Placental Kusakwana

Zvemukati

• Anokosha mabasa epa placenta
• Zvinokonzera kusakwana
• Zviratidzo
• Matambudziko
• Amai
• Mucheche
• Kuongororwa uye manejimendi
• Outlook

Mhedziso

Iyo placenta inhengo inomera mudumbu panguva yepamuviri. Placental insufficiency (inonziwo placental dysfunction kana uteroplacental vascular insufficiency) chinhu chisingawanzo asi chinetso chakakomba chepamuviri. Zvinoitika kana rukuvhute rusingakure zvakanaka, kana kukuvara. Ichi chirwere chekuyerera kweropa chinoonekwa nekuderedzwa kweropa raamai. Iko kunetseka kunogona zvakare kuitika kana ropa raamai rikasawedzera zvakakwana nepakati pekuzvitakura.

Kana placenta ikatadza kushanda, iri kutadza kuwanisa oxygen yakakwana uye zvinovaka muviri kumwana kubva muropa raamai. Pasina iyi tsigiro yakakosha, mwana haagoni kukura uye kubudirira. Izvi zvinogona kutungamira kuhuremu hwekuzvarwa, kuzvarwa nguva isati yakwana, uye hurema hwekuzvarwa. Iyo zvakare inotakura yakawedzera njodzi yezvinetso kuna amai. Kuona dambudziko iri nekukasira kwakakosha kuhutano hwese amai nemwana.

Anokosha mabasa epa placenta

Iyo placenta inhengo yakaoma kwazvo yehupenyu. Inoita nekukura panobatirirwa zai rakasimudzwa pamadziro echibereko.

Rukuvhute rwunokura kubva mupascenta kuenda kuguvhu remwana. Iyo inobvumira ropa kuyerera kubva kuna amai kuenda kumucheche, uye kudzoka zvakare. Ropa raamai neropa remucheche zvinosvinwa kuburikidza nepacenta, asi hazvinyatso sanganisa.

Iyo yekutanga placenta mabasa ndeyekuti:

• fambisa okisijeni muropa remwana
• kutakura carbon dioxide kuenda
• pfuudza zvinovaka muviri kumwana
• chinja marara ekurasa nemuviri waamai

Iyo placenta ine basa rakakosha mukugadzirwa kwehomoni zvakare. Inodzivirira fetus kubva kubhakitiriya inokuvadza uye hutachiona.

Iyo placenta ine hutano inoramba ichikura munguva yese yepamuviri. IAmerican Pregnancy Association inofungidzira kuti iyo placenta inorema mapaundi 1 kusvika maviri panguva yekuzvarwa.

Iyo placenta inobviswa panguva yekusununguka. Sekureva kweMayo Clinic, inoendeswa pakati pemaminitsi mashanu kusvika makumi matatu mushure memwana.

Zvinokonzera kusakwana

Kusakwana kweplacental kwakabatana nematambudziko ekuyerera kweropa. Nepo ropa raamai uye kusagadzikana kwevascular kuchikonzera, mishonga uye maitiro ehunhu anogona zvakare kukonzera.

Mamiriro akajairika anosunganidzwa nekushaya kukwana kwepacental ndeaya:

• chirwere cheshuga
• chisingaperi cheBP (hypertension)
• kusagadzikana kweropa kuvhara
• kupererwa neropa
• mimwe mishonga (kunyanya kuwonda kweropa)
• kusvuta
• kushandisa zvinodhaka (kunyanya cocaine, heroin, uye methamphetamine)

Placental insufficiency inogonawo kuitika kana iyo placenta ikasanamatira zvakanaka kumadziro echibereko, kana kana iyo placenta yakatsemuka kubva pairi (placental abruption).

Zviratidzo

Iko hakuna zviratidzo zvevabereki zvinosanganisirwa ne placental kusakwana. Zvisinei, zvimwe zviratidzo zvinogona kutungamira kukurumidza kuongororwa. Amai vanogona kuona kuti saizi yechibereko chake idiki pane yepamuviri yapfuura. Iyo fetus inogona zvakare kunge ichifamba zvishoma pane zvaitarisirwa.

