Waa maxay Post-Partum hemorrhage.

Postpartum hemorrhage (PPH) waa dhiig-bax aad u badan oo dhaca ka dib marka haweeneydu dhasho. Waa xaalad caafimaad oo degdeg ah oo halis ah, waana mid ka mid ah sababaha ugu weyn ee dhimashada hooyada ee dunida.

Noocyada Postpartum Hemorrhage (PPH) waxaa loo kala saaraa laba qaybood oo waaweyn iyadoo lagu salaynayo goorta uu dhiig-baxu dhaco kadib dhalmada:

 

1. Primary PPH (Early PPH)

• Dhiig-baxa dhaca 24-kii saac ee ugu horreysay kadib dhalmada.
• Waa nooca ugu badan ee PPH.
• Sababaha ugu badan:
• Uterus-ka oo aan is adkeynin (uterine atony).
• Dillaacyo ama jug (trauma) marinka dhalmada.
• Placenta aan dhammaanin ama si khaldan uga go'day (retained placenta).
• Dhibaatooyin dhiig-joojin ah (clotting disorders).

 

2. Secondary PPH (Late PPH)

• Dhiig-baxa dhaca 24 saac ka dib dhalmada ilaa 6 toddobaad (ama 42 maalmood) kadib.
• Sababaha ugu badan:
• Qaybo placenta ah oo ku hadhay gudaha ilmo-galeenka.
• Caabuq (infection) gudaha ilmo-galeenka (endometritis).
• Cillado ku yimaada habka dhiig-joojinta.

 

Postpartum hemorrhage (PPH) waxaa lagu garan karaa iyadoo la fiiriyo calaamadaha jirka ee haweeneyda iyo qiyaasta dhiigga ay luminayso kadib dhalmada.

 

1. Dhiig-bax muuqda oo ka badan caadiga:

• Dhiig bax aan caadi ahayn oo si joogto ah u socda kadib dhalmada.
• Dhiiggu wuxuu noqon karaa mid aad u badan, buuxinaya marooyinka hoosta la dhigto daqiiqado gudahood.

2. Qiyaasta dhiig lumay:

• >500 ml kadib dhalmo caadi ah (vaginal delivery).
• >1000 ml kadib dhalmo qalliin ah (Cesarean section).
• Waxaa sidoo kale la tixgeliyaa haddii dhiig-baxu keeno isbeddel xun oo caafimaad.

3. Calaamadaha jirka ee dhiig-yaraanta:

• Wadna garaac degdeg ah (tachycardia).
• Dhiig-yar (hoos u dhaca cadaadiska dhiigga – hypotension).
• Daal xad-dhaaf ah, wareer, madax wareer, indho madow, ama suuxdin.
• Midabka maqaarka oo baddala
• Qabow ama dhaxan la dareemo.

4. Baaritaan dhakhtarnimo:

• Uterus aan si fiican isu adkeynin (oo jilicsan ama weyn).
• Baaritaan lagu ogaanayo haddii qayb ka mid ah placenta-da ay ku hadhay.
• Baaritaan lagu raadinayo dillaacyo ama jeex-jeex gudaha xubnaha taranka.
• Tijaabooyin dhiig ah oo lagu eegayo heerka dhiigga (hemoglobin, hematocrit).

Sababaha ugu waaweyn ee PPH:

Waxaa loo yaqaannaa "4 Ts":

1. Tone – Uterus-ka oo aan si fiican isu adkeynin (uterine atony) – sababta ugu badan.
2. Tissue – Qaybo ka mid ah ibida oo kusoo harta minka (retained placenta).
3. Trauma – jug ama dillaac ku yimaada marinka dhalmada (vaginal tears, uterine rupture).
4. Thrombin – Dhibaatada dhiig-joojin la’aanta (clotting disorders).

Calaamadaha:

• Dhiig-bax badan oo joogto ah.
• Cadaadis dhiig oo hoos u dhaca (hypotension).
• Wadna garaac degdeg ah (tachycardia).
• Dhaxan ama wareer.
• Laab-la-kac ama madax wareer.

Daaweynta:

• Massage loogu sameeyo uterus-ka si uu u adkaado.
• Dawooyin ka caawiya uterus-ka inuu is adkeeyo (oxytocin, misoprostol, ergometrine).
• Qalliinka haddii sababtu tahay dillaac ama qaliin kale oo degdeg ah haddii aan waxba ka hirgelin.
• Dhiig lagu shubo haddii uu dhiig-baxu aad u badan yahay.

Postpartum hemorrhage waxay u baahan tahay daryeel caafimaad oo degdeg ah si looga hortago khataraha nafta.