Whaea Rhesus-pakanga me te kukune i roto i hapūtanga: he tepu. pakanga ārai o te whaea me te kukune

I te hapūtanga pāngia e te āhuatanga maha. tūponotanga High te maua e te whaea rH-pakanga me te kukune. Heoi, mārama kore katoa nga take mo tenei āhuatanga, e ai wehi o te unknown. Na reira, ki te mohio pehea te kino te take rH me ka reira he takoto rH-pakanga "whaea-kukune" ko nga whaea expectant.

pakanga Rhesus - he aha te mea te reira?

Hei mahino te āhua o te raruraru, he mea nui te tuatahi ki te mārama me pēhea te nui o te take rH. Ko te pūmua motuhake, kei runga i te mata ngeniwhero. Ko reira i roto i te toto o te 85% o nga iwi katoa i tenei pūmua, me te ngaro i te toenga. Na reira, kei te whakaaro te mau taea'eo te tuatahi o ratou pai āhuatanga Rhesus me tuarua te negative.

Ko te kupu, whakatau reira nga āhuatanga immunological o te rauropi, me te tino kahore pānga i runga i te hauora tangata. Ka taea te tohua rh take rh + ko Rh-. Hoki te wā tuatahi tapa tenei wā i roto i te tau 1940 e te pūtaiao, me te Aleksandrom Vinerom Karlom Landshteynerom. Ko rh pakanga whaea me te kukune te immunological incompatibility toto rh i te take, ki te he te reira whaea kino, me te kukune pai. Ko te ati o Rhesus-pakanga takoto i roto i te meka e taea ai te mate fetal, kahukahu, materoto. kia puta tenei āhuatanga i roto i te whaea i mua nei rH-kino i roto i te tukanga o te hapūtanga me te i roto i te mahi. faaite whaea ārai me te pakanga te kukune iho ki te riro te kukune kua rH + i tona papa.

Take o te rH-pakanga whaea me te kukune

Hoki te tinana o te tamaiti toto o te whaea i mua nei ki rH + ko te riri nui, na hua reira paturopi e tauhohe ki te pūtau toto whero fetal, me te whakangaro ia ratou. faataa Rhesus-pakanga whaea me te kukune transplantsentarnym kătahi o pūtau toto whero fetal ki te take pai rH i te toto o te mau metua vahine ki te tohu kino.

Ko te nuinga e tika ana ki te putanga o te hapūtanga tuatahi pakanga immunological. Roto i te hapūtanga kia tika ki e huhu toto i roto i nei e kore e tangohia te take rH ki pūkete, mâtutuhia mua, whakatahe Rhesus-pakanga. Hoki e taea te tiki rH toto hotokore ki te tamaiti i roto i te toto o te whaea i roto i whanau, kia riro i haria ki te take kino rH tinana o te whaea, a ka nui haere te tūponotanga o rH-pakanga i roto i te rua o te hapūtanga. faarahi te reira i te mōrea o te isoimmunization i roto i te wāhanga whakawhānau. Ka taea te whakapataritari incompatibility toto toto i roto i te hapū me te whanau rite ki te hua o te kino ki te ewe.

Ko te tūponotanga o rH pakanga rōpū toto

Kei te ira whakaritea rh take me riro ngoi huru. Ki te mea he rH tōraro, ko tona papa te whaea ina he pai homozygosity, whiwhi tonu te tamaiti rH +. I roto i tenei take, he tiketike rawa te mōrea o te pakanga o te rōpū toto. A i roto i te take o te papa o te heterozygosity tūponotanga o te tuku ki te kukune rH kino pai ranei Inerite.

I te waru o nga wiki o te whanaketanga fetal reira he toto, i roto i nei pūtau toto whero ki te tohu nui o te tūponotanga e taea te mau i roto i te bloodstream o te whaea. I roto i tenei tiaki haerenga ārai whaea rite whakaaro antigen fetal te manene. Na reira, ko te tinana hua he he paturopi rH hapu, e ai te pakanga whaea rH me kukune. Ko te mōrea o te pakanga immunological iti nui roto i te hapūtanga me te he 0.8 anake%, engari he mea tino kino, a na reira titau ako motuhake, me te whakarongo. Whakakitea e pā ana ki te whakamātautau toto tamaiti rH e parauhia i runga i te rōpū o ngā mātua e faati'a ai forecasting rH-pakanga hapūtanga. mārama whakaatu te tepu te tūponotanga o te incompatibility toto.

Mau hopearaa me tuma ki te pakanga Rhesus i roto i te hapū

he mahi wehe, ngaahi nunu'a mamafa mo te tamaiti te whaea ārai me te taupatupatu kukune. Ko te antigens whakaputaina e te tinana whaea, te kimi i te tinana ke hotokore ki tauwehe rH ô i te rere toto fetal roto i te arai, a gematoplatsentarny whakapōrearea tukanga tamaiti hematopoiesis, hëoi anö te hanganga o ngā pūtau toto whero.

