Hemolytic chirwere chemucheche

Hemolytic chirwere cheiye achangozvarwa (HDN) chirwere cheropa mumucheche kana mucheche achangozvarwa. Mune vamwe vacheche, zvinogona kuuraya.

Kazhinji, masero matsvuku eropa (RBCs) anogara kwemazuva angangoita zana nemakumi maviri mumuviri. Mune kusagadzikana uku, maRBC muropa anoparadzwa nekukurumidza uye nekudaro haagare kwenguva yakareba.

Munguva yepamuviri, maRBC kubva kumucheche asati aberekwa anogona kuyambuka achienda muropa raamai kuburikidza nepacenta. HDN inoitika kana immune system yaamai ichiona maRBC emucheche sewekunze. Maantibodies anobva akurwisa maRBC evacheche. Ma antibodies aya anorwisa maRBC muropa remwana uye anoita kuti akurumidze kukasira.

HDN inogona kukura kana amai nemwana wavo asati aberekwa vaine mhando dzakasiyana dzeropa. Mhando idzi dzinovakirwa pazvinhu zvidiki (maantigen) pamusoro pemasero eropa.

Pane nzira dzinopfuura imwe chete dzeropa remwana asati azvarwa dzingasafanane neraamai.

• A, B, AB, uye O ndiwo mana makuru eropa maantigen kana mhando. Iyi ndiyo fomu yakajairika yekutadza. Muzviitiko zvakawanda, izvi hazvina kunyanyisa.
• Rh ipfupi kune "rhesus" antigen kana yeropa mhando. Vanhu vangave vakanaka kana vasina kunaka nekuda kweantigen iyi. Kana amai vasina Rh uye mwana ari mudumbu aine masero eRh-positive, masoja ekudzivirira chirwere kuRh antigen anogona kuyambuka rukuvhute ndokukonzera kupererwa neropa kwakanyanya mumwana. Inogona kudzivirirwa mune dzakawanda zviitiko.
• Iko kune zvimwe, zvishoma zvakajairika, mhando dzekutadza pakati pediki reropa boka maantigen. Zvimwe zveizvi zvinogona kukonzera matambudziko akakomba.

HDN inogona kuparadza masero eropa emwana achangozvarwa nekukurumidza, izvo zvinogona kukonzera zviratidzo zvakaita se:

• Edema (kuzvimba pasi pechiso cheganda)
• Yachangoberekwa jaundice inoitika nekukurumidza uye yakaoma kupfuura zvakajairwa

Zviratidzo zveHDN zvinosanganisira:

• Anemia kana yakaderera ropa kuverenga
• Yakawedzera chiropa kana spleen
• Hydrops (fluid mukati memiviri yemuviri, kusanganisira munzvimbo dzine mapapu, moyo, uye nhengo dzemudumbu), izvo zvinogona kutungamira kukundikana kwemoyo kana kufema kufema kubva kuakawanda mvura

Ndeapi mabvunzo anoitwa zvinoenderana nerudzi rweboka reropa kusapindirana uye kuomarara kwezviratidzo, asi zvinogona kusanganisira:

• Yakazara kuverenga kweropa uye isina kusviba tsvuku reropa (reticulocyte) kuverenga
• Chikamu cheBilirubin
• Kunyorera ropa

Vacheche vane HDN vanogona kurapwa ne:

• Kudyisa kazhinji uye nekugamuchira mamwe emvura.
• Chiedza chemwenje (phototherapy) uchishandisa mwenje webhuruu wakasarudzika kushandura bilirubin muchimiro icho chiri nyore kuti muviri wemwana ubvise.
• Antibodies (intravenous immunoglobulin, kana IVIG) kubatsira kuchengetedza masero matsvuku emwana kubva mukuparadzwa.
• Mishonga yekusimudza BP kana ikadzika zvakanyanya.
• Muzviitiko zvakakomba, kuwedzerwa kuwedzerwa kuwedzerwa kunogona kuda kuitwa. Izvi zvinosanganisira kubvisa huwandu hweropa remwana, uye nekudaro bilirubin yekuwedzera uye maantibhakitiriya. Rutsva rweanopa ropa anopinzwa.
• Kuisirwa nyore (pasina kuchinjana). Izvi zvingangoda kudzokororwa mushure mekunge mwana aenda kumba kubva kuchipatara.

Kuomarara kwechimiro ichi kunogona kusiyana. Vamwe vacheche havana zviratidzo. Mune zvimwe zviitiko, matambudziko akadai sehydrops anogona kukonzera kuti mwana afe asati, kana nguva pfupi yapfuura, kuzvarwa. Yakakomba HDN inogona kurapwa isati yazvarwa nekuiswa kweropa mukati me intrauterine.

Chimiro chakakomba zvikuru chechirwere ichi, icho chinokonzerwa neRh kusapindirana, chinogona kudzivirirwa kana amai vakaedzwa panguva yekuzvitakura. Kana zvichidikanwa, anopiwa pfuti yemushonga unonzi RhoGAM pane dzimwe nguva panguva uye mushure mekubata kwake. Kana iwe wakave nemwana ane chirwere ichi, taura nemupi wako wezvehutano kana iwe ukaronga kuita mumwe mwana.

Hemolytic chirwere chemucheche nemwana achangozvarwa (HDFN); Erythroblastosis fetalis; Kupererwa neropa - HDN; Kusapindirana kweropa - HDN; ABO kusapindirana - HDN; Rh kusapindirana - HDN

• Intrauterine kuwedzerwa ropa
• Antibodies

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Simmons PM, Magann EF. Immune uye isiri-immune hydrops fetalis. Mune: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff uye Neonatal-Perinatal Mushonga: Zvirwere zveMucheche neMucheche. 11th ed. Philadelphia, PA: Elsevier; 2020: chits. 23.