Kuyanjana kwa amniotic madzimadzi m'magazi a mayi panthaŵi ya zowawa amatchedwa embolism. Izi ndizoopsa zomwe zimachititsa kuti mayi ndi mwana amwalira, omwe amatchedwanso amniotic embolism kapena thromboembolism.
Zifukwa za embolism ndi amniotic madzi
Kulowera kwa amniotic madzi m'zotengera zazikulu ndipo mitsempha ya pulmonary imatheka chifukwa cha:
- Kutuluka kwa chiberekero pakubereka kapena chiberekero chokha;
- gawo lachisokonezo;
- zolakwika mu chitukuko cha zipolopolo;
- Kuyankhulana pakati pa njira zamakono ndi amniotic za mayi.
Zomwe zimayambitsa matendawa ndi izi:
- pulasitala;
- phunziro labwino la amniotic fluid;
- Kuwonongeka koyamba kwapadera, komwe kumayambika ndi amniotic madzi ndi magazi;
- kuwonjezeka kwa chiberekero ndi polyhydramnios, mimba yambiri, kutsekedwa, ntchito yovuta.
Pathogenesis wa embolism ndi amniotic madzi
Meconium, mafuta amchere, maselo a khungu, placenta, umbilical chingwe ndi amniotic madzi kudzera m'zombo zowonongeka mumalowa mitsempha yambiri. Posakhalitsa amapezeka kuti ali ndi mankhwala abwino komanso am'mimba. Nthawi zambiri, mavutowa amapezeka kumapeto kwa kubadwa. Nthawi zoopsa zimachitika kwambiri:
- matupi achilendo amachititsa anaphylactic kuchita kapena ngakhale anaphylactic mantha ;
- zigawo za madzi, zimakhala ngati mafuta, zimasokoneza kayendedwe ka kayendedwe kake;
- amniotic madzi amachititsa magazi coagulability, omwe amachititsa kufalitsa intravascular coagulation.
Mawonetseredwe am'chipatala amadalira mwachindunji:
- makina ndi zifukwa za madzi kulowetsa;
- kuchuluka kwa madzi otsekedwa m'magazi;
- zida za mzimayi;
- nthawi yobereka;
- kulumikizana.
Zizindikiro ndi mitundu ya embolism ndi amniotic madzi
Zizindikiro za matendawa ndi izi:
- mpweya wochepa;
- lingaliro la mantha, kukhudzidwa;
- ululu pambuyo pa sternum;
- kutentha kwa thupi;
- maonekedwe a zipsera;
- chifuwa;
- chizungulire ndi kufooka;
- zapadera, koma zofooka;
- Kutchedwa cyanosis ya chapamwamba ndi nkhope;
- kutaya chidziwitso.
Malinga ndi zizindikiro, akatswiri a zazing'amba amasiyanitsa mitundu yosiyanasiyana ya amniotic embolism:
- collaptoid;
- chonchi;
- chosangalatsa;
- chiwonongeko;
- mphezi mofulumira, yomwe imadziwika ndi nthawi yamakono.
Kuzindikira kwa thromboembolism ndi amniotic madzi
Kuzindikira matendawa kumaphatikizapo:
- kuyambitsa maphunziro a electrocardiographic (ECG) omwe amatha kuzindikira tanthauzo la sinus tachycardia, mtima wamtima woopsa, hypoxia wa myocardium;
- atanyamula chifuwa cha x-ray kuti azindikire kutupa kwapakati komwe kuli ngati mapiko a gulugufe;
- kuyesa magazi.
Kuchiza kwa embolism ndi amniotic madzi
Thandizo pakuzindikira amniotic embolism zikuphatikizapo:
- normalization ya kupuma;
- chisokonezo;
- kupewa ndi kuchitapo kanthu chithandizo cha mavuto owopsa;
- kuchita ntchito zofunika.
Thandizo lachidzidzimutso ndilokutumiza kwa dimedrol, promedol, diazepam, antitispasmodics, glycosides mtima ndi corticosteroids omwe amayang'aniridwa ndi diuresis, CVP, AD, ECG, CBS, hematocrit ndi electrolyte. Pambuyo pokwaniritsa ndondomeko zatchulidwa m "menezi, gawo lodziŵika bwino koma lofulumira lodziwika limalimbikitsidwa. Ngati chifuwachi chikuyamba m'gawo lachiwiri la ntchito, gwiritsani ntchito mankhwala osokoneza bongo. Kuyanjana kwa amniotic madzi mu amayi omwe ali ndi pakati m'magazi ndiwo chifukwa chachikulu cha kubereka. Pachifukwa ichi, kupeŵa embolism ndikofunikira kwambiri, komwe kumaphatikizidwa pamodzi ndi coagulologist pogwiritsa ntchito njira zothandizira njira yogwiritsira ntchito.