Obstetric hemorrhage: 'ehaʻeha ka a me ka lapaʻau lula

Eia naʻe, ua mau manaoia kekahi o na kumu nui kumu o ka make i loko o na wahine ma hope o ka nahunahu hanau obstetric hemorrhages. Ia mea ke kumu ia mea nui e noonoo i ka manawa kūpono o ka hāpai keiki complications i hiki ke hoʻolako kupono kōkua.

obstetric hemorrhage

Pinepine i hāpai keiki, ka nahunahu hanau, a me ka postpartum wā, ma laila e e nāʻano likeʻole o nā complications. Kekahi o ia mea obstetric haemorrhage. Ma gynecology, keia makahiki i manaoia kekahi hanahana loa kahe ana ke koko mai ka wahine'āpana, mai ka hapai ana a hiki i ka hopena o postnatal wā.

Wahi a ka 'ikepili helu, ka hapanui pinepine ana kahe ana ke koko i loko o ka lua, kolu trimester, a ma hope o haawi. Aie i ka anatomical a me ka physiological ano o na wahine hiki e kokololio paha nunui obstetric haemorrhage. Ma keia hihia ka mea, pono koke hoʻolako 'ana i mālama', no ka mea, e like me ka moku'āina hiki ke lilo i nui hoʻoweliweli 'ana i na wahine a me na kamalii.

Mea Maluna o obstetric hemorrhage

Keia pilikia ua CATEGORY_NAME e like me kekahi mau kumu. Obstetrical kahe ana ke koko kekahi mau kumu, a triggered ia, e like me ka buke o ke koko nalowale. Mawaena o na pilikia, a i hoʻolaha e like me ka rula mua, ua hiki ke hoomaopopo kahe ana ke koko 'ia:

• ma ka hapa mua o ka hāpai keiki;
• i loko o ka lua o ka hapalua o ka hāpai keiki;
• ma ka hoouka kaua o ka hana;
• i ka waena o ka nōhie kaʻina;
• i loko o ke kahua hope loa;
• ma hope o ka hānau keiki;
• i kekahi mau lā ma hope o haawi.

A eia hoi, e mea hiki ke classify obstetrical kahe ana ke koko i ka buke o ke koko nalowale. Ka mea, ua māheleʻia i loko o? Ueo e like me:

• huʻi ke koko kahe;
• papakaukau koko kahe maʻi pale;
• hemorrhagic kŰia.

Ke kaumaha ma muli o ka 'aʻe' na a me ia, i loko o ka manawa e hoʻomaka ai, i waeia iaoia o ka lapaau.

Kahe ana ke koko i loko o ka trimester mua o ka hāpai keiki

I ka papa kuhikuhiE kumu o kahe ana ke koko i loko o ka mua mau mahina o ka hāpai keiki e:

• miscarriages;
• molar hāpai keiki;
• cervical hāpai keiki;
• cervical pathology.

Inā miscarriage i ka wahine, noonoo iho la e ia i ka papa kuhikuhiE symptoms o, piliʻeha a me ka loa i ke koko me keia poho. Me ka make māinoino o miscarriage puaʻa pūkoʻa a nīnūnē liʻiliʻi a me ka eha ma kahi e paha i ka hoopaa aching külana. Noho'na makaainana i ulu abortion paha e piha paha kāpili. Mai keia mea hilinaʻi nui pili kēia ma luna o ka pono a me ka aoao o ka hoʻolako 'mālama'.

Eia kekahi, kahe ana ke koko e hana ana ka wā e like me ka pilikia me hydatidiform kameleona. Kēia pathology Ua wehewehe aku ma ka mea i ka chorionic villi i lilo iho i loko o vesicles i loaʻa estrogen. At kamepiula i na wahine me ka li nui o ka wahine nā loko, a me ka hormonal kāna hana. Lapaʻau ma keia hihia, heʻano huikau a me ka hilinaʻi nui pili kēia ma luna o ka degere o ka make ana o ka uterine lua.

