Rhesus-rikici uwa da tayin lokacin daukar ciki: da wani tebur. Rigakafi da rikici na uwa da tayin

A ciki ta shafa da yawa dalilai. High kasada daukawa mai RH-rikici uwa da tayin. Duk da haka, ba kowa da kowa fahimci dalilan da wannan sabon abu, wanda ya haddasa tsoro da ba a sani ba. Saboda haka, ya san yadda m da RH factor kuma idan akwai RH-rikici "uwa-tayin" aka zamar masa dole kowane expectant uwa.

Rhesus rikici - abin da yake da shi?

Don gane yanayin matsalar, yana da muhimmanci na farko fahimci yadda muhimmanci da RH factor. Yana da wani takamaiman gina jiki, located a kan erythrocyte surface. Wannan gina jiki ne ba a cikin jini na 85% na dukkan mutane, da kuma sauran bace. Saboda haka, na farko da kambun da su suna dauke m Rhesus factor da kuma na biyu korau.

Saboda haka, shi kayyade immunological halaye da kwayoyin da babu albarkacin sakamako a kan mutum kiwon lafiya. RH factor za a iya sanya RH + kuma Rh-. A karo na farko da wannan lokaci da aka buga a 1940 da masana kimiyya da kuma Aleksandrom Vinerom Karlom Landshteynerom. RH rikici uwa da tayin ne immunological incompatibility jini RH a cikin al'amarin idan yana da mummunan uwa da tayin positive. A hatsari na Rhesus-rikici ya ta'allaka ne da cewa shi zai iya sa fetal mutuwa, stillbirth, ashara. Wannan sabon abu iya bayyana a nan gaba uwa RH-korau a kan aiwatar da gestation kuma a lokacin aiki. Rigakafi da uwa tasa, da tayin rikici bayyana kanta idan da tayin ya gaji RH + daga ubansa.

Sanadin RH-rikici uwa da tayin

Ga jikin nan gaba mahaifiyarsa ta jini baby da RH + ne mai tsanani barazana, don haka shi samar antibodies cewa amsa ga fetal ja jini Kwayoyin, kuma ya halaka su. Rhesus-rikici uwa da tayin ya bayyana transplantsentarnym shigar azzakari cikin farji na fetal ja jini Kwayoyin tare da m RH factor a cikin jini na uwaye da wani mummunan nuna alama.

Immunological rikici ne sun fi mayar saboda da sakamako na farko ciki. A lokacin gestation Rhesus-rikici na iya zama saboda jini a cikin abin da RH factor ba ɗauke shi zuwa lissafi, baya abortions, rashin. Har ila yau RH m jini iya samun cikin da yaro a cikin uwa tasa ta jini a lokacin haihuwa, don haka uwar jiki zama mai saukin kamuwa zuwa wani mummunan RH factor, kuma da alama na RH-rikici a lokacin da na biyu ciki ya karu. Yana kara hadarin isoimmunization a lokacin caesarean sashe. jini incompatibility za a iya tsokani zub da jini a lokacin daukar ciki da na haihuwa a sakamakon lalacewar da Mahaifa.

Yiwuwar RH jini kungiyar rikici

RH factor ne genetically m da rinjaye gaji hali. Idan uwarsa tana da mummunan RH, mahaifinsa a lokacin da homozygosity ne tabbatacce, da yaro ko da yaushe samun RH +. A wannan yanayin, haɗarin wani rikici na jini kungiyar ne sosai high. Kuma a cikin hali na uba na heterozygosity alama na watsa zuwa tayin RH korau ko tabbatacce Yanar gizo.

A na takwas mako na fetal ci gaban akwai jini, a cikin abin da ja da maikacin jini tare da wani babban mataki na yiwuwa za a iya kama a cikin uwa tasa ta jini. A wannan kariya tafiye-tafiye na rigakafi da uwayensu a matsayin fetal antigen yana dauke da dan hanya. Saboda haka, jikin samar da wani ciki RH antibodies, wanda ya haddasa rikici RH uwa da tayin. A hadarin immunological rikici ne kananan isa a lokacin gestation kuma shi ne kawai 0.8%, amma shi ne mai hadarin gaske, saboda haka na bukatar musamman nazari da hankali. Nuna game da ba a haifa ba RH jini gwaje-gwaje a kan wani rukuni na iyaye damar kiyasin RH-rikici ciki. Tebur a fili ya nuna yiwuwar samun jini incompatibility.

Sakamakon da kuma barazanar da rhesus rikici a lokacin daukar ciki

Rigakafi da uwa tasa, da tayin rikici ne fraught tare da tsanani sakamakon ga yaro. A antigens samar da uwar jiki, gano wani kasashen waje jiki m tare da RH factor shiga cikin fetal jini ya kwarara ta cikin shãmaki, kuma gematoplatsentarny rushe hematopoiesis yaro tsari, inhibiting da samuwar ja jini Kwayoyin.

