Njirimara nke mkpọchi ọbara n'oge afọ ime


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N'ime ụmụ nwanyị nkịtị, ọrụ coagulation, anticoagulation na fibrinolysis n'ime ahụ na-agbanwe nke ukwuu n'oge afọ ime na ịmụ nwa, ọdịnaya nke thrombin, coagulation factor na fibrinogen n'ọbara na-abawanye, ọrụ anticoagulation na fibrinolysis na-ebelata, ọbara na-adịkwa n'ọnọdụ hypercoagulable. Mgbanwe nke anụ ahụ na-enye ntọala ihe maka hemostasis ngwa ngwa na nke dị irè mgbe a mụsịrị nwa. Ileba anya na ọrụ coagulation ọbara n'oge afọ ime nwere ike ịchọpụta mgbanwe na-adịghị mma na ọrụ coagulation ọbara n'oge, nke dị mkpa maka mgbochi na ịzọpụta nsogbu nke ịmụ nwa.

N'ime ụmụ nwanyị dị ime nkịtị, ka afọ ime na-abawanye, mmepụta obi na-abawanye ma iguzogide akụkụ ahụ na-ebelata. A na-ekwere na mmepụta obi na-amalite ịbawanye na izu 8 ruo 10 nke afọ ime ma na-eru oke kachasị elu na izu 32 ruo 34 nke afọ ime, mmụba nke 30% ruo 45% ma e jiri ya tụnyere enweghị afọ ime, ma na-anọgide na-enwe ọkwa a ruo mgbe a mụrụ ya. Mbelata nke iguzogide akwara akụkụ na-ebelata nrụgide akwara, nrụgide ọbara diastolic na-ebelata nke ukwuu, ọdịiche nrụgide pulse na-agbasakwa. Site na izu 6 ruo 10 nke afọ ime, olu ọbara nke ụmụ nwanyị dị ime na-abawanye ka afọ ime na-abawanye, ma na-abawanye ihe dị ka 40% na njedebe afọ ime, mana mmụba nke olu plasma karịrị ọnụọgụgụ mkpụrụ ndụ ọbara uhie, plasma na-abawanye site na 40% ruo 50%, mkpụrụ ndụ ọbara uhie na-abawanye site na 10% ruo 15%. Ya mere, n'afọ ime nkịtị, a na-agbaze ọbara, na-egosipụta dị ka mbelata viscosity ọbara, mbelata hematocrit, na mmụba ọnụego sedimentation erythrocyte.

Ihe ndị na-akpata coagulation ọbara Ⅱ, Ⅴ, VII, Ⅷ, IX, na Ⅹ niile na-amụba n'oge afọ ime, ha nwekwara ike iru ugboro 1.5 ruo 2.0 karịa nke nkịtị n'oge afọ ime etiti na nke ikpeazụ, ọrụ nke ihe ndị na-akpata coagulation Ⅺ na  na-ebelata. Fibrinopeptide A, fibrinopeptide B, thrombinogen, platelet factor Ⅳ na fibrinogen mụbara nke ukwuu, ebe antithrombin Ⅲ na protein C na protein S belatara. N'oge afọ ime, oge prothrombin na oge prothrombin nke na-arụ ọrụ na-ebelata, ọdịnaya fibrinogen nke plasma na-abawanye nke ukwuu, nke nwere ike ịbawanye ruo 4-6 g/L na trimester nke atọ, nke dị ihe dị ka 50% karịa nke dị n'oge na-adịghị ime. Na mgbakwunye, plasminogen mụbara, oge mgbasa euglobulin dị ogologo, mgbanwe coagulation-anticoagulation mere ka ahụ nọrọ n'ọnọdụ hypercoagulable, nke bara uru maka hemostasis dị irè mgbe placental absorption gasịrị n'oge ịmụ nwa. Tinyere nke ahụ, ihe ndị ọzọ nwere ike ime ka ọbara jupụta n'ọbara gụnyere mmụba nke cholesterol zuru oke, phospholipids na triacylglycerols n'ọbara, androgen na progesterone nke placenta na-emepụta na-ebelata mmetụta nke ụfọdụ ihe mgbochi coagulation ọbara, placenta, uterine decidua na embrayo. Ọnụnọ nke ihe thromboplastin, wdg, nwere ike ịkwalite ọbara ka ọ nọrọ n'ọnọdụ hypercoagulable, mgbanwe a na-akawanye njọ ka afọ ime na-eto. Hypercoagulation dị oke ala bụ ihe nchebe anụ ahụ, nke bara uru iji nọgide na-enwe fibrin na akwara, mgbidi akpanwa na placental villi, na-enyere aka ịnọgide na-eguzosi ike n'ezi ihe nke placenta ma mepụta thrombus n'ihi iwepụ ya, ma na-eme ka hemostasis ngwa ngwa dị n'oge na mgbe a mụsịrị nwa. , bụ usoro dị mkpa iji gbochie ọbara ọgbụgba mgbe a mụsịrị nwa. N'otu oge coagulation, ọrụ fibrinolytic nke abụọ na-amalitekwa iwepụ thrombus na akwara spiral nke akpanwa na sinuses venous ma mee ka mmụba na ndozi nke endometrium dị ngwa ngwa.

Agbanyeghị, ọnọdụ nke na-agbakọ ọbara nke ukwuu nwekwara ike ibute ọtụtụ nsogbu ime ime. N'afọ ndị na-adịbeghị anya, ọmụmụ ihe achọpụtala na ọtụtụ ụmụ nwanyị dị ime na-enwekarị thrombosis. A na-akpọ ọnọdụ ọrịa thromboembolism a n'ime ụmụ nwanyị dị ime n'ihi nkwarụ mkpụrụ ndụ ihe nketa ma ọ bụ ihe ndị nwere ike ibute ya dịka protein anticoagulant, ihe ndị na-akpata coagulation, na protein fibrinolytic thrombosis. (thrombophilia), nke a makwaara dị ka prothrombotic state. Ọnọdụ prothrombotic a anaghị ebute ọrịa thrombotic, kama ọ nwere ike ibute nsonaazụ afọ ime na-adịghị mma n'ihi enweghị nguzozi na usoro coagulation-anticoagulation ma ọ bụ ọrụ fibrinolytic, microthrombosis nke akwara uterine spiral ma ọ bụ villus, na-ebute enweghị mmanye placental ma ọ bụ ọbụna infarction, dị ka Preeclampsia, placentaal abruption, placental infarction, disseminated intravascular coagulation (DIC), mgbochi uto fetal, ime ọpụpụ ugboro ugboro, ịmụ nwa nwụrụ anwụ na ọmụmụ tupu oge eruo, wdg, nwere ike ibute ọnwụ nne na nwa n'oge ime n'ọnọdụ ndị siri ike.