Njengoba esenqume umsebenzi osebenzayo wokuqeda ukukhulelwa, owesifazane ngokuvamile uthatha isithakazelo kudokotela: indlela yokukhipha isisu, yiziphi izindlela ezikhona. Ake sicabangele ngokuningiliziwe le nqubo, izindlela zokuqhuba, imiphumela engenzeka kanye nezinkinga.
Ukukhipha Isisu - Izinhlobo
Ngaphambi kokuphazamiseka kokukhulelwa , odokotela baxoxa nengane mayelana nemiphumela emibi yokuphathwa kabi. Abaningi emva kokukhipha isisu kunzima ngokukhulelwe. Ngemuva kokwenza isinqumo sokugcina, intombazane idinga ukubonisana nabesifazane, lapho ungathola khona ulwazi mayelana nezinhlobo ezikhona zokusebenza kokukhipha kanye nokusetshenziswa kwesikhathi.
Ngokwenza umkhuba wesisu, izindlela eziningi zokukhipha isisu ziyasetshenziswa. Lapho ukhetha udokotela othile, ziqondiswa yisikhathi sokukhulelwa, iminyaka yesiguli, ngokucabangela ukukhulelwa esikhathini esidlule. Phakathi kwezindlela ezikhona:
- Ukukhipha isisu - kuhilela ukuthatha izidakamizwa ezibangelwa ukufa kwe-embryo nokuxoshwa emgodini wesibeletho;
- ukukhipha isisu (ukufisa ukuphuma) - kwenziwa ngethuluzi elikhethekile, isimiso salo esifana nokuhlanza umshini wokuhlanza;
- ukukhipha isisu (ukukhipha) - umgodla we-uterine uhlanzwa ngamathuluzi akhethekile.
Amathebulethi okukhipha isisu
Lapho ukukhipha isisu kudalwa, izidakamizwa ezisetshenziselwa ukuxhaphaza zibangela ukufa kweqanda lesisu, eliphuma ngaleso sikhathi. Inqubo yenziwa kuphela ngamagama amancane, ngamasayizi amancane embryo. Ukukhuluma ngokuthi ukukhipha isisu kutholakala kanjani, kufanele kuthiwa ukusebenza kwayo kuwu-98%. Kuqhutshwa ezikhungweni zezokwelapha, ngaphansi kokuqondiswa odokotela. Esigabeni sokuqala, basikisela ukuthi uphuze umuthi obangela ukufa kombungu, emva kwalokho umuthi uphonsa umbungu (Mifepreston and Misoprostol).
Ukukhipha isisu
Vumela ukufisa, igama lesibili lokukhipha isisu, kuyindlela yokuhlinzwa yokuphazamisa ukubeletha. Iphethwe ngamagama amancane. Ukusebenza akupheli imizuzu engu-10. Ngosizo lwe-aspirator ekhethekile nge-tip, odokotela basebenzisa isisu se-fetal esiqeshini se-uterine. Kwenziwa ngokudala i-vacuum. Ngenxa yokuntuleka koxhumano oluqinile phakathi kombungu nodonga lwe-uterine, inqola ilula. Ukungahleleki kwalendlela kuyindlela yokukhishwa okungaphelele kwamathambo e-fetal avela emgodini we-uterine. Ngenxa yalokho, kukhona ingozi yokutheleleka kwesibeletho.
Ukukhipha isisu
Lolu hlobo lokukhipha isisu lusetshenziswa ezikhathini zesikhathi esidlule, lapho umbungu ungakwazi ukushiya isigcawu sombeletho ngokuzimela (ngenxa yobukhulu bayo). Ukusebenza kwenziwa ngokusebenzisa i-anesthetics. Ekhuluma ngokuthi lolu hlobo lokukhipha isisu luvela kanjani, odokotela banaka iziguli ukuba zifane nokusebenza okuvamile ohlelweni lokuzala. Ngemuva kokufakwa kwezibuko zesisu, yenza ukwandiswa komlomo wesibeletho. Uma ufinyelela emgodini we-uterine, i-curette isetshenziselwa ukuqothula okuphelele - ukususwa kweqanda lesisu kanye ne-endometrium.
