Ukuphuphuma Kwesisu ekukhulelweni ekuseni: kubangela, uphethwe, nokuvinjelwa, ukuphathwa

Ukungafuni ukukhulelwa akusona nje ukuhlukumeza ngokomzimba kowesifazane, kodwa futhi nokuziphatha okuhle. Kungenxa yalesi sizathu ukuthi inani eliphezulu lokuthola ulwazi mayelana nokuxilongwa, izimbangela, izimpawu, ukwelashwa, kanye nokuvimbela ukukhipha isisu okuzenzekelayo kuqoqwe esihlokweni esilandelayo.

Akukhulelwe ukukhulelwa kokuqala kuyadabukisa kakhulu futhi, ngeshwa, into ejwayelekile kakhulu. Ngokwezibalo, ukukhulelwa komama wesishiyagalombili kusiphazamiseka emavikini ayishumi nambili okuqala. Iningi labo lithola ukukhulelwa kwesisu, ngenkathi kungabikho ukuthi bayakhulelwa. Futhi ezinye zezinto zokulahlekelwa ingane zivele zikhulunywe ekuqaleni kokubonisana futhi zeluleka ukuba zilale phansi ukuze zilondolozwe.

Ukukhipha isisu kubhekwa njengento engathinti kakhulu ukuzala nokuphila komuntu wesifazane. Kubaluleke kakhulu ukuthi ungaphuthelwa isikhathi esinqunyiwe.

Ukuphazamiseka kokukhulelwa kungabonakali owesifazane osezingeni lokuqala. Ukuhlehliswa kwenyanga kukhishwa nje ngokulibala, bese kuqala ukuphuma kwegazi, okuhambisana nokuzwela ubuhlungu. Uma isisu siphelile ngokuphelele, ukuphuma kwegazi nokuhlupheka kuphelile, lo wesifazane angase angazi ngisho nokuthi ukhulelwe.

Uma ingane engapheli ngokuphelele, yimbangela yokuphuma kwegazi isikhathi eside, owesifazane ngokuvamile ubhekisela kumchwepheshe ochaza ukukhulelwa kwesisu. Odokotela abaningi, ukuze babuyisele umzimba wesifazane, emva kokuba icala liqokwe inkambo yokwelapha okwelapha.

Izimbangela

Izizathu zokukhulelwa kwesisu zingaba kanje:

• Ukuhluleka kwe-Hormonal.
• Ukungahleleki kwesisu.
• Izifo ezithathelwanayo.
• I-Rhesus factor.
• Amalungiselelo okwelapha.
• Ukulimala.
• Ukukhipha isisu esikhathini esidlule.

Isongo sokuqedwa kokukhulelwa ku-trimester yesibili sinciphile. Ngokusho kwezibalo, ku-trimester yesibili, kuphela owesifazane kwabayishumi nanhlanu kuphela ongenakekile.

Ngakho-ke, ake sicabangele ngokuningiliziwe ngezizathu ezingenhla zokukhulelwa kwesisu.

Ukuhluleka kwe-Hormonal

Emzimbeni wesifazane, ama-hormone kanye nokulinganisela kwawo okufanelekile kuyinkinga yokufunda inqubo evamile yokukhulelwa. Kwezinye izimo, ukwehluleka kwesizinda sangemuva kungabangela ukuwohloka. Izazi zikhomba i-progesterone njenge-hormone ebaluleke kakhulu, okudingeka ukuthi iqhubeke nokukhulelwa. Uma ukutholakala kwakhe kutholakala ngesikhathi, lo wesifazane unqunywe le hormone ngendlela yemithi, ngenxa yalokho, isithelo singasindiswa.

Ngaphezu kwalokho, ibhalansi ye-fetal ithinteka ngokulingana kwe-androgens. Ngokuzikhulula kwabo emzimbeni wesifazane okhulelwe, ukukhiqizwa kwe-estrogen ne-progesterone kuvinjelwe, futhi lokhu kuyisongo sokukhulelwa kwesisu.

Izifo ezithathelwanayo

Lapho ulungiselela ukukhulelwa, owesifazane kufanele anakekele zonke izifo ezingapheli. Ngaphezu kwalokho, kunconywa ukuthi ugweme izifo ezithathelwanayo. Emva kokungena emzimbeni wesifazane we-pathogen, izinga lokushisa lingakhula ngokuqinile, okwenza kube nokukhulelwa kwesisu.

Isongo esithile ebusweni yisifo esithathelwana ngocansi. Ngakho-ke, abazali abazayo ekulungiseleleni ukukhulelwa kufanele bahlolwe futhi badlulise izivivinyo kulezi zifo. Ngenxa yokuthi lolu hlobo lokutheleleka luya e-fetus ngegazi, ezimweni eziningi phambi kwe-pathology kanye nokuxilongwa kokukhipha isisu.

