ILI ngesikhathi sokukhulelwa

Ngokuvamile, izintambo zomzimba zomzimba wesibeletho ngesikhathi sokukhulelwa zivaliwe ngendandatho eqinile, ziphumula kancane kancane njengoba isikhathi sokubeletha sisondela. Uma kwenzeka lokhu kwenzeka ngaphambi kwesikhathi, umlomo wesibeletho uqala ukunciphisa futhi uvele. Kulesi simo, bakhuluma ngokuthuthukiswa kwe-ischemic-insufficiency (ICI). Lesi sifo senziwa cishe ngo-1-9% wabesifazane abakhulelwe, kuhlanganise no-15-40% wabo ababhekene nokukhubazeka okuvamile, okungukuthi. Ukukhulelwa okungaphezulu kuka-2 nokudlulela kwangaphezulu kwaphela ekukhulelweni kokuphutha.

I-ILI ngesikhathi sokukhulelwa kuholela ekwandiseni intanyeni yebele, ngenxa yalokho umlomo wesibindi owela khona, ophela ngokuvula kwawo. Ngaphezu kwalokho, umsebenzi womsebenzi uqala, okuholela ekukhulelweni kwesisu okuphuthumayo noma ukubeletha ngaphambi kwesikhathi.

Kungani i-ICI ikhona?

Izimbangela eziyinhloko eziholela ekuthuthukiseni i-ICI ngesikhathi sokukhulelwa yizi:

• ukuhlukunyezwa komlomo wesibeletho (izinyembezi, ukulimala) ngesikhathi sokubeletha kwangaphambilini noma nokuqedwa kokukhulelwa kokufakelwa;
• ukungavamile ekuthuthukiseni izitho zokuzala;
• Izinguquko zomsebenzi ezinxenyeni ezixhumene ne-dysplasia, i-hyperandrogenia, nokuntuleka kwamahomoni ocansi;
• ukwenza IVF;
• i-fetus eminingi, i-polyhydramnios, i-fetus enkulu.

Yiziphi izimpawu eziyinhloko ze-NIH?

Izimpawu ze-ICI ngesikhathi sokukhulelwa zifihliwe ezimweni eziningi, ngakho-ke kulula kunzima ukucacisa ukuba khona kwesifo sowesifazane okhulelwe ngokwabo. Ngakho esiteji sokuqala sokuzala ingane (1 trimester) ayengekho ngokuphelele. Kamuva, lapho kubonakala sengathi kuvamile ukukhulelwa kwamanje, omama abasaqaphela ukuvela kwezibonakaliso ezinjalo ze-ICI:

• ukubonakala kwenani elincane lokubala;
• ukubonakala kokuphuma kwamanzi ngegazi;
• ubuhlungu esifundeni se-lumbar ngemuva nangesisu esingaphansi;
• ukubukeka komzwelo "we-raspiraniya" emkhathini.

Kodwa-ke, ezimweni eziningi, njengoba sekushiwo kakade, lesi sifo singenasifo, futhi ukuxilonga i-ICI ngesikhathi sokukhulelwa, udokotela wenza uhlolo lomlomo wesibeletho ngosizo lwezibuko, kanye nokusebenzisa umshini we-ultrasound.

Ngakho-ke, nge-palpation ye-canal yomlomo wesibeletho, umjozi wesifo somzimba angathola ukuthambisa okuphawulekayo kwesibeletho, kanye nokunciphisa ubude bomlomo wesibeletho, nokuvulwa komgudu walo lapho kubonakala khona isitho sangasese. Ngenxa yokuthi emasimini angama-primiparous i-pharynx yangaphandle ingavaliwe, ukuxilongwa kuqinisekiswa yi-ultrasound isebenzisa inzwa ye-transvaginal. Izindlela ezilandelayo zicatshangelwa:

1. Ubude bomlomo wesibeletho. Emasontweni angama-24-28 alingana no-35-45 mm, futhi emva kwamasonto angu-32 wokukhulelwa - 30-35. Uma emavikini angu-20-30 ubude bayo bungaphansi kwama-25 mm, khona-ke bakhuluma ngokuthuthukiswa kwe-ICI.
2. Ukutholakala kokuvulwa kwe-V kwe-pharynx yangaphakathi.

I-ICI iphathwe kanjani?

Kuphelele, kunezindlela ezimbili zokwelapha i-ICI ngesikhathi sokukhulelwa:

• ukuhlinzwa;
• okuqaphele.

Okokuqala ukusetshenziswa kwe-sutures engxenyeni yomlomo wesibeletho. Ngesikhathi esifanayo, umphimbo wangaphakathi wesibeletho uvinjelwe futhi umbeletho wangaphandle ukhonyiwe, okuyinto ekunciphiseni amathuba okuzalwa ngaphambi kwesikhathi. Isikhathi sokusebenza okunjalo senziwa ngabanye, kodwa ukuze kugweme ukuqhubeka kwenqubo, odokotela bazama ukwenza umsebenzi kuze kube amasonto angu-17 uma ukwephulwa kutholakala ekuqaleni kokukhulelwa, kodwa kungakapheli amasonto angama-28.

Indlela yokuqapha ukufaka i- obstetric pessary (indandatho kaMeyer). Lolu hlobo lwedivaysi luphinde lusethe isisindo somntwana futhi lusize umlomo wesibeletho ulondoloze. Ukufaka ama-pessaries kusebenza kuphela uma kucatshangwa ukuthi yi-NIH noma ngezigaba zayo zakuqala. Ngezimpawu ezinzima, le ndlela isetshenziswa, kunalokho, njengomsizi.