Cutar sanyin mara da yadda ake maganin ta (Pelvic inflammatory disease)

Gabatarwa:

Ciwon sanyi ciwo ne wanda hausawa suka chamfa sosai, kusan kowacce cuta ma zaka ji hausawa musamman masu maganin gargajiya suna alaƙanta ta da cutar sanyi. A cikin wannan rubutu zamu warware muku zare da abawa game da cutar sanyi da kuma yadda ake maganin ta.

Mene ne cutar sanyin mara (PID)?

Cutar sanyin mara wata cuta ce dake shafuwar al'aurar mata, mahaifa, bututun Fallopian, ovary da kuma sauran sassan jiki dake cikin kunkumin su (their pelvis). Cutar takan iya yaɗuwa daga cikin kunkumi (kwankwaso) zuwa cikin ciki a inda zata shafi kitsen peritoneum da kuma kitsen da yake lulluɓe da anta wanda hakan yana iya haifar da  cutar da ake kira Fitz-Hugh-Curtis syndrome ko kuma ya haifar da cutar peritonitis ko kuma acute abdomen.

Me ke kawo cutar sanyin mara (PID)?

Cutar sanyin mara tana faruwa ne a lokacin da cututtukan bacteria waɗanda ke  yaɗuwa ta hanayar jima'i suka yaɗu daga farjin mace zuwa cikin mahaifarta, bututun Fallopian, watarana har zuwa cikin kwankwasonta da kuma cikin ciki. Idan mace ta kamu da cututtukan bacteria da ke yaɗuwa ta hanyar jima'i ba kai tsaye cutar kan iya shiga cikin mahaifarta ba saboda akwai wata kariya a ƙofar bakin mahaifa. Cutar tana iya shiga ne a lokacin da cutar ta yawaita a jikin mace ko kuma ta daɗe ba tare da an magance ta ba, toh wannan shi zai bata dama ta shiga cikin mahaifa har ta kawo cutar sanyin mara.

Farjin mace wuri ne mai matuƙar adana ƙwayoyin cutar bacteria, wannan shi yasa ya zama wajibi ga kowace mace ta kula da tsaftace farjin ta saboda kaucewa miyagun cututtuka. Duk da cewa farjin mace yana tara ƙwayoyin bacteria masu yawa, amma ba kowace ƙwayar bakteriya ce kan iya yaɗuwa daga farji zuwa cikin mahaifa har ta kawo cutar sanyin mara ba. Ƙwayoyin cututtukan bacteria waɗanda ke haifar da cutar sanyin mara dukan su ana samun su ne ta hanyar jima'i, manya daga cikin sun haɗa da;

• Ƙwayar cutar Neisseria gonorrhoeae
• Ƙwayar cutar Chlamydia trachomatis

Waɗannan ƙwayoyin cuta guda biyu sune ke da alhakin kawo fiye da kashi hamsin cikin ɗari (50%) na cutar sanyin mara. Sauran ƙwayoyin cutar bacteria da kan iya kawo sanyin mara sun haɗa da:

• Ƙwayar cutar Gadnerella vaginalis
• Ƙwayar cutar Trichomonas vaginalis
• Ƙwayar cutar Mycoplasma hominis
• Ƙwayar cutar Ureaplasma urealyticum
• Ƙwayar cutar Streptococcus agalactiae
• Ƙwayar cutar Haemophilus influenzae
• Ƙwayar cutar Mycoplasma genitalium

Waɗannan ƙwayoyin cuta dake sama duk an tabbatar zasu iya kawo cutar sanyin mara, amma dai bincike ya nuna cewa a girmama magabata watau Neisseria da Chlamydia.

