Casharka 29aad

 Habdhiska taranka ee dumarka iyo Uureyda(Obstetrics).

Casharka 29aad

Uur-beenaad (molar pregnancy)

Waxa uu dhacaa marka aysan sidii caadiga ahayd ugxaanka u bacramismin,taasoo koritaan xad dhaaf ah ku imaneyso nuddaha mandheerta.Markay bacarimintu dhacdo waxa samaysma waxa loo yaqaanno "syncytiotrophoplast " oo ku samaysma gidaarka makaanka taas oo ah waxa hadhaw noqonaysa mandheerta(placenta) oo ah waxa ilmaha iyo hooyada u kala qaada nafaqada ,taas ayaa waxay soo daysaa ilaa 10 isbuuc ee u horreeya xadi badan oo ah HCG(Human chronioc gonadotropin) oo ah hormoon  lagu ogaado inay haweenaydu uur qaaday kaas oo dhiigga iyo kaadidaba laga helo qalabka loo adeegsado baadhitaanka uurkana kaas ayuu sheeggaa balse isagu ma sheego ilmo dhammaytirani ma samaysmay mise ilmo soo dhici doonna ayaa samaysmay .

Waxa loo qeybigaa labo qeybood. 

1:Partial molar ku waxa uu ka samaysmaa marka horre ee bacariminta oo ugxanta haweenka bacarimiya laba mani oo ka timi xagga aabbaha halkii ay mid kaliya bacarimin lahayn dabeetana halkii ilmuhu ka samaysmi lahaa 23 chromosomes aabbaha ah iyo 23 chromosomes hooyada ah ayaa waxa uu ka samaysmayaa 46 aabbaha ah +23 hooyadaha xageeda ka yimi =69 chromosomes .

2:Complete molar waxa ilmuhu ka samaysmayaa oo 23 chromosomes ka yimi xagga aabbaha oo kaliya waxaana meesha kaba maqnaanaya koromsoomkii hooyada ugxanteeda kusii jiri lahaa ,kaddib taran unugyaad ayaa dhacaya ilaa 46 ay ka gaadhayaan ama laba mani oo xagga aabbaha ka timi ayaa ugxan aanay wax koromsoom ahi ku jirin bacariminaya sidaana ku samaysmaya 46 chromosomes xagga aabbaha oo kaliya ka yimi ,noocani waa nooca ugu daran ilme wax u egna uurka gali maayaan kaliya waxa la arki karaa wax u eeg midhaha canabka oo ilma galeenka ku samaysma qabsadana ,waxaanu siyaadiyaa qaaditaanka kansarka makaanka ku dhaca loo yaqaan choriocarcinoma.

Maxaa keenna?

Majirran wax sax la og yahay oo keena uur-beenaadka, laakiin waxa jirra waxyaabo ka qeyb qaata.

1: Da'ada hooyada haddii ay ka yartahay 20 ama ka badan 30 sanno waxa ay ugu jirtaa qatar uur-beenaadka.

2:Haddii horrey ugu soo dhacay uur-beenaadka hooyada, markan inuu ku dhaco qatar ayay ugu jirtaa inuu ku soo laabto.

3: Nafaqo darro. Haddii uu yartahay faytamiin A heerkiisa waxa uu ka qeyb qaadan karaa qatarta siyaadin karta uur-beenaadka.

4: Hiddaha: Haddii koromsoomyada sidii la rabbay u bacramismin waxay ka qeyb qaataa door muhiim in uu uur-beenaadka sameysmo.

Calaamadaha 

1- lallabo iyo matag siyaado ah

2- Dhiigbax xagga hoose ah

3- Hormoonka hCG oo sare u kaca

4- Minka oo aad u weynaada

5- Dhiig kar 6-da bilood ee ugu horreysa

6- Nuunuuxsi la'aan uurjiif

7- Qanjirka toroodka oo kacsan taasoo ugu wacan Hormoonka hCG oo carinaya qanjirka tayroodhka. (Hyperthyroidism)

Waxaa lagu gartaa in haweentu ay uurjiif shuuq wado:

badanaa uurka wuu iska dhammaadaa markii haweentu ay soo saarto wax u eg cinab oo tira badan. Waxaa lagu arki karaa qalabka ultrasoundka ama cabbirka hormoonka hCG.