Cervical hāpai keiki ua keʻakeʻaʻano nui i 12 pule. Ke kamepiula pūʻulu nā wāhine me ka hoʻoʻino maʻi, abnormalities o ka cervix, like hoʻi me 'aʻe' ana o ka menstrual pōʻaiapuni. Mea o ka nui excessive ka hoʻoneʻe mea,ʻaʻole he fertilized hua manu i loko o ka uterus, a ma ka cervical Canal. Kahe ana ke koko ma keia hihia i lawa nui mai wāwahi nui uterine vascular 'ole.

Polyps cervical Canal i kekahi e ka kumu o ke kahe ana ke koko, aka, ka mea, ua mailuilu haalele. Me ka nui kupu polyps kahe ana ke koko e mahuahua, no laila ia mea nui i ka 'eleu kōkua i loko o obstetric hemorrhage.

Malignant hikoko o ka uterus hana ana i hāpai keiki mea pohihihi keia, e like me keia maʻi ua wehewehe akuʻano nui no na wahine mua ma mua o 40 makahiki. Lapaʻau ua lawe mai ma hope o haawi. Inā ka wā mea uuku, e hōʻike i ka piha ana o ka uterus. Eia kekahi, kahe ana ke koko i ke pili me ka ectopic hāpai keiki. E like me ka hopena, i ka wahi o ka embryo i loko o uterine paipu e uhai.

Kahe ana ke koko i loko o ka lua o ka hapalua o ka hāpai keiki

Kahe ana ke koko e hoi ana i loko o ka lua a me ke kolu trimester o ka hāpai keiki. Mai la ko lakou kumu nui i:

• placenta previa;
• placental abruption;
• uterine rupture.

Ke kamepiula pūʻulu nā wāhine, ka poe mua i undergone ka hoʻoʻino maʻi me ka uterine malformations, e like me hypoplasia o na wahine. Aʻe 'ana ka hapanui ana ka wā ke keiki e aia pololei ma luna o ka mua paia o ka uterus. Ma ka lua o ka hapalua o ka hāpai keiki o ka papa kuhikuhiE kumu o ke kahe ana ke koko hiki ke hana uterine pā mai hemo mai i ka hopena o ke alo o ka me ka makaʻu no ma hope oʻoki kino, caesarean pauku a me ke alo o hydatidiform kameleona. Inā uterine rupture, e like me ka rula, i ke kulana welau a lethally. Ma waho kahe ana ke koko mālama pū nō loa eha.

postpartum hemorrhage

Muli o kona kulana pinepine eia obstetrical kahe ana ke koko i hānau, a me ka i kakahiaka nui postnatal wā. He nui nā wāhine koke hoʻomaka i ka panic, no ka mea,ʻaʻole ka manaʻo o ia o ka moku'āina, e hoomau, a me ia mea, ua noʻonoʻo i ka kūmau, a me ka mea pili i ka pathologies. Kahe ana ke koko i ka nahunahu hanau anaʻano nui ma muli o ke:

• cervical rupture;
• uterine rupture;
• PONRP (abruptio placentae).

No ka mea, o ka cervical rupture hiki e ke kaumaha kahe ana ke koko. Kēia ka hana aie i ka mea i ka nahā i hiki e mai ai i ka vaginal vault, a hiki pili i ka lalo paia o ka uterus. At kamepiula i na wahine me ka 'aʻe' ana i ka hana, hua nui, e like me ka hoʻohana 'ana o kekahi mau ai'. cervical rupture hiki ana i loko o ka palapala o ka mālama nui kahe ana ke koko. Heʻano nui ka hihia no ka wahine me ka kokololio hānau. I ka hope loaʻike, o ke kauka e ukuhi i nana o ka hānau Canal.

