HELLP chirwere

HELLP syndrome iboka rezviratidzo zvinoitika mune vakadzi vane nhumbu vane:

• H: hemolysis (kuparara kwemasero matsvuku eropa)
• EL: akakwidziridzwa echiropa enzymes
• LP: yakaderera platelet kuverenga

Chikonzero cheHELLP syndrome hachisati chawanikwa. Inofungidzirwa kunge iri preeclampsia. Dzimwe nguva kuvapo kweHELLP syndrome kunokonzerwa nechirwere chepasi chakadai seantiphospholipid syndrome.

HELLP syndrome inoitika munenge 1 kusvika 2 kubva pa1000 nhumbu. Mune vakadzi vane preeclampsia kana eclampsia, mamiriro acho anokura mu10% kusvika 20% yepamuviri.

Kazhinji kacho HELLP inokura mukati memwedzi mitatu yetatu yenhumbu (pakati pemasvondo makumi maviri nemakumi mana makumi mana ekubata). Dzimwe nguva inokura muvhiki mushure mekunge mwana azvarwa.

Vakadzi vazhinji vane BP yakakwira uye vanoonekwa kuti vane preeclampsia vasati vaita HELLP syndrome. Mune zvimwe zviitiko, zviratidzo zveHELLP ndiyo yambiro yekutanga preeclampsia. Mamiriro acho dzimwe nguva anoonekwa zvisirizvo se:

• Flu kana chimwe chirwere chehutachiona
• Gallbladder chirwere
• Hepatitis
• Idiopathic thrombocytopenic purpura (ITP)
• Lupus flare
• Thrombotic thrombocytopenic purpura

Zviratidzo zvinosanganisira:

• Kuneta kana kunzwa kusagadzikana
• Kuchengetwa kwemvura uye kuwedzera kuwedzera uremu
• Kutemwa nemusoro
• Nausea uye kurutsa izvo zvinoramba zvichitowedzera
• Marwadzo ari kumusoro kwekurudyi kana wepakati chikamu chedumbu
• Blurry chiratidzo
• Nosebleeded kana kumwe kubuda ropa uko kusingamire nyore (zvisingawanzo)
• Kufenda kana kugwinha (zvisingawanzoitika)

Munguva yekuongorora kwepanyama, mupi wezvehutano anogona kuwana:

• Abdominal unyoro, kunyanya kurudyi kumusoro chikamu
• Yakawedzera chiropa
• Kuwedzera kweropa
• Kuzvimba mumakumbo

Chiropa basa bvunzo (chiropa enzymes) inogona kunge yakakwira. Platelet kuverenga kunogona kunge kuri pasi. A CT scan inogona kuratidza kubuda ropa muchiropa. Mapuroteni akawandisa anogona kuwanikwa mumuti.

Kuedzwa kwehutano hwemwana kuchaitwa. Kuyedza kunosanganisira fetus isiri-kunetseka bvunzo uye ultrasound, pakati pevamwe.

Mushonga mukuru ndeyekusununguka mwana nekukurumidza sezvazvinogona, kunyangwe kana mwana asati akurumidza. Zvinetso nechiropa uye zvimwe zvinonetsa zveHELLP syndrome zvinogona kukurumidza kuwedzera uye kukuvadza kuna mai nemwana.

Wako mupi anogona kukurudzira vashandi nekukupa iwe mishonga kuti utange basa, kana anogona kuita C-chikamu.

Iwe unogona zvakare kugamuchira:

• Kuwedzerwa ropa kana matambudziko ekubuda ropa akanyanya
• Corticosteroid mishonga yekubatsira mapapu emwana kukura nekukurumidza
• Mishonga yekurapa BP
• Magnesium sulfate infusion yekudzivirira pfari

Mhedzisiro inowanzo kuve yakanaka kana dambudziko rikaonekwa nekukurumidza. Izvo zvakakosha kuti ugare uchiongororwa prenatal. Iwe unofanirwa zvakare kurega mupi wako azive ipapo ipapo kana iwe uine zviratidzo zveichi chiitiko.

Kana chirwere chacho chikasarapwa nekukasira, kusvika kumukadzi mumwechete pavana anovandudza matambudziko. Pasina kurapwa, vashoma vakadzi vanofa.

Huwandu hwekufa pakati pevana vanozvarwa naamai vane HELLP syndrome zvinoenderana nehuremu hwekuzvarwa uye kukura kwenhengo dzemwana, kunyanya mapapu. Vazhinji vacheche vanozvarwa nguva isati yakwana (vanozvarwa pamberi pemavhiki makumi matatu nemanomwe ekubata).

HELLP syndrome inogona kudzoka inosvika pamukadzi mumwe chete pavana nhumbu dzeramangwana.

Panogona kuve nezvinetso mwana asati uye mushure mekusununguka, kusanganisira:

• Yakaparadzirwa intravascular coagulation (DIC). Chirwere chekugwamba chinotungamira mukubuda ropa zvakanyanya (hemorrhage).
• Fluid mumapapu (pulmonary edema)
• Itsvo kutadza
• Chiropa kubuda ropa uye kutadza
• Kuparadzaniswa kwepacenta kubva mudumbu reu uterine (placental abruption)

Mushure mekunge mwana azvarwa, HELLP syndrome inoenda kazhinji.

Kana zviratidzo zveHELLP syndrome zvikaitika panguva yepamuviri:

• Ona mupiki wako ipapo.
• Fonera iyo yemuno emergency emergency (se911).
• Enda kuchipatara emergency room kana labour uye delivery unit.

Iko hakuna inozivikanwa nzira yekudzivirira HELLP syndrome. Vakadzi vese vane nhumbu vanofanirwa kutanga kuchengetedza prenatal uye voenderera nayo kuburikidza nepamuviri. Izvi zvinobvumidza mupi kuti awane nekurapa mamiriro akadai seHELLP syndrome ipapo.

• Preeclampsia

Esposti SD, Reinus JF. Matumbu uye kusagadzikana kwehuropi mumurwere ane pamuviri. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chirwere: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 39.

Sibai BM. Preeclampsia uye kusagadzikana kwehutano. Mune: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Yakajairwa uye Dambudziko Pamuviri. 7th ed. Philadelphia, PA: Elsevier; 2017: chits. 31.