Ka taea e tenei paturopi whanonga meinga huru tino mōrearea mo te kukune, whakawehi te ora o te tamaiti, āhuatanga nei i te acidosis, hypoxia, anemia. I roto i te tinana o te tamaiti piki rahi o inu, me te ko te takahi o tata katoa whekau me ngā pūnaha. I roto i taua take, ki te kahore e riro mehua i roto i te wā, i reira te mea he nui tūpono o materoto, te mate fetal, kahukahu, whanau o te tamaiti ki te mate hemolytic e ka tonu ki te hanga i te ahunga whakamua e tika ana ki te haaputuputuraa i roto i te tinana o te hanga pēpi antirhesus antibody i meinga te pakanga whaea me kukune i roto i te hapū . Ka taea e meinga hoki te reira i te whanaketanga o mate, e kua whakahuatia i roto i te hua nui i roto i nga whekau, roro, ngakau, lesion paitini o te pūnaha io pokapū.

tohu

e kore tohu haumanu me te tohu motuhake rh pakanga whaea me te kukune i roto i te hapū. Pea ki te tautuhi i te raruraru i roto i anake tātari taiwhanga o toto, e tohu te aroaro o paturopi ki te rH-tōraro.

I roto i te incompatibility toto fetal faaite ake i roto i te whanaketanga o te mate hemolytic o nga whekau, me ngā pūnaha o te tinana, e taea arahi ki tona whakangaromanga i roto i te wā i 20-30 wiki o te hapūtanga, ka rite ki te pai rite ki te putanga o te materoto, kahukahu, tuku taimi halá.

I tua atu, kia puta tamaiti wā-tonu edematous, icteric me anemic ahua o te mate hemolytic. puta Rhesus-pakanga i roto i te kukune i roto i toto ahua o teeki pathologies pūtau toto whero o whekau. meinga tohutanga e te nui o paturopi whakaputaina e te whaea o te tinana. I roto i te puka nui o te mate puta ka te puku o te kukune - i reira he he hua i roto i te rahi o whekau, te takanga o ewe ascites hua me te waimatū rōrahi inu. Ka taea te nui haere ake te taimaha o te tamaiti ki te rua nga wa, kei te maha haere tahi te mate i te edema.

rangahau taiwhanga

Rhesus-pakanga "whaea-kukune" i roto i hapūtanga taea te ārai tātaritanga wawe, rawa i roto i te puka o te tāutu i te papa tauwehe rH me te whaea ki te aroaro o te hapūtanga muri ranei mua ona ngā.

hāngai ana matapae pakanga Rhesus te i runga i nga raraunga o e huhu toto o mua, te rere, me te putanga o te hapū tuatahi, te wātea o te materoto, materoto, te mate fetal roto te kopu o tona whaea, mate hemolytic o te tamaiti, hanga reira pū pono ki te tautuhi i te tūponotanga o te mōrea o te isoimmunization.

whakamātautau Laboratory toto ki te whakatau tinana antirhesus me e puritia taitara mō ngā wahine katoa ki te whakapae hapū rH-pakanga. kia tango tätari, me te papa o te tamaiti. Ki te he nui te tūponotanga ka o rH-pakanga, Me wahine hapu ki te kia whakamatautauria nga marama. I runga i te wiki 32 th o whakamātautau taiwhanga e kawea i roto i rua i te marama, i runga i te 36raa - nga wiki tae noa ki te tuku. Ki te kitea rH-pakanga hapūtanga, ka whakatau i te ako te ihirangi o paturopi i te tinana o te whaea. Te māuiuitanga mua pāngia, te raro te mōrea o pōauautanga, rite te pānga o rH-pakanga piki i runga i te wā.

Ultrasound me tikanga urutomo o te aromatawai mōrearea mo te kukune

Hei tātari pakanga immunological o whaea me te kukune i roto i taipitopito, kawea ultrasound i te iti rawa e wha nga wa i 20 ki te 36 wiki o te hapūtanga me te aroaro o te tuku. Ultrasound taea ki a koe te aroturuki i ngā āhuatanga o te kukune, me te ki te tautuhi i te aroaro o abnormalities.

Ko te ako aromatawai te huru me te rahi o te ewe, fetal rōrahi puku, waikahu, uaua uho.

tikanga rangahau atu ko te hiko-, cardiotocography, phonocardiography e tukua te kukune ki te whakatau i te taumata o te hypoxia i pakanga Rhesus. Whakarato ngā mōhiohio aromatawai urutomo - he ako o waikahu i amniocentesis me te toto uho i cordocentesis. Tātaritanga o te waikahu ki te whakatau i te tinana titer antirhesus, sex o te tamaiti, fetal paari pūkahukahu. Ko te tohu tangohia o mate pāngia e kardotsentoza rōpū toto me te take rH i fetal toto taura. I tua atu, e whakaatu rangahau te aroaro o te pūmua waikuruwhatu, pūtoto, bilirubin, reticulocytes, paturopi, whakaritea i runga i te erythrocytes.

maimoatanga

Ki te kitea he pakanga te whaea me te rōpū toto fetal, ngā te maimoatanga whai hua anake mō te huhu toto ko te kukune i roto i te rua pito roto te kopu. whakamana ana te tukanga i raro i te mana o te ultrasound. Tenei mehua taea ki te hiki i te huru o te kukune, roa hapūtanga, whakaiti i nga tohu o te anemia, hypoxia.

