Eclampsia bu onset of seizures(convulsions) nke na eme nwaanyi nwere pre-eclampsia. Pre-eclampsia bu obara mgbali elu nke afo ime nke n'egosi n'uzo ato nke gunyere onset of high blood pressure, mgbe protein kariri na mamiri maobu organ dysfunction na edema. O buru na agwo ya ofuma onwere Ike ibite cardiovascular disease na nsogbu ndi ozo nke ogologo oge, n'oge ufodu ona ebute onwu nke nne na nwa.[1].[2][3][4][5].[6]

Eclampsia

Ụkpụrụ nchọpụta maka pre-eclampsia bụ ọbara mgbali elu, nke na-eme mgbe izu 20 nke ime ma ọ bụ n'oge ọkara nke abụọ nke ime.[1] Ọ na-emekarị n'oge atọ nke afọ ime ma nwee ike ime tupu, n'oge, ma ọ bụ mgbe amuchara.[1] Ọrịa ndị ahụ bụ ụdị tonic-clonic ma na-adịkarị ihe dịka otu nkeji.[1] Mgbe nkụchi ahụ gasịrị, enwere oge mgbagwoju anya ma ọ bụ coma.[1] Nsogbu ndị ọzọ gụnyere oyi ịba n'ahụ, Ọbara ọgbụgba n'ụbụrụ, nsogbu akụrụ, ọzịza akpa ume, Ọrịa HELLP, coagulopathy, abruption placental na nkwụsị obi.[1][1]

A na-atụ aro obere aspirin iji gbochie pre-eclampsia na eclampsia n'ime ndị nọ n'ihe ize ndụ dị elu.[7] Ntuziaka mgbochi ndị ọzọ gụnyere Mgbakwunye calcium n'ebe ndị calcium dị ala na ọgwụgwọ nke ọbara mgbali elu na ọgwụ mgbochi ọbara mgbali.[8][9] Mmega ahụ n'oge ime nwekwara ike ịba uru.[1] Ojiji nke intravenous ma ọ bụ intramuscular magnesium sulfate na-eme ka nsonaazụ dị mma na ndị nwere nnukwu pre-eclampsia na eclampsia ma bụrụ n'ozuzu ya na-adịghị ize ndụ. [10][11] Nhọrọ ọgwụgwọ gụnyere ọgwụ mgbochi ọbara dịka hydralazine na inye nwa ahụ n'ọnọdụ mberede ma ọ bụ site na akụkụ ahụ nwanyị ma ọ bụ nke a na-aṅụ ara.[4][1]

A na-eme atụmatụ na Pre-eclampsia na-emetụta ihe dị ka 5% nke ọmụmụ n'ụwa niile ebe eclampsia nwere mmetụta nke ihe dị ka 1.4% nke ọmụmụ.[12] N'ime mba ndị mepere emepe, ọnụ ọgụgụ eclampsia bụ ihe dịka 1 n'ime ụmụ 2,000 n'ihi nlekọta ahụike ka mma ebe na mba ndị na-emepe emepe ọ nwere ike imetụta okpukpu 10-30 karịa ọtụtụ ụmụ nwanyị.[1][13] Nsogbu ọbara mgbali elu nke ime ime bụ otu n'ime ihe ndị a na-ahụkarị na-akpata ọnwụ n'ime ime.[3] Ha kpatara ọnwụ 46,900 na 2015. [14] Ọnwụ nne n'ihi eclampsia na-eme na ọnụọgụ nke ihe dịka 0-1.8% nke ndị na-arịa ya na mba ndị na-enweta ego dị elu na ihe ruru 15% nke ndị na ya na mba na-enweta obere ego.[15] Okwu eclampsia sitere na okwu Grik maka àmụ̀mà.[16] Nkọwa mbụ a maara banyere ọnọdụ ahụ bụ nke Hippocrates na narị afọ nke ise BC. [6][16]

Ihe ịrịba ama na mgbaàmà dezie

Eclampsia bụ nsogbu nke ime ime nke a na-ahụ site na nkụchi na ọnọdụ nke pre-eclampsia.[17] Ọtụtụ ụmụ nwanyị nwere ihe ịrịba ama / mgbaàmà na-egosi na awa ole na ole tupu nkụchi mbụ. Dị ka ọ na-adịkarị, nwanyị ahụ na-enwe ọbara mgbali elu tupu mmalite nke convulsion (nkwụsị). [18] Ihe ịrịba ama na mgbaàmà ndị ọzọ ị ga-ele anya gụnyere: [19]

