Wikipedia

Ọbara ọgbụgba n'oge ịmụ nwa

Obstetrical bleeding but igba obara mgbe nwaanyi di ime nke ana ahu tupu nwaanyi amu NWA, mgbe omuru nwa na mgbe omuchara nwa. Igba obara tupu amu NWA bu nke n'eme n'izuka iriabuo na ano nwaanyi di ime. Igba obara nwere Ike ibu vaginal maobu na abdominal cavity mana nkea anaghi eme oge ufodu. Igba obara nke n'eme tupu izuka iriabuo na ano but Ihe amara dika igba obara afo ime N'oge..[1]

Ihe na-akpata ọbara ọgbụgba tupu na n'oge ịmụ nwa gụnyere cervicitis, placenta previa, abruption placental na rupture uterine.[1][2] Ihe na-akpata ọbara ọgbụgba mgbe amuchara nwa gụnyere obere mkpakọ nke akpa nwa, ihe ndị a na-echekwa site na ime, na nsogbu ọbara ọgbụrụ.[1][1]

Ihe dị ka nde 8.7 nke ọbara ọgbụgba siri ike mere na 2015 [3] nke kpatara ọnwụ 83,000 . [4] N'agbata afọ 2003 na afọ 2009, ọbara ọgbụgba kpatara pasent iri abụọ na asaa nke ọnwụ nne n'ụwa niile.[5]

Ime ime mgbe e mesịrị dezie

Ọbara ọgbụgba (APH), nke a na-akpọkwa ọbara ọgbụgbọ tupu ọ mụọ nwa, na-agba ọbara n'oge ime site na izu nke 24 [6] (mgbe ụfọdụ akọwapụtara dị ka site na izu 20 [6]) afọ ime ruo mgbe a mụrụ nwa ahụ.[2] Ihe bụ isi a na-atụle bụ ọnụnọ nke placenta previa nke bụ placenta dị ala ma ọ bụ dị nso na ọkpụkpụ cervical. Ọnọdụ a na-eme n'ihe dị ka afọ ime 4 n'ime 1000 [7] ma na-achọkarị idozi ya site n'ịmụọ nwa ahụ site na ngalaba ịwa ahụ. Ọzọkwa abruption nke placenta (nke enwere nkewa nke placenta n'oge) nwere ike iduga ọbara ọgbụgba obstetrical, mgbe ụfọdụ zoro ezo. Ọrịa a dị mkpa mgbe mmerụ ahụ nne dị ka ihe mberede ụgbọala ma ọ bụ ọdịda.

Ihe ndị ọzọ a ga-atụle gụnyere mgbe a na-enyocha ọbara ọgbụgba tupu amụọ nwa bụ: nyocha nke a na-eme iji nyochaa dilation nke onye ọrịa mgbe izu nke iri anọ na-eru nso. Tinyere ezughi oke akpa nwa akọwapụtara dị ka mgbasa nke etiti ọnwa iri na anọ na izu iri abụọ na isii nke akpa nwa nke nwere ike ịchọ enyemaka ahụike iji nyere aka mee ka afọ ime dịgide.[8]

Mgbe ị na-amụ nwa dezie

E wezụga placenta previa na abruption placental, rupture uterine nwere ike ime, nke bụ ọnọdụ siri ike na-eduga na ọbara ọgbụgba n'ime ma ọ bụ n'èzí. Ọbara na-agbapụta site na nwa e bu n'afọ bụ ihe a na-adịghị ahụkebe, mana ọ nwere ike ime na ọnọdụ abụọ a na-akpọ vasa previa na ntinye eriri umbilical velamentous ebe akwara ọbara nke nwa e bu na-adị nso na ebe ntinye placental na-enweghị nchebe site na jelly Wharton nke eriri ahụ.[9] Mgbe ụfọdụ, enwere ike ịchọpụta ọnọdụ a site na ultrasound. Enwekwara ule iji mee ka ọbara nne dị iche na ọbara nwa ọhụrụ nke nwere ike inyere aka ịchọpụta isi iyi nke ọbara ọgbụgba.