Alamomin cutar sanyin mara (PID)

Alamomin cutar sanyin mara sun danganta daga wata mace zuwa wata mace. Wata takan fuskanci matsanancin alamomi wata kuma baza ta ma gane ta kamu da cutar ba sai dai kawai watarana ta wayi gari da illolin cutar. Alamomin cutar sun haɗa da;

1. Yawan zazzaɓi ko zafin jiki
2. Fitar farin ruwa mai yawa, mai kauri, mai yauƙi da wari daga farjin mace (wata rana kalan ruwan yakan chanja zuwa kore ko kamar ruwan ƙwai).
3. Ciwon mara
4. Warin gaba
5. Ƙaiƙayin gaba
6. Jin ciwo yayin jima'i
7. Zubar da jini yayin jima'i ko bayan an gama
8. Rikicewar al'ada
9. Jin ciwo yayin fitsari
10. Amai.

Wa zai iya kamuwa da cutar sanyin mara (PID)?

1. 'Yan mata masu yin jima'i ba tare da kariya ba, musamman 'yan ƙasa da shekaru ashirin da biyar (25).

2. 'Yan mata masu yin jima'i da fiye da mutum ɗaya

3. Idan kina jima'i da mutum ɗaya amma shi abokin jima'in naki yana jima'i da wasu 'yan mata.

4. Mai yin jima'i barkatai ba tare da robar kariya ta condom ba.

5. Wadda ta taɓa kamuwa da wasu cututtuka masu yaɗuwa ta hanyar jima'i.

6. Namijin da ya sadu da wadda keda cutar sanyin mara.

7. Mace mai saduwa da namijin da yake ɗauke da cututtukan jima'i.

8. Mace mai amfani da robar hana haihuwa wadda ake sawa a cikin mahaifa (IUCD).

9. Mace wadda aka yiwa wankin mahaifa

Yana da kyau a lura cewa, ba'a samun ciwon sanyin mara ta hanyar amfani da toilet ɗaya da mai ɗauke da cutar ko ta hanyar amfani da ƙazamin toilet saɓanin yadda mutane dayawa ke tunani. Haƙiƙa wannan tunanin ya saɓawa ingantaccen ilimin likitanci.

Shin namiji zai iya kamuwa da cutar sanyin mara (PID)?

Namiji yakan iya kamuwa da cutar sanyin Gonorrhoe da Chlamydia da kuma sauran cututtukan da ake yaɗawa ta hanyar jima'i amma namiji baya da mahaifa ko bututun Fallopian wanda nan ne hanyar da cututtukan ke bi su shiga acikin kwankwason mata. Idan har namiji ya sadu da mace mai ɗauke da wannan cutar ta sanyin mara ko kuma ya sadu da mace mai ɗauke da cutar Gonorrhoe ko Chlamydia wadda bata riga ta haifar da cutar sanyin mara ba toh tabbas zai kamu da cutar.

Yana da kyau a gane cewa ko da mace tana saduwa da namiji ɗaya ne kawai, idan har shi namijin bada ita kaɗai yake saduwa ba toh zai iya samo cutar sanyin mara ya shafa mata.

Alamomin cutar sanyin Gonorrhoe da Chlamydia ga namiji sun haɗa da

• Fitar da wasu ruwa fari mai kauri da wari bayan ya gama fitsari
• Jin ciwo yayin fitsari
• Jin ciwo a ya'yan marina
• Kumburin 'ya'yan marina
• Yawan kasala
• Ciwon gabbai
• Zazzaɓi (bai cika aukuwa ba)

A lura, duk da cewa namiji bayada mahaifa a cikin marar sa, amma cutar Gonorrhoe ko Chlamydia sukan iya yaɗuwa ta hanyar bututun fitsari zuwa cikin mafitsara. Wannan yakan iya sa namiji yaji ciwon mara sosai saboda mafitsarar sa zata shiga halin ƙaƙanikayi sakamakon shigar cututtukan a cikinta (cystitis).