  • Isi ọwụwa na-adịgide adịgide (na-adịgide) n'ihu ma ọ bụ occipital ma ọ bụ isi ọwụwa égbè eluigwe) [20]
  • Nsogbu anya (ọhụhụ na-adịghị mma, photophobia, diplopopia)
  • Photophobia (ya bụ, ìhè na-egbuke egbuke na-akpata ahụ erughị ala)
  • Ihe mgbu nke afọ
    • Ma ọ bụ na mpaghara epigastric (etiti afọ n'elu navel, ma ọ bụ eriri afọ)
    • Na / ma ọ bụ n'elu akụkụ aka nri nke afọ (n'okpuru akụkụ aka nri ya nke eriri afọ)
  • Mgbanwe nke ọnọdụ uche (mgbagwoju anya)

Ihe mgbaàmà ọ bụla n'ime ihe mgbaàmà ndị a nwere ike ịdị tupu ma ọ bụ mgbe ọ nwesịrị nkụchi.[21] O nwekwara ike ịbụ na nwanyị ahụ enweghị mgbaàmà tupu mmalite nke nkụchi.

Ihe ịrịba ama ụbụrụ ndị ọzọ nwere ike ibute nkụchi ahụ gụnyere agbọ onunu, ịgbọ agbọ, isi ọwụwa, na ìsì. Ọ bụrụ na nsogbu nke ọdịda ọtụtụ akụkụ ahụ na-esote, ihe ịrịba ama na mgbaàmà nke akụkụ ahụ na - dara ada ga-apụta, dị ka ihe mgbu afọ, yellowness, iku ume dị mkpụmkpụ, na mbelata nsị.

Ihe ndị e ji mara ya dezie

Eclamptic seizure ka akpowara dika tonic-clonic seizure nke nwere Ike ebute Anya aju. Ona ebute kwa shriek maobu ite mkpu na muscle nke aka, ukwu, azu na obi is Ike. Mgbe oge tonic, nwanyi ahu nwere Ike Ina ahu cyanotic.[22].[23].[24]

Nsogbu dezie

Enwere ihe ize ndụ nye nne na nwa e bu n'afọ mgbe eclampsia na-eme. Nwa e bu n'afọ nwere ike itolite nke ọma karịa ka ọ dị n'ime akpa nwa (akpa nwa) nke nwanyị nwere eclampsia, nke a na-akpọ Mgbochi uto intrauterine ma nwee ike ime ka nwatakịrị ahụ yie obere maka afọ ime ma ọ bụ amụọ ya na ịdị arọ dị ala.[25] Eclampsia nwekwara ike ịkpata nsogbu na Placenta. Placenta nwere ike ịba ọbara (ọbara ọgbụgba) ma ọ bụ malite ikewapụ n'oge site na mgbidi nke akpa nwa.[26] Ọ bụ ihe dị mma maka placenta ịpụ na mgbidi akpa nwa n'oge ịmụ nwa, mana ọ bụ ihe na-adịghị mma maka ya ịpụ nwa tupu ịmụ nwa; a na-akpọ ọnọdụ a abruption placental ma nwee ike ịdị ize ndụ maka nwa e bu n'afọ.[27] Enweghị ike nke placenta nwekwara ike ime, ọnọdụ nke placenta na-enweghị ike ịkwado mmepe nwa e bu n'afọ kwesịrị ekwesị n'ihi na ọ pụghị inye nwa e bu pụta ìhè oxygen ma ọ bụ ihe oriri.[2] N'oge eclamptic seizure, ịkụ obi nwa ọhụrụ nwere ike ịdị nwayọ karịa ka ọ dị (bradycardia). [1] [28] Ọ bụrụ na nke ọ bụla n'ime nsogbu ndị a emee, nsogbu nwa ọhụrụ nwere ike ịmalite. Ọgwụgwọ nke nkụchi nne nwekwara ike ijikwa bradycardia nwa ọhụrụ. [29] Ọ bụrụ na ihe ize ndụ maka ahụike nke nwa e bu n'afọ ma ọ bụ nne dị elu, ọgwụgwọ doro anya maka eclampsia bụ ịmụ nwa. Ịmụ nwa site na ngalaba ịwa ahụ nwere ike ịdị mkpa, ọkachasị ma ọ bụrụ na ihe atụ nke bradycardia nwa ọhụrụ anaghị edozi mgbe nkeji 10 ruo 15 nke ntinye aka resuscitative gasịrị. [5][30] O nwere ike ịbụ ihe nchebe ịpụta nwa tupu oge eruo karịa ichere izu 40 zuru ezu nke mmepe nwa ọhụrụ iji gwụchaa, n'ihi ya, ịmụ nwa tupu oge bụkwa ihe mgbagwoju anya nke eclampsia. [2][31]

