Ciki na ciki

Ciwon ciki wani nau'in ciki ne da ba kasafai ake samun ciki ba inda amfrayo ko tayin ke girma da tasowa a wajen mahaifar, a cikin ciki, kuma ba a cikin bututun fallopian (wuri na yau da kullun), ovary, ko babban ligament ba .  name="Nunyalulendho"> name="Agarwal"> 

Saboda ciki na Tubal, Ovarian da Faɗin ligament suna da wuyar ganewa da kuma bi da su kamar masu ciki na ciki, an yi muhawara game da keɓance su daga mafi yawan ma'anar ciki na ciki. 

Wasu - a cikin ƴan tsiraru - suna da ra'ayin cewa ciki na ciki ya kamata a bayyana shi ta wurin mahaifa da aka dasa a cikin peritoneum . 

 Alamomi da alamomi 
Alamun na iya haɗawa da ciwon ciki ko zubar jini a cikin farji yayin ɗaukar ciki.  name="Nunyalulendho"> Da yake wannan ba takamaiman ba ne a wuraren da ba a samun duban dan tayi sau da yawa ana gano ganewar asali ne kawai yayin tiyata don bincikar cututtukan da ba a saba gani ba.  Yawancin lokaci ana bincikar su daga baya a cikin ƙasashe masu tasowa fiye da waɗanda suka ci gaba.  name="Oneko"> A cikin kusan rabin lokuta daga cibiyar a cikin kasashe masu tasowa an rasa ganewar asali.  name="Sunday">

Yana da wani yanayi mai haɗari saboda za a iya samun zubar jini a cikin ciki wanda ke haifar da hawan jini kuma yana iya zama mai mutuwa. Sauran abubuwan da ke haifar da mace-mace a cikin mata masu ciki sun haɗa da anemia, embolus pulmonary, coagulopathy, da kamuwa da cuta .  name="hk">

 Abubuwan haɗari 
Abubuwan haɗari suna kama da ciki na tubal tare da cututtukan da ake ɗauka ta hanyar jima'i suna taka muhimmiyar rawa; name="hk"> duk da haka kusan rabin wadanda ke da ciki ectopic ba su da wasu abubuwan haɗari (wanda ya haɗa da lalacewa ga tubes na fallopian daga aikin tiyata na baya ko daga ciki na ectopic na baya, da taba taba ). 

 Makanikai 
Wuraren dasawa na iya kasancewa a ko'ina cikin ciki to amma suna iya haɗawa da peritoneum a waje da mahaifa, jakar rectouterine (culdesac na Douglas), omentum, hanji da mesentery, mesosalpinx, da peritoneum na bangon pelvic da bangon ciki.  name="Atrash">  name="bonn"> Za a iya manne mahaifa mai girma zuwa gabobin jiki da yawa ciki har da tube da ovary. Sauran wuraren da ba a san su ba sun kasance hanta da maƙarƙashiya,  suna haifar da ciki na hanta  ko ciki na splenic, bi da bi.  Har ma an bayyana ciki da wuri a cikin majiyyaci inda amfrayo ya fara girma a ƙarƙashin diaphragm . 

 Firamare da na biyu dasawa 
Ciwon ciki na farko na ciki yana nufin ciki wanda aka fara dasa shi kai tsaye a cikin peritoneum, ajiye don tubes da ovaries; irin wannan ciki yana da wuya sosai, kawai lokuta 24 da aka ruwaito ta shekara ta 2007. Yawanci ciki na ciki shine dasawa na biyu wanda ke nufin cewa ya samo asali ne daga cikin tubal (wanda ba a saba da shi ba) ciki kuma an sake dasa shi. Sauran hanyoyin yin ciki na biyu na ciki sun haɗa da fashewar mahaifa, fashewar ƙaho mai rudimentary na mahaifa da zubar da ciki na fibrial .

 Bincike 
Zaton ciki na ciki yana tasowa lokacin da za'a iya jin jikin tayin cikin sauƙi, ko karyar ba ta da kyau, an raba mahaifar mahaifa, ko kuma an gaza shigar da nakuda .  Za a iya amfani da hasken X-ray don taimakawa ganewar asali.  Sonography na iya nuna cewa ciki yana waje da mahaifa mara komai, an rage shi zuwa babu ruwan amniotic tsakanin mahaifa da tayin, babu bangon mahaifa kewaye da tayin, sassan tayi yana kusa da bangon ciki, tayin yana da karya mara kyau, mahaifa yayi kama da mara kyau kuma akwai ruwa kyauta a cikin ciki .   An kuma yi amfani da MRI tare da nasara don gano ciki na ciki da kuma shirin tiyata.   Matsakaicin matakan alpha-fetoprotein wani alamar kasancewar ciki na ciki. 

 Ultrasound 
Yawancin lokuta ana iya gano su ta hanyar duban dan tayi .  Duk da haka ana iya rasa ganewar asali tare da duban dan tayi dangane da ƙwarewar mai aiki.  

