Igama elithi "ukukhipha isisu ngokuzenzekelayo" ku-obstetrics ngokuvamile kuvame ukubhekisela ekubhekaneni nenqubo yokukhulelwa, lapho ukuphazanyiswa kwalo kwenzeka khona kuze kube amasonto angu-22. Ukuqedwa kokuzenzekelayo kokubeletha akuvumeli ingane ukuba ifike emvuthweni ovuthiwe, ukufa kwayo kuvele. Cabangela ngokuningiliziwe izimbangela zokuphulwa, izimpawu, izindlela zokwelapha.
Kungani ukukhulelwa kwesisu kwenzeka?
Izizathu zokukhipha isisu ngokuzenzekelayo zihluke kakhulu kangangokuthi kunzima ukucacisa ngqo ukuthi ubani obangela ukukhulelwa kwesisu. Phakathi kwezizathu eziyinhloko zaso ezinyathelweni zokuqala zokubeletha, odokotela babiza ukukhubazeka kwe-chromosomal. Izingqinamba eziningi zezakhi zofuzo zenza ukungasebenzi kahle ekusebenziseni ibhukhimakhi ye-intrauterine yamalungu axial, ngenxa yalokho - ukukhulelwa kwesisu ekuqaleni. Phakathi kwezinye izizathu:
- ukuphazamiseka kwesistimu ye-endocrine - ukungabi khona kweprogesterone , hypothyroidism;
- izifo ezithathelana ngokuzenzakalela kwabesifazane (antiphospholipid syndrome);
- ukungabikho kokuzalwa okungenasifo esibelethweni ohlelweni lwesimiso sokuzala - i- bicornic uterus , ukutholakala kwe-septum emgodini we-uterine;
- izinqubo zokuvuvukala nezindlala ezincelweni - i-myoma, ukunamathela, i- endometritis , i-adnexitis, i-oophoritis;
- ukuvela kwezisu ku-anamnesis;
- izinqubo ezithathelwanayo emzimbeni - chlamydia, mycoplasmosis, toxoplasmosis, umkhuhlane, okungenzeka ngemuva kokukhulelwe.
Ingozi yokukhulisa isisu okuzenzekelayo isanda kakhulu lapho (ukukhipha isisu kuqala):
- ukukhulelwa kwesisu okujwayelekile;
- ukukhulelwa okuningi;
- I-Rhesus-impikiswano;
- ukutholakala kwesifo sikashukela kumuntu wesifazane;
- ukwehluleka kwenqunu;
- ukwehluleka kwe-folic acid emzimbeni;
- ukutholakala kwama-IUD ngesikhathi sokukhulelwa.
Ukushada indiva ekukhulelweni kokuqala
Isongo sokukhulelwa kwesisu ekuqaleni kwezinyathelo zokubeletha kuvame ukuhambisana nokuphulwa kwenqubo yokufakelwa. Kulesi simo, ukwehluleka kwenzeka esiteji sesingeniso seqanda lesibusiso emdongeni wesibeletho. Ngenxa yalokho, inqubo ebhubhisayo ibonakala, okuholela ekufeni kwe-fetus ezayo. Ngaphezu kwalokho, ukukhipha isisu ngesikhathi sokuqala kungabangelwa izifo ze-hormonal. Izinga eliphansi le-hCG lidala ukwehluleka kokuthuthukiswa kombungu esigabeni sokuhlukana.
Ukuphutha kwesisu okuzayo
Akuqedwe ukwesatshiswa kokukhipha isisu ekuqaleni kokukhulelwa, emibhalweni elandelayo ikhubaza ukukhipha isisu kokukhulelwa Kubangelwa kaningi ngenkambo engalungile yenqubo yokukhulelwa noma ngokungahambisani nokubekwa kwabesifazane kulezincomo zezokwelapha. Ukushada indiva ngesikhathi samaviki angu-12-22 kuthiwa sekwephuzile. Izimbangela zokucindezeleka yizi:
- izifo ezingapheli zesistimu yokuzala;
- Izifo ezithathelwana ngokocansi - ureaplasmosis, chlamydia, i-gonorrhea;
- ukulimala kwesisu nesisu;
- ukwephulwa kwentuthuko yesisu.
Izimpawu zokukhipha isisu okuzenzekelayo
Ekhuluma ngezibonakaliso zokukhulelwa kwesisu ekuqaleni kwezinyathelo zokukhulelwa, odokotela phakathi kwezimpawu zokuqala ezibizwa ngokuthi uterine igazi. Ngokukhipha isisu, izibilini zamabriyoni ziyasuswa odongeni lwe-uterine, lapho ubuqotho bemithambo yegazi buphazamiseka khona, okuhambisana nalokhu:
- ukucindezela izinhlungu emathunjini aphansi;
- i-tachycardia;
- i-blanching yesikhumba;
- isiyezi;
- ubuthakathaka;
- ukunciphisa ukucindezelwa kwegazi.