Baadhitaanka. 

1:Ultrasound:  waxa lagu arkayaa waxyaabo sidii canabka oo kale ah.

2:Waxaa kaloo la baadhayaa heerka hormoonka hCG  isagoo la barbadhigayo heerka caadiga ee uurka. Marka uu jirro uur-beenaad dhammayska tiran waxa uu noqdaa mid aad u sareeya hormoonka hCG (>100,000 mIU/mL).

3:Waxaa lii samaynayaa baadhitaanka cadka(Histopathology ).

Marka laga soo xaaqo uurbeenaadka waxa laga qaadayaa cad si markaasi baadhitaan loogu sameeyo, si markaasi loo ogaado nooca uurbeenaadka, haddii uu yahay midka dhammayskatiran ama midka badhka ah.

4:Waxaa loo dirayaa raajada laabta(Chest X-Ray).

Waxa loogu dirayaa haddii uu kansar isku beddelay, kansarka meelaha ugu caansan uu saamaynayaa waa sambabada. 

5:Waxaa lii dirayaa hubbinta dhiigga.

A:Waxa laga baadhayaa ama la hubinayaa shaqada qanjirka tayroodhka  taasoo ugu wacan hormoonka Beta-hCG.

B:Waxaa kaloo loo dirayaa dhiigga guud si markaasi loo eego haddii au jirto dhiig yaraan. Taasoo ugu wacan dhiig bax haddii uu ku yimid haweeneyda. 

C:Waxaa kaloo la hubinayaa shaqada beerka iyo kelyaha.

Daaweynta. 

Suction Curettage:  Waa daweynta ugu horreyso taasoo looga soo xaaqayo uur-beenaadka.

2:Hysterectomy: haddii laga maarmi waayo in hooyada loo sameeyo kasaarida minka. Se waa xaalad dhif ah in la sameeyo.

3Chemotherapy:  haddii uu jirro kansar waxa loo baahanayaa daweynta shucaaca(choriocarcinoma).

4:Follow-up:  In loo sameeyo ka warqab heerka uu marayo hormoonka hCG iyado xaqiijinayo dhammeystiranka uur-beenaadka.

A:Booqashada koowaad

Haweeneyda waxay imaneysaa kaddib labo maalin marka loo sameeyo daaweynta. Waxa la fiirinayaa hormoonka( bet hCG), iyadoo markaasi la hubbinayo wali inuu jirro uur-beenaadka.

B:Booqashada isbuuca.

Waxa la fiirinaya hormoonka beta hCG  isbuuc walba, ilaa ay natiijada ka noqoto mid caadi ah( seddex jeer waa in ay noqoto mid taban).

C:Booqashada bilaha.

Kaddib marka seddex jeer uu noqdo mid taban( hormoonka hCG), waxa la bilaabayaa hubbinta billaha. Ilaa lix bilood ayaa la wadayaa, waxa la fiirinayaa bil walba, ilaa laga xaqiijiyo inuu ku soo laabtay sidiisa caadiga ahayd.

D:Haweeneyda waa in ay ka fogaataa uur in ay qaado.

E:Haweeneyda waxa la siinayaa dawooyinka ka hortaga uurka( birth pills).

F:Waxa la fiirinayaa haddii ay xaalad qatar ah jirto.

G:Haddii wali uu sarre noqonayo hormoonka hCG taasina waxay muujinaysaa inuu jirro kansar(GTN).

Tixraaca. 

1:Medscape: Useful for up-to-date clinical practices and case studies.

2:Current Obstetrics & Gynecology: Latest updates on diagnosis and management protocols.

3:Ten Teachers Obstetrics: Offers clear guidance on the clinical aspects of molar pregnancy.

4:Dutta’s Textbook of Obstetrics: A comprehensive resource on molar pregnancy and other gestational trophoblastic diseases.

5:Amboss: Provides detailed information on the pathophysiology, diagnosis, and management of molar pregnancy.

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