Rhesus-e kue ana makuahine a me ka fetus i hāpai keiki: i ka papaʻaina. 'ōnaehana paleʻea kaua o ka makuwahine, a me ka fetus

Ma hāpai keiki loli ana e na mea he nui aʻe. High ka pilikia hāpai he RH-e kue ana makuahine a me ka fetus. Naʻe, i kela mea keia mea maopopo ke kumu no keia kŰia, i kumu no ka makau o ka IKE OLE IA. Nolaila, e ike pehea pilikia ka RH ololi a me ka wā ma laila o RH-kue "makuahine-fetus" ua koi na expectant makuwahine.

Rhesus kaua - He aha ka mea?

E maopopo i ka 'ano o ka pilikia, ia mea pono mua e maopopo pehea nui ka RH ololi. He He maopopo kumuʻiʻo, Aia ma luna o ka erythrocyte ili honua. Kēia kumuʻiʻo mea i loaʻa i loko o ke koko o ka 85% o nā kanaka, a me ke koena ua nalowale. No laila, e noʻonoʻo i ka mua nā mea hōʻoia o ia maikaʻi Rhesus ololi, a me ka lua o ka io.

Penei, ka mea e hoʻoholo i ka immunological ano o ka meaola a me ka loa ole i kanaka ola. RH ololi hiki ke koho RH + a me Rh-. No ka mea manawa mua i dala i kēia manawa i ka 1940 ma kānakaʻepekema, a Aleksandrom Vinerom Karlom Landshteynerom. RH e kue ana makuahine a me ka fetus o ka immunological incompatibility koko RH i loko o ka hihia ina ia mea io makuwahine a me fetus maikaʻi. Ka pilikia o Rhesus-kue ke moe ma ka oiaio i ka mea hiki i fetal make, stillbirth, miscarriage. O kŰia e hōʻike i ka wā e hiki mai makuwahine RH-hopena maikaʻi i loko o ke kaʻina hana o ka gestation, a ma ka hana. 'ōnaehana paleʻea makuahine a me ka fetus kue hoike mai ai ia ia iho, ina o ka fetus ua ili RH +, mai kona makua kāne.

Kumu o RH-kue makuahine a me ka fetus

No ka mea kino o ka wā e hiki mai makuwahine koko bebe me RH + mea he nui hoʻoweliweli, no laila ia produces nā mea'aʻaʻa e pane koke ai i ka fetal ulaula koko keena, a luku aku ia lakou. wehewehe Rhesus-e kue ana makuahine a me ka fetus transplantsentarnym anal o fetal ulaula koko keena me ka maikaʻi RH ololi i loko o ke koko o ka makuwahine a me ka io anakahi.

Immunological kue Ua pili kēia i ka hope o ka hāpai keiki mua. Ma gestation Rhesus-kue paha e ma muli o ke koko transfusions ma i ua ole ia i ka RH ololi i loko o ka mooolelo, mamua abortions, miscarriages. No hoi o RH incompatible koko ke kiʻi i loko o ke keiki i loko o ka makuwahine o ka koko i hānau, pela no ke kino o ka makuahine ka i susceptible i ka io RH ololi, a me ka likelihood o RH-kue i ka lua o ka hāpai keiki māhuahua. Ua maoli i ka pilikia o ka isoimmunization ma caesarean pauku. koko incompatibility hiki e hoʻonāukiuki kahe ana ke koko i hāpai keiki, a hānau like me ka hopena o ke poho i ke keiki.

Ka pahiki o RH koko pae kue

RH ololi ua genetically manaʻo a me ka Hoʻohaku ili kāna moʻolelo. Inā ka makuahine i ka io RH, a me kona makua kāne ia homozygosity mea 'oluʻolu, ke keiki mau loaʻa RH +. Ma keia hihia, no ka pilikia o ke kaua o ke koko pūʻulu ka loa kiʻekiʻe. A i loko o ka hihia o ka makua kāne o ka heterozygosity likelihood o EYI i ka fetus RH io a me ka maikaʻi Isometric.