 Ma'auni 
Don tantance ciki na ciki na farko da ba kasafai ba, ana buƙatar cika ka'idodin Studdiford: tubes da ovaries ya kamata su kasance na al'ada, babu wata alaƙa mara kyau ( fistula ) tsakanin mahaifa da kogon ciki, kuma ciki yana da alaƙa kawai da saman peritoneal ba tare da alamu ba. cewa akwai ciki na Tubal da farko.   Friedrich da Rankin sun inganta ka'idodin Studdiford a cikin 1968 don haɗa da binciken da aka gano . 

 ganewar asali daban-daban 
Dangane da shekarun ciki bambance-bambancen bincike don ciki na ciki sun haɗa da zubar da ciki, mutuwar tayin ciki, zubar da ciki, ciwon ciki mai tsanani tare da ciki na ciki da kuma mahaifar fibroid tare da ciki na ciki . 

 Magani 
Da kyau kula da ciki na ciki ya kamata a yi ta ƙungiyar da ke da ma'aikatan kiwon lafiya daga ƙwarewa da yawa .  Magunguna masu yiwuwa sun ƙunshi tiyata tare da ƙarewar ciki (cire tayin) ta hanyar laparoscopy ko laparotomy, amfani da methotrexate, embolization, da haɗuwa da waɗannan. Sapuri da Klufio sun nuna cewa maganin ra'ayin mazan jiya yana yiwuwa kuma idan an cika waɗannan sharuɗɗa: 1. babu manyan cututtuka na haihuwa; 2. tayin yana raye; 3. ana ci gaba da kwantar da marasa lafiya a cikin ingantattun kayan aiki da ma'aikatan haihuwa waɗanda ke da wuraren ƙarin jini nan take; 4. akwai kulawa da hankali game da lafiyar uwa da tayi; kuma 5. dasawa na mahaifa yana cikin kasan ciki nesa da hanta da saifa.  Zaɓin ya fi dacewa da yanayin asibiti. Gabaɗaya, ana nuna magani lokacin da aka gano cutar; duk da haka, yanayin ci gaban ciki na ciki ya fi rikitarwa.

 Ci gaba na ciki 
Babban ciki na ciki yana nufin yanayin da ciki ya ci gaba da ci gaba da makonni 20 na ciki (da farkon ciki na ciki <20 makonni).   A irin waɗannan yanayi, an ba da rahoton haihuwar raye-raye a cikin jaridu inda ba a saba kiran jariran a matsayin 'jarirai masu banmamaki'.   Mara lafiya na iya ɗaukar mataccen tayin amma ba zai shiga naƙuda ba. Da shigewar lokaci, tayin yana lanƙwasa kuma ya zama lithopedion . 

Gabaɗaya ana ba da shawarar yin laparotomy lokacin da aka gano ciwon ciki. Maurice King; Peter C. Bewes; James Cairns; Jim Thornton (eds.). "Primary Surgery; Volume One: Non-trauma. Chapter 8, Abdominal pregnancy". Bonn University. Archived from the original on 2009-04-06. Retrieved 2010-01-25. Duk da haka, idan jaririn yana raye kuma ana samar da tsarin tallafin likita, ana iya yin la'akari da kulawa da kyau don kawo jariri ga rayuwa .  Mata masu ciki na ciki ba za su shiga nakuda ba. Bayarwa a cikin yanayin ci gaba na ciki na ciki dole ne ta hanyar laparotomy . Rayuwar jaririn ya ragu kuma an ba da rahoton yawan mace-mace tsakanin kashi 40% zuwa 95%. 

Yaran da ke cikin ciki suna fuskantar lahani na haihuwa saboda matsewa idan babu bangon mahaifa da kuma sau da yawa raguwar adadin ruwan amniotic da ke kewaye da jaririn da ba a haifa ba.  An kiyasta adadin rashin daidaituwa da nakasawa kusan kashi 21%; nakasassu na yau da kullun sune asymmetries na fuska da cranial da rashin daidaituwa na haɗin gwiwa kuma mafi yawan nakasassu sune lahani na gaɓoɓi da nakasassu na tsakiya. 

Da zarar an haifi jariri kula da mahaifa ya zama matsala. A cikin haihuwa na yau da kullun, ƙwayar mahaifa yana ba da hanya mai ƙarfi don sarrafa asarar jini, duk da haka, a cikin ciki mahaifar mahaifa tana kan nama wanda ba zai iya haɗuwa ba kuma ƙoƙarin cire shi na iya haifar da asarar jini mai haɗari. Don haka ana yawan samun ƙarin jini a cikin kula da marasa lafiya da irin wannan ciki, tare da wasu har ma da amfani da tranexamic acid da recombinant factor VIIa, wanda duka suna rage asarar jini.