Wannan hali antibodies iya haifar da hadarin gaske musamman yanayin ga tayin, barazana da rayuwar da yaro, wanda aka halin acidosis, hypoxia, anemia. A jikin jariri accumulates matsanancin yawa na ruwa da kuma a take kusan dukan gabobin da kuma tsarin. A wannan yanayin, idan matakan da ake ba su riƙi a dace hanya, akwai wani tsanani hadarin ashara, fetal mutuwa, stillbirth, haihuwar jariri, da hemolytic cutar da cewa zai ci gaba da samun ci gaba, saboda da jari a cikin jikin jariri antirhesus antibody samar da ya sa uwar rikici da tayin lokacin daukar ciki . Yana kuma iya sa ci gaban da cututtuka, wanda aka bayyana, a wani wuce kima karuwa a ciki gabobin, kwakwalwa, zuciya, mai guba rauni na tsakiya m tsarin.

cututtuka

RH rikici uwa da tayin lokacin daukar ciki yana da wani asibiti cututtuka da kuma takamaiman bayyanar cututtuka. Zai yiwu a gano matsalar kawai ta hanyar gwaje-gwaje da bincike na jini, wanda ya nuna gaban antibodies da RH-korau.

A fetal jini incompatibility bayyana kanta a gaban hemolytic cuta daga cikin kayan ciki da kuma tsarin na jiki, wanda zai iya kai wa ga ta hallaka a lokacin daga 20-30 makonni na ciki, kazalika zuwa fitowan da ashara, stillbirth, wanda bai kai ba bayarwa.

Bugu da kari, da cikakken-lokaci jariri na iya bayyana edematous, icteric kuma m nau'i na hemolytic cuta. Rhesus-rikici bayyana a cikin tayi a jini bayyanar m ja jini cell pathologies na ciki gabobin. Symptomatology ne ya sa ta adadin antibodies samar da jiki ta uwa. A cikin tsanani nau'i na cutar faruwa a lokacin da kumburi da tayin - akwai wani karuwa a cikin size of ciki gabobin, da ya faru na ascites karuwa mahaifa da ruwar girma. yaro ya nauyi za a iya ƙara har zuwa biyu sau, cutar da ake sau da yawa tare da edema.

dakin gwaje-gwaje da bincike

Rhesus-rikici "uwa-tayin" a lokacin daukar ciki zai iya hana farkon ganewar asali, musamman a cikin irin gano mahaifin RH factor da kuma mahaifiyar kafin na gaba ciki ko a baya ta sharuddan.

Hasashen Rhesus rikici dogara ne a kan data na baya jini, da ya kwarara da kuma sakamako na farko ciki, da samuwan zubar da ciki, ashara, fetal mutuwa cikin mahaifar uwa, hemolytic cuta daga cikin yaro, yin shi a dogara da daidaici don gane da yiwuwar hadarin isoimmunization.

Laboratory jini gwaje-gwaje domin sanin antirhesus jikuna da lakabobi an gudanar da duk mata da ake zargin RH-rikici ciki. Ƙididdiga tafii da kuma uban yarinyar. Idan da alama na RH-rikici ne high, mata masu ciki da bukatar da za a jarraba kowane wata. A cikin 32 ga watan da ya gabata na dakin gwaje-gwaje gwaje-gwaje suna da za'ayi sau biyu, a wata, a kan 36th - kowane mako har bayarwa. Idan gano RH-rikici ciki, binciken zai ƙayyade abun ciki na antibodies a cikin uwa tasa ta jiki. A baya kamu Pathology, da ƙananan hadarin rikitarwa, kamar yadda sakamakon RH-rikici accumulates a kan lokaci.

Duban da kuma cin zali hanyoyin da kiman hadari ga tayin

Don gane asali immunological rikici na uwa da tayin, daki-daki, za'ayi duban dan tayi a kalla sau hudu daga 20 zuwa 36 makonni na ciki da kuma kafin bayarwa. Duban ba ka damar waƙa halaye da tayin, kazalika don gane gaban munanan.

A binciken da assesses da yanayin da size da Mahaifa, fetal ciki ƙarfi, ruwar, cibiyarki igiyar jijiyoyinmu.

Ƙarin bincike hanyoyin su ne wani electrocardiogram, cardiotocography, phonocardiography cewa ba da damar tayin domin sanin matakin na hypoxia a rhesus rikici. Samar da muhimmanci da bayanai masu cin zali kima - a nazarin ruwar ta amniocentesis da cibiyarki igiyar jini da cordocentesis. Ganewar asali da ruwar domin sanin titer antirhesus jikinsu, jima'i da baby, fetal huhu balaga. A daidai mataki na cuta kamu da kardotsentoza jini kungiyar da kuma RH factor a fetal igiyar jini. Bugu da kari, nazarin ya nuna gaban whey gina jiki, haemoglobin, bilirubin, reticulocytes, antibodies, gyarawa a kan erythrocytes.

magani

Idan wani rikici da aka gano uwarsa da fetal jini kungiyar, kusan kadai tasiri magani ga jini ne da tayin ta cikin cibiyarki jijiya a cikin mahaifa. A hanya aka yi karkashin iko na duban dan tayi. Wannan gwargwado damar don ya rage da yanayin da tayin, tsawanta ciki, rage bayyanar cututtuka na anemia, hypoxia.

