Igama elithi "ukukhulelwa kwesisu ngokujwayelekile" ku-obstetrics ngokuvamile kuvame ukusetshenziselwa ukuchaza isimo lapho izikhwama ezimbili noma ngaphezulu ziphazanyiswa ngokulandelana. Ngesikhathi esifanayo, ukuphulwa kungenziwa kokubili ngesikhathi esifushane naku-2-3 trimesters. Ake sicabangele le pathology ngokuningiliziwe, sizochaza izizathu.
Ukukhubazeka kokukhulelwa kokukhulelwa - izimbangela
Ukuxilongwa kwalolu hlobo lwadokotela kubonisa kaningi uma inqubo yokubeletha iphazamiseka ngesikhathi esifanayo 2 noma ngaphezulu izikhathi ezilandelanayo. Uma kutholakala ukukhulelwa kwesisu, izizathu ezahluke ngazo, odokotela benza ukuhlolwa okugcwele kwesimo sezingxenye zowesifazane okhulelwe. Ngokusho kwezokwelapha, lesi sifo sivela ngenxa yalokho:
- Okungajwayelekile kwe-Chromosomal. Cishe amaphesenti angama-60 kuwo wonke amacala okuphazanyiswa kwesikhathi sokubeletha ngenxa yalesi sici. Phakathi kwezimo eziphuthumayo ze-trisomy kukhona ama-chromosomes angu-18, 22, 14, ama-15. Lezi zifo ezivame ukudala ukukhulelwa komzimba ngesonto 12.
- Izinqubo ezizenzakalelayo. Ngamaphesenti angama-80 abesifazane abathintekayo kukhona ukuthuthukiswa kwe-interferon-gamma ekuphenduleni ama-antigens e-fetal okwamanje. Kufanele kuqaphele ukuthi ukukhubazeka okuphindaphindiwe kukwandisa ukuhlushwa kwama-antibodies okuthinta ama-envelops embryo egazini legazi lomama.
- Izimo ezicindezelayo. Ezimweni ezinjalo, ukukhiqizwa kwezinto eziyingxenye yempendulo yegciwane lengculazi kubonakala. Kodwa-ke, kunciphisa imithwalo yegazi ye-placenta, eyondla isisu.
- Ukuphazamiseka kwamahomoni. Kunezinhlobo eziningi zokungasebenzi kahle kwe-hormonal system eholele ekuphazanyeni: ukukhula okwenziwe ngama-hormone wesilisa wesilisa, i-hyperprolactinaemia, ukuphazanyiswa kwegciwane le-thyroid.
- Izifo ze-Anatomic zesakhiwo sezitho. Ngokusho kwedatha, izimo ezingavamile ekuthuthukiseni uhlelo lokuzala ziholela ekuthuthukiseni ukukhubazeka kwamacala angu-12%.
- Izinqubo ezithathelwanayo ezithathelwanayo ohlelweni lokuzala. Phakathi kwezifo ezijwayelekile ezithathelwanayo ezibangela ukuphazanyiswa kokubeletha nganoma isiphi isikhathi: i- mycoplasmosis , i-chlamydia, i-ureaplasmosis.
- Imiphumela yezinto zangaphandle (izingozi zomsebenzi, utshwala, i-nicotine).
Ukungafuni ukukhulelwa kokuqala
Ukukhulelwa kwesisu okusemthethweni ekuqaleni kwesibindi kuvame ukubhalwa kwabesifazane abasha abanemvelaphi engavamile ye-hormonal. Ngaphezu kwalokho, lezi zici ezilandelayo ziholela ekuphazamiseni inqubo yokubeletha ekuqaleni:
- ukungafani kwe-chromosomal ebusweni;
- izinhlobo ezimbi ze- toxicosis ;
- ukungajwayelekile esimweni sezitho zokuzala (ukufakelwa emva kokukhulelwa okuphumelelayo akunakwenzeka ngenxa yesimo somzimba esingajwayelekile).