N'ime nne, mgbanwe n'ọhụụ nwere ike ime n'ihi eclampsia, mgbanwe ndị a nwere ike ịgụnye ọhụụ na-adịghị mma, ìsì otu akụkụ (ma ọ bụ nwa oge n'ihi amaurosis fugax ma ọ bụ nke nwere ike ịdịgide adịgide n'ihi retinal detachment), ma ọ bụ ìsì cortical, nke na-emetụta ọhụụ site na anya abụọ.[32][33] Enwekwara nsogbu ndị nwere ike ịdị na akpa ume. Nwanyị ahụ nwere ike ịnwe mmiri na-eji nwayọọ nwayọọ na-anakọta n'ime akpa ume n'usoro a maara dị ka ọzịza akpa ume.[26] N'oge eclamptic seizure, ọ ga-ekwe omume ka mmadụ gbasaa ihe dị n'ime afọ ma na-ekuru ụfọdụ n'ime ihe ndị a n'usoro a maara dị ka aspiration.[25] Ọ bụrụ na ọchịchọ ahụ emee, nwanyị ahụ nwere ike inwe nsogbu iku ume ozugbo ma ọ bụ nwee ike ibute ọrịa n'ime akpa ume mgbe e mesịrị, nke a na-akpọ aspiration pneumonia. [21][34] O nwekwara ike ịbụ na n'oge nkụchi iku ume ga-akwụsị nwa oge ma ọ bụ ghara ịrụ ọrụ nke ọma, a ga-ebelata oke oxygen na-eru n'ahụ na ụbụrụ nwanyị (n'ọnọdụ a maara dị ka hypoxia). [5][35] Ọ bụrụ na ọ na-esiri nwanyị ahụ ike iku ume, ọ nwere ike ịchọ ka iku ume ya kwado nwa oge site na ngwaọrụ enyemaka na usoro a na-akpọ ventilation igwe. N'ọnọdụ ụfọdụ siri ike nke eclampsia, nne nwere ike ịda mbà ma bụrụ onye umengwụ (ụra) ma ọ bụ ọbụna onye nọ n'ọnọdụ coma.[2] Ndị a nwere ike ịbụ ihe ịrịba ama na ụbụrụ na-ebu ibu (cerebral edema) ma ọ bụ ọbara ọgbụgba (intracerebral hemorrhage). [2][3][33]

Ihe ize ndụ dezie

Eclampsia, dị ka pre-eclampsia، na-emekarị na ime mbụ karịa ime ndị ọzọ. [36] [37][38] Ụmụ nwanyị ndị nwere ọbara mgbali elu ogologo oge tupu ha atụọ ime nwere ihe ize ndụ ka ukwuu nke pre-eclampsia.[1][2] Ndị ọrịa nwere ọbara mgbali elu na pre-eclampsia nwere ohere dị ukwuu nke eclampsia.[39] Ọzọkwa, ụmụ nwanyị nwere ọrịa vascular ndị ọzọ dịbu adị (Ọrịa shuga ma ọ bụ nephropathy) ma ọ bụ ọrịa thrombophilia dị ka ọrịa antiphospholipid nọ n'ihe ize ndụ dị elu iji mepụta pre-eclampsia na eclampsia.[1][2] Inwe placenta nke na-eto site na ọtụtụ ime ma ọ bụ hydatidiform mole na-emekwa ka ihe ize ndụ nke eclampsia dịkwuo ukwuu. [1] [2][40] Na mgbakwunye, enwere akụkụ mkpụrụ ndụ ihe nketa: nwanyị nne ya ma ọ bụ nwanne ya nwanyị nwere ọnọdụ ahụ nọ n'ihe ize ndụ dị elu karịa ndị ọzọ.[41] Ndị ọrịa nwere eclampsia nọ n'ihe ize ndụ dị ukwuu maka pre-eclampsia / eclampsía n'oge ime.[2] Ọbịbịa nke pre-eclampsia bụ 5% na ndị ọcha, 9% na ndị Hispanic, na 11% na ndị ọrịa Africa America na nke a nwere ike igosipụta ihe ize ndụ dị oke egwu nke ịmalite pre-eclempsia n'etiti agbụrụ.[42] Tụkwasị na nke a, e gosipụtara na ndị ọrịa ojii nwere ihe ize ndụ dị elu nke ịnwụ site na eclampsia.[7][42]

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