Igama elithi "usongelo lokuphuphuma kwesisu" elikhankanywe kwisigqibo sikagqirha luhlala lubangela ukwethuka kwixesha elizayo. Ababelethisi bakhawuleza ukuqinisekisa abafazi abakhulelweyo ukuba oku akusiyo i-pathology kunye neyeza elifanelekileyo lokubhala, kunokwenzeka ukukhupha ukuphazamiseka kokukhulelwa.
Yintoni isongelo sokupheliswa kokukhulelwa kuthetha ntoni?
Ingongelo yokupheliswa kokukhulelwa kukudibanisa imiba, iinkqubo zentlupheko ezingathinteli kakubi i-fetus, inkqubo yokwenza isisu. Ngokwezibalo, i-20% yazo zonke ukukhulelwa ezizayo ziphela ekuphumuleni. Kule meko, ukuphazamiseka kuya kwenzeka kumaxesha ahlukeneyo omzimba. Ngokuqhelekileyo kubonakala kwiiveki zokuqala, kwi-trimester yokuqala.
Ukuba isisongelo sokuphuphuma kwesisu senzeke kwiiveki ezingama-28 zokukhulelwa, izigqirha zithetha ngokukhipha isisu. Xa ithuba lokuphucula le pathology lugcinwa emva komhla, emva kweveki ezingama-28-37, oogqirha basebenzisa igama elithi "usongelo lokuzalwa kwangaphambi kokuzalwa". Oku kubangelwa ubukho bokuba unomntwana osanda kuzalwa, ozalwa emva kweveki ezingama-28. Kwimeko yokukhulelwa ngokukhawuleza kokukhulelwa ngexesha elifutshane, ukufa komntwana kungenakupheka.
Ingozi yokukhipha isisu - izizathu
Izinto ezibangela ukuphuhliswa kwezi zifo zihlukeneyo. Kwixesha lokuxilongwa emva kokukhipha isisu, oogqirha abahlala bekwazi ukulawula isizathu. Oku kuchazwa yimiba eninzi, ubukho bemiba ephindaphindiweyo yezizathu ezininzi, ngokudibanisa ukuphakamisa umngcipheko wokukhipha isisu. Ekuqwalaseleni le ngxaki, oogqirha bahlala bebiza izizathu ezilandelayo zesongelo sokukhulelwa kwesisu:
- I-genetic pathology ye-fetus. Ukuphuhliswa kwemiphumo ye-chromosomes, ukwanda kwenani labo kwandisa ingozi yokukhipha isisu. Ngokuqhelekileyo, usongelo lubangelwa utshintsho kwimpahla yesifo.
- I-Hyperandrogenia - ukwanda okwenziwe kwigazi lamademoni wesini. Ngokwe-pathology, kukho ukuncipha kwi-concentration ye-estrogens kunye neprogesterone, ejongene nophuhliso oluqhelekileyo lokukhulelwa.
- Ukungasebenzi kwe-adrenal kunye ne-thyroid gland - ukwanda okanye ukunciphisa ukuxinwa kwee-hormone ezenziwe zenziwa ngabo.
- I-Rhesus-impikiswano yintsholongwane apho umama ongenawo ama-Rh ophethe i-fetus, igazi layo li-Rh-positive.
- Ubukho bokukhupha isisu kwi-anamnesis.
- Ukuxhamla kwamanye amayeza kunye nemifuno - i-hormone agents, i-analgesics, izityalo zonyango (i-tansy, i-nettles, iSt John's Wort) inokunyusa umngcipheko wokwenza isongelo sokukhulelwa kwesisu.
- Ukulimala kwesisu.
- Umsebenzi omzimba ongapheliyo.
Ngokwahlukileyo kubalulekile ukuqaphela izifo ezithathelwanayo. Ngokubhekiselele kwisongelo sokuphuphuma kwesisu, bahlulwe ngo:
- i-gonorrhea, i-chlamydia, i- trichomoniasis , i-toxoplasmosis;
- engabalulekanga - i-hepatitis, i-pneumonia, i-influenza, i-appendicitis, i-pyelonephritis.
