Oligohydramnios Lokulingene ngesikhathi sokukhulelwa: izimbangela nemiphumela, ukuxilongwa kanye nokwelashwa

umzimba Female ngendlela okurarako bazivumelanisa kokuzalwa kwengane nokukhuliswa. Yonke into it unikezwa ukuze ukukhanya kwaba khona ingane izizwa induduzo ephelele futhi akukho lutho okungathenjelwa ukumvimbela kahle futhi zikhula ngokushesha. Futhi, iqukethe Ukuvikelwa esiphezulu kusukela izici eziyingozi zangaphandle. Amniotic fluid, okuyinto ingane, thatha kulowo msebenzi. Kodwa esimangalisweni encane kwaba ukhululekile ngempela futhi akazange uhlangabezana nobunzima, amanzi kufanele itholakale zokwandisa edingekayo. Lokulingene oligohydramnios ngesikhathi sokukhulelwa kwenzeka kaningi impela, kodwa musa ngokushesha ukukhulisa i-alamu. Ekuqaleni, udinga siyixazulule le nkinga.

Ukubaluleka amniotic fluid

amniotic fluid (igama yezokwelapha) ngokuphelele inikeza konke ludingeka ekuthuthukisweni kahle ingane engakazalwa. Ngo ngezithako zawo kukhona amavithamini ahlukahlukene, compounds hormone nomoya-mpilo kuyadingeka kakhulu nosawoti fetus compounds okuyizinto izinto eziyisisekelo futhi ukwakhiwa wonke sehlangano encane.

amniotic fluid - akuyona kuphela ayizidleke ingane Basaba bayalazisa ngazo zonke izindlela kusukela ezahlukahlukene negative, ngomusa ekunciphiseni nemiphumela engokomzwelo iwukudambisa kuhlasela ezithathelwanayo. Njengoba sokukhulelwa iqhubeka inombolo kumele lenyuke, kwaba nabantu bezizwe ezixubile - avuselelwe, njengoba izidingo umzimba asathuthuka futhi siyakhula futhi siyashintsha. Kubalulekile kakhulu ukuthi udokotela ogcina indlela kwabakhulelwe nesineke ethungatha zonke anomalies futhi eziyimbangela yezinkinga ezizuzwa kungenzeka, ngokukhethekile, lena ukwehla emanzini. Le nkinga kungaholela eziyingozi phakathi sokukhulelwa.

Incazelo namazinga

oligohydramnios Lokulingene ngesikhathi sokukhulelwa - lena uma imali ye-amniotic fluid kancane kancane kunesidingo. ngokuvamile isimo esinjalo kulula ukulungisa. Ngosizo imishini yesimanje uvele okuthile ngale nkinga kungenza ihlonzwe ngesikhathi 2-3 senyanga. Ngokuvamile, lokhu zokugula libizwa kwenqatshwa ngokuphelele.

Emazingeni ahlukahlukeneko wendlela sokukhulelwa inevolomu yabo indices-amniotic fluid. Emavikini ayisithupha lokuqala bakha ml 5 kuphela. Ngaphezu kwalokho kukhona okuqhubekayo ivolumu yabo, amasonto ambalwa ngaphambi usana zingaba phakathi 1 kuya 1.5 amalitha. Ngokushesha ngaphambi kokuzalwa amanzi kuba esingaphansi: mayelana 600 ml.

uketshezi Intrauterine othuthukiswa njalo. Ezigabeni lokugcina sokukhulelwa, lezi zinqubo zenzeke njalo ngemuva kwamahora amathathu. Ngosuku umntwana edla cishe 4 amalitha amanzi. imikhiqizo yayo imfucuza isuswa ngemigudu akhethekile ezimbotsheni amnion. Lo luketshezi etholwe epithelium amanzi inqubo igobolondo.

Uma kukhona ngeziphambeko ezincane kusukela uthola ohlangothini ezincane, isimo esinjalo ichazwa njengesifo oligohydramnios ngokulinganisela ngesikhathi sokukhulelwa. Ukwelashwa kanye nemiphumela yalesi sifo zingase zihluke, ngakho le nkinga kudinga ukuhlale ebhekiwe ongoti, futhi ngemva - injongo ukulungiswa wezokwelapha.

ngezigaba

Lesi sifo ingahlukaniswa yi-degree of ubude amafomu chronic oyingozi. Inkinga ohlobene uhlobo lokuqala, eba ngezigaba. Ukwelashwa kuzodinga isikhathi eside. In the ukungabikho ukwelashwa umphumela kancane kancane iqala ukuba bathuthuke. Leli fomu kungavuka unina esizayo khona isifo ezinzima, njengesifo sikashukela. Ukuze unciphise imiphumela engemihle, owesifazane kufanele njalo ukudlula zonke izivivinyo ebekiwe futhi ukuthatha imithi ezifanele.