Hei faaiti i te pānga o te rH pakanga hāora therapy te whakahaere whakaritea ano auau therapy nonspecific, e ngā huaora, taka ki te ihirangi o te rino, te konupūmā, antihistamines. Ki te kitea te kukune te huru taumaha, whakamana te wāhanga whakawhānau i 37-38 wiki o te hapūtanga. Ano, whakahaere wahine hapu plasmapheresis, i te whakaiti i te ihirangi o paturopi i roto i te toto ki ngā pūtau toto whero o te kukune.

I muri ki te whanautanga o te tamaiti kawea huhu whakakapi whakakapi erythrocytes whati, me te whakahau mate hemolytic - dropper ārahi atu matū paitini i te tinana, me te whakaiti ngeniwhero te pirau, irradiation ki hihi katinga. titau Treatment akoranga kaha o therapy, te aroturuki neonatologists, ētahi wā whakanohoia te tamaiti i roto i te kōwae whāomo. e kore e kai i te tamaiti i roto i te waiu uma tūtohutia i roto i te 2 wiki tuatahi i muri i te whanautanga i te take o te mate hemolytic.

Puninga ki pakanga Rhesus

Nuinga o ngā wā i te putanga o te hapūtanga i te aroaro o te rH-pakanga - whanau ka werowero. Na reira, ko te mahi o ngā tākuta, ko te toronga o te whanautanga tamariki, aroturuki whānui o tona tukanga whanaketanga. Hoki te tātaritanga i roto i te wā katoa o te hapūtanga kawea ultrasound, Doppler, CTG. Ki te poipoi anō i te ati nui ki te kukune, te whakatau i runga i materoto.

I roto i te nuinga o te wā, ka tou haputanga pakanga Rhesus mutu wāhanga whakawhānau. Whanau fakanatula e tino onge, me te anake, ki te he pai huru fetal a kahore he i roto i te tau te ora o te tamaiti. whakaaro wāhanga whakawhānau ko te tino haumaru, me te ngawari ki te kukune. I roto i whanau titau te aroaro o neonatologists ki te mahi whakaora, ki te tika. kia whakamana tari whānautanga i roto i te pai-rawa ki te taputapu tika katoa hauora me te whare i raro i te mātakitaki o kaiwhakaako tino tohu.

āraihia

Papā "whaea-kukune" i roto i hapūtanga taea meinga nunua mamafa mo te tamaiti. Na reira, e hāngai ana faufaa mehua nui ārai i te ārai o te rH-pakanga me te whanaketanga isoimmunization. A, no te he nui ki te whakaaro i te hototahi ki te kaituku, he huhu toto, he mea e tika ana ki te whakaora i te hapūtanga tuatahi, engari ano hoki ki te ārai i mâtutuhia. E rite nui ko te whakamahere tupato o te hapūtanga. Ko te ako o ngā rōpū toto, ka ārai rH take rH-pakanga hapūtanga. Ripanga hototahi rōpū toto ki te karo i ngā raruraru heke mai. E tika ana kia tahuri ki te akoranga o te hapūtanga. Ka rite ki prophylaxis whakamahia werohia intramuscular o rH immunoglobulin i te wahine toto kaituku ki rH-kino, me te nui haere susceptibility ki antigen pai. Tenei faaineineraa whakangaromia e nga pūtau toto whero e i pai i te kawe rH tauwehe, reira whakaiti i te mōrea o te isoimmunization me rH pakanga.

Kua kawea te werohanga i muri i te mutunga o te hapūtanga, materoto, tafa intrauterine ki te ārai te hapūtanga. Ano, rH globulin ārai te whakahaere ki nga wahine hapu, no ki te rōpū tūpono i 28 wiki, me te ano i 34 ki te whakaiti i te tūponotanga o te whanaketanga o te mate hemolytic o te kukune. I tua atu i faaterehia te werohanga i roto i 2-3 ra i muri i whanau, reira whakaiti i te mōrea o Rhesus-pakanga i roto i hapūtanga muri. faaterehia immunoglobulin te ki ia hapū, ki te te tūponotanga o ia i te tamaiti ki te take pai rH.

Ko te kupu, e kore te mea he take mo whakamutunga o hapūtanga te whaea rH-pakanga me te kukune. Ko tino iti te tūponotanga o te whakawhanake Rhesus pakanga, na reira he kore take ki te hepohepo. Ngā mihi ki fakalakalaka hou o te immunology reira he taea ki te faaohipa i te tamaiti kaha, me te hauora tonu.