Kurapa kwePterm Labor: Tocolytics

Zvemukati

• Tocolytic mishonga
• Ndeupi rudzi rwemishonga yetokolytic inofanira kushandiswa?
• Panguva ipi panguva yekuzvitakura kwangu pandinogona kutora tocolytic mishonga?
• Inguva yakareba sei mishonga inocolytic inofanira kuenderera?
• Inobudirira sei mishonga tocolytic?
• Ndiani asingafanire kushandisa tocolytic mishonga?

Tocolytic mishonga

Tocolytics mishonga inoshandiswa kunonoka kuendesa kwako kwenguva pfupi (inosvika maawa makumi mana nemasere) kana ukatanga basa nekukurumidza mukubata kwako.

Vanachiremba vanoshandisa mishonga iyi kunonoka kuendesa paunenge uchiendeswa kuchipatara chinonyanya kugadzirisa preterm care, kana kuitira kuti vakwanise kukupa corticosteroids kana magnesium sulfate. Majekiseni e corticosteroid anobatsira kusimbisa mapapu emwana.

Magnesium sulfate inodzivirira mucheche ari pasi pemasvondo makumi matatu nemaviri kubva kucerebral palsy, asi inogona zvakare kushandiswa sechinhu checolytic. Magnesium sulfate inoshandiswawo kudzivirira kubatwa nevakadzi vane pamuviri vane preeclampsia (yakakwira BP).

Mimwe mishonga inogona kushandiswa se tocolytic inosanganisira:

• beta-mimetics (semuenzaniso, terbutaline)
• calcium chiteshi blockers (semuenzaniso, nifedipine)
• asiri-steroidal anti-anogumbura zvinodhaka kana NSAIDs (semuenzaniso, indomethacin)

Ruzhinji ruzivo nezve iyi mishonga inopihwa pazasi.

Ndeupi rudzi rwemishonga yetokolytic inofanira kushandiswa?

Iko hakuna data rinoratidza kuti mumwe mushonga unogara uri nani pane mumwe, uye vanachiremba munzvimbo dzakasiyana dzenyika vane zvido zvakasiyana.

Muzvipatara zvakawanda, terbutaline inopihwa kunyanya kana mukadzi ari panjodzi yakaderera yekusununguka mwana wake nekukurumidza. Kune vakadzi vari panjodzi yakanyanya yekusununguka mukati mevhiki rinotevera, magnesium sulfate (inoiswa mukati mehasha) inowanzo kuve mushonga wesarudzo.

Panguva ipi panguva yekuzvitakura kwangu pandinogona kutora tocolytic mishonga?

Tocolytic mishonga yebasa rekutanga haisati yashandiswa pamberi pemavhiki makumi maviri nemana ekuzvitakura. Mune mamwe mamiriro ezvinhu, chiremba wako anogona kuishandisa kana iwe uri pamasvondo makumi maviri nemaviri ekuzvitakura.

Vanachiremba vazhinji vanomira kupa tocolytics mushure mekunge mukadzi asvika pavhiki yake makumi matatu nemana yekubata, asi vamwe vanachiremba vanotanga kuocolytics kusvika masvondo makumi matatu nematanhatu.

Inguva yakareba sei mishonga inocolytic inofanira kuenderera?

Chiremba wako anogona kutanga kuyedza kurapa yako yekutanga basa nekuzorora kwemubhedha, zvimwe zvinwiwa, mushonga wekurwadziwa, uye imwe chete dhizaini yecolytic mishonga. Ivo vanogona zvakare kuita kumwe kuongorora (senge fetal fibronectin bvunzo uye transvaginal ultrasound) kugadzirisa zvirinani njodzi yako yekutangira preterm.

Kana zvibodzwa zvako zvikasamira, sarudzo yekuenderera nemishonga yecolytic, uye kwenguva yakareba zvakadii, inoenderana nenjodzi yako chaiyo yekuzvitangira (sekutarisirwa nemiedzo yekuongorora), zera remwana, uye chinzvimbo chemwana mapapu.

Kana bvunzo dzichiratidza kuti uri panjodzi huru yekutangira preterm, chiremba wako anogona kukupa magnesium sulfate kwemaawa makumi maviri nemasere kusvika makumi mana nemasere pamwe necorticosteroid mishonga yekuvandudza mapapu emwana.

Kana zvipingaidzo zvamira, chiremba wako achadzikisa uye obva amisa magnesium sulfate.

Kana zvipikiso zvikaenderera, chiremba wako anogona kuraira mimwe bvunzo kuti utonge kunze kwechirwere chiri muchibereko. Chiremba anogona zvakare kuita bvunzo kuti aone mamiriro emapapu emwana.

Inobudirira sei mishonga tocolytic?

Hapana tocolytic mishonga yakaratidzirwa kuti inogara ichinonoka kuendesa kwenguva yakakosha yenguva.

Nekudaro, mishonga inocolytic inogona kunonoka kuendesa kweinenge pfupi pfupi (kazhinji mazuva mashoma). Izvi zvinowanzo kupa nguva yakakwana yekugamuchira kosi yesteroids. Majekiseni e corticosteroid anoderedza njodzi kumwana wako kana achinge akurumidza kusvika.

Ndiani asingafanire kushandisa tocolytic mishonga?

Vakadzi havafanire kushandisa tocolytic mishonga kana njodzi dzekushandisa mishonga dzakapfuura bhenefiti.

Aya matambudziko anogona kusanganisira vakadzi vane preeclampsia yakaoma kana eclampsia (yakakwira BP iyo inokura panguva yepamuviri uye inogona kukonzera matambudziko), kubuda ropa kwakanyanya (kubuda ropa), kana hutachiona mudumbu (chorioamnionitis).

Tocolytic mishonga haifanire kushandiswa kana mwana akafira muchibereko kana kana mwana aine zvisizvo zvinotungamira kurufu mushure mekusununguka.

Mune mamwe mamiriro ezvinhu, chiremba anogona kungwarira nezvekushandisa mishonga inocolytic, asi anogona kuvaraira nekuti mabhenefiti anodarika njodzi. Aya mamiriro anogona kusanganisira kana amai vaine:

• nyoro preeclampsia
• kubuda ropa kwakadzikama mukati memwedzi wechipiri kana wechitatu
• hutano hwakakomba
• muromo wechibereko uyo watodhonzera masendimita mana kusvika matanhatu kana kudarika

Chiremba anogona achiri kushandisa tocolytics apo mwana ane chisina kujairika kurova kwemoyo (sezvakaratidzwa pane fetal monitor), kana kunonoka kukura.