Ukukhipha isisu - ukulethwa kokufakelwa
Ekhuluma ngokuthi ukukhipha isisu kwenzeka kanjani ngasekugcineni, odokotela babhala ukungabi khona kwamathuba okuqhuba inqubo ngesifiso nje somfazi okhulelwe. Ukuze wenze ukuphathwa okunjalo, izizathu ezinhle ziyadingeka. Ukukhethwa kwezindlela zokwenza lokhu kuxhomeke esimweni sowesifazane, ukutholakala noma ukungabikho kwezifo ezingapheli. Uma kungekho ukuphikisana, isisombululo esikhethekile (i-chlorine ye-sodium hypertonic) ifakwe ku-amniotic fluid nge-cervix, ebangela ukufa komntwana. Isinyathelo esilandelayo egazini labesifazane abakhulelwe lijova ngezidakamizwa ezandisa ukwelapha kwesibeletho.
Ukuphazamiseka kokukhulelwa ngamakhambi abantu
Ukukhipha isisu ekhaya kuyindlela eyingozi, yokusongela impilo. Izindlela ezifana nokugeza okufudumele ne-mustard powder, ukuvakashela ukugeza, ukuphakamisa izisindo, kungathinta impilo yabesifazane. Lezi zimbangela zenza ukuqhuma kwegazi ezingxenyeni zomzimba. Ukucindezela okwandayo ngaphakathi kwezitsha ze-pelvis encane, okubangelwa yizinyosi ze-uterine, ngenxa yalokho umbungu oxoshwa ngaphandle.
Kumele kucatshangelwe ukuthi izakhi zokukhipha ezisetshenzisiwe azikwazi ukuholela njalo kumphumela we-100%. Ngenxa yalokho, kukhona ingozi yokutheleleka okuthelelekile - izindawo zezicubu zombungu ezihlala emgodini we-uterine ziqala ukudala. Isimo sidinga ukungenelela kwezokwelapha, ukuhlanza igumbi lesisu. Ngaphezu kwalokho, kukhona ingozi yokuthuthukisa ukuphuma kwegazi uma usebenzisa abantu abortifacients kanye nezindlela. Ukuntula ukunakekelwa okufanelekayo kwegazi kungaholela ekufeni.
Izinkomba zokukhipha isisu
Ukukhipha isisu esifushane kuvame ukwenziwa ngesicelo sowesifazane ngokwayo. Nokho, kukhona okuthiwa izinkomba zokukhipha isisu. Zihlukaniswe zibe ezokudokotela nezenhlalakahle. Owokuqala uhlanganisa izifo ezingavumelani nokuphila kwe-fetus - kukhona ukukhulelwa kwesisu, ingane izalwa enezimo ezimbi nezibi. Ukukhipha isisu kungahle kubekwe imishanguzo, lapho leyo nqubo yokukhulelwa ingathandeki emzimbeni wesifazane - isisu esikhumbeni esincane, ukukhulelwa kwesisu okwakamuva.
Izizathu zenhlalo zisetshenziselwa ukubhekisela kulezo zizathu ezidingekayo, kokubili impilo yomama, nezimo zokuphila kwakhe - imindeni engasebenzi, ukutholakala kwezifo zofuzo ezakhiweni. Ezimweni ezinjalo, ikhomishana yezokwelapha inquma ukukhipha isisu. Kulokhu, isifiso sowesifazane ngokwawo siphathwa. Uhlu lwezinkomba zokukhipha izisu ngenxa yezizathu zomphakathi luhlukile emazweni ahlukene, futhi kuchazwe ngendlela yoMnyango wezeMpilo.
