Kuchiza kwa Preterm Labor: Tocolytics

Zamkati

• Mankhwala a Tocolytic
• Kodi ndi mankhwala otani a tocolytic omwe ayenera kugwiritsidwa ntchito?
• Ndi nthawi iti yomwe ndili ndi pakati pomwe nditha kumwa mankhwala a tox?
• Kodi mankhwala opatsirana ayenera kupitilizidwa mpaka liti?
• Kodi mankhwala a tocolytic ndi opambana motani?
• Ndani sayenera kugwiritsa ntchito mankhwala a tocolytic?

Mankhwala a Tocolytic

Tocolytics ndi mankhwala omwe amagwiritsidwa ntchito kuchedwetsa kubereka kwanu kwa kanthawi kochepa (mpaka maola 48) mukayamba kugwira ntchito mochedwa kwambiri mukakhala ndi pakati.

Madokotala amagwiritsa ntchito mankhwalawa kuti achedwetse kubereka mukamamusamutsira kuchipatala chomwe chimayang'anira chisamaliro choyambirira, kapena kuti athe kukupatsani corticosteroids kapena magnesium sulphate. Majakisoni a corticosteroid amathandiza kukhwimitsa mapapu a mwana.

Sulphate ya magnesium imateteza mwana wosakwana masabata 32 kuchokera ku matenda a ubongo, koma amathanso kugwiritsidwa ntchito ngati tocolytic. Magnesium sulfate imagwiritsidwanso ntchito popewa kugwidwa kwa amayi apakati omwe ali ndi preeclampsia (kuthamanga kwa magazi).

Mankhwala ena omwe angagwiritsidwe ntchito ngati tocolytic ndi awa:

• beta-mimetics (mwachitsanzo, terbutaline)
• calcium channel blockers (mwachitsanzo, nifedipine)
• mankhwala osagwiritsa ntchito zotupa kapena ma NSAID (mwachitsanzo, indomethacin)

Zambiri pazokhudza mankhwalawa zaperekedwa pansipa.

Kodi ndi mankhwala otani a tocolytic omwe ayenera kugwiritsidwa ntchito?

Palibe chidziwitso chosonyeza kuti mankhwala amodzi ndiabwino kuposa ena, ndipo madotolo m'malo osiyanasiyana mdzikolo ali ndi zokonda zosiyanasiyana.

M'zipatala zambiri, terbutaline amapatsidwa makamaka ngati mayi ali pachiwopsezo chobereka mwana msanga. Kwa amayi omwe ali pachiwopsezo chachikulu chobereka sabata yamawa, magnesium sulphate (yoperekedwa kudzera m'mitsempha) nthawi zambiri imakhala mankhwala osankhika.

Ndi nthawi iti yomwe ndili ndi pakati pomwe nditha kumwa mankhwala a tox?

Mankhwala opatsirana pogonana asanagwiritsidwe ntchito asanagwiritse ntchito milungu 24 isanakwane. Nthawi zina, dokotala akhoza kugwiritsa ntchito mukakhala ndi milungu 23 yapakati.

Madokotala ambiri amasiya kupereka mankhwala osokoneza bongo mayi atakwanitsa sabata la 34 la mimba, koma madokotala ena amayamba kumwa mankhwalawa mpaka milungu 36.

Kodi mankhwala opatsirana ayenera kupitilizidwa mpaka liti?

Dokotala wanu angayesere kuchiza msana wanu musanagwire ntchito ndi kupumula pabedi, madzi owonjezera, mankhwala opweteka, ndi mlingo umodzi wokha wa mankhwala opatsirana. Akhozanso kuwunikiranso (monga mayeso a fetal fibronectin ndi transvaginal ultrasound) kuti adziwe bwino za chiopsezo chanu chobereka asanakwane.

Ngati mabvuto anu sasiya, lingaliro loti mupitilize mankhwala opatsirana, komanso kwa nthawi yayitali bwanji, lingatengera chiopsezo chanu choberekera asanakwane (malinga ndi kuyezetsa), zaka za mwana, komanso udindo wa mwana mapapo.

Ngati mayeso akuwonetsa kuti muli pachiwopsezo chachikulu chobereka musanabadwe, dokotala wanu atha kukupatsani magnesium sulphate osachepera maola 24 mpaka 48 komanso mankhwala a corticosteroid kuti muthane ndi mapapo a mwana.

Ngati mavutowo ayima, dokotala wanu amachepetsa ndikusiya magnesium sulphate.

Ngati zopitilira kupitilirabe, dokotala wanu atha kuyitanitsa mayeso ena kuti athetse matenda omwe ali m'chiberekero. Dotolo amathanso kuyesa kuti adziwe momwe mapapu a mwana alili.

Kodi mankhwala a tocolytic ndi opambana motani?

Palibe mankhwala opangidwa ndi tocolytic omwe adawonetsedwa kuti amachedwa kubereka kwakanthawi kochepa.

Komabe, mankhwala a tocolytic amatha kuchedwa kubereka kwakanthawi kochepa (nthawi zambiri masiku ochepa). Izi nthawi zambiri zimapereka nthawi yokwanira kuti mulandire ma steroids. Majakisoni a corticosteroid amachepetsa ziwopsezo kwa mwana wanu akafika msanga.

Ndani sayenera kugwiritsa ntchito mankhwala a tocolytic?

Amayi sayenera kugwiritsa ntchito mankhwala a tocolytic pakawopsa chifukwa chogwiritsa ntchito mankhwalawa kuposa phindu lake.

Zovutazi zimatha kuphatikiza amayi omwe ali ndi preeclampsia kapena eclampsia (kuthamanga kwa magazi komwe kumachitika panthawi yapakati ndipo kumatha kubweretsa zovuta), kutuluka magazi kwambiri (kutaya magazi), kapena matenda m'mimba (chorioamnionitis).

Mankhwala opatsirana pogonana sayenera kugwiritsidwanso ntchito ngati mwana wamwalira m'mimba kapena ngati mwana ali ndi vuto lomwe limamupangitsa kuti akamwalira akabereka.

Nthawi zina, adokotala amatha kusamala pakagwiritsa ntchito mankhwala a tocolytic, koma angawapatse mankhwalawa chifukwa maubwino ake amaposa kuopsa kwake. Izi zitha kuphatikizira pamene mayi ali ndi:

• preeclampsia wofatsa
• Kutuluka magazi kokhazikika m'kati mwa theka lachiwiri kapena lachitatu
• matenda aakulu
• khomo pachibelekeropo lomwe latulutsa kale masentimita 4 mpaka 6 kapena kupitilira apo

Dokotala amatha kugwiritsabe ntchito tocolytics pamene mwana ali ndi vuto la mtima losazolowereka (monga zikuwonetsedwera pa fetus Monitor), kapena kukula pang'ono.