Matenda a ovarian hyperstimulation

Matenda a ovarian hyperstimulation (OHSS) ndi vuto lomwe nthawi zina limawoneka mwa azimayi omwe amamwa mankhwala obereketsa omwe amalimbikitsa kupanga mazira.

Nthawi zambiri, mkazi amatulutsa dzira limodzi pamwezi. Amayi ena omwe amavutika kutenga pakati amatha kupatsidwa mankhwala owathandiza kupanga ndi kumasula mazira.

Ngati mankhwalawa atulutsa mazira ochulukirapo, thumba losunga mazira limatha kutupa kwambiri. Madzi amatha kutuluka m'mimba ndi pachifuwa. Izi zimatchedwa OHSS. Izi zimachitika pokhapokha mazirawo atatuluka m'mimba (ovulation).

Mutha kukhala ndi mwayi wopeza OHSS ngati:

• Mumalandira kuwombera kwa anthu chorionic gonadotropin (hCG).
• Mumalandira mlingo umodzi wa hCG mutatha kuyamwa.
• Mumakhala ndi pakati munthawi imeneyi.

OHSS kawirikawiri imapezeka mwa amayi omwe amangotenga mankhwala osokoneza bongo pakamwa.

OHSS imakhudza azimayi 3% mpaka 6% omwe amadutsa mu vitro feteleza (IVF).

Zina mwaziwopsezo za OHSS ndi monga:

• Kukhala ochepera zaka 35
• Kukhala ndi mulingo wokwera kwambiri wa estrogen panthawi yachithandizo cha chonde
• Kukhala ndi matenda a polycystic ovarian

Zizindikiro za OHSS zitha kukhala zochepa mpaka zovuta. Amayi ambiri omwe ali ndi vutoli amakhala ndi zizindikiro zochepa monga:

• Kutupa m'mimba
• Kupweteka pang'ono pamimba
• Kulemera

Nthawi zambiri, azimayi amatha kukhala ndi zizindikilo zowopsa, kuphatikiza:

• Kukula msanga (mapaundi opitilira 10 kapena ma kilogalamu 4.5 m'masiku 3 mpaka 5)
• Kupweteka kwambiri kapena kutupa m'mimba
• Kuchepetsa kukodza
• Kupuma pang'ono
• Nseru, kusanza, kapena kutsegula m'mimba

Ngati muli ndi vuto lalikulu la OHSS, wothandizira zaumoyo wanu adzafunika kuwunika matenda anu mosamala. Mutha kulowetsedwa kuchipatala.

Kulemera kwanu ndi kukula kwa gawo lamimba lanu (pamimba) kudzayesedwa. Mayeso omwe angachitike ndi awa:

• M'mimba ultrasound kapena ukazi ultrasound
• X-ray pachifuwa
• Kuwerengera kwathunthu kwa magazi
• Gulu lamagetsi
• Kuyesa kwa chiwindi
• Kuyesa kuyeza kutuluka kwamkodzo

Matenda ofatsa a OHSS nthawi zambiri safunika kuthandizidwa. Vutoli litha kusintha mwayi wokhala ndi pakati.

Njira zotsatirazi zingakuthandizeni kuchepetsa mavuto anu:

• Pezani mpumulo wochuluka mutakweza miyendo yanu. Izi zimathandiza thupi lanu kumasula madzimadzi. Komabe, kuchita zinthu mopepuka nthawi ndi nthawi kuli bwino kuposa kupumula pabedi pokha, pokhapokha dokotala atakuwuzani zina.
• Imwani magalasi osachepera 10 mpaka 12 (pafupifupi 1.5 mpaka 2 malita) amadzimadzi patsiku (makamaka zakumwa zomwe zimakhala ndi ma elektrolyte).
• Pewani zakumwa zoledzeretsa kapena zakumwa za khofi (monga makola kapena khofi).
• Pewani kuchita masewera olimbitsa thupi kwambiri komanso kugonana. Izi zimatha kuyambitsa mavuto m'mimba ndipo zimatha kupangitsa kuti ma cyst amatuluka kapena kutuluka, kapena kupangitsa kuti thumba losunga mazira lipotoze ndikudula magazi (ovarian torsion).
• Tengani mankhwala ochepetsa ululu monga acetaminophen (Tylenol).

Muyenera kudziyesa tsiku lililonse kuti muwonetsetse kuti simukulemera kwambiri (mapaundi awiri kapena kupitilira apo kapena pafupifupi kilogalamu imodzi kapena kupitilira apo patsiku).

Ngati wothandizira wanu atazindikira kuti OHSS yayikulu asanasamutse mazira mu IVF, atha kusankha kuchotsa kamwana kameneka. Mazirawo ndi achisanu ndipo amadikirira OHSS kuti athetsere asanakonzekere mazira osunthira mazira.

Nthawi zambiri mukakhala ndi OHSS yovuta, mungafunike kupita kuchipatala. Woperekayo amakupatsirani madzi kudzera mumitsempha (madzi amkati mwamitsempha). Amachotsanso madzi omwe asonkhana mthupi lanu, ndikuwunika momwe mulili.

Matenda ambiri ofatsa a OHSS amatha okha pakatha msambo. Ngati muli ndi vuto lokulirapo, zimatha kutenga masiku angapo kuti zizindikilo ziziyenda bwino.

Mukakhala ndi pakati pa OHSS, zizindikilozo zitha kukulirakulira ndipo zimatha kutenga milungu ingapo kuti zithe.

Nthawi zambiri, OHSS imatha kubweretsa zovuta zakufa. Izi zingaphatikizepo:

• Kuundana kwamagazi
• Impso kulephera
• Kusagwirizana kwakukulu kwa electrolyte
• Kutulutsa kwamadzimadzi kwakukulu pamimba kapena pachifuwa

Itanani omwe akukuthandizani ngati mungakumane ndi izi:

• Kutulutsa mkodzo pang'ono
• Chizungulire
• Kulemera kwambiri, kopitilira kilogalamu imodzi patsiku
• Mseru woyipa kwambiri (sungathe kusunga chakudya kapena zakumwa)
• Kupweteka kwambiri m'mimba
• Kupuma pang'ono

Ngati mukupeza jakisoni wa mankhwala obereketsa, muyenera kuyesedwa magazi nthawi zonse ndi ma ultrasound m'chiuno kuti muwonetsetse kuti mazira anu samayankhidwa kwambiri.

OHSS

Catherino WH. Endocrinology yobereka komanso kusabereka. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier Saunders; 2020: chap 223.

Cholakwika BCJM. Njira zamankhwala zolimbikitsira ovarian za kusabereka. Mu: Strauss JF, Barbieri RL, olemba.Endocrinology Yobereka ya Yen & Jaffe. 8th ed. Philadelphia, PA: Elsevier; 2019: chap 30.

Lobo RA. Kusabereka: etiology, kuwunika matenda, kuwongolera, kudwala. Mu: Lobo RA, Gershenson DM, Lentz GM, Valea FA, olemba. Gynecology Yambiri. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 42.