Ma ke kahua mua o ka hana i hana PONRP i ua wehewehe aku e loa kaʻeha ma nā uterus i mai ole coincide me na contractions. Ma keia hihia, ke uterus relaxes paha insufficiently nanea wale, a ma laila nō nui kahe ana ke koko clots. Keia ano ua ka hapanui diagnosed i na wahine me ka discoordination hana, i ka hoʻokomo 'ia' ana o kekahi lāʻau lapaʻau ai ', i ke alo o ka hypertension. Ka mea hiki e loa ola hānau.

Uterine rupture Kauka hiki diagnose insufficiently ikaika contractions, oiai ka wahine e hopohopo e pili ana i ka pili eha. Ma keia hihia, eia, ua hanahana loa kahe ana ke koko mai ka vagina, like hoʻi me hiki fetal hypoxia. I ka ua PAaIEN me ka mākaʻi caesarean pauku.

Aia i e kahe ana ke koko ma obstetric postpartum i kupu mai no ia mau kumu e like me:

• paakiki ka hanau ana;
• nui ka hua;
• mau hāpai keiki;
• polyhydramnios.

Kahe ana ke koko kānāwai i loko o ka hopena o postpartum wā, i mea no ke aha la mua oe i haʻalele i ke kauka e lawelawe ai i ka hoʻokolokolo pono ninaninau o ka makuwahine no, mai hemo mai a me nā 'aʻe', a e koi me ka pili ana i ka lōʻihi like 'ole a me nā' ano o ka postpartum wā. Maʻamau 'ano ikaika o puaʻa pūkoʻa a malama no kekahi mau lā ma hope o ka hānau, i hiki i ka manawa, i ka wa o ka poino mucous'aʻaʻa o ka uterus i hoolaia. Loa kia-partum haemorrhage, ua noho pilikia loa complications i hiki alakai i maternal make. ʻO ka oolea o ke kahe ana ke koko hilinaʻi nui ma luna o ka nui o ke koko nalowale. Oia ke ano pono koke resuscitation.

Nā kumu o ka obstetric hemorrhage

Mua oe i lawe mai i ka iapaau ana, ia mea pono ke hookupaa aku i ke kumu i hoʻonāukiuki aku e like me ka pohāʻana. Muli o kona kulana pinepine eia obstetric hemorrhage. Help ma keia hihia ua ma muli o ka precipitating kumumea i loko o kela a me keia manawa o ka hāpai keiki a me ka hana iʻokoʻa. Nui ke koko poho hiki e loa mea no ka wahine, a me ka fetus. Ma ka hapa mua o ka hāpai keiki kahe ana ke koko e ku oe ma muli o ke ectopic fertilization paha abortion. Ma ka lua a me ke kolu o trimester kahe ana ke koko e hana ma muli o ke premature hookuuia ana o ke keiki.

Pakahi aku la ia noteworthy kahe ana ke koko ma hope o ka pau ana o ka hana. I keia manawa, aole e e pili ana i ka mea i pilikia.

• placental villi ulu i loko o ka uterus;
• kekahi māhele o ke keiki i koe i loko o ka uterus;
• iki i hanau Canal.

Kahe ana ke koko e ia lŘlŘ ma ka postpartum au i ke pili me ka ua hoʻemi uterine leo. Naʻe, ka mea, ua ole hoemi, a no laila, i ke koko, aole ia e pau. Ua hiki no hoi ia i ka pilikia, a me ka poe ilihune koko clotting.

Symptoms o obstetric hemorrhage

Kahe ana ke koko i e maloko, mawaho, a me ka hoʻohui pū. Mawaho kahe ana ke koko ua malama me ka placental abruption a me ka cervical dilatation. PONRP e hana hematoma wehewehe aku maloko kahe ana ke koko. Alu kahe ana ke koko e ana ka wā i ke kīloi paʻewa placental abruption me hōʻemi iki puka o ka cervical Canal.

pono mau e haawiia pilikia mālama no obstetric kahe ana ke koko ma ka hihia o ka hoailona mua, e like me:

• kahe ana ke koko mai ka vagina, nānā 'ole o ko lākou nui a me ke ano maoli;
• uterine eha;
• pōniuniu, paleʻili, nawaliwali, maʻule hou ihola nō;
• puʻe ka ho'ēmiʻana;
• hoʻololi i ka naʻau ana o ka fetus.

