Uma ukhulelwe, umthambo wezifo uzokutshela ukuthi uthathe uvivinyo lokuhlolwa: okuphoqelekile, okuyinto bonke abesifazane abakhulelwe okufanele bathathe emigqeni ethile, futhi eyengeziwe - uma beyidinga. Ukuzihlanganisa ngesikhathi sokukhulelwa kungenye yezivivinyo eziphoqelekile. Yenza kanye nge-trimester (kulula ukusho, kanye kanye nezinyanga ezintathu). Kodwa uma owesifazane ebhaliswa ngemuva kweviki le-12 lokukhulelwa, khona-ke kuzoba nezifundo ezimbili ezinjalo: ngokushesha lapho owesifazane ebhalisiwe futhi ngaphambi kokuhamba kwebeletha - emavikini angu-30.
Ukwengeza, ukuhlaziywa kwe-coagulogram ngesikhathi sokukhulelwa kwenziwa ngemuva kokuthola ukwelashwa, uma kunokungajwayelekile emalini, nangaphambi kokubeletha, uma uzonikezwa isigaba sokudla. Igazi nge-coagulogram ngesikhathi sokukhulelwa liyathathwa, ngokuqondene nokuhlaziywa kwezinto eziphilayo - kusukela emithanjeni nasesisu esingenalutho.
Iyini i-coagulogram yegazi?
Izinkomba eziyinhloko ze-coagulogram yomuntu onempilo:
isikhathi sokuvala - 5-10 imizuzu;- isikhathi sokuvuselelwa esisebenzayo (ATS) - amasekhondi angu-50 - 70;
- isikhathi se-thromboplastin esasetshenziselwe (APTT) - amasekhondi angu-24 kuya kwangu-35;
- I-prothrombin index - 80 - 120%;
- okuqukethwe kwe-fibrinogen - 2 - 4 g / l;
- isikhathi se-thrombin - imizuzwana engu-11 - 17.8;
- i-fibrin-monomer complexes (RNMC) - 4 mg / 100 ml;
- Umsebenzi we-fibrinolytic - 183 - 263 imizuzu;
- i-trombotest - i-IV-V degree;
- i-fibrinogen - 5.9 - 11.7 μmol / l;
- i-fibrinogen B - engekho;
- i-plasma ibekezelelana ne-heparin - imizuzu engu-3 - 11;
- isikhathi sokuphumula i-Duroku kuze kube semaminithi amane;
- ukuhoxiswa kwe-clot yegazi - 44 - 65%;
- isikhathi se-plasma recalcification (VPR) yimizuzwana engu-60 kuya kwangu-120.
Kungani ushintshe imiphumela ye-coagulation ngesikhathi sokukhulelwa?
Izikhombisi ze-coagulation ngesikhathi sokukhulelwa zihlukile ngokuvamile, ngoba umzimba ulungiselela ukuzalwa okuzayo, ukulahlekelwa igazi okuncane ngesikhathi sabo, futhi igazi liqala ukugubha ngokushesha. Lokhu kubonakala ngisho ne-coagulogram elula, uma kuphela inani lamaplatelet lizimisele - izakhi zegazi lapho i-thrombus base yakha khona (ngokuvamile inombolo yabo ivela ku-150 kuya ku-400 x 109 / L), isikhathi sokuvala (5-10 imizuzu kuye ngokwendlela), ukuhlushwa i-fibrinogen ne-prothrombin index.
I-blood coagulability ikwandisa umzimba, futhi lokhu kuyabonakala lapho ukucacisa ezinye izinkomba:
- i-fibrinogen - iprotheni lapho i-fibrin ihlanganiswa khona ngenkathi kuphuma igazi - ngesikhathi se-trimester yesithathu yokukhulelwa inani layo likhula kusuka ku-2 ukuya ku-4 kuya ku-6 g / l;
- i-prothrombin index kubesifazane abakhulelwe akufanele ihluke kumakhosi avamile: i-prothrombin - iphrotheni ye-plasma yegazi, okuvela kuyo i-thrombin - inkomba iphakama uma kwenzeka ukuphazamiseka kweplate ngaphambi kwesikhathi.
Kungani unikeza i-coagulogram ende ngesikhathi ukhulelwe?
Kwamanye ama-laboratories ngesikhathi esisodwa noma ekuphambanweni okujwayelekile noma isilinganiso kwi-coagulogram elula i-coagulogram ekukhulelwe isetshenziswa. Kodwa isiqondiso se-coagulogram ekhethekile senzelwa izinkomba ezikhethekile: ukukhulelwa okuphindaphindiwe , ukukhulelwa okukhudlwana nokukhulelwa kwesikhathi sokubeletha, ukushona kwe-intrauterine fetal, izifo zegazi, umlando omdala wokungabikho komzimba, ukukhulelwa komzimba okuvamile.
Isikhathi se-thromboplastin esakhiwe eceleni (APTT) sikhombisa ukuthi kukhona khona izici zokuvala, ngaphandle kwalokho okungenakwenzeka ukwakha i-clot yegazi. Kubesifazane abakhulelwe, kufinyelelwe imizuzwana engu-17 kuya kwangu-20 (i-thrombus esuka ku-fibrinogen ngosizo lwabo lwakhiwa ngokushesha). I-Lupus anticoagulant akumele ibe khona kwabesifazane abakhulelwe, kodwa ivela ezifweni ezizimele kanye ne-toxicosis ephuzile yokukhulelwa, ukuba khona kwayo kuholela ekwandeni ku-APTT. Isikhathi se-Thrombin (imizuzwana engu-11 kuya kwangu-18) kwabesifazane abakhulelwe banda ku-18 - 25 imizuzwana. Lesi sikhathi yisigaba sokugcina sokugaya igazi, lapho izinsimbi ze-fibrin zakhiwa kusuka ku-fibrinogen ngaphansi kwesenzo se-thrombin (coagulation factor).
Yini evimbela izinguquko ku-coagulogram ekukhulelweni?
Uma imingcele ye-coagulogram ihluke ngokujwayelekile, ke, okokuqala, kufanele siqaphele ukuthi yikuphi ukuguquka okwenzekayo: i-blood coagulation yanda noma, ngokuphambene, yancipha. Futhi wenze kangcono kunokwazi. Ngempela, ukunciphisa amandla e-coagulation yegazi kungaba umphumela wokuthungatha isikhathi esingaphansi kwe-placenta ne-hemorrhage: izinqolobane zokugcoba igazi ziphelile futhi i-intravascular coagulation syndrome, okuyinto engasongela umama, ingahlakulela. Futhi ukwanda kwegazi lokugwedla kuholela enhlotsheni ehlukile ye-thrombosis.