Zomwe Zimayendera Pakati Pa Mimba
Anaphylaxis ndizovuta kwambiri, chifukwa cha kutulutsidwa kwa mankhwala osokoneza bongo monga histamine kuchokera ku maselo osokonezeka monga maselo a mast . Zifukwa za anaphylaxis ndizo zakudya, mankhwala monga penicillin ndi NSAIDs , latex ndi tizilombo toyamwa ndi kulumidwa . Zizindikiro za anaphylaxis zingakhale urticaria ndi angioedema , zizindikiro za mphumu , kunyowa / kusanza ndi kutsekula m'mimba, ndi kutsika kwa magazi.
Anaphylaxis amatha kupezeka pa nthawi yomwe ali ndi mimba, makamaka panthawi yolimbitsa thupi komanso yobereka, ndipo imatha kuwonetsa kuti mwanayo ali pangozi yapadera, chifukwa kuthamanga kwa magazi komwe kumakhudzana ndi anaphylaxis mwa mayi kungakhudze magazi kupita ku ziwalo zofunika m'mimba, monga ubongo ndi mtima. . Zizindikiro zowonjezera za anaphylaxis pa nthawi yomwe ali ndi mimba zimaphatikizapo kuyabwa kwa amayi ndi abambo, uterine zopweteka komanso kupweteka kwa msana.
Zifukwa za Anaphylaxis Pakati pa Mimba
Zomwe zimayambitsa anaphylaxis nthawi zambiri mimba ndi zofanana ndi mkazi wosakhala ndi pakati. Komabe, panthawi yolimbitsa thupi ndi yobereka pali zifukwa zosiyana za anaphylaxis zomwe ziyenera kuganiziridwa. M'mbuyomu kafukufuku wa odwala 23 omwe ali ndi anaphylaxis pa nthawi ya mimba, 8 anali ndi anaphylaxis penicillin ndi antibiotic yowonjezereka, 6 anali anaphylaxis mpaka latex, 1 anali ndi anaphylaxis kwa njuchi, ndipo otsala anali ndi anaphylaxis ku mankhwala ena osiyanasiyana.
Phunziro lina linanso lochokera ku chipatala cha Texas linayesa amayi 700,000 omwe amachotsedwa pambuyo pobereka anawonetsa 19 milandu ya anaphylaxis (0.0027% ya kubereka), ndi zoposa theka la milandu yomwe imayamba chifukwa cha penicillin ndi mankhwala ena otero.
Ambiri mwa amayi omwe ali ndi anaphylaxis mu phunziro ili adaperekedwa ndi gawo loletsa.
Penicillin ndi maantibayotiki otero. Pa nthawi yobereka komanso yobereka, mankhwalawa amachititsa kuti ana asamapweteke kwambiri. Penicillin (ndi mankhwala oletsa antibiotics) ndi mankhwala osankhidwa omwe amathandiza kupewa matenda opatsirana pogonana omwe ali ndi HIV (GBS) ndi matenda ena (monga prophylaxis panthawi yamagazi) ndipo nthawi zambiri amapatsidwa nthawi yobereka komanso yobereka.
Ngakhale kuyesedwa khungu ndi njira yabwino kwambiri yodziwira penicillin zowopsa, izi sizikulimbikitsidwa pa nthawi ya mimba, kupatsidwa mwayi wochepa wa anaphylaxis womwe ukhoza kuchitika chifukwa cha kuyesedwa. Kupewa penicillin kumapindulitsa pa nthawi ya mimba (pogwiritsira ntchito mankhwala ena osagwiritsa ntchito penicillin), pokhapokha palibe njira ina, monga momwe amayi alili ndi kachilombo.
Latex mankhwala. Mankhwalawa amachititsa kuti ana asamapweteke nthawi yobereka. Amayi oyembekezera omwe ali ndi mbiri ya latex akuyenera kuyesedwa asanayambe kugwira ntchito ndi kubweretsa pogwiritsa ntchito serum IgE ELISA kuyesa , m'malo moyesera khungu mpaka latex, kupatsidwa mwayi wambiri wochititsa anaphylaxis ndi kuyesedwa khungu. Azimayi oyembekezera amatha kupatsidwa malo opanda mvula chifukwa cha ntchito ndi kubereka.
Kuchiza kwa Anaphylaxis Pakati pa Mimba
Kawirikawiri, chithandizo cha mankhwala opatsirana pa nthawi yomwe ali ndi mimba sichinthu chosiyana ndi chomwe sichinali mimba. Epinephrine ndi chithandizo choyenera, ndipo kuthamanga kwa magazi kumakhala koyenera kupwetekedwa ndi mafupipafupi a epinephrine (monga momwe akufunira), madzi osakaniza, ndi mankhwala ena kuti asunge magazi. Kuthamanga kwa magazi m'mayi kungachititse kuti magazi otsika apite ku ziwalo zofunika m'mimba, makamaka ubongo.
Kuvulala kwa ubongo kungapangitse pamene magazi akuchepetsedwa mpaka mwanayo kwa mphindi zoposa zisanu.
Chithandizo chabwino cha anaphylaxis pa nthawi yomwe ali ndi mimba ndi kupewa anaphylaxis pamalo oyamba. Choncho, odwala onsewa ndi ofunika kwambiri powasamalira amayi omwe ali ndi pakati omwe ali ndi mbiri ya anaphylaxis ku zakudya, mankhwala, latex ndi tizilombo toyambitsa matenda. Kuyesedwa kwa chifuwa chachikulu kuyenera kutayika pa nthawi ya mimba, kapena kuyesedwa pogwiritsa ntchito kuyezetsa magazi, kuti kuchepetseni mwayi wa anaphylaxis chifukwa cha kuyesedwa khungu.
Chitsime:
Simons FER, Schatz M. Anaphylaxis Pakati pa Mimba. J Kupatsirana ndi Khunyu Immunol. 2012; 130: 597-606.