Uqhagamshelwano lwe-amniotic fluid egazini lomama ngexesha lomsebenzi libizwa ngokuba yi-embolism. Le yingozi yokukhubazeka kwengqondo engakhokelela ekufeni komama kunye nomntwana, okubizwa ngokuba yi-amniotic embolism okanye thromboembolism.
Izizathu zokubambisana ne-amniotic fluid
Ukungena kwe-amniotic fluid kwiinqanawa ezinkulu kwaye umzobo weplmonta unokwenzeka ngenxa yokuba:
- ukuphuka komlomo wesibeleko ngexesha lokubeletha okanye umbele ngokwawo;
- icandelo lokugcina;
- iimpazamo ekuphuhliseni iigobolondo;
- unxibelelwano phakathi kweziteshi ze-vascular and amniotic zomama.
Iimeko ezibangela ukuba le ngozi isele:
- placenta previa;
- Uphononongo olulungekileyo lwe-amniotic fluid;
- ukuphazamiseka kwangaphambili kweplacental, okuphambi kwe-amniotic fluid ngegazi;
- uxinzelelo olwandayo kwi-uterus ne-polyhydramnios, ukukhulelwa okuphindaphindiweyo, ukuchithwa kwemisebenzi, ukungasebenzi ngokugqithisileyo.
I-Pathogenesis ye-embolism yi-amniotic fluid
I-Meconium, i-grease yamanzi, iiselisi zesikhumba, i-placenta, intambo ye-umbilical kunye ne-amniotic fluid ngokusebenzisa iinqanawa ezilimele zingena emithambo emikhulu. Kungekudala bafumana i-atrium ne-pulmonary artery. Ngokuqhelekileyo, iingxaki ezinjalo zenzeka ekupheleni kokuzalwa. Ixesha eliyingozi livela kakhulu:
- Amazwe angaphandle angabangela ukuphendula kwe-anaphylactic okanye ukutshatyalaliswa kwe-anaphylactic ;
- izixhobo zamanzi, ezisebenza njenge-fat embol, ziphazamise ukusebenza kwenkqubo yokujikeleza;
- i-amniotic fluid yandisa i-coagulability yegazi, ekhokelela ekusasazeni i-coagulation ye-intravascular.
Ukubonakaliswa kwezonyango kuxhomekeke ngqo kwi:
- umbane kunye nezimbangela zamanzi ezinxibayo;
- umthamo wamanzi obanjwe egazini;
- iimpawu zomzimba zomfazi;
- ngexesha lokubeletha;
- yokudibanisa.
Iimpawu kunye neentlobo ze-embolism ne-amniotic fluid
Izibonakaliso eziqhelekileyo zesifo sesi sifo zilandelayo:
- ukuphefumula okufutshane;
- uloyiko loloyiko;
- intlungu emva kwe-sternum;
- ukwanda kweqondo lomzimba;
- ukubonakala kwee-chills;
- ukukhwehlela;
- utywala kunye nobuthathaka;
- ngasese, kodwa buthathaka;
- I-cyanosis ebizwa ngokuba yinto ephezulu yesifuba kunye nobuso;
- ukulahleka kwengqondo.
Ngokuxhomekeka kwiimpawu, abagqithisi bahlula iintlobo ezininzi ze-amniotic embolism:
- i-collaptoid;
- zixhala;
- ezihle;
- ixhepha;
- ukukhanya ngokukhawuleza, okubonakalayo ngoku ngokukhawuleza.
Ukuxilongwa kwe-thromboembolism kunye ne-amniotic fluid
Ukuxilongwa kwezilwanyana kubandakanya:
- ukuqhuba isifundo se-electrocardiographic (ECG) esinokukwazi ukubona i-sinus tachycardia, i-heart pulmary heart, i-hypoxia ye-myocardium;
- ukuthwala i-x-ray yesifuba ukufumana ukuvuvukala komzimba okufana neeplanfly;
- iimvavanyo zegazi.
Unyango lwe-embolism ne-amniotic fluid
Uncedo ekufumaneni i-amniotic embolism iquka:
- ukuqheleka kokuphefumla;
- ukutshitshiswa kokumisa;
- ukukhusela nokukhawuleza unyango lweengxaki ezinzima;
- ukwenza imisebenzi efunekayo.
Ulwaphulo oluphuthumayo luquka ukuphathwa kwe-dimedrol, i-promedol, i-diazepam, i-antispasmodics, i-glycosides ye-cardiac kunye ne-corticosteroids phantsi kolawulo oluqhubekayo lwe-diuresis, i-CVP, i-AD, i-ECG, i-CBS, i-hematocrit kunye ne-electrolyte. Emva kokufezekisa amanyathelo angxamisekileyo okukhankanywe ngasentla, kucetyiswa iqela eliqapheleyo kodwa elikhawulezayo. Ukuba ukumbumba kuqhubeka kwisigaba sesibini sezabasebenzi, sebenzisa i-obstetric forceps. Uqhagamshelwano lwe-amniotic fluid kubasetyhini abakhulelweyo kwigazi leyona nto ibangela imbangela yokubeletha. Ngenxa yoko, ukuthintela ukubambisana kubaluleke kakhulu, okwenziwa kunye kunye ne-coagulologist usebenzisa iindlela zokuchaphazela inkqubo ye-coagulation.