Hydrops fetalis

Hydrops fetalis mamiriro akakomba. Izvo zvinoitika kana huwandu husingaenzanisike hwemvura huchivaka munzvimbo mbiri kana kupfuura dzemuviri wemucheche kana mwana achangozvarwa. Icho chiratidzo chematambudziko ari pasi.

Kune mhando mbiri dzehydrops fetalis, immune uye nonimmune. Mhando yacho inoenderana nechikonzero chemvura isina kujairika.

• Immune hydrops fetalis inowanzo kuve kuomarara kwechimiro chakakomba cheRh kusapindirana, uko kunogona kudzivirirwa. Aya ndiwo mamiriro ezvinhu amai vane Rh mhando yeropa vanoita ma antibodies kumwana wavo Rh akanaka masero eropa, uye masoja ekudzivirira anoyambuka rukuvhute. Rh kusapindirana kunokonzera kuwanda kwemasero matsvuku eropa mu "fetus" kuti aparadzwe (Izvi zvinozivikanwawo sehemolytic chirwere chemwana achangozvarwa.) Izvi zvinotungamira kumatambudziko anosanganisira kuzvimba kwese kwemuviri. Kuzvimba kwakanyanya kunogona kukanganisa mashandiro emitezo yemuviri.
• Asina kusimba hydrops fetalis zvakajairika. Iyo inosvika makumi mapfumbamwe muzana ezviitiko zvehydrops. Mamiriro acho anoitika apo chirwere kana chirwere chinokanganisa kugona kwemuviri kubata fluid. Pane zvikonzero zvitatu zvakakura zvemhando iyi, moyo kana mapapu matambudziko, kushomeka kweanemia kwakanyanya (senge kubva thalassemia kana kutapukirwa), nematambudziko emajini kana ebudiriro, kusanganisira Turner syndrome.

Huwandu hwevacheche vanovandudza immune hydrops fetalis hwaderera nekuda kwemushonga unonzi RhoGAM. Mushonga uyu unopihwa sejekiseni kuvanaamai vane nhumbu vari panjodzi yekusawirirana kweRh. Mushonga unovadzivirira kubva pakugadzira masoja ekudzivirira maseru matsvuku evana vavo. (Kune zvimwe, zvisingawanzoitika, boka reropa kusapindirana kunogona kukonzera immune immune hydrops fetalis, asi RhoGAM haibatsire neizvi.)

Zviratidzo zvinoenderana nekuomarara kwemamiriro acho. Mafomu akapfava anogona kukonzera:

• Chiropa kuzvimba
• Chinja muvara rweganda (pallor)

Mamwe mafomu akaomarara anogona kukonzera:

• Matambudziko ekufema
• Kupwanya kana kupwanya-kupwanya-senge mavara paganda
• Kutadza kwemoyo
• Yakanyanya kupererwa neropa
• Yakanyanya jaundice
• Kwese muviri kuzvimba

Iyo ultrasound yakaitwa panguva yekuzvitakura inogona kuratidza:

• Yakakwira mazinga eamniotic fluid
• Pasina kujairika yakakura placenta
• Mvura inokonzera kuzvimba mukati nekukomberedza nhengo dzemwana asati aberekwa, kusanganisira chiropa, spleen, moyo, kana nzvimbo yemapapu.

An amniocentesis uye kazhinji ultrasound ichaitwa kuti uone kuomarara kwemamiriro acho.

Kurapa kunoenderana nechikonzero. Panguva yekuzvitakura, kurapwa kunogona kusanganisira:

• Mushonga wekukonzeresa kuberekwa nekuzvarwa kwemwana
• Kutanga kuburitsa carearean kana mamiriro akanyanya
• Kupa ropa kumwana achiri mudumbu (intrauterine fetal kuwedzerwa ropa)

Kurapa kwemucheche kunogona kusanganisira:

• Kune immune hydrops, kuisirwa zvakananga masero matsvuku eropa anoenderana nerudzi rweropa remucheche. Kuwedzeredzwa kuwedzerwa kubvisa muviri wemwana wezvinhu zviri kuparadza masero matsvuku eropa kunoitwawo.
• Kubvisa mamwe emvura kubva kwakatenderedza mapapu nenhengo dzemudumbu netsono.
• Mishonga yekudzivirira kutadza kwemoyo uye kubatsira itsvo kubvisa zvinowedzera zvinwiwa.
• Maitiro ekubatsira kufema kwechecheche, senge muchina wekufema (mweya wekufema).

Hydrops fetalis inowanzoguma nekufa kwechecheche nguva pfupi kana mushure mekusununguka. Njodzi yacho yakanyanya kuvana vanozvarwa vachiri vadiki kana vanorwara pakuzvarwa. Vacheche vane hurema hwekuumbwa, uye avo vasina chikonzero chakazivikanwa cheiyo hydrops vari panjodzi huru.

Kukuvara kwehuropi kunonzi kernicterus kunogona kuitika mune yekusawirirana kweRh. Kukurumidza kunonoka kwakaonekwa muvacheche vakagamuchira kuwedzerwa kweropa.

Rh kusapindirana kunogona kudzivirirwa kana amai vakapihwa RhoGAM panguva uye mushure mekuzvitakura.

• Hydrops fetalis

Dahlke JD, Magann EF. Immune uye nonimmune hydrops fetalis. Mune: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff naMartin's Neonatal-Perinatal Mushonga. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015: chitsiko 24.

Langlois S, Wilson RD. Fetal hydrops. Mune: Pandya PP, Oepkes D, Sebire NJ, Wapner RJ, eds. Fetal Mushonga: Basic Science uye Clinical Practice. 3rd ed. Philadelphia, PA: Elsevier; 2020: chitsiko 36.

Suhrie KR, Tabbah SM. Kubata zvine njodzi zvakanyanya. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chits. 114.