Ngenkathi idabukisayo, iningi lezinkinga zokukhubazeka okungenani lihilela ukutakula okusheshayo ngokomzimba. Ukukhulelwa kwe-Molar akukona kulowo mthetho.
Ukukhulelwa kwe-Molar kungabangela izinkinga zempilo ezesabekayo, ezidinga izinyanga zokuqapha kokuqapha ngemuva kokwelashwa, ngokuvamile okuyi- D & C. Isikhathi esiningi ukukhulelwa kwe-molar kuyahamba ngaphandle kokunye ukucindezeleka, kepha ukukhathazeka okungeziwe kungenza ukubhekana nokukhuni kunokuba kuvamile.
Okuyisisekelo
Ukukhulelwa kwe-Molar uhlobo lwe- gestational trophoblastic disease (GTD). Kubangelwa ukungajwayelekile kwe-chromosomal ngesikhathi sokukhulelwa.
Ukukhulelwa kwe-Molar kufana nezigaba ezimbili: i-hydatidiform moles egcwele futhi eyingxenye. Zombili zibangelwa izinkinga ze-chromosomal eqanda elikhulelwe, okuholela ekukhuleni kwamathishu wokukhulelwa. Nakuba ukukhulelwa okuncane okungahle kwenzeke kungahle kube yintsana, i-placenta engavamile ayikwazi ukusekela ukukhulelwa nezinkinga ze-chromosomal azihambisani nokuphila. Ukukhulelwa okuphelele kwe-molar ngeke kuhlakulele ingane ebonakalayo.
Kungani Ukukhulelwa Kwama-Molar Kungaba Nengozi
Amaphesenti angama-20% abesifazane abesenesikhathi sokukhulelwa kuzokwakhiwa kweyodwa yezinkinga ezimbili ezibalulekile: imvukuzane engenayo noma i-choriocarcinoma. Ama-moles amangazayo avamile. Ingozi yalesi simo ikhula isikhathi eside lapho ukukhulelwa kuqhubeka ngaphandle kokwelashwa. (Ama-moles abandayo angakhula ngaphambi noma emva kokwelapha okuhlinzekwayo.)
I-choriocarcinoma uhlobo lomdlavuza ongathuthuka endaweni ye-placenta futhi isakaze emzimbeni. Nakuba sína, cishe njalo ilashwa nge-chemotherapy.
Kungenzeka kulezi zimo cishe kungenzeka ngemuva kokukhulelwa kwe-molar ephelele; ama-moles amabili kuphela kuya kwangu-4 kuphela azokhula noma isimo.
Izingozi Zezingozi
Izici ezimbalwa eziyingozi, njengokukhulelwa kwangaphambili noma ngaphezulu kwezingu-35, zingandisa amathuba okukhulelwa komzimba, kepha njengamanye ama-miscarriages, izici eziyingozi azidingeki zibe khona ukuze ukhulelwe ukukhulelwa.
ENyakatho Melika, i-hydatidiform moles yohlobo oluthile lwenzeka cishe ku-2 kuya kwezingu-3 kuzo zonke ukukhulelwa okungu-10 000.
Izimpawu
Abesifazane abanokukhulelwa kwe-molar bangenayo izimpawu ezithile, kodwa izinkomba zokuxilonga ezikhomba ukukhulelwa kwe-molar zingase zibandakanye amazinga aphezulu we- hCG (ukuphelelwa ukukhulelwa kwe-molar), ama-ovarie awandisiwe, nokuqala kwangaphambi kwe-eclampsia.
Ukusuka kwamagciwane kanye nokucabangela kuvela ekukhulelweni okuningi kwe-molar, kodwa kungase kwenzeke nokukhulelwa okujwayelekile noma ukuhlukunyezwa okuvamile. Ngaphezu kwalokho, ukukhulelwa kwe-molar kungabangela ukuvuvukala endaweni yangasese - kepha abesifazane abakhulelwe ngokujwayelekile bangabonisa "ekuqaleni" futhi.
Ukuxilongwa
Ukukhulelwa kwe-Molar kungatholakaliswa uma ukushaya kwenhliziyo kungatholakali ngamasonto angu-12, kodwa lokhu kungase kwenzeke nakwezintambo ezilahlekile . Indlela yokuxilongwa ngokuvamile i- ultrasound , eveza i-placenta engavamile ebonakala njengeqembu lamagilebhisi.
Ukwelashwa Nokubuyiswa
Ezinye ukukhulelwa kwe-molar zizophutha ngaphandle kokungenelela, kodwa uma odokotela bebona ukukhulelwa kwe-ultrasound, bavame ukuncoma i-D & C noma imithi ukuze kuncishiswe ingozi yokubhekana nezinye izinkinga.