Ingozi yokuphuphuma kwesisu kwi-trimester yokuqala
Ubungozi bokupheliswa kokuqala kokukhulelwa kudla ngokudibanisa nokungalingani kwinkqubo ye-hormonal. Ngokuqhelekileyo, ngokukodwa kubasetyhini abaselula ngokuqala kwenkqubo yokugaya, kukho ukunqongophala kwe-progesterone ye-hormone. Le nkunkuma ijongene nokufakelwa okuqhelekileyo. Ngaphantsi kwempembelelo yalo, ukukhula kweeseli ze-uterine i-myometrium kwanda, eqokelela ubungakanani obukhulu bokufakelwa kweqanda lomntwana. Ukungaqiniseki kweprogesterone kuvimbela uphuhliso oluqhelekileyo lwe-endometrium, ngenxa yoko ukukhulelwa kukuphazamiseka ngexesha elifutshane.
Kwindawo yesibini phakathi kwezinto ezibangele ukwesaba ukuphuphuma kwesisu kwi-trimester yokuqala, zizifo ezingapheliyo zenkqubo yokuzala, ukusuleleka kwesondo. Ngokuchasene nemvelaphi yokunciphisa ukukhulelwa, okubonakalayo ekuqaleni kokukhulelwa, izimo ezifanelekileyo zidalwa ukuguqulwa kweenkqubo ezingapheliyo, ezilukhuni kwiifomu ezinzima. Phakathi kwezifo ezingaphazamisa inkqubo yokukhulelwa eqhelekileyo:
- chlamydia ;
- gonorrhea;
- i-syphilis;
- iitalpes zomzimba.
Ingozi yokuphuphuma kwesisu kwi-trimester yesibini
Kwiimeko ezininzi, isisongelo sokupheliswa kokukhulelwa kwisibini se-trimester sidibene nokuphulwa kwezitho zangaphakathi zowesifazane okhulelweyo, kungekhona umntwana. Ngokuqhelekileyo, ukuphazamiseka kwesigxina kwisithuba se-13-24 kweeveki kwenzeka ngenxa yokuphelelwa yintsholongwane yabasetyhini abakhulelweyo. Esi sifo sihamba kunye nokusilela emzimbeni wensimbi, eyingxenye ye-hemoglobin. Ngosizo lwaloo nto, i-oksijeni iyathunyelwa kwizitho kunye nezicubu zomntwana. I-anemia ingakhokelela kwindlala ye-oksijini yenyama encinci, echaphazela kakubi ukuphuhliswa kwe-intrauterine-isongelo sokukhulelwa kwesisu.
Ukuphazamiseka kokukhulelwa phakathi kwekota kunokwenzeka kwaye ngenxa ye-placenta previa. Ngolu hlobo lokubekwa kwendawo yomntwana, enye yamaphethelo isondele kwintliziyo yangaphakathi yombeleko. Ngenxa yoko, umngcipheko wokuphazamiseka kwendawo ye- placental kwenyuka, engabangela i-hypoxia engapheliyo nokufa komntwana. Kwakhona, isisongelo sokuphuphuma kwesisu singaqwalaselwa njengesiphumo sokungenakusebenza komlomo. Kulephulo-mthetho, kuncipha kwi-intanethi yentamo ye-uterine, leyo, ejongene noxinzelelo olukhulu kumzimba womntwana, inokuvulwa.
Ingozi yokukhulelwa kwesisu emva kokukhulelwa kwangaphambili
Isongelo sokupheliswa kokukhulelwa kwixesha elizayo alinqabile. Ngokwesigama esasetyenziswa ngabagqirha, lukhula ngaphandle kweveki ezingama-28 zesigxina. Emva kolu xeshanye izigqirha zisebenzise igama elithi "ukuzalwa kwangaphambi kwexesha". Le nkcazo ibonisa ukuba usana olubonakalayo ngeli xesha lusetyenziswa. Kwimiqathango kamva, ukuphuhliswa kwengxaki kuqhubeka ngokulandela enye yeemeko ezilandelayo:
- Ukusongela isisu - kubonakala ngokunyuka kwetoni ye-uterine musculature, i-bleeding emancinci esuka kwi-uterine cavity. Ngokunyamekela ngexesha elifanelekileyo kunye nolwazi, umntwana angasindiswa.