Ukungafuni ukukhulelwa ngasekupheleni kwesikhathi
Ukuqiniswa kombuso, ukujwayelekile kwezigaba ezinyathelweni zamuva, kubangele ukuthuthukiswa okungajwayelekile kwezimo eziphuthumayo ezinyangeni ezimbili no-3. Kodwa-ke, akunakwenzeka ukukhipha ngokuphelele lokho. Ekupheleni kwesikhathi sokukhulelwa, ukukhulelwa kwesisu okuqhubekayo kukhula, izimbangela zazo zingase zilandele lokhu:
- ukungakwazi ukusebenza ngokweqile - ukuphulwa kwezinqubo zokwakheka nokukhula kwendawo yengane, ukusebenza kwayo;
- ukungakwazi ukusebenza komlomo wesibeletho ñ ukuvulwa komsele womlomo wesibeletho ngokuvamile kubangela ukukhipha isisu ngokuzenzekelayo nokuzalwa ngaphambi kwesikhathi;
- izifo ze-genitourinary sphere
- i-gestosis - isimo esihambisana nokuthuthukiswa kwe-edema, ukwanda kwegazi.
Ukuqaphela ukukhulelwa kwesisu
Ukuxilongwa ngokuthi "ukukhulelwa komzimba okuvamile" kwenziwa udokotela ngesisekelo semiphumela yokuhlolwa okuphelele. Ukuxilongwa kwalokhu kwephula kuhlanganisa:
- ukubonisana nge-geneticist;
- I-Ultrasound noma i-MRI yezitho zomzimba;
- i-endoscopy ye-uterine cavity;
- ukuhlolwa kwegazi ngezinga lamahomoni (TSH, FSH, progesterone, LH);
- ukuhlola igazi nge-cytomegalovirus, i-herpes;
- Ama-smears avela e-urethra nasesiswini;
- i-endometrial biopsy;
- ukuhlolwa kwegazi emzimbeni we-antispermal;
- Ukuhlolisiswa kwesandulela-ngcebo ku-thrombophilia.
Ukukhubazeka kokukhubazeka kokukhulelwa - ukwelashwa
Uma kutholakala "ukukhulelwa komzimba okuvamile", ukwelashwa kuqala ngemuva kokuba imbangela yesiguli ibonwe. Inqubo yokwelapha ngokuqondile ixhomeke kulesici esibangela ukukhubazeka. Inkambo yokwelapha yenziwa udokotela ngabanye ngesisekelo semiphumela yocwaningo. Ngokuvamile inqubo yokwelapha ide, iqukethe izigaba eziningana.
Ngakho-ke, uma owesifazane enezinguquko zesakhiwo esithombeni socansi esibangele ukukhulelwa kwesisu okuqalile ukukhulelwa okuqala, ukwelashwa kuhilela ukungenelela kokuhlinzwa ukuze kuqedwe. Ngobuthakathaka bendandatho emisipha emgodini womsele wesibeletho, odokotela bafaka izingxenye ezikhethekile ezivimbela umlomo wesibeletho ekuvuleni, ukuvimbela ukuzalwa ngaphambi kwesikhathi. Ngakho kungenzeka ukugwema izinkinga, ukulondoloza ingane.
Ngezinguquko ze-hormone, isisekelo sokwelapha isifo esinjalo njengesisu sokukhulelwa kokukhulelwa yisikhathi semithi yokwelapha. Ukungakwazi ukusebenza kwe-progesterone ngokuvamile kuvusa ukuthuthukiswa kokukhipha isisu okuzenzekelayo. Uma kwenzeka ukukhubazeka ngokwezakhi zofuzo okuphazamisa ukukhulelwa kungakhathaliseki ukuthi yiliphi igama, indlela kuphela yokuphuma nge-IVF usebenzisa i-ejaculate noma iqanda lomnikelo.
Ukukhulelwa okungaqondakali - ukubukeka kwenkambiso yanamuhla
I-genotyping hemostasis enekhanda lokukhubazeka yindlela ephakeme yokuxilonga lesi sifo, ngokukhomba i-thrombophilia. Ngalesi sifo, kunesimo esinqunyiwe sokubunjwa kwama-blood clots. Ngenxa yalokho, uketshezi kwegazi kunciphisa. Ngokuvamile lesi sifo siwufa. Ngaphandle kokugula okunjalo njengokwesisu okungajwayelekile, isifo sezakhi zofuzo singabangela:
- ukuphuza kwe-intrauterine ukukhula;
- ukungakwazi kahle kwamapayipi;
- i-toxicosis ephuzile.