Marar dhif ah, uurka waxay keeni kartaa xaalad loo yaqaan 'cardiomyopathy postpartum', ama uur-ku-hadalka wadnaha oo la xiriirta. Kaadi-wadeenka ka-dib-u-dhaca kaadida ee 'postpartum cardiomyopathy' waa nooc ka mid ah wadnaha oo loo yaqaan 'cardiomyopathy' . (Cardiomyopathy macnaheedu waa macquulnimada daciifka wadnaha.)
Dumarka qaada kiniiniyada kaadimareenka dhalmada ka dib waxay dareemaan bilawga wadnaha wadnaha bilaha ugu dambeeyey ee uurka, ama shan bilood gudahood dhalmada kadib.
Sababtoo ah "cardiomyopathy postpartum" waxay dhab ahaantii dhici kartaa ka hor intaan ilmuhu dhalan, qaar badan oo ka mid ah wadnoolajiyadu waxay hadda ku tilmaameen "peripartum cardiomyopathy." (Peripartum micnaheedu waa "wakhtiga dhalmada.")
Haweenka qaba xaaladdan caadi ahaan ma laha cudurada wadnaha ee hore, iyo sabab kale oo loo garan karo si loo horumariyo cudurka wadnaha. Wadashaqeyn la'aanta wadnaha waxay noqon kartaa mid ku-meel-gaar ah, xaddidan oo is-xaddidan, ama waxay u sii gudbi kartaa cillad wadnaha oo daran, wadnaha oo nafta khatar galinaya
Maxaa keena kiliinikada 'postpartum cardiomyopathy'?
Sababta loo yaqaan 'cardiomyopathy postpartum' lama yaqaan. Waxaa jira caddayn ah in caabuq ku yimaada muruqa wadnaha (oo sidoo kale loo yaqaan ' myocarditis' ) uu ka ciyaari karo kaalin muhiim ah, waxaana laga yaabaa inuu la xidhiidho borotiinka bararka oo mararka qaarkood laga heli karo dhiigga xilliga uurka. Waxaa sidoo kale jira caddayn in unugyada uur-ku-jirta ee mararka qaarkood ka baxa dhiigga hooyada ay sababi karto fal-celin difaaceed, taasoo horseedaysa mareenka (myocarditis).
Waxaa intaa dheer, waxaa dhici karta in qadarin hiddo-wadaha ah ee qoyskooda qaliinka ah ee qaliinka ah ee qoysaska qaarkood. Si kastaba ha ahaatee, qadka hoose ayaa ah inaan dhab ahaan ogeyn sababta.
Yaa Kusoo Kordhi Kaadi-Kelyoodh Dhimista?
Inkasta oo kiniiniga ka-dib-u-dhaca ee postpartum ay tahay arrin nasiib-darro ah (oo ku dhacda qiyaastii 1-ta 4,000 ee dhalashada Mareykanka), haweenka qaarkood waxay u muuqdaan inay halis badan yihiin kuwa kale.
Calaamadaha khatarta ah ee kiliinikada postpartum-ka waxaa ka mid ah: da'da 30 sano, oo carruurtu horay u soo qaadeen, uur leh ilmo-galeeno kala duwan, Afrikaanka soo-galootiga ah, taariikh hore ee preeclampsia ama hypertension post-disorder, ama isticmaalka kookeynta.
Waa Maxay Astaamaha Kaadi-Kicinta Dambiyada Kadib?
Sababtoo ah kalkaalisada wadnaha ee dhalmada ka dib waxay keenaysaa wadne-la'aanta wadnaha, astaamaha asalkoodu waa isku mid sida qaababka kale ee wadnaha ee wadnaha. Calaamadaha wadnaha ee ku fashilma wadnaha badiyaa badanaa waxaa ka mid ah xanuunka dyspnea , ortopnea , nocturnal dyspnea , iyo dheecaan dheecaan. Akhri wax dheeraad ah oo ku saabsan calaamadaha wadnaha oo aan shaqeynin.
Sidee loo daaweeyaa kiliinikada 'Postpartum Cardiomyopathy'?
Iyadoo laga reebo waxyaabo yar oo ka soo bixi kara, kiniiniyada kaadiheysta ee postpartum waxay la mid tahay daaweynta nooc kasta oo ka mid ah kiniiniyada wadnaha ee loo yaqaan 'kardiomyopathy' .
Waxyaabaha ugu muhiimsan ee laga reebo daaweynta "wadnaha" ee wadnaha istaagay ayaa geli kara marka uu wadnuhu yimaado ka hor inta aanu ilmuhu dhicin. Qaar ka mid ah daaweynta "caadiga ah" ee wadnaha oo ku fashilmay wadnaha waa in la xannibaa illaa dhalidda.