Mgbe a mụsịrị ya dezie

Ọbara na-adịghị mma mgbe a mụsịrị nwa, ma ọ bụ ọbara ọgbụgba mgbe a mụrụ nwa, bụ ọnwụ nke ihe karịrị 500 ml nke ọbara mgbe a mụọ nwa, maọbụ 1000 ml nke ọbara na-esote akụkụ ahụ. Nkọwa ndị ọzọ nke ọbara ọgbụgba mgbe amuchara bụ hemodynamic instability, ọdịda nke hemoglobin nke karịrị 10%, [10] ma ọ bụ chọrọ mmịnye ọbara. N'akwụkwọ, a na-akọwa ọbara ọgbụgba mbụ mgbe amuchara nwa dị ka ọbara ọgbụrụgba a na-achịkwaghị achịkwa nke na-eme n'ime awa 24 mbụ mgbe amịchara nwa ebe ọbara ọgburu ọbara nke abụọ na-eme site na awa 24 ruo izu isii.[11]

Ihe ize ndụ dezie

N'ọnọdụ ndị a na-adịghị ahụkebe, nsogbu ọbara ọgbụgba, dị ka hemophilia, Ọrịa von Willebrand (vWD), ma ọ bụ ụkọ ihe IX ma ọ bụ XI, nwere ike ịkpata ọbara ọgbgbụgba siri ike mgbe amuchara, yana ohere dị ukwuu nke ọnwụ karịsịa n'oge amuchara.[11] Ihe ize ndụ nke ọbara ọgbụgba mgbe amuchara nwa n'ime ndị ọrịa nwere vWD na ndị na-ebu hemophilia achọpụtara na ọ bụ 18.5% na 22% n'otu n'otu. Ọrịa a na-eme n'ihi ọdịda ahụike dị mma n'ihe ndị na-eme ka nne nwee ọbara ọgbụgba mgbe ọ mụsịrị nwa nke na-eme nke ukwuu ihe ize ndụ nke ọbara ọgbụrụgba mgbe ọ amuchara.[12]Ihe ọzọ na-akpata ọbara ọgbụgba bụ thrombocytopenia, ma ọ bụ mbelata platelet, nke bụ mgbanwe ọbara kachasị na-emetụta ọbara mgbali elu nke ime ime. Ọ bụrụ na ọnụ ọgụgụ platelet adaa n'okpuru 100,000 kwa microliter onye ọrịa ga-anọ n'ihe ize ndụ siri ike maka enweghị ike ịkpụkọ n'oge na mgbe ọ mụsịrị nwa.[13]

Nnyocha ahụike dezie

Ọ bụrụ na a hụ obere ọbara ọgbụgba n'oge ime ime, dọkịta nwere ike ịrịọ:

  • Nnyocha ọbara chorionic gonadotropin (hCG) nke mmadụ iji kwado afọ ime ma ọ bụ nyere aka n'ịchọpụta ime ọpụpụ nwere ike ime [14]
  • Transvaginal pelvic ultrasonography iji kwado na afọ ime ahụ abụghị n'èzí akpa nwa [1][14]
  • Ụdị ọbara na nyocha Rh iji wepụ ọrịa hemolytic nke nwa a mụrụ ọhụrụ [1][14]

Maka ọbara ọgbụgba a hụrụ na nyocha ime mgbe e mesịrị nwere ike ịgụnye:

  • Ọnụ ọgụgụ ọbara zuru ezu (CBC) na ụdị ọbara na ihuenyo [14]
  • Ultrasound iji chọpụta ebe placenta dị [1][14]
  • Nnyocha Kleihauer-Betke (KB) karịsịa ma ọ bụrụ na enwere mmerụ ahụ nne [1][14]

