Matenda a HELLP

Matenda a HELLP ndi gulu la zizindikilo zomwe zimapezeka mwa amayi apakati omwe ali ndi:

• H: hemolysis (kuwonongeka kwa maselo ofiira amwazi)
• EL: michere yokwera ya chiwindi
• LP: kuchuluka kwamagazi

Zomwe zimayambitsa HELLP syndrome sizinapezeke. Amadziwika kuti ndi preeclampsia. Nthawi zina kupezeka kwa matenda a HELLP kumachitika chifukwa cha matenda oyamba monga antiphospholipid syndrome.

Matenda a HELLP amapezeka pafupifupi 1 mpaka 2 mwa mimba 1,000. Kwa amayi omwe ali ndi preeclampsia kapena eclampsia, vutoli limayamba ndi 10% mpaka 20% ya mimba.

Kawirikawiri HELLP imayamba pakatha miyezi itatu yapakati (pakati pa 26 mpaka 40 milungu). Nthawi zina zimamera pakatha sabata mwana atabadwa.

Amayi ambiri amakhala ndi kuthamanga kwa magazi ndipo amapezeka kuti ali ndi preeclampsia asanayambe kudwala HELLP. Nthawi zina, zizindikiro za HELLP ndiye chenjezo loyamba la preeclampsia. Vutoli nthawi zina limadziwika kuti:

• Chimfine kapena matenda ena a tizilombo
• Matenda a gallbladder
• Chiwindi
• Idiopathic thrombocytopenic purpura (ITP)
• Lupus flare
• Thrombotic thrombocytopenic purpura

Zizindikiro zake ndi izi:

• Kutopa kapena kusamva bwino
• Kusungidwa kwamadzimadzi ndi kunenepa kwambiri
• Mutu
• Nsautso ndi kusanza zomwe zikupitilira kukulira
• Ululu kumtunda chakumanja kapena chapakati pamimba
• Masomphenya owoneka bwino
• Kutulutsa magazi m'mphuno kapena magazi ena omwe sangayime mosavuta (osowa)
• Kugwidwa kapena kugwedezeka (kawirikawiri)

Pakuyesa kwakuthupi, wothandizira zaumoyo atha kupeza:

• Kukonda m'mimba, makamaka kumanja kumtunda
• Kukulitsa chiwindi
• Kuthamanga kwa magazi
• Kutupa m'miyendo

Kuyesa kwa chiwindi (ma enzyme a chiwindi) kumatha kukhala kwakukulu. Kuwerengera kwa ma Platelet kumakhala kotsika. Kujambula kwa CT kumatha kuwonetsa magazi m'chiwindi. Mapuloteni owonjezera amapezeka mumkodzo.

Kuyesedwa kwa thanzi la mwana kudzachitika. Kuyesa kumaphatikizapo kuyesedwa kosalemetsa kwa fetus ndi ultrasound, pakati pa ena.

Chithandizo chachikulu ndikubereka mwana posachedwa, ngakhale mwanayo asanabadwe msanga. Mavuto a chiwindi ndi zovuta zina za HELLP syndrome zitha kukulirakulira ndikuvulaza mayi ndi mwana.

Wothandizira anu akhoza kuyambitsa ntchito ndikukupatsani mankhwala oti muyambe kugwira ntchito, kapena atha kuchita gawo la C.

Muthanso kulandira:

• Kuthiridwa magazi ngati mavuto akutuluka magazi amakula
• Mankhwala a Corticosteroid othandiza mapapu a mwana kukula msanga
• Mankhwala ochizira kuthamanga kwa magazi
• Kulowetsedwa kwa magnesium sulphate kuti tipewe kugwidwa

Zotsatira zimakhala zabwino kwambiri ngati vuto limapezeka msanga. Ndikofunika kuti azipimidwa kaye asanabadwe. Muyeneranso kudziwitsa omwe akukuthandizani nthawi yomweyo ngati muli ndi zizindikilo za vutoli.

Matendawa akapanda kuchiritsidwa msanga, amayi amodzi (1) mwa amayi anayi (4) amakhala ndi zovuta zina. Popanda chithandizo, amayi ochepa amamwalira.

Kuchuluka kwaimfa mwa ana obadwa kwa amayi omwe ali ndi matenda a HELLP kumadalira kulemera kwa thupi komanso kukula kwa ziwalo za mwana, makamaka mapapu. Ana ambiri amabadwa asanakwane (obadwa asanakwane milungu 37 ya mimba).

Matenda a HELLP amatha kubwerera m'modzi mwa amayi anayi aliwonse apakati.

Pakhoza kukhala zovuta mwana asanabadwe komanso atabereka, kuphatikizapo:

• Kufalitsa kugunda kwamitsempha yamagazi (DIC). Matenda oundana omwe amabweretsa magazi ochulukirapo (kukha magazi).
• Zamadzimadzi m'mapapu (pulmonary edema)
• Impso kulephera
• Kuchepa kwa chiwindi komanso kulephera
• Kupatukana kwa placenta kuchokera kukhoma lachiberekero (kuphulika kwapakhosi)

Mwana akabadwa, matenda a HELLP amatha nthawi zambiri.

Ngati zizindikiro za matenda a HELLP zimachitika panthawi yapakati:

• Onani wothandizira wanu nthawi yomweyo.
• Imbani nambala yadzidzidzi yakomweko (monga 911).
• Fikani kuchipatala chodzidzimutsa kuchipatala kapena kuntchito ndi kubereka.

Palibe njira yodziwika yopewera matenda a HELLP. Amayi onse apakati ayenera kuyamba kusamalira amayi asanabadwe ndikupitiliza kupitilira pathupi. Izi zimathandizira wopezayo kuti apeze ndikuchiza matenda a HELLP nthawi yomweyo.

• Preeclampsia

Esposti SD, Reinus JF. Matenda am'mimba ndi chiwindi mwa wodwala wapakati. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Fordtran's Mimba ndi Matenda a Chiwindi: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chaputala 39.

Sibai BM. Preeclampsia ndi matenda oopsa. Mu: Gabbe SG, Niebyl JR, Simpson JL, et al, olemba. Obstetrics: Mimba Yachibadwa ndi Mavuto. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 31.