Gaar ahaan, xanuunka ACE sida Vasotec (enalapril), oo ah daroogo dila xididdada dhiigga, waa in aan loo isticmaalin xilliga uurka, maadaama daawooyinkan ay si xun u saameyn karaan uur-jiifka. Taas bedelkeeda, hydralazine waxaa lagu bedeli karaa adigoo dhiig saaraya marin biyood ilaa laga soo saaro.
Sidoo kale, daawooyinka Spironolactone iyo Inspra (eplerenone) - kuwaas oo loogu yeero antagonists, kuwaas oo ku caawin kara daawaynta bukaanjiifka qaba kiniiniyada wadnaha ee loo yaqaan 'kardiomyopathy' - looma baarin xiliga uurka, waana in laga fogaadaa.
Dhawaanahan, caddaymo hordhac ah ayaa la soo sheegay in haweenka qaba xanuunka 'cardiomyopathy' ee laga yaabo in ay ka faa'iideystaan daawada bromocriptine - daroogada loo isticmaalo daaweynta noocyo kala duwan oo ay ka mid yihiin cudurka Parkinson iyo cudurka hyperprolactinemia .
Bromocriptine ma aha daroogo si khaas ah loo qaato, hase yeeshee (waxyaabaha kale, waxay joojisaa nuujinta), tijaabooyinka caafimaad ee ballaadhanna waa lagama maarmaan ka hor inta aan guud ahaan lagula talin.
Guud ahaan, saadaasha dumarka qaba kiniiniyada kaadimareenka dhalmada ka dib waxay u muuqataa inay ka fiican yihiin dumarka qaba noocyada kale ee wadnaha ee wadnaha (cardiomyopathy). Daraasadaha qaar, inta badan 60% haweenka qaba xaaladdan waxay samaysay soo kabasho dhammeystiran. Hase-yeeshee, heerka dhimashada dhalmada ee kiliinikada postpartum-ka ayaa u sareeya 10% laba sano ka dib.
Tixgelinnada muddada dheer
Waxaa si gaar ah muhiim u ah in la ogaado in haweenka uur-ku-jirka ah ee kaadimareenka ee 'posti-cardiomyopathy' - xataa dumarka u muuqda inay soo kabsasho buuxa sameeyeen - waxay halis ugu jiraan in ay mar labaad uur qaadaan marxaladaha uurka.
Iyo haddii kaansarka 'posti-cardiomyopathy' ay dhacdo mar labaad, khatarta dhaawaca wadnaha oo joogto ah iyo mid daran ayaa noqonaya mid aad u sarreeya.
Sidaa daraadeed mar marka haweeney ay qabatay kilyiomyopathy kadib, waxaa muhiim ah in la qaado tallaabooyin si looga badbaado mar kale uurka.
Ereyga
Kaadi-wadeenka kaadida ee 'postpartum cardiomyopathy' waa xaalad halis ah oo soo saarta qaliin wadnaha ah xilliga dambe ee uurka ama wax yar ka dib dhalmada. Inkastoo daaweynta la heli karo oo caawisa inta badan haweenka ay dhibaatadu ka soo reyneyso, weli waa dhibaatada wadnaha oo halis ah kaas oo soo saara heer siyaado ah oo naafo ah iyo dhimasho. Dumarka xaaladdan ku dhacay waxay halis weyn ugu jiraan inay dib u soo noqdaan iyo uurarka dambe.
> Ilo:
> Habedank D, Kühnle Y, Elgeti T, iyo al. Soo-kabasho ka yimid Peripartum Cardiomyopathy Daaweeynta Ka Dib Daweynta Bromocriptine. Eur J Heart Fail 2008; 10: 1149.
> Habli M, O'Brien T, Nowack E, et al. Peripartum Cardiomyopathy: Calaamadaha Prognostik ee Natiijada Hooyada uurka leh. Am J Obstet Gynecol 2008; 199: 415.e1.
> Sliwa K, Hilfiker-Kleiner D, Petrie MC, iyo al. Xaaladda Hadda ee Aqoonta ku Saabsan Aetology, Diagnosis, Maareynta, iyo Daaweynta Cudurka Peripartum Cardiomyopathy: Warbixinta Mawqifeed ee ka soo baxay Ururka Wadnaha Wadnaha ee Yurub ee Ka Shaqeynta Wadnaha ee Wadnaha (Cardiomyopathy Peripartum Cardiomyopathy). Eur J Heart Fail 2010; 12: 767.