Ukuphazanyiswa kokukhulelwa ngokweqile kungenzeka kuphela ezimweni ezihlukile. Isifiso sowesifazane ngesikhathi esisodwa akuyona inkomba yokungenela okuhlinzekwayo. Odokotela bayesaba imiphumela engalungile yokukhipha isisu, okuyinhloko okungukuthi ukungabi nabantwana okungezansi.
Ingabe ukukhipha isisu kwenziwa ngosuku olwedlule?
Ukuphazamiseka kwesisu ngokucela owesifazane kungenziwa ezinyathelweni zokuqala zokuthuthukiswa komntwana. Inkathi yakamuva yokuqeda ukukhulelwa okuqala ngumama ngamaviki angu-12. Ukukhipha isisu emva kwalesi sikhathi kuthiwa sekuphuzile futhi kwenziwa kuphela ezimweni ezihlukile. Ukukhethwa kwendlela indlela yokukhulelwa ephazanyiswa ngayo kwenziwa ngesilinganiso samanje, iminyaka yobufazi okhulelwe kanye nesimo sempilo yakhe. Ngakho-ke, ngemva kwamasonto angu-20 wokubeletha, odokotela abasebenzisi ama-classical avortive techniques, kodwa benza ukuzalwa kokuzalwa.
Izinkomba zokukhipha isisu
Isinqumo sokuthi kunesidingo sokukhipha isisu esikhathini esizayo sithathwa yikhomishini yezokwelapha. Odokotela abangenayo (udokotela wezifo zezinkinga, ochwepheshe bezinsizakalo emkhakheni obangela isidingo sokukhipha isisu (isazi sezenhlalo, abamele izinhlangano zombuso) bahlolisise imiphumela yokuhlolwa kwezokwelapha, isimo somphakathi lapho owesifazane okhulelwe ekhona. Isinqumo sokugcina ngesidingo sokuphazamisa ukubeletha emva kwamasonto angu 12 singathathwa ngesisekelo se:
- izinkomba zezokwelapha;
- izinkomba zenhlalo.
Izinkomba zezokwelapha zokukhipha isisu
Lolu hlobo lwembonakaliso lokuqeda ukukhulelwa ngesikhathi esilandelayo kuthathwa kuqala ekuqaleni. Ezimweni eziningi, zihlotshaniswa nobukhona besifazane okhulelwe abanezifo ezingamvimbela ukuba angaphumi futhi abelethe umntwana. Ngaphezu kwalokho, ukukhipha isisu kwesikhathi sekwephuzile kungaboniswa ngokukhomba ukukhubazeka komntwana kanye nezinkinga zokuthuthukisa ukuthi, emva kokubeletha, kuzobangela ukukhubazeka kwengane noma ukufa. Phakathi kwezinkomba ezinkulu zezokwelapha zokukhipha isisu emva kwamasonto angu-12 yilokhu:
- izifo ezingokwengqondo nezingokwenyama zowesifazane okhulelwe;
- ukutholakala kwamathambo womlingiswa we-chromosome ebusweni, akuhambisani nokuphila;
- ukukhulelwa okubandayo ;
- izifo ezimbi ezikhulelwe (i-hematite, izifo ezibangelwa amagciwane, isifo sofuba);
- kungenzeka ukuthi ukufa komfazi okuqhubekayo nokuthuthukiswa kokukhulelwa.
Izinkomba zomphakathi zokukhipha isisu
Izizathu zomphakathi zokukhipha isisu ngokwemibandela yamuva zibangelwa ukutholakala kwezici ezingalimaza izimo zokuphila zezingane ezikhulelwe noma ezizayo. Ngokuvamile, odokotela bayazicabangela lezo zindaba zomphakathi ezavela ngokuqondile ngesikhathi sokukhulelwa ngokwazo:
- ukufa komlingani;
- isahlukaniso;
- ukuboshwa komunye wabazali wengane.
Ngaphezu kwalokho, kunezici eziningi zezenhlalo ezingacatshangelwa lapho zikhetha ukukhipha isisu, kodwa ukutholakala kwazo akuyona inkomba eqondile yokuphazanyiswa kwesisu:
- ukuntuleka kwezindlu;
- ukuba khona emndenini wezingane ezingaphezu kwezingu-3;
- unyaka womama ozayo uneminyaka engaphansi kwengu-18.
Ukukhipha isisu kwenzeka kanjani ngosuku olwedlule?