Yadda ake gane cutar sanyin mara (PID) a asibiti

Tarihin ciwo da sauran bayanai

Babu wani gwaji ƙwara ɗaya da zai iya tabbatar da cutar sanyin mara. Saboda haka likitoci sukan dogara ne da abubuwa masu yawa:

Na farko shi ne za'a ɗauki ingantaccen bayani daga marar lafiya dangane da yadda ciwon ya fara da kuma irin alamomin da take ji na ciwon. Haka kuma za'a tambayi marar lafiya ta bada ingantaccen bayani akan rayuwarta ta jima'i.

Bayan ɗaukar taƙaitaccen tarihin ciwon daga bakin marar lafiya za'a duba marar lafiya akan gadon asibiti. Duba marar lafiyar ya ƙunshi duba lafiyar jikinta baki ɗaya (general examination) da kuma duba farjinta da mahaifar ta (Pelvic examination).

Pelvic examination - Duba farji da mahaifa

Wannan shi ne duba mai matuƙar amfani a cutar sanyin mara. Idan za'a yi wannan duban likita zai fara duba lafiyar farjin mace da wata roba da ake kira speculum kamin ya sanya yatsan sa aciki. Likita zai sanya yatsan sa a cikin farjin domin gano wasu manyan alamomi na cutar sanyin mara. Manyan alamomin sanyin mara da za'a iya samu yayin da likita ya sanya yatsan sa acikin farji sune:

• Adnexal tenderness: Raɗaɗin ciwo idan an taɓa gefen mara ta ciki (gefen hagu da na dama).
• Cervical excitation tenderness: Raɗaɗin ciwo idan an taɓa bakin mahaifa.
• Lower abdominal tenderness: Raɗaɗin ciwo idan an taɓa mara ta waje (ana duba shi kamin a sanya yatsa).

Haka kuma kamin a sanya yatsa za'a iya ganin waɗannan alamomin ta cikin robar speculum:

• Hyperemic cervix: Bakin mahaifa yayi jajir
• Abnormal cervical discharge: Fitar wani mummunan ruwa daga bakin mahaifa.

Gwaje-gwajen da za'a iya yi

1. High vaginal swab M/C/S: Wannan wani kalan gwaji ne da za'a sanya kaɗa a can cikin ƙolin farjin mace a ɗebo farin ruwan da ke fitowa daga bakin mahaifa sannan a je ɗakin gwaje-gwaje sai a auna shi domin tantance wace irin ƙwayar bacteria ce ke da alhakin kawo cutar. Bayan an gano cutar haka zalika, za'a gwada mata magunguna daban daban domin gane wane magani ne yafi inganci wajen kashe ƙwayar cutar.

2. Hoton ciki - Abdominal Ultrasound: Wannan wata fasaha ce da ake amfani da igiyoyin sauti domin ɗaukar hoton abubuwan da ke cikin ciki. Yin wannan hoton yana da amfani a ciwon sanyin mara saboda zai nuna yanayin da mahaifa take ciki da kuma sauran kayan ciki. Haka kuma idan akwai taruwar ruwan ƙurji a cikin ciki ko kuma a cikin bututun Fallopian za'a gani, wanda hakan yana yawan faruwa a cutar sanyin mara.

3. Gwaje-gwajen jini - Blood tests: Waɗannan sun ƙunshi gwaje-gwajen da za'a ɗibi jini aje ayi, kamar su FBC - wanda zaj iya nuna ƙaruwar WBC fiye da misali saboda maida martani ga cutar, ESR - zai yi sama, C-reactive protein shima zai yi sama da kuma sauran gwaje-gwajen cututtukan da zasu iya yaɗuwa ta hanyar jima'i kamar su HIV, Hepatitis B and C, Sphyllis da dai sauransu.

4. Hoton video na ciki - Laparoscopy: Wannan wani gwaji ne na musamman da za'a iya yi, za'a yi kussuwa kaɗan acikin mutum sai a sanya wata na'ura da zata shiga ta ɗauki hoton bidiyo na abinda ke cikin cikin marar lafiya ta nuna a akwatin talabijin. Likitocin tiyata su keyin wannan gwaji.