Hoike ana mai o ka postpartum haemorrhage, kena ae la ma ka helu a me ka nui o ke koko me keia poho. Inā ka uterus aole e pane i ka pākōlea manipulation, i ke kahe ana ke koko ma keia hihia ka loa ikaika, a hiki e weluwelu wavy külana. Manawa ia subsides ma lalo o ka hana ana o kekahi mau ai '. Eia hou, he wahine i excessive ili pallor, tachycardia, hypotension.

I ka buke o ke koko lilo ana i ka 0.5% ma ke kaupaonaʻana o ka hapai wahine ua manaoia e e physiologically alana pono, oiai e hoʻoulu ai i ka buke o kēia palapala nā loli ana i loko o ke kino, no laila ia mea nui, e hoʻopau i ka pilikia i loko o ka 'eleu kūpono. Ma ka postpartum au, o ka wahine e e Tilly i oi aku ka ikaika, a hoʻolōʻihiʻia lochia me ka nui na pai, a huki eha i loko o ka abdomen.

ka lawelaweʻana mea

lapaʻau o obstetrical kahe ana ke koko algorithm ua i ma hope o ka hulinaʻike, wale. ʻike, hoʻomaka me ka hoʻomanawanui anamanaʻo e hooholo i ka lōʻihi like 'ole o ke kahe ana ke koko a me kona ano. Ke kauka laila puka mai e ohi i 'inikua mōʻaukala e loaʻa mai nā mea a pau i ka maʻi ua lede hāpai keiki, a hānau.

I ka Ia manawa, e nānā i nā wāhine, ana ma ka lāʻau ikiʻai wale ana, ke koko, hookolokolo aku la ia i ka uterus. I ka Ia manawa, ua pono i ka pelvic hōʻike me ke kōkua o ke aniani, uterine palpation e hooholo i ka hoʻopilikia o na nāʻiʻo. Ma ka hou study alakai ultrasound e ike ai i ko placental abruption mea, e like me ka mea i ka piko a me ka uterus ina i ka manao pono, i kona. He nui ke kūkulu i ka loa maopopo algorithm. Obstetric hemorrhage ka loa pilikia no ka wahine a me ke keiki, no laila, e pono kōkua koke.

First kōkua

Pono koi pilikia mālama no obstetric kahe ana ke koko, no ka mea, he ano e e noho pilikia a me ka hoʻonāukiukiʻana mai o na mea he nui kekahi mau complications. Ma ke alo o ka wahine kahe ana ke koko koiia waiho i loko o ka haukapila no kilo lapaau, a. pono e lawe mai halihali wale i loko o ka supine kulana. Ma ka hihia o ka abortion, a ua nui ke koko poho huʻi malama hoʻohuʻu i ka pio ana o ke hemorrhagic kŰia. Ai 'ka lawelaweia ana intravenously ma mua a hiki i ka hoʻomanawanui ka komo. I ka maopopo hoʻolauna abortion 'o ia hoʻi, e kōkua i ka ka ho'ēmiʻana o ka uterus, intravenously.

Inā he obstetric hemorrhage, pilikia Hola Pūnaewele me ectopic hāpai keiki komo ai i ka hoike o ka ai 'e kōkua hoʻopau i nā symptoms o hemorrhagic kŰia. Eia naʻe, na wahine pana aku au i ka oxygen inhalation. Lapaʻau ma aaieieno? O glucocorticoids me ka mākaʻi wale ka wā i hōʻike. Ke hoomanawanui hōʻike kaʻenaʻena hospitalization, ke halihali ua hana i loko o ka prone kulana. Ma amo, ka'aloʻahiʻa ua mālama 'ia ma 80-100 mm o Hg. Art. Me ka loa ikaika hemorrhage hospitalization paʻa resuscitative-ʻoki lāʻau lapaʻau hui.

