Hauv obstetrical xyaum, qhov teeb meem los ntshav yog qhov tseem ceeb heev. Tom qab tag nrho, cov ntshav loj heev tuaj yeem tsis yog vim qhov kev tuag ntawm tus me nyuam hauv plab, tab sis nws kuj yog ib qho mob uas yuav ua rau tus poj niam lub neej.
Kev faib tawm ntawm cov ntshav hauv cov poj niam
Kev mob ntshav ntws thaum lub cev xeeb tub tau muab cais ua pawg hauv qab no:
- los ntshav hauv thawj ib nrab ntawm cev xeeb tub;
- hemorrhages ntawm ob ib nrab ntawm cev xeeb tub;
- los ntshav thaum lub sijhawm ua haujlwm;
- Tom qab yug menyuam tas.
Ua tsaug rau kev cais ntawm obstetric hemorrhages, nws ua kom meej tias lawv tuaj yeem tshwm sim ntawm ntau theem ntawm cev xeeb tub. Nws yog tsim nyog sau cia tias qhov ua rau ntawm txoj kev los ntshav yuav txawv nyob ntawm lub sij hawm gestation. Thiab yog li ntawd, cov ntshav yuav tsis nrog nws cov ntshav tawm rau txhua tus mob.
Ob qho ntshav los ntshav
Qhov ua rau obstetric hemorrhages nyob rau hauv thawj ib nrab ntawm cev xeeb tub yuav ua tau ectopic cev xeeb tub, lub zais zis , ib tug me nyuam me. Nyob rau ob feem ntawm kev ua gestation, los ntshav nrog nrog lub caij nyoog ntxov ntawm lub tsho me nyuam los yog nws qhov kev nthuav qhia.
Tsis tas li ntawd xwb, peb yuav soj ntsuam qhov ua rau obstetric hemorrhages ncaj qha thaum yug me nyuam. Yog tias cov ntshav tau tshwm sim rau thawj lub caij ua haujlwm, uas yog, thaum lub sijhawm qhib qhov ncauj tsev menyuam, ces qhov no yuav yog qhov yuav tau ua:
- kev txiav tsis pub plas;
- kev mob ntawm ncauj tsev menyuam;
- rupture ntawm lub uterus .
Tib yam kev mob yog qhov ua rau cov ntshav poob hauv cov theem ob ntawm kev yug menyuam. Qhov thib peb ntawm kev ua haujlwm, uas yog, qhov kev sib cais ntawm lub tsho me nyuam, yog nrog kev mob loj hauv obstetrical hauv cov nram qab no:
- nrog ib tug ntom, sib sib zog nqus germination ntawm villi placenta rau hauv phab ntsa ntawm uterus;
- nrog rau qeeb ntawm cov neeg ntawm cov nqaij mos hauv plab rau hauv plab menyuam;
- puas tsuaj rau cov nqaij mos ntawm qhov chaw yug me nyuam.
Thaum lub sijhawm tomqab yug menyuam tag, yuav los ntshav los ntawm lub suab ntawm lub tsev menyuam. Hauv cov ntaub ntawv no, cov nqaij leeg tsis ua ntawv cog lus thiab cov hlab ntsha tsis tuaj yeem tso, vim yog cov ntshav tsis ua haujlwm ntxiv. Tsis tas li ntawd, yuav ua rau muaj ntshav hauv lub sijhawm no yog muaj kev mob ntawm cov ntshav khov thiab kev nyab xeeb ntawm amniotic kua.
Hais txog kev los ntshav, nws yog qhov yuav tsum tau nco txog qhov ua rau ntau tshaj qhov ua rau ntshav ntws tawm sab nraud thaum lub caij yug tus me nyuam. Cov no muaj xws li mob qog nqaij hlav cancer thiab ncauj tsev menyuam, uterine fibroids, endometriosis thiab hormonal ntshawv siab.
Kev tiv thaiv thiab kev kho mob
Kev tiv thaiv ntawm obstetric hemorrhages yuav tsum pib ntev ua ntej qhov pib ntawm cev xeeb tub. Tom qab tag nrho, kev sib haum xeeb ntawm tus poj niam txoj kev ua me nyuam kuj tau txo txoj kev pheej hmoo ntawm kev mob lub sijhawm thaum me nyuam yaus tuaj yeem. Tseem ceeb hauv kev tiv thaiv yog kev kho mob ntawm cov kab mob hauv extragenital.
Txhua txoj kev los ntshav yuav tsum tau kev thauj mus los sai sai rau tsev kho mob. Kev kho mob ntawm obstetric hemorrhages yuav tsum yog cov theem hauv qab no:
- tso ntshav;
- tshem tawm qhov ua rau mob los ntshav;
- restoration ntawm hemodynamics los ntawm tshem tawm qhov nyiaj tsawg ntawm lub ntim ntawm cov ntshav.
Tag nrho cov kev tswj hwm tswj kev tshem tawm cov ntshav tawm yuav tsum tau nqa tawm sai heev.
Kev kho mob thaum muaj xwm ceev nyob rau hauv qhov cuam tshuam ntawm obstetric hemorrhage yog kev sib ntaus tawm tsam kev kho siab ntawm hypovolemic. Ua li no, siv txoj kev kho infusion nrog ntau lub ntsiab. Txhob xav kom tsis txhob tso ntshav ntws mus rau hauv, Dicinone, aminocaproic thiab tranexamic acid, NovoSeven yog muab rau.