Ngelixa eliphazamisayo, ubuninzi bezinto ezilahlekileyo zithintelo zibandakanya ukuphulukana ngokukhawuleza kwenyama. Ukukhulelwa kwe-Molar ayikho kulo mgaqo.
Ukukhulelwa kwe-Molar kunokuba neengxaki zezempilo, ezifuna iinyanga zokulumkisa emva kokunyanga, okuqhelekileyo i- D & C. Ininzi yexesha ukukhulelwa kwe-molar kuhamba ngaphandle kweengxaki ezingaphezulu, kodwa iingxaki ezongeziweyo zingenza ukuba kunzima kunzima ukuhlangabezana nokuqhelekileyo.
Ezisiseko
Ukukhulelwa kwe-Molar uhlobo lwesifo se- trophoblastic gestational (GTD). Kubangelwa yi- chromosomal engavamile ngexesha lokukhulelwa.
Ukukhulelwa kwe-Molar kuyahlula kwiindidi ezimbini: i-molatidiform moles epheleleyo kunye neyodwa. Zombini zibangelwa iingxaki ze-chromosomal kwiqanda elichumayo, elikhokelela ekugqibeleni kweethambo zokukhulelwa. Nangona ukukhulelwa kwe-molar kungakhula ibe ngumntwana, i-placenta engavumelekanga ayikwazi ukugcina ukukhulelwa kunye neengxaki ze-chromosomal azihambelani nobomi. Ukukhulelwa kwe-molar epheleleyo akuyi kuvelisa umntwana obonakalayo.
Kutheni ukukhulelwa kweMolar kungabungozi
Phantse i-20% yabasetyhini abaye bafumana ukukhulelwa kwe-molar baya kuhlakulela enye yeengxaki ezimbini ezibalulekileyo: i-mole engenayo okanye i-choriocarcinoma. Iilesi ezinomdla ziqhelekileyo. Umngcipheko wale meko ukwandisa ixesha elide ukukhulelwa kuqhubeka ngaphandle kwonyango. (I-moles i-Invasive iyakhula ngaphambi okanye emva kokunyangwa ngonyango.)
I-Choriocarcinoma luhlobo lomhlaza ongakhula kwisayithi ye-placenta kwaye isasazeka emzimbeni. Ngelixa linzulu, liphantse lilapheke ngekhemotherapy.
Kukho kwezi meko kunokwenzeka ukuba zenzeke emva kokukhulelwa kwe-molar; I-2% ukuya kwi-4% ye-moles ekhethekileyo iya kuphuhlisa imeko.
Izinto zobungozi
Izinto ezinobungozi ezimbalwa, ezifana nokukhulelwa kwexesha elidlulileyo okanye ngaphezulu kwama-35, kunokunyusa amathuba okuba ukhulelwe, kodwa njengamanye ama-miscarriages, izinto ezinobungozi azidingeki ukuba zifumane ukukhulelwa kwe-molar.
KwiNyakatho yeMerika, i-hydatidiform moles yolunye uhlobo lwenzeka kwi-2 ukuya kwi-3 nganye kwi-10,000 yokukhulelwa.
Iimpawu
Abafazi abanokukhulelwa kwe-molar abanakho iimpawu ezithile, kodwa izikhombandlela zokuxilonga ezibonisa ukukhulelwa kwe-molar zingabandakanya ngaphezulu kwamazinga e- hCG (ukugqiba ukukhulelwa kwe-molar), ii-ovaries ezandisiweyo kunye ne-pre-eclampsia yokuqala.
Ukuphuma kwintsholongwane kunye neengcambu zenzeke kwiinkqubo ezininzi zokukhulelwa komama, kodwa nazo ziyakwenzeka ngokukhulelwa ngokuqhelekileyo okanye ukukhulelwa komzimba. Ukongezelela, ukukhulelwa kwe-molar kungabangela ukuvuvukala kwindawo yesisu - kodwa abafazi abanokukhulelwa ngokuqhelekileyo bangakwazi "ukubonisa" ekuqaleni.
Ukuxilongwa
Ukukhulelwa kwe-Molar kungafunyanwa xa intliziyo ingabonakali kwiiveki ezili-12, kodwa oku kunokuba kunjalo nangamabhaja alahlekileyo . Iindlela zokuxilonga zidla ngokuba yi- ultrasound , ezityhila i-placenta engavamile ebonakala njengeqela leidiya.
Unyango kunye nokubuyiswa
Ezinye ukukhulelwa kwe-molar ziza kuphazamiseka ngaphandle kokungenelela, kodwa ukuba oogqirha bafumana ukukhulelwa kwe-molar nge-ultrasound, bavame ukucetyiswa iD & C okanye amayeza ukuze kuncitshwe ingozi yeengxaki ezingaphezulu.