Eia kekahi, hospitalization ua lawe mai, a me ka luna 'mahope iapaau ana me ka placenta previa paha poe. E noke i kekahi'ē aʻe pilikia a me ka maʻi e kāhea kahe ana ke koko, e noi mai ana i kekahi kauka i ka hooponopono, no laila, hāpai pono i hoʻokomo i ka haukapila.

Lapaʻau o obstetric hemorrhage

Loa ke koko poho ke kāhea i keʻano o kāna hana okoa, a complications. Ma ka iapaau ana o obstetric hemorrhage initially pono e hooki aku i ke koko poho, a hoʻopau i ka make māinoino i nā wāhine a me nā keiki. Hapai pono hōʻike i ka piha koena, kapu o physical haʻawina, a me ka haukapila iaʻu. Ka luna 'o ka Inc koho oi pākahi a me ke kaumaha ma muli o ka kahe ana ke koko pii ma luna o ka manawa. Kāohiʻana, lapaau a me ka algorithm o obstetric hemorrhage hoʻomohalaʻia e ke Kuhina o Health, a ia pono e mahaloia e na kumu ao i ka wa a ka hoʻomanawanui hōʻea ma ka haukapila.

Inā he ua kahe ana ke koko i loko o kakahiaka hāpai keiki prescribers, 'ō koko (viscosity), kiaha dala a me ka hooikaika ana konohiki. Ma ka hihia o ke ano nui o ka wahine, a me ka fetus hōʻike mālama nui malama. Ma ke alo o ke kolu o ka trimester kahe ana ke koko hōʻike i ka hana no ka haawi. Ināʻoe eʻike piʻi postpartum obstetric hemorrhage, he iapaau ana Hola Pūnaewele paha e okoa - mai ka pono o ka ai ', a, e wehe i ka uterus. Ua pau hilinaʻi nui ma luna o ka ka manaʻo pohihihi o ka pilikia, no ka mea, o ka mea nui wale - e hoola i kekahi wahine o ka ola.

prophylaxis

Kāohiʻana o obstetric hemorrhage mea i kaupalena 'ia kaʻaeʻana kekahi mau nui kumu. Mua o nā mea a pau, e pono i ka manaʻo i hāpai keiki i loko o ka 'eleu kūpono e inoa, a kipa i ke kauka mau. Ua E hoi e loaʻa i ka manawa, e hana lakou i na mai o ka wahine. Inā pono, e pono e lawe ia i ka luna 'o ka physiotherapy. Ma ke kaʻina hana o ka hānau keiki, e hele pono, e lawe i ka mooolelo a pau o nā koi o ka kauka, e like me ka loiloi i nā nāʻikepili a me contraindications.

E pale aku i ka hanana o ke kahe ana ke koko i loko o ka postpartum au, e pono e hahai i kēia mau rula:

• breastfeed ma koi;
• kanaka hoʻoponopono i ka bladder;
• e moe ana ma luna o kona'ōpū;
• ana anu i ka lalo abdomen.

A pau kēia mau kāohi ana, e kōkua i ka pale o ka hanana o ke kahe ana ke koko a me ka hoʻoikaika 'ana i ka noho maikaʻiʻana o nā wāhine.

Complications a me sequelae o ke kahe ana ke koko

Hiki e muli o kona kulana pilikia complications a me ka hopena o kahe ana ke koko. I ka poe nā:

• Fetal hypoxia;
• fetal make;
• hemorrhage i loko o ka Kalaiaina paia o ka uterus;
• hemorrhagic kŰia;
• o kona makuwahine o ka make.

Eia hou kekahi, complications nā loa kāna hana o ke koko coagulation, e lilo i ka ai iiiaanoaa o thrombi a me ka hanana o ke kahe ana ke koko. Ua hiki no hoi e ka nele i ke koko lako, hoʻohuikau o ka endocrine'ōnaehana a me ka nele o ka hōmona? Iecaianoaaiiuo.