Ukuphazamiseka kokukhulelwa ngenxa yezimo zezokwelapha
Ukuphazamiseka kokukhulelwa ngokufisa okuzenzakalelayo kwenziwa futhi ngezizathu zezokwelapha. Lokho kuboniswa emibhalweni evamile yoMnyango wezeMpilo. Uma owesifazane ene-pathology noma engakwazi ukuthwala umntwana, usuku lomsebenzi luqokwa. Ukukhethwa kwendlela kuncike esikhathini sokubeletha, ukutholakala kwamathologi ahambisanayo. Phakathi kweziqondiso ezivamile zezokwelapha zokuphazamiseka kokukhulelwa yilokhu:
- isigaba esisebenzayo sesifo sofuba;
- i-rubella - uxhumane nesiguli kuze kube amasonto angu-12 wokukhulelwa, ukuntuleka kokuzivikela;
- izicubu zomzimba, ukwelashwa okubandakanya ukusetshenziswa kwe-X-ray;
- isifo sikashukela sinamafomu aqinile (ngomonakalo wempuphu);
- i-leukemia elula;
- ukuphazamiseka kwengqondo okukhulu;
- ukulutha izidakamizwa;
- i-meningitis, i-encephalitis;
- isithuthwane esinesimo esinqunyiwe sokuqothulwa njalo;
- izinkinga zenhliziyo;
- isilonda esiswini ngegazi;
- isifo sofuba nesibindi;
- i-glomerulonephritis.
Ukuphazamiseka kokukhulelwa ngokusho kwezinkomba zomphakathi
Ngaphambi kobufakazi obunjalo, ukuphazamiseka kokukhulelwa ngamaphilisi kwenziwa esibhedlela. Uhlu lwezinkomba zomphakathi lungase luhluke, futhi kuxhomeke ezweni lokuhlala kowesifazane okhulelwe. Ngakho emazweni e-CIS, izinkomba zomphakathi eziyinhloko zokukhipha isisu yizi:
- ukukhubazeka komyeni (iqembu lama-1,2);
- ukufa komnakekeli ngesikhathi sokukhulelwa;
- ukuhlala kowesifazane okhulelwe noma oshade naye ezindaweni zokulahla inkululeko, isinqumo sokwahlulela ngokushiywa kwamalungelo omzali;
- isehlukaniso ngesikhathi sokukhulelwa kwamanje;
- ukuba khona kwesimo sababaleki;
- ukungabi nendlu yokuhlala;
- Imali engenayo yomndeni (ngaphansi kwezinga lokuphila).
Ukukhipha isisu - ukuphela kwesikhathi
Ngeke njalo, uma kukhona isifiso somama okhulelwe, ukukhipha isisu kungenziwa - isikhathi salo msebenzi sizimisele. Uma kungekho izinkomba zezokwelapha, izinyathelo zokukhipha isisu zivunyelwe kuze kube amasonto angu-12. Lokhu ukukhipha isisu kuthathwa njengokuthi kusenesikhathi. Ingabe odokotela bangakwazi futhi kamuva - amasonto angu-12-22, uma kukhona imithi. Kuncike esikhathini sokubeletha, indlela yokuhlinzekwa kokuhlinzwa ikhethiwe. Ekhuluma ngendlela ukukhipha isisu kwenziwa ngesikhathi esifushane, odokotela babiza ukwelashwa nokukhishwa kwesisu.
Ukukhipha isisu kuqala
Uma owesifazane efisa ukuqeda ukukhulelwa ekuqaleni, odokotela basebenzisa isisu sokukhipha isisu, emigomo lapho kufika amasonto amahlanu wokubeletha okubandakanya. Odokotela bangakwazi ukuxilonga ukukhulelwa nge-ultrasound emavikini amathathu. Uma usola ukukhulelwa okungafisi, kufanele uxhumane nomjozi wakho wezifo. Ukungabikho kokuhlinzwa kwe-hardware, kuyinzuzo yokukhipha isisu, imiphumela engayitholi imvelo.