Gabaɗaya, sai dai idan za'a iya ɗaure mahaifa cikin sauƙi ko cirewa, zai fi dacewa a bar ta a wuri kuma a ba da izinin koma baya. KY Kun; PY Wong; MW Ho; CM Tai; TK Ng (2000). "Abdominal pregnancy presenting as a missed abortion at 16 weeks' gestation" (PDF). Hong Kong Medical Journal. 6 (4): 425–7. PMID 11177167. Retrieved January 25, 2009. Maurice King; Peter C. Bewes; James Cairns; Jim Thornton (eds.). "Primary Surgery; Volume One: Non-trauma. Chapter 8, Abdominal pregnancy". Bonn University. Archived from the original on 2009-04-06. Retrieved 2010-01-25. Wannan tsari na iya ɗaukar watanni Roberts, R. V.; Dickinson, J. E.; Leung, Y.; Charles, A. K. (2005). "Advanced abdominal pregnancy: Still an occurrence in modern medicine". The Australian and New Zealand Journal of Obstetrics and Gynaecology. 45 (6): 518–521. doi:10.1111/j.1479-828X.2005.00489.x. PMID 16401220. S2CID 32321948. kuma ana iya lura da shi ta hanyar bincike na asibiti , duba matakan gonadotropin chorionic na mutum da kuma ta hanyar duban dan tayi (musamman ta yin amfani da doppler ultrasonography . wani wuri mai yuwuwar kamuwa da cuta,  kuma an yi amfani da mifepristone don inganta haɓakar mahaifa  . Hakanan an toshe tasoshin placental ta hanyar angiographic embolization  Matsalolin barin mahaifa na iya haɗawa da ragowar zubar jini, kamuwa da cuta, toshewar hanji, pre-eclampsia (wanda zai iya buƙatar ƙarin tiyata)   da gazawar ciyarwar nono. saboda kwayoyin halittar mahaifa  .

Sakamakon tare da ciki na ciki zai iya zama mai kyau ga jariri da mahaifiyarsa; Lampe ta bayyana wani jariri mai ciki na ciki da mahaifiyarta da ke da kyau fiye da shekaru 22 bayan tiyata. 

 Epidemiology 
Kimanin kashi 1.4 cikin 100 na ciki na cikin mahaifa na ciki ne, ko kuma kusan 1 cikin kowane ciki 8,000.  Wani rahoto daga Najeriya ya nuna adadin a wannan kasa a kashi 34 cikin 100,000 da ake bayarwa da kuma rahoto daga Zimbabwe, kashi 11 cikin 100,000 na isarwa. Sunday-Adeoye I, Twomey D, Egwuatu EV, Okonta PI (2011). "A 30-year review of advanced abdominal pregnancy at the Mater Misericordiae Hospital, Afikpo, southeastern Nigeria (1976-2006)". Archives of Gynecology and Obstetrics. 283 (1): 19–24. doi:10.1007/s00404-009-1260-4. PMID 19876640. S2CID 9781858. White RG (March 1989). "Advanced Abdominal Pregnancy – A Review of 23 Cases". Irish Journal of Medical Science. 158 (3): 77–8. doi:10.1007/BF02942151. PMID 2753657. S2CID 28498724. Archived from the original on 2011-07-14. An kiyasta adadin mace-macen mata masu juna biyu kusan kashi 5 cikin 1,000, kusan sau bakwai na adadin abubuwan da suka shafi muhalli gabaɗaya, kuma kusan sau 90 na isar da “al’ada” (bayanin 1987 na Amurka). 

 Tarihi 
Al-Zahrawi (936-1013) an lasafta shi da farko gane ciki na ciki wanda da alama likitocin Girka da na Romawa ba su sani ba kuma ba a ambata a cikin rubuce-rubucen Hippocrates ba; Jacopo Berengario da Carpi (1460-1530) Likitan Italiyanci an ƙididdige shi tare da cikakken bayanin halittar jiki na farko game da ciki na ciki. 

 Gwajin dabi'a 
Domin ciki yana wajen mahaifa, ciki na ciki ya zama abin koyi na ciki na namiji ko kuma ga matan da ba su da mahaifa, ko da yake irin wannan ciki yana da haɗari.   Ciki cikin ciki ya yi aiki don ƙara fayyace cutar pre-eclampsia wanda a baya tunanin (1980s) ya buƙaci mahaifa don ya faru, duk da haka faruwar pre-eclampsia a cikin ciki (tare da ra'ayi a wajen mahaifa) ya taimaka jefa haske a kan pre-eclampsia. Eclampsia ta etiology .  An ba da rahoton lokuta na haɗakar juna biyu na ciki da na ciki. Huang K, Song L, Wang L, Gao Z, Meng Y, Lu Y (2014). "Advanced abdominal pregnancy: an increasingly challenging clinical concern for obstetricians". Int J Clin Exp Pathol. 7 (9): 5461–72. PMC 4203159. PMID 25337188. 

 Manazarta 

Rukuni:Shafuka masu fassarorin da ba'a duba ba