Sibutsetelo imbangela, ukuvimbela, kanye nokwelashwa kwalesi sifo
Izifo ze-Hemolytic of the Newborn (HDN) yinkinga yegazi elibomvu elingafani phakathi komama nengane yakhe. Lokhu kwenzeka lapho uhlobo lwegazi lomama linguRhibi futhi ingane i-Rh enhle. Phakathi nokukhulelwa umama ukhiqiza imishanguzo ehlasela futhi echitha amangqamuzana egazi abomvu, okubangelwa i-anemia emntwaneni. Isimo esifanayo senziwa ngamaplatelets okuthiwa i- neonatal alloimmune thrombocytopenia .
Kungani Izifo ZaseHemolytic Zenzeka?
Amangqamuzana ethu abomvu egazi agcwele ama-antigen, izinto ezibangela ukuphendula kwamagciwane. Amanye alawa antigens asinika uhlobo lwegazi lethu (A, B, O, AB) kanye nabanye iqembu lethu le-Rh (elihle, elibi). Iqembu le-Rh libizwa nangokuthi i-D antigen. Abesifazane abangama-Rh angenalo i-antigen e-D kumaseli abo abomvu. Uma ingane yabo engakazalwa inguRh-positive (ifa elivela kubaba), une-D antigen okwamanje. Lapho amangqamuzana omzimba omzimba omzimba evezwa ngamaseli e-fetus (angase avele ngesikhathi sokubeletha, egazini ngesikhathi sokukhulelwa, ukukhulelwa kwesisu sangaphambilini), isimiso somzimba sokuzivikela somzimba siyabona i-D antigen ngokuthi "engaphandle" futhi sithuthukise ama-antibodies ngokumelene nabo.
Ukukhulelwa kokuqala ne-Rh-positive baby akuthinteki njengoba ama-antibodies akhiwe ekuqaleni angakwazi ukuwela i-placenta. Kodwa-ke, ekukhulelweni okuzayo, uma amaseli omzimba omama ehlangana ne-D antigen emangqamuzaneni egazi lesisu, amasosha omzimba akhiqiza ngokushesha amasosha omzimba aphikisayo awela i-placenta.
La ma antibodies axhunyaniswe namaseli e-fetal egazi, ewabeka ekubhujisweni, okwenza ukuba i-anemia. Isimo esifanayo singenzeka uma kunokungahambisani nhlobo lwegazi okuthiwa i-ABO engahambelani.
Indlela iNtsana Eyithinta Ngayo
Njengoba kuxoxwe ngenhla, ukukhulelwa kokuqala nengane enhle kaR Rh, ayikho izinkinga.
Uma lokhu kungaqondakali kungaziwa ekukhulelweni kokuqala (kwenzeka ngezinye izikhathi uma kuqala ukukhulelwa kubangela ukukhulelwa kwesisu) noma uma izinyathelo zokuvimbela ezifanele (okuzoxoxwa kamuva) azithathwa, ukukhulelwa esikhathini esizayo kungathinteka. Emva kokukhulelwa kokuqala okukhuthele, ukuqina kwesifo se-hemolytic yengane esanda kuzalwa kuyabuhlungu ngokukhulelwa.
Izimpawu zinqunywa ubukhulu be-red red cell cell (ebizwa ngokuthi i-hemolysis). Uma kungathinteka kuphela, kungase kube nezinkinga ezincane ezifana ne- anemia kanye / noma i-jaundice engadingi ukwelashwa. Uma inani le-hemolysis libi kakhulu, uzoba ne-jaundice ephawulekayo (i-bilirubin ephakeme) ngemva nje kokuzalwa.
Ngeshwa, i-hemolysis ayigodli lapho umntwana ezalwa njengama-antibodies omama ahlala isikhathi eside amasonto ambalwa. Lawa mazinga amaningi ngokweqile we-bilirubin angabangela umonakalo ebuchosheni. Kwezinye izimo, i-anemia inkulu kakhulu ku-utero (ngaphambi kokubeletha) ukuthi isibindi nesiteji sikhulisa ukwandisa ukukhiqizwa kwegazi elibomvu eliholela ekuhlulekeni kwesibindi. Isifo se-hemolytic singase siphinde sibe ne-hydrops fetalis ne-edema ejwayelekile (ukuvuvukala), izitho ezizungeze amanzi, ngisho nokufa.