- Ukukhipha isisu ekhosini - ukuphulwa kuhambelana nokuphazamiseka kwembulunga, ukuxoshwa komntwana kwi-uterine cavity. Kuhamba kunye neentlungu zokugaya, ukuphuma kwegazi. Akunakwenzeka ukugcina ukukhulelwa.
- Ukukhipha isisu - akubonakalwanga ngokukhululwa kwenxalenye yomntwana okanye ukukhulelwa kweembrane. Umntwana uyasuswa ngokuhlinzwa.
Ingozi yokuphuphuma kwesisu - iimpawu
Kunzima ukuqaphela ingozi yokuphazamiseka kumfazi okhulelweyo. Ngokomyinge, i-10-15% yazo zonke iimeko zokukhubazeka zihambelana neempawu ezifihlakeleyo okanye ezilukhuni. Into yokuqala efuna ukuhlawulwa kwindoda ekhulelwe yinto yokukhawuleza yokuphuma kwegazi kumfazi. Ekuqaleni ingaba ngamaconsi ambalwa kwiingubo zangaphantsi zakho. Nangona kunjalo, ngokuhamba kwexesha, iimpawu zanda. Eli bhinqa libuye lirekho ezinye iimpawu zengozi yokuphuphuma kwesisu:
- uvakalelo, ubunzima, ubuhlungu buhlungu kwisisu esezantsi;
- ukuwohloka kweentlalo-ntle;
- ukunciphisa uxinzelelo lwegazi;
- isicefe
- ukuhlanza.
Xa uhlolwe kwisihlalo somzimba, oku kulandelayo kufunyanwa:
- Isibeleko asiphenduli kwimviwo ngokunyusa ixabiso;
- i-sulcus yangaphandle ivalwe okanye i-ajar encane;
- Kukho igazi kwicandelo lomzimba.
Ulwabiwo xa kusongelwa ukukhulelwa kwesisu
Isongelo sokuphuphuma kwesisu ngexesha lokuqala lokukhulelwa lihlala lihamba kunye nokubonakala kwegazi ukusuka kwinqanaba lomzimba. Kwinqanaba lokuqala, umthamo wayo uncinci, malunga nokufana nokubonakala kwimihla. Umbala wokukhutshwa ungadlulela kwi-red ebomvu ukuya kwi-serous-bloody. Ngokweziganeko zogqirha, kwi-12-13% yamatyala okuphuma kwegazi kuholele ekupheleni kokukhulelwa. Xa kuphuma igazi elininzi, kukho umngcipheko wokuhlamba igazi, ohamba kunye:
- intloko;
- ukuhlanza;
- ukunciphisa uxinzelelo lwegazi;
- i-blanching yolusu;
- ukwanda kwenani lentliziyo;
- ukulahleka kwengqondo.
Ubuhlungu xa kusongelwa ukukhulelwa kwesisu
Ubungozi bokupheliswa kokukhulelwa, iimpawu zazo ezixutyushwa ngasentla, zihlala zihamba kunye nentlungu kwisisu esezantsi. I-Symptomatology inxulumene nokunyuka kwetoni ye-myometrium, okwandisa isivumelwano sayo. Lo mzekelo uhamba kunye nobuhlungu obuqinileyo, ukudonsa umlingiso weentlobo (ubuncinci obuthatywayo okanye obunzima). Ngesongo sokuphuphuma kwesisu, intlungu ihlala kwindawo ephezulu, ingabuyisa umva ongaphantsi okanye i-sacrum. Ubukhulu beentlungu azixhomekeke kwisithuba somzimba.
Yintoni enokuyenza xa usongela ukukhulelwa kwesisu?
