o tla shebisisa uena le lesea la hau ka li-ultrasound tse tloaelehileng le ho hlahloba tšoaetso. U kanna ua tlameha ho robala betheng ka nako ena.

Pono ke Efe?

Ponahalo e latela sethaleng sa bokhachane ba hau. Bana ba hlahang kapele haholo ba kotsing e kholo ea mathata. Leha ho na le boiteko ba ho lelefatsa bokhachane kamora PPROM, basali ba bangata ba tla pepa nakong ea beke e le 'ngoe. PPROM e fella ka lefu la lesea ka karolo ea 1 ho ea ho 2 lekholong ea linyeoe, ho latela American Family Physician.

Nka thibela PROM joang?

U ke ke ua lula u thibela PROM, empa liphetoho tse itseng tsa bophelo li ka fokotsa kotsi ea hau. Nalane ea mafu a tšoaetsanoang ka thobalano le ho tsuba nakong ea bokhachane e ka eketsa menyetla ea ho ba le PROM (ho tsuba ho lokela ho qojoa).

Bua le mofani oa hao oa tlhokomelo ea bophelo haeba u noa meriana ea steroid. Ba kanna ba khothaletsa hore o emise ho li noa haeba ho sa hlokahale hore o phekole bothata bo bong

Ho ikoetlisa nakong ea bokhachane ho lokile, empa o lokela ho bua le mofani oa tlhokomelo ea bophelo ka boemo ba boikoetliso boo u ka bo etsang ka polokeho nakong ea bokhachane. Ho ikoetlisa ka thata ho ka baka PROM.