Isidingo sokuqedwa kokuqala kokukhulelwa kungenxa yezizathu eziningi. Lezi yizinkomba zezokwelapha, nezizathu ezihlukahlukene zokwenyama noma kwengqondo.
Izinhlobo zokukhipha isisu kuqala
Ukukhipha isisu ekuqaleni kwesigaba kungenziwa ngezindlela ezimbili eziyinhloko: ngezokwelapha noma ngokuhlinzwa. Ake sicabangele ngokunye okukhethwa kukho kokukhipha isisu ekuqaleni kwezigaba zokukhulelwa.
1. Ukukhipha isisu esikhathini sokuqala. Kuze kube yimanje, lokhu kuyindlela ebhekwa njengokwesaba kakhulu umzimba womuntu wesifazane. Akuhlinzekeli ukungenelela kokuhlinzeka, kodwa ukusetshenziswa kwayo kuvunyelwe kuphela ngokwemibandela yama-6-7 amasonto. Phakathi nalesi sikhathi, iqanda le-fetal lisalokhu liqinile phezu kodonga lwesibeletho. Ukukhipha isisu ekuqaleni kwesigaba sokukhulelwa: i-methotrexate ne-prostaglandin, i-mifepristone ne-prostaglandin, kanye ne-misoprostol. Isikimu ngasinye sinomthelela ohlukile emzimbeni wesifazane.
- Ukusetshenziswa kwe-mifepristone ne-prostaglandinoma kunikeza isiqiniseko sokuthi isisu esingu-94% sokukhipha isisu. Izidakamizwa zilawulwa ngezidakamizwa, ngokuzenzekelayo zonke izinsuku. Le ndlela ithatha isikhathi esithile futhi ihambisana nokuphazamiseka okuthile. Ngokuqondene nemiphumela emibi, ukuhlukunyezwa, ukuhlanza noma ukuphazamiseka kwamathumbu kungenzeka.
- I-Methotrexate ilawulwa nge-intramuscularly, futhi ngemuva kwezinsuku ezinhlanu, i-prostaglandin ilawulwa ngamanzini. Iphesenti yenani eliphumelelayo lingu-90%. Phakathi kokusungulwa kwesidakamizwa nokukhipha isisu okuphelele kungahamba kusukela ezinsukwini eziyisikhombisa kuya emavikini ambalwa.
- Ukusetshenziswa kwe-misoprostol kunika umphumela ophumelelayo kumacala angu-90%. Yilezi zidakamizwa ezinconywa kakhulu ukukhipha isisu ekuqaleni, ngoba umphumela wayo awunobungozi emzimbeni wesifazane.
2. Ukufunwa kwe-Manual vacuum. Ukukhipha isisu ezinyangeni zokuqala kungenziwa uma ukukhulelwa kungapheli amasonto ayisithupha. Le ndlela ihlanganisa ekunakekeleni okuqukethwe kwesibeletho se-uterine nge-syringe ekhethekile ngokusebenzisa i-anesthesia. Njengomthetho, sikhuluma nge-anesthesia yendawo, ukusetshenziswa okujwayelekile kuyinto engavamile kakhulu. Le ndlela ingasetshenziswa izinsuku ezimbalwa emva kokubambezeleka kokuya esikhathini.
3. Ukukhipha isisu ekukhulelweni kokuqala. Le ndlela isetshenziselwa ukuphazamisa isikhathi semasonto ayisithupha kuya ku-12. Kusukela esibelethweni, iqanda le-fetal likhishwa kanye ne-membrane. Lokhu kubangela ukuhlukunyezwa komzimba wesifazane, ngakho-ke ukungenelela okunjalo akudluli ngaphandle kokulandelela. Izinkinga kulokhu zixhomeke ngokuphelele esikhathini sokukhulelwa.
Imiphumela yokukhipha isisu ekuqaleni
Ukuphazanyiswa emazingeni okuqala ngokuvamile kubangele izifo eziningi zesifo somzimba. Uma owesifazane engazange abelethe, khona-ke kukhona amathuba amakhulu okungazalwa. Ezigulini ezingu-12%, umjikelezo wokuya esikhathini uphukile futhi kungabuyiselwa kuphela ukwelashwa okwesikhashana. Enye yezinkinga ezimbi kunazo zonke ukuphazanyiswa kobuqotho besisu noma ukuphuka kwayo. Ngenxa yalokho, izitsha ezinkulu, amathumbu, isambiso noma ukuvuvukala kwesisu kungalimala.
Ngokuvamile, odokotela babhekana nokuphuma kwegazi isikhathi eside, izilonda ezihlukahlukene zomlomo wesibeletho kanye nokuphazamiseka kwegazi. Kukhona amathuba okufakelwa kwamaqanda angaphelele. Uma owesifazane enesifo esingelapheki sezinhlobo zomzimba, khona-ke baya esiteji sokucindezela. Kubalulekile ukukhumbula ukuthi kukhona amathuba okutheleleka esibelethweni ngesikhathi sokuhlinzwa, okungabangela ukuvuvukala kwama-ovari kanye nesiguli se-uterine.
Ukukhipha isisu ngosuku lokuqala kubangela ukulimala hhayi kuphela ngokomzimba, kodwa futhi nomlingiswa wokuziphatha. Ngokuvamile le nqubo ibonakala njengobudlova emzimbeni, ngoba abesifazane bavame ukubhekana nokucindezeleka nokucindezeleka.