Xa umfazi okhulelweyo efumana ukuba usongelo lokukhulelwa komzimba, unyango luqala ngokukhawuleza. Unyango luqhutyelwa esibhedlele, ngelixa isiseko salo sihambisana nokuphumla komntwana (kwiimeko ezinzima, umfazi okhulelweyo akavunyelwe ukuba aphume ebhedeni). Umngcipheko wokukhipha isisu kubangele ukuxhalaba kunye nokwesaba kwintombi, ngoko kunikezelwa ukuba kunqunywe. Oogqirha bacebisa ukuba bahlale bezolile xa nje ufuna ukucinga ngezinto ezimnandi.
Iingcebiso zeklinikhi ezisongela ukukhipha isisu
Ukuba usongelo lokuphuphuma kwesisu ekuqaleni kwezinto aluzange lukhokele ekupheliseni ukukhulelwa, oogqirha bancomela abafazi ukuba bagcine le miqathango ilandelayo:
- Umlinganiselo wokuzilolonga.
- Ukuphumla okungakumbi.
- Ukuphelisa uxinzelelo kunye nokuxhalabisa.
- Musa ukulala ngesondo.
- Qaphela ukutya okuphantsi kweekhalori.
Iibhulile xa kusongelwa ukukhulelwa kwesisu
Zonke iziyobisi xa kwenzeka ukukhulelwa komzimba kufuneka zibekwe kuphela ngugqirha. Iingcali, ngokuqwalasela ubunzima beemeko, isimo sempilo yowesifazane okhulelweyo, umisela amayeza kwisilinganiso esifanelekileyo. Phakathi kweziyobisi ezisetyenziswayo:
- i-antispasmodics (Papaverin, No-shpa, i-Drotaverin);
- i-gestagens (iDyufaston kwisoyiko lokuphuphuma kwesisu ekuqaleni kweegalelo kunceda ekupheliseni i-pathology);
- i-glucocorticoids (iDexamethasone, iMpepred);
- i-hemostatics (iDicinon, iVikasol, i-Ascorutin);
- iivithamini (folic acid, vitamin K, E).
Ekuseni kusongelo lokuphuphuma kwesisu kusetshenziswanga ngokuqhelekileyo kunezinye izigulane. Kule meko, oogqirha bancomeka ukuyisebenzisa kwikhandlela. Isisombululo kunye nokuphindaphindwa kusekwe ngabanye, kodwa kwiimeko ezininzi, oogqirha banamathela kule nkqubo yonyango elandelayo:
- 1 i-suppository kunye nomyinge wama-200 mg ngosuku;
- Amakhandlela a-2 ngelilanga kunye neli-100 mg.
Xa ujojowe usongelo lokuphuphuma kwesisu
Unyango lwesongelo lokukhupha isisu esibhedlele lubandakanya ukusetyenziswa kweendlela ezinobungozi zamachiza. Kule meko, izidakamizwa ezifanayo ezibhalwe apha ngasentla zisetyenzisiweyo, kodwa ngeendlela zesisombululo. Indlela enjalo yokulawula yenza ukuba kufikeleleke ukuqala kokuqala kwendlela yokwelapha. Phakathi kweziyobisi ezisetyenziswe ngeenjini:
- I-Magnesium sulphate ;
- Partusisten;
- Ritodrin;
- Apentage.
Unokuthintela njani ingozi yokusweleka kwesisu?
Ukulondolozwa kokukhusela isisu kufuneka kuqale kwinqanaba lokucwangcisa ukukhulelwa. Ngaphambi kokuqhawula isibini esitshatileyo kubalulekile ukuba uphononongo, ukuphumelela iimvavanyo, ukuqhuba ikhosi yeyeza ekufumaneni izifo ezingapheliyo.
Amanyathelo okukhusela okujoliswe ekupheliseni ubungozi bokuphuphuma kwesisu kuquka:
- ukubhaliswa ngexesha elifanelekileyo lokukhulelwa;
- Ukuthobela iingcebiso zegqirha;
- ukugatya imikhwa emibi;
- ukupheliswa kweemeko ezixinzelelekileyo;
- ukwenqaba ukunyamekela ngokomzimba, ukuqeqeshwa kwezemidlalo;
- ukujongwa kolawulo lwaloo mini.