Igama elithi "ukukhulelwa okubandayo" ngezigameko ezivame ukusetshenziselwa ukubhekisela ekubhekaneni nenqubo yokugaya, lapho ukufa kwezingane ezitholakala khona. I-pathology iqala ekuseni, kuze kube amasonto angama-20, kodwa kwezinye izimo, lesi sifo singenzeka ezinyangeni ezimbili no-3. Isiphetho esingenakuvinjelwa sesiyaluyalu ukukhipha isisu okuzenzakalelayo.
Kungani ukukhulelwa kumisa?
Odokotela abakwazi ukunikeza impendulo engaqondakali embuzweni, ukuthi kungani umntwana eyeka. Kukhona izici eziningi ezikwazi ukukhubaza lokhu kuhlasela. Ngokuvamile, odokotela bathi ngesikhathi esifanayo ngezizathu eziningana ezibangela ukukhula kokukhulelwa, ngoba akunakwenzeka ukuthola ukuthi yini eyabangela ukugqugquzelwa. Phakathi kwezimbangela eziningi zokwelashwa, odokotela bahlukanisa:
- izinqubo ezibangelwa amagciwane nezifo ezithathelwanayo emzimbeni;
- ukungahambisani ne-Rh factor ye-fetus nomama;
- ukwephula inqubo yokweqa igazi emzimbeni womama ozayo;
- ukutholakala kwamathologi wesibeletho;
- ukuba khona ku-anamnesis yokukhipha izisu;
- imikhuba emibi (utshwala, i-nicotine);
- izimo ezicindezelayo njalo;
- ukwenza IVF .
Ukukhulelwa okukhulelwe ekuqaleni kwesigaba - izizathu
Ezimweni eziningi, ukukhubazeka kuyaqala ekuqaleni kwe-intrauterine ukuthuthukiswa kombungu. Kulesi simo, odokotela abathintekayo basho izifo ezithathelwanayo zikamama:
- umkhuhlane;
- i-herpes;
- i-chlamydia;
- i-mycoplasmosis;
- i-toxoplasmosis;
- ureaplasmosis.
Echaza ukuthi kungani ingane ikhula ekuthomeni kokukhulelwa, odokotela kwelinye lezindawo zokuqala bafaka phambili nokuphazamiseka kwezakhi zofuzo emntwaneni. Ngokuvamile kuthinta izinqubo zokuthuthukiswa kwe-intrauterine kwezitho nezinhlelo. Ngenxa yalokho, amacebo ezinhlelo ze-cardiovascular and respiratory develop, ezingavumelani nokuphila. Ingane ifa, futhi ukukhulelwa kuyama.
Ukukhulelwa kwe-Fetal ku-trimester yesibili - izizathu
Ukukhulelwa okukhudlwana ku-trimester yesibili kuningi. Ukuthuthukiswa kwakhe kuvame ukuhambisana nokuziphatha kwabesifazane abakhulelwe ngokwabo. Ukungahambisani nombuso osungulwe, ukunganakwa kwezikhundla zezokwelapha, okuhlangenwe nakho okuvamile kanye nokucindezeleka kuyithinta kabi inhlalakahle jikelele yowesifazane kanye nenqubo yokukhulelwa. Ngenxa yezimo ezinjalo, kuvame ukwanda kwezifo ezingapheliyo. Phakathi kokuhlukunyezwa okungabangela ukukhula kokukhulelwa:
- ukuphazamiseka kwesimiso senhliziyo;
- isifo sezinso;
- ukwehluleka ohlelweni lwe-endocrine;
- isifo sikashukela.
Ukukhulelwa okukhulelwe ku-trimester yesithathu - izizathu
Lapho ukukhulelwa okubandayo kuvela ku-trimester yesithathu, izimbangela zayo zivame ukuhambisana nokushintsha okungazelelwe empilo kamama. Ngokuvamile, ukukhubazeka kwenzeka kubantu besifazane abanezinqubo ezingavamile zokuvuvukala emzimbeni. Ukuze kuholele ukukhulelwa ngesikhathi esizayo, ukuphazamiseka ohlelweni lwe-endocrine nakho kungenzeka: isifo sikashukela, ukungasebenzi komzimba wegciwane - ngokuvamile kubhekwa njengezimbangela eziyinhloko zesifo. Noma kunjalo, asikwazi ukukhipha ngokuphelele izimbangela eziqondile zokukhula:
- ukuhlukunyezwa kwesisu;
- ukuphuza utshwala;
- ukucindezeleka okukhulu;
- ukulutha izidakamizwa.
Ungayiqonda kanjani ukuthi ingane iqhwa?
Isici se-pathology ukungabi khona kwezimpawu ezinkathini zokuqala. Izimpawu zokuqala zokukhulelwa okubandayo zingabonakala ezinsukwini ezimbalwa, nangemva kwamasonto amabili. Ukuze kutholakale ukuphulwa kwesikhathi, owesifazane okhulelwe kufanele aqaphele isimo sakhe sempilo, ukwazi izimpawu zokukhulelwa okubandayo. Eyokuqala, ngisho nokusola okusobala kuyadingeka ukuba ukhulume nodokotela ozofika.
