I-placenta accreta yimeko esongela ubomi eqhubekayo ekukhuleleni xa i-placenta ikhula ngokugqithiseleyo eludongeni lwe-uterine eyenza ikwazi ukuhlukana ngokulula. Ngokuqhelekileyo i-placenta ifakwa kwisibeletho ngendlela yokuba, emva kokuba umntwana ezalwe, izivumelwano zesibindi kunye ne-placenta zikhishwa-ngokuqhelekileyo zingaphantsi kwesigama seyure emva kokuzalwa komntwana.
Oku akukwenzeka kwimeko ye-placenta accreta, engakhokelela ekuphumeni kwegazi, ukubola, ukulahlekelwa kwesisu, kunye nokufa kwabazali. Ukuba i-placenta ikhula ukubandakanya izihlunu zesisu, kuthiwa yi-placenta increta. Ukuba i-placenta ikhula ngodonga lwe-uterine, yaziwa ngokuba yi-placenta percreta.
Izinto zobungozi
Unomngcipheko wokuba unikwe i-placenta accreta ukuba uye wafumana ukuhanjiswa kwangaphambili kunye neziplantsa ze-placenta phezu kwesibalo sakho. I-ultrasound eqhelekileyo ingaba yinto efanelekileyo kakhulu yokuqwalasela ukuba unesifo esingaqhelekanga kunye ne-placenta yakho. Ngoko ukuba unesibeleko sokugqibela, uya kufuna ukucela umniki wakho wezempilo malunga nokujonga i-ultrasound ubungqina bokuthi i-placenta yakho ifakwe ngokuqhelekileyo.
Umlinganiselo we-placenta accreta uye wenyuka, ohambelana nokunyuka kwamazinga okuhlalisa. Ngama-1970, uphando lubonisa isantya se-1 kwi-4,027 ukukhulelwa kwaba nama-accreta, aphakama ukuya kwi-1 kwi-2,510 yokukhulelwa ngo-1982.
Nangona kunjalo, ukuba ukhangela idatha ngo-1982-2002, izinga le-accreta li-1 ngo-533 ukukhulelwa.
Ukuba unayo i- placenta previa , apho izimpembelelo ze-placenta ezikufutshane nxalenye engaphantsi kwesibeleko, ehlanganisa zonke okanye inxalenye yomlomo wesibeleko, umngcipheko we-placenta accreta ukhuphuka kunye nokunikezelwa kwexesha elidlulileyo.
Abaphandi bafumanise ukuba umngcipheko we-placenta accreta xa une-placenta previa kunye neyodwa idlulileyo yangaphambili iyingxenye ezintathu.
Njengoko inani labagciniweyo likhuphuka, kunjalo nomngcipheko we-placenta accreta. Emva kokuzalwa okuhlanu okanye ngaphezulu kwe-laarean-ukuba unayo i-placenta previa-unamava engama-67 okufumana i-accreta ngokunjalo. Ukubeka oku ngolu hlobo, ukuba unayo i-placenta previa ngaphandle kokuhlinzwa okwenziwa kwangaphambili, uza kuba nomngcipheko we-one to five of accreta.
Kukho ezinye izinto ezinobungozi ezinokunyusa ingozi yokuba ne-placenta accreta, nangona isithuba esiphezulu sishiya phambili. Ezi ziquka:
- Ubudala bomama obudala
- Ukuba nomntwana omnye
- I-myomectomy yangaphambili
- Ukunyuka kwamafutha
- Ubunjineli obumbini
- I-Asherman syndrome
Ukunikezwa nge-Placenta Accreta
Ukuba unayo imeko eyaziwayo ye-placenta accreta, uya kucetyiswa ukuba ube nokunikezelwa okucwangcisiweyo. Nangona usuku olukhethiweyo luya kulinganisa impilo yentsana yakho kunye nempilo yakho, oku kusenokuba kusekupheleni kwamaviki angama-34. Oku kuthetha ukuba unyango kunye ne-steroids ukukunceda ukuphucula imiphunga yengane yakho iya kucetyiswa. Kwaye, kunye nokunikezelwa okucwangcisiweyo, kufuneka ucele ukuba wenzeni ukuba ucinga ukuba uye waqala ukubeleka kwaye ezinye izibonakaliso zikhangeleke.