Enough ezivamile ne-acute nokuntuleka kwamanzi ngesikhathi ekhulelwe, izimbangela kanye nemiphumela okuyinto singabi sibi. Ngokuvamile, umthombo wenkinga kukhona izifo ezithathelwanayo. isimo esinjalo libhekene nezinkinga ezimbalwa futhi asikho isidingo nezinqubo ekhethekile.

Ingase futhi ihlukaniswe isifo eyinhloko eba ngaphandle kokuphula amagobolondo we ukusebenza kanye uhlobo yesibili okwenzeka ku isizinda ezihlukahlukene pathologies. Ngaphansi kwethonya amniotic fluid umane ageleza.

Oligohydramnios ngesikhathi sokukhulelwa. Izimbangela nemiphumela

Izibuyekezo lochwepheshe yesimanje avunyelwe ukuhlonza izigaba amathuba okuba nemiphumela engemihle oligohydramnios:

- okungavamile kwengane esiswini. Ngokuvamile kuba izinkinga ezihlukahlukene kwetinhlavu izinso nobuso bobunjwa. Siqambe khona kwale isici, kungenzeka, kusukela emasontweni 23 emva kabusha izobanjelwa ultrasound.
- A ezihlukahlukene insufficiently iphathwa izifo ezibangelwa amagciwane, okuyinto wahlupheka abakhulelwe. Kaningi-ke kungaba isifo ukuthi kakade luphakamile owesifazane uthwele i-fetus. Ingozi iba lula ukuxilonga kakade ngesikhathi ngesonto lama-20. Kuleli qophelo ziqala ukuba ngenkuthalo bathuthuke hormone, kanjalo okubangela nokuntuleka kwamanzi.
- wehlise uketshezi umsebenzi igobolondo esakha esibelethweni kanye runningaway epithelium sokugembula.
- komfutho wegazi angawi ngesikhathi sonke isikhathi sokukhulelwa. Endabeni ka uthuthumele abalulekile ingalahleka obusamanzi kuvamile kakhulu kulo lonke isonto 21 th.
- Uma owesifazane ubeletha umntwana amasonto angaphezu kuka-40, isivele ne oligohydramnios 38th ungase uqale ngesikhathi sokukhulelwa. I oligohydramnios eziyingozi, oluchazwe ngenhla. Kuyancomeka ntombazane nokubeletha, njengoba amasonto umntwana 36 ngomumo ngokuphelele wayeyozalelwaphi.
- ukukhulelwa amaningi. Kulokhu, a zokugula enjalo ithuthukisa ngenxa division engalingani e ukugeleza placenta igazi.
- ukwephula Obalulekile we izinqubo umzimba ukuthi cishe kutholakale amasonto 21-22.

Lezi izinkinga main ukuthi kungabangela oligohydramnios ngesikhathi sokukhulelwa.

Iyini ingozi

Izizathu kuyo okudingekile uye kudokotela uyofuna icebiso, kungaba kokubili imihuzukwana abanye balimala. Ukugula ezenzeka phakathi senyanga yesibili, zihlukile ngokwemvelo. Ngezinye maphakathi no-umjikelezo pripadaet ukukhula asebenzayo we umntwana, futhi esimweni ukunciphisa izithelo ketshezi uqale cindezela odongeni lesizalo. Ngebanga lalokho, lokhu kungaholela ukusonteka amathambo skull, uyisithulu hip dislocation kanye nezinye kwezinso. Khona-ke lezi zingane sezikhulile ngaphansi kokuqondisa udokotela wezinyawo. Uma isikhathi ukubona onguchwepheshe, lezi ukukhubazeka ongamelana ukulungiswa.