5. Endometrial biopsy: Wannan wani gwaji ne da za'a ɗebi wani sashe na bangon mahaifa na ciki domin aje dashi a gwada a ɗakin gwaje-gwaje.

Yadda ake maganin cutar sanyin mara (PID)

Yana da kyau da an fara ganin alamomin cutar sanyin mara ko cututtukan da akan iya kwasa ta hanyar jima'i toh a gaggauta neman magani ingantacce na asibiti. Saboda cutar sanyin mara ana iya maganinta kai tsaye amma ba'a iya maganin wasu illolin da take haifarwa jikin mutum.

Masana sun ayyana sharuɗɗa guda uku waɗanda za'a bi domin maganin cutar sanyin mara. Waɗannan sharuɗɗan sun zama dole a bisu baki ɗaya idan ana son ayi maganin cutar yadda ya kamata kuma a hana ta sake bayyana a jikin mutum. Sharuɗɗan su ne:

1. Amfani da magungunan antibiotics

Wajibi ne ayi amfani da magungunan antibiotics yadda ya kamata a wajen magance cutar sanyin mara, ana amfani da allurorin antibiotics da kuma magungunan sha. Idan mace tazo asibiti cikin yanayin gaggawa (emergency) sakamakon cutar sanyin mara to ya wajaba a bata gado a asibiti ayi mata allurorin jijiya na antibiotics na aƙalla kwana biyu (2 days). Allurorin da za'a yi mata su ne:

• IV Ceftriaxone 1g dly × 2/7
• IV Metronidazole 500mg bd × 2/7
• IV Doxycycline 100mg bd × 2/7 (Saboda IV Doxycycline yana da ciwo sosai anfi so ayi amfani da ƙwayoyin magani)

Daga nan idan an gama mata waɗannan allurorin antibiotics na kwana biyu sai a maida ta kan ƙwayoyin magani da zata sha na sati biyu (ana iya sallamar ta taje gida taci gaba da shan magani idan taji dama bayan ƙare allurorin). Magungunan da zata ci gaba da sha sune:

• Tabs Metronidazole 400mg tds x 2/52
• Caps Doxycycline 100mg bd x 2/52
• Tabs cefixime 400mg bd x 2/52

Wadda kuma tazo ba cikin yanayin gaggawa ba amma tanada alamomin cutar sanyin mara, toh ana yi mata allura daya ta Ceftriaxone ta tsoka (IM Ceftriaxone 500mg stat) sannan sai a aza ta kan magungunan sha har sati biyu kamar yadda muka ambace su a sama.

2. Barin yin jima'i har sai mace ta warke

Wadda aka gane tana da cutar sanyin mara ya zama wajibi gareta ta daina yin jima'i da kowa har sai ta gama shan magani ta warke gaba daya. Wannan shi ne sharaɗi na biyu da dole a bishi idan anaso a warke daga cutar.

3. Yiwa abokan jima'i magani

Idan aka gane mutum yanada sanyin mara, mace ko namiji, toh duk wanda ya taɓa yin jima'i dashi cikin kwanaki sittin (60) da suka shuɗe ya zama wajibi yasha maganin sanyin mara. Dole ne abokin jima'i ayi masa allurar tsoka ta ceftriaxone kamar yadda muka ambata a baya kuma yasha maganin ƙwayoyin da muka ambata a sama har na tsawon sati biyu koda ko baya da wata alamar rashin lafiya a tattare dashi. Haka kuma dole ne su daina yin jima'i har sai kowannen su ya gama shan magani.

A lura cewa idan mutum yana da mata fiye da ɗaya, sai aka same shi ko ɗaya daga cikin matansa da cutar sanyin mara toh fah aiki ya samesu su duka. Saboda ya zama wajibi shi namijin da dukkan sauran matansa ayi musu allura kuma su sha magunguna har na tsawon sati biyu, sannan kuma su kame daga yin jima'i baki ɗaya har sai duk sun gama shan magani.

