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Placenta accreta: he pilikia e makaʻala ai
ʻAʻohe implantation o ka placenta
Pili ka placenta accreta, increta a percreta i a kūlana maikaʻi ʻole o ka placenta i loko o ka ʻōpū, wehewehe ʻo Dr Frédéric Sabban, he kauka obstetrician-gynecologist ma Paris. Ma kahi o ka hoʻopili wale ʻia ʻana i ke kapa o ka ʻōpū (a i ʻole endometrium), noho hohonu loa ka placenta. Ke kamaʻilio nei mākou placenta acreta ke hoʻokomo māmā ʻia ka placenta i loko o ka myometrium (ʻiʻo ʻōpū), increta placenta ke hookomo piha ia iloko o kela io, a i ole percreta placenta i ka wā e "hoʻokahe" ma waho o ka myometrium i nā kino ʻē aʻe.
Hoʻopili ʻia, kahi ʻōpū ʻulaʻula
Wahi a Dr Sabban, ke kumu pilikia nui no kēia ʻinoʻino o ka placenta is a ʻōpū ʻeha. ʻO ka ʻoiaʻiʻo, he ʻōpū i loaʻa i hoʻokahi a ʻoi aʻe paha nā ʻili, ma muli o kahi hana. He ʻula paha ia ma muli o kahi anomaly o ka ʻōpū i hana ʻia (fibroid, intrauterine endometriosis, a me nā mea ʻē aʻe) a i ʻole kahi ʻili ma muli o ka ʻāpana cesarean. I ka wā o ka hāʻule ʻana a i ʻole ka hāʻule ʻana, a curettage hana pinepine ia. ʻO ia ke ʻoki ʻana i ka ʻili o ka ʻōpū me kahi mea hana e wehe ai i ke koena o ka placenta a hiki i kēia ke hoʻoulu i kahi ʻula a laila e alakaʻi i kēia ʻano ʻino.
Akā naʻe, kakaʻikahi ka loaʻa ʻana o kahi placenta accreta a i ʻole kekahi o kāna mau mea : pili ia i ka 2 a hiki i ka 3% o nā wahine me ka ʻōpū ʻeha. ʻO ka pilikia o ka loaʻa ʻana o kēia ʻano o ka placental abnormality he mea kakaikahi loa i nā wahine ʻē aʻe.
I ka manawa a pehea e ʻike ʻia ai?
He liʻiliʻi nā hōʻailona e hōʻike ana i kahi placenta accreta. Eia kekahi, maʻamau kēia pathology o ka placenta ʻike lohi, i ka 3 o ka trimester o ka hapai a i ka hope loa o ka hapai. ʻO ka hapa nui o ka manawa, hana ʻia ka maʻi e ka ultrasound a i ʻole pelvic MRI. ʻO kēia mau mea maʻamau kahe koko ʻole i ka hopena o ka hāpai ʻana a i ka hoʻomaka ʻana o ka hānau ʻana e hōʻike ana i ke ʻano o kēia anomaly.
ʻO ka hānau keiki ma lalo o ka mālama kino
Inā i ka wā hāpai, ʻaʻole pono ka placenta accreta i ka nānā kūikawā, pono ia i ka mālama kūikawā i ka wā hānau. ʻO kēia no ka mea ʻo ka pilikia nui mai kahi placenta accreta kahe koko mai ka hānau ʻana, e hooweliweli ana i ke ola kino o ka makuahine. No ka hōʻemi ʻana i nā pilikia, e hana ka hui lapaʻau i kahi ʻāpana cesarean. Wahi a Dr Sabban, pono ka hāpai ʻana me ka placenta accreta hanau lapaau nui, i hiki ke hookaheia ka mea ma'i ina he nui ke koko.
Ma hope, hiki i nā kauka ke kuhikuhi ka wehe ʻana i ka ʻōpū (hysterectomy) a i ʻole ka ʻoki ʻana i ka ʻōpū ma muli o ka makemake o ka mea maʻi no ka hāpai hou ʻana.