Izigaba zokukhipha isisu okuzenzekelayo
Kuye ngokuthi yisiphi isithombe somtholampilo esibonakala kule nkinga, ababelethisi bahlukanisa izigaba ezilandelayo zokukhipha isisu okuzenzekelayo:
1. Ukusongela ukukhipha isisu okuzenzekelayo. Lesi sigaba sibonisa ingozi enkulu yokuphazanyiswa kokuqala kokubeletha. Kulokhu, lo wesifazane ulungisa ukubonakala kwesimpawu sokuthi:
- Ukunciphisa ubuhlungu esiswini esingaphansi, ukunikeza emuva kwe-back;
- ukuphahlazeka okuvela emkhathini.
Uma owesifazane ehlolwe ngumjozi wezifo zogciwane, kukhona ukwanda kwethemikhali ye-myometrium ye-uterine, ehleliwe kanye ne-palpation ngokusebenzisa udonga lwangaphakathi lwesisu. I-cervix ayifinyelelwanga ngalesi sigaba, i-pharynx yangaphakathi ivaliwe ngokuphelele, futhi ubukhulu bomzimba wesibeletho buhambisana nesikhathi sokubeletha. Uma uthola izinkinga kule nkathi, umphumela uyajabulisa.
2. Kwaqala ukukhipha isisu. Efaniswa nokubonakala kokuphuma kwegazi okuvela kumgogodla womzimba. Ukuhlolwa kwesiguli esihlalweni sobubeleko kusiza ukusungula isimo se-pharynx, esivulwe kancane. Kwaqala ukukhipha isisu okuzenzekelayo kuhambisane nokuvulwa okuncane komlomo wesibeletho, kodwa ukuphazamiseka kwemithi ye-myometrium engekho.
3. Ukukhipha isisu kule nkambo. Ngalesi sikhathi, odokotela balungiselela ukubonakala kokuvundisa okujwayelekile kwesibeletho. Kulesi simo, ubukhulu begciwane lokuzala linciphisa - ubukhulu besibeletho abuhambisani neminyaka yobudala. Lapho ehlolwa, udokotela ulungisa ukuvulwa kwengqamuzana yangaphakathi nangaphakathi, futhi izakhi zeqanda lesisu noma umbungu zikhona emgodini womlomo wesibeletho noma emgodini wesifazane.
4. Ukukhipha isisu esingaphelele. Kubonakala ngokulibaziseka emgodini wesibindi sezingxenye zomuntu ngamunye weqanda le-fetal, ngenxa yokungabi khona kwezingqinamba ze-uterine, ukuvalwa kwesibeletho se-uterine. Ngenxa yalokho, ukuphuma kwegazi okuqhubeka isikhathi eside kukhula, okuholela ekulahlekelweni kwegazi elikhulu.
5. Gcwalisa isisu. Ivela ezinkathini eziseduze, ihambisana nokukhishwa okugcwele kweqanda lomntwana wesisu kanye ne-embryonic membranes. Isibeletho sibheka ngamandla, kanti ubukhulu bayo bufushane kunesikhathi. Nge-ultrasound, i-contours iyacacile, ayikho izicubu ezisele emgodini.
Ingabe ukukhipha isisu ngaphandle kwegazi?
Uma sicabangela izimpawu zokukhulelwa kwesisu ekuqaleni, kufanele kuthiwe kwezinye izimo, ukuphuma kwegazi kungase kungabi khona. Lokhu kwenza kube nzima ukuhlolisisa i-pathology. Isimo esifanayo singenzeka ngenhlobo engaphelele, lapho iqanda lesisu eliyisisu lingashiyi i-uterine cavity ngokuzimela. Odokotela bachitha ukuhlunga, ngaphandle kokutheleleka - i-antibioticotherapia ikhethwe.
Ukushada indiva - yini okufanele uyenze?
Uma kunezinhlungu zokudweba esiswini, ukukhulelwa kwamanzi okuphuma emzimbeni, ukuwohloka kwenhlalakahle jikelele, owesifazane okhulelwe kufanele abonane nodokotela. Ngokuya ngesiteji sokukhipha isisu, odokotela bahlakulela amaqhinga wezokwelapha. Ezimweni eziningi, kunciphisa:
- ukususwa kwe-membranes, izicubu ezivela emgodini wesibindi - ukuhlanza emva kokukhulelwa kwesisu kukhonjiswe ukukhipha isisu okungapheli;
- ukubuyiselwa kwevolumu yegazi elahlekile;
- ukuvimbela ukutheleleka kohlelo lokuzala (ukulwa namagciwane);
- Ukwandisa ukukhulelwa kungenzeka ngokususa isisu, lapho inqamuzana leqanda lomntwana elifayo lingenzeki.
Ukukhulelwa emva kokukhipha isisu okuzenzakalelayo
Ngemuva kokukhulelwa kwesisu, izifo zezinkinga zokubeletha zeluleka ukuba zigweme ukuhlela ukukhulelwa. Kulesi simo, abesifazane batuswa ukuba basebenzise izisu zokuvimbela ukuvimbela ukubeletha okulandelayo. Kuthatha okungenani izinyanga ezingu-6 ukubuyisela umzimba. Okwamanje owesifazane angakwazi ukulungiselela ngokuhlelekile ukuhlela:
- ukuhlolelwa izifo ezifihliwe;
- Ukuze kudlule noma kwenzeke ukuhlolwa kokusungulwa kwesizathu sokukhipha isisu.