Waɗannan su ne sharuɗɗan da aka gindaya idan anaso a warke daga cutar sanyin mara kuma a kaucewa illolin da take haifarwa.

Illolin cutar sanyin mara (PID)

1. Infertility - Rashin haihuwa ga mata: Cutar sanyin mara tana haifar da rashin haihuwa ga mata ta hanyar toshe musu bututun Fallopian. Wannan bututun kamar yadda muka sani shi ke da alhakin ɗauko ƙwan mace daga ovary zuwa cikin mahaifa domin a samu ciki (Domin ƙarin bayani game da amfanin bututun Fallopian a waje samun juna biyu toh karanta wannan rubutu "Ingantaccen bayani akan ilimin kimiyyar jima'i")

2. Ectopic pregnancy - Mace ta samu ciki a wajen mahaifa (pregnancy outside uterus).

3. Tubo-ovarian abscess - Ƙurji tsakanin ovary da bututun Fallopian.

4. Yawan ciwon mara da kwankwaso

5. Urethral structure - Tsukewar bututun fitsarin maza da ke cikin azzakari: Kamuwa da cutar sanyin Gonorrhoe ko Chlamydia yakan iya sa bututun fitsarin maza ya tsuke har namiji ya kasa fitar da fitsari da kansa sai anyi masa tiyata. Hakan yana faruwa ne idan cutar ta daɗe a jikin namiji ba tare da magani ba. Wannan baya shafuwar mata saboda bututun fitsarin mata baya da tsayi sosai.

6. Adhesions: Adhesions wasu abubuwa ne masu kamar zare da ke faruwa a cikin ciki sakamakon irin wannan cutar, adhesions suna da matsala sosai, domin sukan iya hana mace haihuwa ko kuma su kawo mata toshewar hanji.

7. Ophthalmia neonatorum: Mace mai juna biyu wadda ke ɗauke da cutar Gonorrhoe ko Chlamydia takan iya shafawa jaririn da zata haifa wannan cutar a wurin haihuwa. Yayin da jariri yake fitowa a cikin farjin mamar sa yakan haɗu da ruwan da ke ɗauke da waɗannan ƙwayoyin cutar. Wannan yakan sa jim kaɗan bayan haifuwar yaro ya kama ciwon ido kamar na Apollo, idanun sa suyi ja suna fitar da kwantsa.

Yadda zan kare kaina daga cutar sanyin mara (PID)

1. Yin aure ko kuma yin jima'i da mutum ɗaya kacal

2. Yin amfani da robar kariya ta condom yayin jima'i.

3. Kamewa ko barin yin jima'i baki ɗaya

4. Auren mutumin kirki wanda baya jima'i da wasu matan banza.

5. Gwaje-gwajen riga-kafi

6. Daina yin amfani da robar mahaifa ta hana haihuwa (IUCD).

Kammalawa

Cutar sanyin mara cuta ce da wasu ƙwayoyin bacteria da ke yaɗuwa ta hanyar jima'i ke kawo wa. Ita wannan cutar tafi shafuwar mata yara ƙanana waɗanda ke yin jima'i barkatai. Alamomin cutar sun haɗa da fitar wani mummunan ruwa mai wari daga farjin mace, jin ciwo yayin jima'i, rikicewar al'ada, yawan ciwon mara da kuma jin ciwo yayin fitsari. Haka kuma ana maganin wannan cutar ta hanyar shan magungunan ƙwayoyi na antibiotics, kamewa daga jima'i har na tsawon lokacin shan magani da kuma yiwa abokan jima'i magani.

Idan kuna da tambaya sai kuyi a cikin akwatin sharhi dake ƙasa, Insha Allah zamu karba ba tare da jinkiri ba. Haka kuma zaku iya shiga group dinmu na WhatsApp domin kasancewa damu damu a koda yaushe da kuma samun ingantattun bayanan mu a cikin sauki. Ku danna wannan domin shiga: Lafiyata Group 3. 

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