Kubalulekile ukuqonda ukuthi yini esongela futhi ezigabeni kamuva yokukhulelwa oligohydramnios ngokulinganisela. Izimbangela, Izimpawu futhi ayahlukahluka. Kulesi sigaba, lo wesifazane uphasisa ultrasound zokugcina, imiphumela lapho udokotela anqume inani amniotic fluid. Phakathi nale nkathi, amanzi ekuqaleni kakade ukuba bawe, nxa bezilinganisa ngezingqobo ngokwabo, kodwa uma buzoba buncane kakhulu kunalokhu okujwayelekile, lokho-ke kuyadingeka ukuba unake okukhethekile, ngoba lokhu isici kungaba nomthelela ukugeleza zomsebenzi. Uma kukhona ngisho oligohydramnios ngokulinganisela, ngokuvamile kuba kubabangele ukubukeka umntwana ngaphambi kwesikhathi ezweni. Endabeni ingane ngesikhathi kukhona ukuzalwa ithuba ukuthi sizothinta ukuvulwa kwesibeletho, njengoba kuba esinyeni fetus ngesikhathi ukulethwa ubeka ingcindezi, ngakho lo dade kwembula.

ubufakazi

Lokulingene nokuntuleka kwamanzi kuyaqabukela ephelezelwa izimpawu ezithile, kodwa namanje ngezinye izikhathi abesifazane bangase babe ezinye kabi. Ngemva kwalokho, kuzoxoxwa kabanzi:

1. Okokuqala kumele ubuhlungu uxwayiswe esiswini.
2. Kwangathi avele eliqhaqhazelayo nesicanucanu ngesikhathi ukunyakaza fetus.
3. Ngesikhathi senyanga yesibili kukhona luyanda umsebenzi wokukhulisa ingane. Uma sac amniotic libhekene kusilela uketshezi ukunyakaza kuzokwenza unina kubonakala kuphatheke kabuhlungu kakhulu.
4. Udokotela ungase umbonise ukuchaza inkinga, okusekelwe ubukhulu elincane kwesibeletho, kanye ayihambisani le diameters we selilonke kwamathumbu.
5. Isithelo esincane ukuhamba.

ukwelashwa

Namuhla isibe uphethwe ngempela njalo "oligohydramnios omnene." Ukwelashwa izimbangela kungaba ngempela omnene futhi asidingi kokungenela zangaphandle. Nge ukwehla okuncane oketshezini ngaphakathi 400-700 ml Kunconywa ukunciphisa kokuvivinya umzimba, izinga okusezingeni ngabondla ngokugcwele, kudle izakhiwo multivitamin futhi njalo amqaphela wezifo zabesifazane.

Ukuze uvimbele okubi kakhulu kwesimo, kungase kudingeke ultrasound ezengeziwe unscheduled. Uma izimpawu ziba evelele, izimbangela kanye nokwelashwa oligohydramnios ngesikhathi sokukhulelwa zizohluka. Kulokhu, isidingo esibhedlela saziso.

Uma udokotela uye zingatholakalanga owesifazane baphuthuma esibhedlela ukufeza cwaningo kunesidingo. Lapho observation umile olwenziwa zonke izinqubo ezidingekayo, okuyilezi:

- ultrasound (ultrasound);
- CTG (cardiotocography);
- ukuhlolwa laboratory (egazi noma omchamo).

Uma udokotela wezifo zabesifazane kusikisela ukuthi isiguli amnionalnaya gidroreya, okungukuthi, ukuvuza-amniotic fluid, qiniseka ukuba ayeke swab ekhethekile. Uma owesifazane kuleli viki 38th, futhi wesibeletho cishe uqeda ukulungiselela sokubelethisa, isiteshi wakhe nje miss amnioscope. Nge insimbi enjalo yezokwelapha, kuba lula kakhulu ukunquma Ukwakheka eziwuketshezi fetus kanye nobungako. Le nqubo akwephuli ubunye nolwelwesi futhi ngeke ukulimaza ingane. Phela Luhlolokulinganisa lwetivivinyo neluhlolo eyenziwa ngudokotela inquma indlela yokuphatha oligohydramnios ngesikhathi sokukhulelwa. Izizathu ezibangela yezinkinga ezifana zingase zishintshe kakhulu, kodwa izinkinga eziyisisekelo futhi izixazululo zabo kuchazwe lapha ngezansi:

1. amnionalnoy gidroree nesineke ezinqunyiwe esiqinile embhedeni ukuphumula, kanye nokwamukela izakhiwo olukhethekile amavithamini nezidakamizwa, okuzosiza ekunciphiseni ithoni kwesibeletho kanye nokuvimbela ukutheleleka nemisipha ingane. Abaningi kulaba besifazane abakhulelwe esibhedlela kwaze kwazalwa uqobo, ukuze odokotela kungaba njalo ukuqapha isimo umbungu.
2. Kubalulekile ukwazi ukuthi nokuntuleka kwamanzi kuyingozi ngesikhathi ekhulelwe, izimbangela zazo amanga izifo ezibangelwa amagciwane. ukwephulwa ezinjalo kungabangela zonke izinhlobo zezifo. Ukuze uxazulule le nkinga kumele uthathe izinhlelo namagciwane futhi ngokubhukula. Ngaphezu kwalezi amavithamini edingekayo kanye therapy preparative, ethuthukisa kwegazi. Uma udokotela uyogcina umkhuba omuhle, kungavumela umama okhulelwe uya ekhaya, kodwa awubeka control unomphela emtholampilo.
3. Uma ukuthuthukiswa okungavamile ulwelwesi fetus udinga ukusebenzisa amasu okuhloswe ngazo zokuvimbela ukutheleleka intrauterine bese ugcine i-fetus. Ukunquma izimbangela, ukuxilongwa kanye nokwelashwa nokuntuleka kwamanzi kubantu besifazane abakhulelwe olwenziwa emnyangweni egunjini lokuhlolwa kwezifo. Impela lokhu kugadwa kogulayo ngomntanakhe.
4. Endabeni perenashivanie egcinwe puncturing bubble - amniotomy. Ngemva le nqubo, ngokushesha uqala inqubo bokubeletha.

Uma welashwe kusenethuba ukuhlela bese ukuxazulula lesi simo, isibikezelo ukuzalwa kwengane enempilo ezimweni eziningi kuyoba evumayo.

imiphumela

Isikhathi esining impela, abaningi abalibheki inkinga futhi ungafuni ukuba aphathe oligohydramnios ngokulinganisela ngesikhathi sokukhulelwa. Izimbangela Nezingozi imiphumela uthathe leso sinyathelo zingase zishintshe kakhulu. Khona-ke abakhululiwe eziyinhloko isisindo ongaphakeme ngayo lapho usana, noma ugobile yomgogodla, futhi hip dysplasia. Uma ulalele izeluleko lochwepheshe, ezimweni eziningi, ukuqeda isidina ezinjalo kungenzeka. Lokhu kungenzeka kuphela uma umama okhulelwe esifike khona bonke abahlola okuhleliwe, kufanele ihlolwe futhi kwenziwe ukuze afeze injongo yayo udokotela ukuba khona. Ngenxa yalokhu odokotela bangathola ukuthi ngesikhathi esifanele aphendule inkinga yamanje bese ukukulungisa.

Ayikho izimbangela nemiphumela nokuntuleka kwamanzi kufanele kungathathwa njengesigwebo ukuxilongwa esichazayo. Baphetha ngokuthini main, okungase ukunikela, imele retested. Kungcono kwenziwa ngenye umtholampilo. It is ibuye Kunconywa ukuba afeze semithambo Doppler, ngoba isifundo esinjalo kuyabaveza kwezinso ukuthi lihlotshaniswa nokuthuthukiswa imisiwe umbungu. Enye kukulandzelela inhliziyo ekuhloleni isimo ingane kabanzi.

Uma kukhona kungenzeka ezifana ke, kanye wezifo zabesifazane, ababethwala sokukhulelwa, cabanga zonke izici ukuthi kungaba nomthelela wokukhula okuthe inciphise amniotic fluid.

yezinkinga

Oligohydramnios ngesikhathi sokukhulelwa, izimpawu kanye nemiphumela okungaba ehlukene kakhulu, enezinto eziningi yezinkinga ezithile:

1. Ukuminyanisa we-canal enkabeni. Ngaphansi kwethonya lokhu Ukungena komoya kuyoba nzima, futhi mhlawumbe bacale kutfutfukisa anoxia ingane. Uma lesi simo asisho nakani, ungalahlekelwa ngisho yingane.
2. Endabeni anenombolo enganele amniotic kwegazi uketshezi kuzoba oyinkimbinkimbi kakhulu. It kukhulisa ematfuba nesenzakalo izifo eziningi esibelethweni. Lo magazini uzalela ingozi yokulimala ngesikhathi sokubeletha.
3. Kaningi kukhona abruption esinomhlapho, kuba ingozi enkulu ngaphezulu umonakalo wesibeletho. I ingaphakathi angahlala moieties of ulwelwesi, elibuye kuphakamisa nesenzakalo ebangela ukopha.
4. Endabeni ulwelwesi flat kungenzeka ukuthi ubuthakathaka ngokuyinhloko ngaleso sikhathi zomsebenzi.
5. Uma amasonto 32 umama okhulelwe ukubeka kokutshelwa ngokukhubazeka kwengane, idinga ukuqonda ukuthi yini esongela oligohydramnios. Imiphumela kanye izimpawu zalesi sifo uvame ephelezelwa ukubambezeleka kumiswa ezingenzeka embungwini, okungase izinkinga yokwelapha wezokwelapha.
6. Ukungabi amniotic fluid alinalo nomphumela ongemuhle ekukhuleni kanye nasekuthuthukeni. Kid engakutholi wonke umsoco ngobungako kwesokudla.

Uma oligohydramnios likhona, ingane silahlekelwa nayithuba lokuthola sebehamba ngokukhululeka besuka ezweni. Ngokuvamile, ngemva kokuzalwa lezi zingane uxilongwe "dysplasia hip", futhi ngokuvamile fixed ugobile yomgogodla. Kodwa uma isikhathi ukuphendula isimo, sibonga imishini yesimanje kungaba ukunciphisa noma yikuphi imithelela emibi futhi, ezimweni eziningi, ngisho aluqede ngokuphelele ke.

Kungenzeka yini ukuvimbela nokuntuleka kwamanzi?

Izimpawu, izimbangela, ukuxilongwa kanye nokwelashwa - ke isici esibaluleke kakhulu, kodwa kungakhathaliseki ukuthi kungenzeka kusengaphambili ukubikezela ukuvela inkinga futhi ukuze uqinisekise lona wesifazane wasala okunempilo? Ngeshwa lezi izinyathelo zokuvimbela abekho. Kodwa ikhona imithetho ekhethekile, kokubona ukuthi unganciphisa ukuthuthukiswa ezihlukahlukene pathologies. Bahlanganisa ukwenqaba umsebenzi ngokweqile futhi imithwalo esindayo.

Kubalulekile ukuba kudlule lonke uvivinyo isikhathi ukuba bahlolwe ukusiza ukuqeda izifo ezihlukahlukene, okungase kusebenze ukuthayipha oligohydramnios ngesikhathi sokukhulelwa. Izimbangela nemiphumela ye adluliselwe isifo ezimbi. Ngakho-ke kungcono ukuthatha isinyathelo futhi bafune usizo, kuthuthukisa impilo kokubili umama esizayo kanye nengane.

Ukuze uthuthukise isimo sempilo kudingeka udle kwesokudla. Odokotela futhi izazi zokudla zitusa udle fractionally, ukudla ngokweqile okungenani kahlanu ngosuku, kodwa izingxenye ezincane. Lokhu kunomthelela omuhle empilweni yabesifazane kanye nengane.

Ukukhulelwa nokubeletha

Omama abakhulelwe kuyinto uphethwe very scary ezifana "oligohydramnios ngokulinganisela" ngesikhathi sokukhulelwa. Izimbangela nemiphumela yalesi uphethwe zingase zihluke, ngakho into yokuqala kufanele acabangele ngokwezinga lesi sifo. Uma ukwehla amniotic fluid avele izigaba kamuva ke ngokungabi bikho ekukhuleni kwengane of pathologies zonke ukuqeda kahle.

Uma oligohydramnios zazidilivwa ngesonto lama-27, kungcono ukuqhuba luhlolo olunzulu isiguli - ibhekane kwamakhemikhali kanye ultrasound, ukuze nginikeze ihlaziya hormone.

Uma zonke miphumela izotholwa uma ukwephulwa umbungu sobala atholakala, kubalulekile ukuthatha isinqumo esinzima ngokukhipha isisu.

Lapho inkinga ilungiswe yokuthathu yesithathu kanye nengane ucala kutfutfukisa ephethe ukulibala eside, ngokuvamile unquma ukubeletha singakafiki isikhathi. Kunoma ikuphi isinqumo sokugcina isezandleni udokotela ukuba khona. Ithola ukuthi benzeni esimweni samanje, ukuze unciphise ingozi yezinkinga okwengeziwe futhi ukulungiselela abesifazane kule nqubo bokubeletha.