Ukukhulelwa okukhukhulayo - izibonakaliso ku-trimester yokuqala
Ezimweni eziningi, ukukhulelwa okubandayo kuhambisana nokubonakala kwezibonakaliso ezithile ezisiza ukusola ukuthi akulungile. Izimpawu zokukhulelwa okufriziwe ezinkathini zokuqala azikho izici ezikhethekile, ngakho omama ngokwabo bangabathatha ngezikhathi zesikhashana. Izimpawu zokuqala zokukhulelwa okuqhubekayo ngesikhathi esifushane zivela kanje:
- Ukususwa ngokungazelelwe kwe-toxicosis - ukuhlanza okuqhubekayo kanye nokucabangela, okwahlupha umbhangqwana okhulelwe izinsuku ezimbalwa, ulahlekile.
- Ukubukeka kwezinhlungu ezibukhali emathunjini aphansi, okungazinzile, kunomqondo ophansi futhi kungagcizelela.
- Ukunyamalala kokuvuvukala kwezigulane ze-mammary nokunciphisa ivolumu yabo - isifuba siba ngesayizi ofanayo, ubuzwe bezinsipho buyancipha.
- Ukusuka kwamanzi okuphuma emzimbeni - kuhlotshaniswa nokwenqatshwa kweqanda lesisu.
- Ukunciphisa kancane kancane ekushiseni okuyisisekelo - lapho kuqala ukukhulelwa, le nkhomba isethwe kuma-37 degrees, kodwa ngokukhula kwehle kuye kwaba yi-36.7-36.8.
- Ukushisa komzimba okwandisiwe, ukubola, ubuthakathaka kubangelwa ukubhujiswa kwezingqimba zomntwana.
Ukukhulelwa okukhukhulayo ku-trimester yesibili - izimpawu
Uma ingane ishona ku-2 trimester, izimpawu zowesifazane zifana nalokho okubalwe ngenhla. Ngesikhathi esifanayo, kunezibonakaliso ezifana nokuqeda ngokuzumayo ukunyakaza kwesisu. Uma ngaphambilini umama olindelekile ebona ukuzamazama okuphindaphindiwe nokufiphaza isisu esiswini, khona-ke ekuthuthukiseni ukukhubazeka abakho. Ukuze uhlolisise ukwephulwa kwesikhathi futhi uthathe isenzo, odokotela beluleka ukuthi baxhumane nesikhungo sezokwelapha uma ingane ingazizwanga izikhathi ezingaphezu kuka-12 ngokulandelana.
Ukukhulelwa okukhukhulayo ku-trimester yesithathu
Ukuze ugweme ukucindezeleka, wonke umama ozayo kufanele acabange ukuthi lesi sifo sibonakala kanjani emibhalweni yamuva nokuthi yiziphi izimpawu uma isisu sifundiwe. Esikhathini eside, ingane ayisasebenzi kakhulu, yenza ukunyakaza okuncane, ngakho ukukhulelwa kwentombazane kungenziwa iphutha ngesenzakalo esivamile somzimba. Noma kunjalo, ezimweni eziningi, izinyathelo ezingekho zihlanganiswe yi:
- ukubona;
- ukucindezela izinhlungu emathunjini aphansi;
- ukuhlanza okukhulu;
- ukushisa komzimba okwandisiwe;
- ukuwohloka kwenhlalakahle jikelele;
- ukunciphisa ukucindezelwa kwegazi;
- ukwanda kwentando yenhliziyo;
- isimo sokuphelelwa amandla (ngegazi elibi kakhulu).
Ukukhulelwa okukhululekile - ukuxilongwa
Ezimweni eziningi, kungokwesifazane ukucacisa ukuthi ngabe ingane ikhulile yini, owesifazane akakwazi. Owesifazane okhulelwe angacabanga nje ngokuthuthukiswa kwesifo, ngoba ukuhlolwa ukuthi kuyadingeka yini ukubonana nodokotela. Lapho ukukhulelwa okubandayo kuvela esikhathini esilandelayo, umama wayo wezifo angabuye anqume ngesikhathi sokuhlolwa okuvamile. Ukuqinisekisa ukucabanga kwakhe, udokotela unikeza lezi zinyathelo ezilandelayo zokuxilonga:
- ukuhlolwa kwegazi nge- hCG - ngokufiphala kwe-fetal, ukuhlushwa kwe-hormone egazini labesifazane abakhulelwe kuyaphansi kunezimiso ezibekwa yisikhathi sokukhulelwa;
- ukungahambisani nobukhulu besibeletho isikhathi;
- ukungabi khona kwe-palpitation ye-fetus ngenkathi kuhlaselwa ngodonga lwangaphakathi lwesisu.