Yeka ukuthi izifo zeHemolytic Zivinjelwe kanjani
Yebo. Namuhla bonke abesifazane abathola ukunakekelwa kokubeletha banomsebenzi wegazi okhethwe ukunquma uhlobo lwakhe lwegazi neqembu.
Uma enguRh-negative, umsebenzi wegazi uthunyelwa ukucacisa ukuthi usuvele unezinhlobo zokulwa nama-anti-D. Uma engenayo i-antibodies, uzothola imithi ebizwa nge-RhoGAM. I-RhoGAM noma i-anti-D Ig isilwane esinikezwa emavikini angu-28, iziqephu zokuphuma kwamanzi (kubandakanya ukukhubazeka ngemva kwamasonto angu-13 ukubeletha), futhi ngesikhathi sokubeletha. I-RhoGAM ifana ne-antibody umama angayenza ku-D-antigen. Umgomo wukuthi i-RhoGAM ibhubhise noma yimaphi amangqamuzana egazi abomvu ekusakazeni komama ngaphambi kokuba akhule ama-antibodies.
Uma ama-anti-D anti-D atholakele, i-RhoGAM ngeke ibe usizo kepha ukuhlolwa okwengeziwe kwe-fetus kuzokwenziwa njengoba kuchazwe ngezansi.
Izifo ZamaHemolytic Zithathwa Kanjani?
Uma umama enqume ukuthi abe nama-anti-D anti-D kanti ubaba unguRh-positive, kungenzeka ukuthi izifo ze-hemolytic ezisanda kuzalwa zingenzeka. Kulesi simo, ukuhlolwa kwenziwa kwi-amniotic fluid noma igazi kusuka entanyeni yomzimba ukuze kunqume uhlobo lwegazi neqembu lomntwana. Uma ingane ithola ukuthi i-Rh ayikho, akukho ukwelashwa okuqhubekayo okudingekayo.
Kodwa-ke, uma umntwana enguRh-positive, ukukhulelwa kuyolindelwa eduze. Ama-ultrasound azosetshenziswa ukuhlola i-anemia yokukhulelwa futhi ukucacisa isidingo sokumpompela kwe-intrauterine (ukumpontshelwa okunikezwa embusheni ngenkathi usesisu). Igazi lomama lizovivinywa ngezikhathi ezithile ngesikhathi sokukhulelwa ukuze kunqume ukuthi i-antibody ikhiqiza kangakanani. Uma ingane ithola ukuthi i-anemic, ukumpompela igazi kunganikezwa ngesikhathi sokukhulelwa ukuvimbela izinkinga (i-intrauterine transfusionons). Uma ingane itholakale inesifo sofuba futhi iseduze nesikhathi esigcwele, ukulethwa kokuqala kungase kuphakanyiswe.
Ngemuva kokuzalwa kwengane, umsebenzi wegazi uthunyelwa ukuqapha amazinga e-anemia ne-bilirubin. Ukuwohloka kwamaseli abomvu angeke ayeke ngokushesha nje lapho umntwana ezalwa ukuze i-bilirubin ingavuka emazingeni angozini ezinsukwini ezimbalwa zokuqala. Amazinga aphezulu e-bilirubin (i-jaundice) aphathwa nge-phototherapy lapho umntwana efakwe ngaphansi kwezibani eziluhlaza okwesibhakabhaka. Izibani zidiliza i-bilirubin evumela umzimba ukuba uwuqede. Ukuguqulwa kuyasetshenziswa futhi ukuphatha i-anemia. Uma i-anemia ne-jaundice inzima, umntwana uphathwa ngegazi lokushintshaniswa. Kulolu hlobo lokumpontshelwa igazi, inani elincane legazi lisuswa emntwaneni futhi lithathwa esikhundleni segazi lokumpontshelwa igazi.
Uma usukhishiwe esibhedlela, kubalulekile ukuba ulandelelwe eduze nodokotela wezingane noma i-hematologist ukuqapha i-anemia. Ama-antibodies omzimba obomvu obomvu angabangela ukubhujiswa amasonto 4-6 emva kokubeletha kanye nokumpontshelwa okwanele kungadingeka.
Imithombo:
I-Nandyal RR. Izifo ze-Hemolytic of the Newborn. I-Journal ye-Hematology ne-Thromboembolic Izifo. 2015.