Ukukhipha isisu kungenzeka kuze kube amasonto angu-7 . Unomsebenzi omkhulu kunalawo angenhla, kepha kunezingozi zokuhlukumezeka ezizindongeni ze-uterine. Ngokuvamile, okwesikhashana, isifiso singasetshenziswa njengendlela yokulawula i-medabort. Ukususwa okuphelele kwezinsalela zezicubu zamabryonic kuvimbela ukuthuthukiswa kwezinkinga zesimo sokuvuvukala nesifo esithathelwanayo.
Ukukhipha isisu esikhathini esikupheleni
Ukutshela ukuthi singakhipha kanjani isisu ekuqaleni, siyaqaphela ukuthi kungenzeka ngezintathu ezintathu. Ukuphazanyiswa kokukhulelwa ngasekugcineni kungenzeka kuphela ngenxa yezizathu zezokwelapha. Inqubo ngokwayo ifana nokuzalwa - ukuvuselelwa kwenqubo yokuzalwa kwenziwa futhi. Uma kunesidingo sokususwa kwesibalo esiphuthumayo, i-caesarean (engavamile) ingasetshenziswa. Ekusetshenzisweni kokusebenzisa ukusetshenziswa kwesidumbu noma isingeniso se-transcervical yezixazululo ezikhethekile (ngokusebenzisa udonga lwesisu noma i-uterine neck).
Ngaphambi kokukhipha isisu, i-catheter ekhethekile ifakwe emgodini wezintambo, ngemva kwalokho isilonda sesisu sifike futhi siphucwe, isisombululo se-hypertonic singenwe. Ukubalwa kwe-fluid edingekayo kwenziwa ngokucabangela isikhathi sokubeletha - 6 ml ngesonto elilodwa. Esikhundleni sesisombululo se-hypertonic sodium chloride, i-glucose ivame ukusetshenziswa isisombululo se-20%. Ngemuva kwalokhu, izidakamizwa ezivusa ukuchotshozwa kwezibeletho zenziwa.
Ukukhipha isisu - izinkinga
Izinkinga emva kokukhishwa isisu kwenzeka ezinsukwini ezimbalwa emva kokuphathwa. Zingaxhunyaniswa, kokubili ukuqaliswa okungalungile kwe-algorithm yokukhipha isisu, kanye nenkathi yokuphumula. Phakathi kwezinkinga ezivame ukukhipha isisu:
- ukuphuma okukhulu;
- ukuguqulwa kwodonga lwe-uterine;
- isizinda esingaphelele;
- izinqubo zokuvuvukala ohlelweni lokuzala.
Imiphumela yokukhipha isisu
Ayikho uhlobo oluphephile lokukhipha isisu. Ngesikhathi esifanayo, akukho ukuthembela kwemiphumela yokukhipha isisu. Akuphephile futhi ukubiza isisu sokukhipha isisu, imiphumela okungaba yinkinga emva kwezinyanga ezimbalwa noma iminyaka. Ngokuvamile, unomlando wokukhipha isisu, abesifazane benza izikhalazo mayelana nokuphulwa komjikelezo wesimiso: ukuhlala njalo kulahlekile, izinguquko zevolumu. Ukuhluleka kwe-Hormonal kwenzeka ngaso sonke isikhathi, kungakhathaliseki ukuthi owesifazane uphonswa kanjani. Iphula ngokuqondile umsebenzi wezinhlayiya. Ukukhubazeka kwabo kubangela ezinye izifo nokukhathazeka:
- i-endometriosis;
- i-myoma ;
- i-endometrial hyperplasia;
- i-polycystic;
- izinqubo zezinto eziphilayo ezinkambisweni zokuzala;
- ukwephulwa komsebenzi wokuzala (ukungasebenzi);
- ubuthakathaka bezixhobo zamathambo yomlomo wesibeletho;
- Ukwakhiwa kwezibazi emasongweni omzimba (emva kokushaya).