Don magance matsalar RH rikici oxygen far an kuma gudanar da sanya kudi nonspecific far, wanda ya hada da bitamin, da shirye-shirye tare da wani abun ciki na baƙin ƙarfe, da alli, antihistamines. Idan tayin da aka lura tsanani yanayin, da Caesarean sashe aka yi a 37-38 makonni na ciki. Har ila yau, mata masu ciki da gudanar plasmapheresis, wanda rage abun ciki na antibodies a cikin jinin, ya ja jini Kwayoyin da tayin.

Bayan haihuwar jariri kwashe transfussion canza don maye gurbin karye erythrocytes kuma rubũta hemolytic cuta - dropper manyan fitar guba abubuwa daga jiki da kuma rage erythrocyte lalace, sakawa a iska mai guba da hasken ultraviolet. Jiyya na bukatar m hanya na far, sa idanu neonatologists, wani lokacin da yaro yana sanya a wani m kula naúrar. Ciyar da jariri a cikin ƙirjinka madara ba da shawarar a lokacin farko da makonni 2 bayan haihuwar a cikin hali na hemolytic cuta.

Danginsu da Rhesus rikici

Mafi sau da yawa sakamakon ciki a gaban RH-rikici - wanda bai kai haihuwa. Saboda haka, aikin likitoci sigar tsawo na haihuwa, m saka idanu na ta ci gaba da aiwatar. Ga ganewar asali a lokacin da dukan tsawon ciki kwashe duban dan tayi, Doppler, CTG. Idan kara nurturing wani tsanani hatsari ga tayin, da yanke shawara a kan haihuwa prematurely.

A mafi yawan lokuta, a lokacin da haihuwa Rhesus rikici ƙare caesarean sashe. Haihuwa da sauƙi ne musamman rare kuma kawai idan fetal yanayin ne m da kuma jaririn ta rayuwa ne ba cikin hadari. Caesarean sashe yana dauke da mafi hadari da kuma m zuwa tayin. A lokacin haihuwa da bukatar gaban neonatologists yin farfado idan ya cancanta. Sauran ranakun haihuwar ta ya kamata a yi a cikin rijiya-sanye take da dukan zama dole kayayyakin kiwon lafiya da kuma gabatarwa a karkashin kulawa na sosai m likitoci.

m matakan

Rigingimu "uwa-tayin" a lokacin daukar ciki zai iya sa tsanani sakamakon ga yaro. Saboda haka, bayar da muhimmanci m matakan da nufin a cikin rigakafin RH-rikici da kuma ci gaban isoimmunization. Lokacin da jini da muhimmanci a yi la'akari da karfinsu da mai bayarwa, shi wajibi ne don ajiye farko ciki, amma kuma su hana abortions. Daidai da muhimmanci ne hankali shiryawa na ciki. A binciken da na jini kungiyoyin, RH factor zai hana RH-rikici ciki. Table jini kungiyar karfinsu don kauce wa nan gaba matsaloli. Ya kamata ya zama m zuwa cikin shakka daga ciki. Kamar yadda prophylaxis amfani intramuscular allura RH immunoglobulin daga jini bayarwa mata da RH-korau kuma Ya ƙãra laulayi m antigen. Wannan shiri halakar da ja jini Kwayoyin cewa kasance tabbatacce daga m RH factor, game da shi, rage hadarin isoimmunization da RH rikici.

A injections suna da za'ayi bayan da karewa na ciki, ashara, intrauterine tiyata don hana daukar ciki. Har ila yau, RH rigakafi globulin aka gudanar a mata masu juna biyu na da hadarin kungiyar a 28 makonni da kuma sake a 34 don rage alama na ci gaba hemolytic cuta daga tayi. Kazalika da allura da aka gudanar a kwanaki 2-3 bayan haihuwa, game da shi, rage hadarin Rhesus-rikici a m ciki. Immunoglobulin aka gudanar da kowane ciki, idan yiwuwar ciwon baby tare da m RH factor.

Saboda haka, RH-rikici uwa da tayin ba dalilin ƙarshe na ciki. Da alama na tasowa Rhesus rikici ne musamman kananan, don haka babu wani dalilin da ya kãsa magana. Godiya ga zamani ci gaba da immunology akwai ko da yaushe iya motsa jiki mai karfi da lafiya baby.