Izindlela zokukhipha isisu ngasekugcineni azifani nezezo ezisetshenziswa odokotela ekuqaleni kwezinyathelo zokubeletha. Kodwa-ke, ukuphazanyiswa kokukhulelwa ekupheleni kwamaphilisi okuphela kwesikhathi akukwenziwa. Ukuzikhethela kwezindlela kwenziwa yikomitjhini yezokwelapha ngesisekelo semiphumela yokuhlolwa, ngokucabangela isikhathi sokukhulelwa kanye neemfanelo zenkambo yayo. Ngamanye amasu anezici zalo siqu, inqubo ethile. Phakathi kwezindlela ezisetshenziselwa ukuphazamisa ukukhulelwa, emva kwamasonto angu-12 usebenzise:
- Ukuphathwa kwe-fluids kwamanzi.
- Ukuphoqelelwa komlomo wesibeletho.
- Ukubeletha kokufakelwa .
- Isigaba esincane se-cearean.
Indlela yokwethulwa kweziphuzo zangaphakathi
Ukukhipha isisu ekukhulelweni kwesikhathi eside nokusetshenziswa kwezixazululo ze-hypertonic kuyindlela ejwayelekile. Indlela yokwenza le ndlela yokuphazamisa ukubeletha ihlotshaniswa nenguquko kumthamo we-amniotic fluid, ingcindezi yayo ye-osmotic. Ngenxa yalokho kuguqulwa, kukhona ukwehlukaniswa kwezakhiwo zemisipha yesisu ngokunciphisa okulandelayo.
Ukwandisa ithoni lesibeletho kuleso simo, odokotela bahlobanisa kanye nomphumela onobungozi wezinto eziqala ukuvela ngemuva kokuba ingane ifile (ngenxa yethonya lesisombululo se-hypertonic). Ukunyakaza okunamandla kwesivumelwano se-myometrium kuholela ekuxosheni i-fetus ngaphandle, ngenxa yalokho ukukhulelwa kuphazamiseke ngokuphelele. Ngendlela yayo, le ndlela ifana nokuqedwa kwezidakamizwa zokukhulelwa, okungasetshenzisiwe emibhalweni yamuva. Ngemva kwenkambiso, odokotela bahlola ngokucophelela umgodi wesibindi ukukhipha ukuhlala kwezinthambo zesisu.
Ukuxuba nokuphuma
Ukukhishwa kwesisu kokukhulelwa ngezikhathi ezidlule ngenxa yezizathu zezokwelapha kuvame ukuqhutshwa ngendlela yokuhlanzwa nokukhishwa. Isikhathi esihle sokukhipha isisu ngamaviki angu-15-18. Okokuqala, udokotela wenza ukuxilongwa kokufakelwa komsele womlomo wesibeletho, usebenzisa izinsimbi zokuhlinza ngokukhuliswa kancane kancane kwe-dilator (dilatation).
Ngemuva kokuthola indawo yokubeletha, odokotela benza isisombululo se-fetus kanye nokukhishwa kwezingqimba zesisu. Ekupheleni kwalesi sigaba, baqala ukuphuma - ukukhipha isisu kuphelelwe ngaphandle ngosizo lokuncibilika okuphuthumayo. Ukususwa kokuqala nge-dilatation kubonakala njengendlela emnene yokukhipha isisu ezikhathini ezizayo futhi kunconywa yi-WHO njengendlela ehlukile yokukhipha isisu.
Isigaba esincane se-cearean
Lolu hlobo lokukhipha isisu esikhathini esilandelayo aluhambisani neze learean evamile. Ukufinyelela embuseni kungukungcoliswa kwendonga yangasese yangasese, okulandela ukuthi isithelo sithathwe. Ukusebenza kwenziwa ngaphansi kwe-anesthesia jikelele. Le ndlela ayivame ukusetshenziswa, uma kunqatshelwe indlela eyachazwe ngenhla. Ngesikhathi sokusebenza, kunengozi enkulu yokugaya okungalawuleki, ngakho-ke isinqumo sokuyithatha sithathwa uma kunesongo empilweni yowesifazane uqobo.
Indlela yokulethwa kokufakelwa
Uma kunesidingo sokukhipha isisu ngesikhathi esilandelayo, emva kwamasonto angu-20 , odokotela bashintsha amaqhinga okulethwa kwezidingo. I-fetus kuleli cala ayixoshwa emgodini we-uterine, kodwa izinqubo zenziwa ukuthi kubangelwe ukuxoshwa okuzimele ngaphandle. Ukukhuluma ngokuthi ukukhipha isisu kwenzeka kanjani ekupheleni kwesikhathi, odokotela bavame ukusebenzisa igama elithi "ukuvuselelwa kokubeletha ngaphambi kwesikhathi".