Ma ka hebedoma walu o fetal? Acaeoey he mea koko, ma i ula koko keena me ka degere kiʻekiʻe o ka pahiki hiki ke loaa i loko o koko o ka makuahine, o ka. Ma keia hoomalu huakaʻi 'ōnaehana paleʻea makuwahine like fetal antigen ua kuhi malihini. No laila, i ke kino produces ka hapai RH nā mea'aʻaʻa, i kumu no ka RH e kue ana makuahine a me ka fetus. Ka pilikia o ka immunological kue mea uuku lawa i gestation a me ka mea wale 0,8%, akā, ka mea, ua pilikia loa, a no ia mea, pono kūikawā study a me ka hoolohe. Hōʻike e pili ana i ka unborn keiki RH koko e ho'āʻo ai ma luna o ka pūʻulu o na makua ae forecasting RH-kaua hāpai keiki. Ka papaʻaina maopopo wehewehe i ke pahiki o ke koko incompatibility.

Hopena a me ka olelo hooweliweli a me rhesus kaua i hāpai keiki

'ōnaehana paleʻea makuahine a me ka fetus kue mea fraught me ka nui hopena no ke keiki. Nā antigens hua mai la ia e ka makuahine kino, loaa ia makou he haole kino incompatible me RH ololi komo iloko o ka fetal koko ma ka'ākeʻakeʻa mai, a gematoplatsentarny loko hematopoiesis child kaʻina hana, inhibiting i ke kahua o ka ula koko keena.

Kēia hana nā mea'aʻaʻa hiki i loa pilikia ana no ka fetus, hoʻoweliweli i ke ola ana o ke keiki, a ua wehewehe aku ma ka acidosis, hypoxia, anaemia. Ma ke kino o ke keiki accumulates excessive dala o ka loli a me ka mea i ka 'aʻe' ana o aneane pau nā loko, a nenoai. Ma ia hihia, ina ana i ole ia i loko o ka 'eleu kūpono, he mea he nui pilikia o ka miscarriage, fetal make, stillbirth, hanau o ke keiki me ka hemolytic maʻi hoʻomau i ka e holomua ana, e ku pono ana i ka hoʻomāhuahua i loko o ke kino o ke keiki antirhesus lāʻau lapaʻau kino? Iecaianoaaiiuo a kena ae la i ka makuahine e kue ana a me ka fetus i hāpai keiki . Ua hiki no hoi i ka ulu ana o ka maʻi, i hoʻohikiʻia i loko o ka excessive mahuahua ma ka na nā loko, lolo, naau,ʻawahia lesion o ka Central ko mākou hopohopo nenoaiu.

symptoms

RH e kue ana makuahine a me ka fetus i hāpai keiki, aole lapaʻau symptoms a me kekahi symptoms. Hiki ke kuhikuhi i ka pilikia ma keʻena hoʻokolohua Ka Ikepili o ke koko, i Hōʻike i ke alo o nā mea'aʻaʻa i ka RH-io wale.

Ma fetal koko incompatibility hoike mai ai ia ia iho i loko o ka ulu ana o ka hemolytic mai o ka na nā loko, a nenoai o ke kino, i hiki alakai ai i kona luku iloko o ka manawa mai ka 20-30 pule o ka hāpai keiki, e like me ia i ka muli o miscarriage, stillbirth, premature hānau.

Eia hou, piha-manawa bebe e ikea edematous, icteric a me anemic ano o hemolytic maʻi. Rhesus-e kueʻia i loko o ka fetus i loko o ke koko nānā aku ana iʻiliahi ulaula koko aeea pathologies o na nā loko. Symptomatology ua kena ae la e ka nui o nā mea'aʻaʻa i lawe ma ke kino o ka makuahine. Ma ka hanahana loa ano o ka maʻi ia lŘlŘ ka wā i ka nani o ka fetus - he mea he mea ulu ma ka nui o na nā loko, i ka hanana o ascites mahuahua placenta a me amniotic loli ka leo. keiki ka ke kaupaona hiki ke mahuahua mai ia mau manawa, i ka maʻi ua pinepine pu ma edema.

keʻena hoʻokolohua noiʻi

Rhesus-kue "makuahine-fetus" i hāpai keiki hiki ole ai iʻike,, o ka oi aku i loko o ke kino o nä ka makuakane RH ololi, a me ka makuwahine mua o ka aʻe hāpai keiki a mamua kona hua'ōlelo.