Ugqirha wakho uya kubamba iqela lokunceda ngexesha lotyando lwakho. Oku kunokuthetha ukuba kufuneka udluliselwe kwisibhedlele esilungele ukuphatha olu hlobo lokuzalwa. Izibhedlele ezikhudlwana, ezixhotyiswe kakuhle zikunika ithuba elihle lokufumana impembelelo. Ukususela malunga neepesenti ezingama-90 zoomama abane-placenta accreta kufuna ukudluliselwa kwegazi, ukucwangcisa phambili kunye nokubambisana nabasebenzi bebhedlele kunye neebhanki zegazi ngamanyathelo abalulekileyo. Ngamanye amaxesha, unokubuza ugqirha wakho ngegazi lebhanki ngokusetyenziswa kwakho, ukuba unomdla.
Ugqirha wakho kufuneka akhulume nawe malunga nokuba unokulahlekelwa ngumbeletha wakho kwinkqubo.
Ezinye iingxelo zibonisa ukuba iziphumo eziphambili ziquka ukucwangcisa kwangaphambili ukwenza i-hysterectomy. Oku kuthetha ukuba emva kokuzalwa komntwana ngeqendu le- calary , isibeleko sisuswa kunobungozi ukuzama ukususa i-placenta kwi-uterus kwaye ibe nomngcipheko ophezulu wokukhupha kunye nokulimala. Le yimeko ebalulekileyo. Enyanisweni, umngcipheko wokufa kwabazali ochaphazelekayo kule nkqubo kuphezulu njengama-7 ekhulwini.
Iindaba ezilungileyo kukuba sineteknoloji ukuchonga ukuba unemvume ye-placenta kakuhle ngaphambi kokunikezelwa. Sineeteknoloji kunye nokuqhubela phambili ekuncedeni ukukunceda ngexesha lokuzalwa. Ukuba uye wafumanisa ukuba une-accentate ye-placenta, unokucela ugqirha wakho ukuba akuncede ukudibanisa nabanye abaye bafumana amava afanayo. Ukuthetha ngale nto kunokuba luncedo kakhulu kwaye kukuve ukhulule ngenkqubo.
Imithombo
Al-Serehi A, Mhoyan A, Brown M, Benirschke K, Hull A, Pretorius DH. I-placenta accreta: umbutho kunye ne-fibroids kunye ne-Asherman syndrome. J Ultrasound Med 2008; 27: 1623-8.
Comstock CH. Ukuxilongwa kwe-Antenatal ye-placenta accreta: ukuhlaziywa. I-Obset Ultrasound Gynecol 2005; 26: 89-96.
UHamar BD, i-Wolff EF, i-Kodaman PH, i-Marcovici I. Ukusabalalisa kwangaphambili kweembrane, i-placenta increta, kunye ne-hysterectomy ekukhulelweni kulandela ukuphuma kwe-endometrial. J Perinatol 2006; 26: 135-7.
UMiller DA, i-Chollet JA, i-Goodwin TM. Iziphumo zemingcipheko ye-placenta previa-placenta accreta. U-J Obstet Gynecol 1997; 177: 210-4.
OBrien JM, Barton JR, uDonaldson ES. Ukulawulwa kweplacenta percreta: izicwangciso zokulondoloza kunye nokusebenza. IJ Obstet Gynecol 1996; 175: 1632-8.
I-placenta accreta. Iingxelo zeKomidi No. 529. Ikholeji yaseMerika yase-American and Gynecologists. I-Obstet Gynecol 2012; 120: 207-11.
I-G G, i-Mocarski E, i-Bennett J, i-Vilos G, i-Common A, i-Vanderburgh L. Ukukhulelwa emva komgubo wesibindi sokubambisa i-leiomyomata: ityala le-Ontario elibanzi. Iqela leQumrhu eliBambisana ne-Ontario UFE. I-Obstet Gynecol 2005; 105: 67-76.
Funda iJA, iCotton DB, iMiller FC. I-placenta accreta: ukutshintsha imiba yekliniki kunye nesiphumo. I-Obstet Gynecol 1980; 56: 31-4.
Shellhaas CS, Gilbert S, Landon MB, Varner MW, Leveno KJ, Hauth JC, et al. Iimvama kunye neengxaki zeengxaki ze-hysterectomy ezihamba kunye nokuhambisa. U-Eunice Kennedy Shriver amaZiko eZiko lezeMpilo kunye nophuhliso loLuntu lweNtsholongwane kaMntwana. I-Obstet Gynecol 2009; 114: 224-9.
I-Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Ukuxhatshazwa komama okubandakanyeka nokuphindaphinda okuphindaphindiweyo. ISiko leSizwe seMpilo yabantwana kunye noPhuhliso lwaBantu baseMantal-Fetal Medicine Units Network. I-Obstet Gynecol 2006; 107: 1226-32.
Wu S, iKocherginsky M, iHibbard JU. Uhlu lokungaqhelekanga: uhlalutyo lweminyaka emashumi mabini. U-J Obstet Gynecol 2005; 192: 1458-61.