Ọbara na-enweghị ihe jikọrọ ya dezie

Ndị ọrịa dị ime nwere ike ịnwe ọbara ọgbụgba site na ụzọ ọmụmụ n'ihi mmerụ ahụ, gụnyere mmerụ ahụ mmekọahụ, neoplasm, nke kachasị Ọrịa kansa akpa nwa, na Nsogbu ọbara. Ime ime (nke a na-akpọkwa hydatiform mole) bụ ụdị ime ime ebe sperm na àkwá jikọtara n'ime akpa nwa, mana nsonaazụ ya bụ cyst yiri ụyọkọ mkpụrụ vaịn kama ịbụ embryo. Ọbara nwere ike ịbụ ihe ịrịba ama mbụ nke ọkpụkpụ a na-eto eto.[15]

  1. ↑ 1.0 1.1 1.2 Walfish (December 2009). "Maternal haemorrhage". British Journal of Anaesthesia 103: i47–i56. DOI:10.1093/bja/aep303. PMID 20007990. Walfish, M.; Neuman, A.; Wlody, D. (December 2009).
  2. ↑ 2.0 2.1 Stables (2010). Physiology in Childbearing: With Anatomy and Related Biosciences (in en). Elsevier Health Sciences. ISBN 978-0702044113. Stables, Dorothy; Rankin, Jean (2010).
  3. ↑ Vos (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet 388 (10053): 1545–1602. DOI:10.1016/S0140-6736(16)31678-6. PMID 27733282. 
  4. ↑ Wang (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet 388 (10053): 1459–1544. DOI:10.1016/S0140-6736(16)31012-1. PMID 27733281. 
  5. ↑ Say (2014). "Global causes of maternal death: a WHO systematic analysis". The Lancet Global Health 2 (6): e323–e333. DOI:10.1016/S2214-109X(14)70227-X. ISSN 2214-109X. PMID 25103301. 
  6. ↑ 6.0 6.1 patient.info » PatientPlus » Antepartum Haemorrhage Last Updated: 5 May 2009
  7. ↑ (2016) "Relation between Birth Weight and Intraoperative Hemorrhage during Cesarean Section in Pregnancy with Placenta Previa". PLOS ONE 11 (11): e0167332. DOI:10.1371/journal.pone.0167332. PMID 27902772. 
  8. ↑ Berghella, MD (July 2017). Cervical insufficiency. UpToDate.
  9. ↑ Velamentous umbilical cord insertion and vasa previa. UpToDate (July 2017). Archived from the original on 2018-08-08. Retrieved on 2024-05-19.
  10. ↑ (2016) "Measuring Post-Partum Haemorrhage in Low-Resource Settings: The Diagnostic Validity of Weighed Blood Loss versus Quantitative Changes in Hemoglobin". PLOS ONE 11 (4): e0152408. DOI:10.1371/journal.pone.0152408. PMID 27050823. 
  11. ↑ 11.0 11.1 Global burden of maternal haemorrhage in the year 2000 Carmen Dolea1, Carla AbouZahr2, Claudia Stein1 Evidence and Information for Policy (EIP), World Health Organization, Geneva, July 2003
  12. ↑ (October 2000) "Obstetrical and gynaecological bleeding: a common presenting symptom". Clinical and Laboratory Haematology 22 (Suppl 1): 12–6; discussion 30–2. DOI:10.1046/j.1365-2257.2000.00007.x. PMID 11251653. 
  13. ↑ Aldred (1997). Pregnancy and birth sourcebook. health reference series. ISBN 9780780802162. 
  14. ↑ 14.0 14.1 14.2 14.3 14.4 14.5 Vaginal bleeding during early pregnancy. Merck Manual (August 2009).Heine PR, Swamy GK (August 2009).
  15. ↑ Aldred (1997). Pregnancy and birth sourcebook. Omnigraphics. ISBN 9780780802162. 
Ewepụtara na https://ig.wikipedia.org/w/index.php?title=Ọbara_ọgbụgba_n%27oge_ịmụ_nwa&oldid=167102