Esikhathini sokuphela kwesikhathi, ukukhipha isisu akubizwa ngokuthi ukukhipha isisu kusuka ekubukeni kwesimo sengqondo: i-fetus ngalesi sikhathi ingakwazi ukubizwa ngokuthi ingane, futhi umama ozayo usenalo uthando lomntwana. Ukuhlanganiswa kwamahomoni akhe kwakha umqondo womama. Ukubeletha okufakelwayo kuqala ngokugqugquzela - bafaka i-prostaglandin emzimbeni, okwandisa ithoni ye-musculature ye-uterine futhi ibangele ukuchotshozwa. Ngenxa yalokho, umsebenzi wesizwe uqala.
Ukukhishwa emva kokuqedwa kokukhulelwa ngezikhathi zakamuva
Ukukhipha isisu kuhlale kuyimbangela yomzimba, kunciphisa igciwane, ngakho kubalulekile ukuqapha isimo sempilo yowesifazane. Uhlelo lokuzala ludala indawo enhle yokuthuthukiswa kokutheleleka nokuvuvukala. Njengombonakaliso wesimo sesimiso sokuzala, ukukhishwa emva kokukhipha isisu kuhlolwa. Ngokujwayelekile, zivela ngosuku lwesithathu emva kwenkambiso, ingaba negazi elincanyana, kodwa ungalizwa. Izinguquko kulezi zimingcele zingabonisa ukutheleleka. Ukukhishwa okwesibhakabhaka nephunga lokubola kufanele kube isizathu sokuxhumana nodokotela.
Ukuthuthwa okubomvu okwenzeka ngemuva kokukhulelwa okuphelile kungaphazamiseka kuze kube yizinsuku ezingu-10. Kwezinye izimo, abesifazane bangase babone ukubonakala kwezindwangu zamagazi (ukubhoboza kwenzeka ngaphansi kwethonya lokushisa komzimba). Umthamo wezinhlamvu ezinjalo ulinganiselwe, futhi wona ngokwawo awahambisani nezinzwa ezibuhlungu esiswini esingaphansi noma endaweni yangasese. Ukushintsha izimfihlo ukuze kube mnyama omnyama kungase kubonise izintambo ngaphakathi kwesibeletho.
Ukubuyiswa ngemuva kokukhipha isisu ezikhathini ezizayo
Ubude besikhathi sokubuyiselwa kunqunywa indlela yokuqeda ukukhulelwa kanye nesikhathi esenziwa ngalo. Ukukhipha isisu esikhathini sekwephuzile kubonakala ukuhlukunyezwa okuphezulu nokucindezeleka komzimba. Ukukhipha ingcindezi yokuqala, owesifazane ungaphansi kokuqondiswa udokotela okhethekile esibhedlela. Ngokuvamile, ukuphumula okukhipha isisu kuhilela:
- Ukuvimbela ukulahlekelwa kwegazi.
- Ukukhishwa kwesifo sokutheleleka (ukwelashwa kwama-antibiotic, izidakamizwa eziphikisayo).
- Ukuhlolwa kwe-Instrumental kwendlela yokuzala yesifazane ukukhipha amakhemikhali e-fetal asele.
Imiphumela yokuphela kokukhulelwa ngasekugcineni
Ethakazelisa odokotela ngemiphumela engenzeka, abesifazane bazama ukuthola ukuthi kungenzeka yini ukukhipha isisu nokuthi kuyingozi kangakanani le nqubo. Izazi ze-gynecologists zithi le nqubo iyinto engathandeki kakhulu - izinkinga nemiphumela yokukhipha isisu kwangaphambilini kungavela emva kwezinyanga eziningana neminyaka. Njengoba kunikezwe isikhathi sokuthuthukiswa kwabo, odokotela bahlukanisa izixazululo ezinokwenzeka:
- Ukuqala- kwenzeka ngesikhathi senqubo yokuphazamiseka (ukukhishwa kwesisu, ukuphuma kwegazi).
- Ekhethiwe - ithuthuke kungakapheli inyanga ngemuva kokusebenza (endometritis, hematoma, ukuqhubeka kokukhulelwa).
- Ezikude - zivela ngemuva konyaka nangemva kwesikhathi (izinguquko zamacicatric in the pharynx yangaphakathi, umlomo wesibeletho, umonakalo we-endometrium, ukuphulwa kokungahambi kahle kwamatayipi wezintambo).