Ukukhulelwa okuqinile - i-ultrasound
Ukuhlolwa kwe-hardware kukuvumela ukuba uhlolisise i-pathology ekuqaleni kokubeletha. Ukukhulelwa ngaphambi kwesikhathi kusencane kungatholakala emasontweni angu-6-7 okukhulelwa. Phakathi nokuhlolwa kwesibeletho somzimba, udokotela wenza ukuxilongwa kokugcina ngesisekelo sezinto ezitholakalayo nge-ultrasound. Kuthiwa ukukhulelwa okubandayo uma:
- Iqanda lesisu liba nobubanzi obuyi-20 mm noma ngaphezulu, kepha ayikho imbryo (anembrionia) kuyo;
- ayikho imithwalo yezinhliziyo emntwaneni omncane kunama-5 mm (i-ultrasound yangaphandle) noma i-9 mm (ngokuhlolwa kwe-transabdominal).
Ukukhulelwa okukhukhulayo - ukuhlolwa
Ucwaningo oluyinhloko lwe-laboratory lokukhulelwa okunamandla ukuhlolwa kwegazi ku-hCG. Ukugxila kwayo ngamagama amancane kukhula njalo. Kodwa-ke, i-hCG ekukhulelweni okufile kuyancipha, futhi kwezinye izimo, ukuguquguquka kokwanda kwayo egazini akukwazi ukulandelwa. Ukuze ekugcineni wenze ukuxilongwa, owesifazane okhulelwe unikezwa ukuhlolwa okuphindaphindiwe okuphindaphindiwe, ngekhasi elingu-1, futhi i-ultrasound yenziwa.
Ukuhlaziywa kwengane efile
I-hertology ye-fetus emva kokukhulelwa okubandayo ihlanganisa microscopy yesampula yama-tissu omzimba we-fetal embryo. Lolu cwaningo luhlose ukusungula imbangela eyabangela ukugula. Ngokusekelwe emiphumeleni yokuhlaziywa, owesifazane angabelwa izifundo ezengeziwe ukuze aziqinisekise. Phakathi kwabo:
- ukuhlaziywa kokutheleleka kwe-TORCH - kwenziwa ngezinsuku ezimbalwa ngemva kokukhipha;
- ukuzimisela izinga lama hormone ocansi - progesterone, estradiol, thyroxine;
- i-immunogram;
- smears kwi microflora;
- ukuzimisela kwezinkomba ezinkulu ze-blood coagulation system - i-fibrinogen, i- prothrombin , i-antithrombin.
Ukuhlanzwa kokukhulelwa okuqinile
Ukungenelela kokuhlinzwa akuyona yindlela kuphela yokuphatha ukukhulelwa okubandayo. Ngesikhathi esifushane kakhulu, ukususwa kweqanda lokufelwa kwefesheni elifayo kungenziwa ngokuthatha imithi ewuxoshayo. Ukuhlanza emva kokukhulelwa okubandayo kuboniswa uma ukutholakala kwegazi kutholakala ngesikhathi samasonto ayisikhombisa noma kamuva. Lokhu kungenelela kokuhlinzwa kwenziwa esibhedlela besebenzisa i-anesthesia jikelele noma yendawo.
Ngesikhathi sokuhlinzwa, udokotela ususa i-fetus efriziwe, ngesikhathi esifanayo ahlamba i-endometrium yezibeletho. Izinhlayiya zezicubu ze-embryo zifakwa kwisitsha esinyumba futhi sithunyelwa ebhokisithri ye-histology. Ekupheleni kwenkambiso yokuhlunga, owesifazane uhlinzeka nge-oxytocin, okubangela ukuchithwa kwe-uterine. Ngesikhathi sokuphumula, isiguli sithatha ama-antibiotic ukugwema ingozi yezifo ezithathelwanayo.
Kumele uqaphele ukuthi emva kokuqothula bonke abesifazane ukulungisa ukukhishwa kwamagciwane. Ngokuvamile kufanele babe semvelo futhi bangapheli isonto elilodwa. Ukubonakala kwegazi, ngisho nenani elincane lokukhulelwa kwamanzi, okungahambisane nobuhlungu esifubeni esingaphansi, kufanele kube isizathu sokuya kudokotela. Lezi zibalo zivame ukwelapha i-uterine, okudinga ukunakekelwa okuphuthumayo.
Ukukhulelwa emva kokukhulelwa okuqinile
Kuthatha isikhathi ukubuyisela uhlelo lokuzala komzimba, ngakho odokotela abacebisi ukuhlela ukukhulelwa izinyanga ezingu-6. Uhlelo lwe-hormonal ngalesi sikhathi lubuyela esimweni salo esidlule kancane kancane. Ukuvuthwa akukwenzeka njalo, ngakho-ke, futhi nyangazonke emva kokukhulelwa okuphelile akukhona njalo. Konke lokhu kuyinkimbinkimbi inqubo yokuhlela ukukhulelwa, ngakho odokotela batusa ukuthi baqale uhlelo lwezokwelapha ngaphambi kokuba luqale, oluhlanganisa:
- Ukukhishwa kwesici esasiholela ekwenzeni ukukhulelwa ;
- ukuthatha izidakamizwa ezihloswe ekuqedeni izifo ezingapheli zesimiso sokuzala;
- i-vitamin therapy kanye ne-physiotherapy.