Ka olelo wanana a Rhesus kaua ua ma muli o kaʻikepili o ka mua koko transfusions, ke kahe a me ka hope o ka hāpai keiki mua, i ka loaʻa nui o ka abortion, miscarriage, fetal make i loko o ka opu o kona makuwahine, hemolytic maʻi o ke keiki, e ka mea ike loea miomio e kuhikuhi i ka pahiki o ka pilikia o ka isoimmunization.

Keʻena hoʻokolohua koko e ho'āʻo ai i ka hooholo antirhesus kino, a ua paa aʻe no ka wahine me kēia RH-kaua hāpai keiki a pau. Kālailai e lawe a me ka makua kāne i ke keiki kāne. Inā ka likelihood o RH-kue mea kiʻekiʻe, hapai wahine pono e e ikea ai kela mahina. Ma ka 32 la hebedoma o ke keʻena hoʻokolohua ho'āʻo ma i lawe mai palua i ka mahina, ma luna o ka 36th - kela hebedoma a haawi. Inā ia akulla RH-e kue hāpai keiki, i ke ao, e hoʻoholo i ka maʻiʻo o nā mea'aʻaʻa i loko o ke kino o ka makuwahine o ka. Na diagnosed mua pathology, me ka haahaa o ka pilikia o complications, e like me ke kanawai o RH-kue accumulates ma manawa.

Ultrasound a invasive ano o ka kamepiula auhau no ka fetus

E diagnose immunological kaua o ka makuwahine, a me ka fetus ma ka au mamuli, lawe ultrasound ma ka liʻiliʻi eha manawa mai ka 20 a hiki i 36 pule o ka hāpai keiki, a ma mua haawi. Ultrasound apono 'oe e Hoʻokolo' ano o ka fetus, e like me ke kuhikuhi i ke alo o abnormalities.

Ka like assesses ke ano a me ka nui o ke keiki, fetal abdominal ka leo, amniotic loli, ka piko aa koko.

Additional noiʻi kāu kiʻina hana i ka electrocardiogram, cardiotocography, phonocardiography e ae i ka fetus, e hooholo i ke kiʻekiʻe o ka hypoxia ma rhesus kaua. Hōʻike i waiwai 'ike invasive helu - he ao o amniotic loli ma ka amniocentesis a me ka piko koko ma ka cordocentesis. ʻike, o amniotic loli, e hooholo i ka titer antirhesus kino, ke keka o ke keiki, fetal akemāmā waiwai nui. Ke mau degere o ka maʻi diagnosed e kardotsentoza koko pae a me ka RH ololi i loko o fetal kaula koko. Eia hou kekahi, haʻawina hōʻike i ke alo o whey kumuʻiʻo, hemoglobin, bilirubin, reticulocytes, nā mea'aʻaʻa, paa ma ka erythrocytes.

lapaʻau

Inā he kaua ua 'akomi i kona makuwahine, a me ka fetal koko pae, kokoke i ka wale pono ka iapaau ana no ke koko transfusion o ka fetus ma ka umbilical aa koko i loko o ka opu. Ke hana ua hana ma lalo o ka mana o ke ultrasound. Kēia ana apono 'e alleviate i ke ano o ka fetus, hoʻolōʻihi nō hāpai keiki, emi na symptoms o anaemia, hypoxia.

E mitigate i ka hopena o RH kue i oxygen Inc ua mālama 'ia kekahi uku nonspecific Inc, i nā nā wikamina, hoʻomākaukau me ka maʻiʻo o ka hao, kalipuna, antihistamines. Inā ka fetus ua malama nui ana, ka Caesarean pauku ua hana ma 37-38 E pule o ka hāpai keiki. Kekahi, hapai wahine lawelawe plasmapheresis, a ho'ēmi i kā ka maʻiʻo o nā mea'aʻaʻa i loko o ke koko e ulaula koko keena o ka fetus.

