Bayani akan hanyar, rigakafi, da kuma maganin wannan cuta
Cututtukan Hemolytic na jariri (HDN) wani hali ne na rashin jinin jini tsakanin mahaifi da jariri. Wannan yana faruwa a yayin da jiniyar mahaifiyar jini ta kasance Rh kuma jaririn ya tabbatacce. Yayin da aka haifa, mahaifiyar ta haifar da kwayar cutar da ta kai hari da kuma halakar da jinin jini, ta haifar da anemia a cikin tayin. Irin wannan yanayin ya faru da platelets da ake kira neonatal alloimmune thrombocytopenia .
Me yasa cutar cututtuka ta faru?
Kwayoyin jinin mu suna mai rufi tare da antigens, abubuwa da ke haifar da amsawar da ba ta dace ba. Wasu daga cikin wadannan antigens sun ba mu nau'in jini (A, B, O, AB) da sauransu wasu Rh ɗinmu (tabbatacce, korau). Har ila yau ana kiran Rh ƙungiyar D antigen. Mata wadanda ke da Rh ba su da D antigen akan jikinsu. Idan jariri ba a haifa ba ne Rh-tabbatacce (gado daga mahaifinsa), yana da D antigen yanzu. Lokacin da yaduwar jikin mahaifa ke nunawa ga jini na tayin (zai iya faruwa a lokacin bayarwa, zub da jini a lokacin tashin ciki, ɓacewar da ta gabata), tsarin na rigakafin mahaifiyar ya gane D antigen a matsayin "kasashen waje" da kuma ci gaba da maganin rigakafi a kansu.
Hanyar ciki ta farko tare da jaririn Rh-tabbatacce ba shi da tasiri kamar yadda kwayoyin rigakafi da aka kafa a farkon ba zasu iya ƙetare mahaifa ba. Duk da haka, a cikin hawan ciki na gaba, idan sassan jikin mahaifa sun hadu da D antigen a jikin tarin jini na tayi, tsarin na rigakafi ya samar da kwayoyin anti-D da sauri wanda zai iya haye ƙwayar.
Wadannan cututtuka sun haɗa kai zuwa jikin jini na tayi, suna yin alama don lalata, haifar da anemia. Irin wannan yanayi zai iya faruwa idan akwai rashin daidaituwa a cikin jini wanda ake kira ABO rashin daidaituwa.
Yadda Yayi Yarinyar Yayi
Kamar yadda aka tattauna a sama, jaririn farko da jaririn Rh-positive, babu matsaloli.
Idan wannan rashin fahimta ba a sani ba a cikin ciki na farko (yakan faru a wasu lokuta idan an sami sakamakon haifuwa ta farko a cikin wani ɓarna) ko kuma idan an dauki matakan da suka dace (wanda za'a tattauna a baya), za a iya haifar da ciki a nan gaba. Bayan na farko da ya shafi ciki, rashin lafiyar cutar da jaririn ya kamu tare da kowane ciki.
Kwayar cututtuka an ƙaddara ta ƙananan rashin jinin jini (wanda ake kira hemolysis). Idan kawai yana da matukar damuwa, akwai ƙananan matsalolin kamar ƙananan anemia da / ko jaundice wanda basu buƙatar magani. Idan yawan adadi yana da tsanani, zai kasance da jaundice mai muhimmanci (bilirubin mai girma) jimawa bayan haihuwa.
Abin takaici, lalatawar ba ta daina lokacin da jaririn ya haife shi a matsayin mahaifiyar mahaifiyar mamaci don 'yan makonni. Wadannan matsanancin matakan bilirubin na iya haifar da lalacewar kwakwalwa. A wasu lokuta, anemia yana da tsanani a cikin utero (kafin haihuwa) da hanta kuma yayi girma don kara yawan yaduwar jini wanda zai haifar da gazawar hanta. Hakanan zai iya haifar da hydrops tayin tare da rubutattun kwayoyin halitta (busawa), ruwa a jikin gabobin, har ma da mutuwa.
Yadda aka haramta Ciwon Hemolytic
Ee. A yau dukan mata masu karɓar kulawa da jin dadin mata suna da aikin jini don ƙayyade irin jini da rukuni na jini.
Idan ta kasance Rh-negative, an aika aikin jini don sanin idan ta riga tana da anti-D maganin. Idan ta ba ta da maganin rigakafi, za ta sami magani da ake kira RhoGAM. RhoGAM ko anti-D Ig wata allura ne da aka ba a makonni 28, hadaddun zub da jini (ciki har da ɓarna a bayan makonni 13), kuma a lokacin bayarwa. RhoGAM yayi kama da antibody wanda mahaifi zai yi wa D-antigen. Manufar ita ce RhoGAM ta hallaka kowane nau'in jini a cikin mahaifa a cikin mahaifiyar mahaifa kafin ta iya ci gaba da maganin rigakafi.
Idan an gano anti-D maganganu, RhoGAM ba zai taimaka ba amma ƙarin nunawa na tayin za a yi kamar yadda aka tsara a kasa.
Yaya Yayi Cutar da Ciwon Yamma?
Idan mahaifiyar ta ƙaddara don samun maganin anti-D kuma mahaifinsa Rh-tabbatacce ne, akwai yiwuwar cututtuka na cutar jariri. A wannan yanayin, an yi gwajin gwaji a kan ruwan amniotic ko jini daga igiya na umbilical domin sanin irin jini da rukuni na jariri. Idan an sami jariri ya zama Rh-negative, babu ƙarin magani da ake bukata.
Duk da haka, idan jaririn ya kasance Rh-tabbatacce, za a kula da ciki sosai. Za a yi amfani da magunguna don tantance cutar anemia ta tayi kuma don ƙayyade bukatar bugun jini na intrauterine (transfusion da aka ba tayin lokacin da yake a cikin mahaifa). Zubar da jinin mahaifiyar za a jarraba shi a lokacin da yake ciki don sanin yawancin wanda yake samarwa. Idan an sami jariri ya zama mahaukaci, ana iya ba da yaduwar jini lokacin daukar ciki don hana rikitarwa (intrauterine transfusions). Idan an sami jariri ya zama anemic kuma yana kusa da cikakken lokaci, ana iya bada izinin farkon wuri.
Bayan haihuwar jariri, an aika aikin jini don saka idanu ga matakan anemia da bilirubin. Rashin rashawar jini bai tsaya ba da zarar an haife jaririn don haka bilirubin zai iya tashi zuwa matakan hatsari a cikin kwanakin farko. Matakan bilirubin da aka hawanta (jaundice) ana bi da shi tare da phototherapy inda aka sanya baby a karkashin hasken wuta. Hasken wuta ya rushe bilirubin yana barin jiki ya kawar da shi. Har ila yau ana amfani da karfin jini don magance anemia. Idan anemia da jaundice suna da tsanani, ana kula da jaririn tare da musayar musayar. A cikin irin wannan transfusion, an cire ƙananan jini daga jariri kuma an maye gurbinsu da jini mai karfin jini.
Da zarar an fitar da shi daga asibitin, yana da muhimmanci a yi tafiya tare da dan jaririn ko likitan jini don dubawa don anemia. Kwayoyin kare jini na mahaifa na iya haifar da lalacewa na tsawon makonni 4-6 bayan an kawowa kuma ana iya buƙatar ƙarin ƙwayar jini.
Sources:
Nandyal RR. Cututtukan Hemolytic na jariri. Journal of Hematology da Thromboembolic Disease. 2015.