Ngokuqhelekileyo, ukukhulelwa kwe-molar kungenzeka kwiimpawu ezimbini nge-molecule ye-hydatidiform kunye nokukhulelwa okunye okunokwenzeka. Kule meko, ukuqhubeka nokukhulelwa kungabangela ingozi enkulu kwimpilo kamama (ngenxa yekheba elingama-60% lokuphuhlisa i-GTD eqhubekayo) kwaye abaninzi banquma ukuphelisa ukukhulelwa, oku kungabangela omnye umthombo weengxaki ezixubileyo kwinkqubo yokulila.
UkuLawulwa kwezoNyango
Ngenxa yomngcipheko wokwakha i-mole engenayo okanye i-choriocarcinoma, oogqirha bancomela ukuba abafazi abakhulelwe ngokukhawuleza baqhubeke bebeka iliso kwiinyanga eziliqela. Ukubeka iliso kubandakanya ukuhlolwa kwegazi ngeveki okanye ngenyanga, kuba ukuba i-hCG ihluleka ukunciphisa okanye iqala ukuvuka kwakhona, oku kungabonakalisa uphawu lwe-GTD eqhubekayo.
Ukuba le ntokazi ibeneemvavanyo ezintathu zegazi ze-HCG ezilandelelanayo, inokuthi ivela kwindawo yengozi. Abanye oogqirha abaxhasi kakhulu malunga nokubeka esweni abafazi ababengakhulelwa ngokukhawuleza, kuba iingxaki zeengxaki ziphantsi.
Ukujamelana
Ukukhulelwa kwe-Molar kunokubandakanya izigaba ezifanayo zesisindo njengenye i-miscarriages, kodwa njengokwakhulelwa kwe- ectopic (enye imeko enobungozi), ukuxhalabisa ngokukhulelwa kwe-molar kungabinceda ukuba imeko ifunyenwe kunye nentlungu ngenxa yokulahlekelwa ngumntwana osalindelekileyo. Unokuva iimpendulo kunye nemigca "ubuncinci bawubambe ngexesha" okanye "ubuncinane bekungengumntwana onyanisekileyo," kodwa ngokuqhelekileyo ukuxhalaba nokulila. Qinisekisa ukuba ufuna amaqela enkxaso kunye nezinye izixhobo ukukunceda ukuba uphumelele kwinkqubo.
Ukuzama kwakhona emva kokukhulelwa kwe-Molar
Ixesha elilindelekileyo lokulinda liyahluka, kodwa oogqirha badla ukuba balinde ubuncinane iintsuku ezintandathu ukuzama ukukhulelwa kwakhona emva kokukhulelwa kwe-molar. Le ngcebiso kufuneka ilandelwe rhoqo kwaye inesizathu esicacileyo sezokwelapha.
Ngoba? Ukunyuka kwamazinga e-hCG kungabonakaliswa kokuqala kwee-moles okanye i-choriocarcinoma, kwaye zombini ezo meko zonyango xa zifunyenwe. Ukukhulelwa okutsha kuya kubangela ukuba amazinga e-hCG aphakame, kwaye ukuba oko kwenzeka, oogqirha abayi kukwazi ukwahlula i-hCG ukukhulelwa okutsha kwi-hCG kwiimeko ezinxulumene nezifo ezinxulumene nezifo zesifo se-trophoblastic.
Kwakhona, ngenxa yokuba unyango lwe-moles engenayo kunye ne-choriocarcinoma inokubandakanya i-chemotherapy, ukukhulelwa kufuneka kugwenywe de ukuba oogqirha banokuqiniseka ukuba imfuno ye-chemotherapy ayiyi kuvela.
U-1% ukuya ku-2% wabasetyhini abanokukhulelwa kwe-molar baya kuba nelinye, ngoko ugqirha wakho unokufuna ukulandelelana kunye ne-ultrasounds kunye nokuhlolwa kwegazi kwi-hCG ekukhulelweni kwakho okuzayo ukulawula ukukhulelwa kwe-molar.
Imithombo:
> I-American Cancer Society, "Yiyiphi i-Gestational Trophoblastic Disease?" Isikhokelo esinqununu: Isifo se-Gestational Trophoblastic Disease ngoMeyi 2006.
> Umbutho waseMelika wokukhulelwa, "Ukukhulelwa komama." Ngo-2006.
> Matshi weDeses, "i-Ectopic kunye ne-Molar Pregnancy." Izikhokelo ezikhawulezayo kunye namaShidi e- 2005.