Ukuxhumana kwe-amniotic fluid egazini lomama ngesikhathi sokubeletha kuthiwa i-embolism. Lesi yisifo esiyingozi esiyingozi esingaholela ekufeni komama kanye nesisu, okuthiwa i-amniotic embolism noma i-thromboembolism.
Izimbangela zokubambisana ne-amniotic fluid
Ukungena kwe-amniotic fluid zibe ezitsheni ezinkulu futhi umthambo we-pulmonary kungenzeka ngenxa yokuthi:
- ukuphuka komlomo wesibeletho ngesikhathi sokubeletha noma kwesibeletho;
- isigaba se-cearean;
- ukuhlukunyezwa ekuthuthukiseni kwamagobolondo;
- ukuxhumana phakathi kweziteshi ze-vascular and amniotic zomama.
Izici ezenza lokhu kuphazamiseka yilokhu:
- i-placenta previa;
- Ucwaningo olunzulu lwe-amniotic fluid;
- ukuphazamiseka kwamapayipi okuqala, okulandelwa yi-amniotic fluid ngegazi;
- ukucindezeleka okwandayo esibelethweni nge-polyhydramnios, ukukhulelwa okuphindaphindiwe, ukutholakala kwemithi, ukukhwabanisa okukhulu.
I-pathogenesis ye-embolism yi-amniotic fluid
I-Meconium, i-grease yamanzi, amangqamuzana esikhumba, i-placenta, intambo ye-umbilical kanye ne-amniotic fluid ngokusebenzisa izitsha ezimele zifaka imishanguzo emikhulu. Ngokushesha bazitholela e-atrium ne-pulmonary artery efanele. Ngokuvamile, izinkinga ezinjalo zenzeka ekupheleni kokuzalwa. Izikhathi eziyingozi zivela kakhulu:
- izidumbu zangaphandle zibangela ukusabela kwe-anaphylactic noma ukushaqeka kwe-anaphylactic ;
- izakhi zamanzi, ezisebenza njenge-fat embol, ziphazamise ukusebenza komshini wokujikeleza;
- i-amniotic fluid ikwandisa i-blood coagulability, eholela ekusakazeni i-coagulation ye-intravascular.
Ukubonakaliswa kwemitholampilo kuxhomeke ngqo ku:
- indlela kanye nezimbangela zamanzi zokugcoba;
- umthamo wamanzi obanjwe egazini;
- izivikeli zomzimba zomuntu wesifazane;
- isikhathi sokubeletha;
- i-concomitant pathology.
Izimpawu nezinhlobonhlobo ze-embolism ne-amniotic fluid
Izimpawu ezijwayelekile zomtholampilo zalesi sifo zilandelayo:
- ukuphefumula;
- umqondo wokwesaba, ukukhathazeka;
- ubuhlungu ngemuva kwe-sternum;
- ukushisa komzimba okwandisiwe;
- ukubonakala kwezibungu;
- ukukhwehlela;
- isiyezi nobuthakathaka;
- amapulazi angasese, kodwa abuthakathaka;
- I-cyanosis ebizwa ngokuthi isifuba nesifuba esingaphezulu;
- ukulahlekelwa kokwazi.
Kuye ngezibonakaliso, izidakamizwa zihlukanisa izinhlobo eziningana ze-amniotic embolism:
- i-collaptoid;
- ukuxhuma;
- i-edematous;
- i-hemorrhagic;
- ukukhanya okusheshayo, okubhekene nesikhathi samanje esheshayo.
Ukuxilongwa kwe-thromboembolism ne-amniotic fluid
Ukuxilongwa kwe-pathology kuvame ukufaka:
- ukuqhuba isifundo se-electrocardiographic (ECG) esakwazi ukuthola isifo se-sinus tachycardia, i-heart pulmary acute, i-hypoxia ye-myocardium;
- ukuthwala i-x-ray esifubeni ukuze kutholakale ukuvuvukala komzimba okufana namaphiko evemvane;
- ukuhlolwa kwegazi.
Ukwelashwa kwe-embolism nge-amniotic fluid
Ukusizwa ekutholeni ukuhlanganiswa kwe-amniotic kuhlanganisa:
- ukujwayelekile kokuphefumula;
- ukushaqeka ukumisa;
- ukuvimbela kanye nokwelapha ngokushesha izinkinga ezinzima;
- ukwenza imisebenzi edingekayo.
Ukwelapha okuphuthumayo kuqukethe ukulawulwa kokudabuka kwe-dimedrol, promedol, diazepam, i-antispasmodics, i-glycosides yenhliziyo kanye ne-corticosteroids ngaphansi kokuqondiswa njalo kwe-diuresis, i-CVP, i-AD, i-ECG, i-CBS, i-hematocrit kanye ne-electrolyte balance. Ngemuva kokufeza izinyathelo eziphuthumayo ezishiwo ngenhla, kunconywa isigaba sokuqapha esicacile kodwa esisheshayo. Uma ukuqubuzana kuqhubeka esigabeni sesibili sokusebenza, sebenzisa i-obstetric forceps. Ukuxhumana kwe-amniotic fluid kubesifazane abakhulelwe egazini kuyisisusa esiyinhloko sokubeletha. Ngenxa yalesi sizathu, ukuvimbela ukumbumbulu kubaluleke kakhulu, okwenziwa kanye ne-coagulologist esebenzisa izindlela zokuthonya uhlelo lwe-coagulation.