Ngokuvamile, ukukhulelwa kwe-molar kungase kwenzeke emibonweni emibili nge-molecule ye-hydatidiform eceleni kokukhulelwa okungcono. Kulezi zimo, ukuqhubeka nokukhulelwa kungabangela ingozi enkulu empilweni yomama (ngenxa ye 60% ithuba lokuthuthukisa i-GTD ephikisanayo) futhi abaningi bakhetha ukuqeda ukukhulelwa, okungaba omunye umzwelo womzwelo ohlelweni lwensizi.
Ukuqapha kwezokwelapha
Ngenxa yengozi yokuthuthukisa imvukuzane engenayo noma i-choriocarcinoma, odokotela bancoma ukuthi abesifazane abakhulelwe beqhubeka nokuqapha izinyanga ezimbalwa. Ukuqapha kubandakanya ukuhlolwa kwegazi ngeviki noma njalo ngenyanga, ngoba uma i-hCG ihluleka ukwehla noma iqala ukuvuka, lokhu kungaba uphawu lwe-GTD ephikisayo.
Uma lo wesifazane enezifo ezintathu ezilandelanayo ze-hCG zegazi, kungenzeka ukuthi uvela endaweni engozini. Abanye odokotela abahlukumezi kakhulu ngokuqapha abesifazane abakhulelwe ngokweqile, ngoba izinkinga zezinkinga ziphansi.
Ukubhekana
Ukukhulelwa kwe-Molar kungabandakanya izinyathelo ezifanayo zokudabuka njengenye ukulahlekelwa, kodwa njengo- ectopic pregnancy (esinye isimo esingase sibe yingozi), ukulila ngenxa yokukhulelwa kwe-molar kungaba kokubili ukukhululeka ukuthi isimo sitholakale kanye nokudabuka kokulahlekelwa ingane elindelekile. Ungase uzwe ukuphawula emigqeni "okungenani babambe ngesikhathi" noma "okungenani kwakungeyona ingane yangempela," kodwa kuyinto evamile ukudabuka nokulila. Qinisekisa ukuthi ufuna amaqembu okusekela kanye nezinye izinsiza ukukusiza ukuthi uphumelele inqubo.
Ukuzama futhi emva kokukhulelwa kwe-Molar
Isikhathi esiqondile sokulinda siyahlukahluka, kodwa odokotela bavame ukweluleka ukulinda okungenani izinyanga eziyisithupha ukuze bazame ukukhulelwa futhi emva kokukhulelwa kwe-molar. Lesi seluleko kufanele silandelwe ngaso sonke isikhathi futhi sinesizathu esicacile sokwelashwa.
Kungani? Amazinga aphezulu weHCG angabonakalisa okokuqala ama-molecular invasive noma i-choriocarcinoma, futhi kokubili lezo zimo zitholwa kakhulu uma zibona. Ukukhulelwa okusha kuzobangela ukuba amazinga e-hCG akhuphuke, futhi uma lokhu kwenzeka, odokotela babengeke bakwazi ukuhlukanisa i-hCG nokukhulelwa okusha ku-hCG kusuka esimweni esihlobene nesifo esithinta isifo se-trophoblastic.
Futhi, ngoba ukwelashwa kwama-molecular invasive kanye ne-choriocarcinoma kungabandakanya i-chemotherapy, ukukhulelwa kufanele kugwenywe kuze odokotela bakwazi ukuqinisekisa ukuthi isidingo samakhemikhali asizovela.
Cishe u-1% kuya ku-2% wabesifazane abanokukhulelwa kwe-molar kuzoba nomunye, ngakho udokotela wakho angase afune ukulandela nge-ultrasounds zakudala nokuhlolwa kwegazi kwe-hCG ekukhulelweni kwakho okulandelayo ukulawula ukukhulelwa kwe-molar.
Imithombo:
> I-American Cancer Society, "Iyini Isifo Sokuqothulwa Kwesifo Sokuqeda Amantombazane?" Umhlahlandlela Oningiliziwe: Isifo Sokuqothulwa Kwesifo Sofuba Ngo-May 2006.
> Inhlangano Yokuzikhulela yaseMelika, "Ukukhulelwa Kwama-Molar" ngoMashi 2006.
> NgoMashi we-Dimes, "Ukukhulelwa kwe-Ectopic kanye ne-Molar." Izikhombisi Ze-Quick and Fact Sheets 2005.