Ma hope iho o ka hanau ana o ke keiki lawe transfusion ae pani e puku pepe erythrocytes, a i hoakaka ia hemolytic maʻi - dropper alakai maiʻawahia waiwai, mai ke kino, a ho'ēmi i kā erythrocyte palaho, irradiation me ultraviolet kukuna. Lapaʻau pono mālama nui papa o ka Inc, ka mālamaʻana neonatologists, i kekahi manawa ua hoʻonoho i ke keiki i loko o ka mālama nui mālama pa alima. Hanai i ke keiki i loko o ka umauma waiu uaʻaʻole e waiho i ka mea mua 2 pule ma hope o ka hānauʻana i loko o ka hihia o hemolytic maʻi.

Genera me Rhesus kaua

Loa pinepine i ka hope o ka hāpai keiki i loko o ke alo o RH-kue - premature hanau. No laila, i ka hana o ke kauka o ka palena manawa no ka hanau keiki ana, hulina ka mālamaʻana o kona ulu ana kaʻina. No ka meaʻike, i ka mea a pau wā o ka hāpai keiki lawe ultrasound, Doppler, CTG. Inā hou paipai 'kekahi pilikia nui i ka fetus, i ka hoʻoholo' ia ma ka hanau ana prematurely.

Ma ka hapanui o na hihia, ka wā ka hanau keiki Rhesus kue welau caesarean pauku. Ka nahunahu hanau maoli nō loa pohihihi a wale ina fetal ana mea kupono, a me ka pēpē ka ola mea,ʻaʻole i loko o ka pilikia. Caesarean pauku ua noʻonoʻo i ka loa a me ka palekana akahai i ka fetus. Ma ka nahunahu hanau pono i ke alo o neonatologists e hana resuscitation inā pono. Hanau e, e hanaʻia i loko o pono-i hoʻolako pono a me nā mea a pau i ka mea e pono ai 'inikua lako a pan, a pa ma lalo o ka hooponopono ana o loa palapala hōʻoia no kauka.

kāohi ana

Kue "makuahine-fetus" i hāpai keiki hiki i ka hopena nui no ke keiki. No laila, nui kāohi ana nona ma ka Kāohiʻana o RH-kue a me ka ulu ana isoimmunization. A i ke koko transfusion mea nui e noonoo i ka hoʻokaulike me ka mau pou, he mea pono e hoola i ka hāpai keiki mua, akā, no hoi, e ole abortions. Like nui o ke akahele hoʻolālā o ke hāpai keiki. Ka like ana o ke koko pūʻulu, RH ololi e pale RH-kaua hāpai keiki. Table koko hui hoʻokaulike e pale aku wā e hiki mai pilikia. It e e hooikaika ana i ka papa o ka hāpai keiki. Like prophylaxis hoʻohana intramuscular ka pahu kui o RH immunoglobulin mai ke koko mau pou wahine me RH-io, a mahuahua susceptibility i ka maikaʻi antigen. Kēia kanaka e hoomakaukau i pepehi i kaʻulaʻula keena koko i ua maikaʻi mai o ka lawe RH ololi, malaila hoemi i ka pilikia o ka isoimmunization a me RH kaua.

Nā injections i lawe mai ma hope o ka hoopau ana o hāpai keiki, miscarriage, intrauterineʻoki kino e ole hāpai keiki. Nō hoʻi, RH'ōnaehana paleʻea globulin ua lawelawe i ka hapai wahine e pili ana i ke kamepiula pae ma 28 pule, a hou ma 34 e emi i ka likelihood o? Acaeoey o hemolytic mai o ka fetus. Like pono me ka ka pahu kui ua lawelawe i 2-3 lā ma hope o ka hanau ana, a poina hoemi i ka pilikia o Rhesus-kaua ma hope pregnancies. Immunoglobulin ua lawelawe i kela a me keia hāpai keiki, ina ka pahiki o ka ke keiki me ka maikaʻi RH ololi.

Pela, ke RH-e kue ana makuahine a me ka fetus mea,ʻaʻole he kumu no ka hoopau ana i hāpai keiki. Ke likelihood o ka ulu Rhesus kue ka loa uuku, no laila,ʻaʻole nō he pono i ka manao. Mahalo i kēia hana 'ia he o ka immunology, he mea manawa hiki ke hana i ka ikaika a me ka olakino pēpē.