Kana mwana asiri kukura zvakanaka, dumbu raamai richava diki, uye kufamba kwemwana hakuzonzwikwe zvakanyanya.

Vaginal kubuda ropa kana preterm yebasa contractions inogona kuitika nekumarara kwepascenta.

Matambudziko

Amai

Kusakwana kweplacental hakuwanzo kutariswa kutyisidzira hupenyu kuna amai. Nekudaro, njodzi yakanyanya kukura kana amai vaine hypertension kana chirwere cheshuga.

Panguva yekuzvitakura, amai vanowanzo kusangana:

• preeclampsia (yakakwira BP uye yekupedzisira-nhengo kusagadzikana)
• kuputika kwepashure (placenta inodhonza kubva pamadziro echibereko)
• kutanga kwebasa uye kuburitsa

Zviratidzo zve preeclampsia kuwandisa kwehuremu, gumbo uye ruoko kuzvimba (edema), kutemwa nemusoro, uye kuwedzerwa kweropa.

Mucheche

Pakutanga kwepamuviri iko kusagadzikana kwepasino kunoitika, zvakanyanya kutomesa matambudziko anogona kuve emwana. Njodzi dzemwana dzinosanganisira:

• njodzi yakakura yekubviswa kweoksijeni pakuzvarwa (inogona kukonzera cerebral palsy uye zvimwe zvinetso)
• kuremara pakudzidza
• tembiricha yemuviri yakaderera (hypothermia)
• shuga shoma yeropa (hypoglycemia)
• yakawandisa ropa calcium (hypocalcemia)
• masero matsvuku eropa (polycythemia)
• basa risati rasvika
• kuregedza kurega
• kuberekwa
• rufu

Kuongororwa uye manejimendi

Kuwana rubatsiro rwakakodzera rwekusununguka kunogona kutungamira kukurumidza kuongororwa. Izvi zvinogona kuvandudza mhedzisiro kuna amai nemwana.

Miedzo inogona kuona kusakwana kwepasiki inosanganisira:

• nhumbu ultrasound kuyera kukura kweiyo placenta
• Ultrasound yekutarisa saizi yechibereko
• alpha-fetoprotein mazinga muropa raamai (puroteni inogadzirwa muchiropa chemwana)
• fetus nonstress test (inosanganisira kupfeka mabhanhire maviri padumbu raamai uye dzimwe nguva kupfava kumutsa mwana) kuyera kurova kwemoyo wemwana uye kupunzika

Kurapa kubereka kweBP kana chirwere cheshuga kunogona kubatsira kuvandudza kukura kwemwana.

Chirongwa chekuchengetwa kwevabereki vanogona kukurudzira:

• dzidzo pa preeclampsia, pamwe nekuzviongorora pachirwere
• kunyanya kushanyira chiremba
• zororo pamubhedha kuchengetedza mafuta uye simba kumwana
• kubvunzurudza nenjodzi yehutachiona hwemadzimai ane njodzi huru

Ungangoda kuti uchengete zvinyorwa zvezuva nezuva zvekuti mwana anofamba kana kukamba.

Kana paine kunetsekana nezvekuzvarwa nguva isati yakwana (mavhiki makumi matatu nemaviri kana apfuura), amai vanogona kugamuchira majekiseni esteroid. Steroid inonyungudika kuburikidza neiyo placenta uye inosimbisa mapapu emwana.

Iwe ungangoda kurapwa kwakanyanya kwevanorwara kana varwere vepatient kana preeclampsia kana intrauterine kukura kweanorambidzwa (IUGR) ikava yakaoma.

Outlook

Kusakwana kweplacental hakugone kurapwa, asi kunogona kutarisirwa. Zvakakosha zvakanyanya kuti utange kuongororwa nekukurumidza uye hutano hwakakwana hwepamuviri. Izvi zvinogona kuvandudza mikana yemwana yekukura zvakajairika uye kudzikisa njodzi yematambudziko ekuberekwa. Zvinoenderana neGomo reSinai Hospital, maonero akanakisa anoitika kana mamiriro acho abatwa pakati pemasvondo gumi nemaviri kusvika makumi maviri.