Ukungahleleki kwesisu

Isabelo sezingonyama saso sonke isisu senzekile ngenxa yalesi sizathu. Odokotela babiza inombolo engu-73% yenani labo eliphelele. Ezweni lanamuhla, lesi sici sidlala indima enkulu. Imikhiqizo ephansi kakhulu, ukungcola kwemisebe, ukungcola kwemvelo - konke lokhu kuthinta umzimba wesifazane nsuku zonke.

Kuze kube manje, ukulungiselela ukukhulelwa, abesifazane abaningi bazama ukushiya idolobha eliyidlabha eliyingozi futhi basebenzise lesi sikhathi esimweni esihle kakhulu. Naphezu kokuthi lezi zinto aziqedwe kalula, izinguquko ezihlobene nazo azibhekwa njengefa, ukukhulelwa okulandelayo kungaphumelela.

I-Rhesus factor

Lesi sici cishe ngaso sonke isikhathi sikhuthaza ukuqedwa kokukhulelwa kakade ezinkathini zokuqala. Ngenxa yalesi sizathu, uma owesifazane enesici se- Rh esingalungile futhi umuntu enesimo esihle, lesi simo singabangela ukuxabana kwe-Rh futhi, ngenxa yalokho, ukukhulelwa kwesisu.

Kuze kube manje, imithi ifunde ukubhekana nale nkinga ngokusungulwa komzimba wesifazane we-progesterone. Ngakho-ke, i-fetus ivikelekile kumzimba wesifazane omzimba ononya. Nokho, kulokhu, kungase kube nenkinga yokukhulelwa kwesisu.

Imithi

Ochwepheshe batusa ngalesi sikhathi ukugwema ukuthatha imithi, ikakhulukazi ezinyathelweni zokuqala. Kubaluleke kakhulu ukukhipha wonke ama-analgesics nama-hormone. Kuyinto engathandeki ukusebenzisa izindlela zokupheka lapho iSt John Johnson, i-nettle, i-cornflower ne-parsley zikhona njengezithako.

Izimo zokucindezeleka

Usizi olungazelelwe, ukuxabana emndenini, noma ukucindezeleka emsebenzini - zonke lezi yizimbangela zokukhulelwa kwesisu zisencane. Kumele kuncishiswe noma, uma kungenzeka, kugweme lezi zici. Inendima ebalulekile ekwakheni indawo enokuthula owesifazane ungowomuntu. Uma kungenakwenzeka ukugwema isenzo sezici ezicindezelayo, ke odokotela bahlinzekela ukukhanya okulula.

Imikhuba emibi

Ngisho nangaphambi kokukhulelwe, kubalulekile ukuyeka ukuthatha utshwala nokuyeka ukubhema. Ukubhema kungaphazamisa uhlelo lwe-fetal cardiovascular system. Kunconywa ukwakha uhlelo oluqhubekayo lokudla okunomsoco, ngesethi yamaminerali abalulekile namavithamini. Kudingeka futhi ukulungisa isimiso sosuku nosuku.

Ukulimala

Ngokuhambisana nezici ezibalwe ngenhla, ukukhulelwa kwesisu kusencane kungabangela ukushaywa kanzima, ukuwa noma ukuphakamisa izinto ezinzima. Ngakho-ke, kufanele uziphatha ngokucophelela ngangokunokwenzeka.

Ukukhipha isisu esikhathini esidlule

Lokhu akusiyo nje ingxabano esetshenziselwa ukusongela abesifazane abasha, kodwa futhi isici sangempela sezinkinga esikhathini esizayo. Kwezinye izimo, ukukhipha isisu kungabangela ukungabi nabantwana futhi kuqhube isisu esingenasifo.

Ukuxilongwa

Ukwehlukaniswa kwezidakamizwa ukukhulelwa kuyisifo sezinhlobo eziningi lapho iziguli eziningi zihlangana khona nezinambuzane eziningana ngesikhathi esifanayo. Ngenxa yalesi sizathu, ukuhlolwa kweziguli kufanele kwenziwe ngendlela ephelele futhi kufaka zonke izindlela zamasosha zanamuhla, izinsimbi nezindlela zomtholampilo.

Ngesikhathi sokuhlolwa, akuzona kuphela izimbangela zokukhipha isisu okuzenzekelayo, kodwa isimo sesimiso sokuzala sihlolwe ngokuvimbela okulandelayo ukubonakala kwesimo esinjalo.

Ukuhlolwa ngaphambi kokukhulelwa

Umlando uhlanganisa ukucaciswa kokutholakala kwezifo ze-somatic, zezinto eziphilayo, zezifo kanye ne-neuroendocrine pathology. Umlando we-gynecologic ikuvumela ukuba uthole ukuthi kukhona ukutheleleka ngegciwane, izifo ezivuthayo ezithombeni zofuzo, izici zokuzala nokubeletha (ukukhipha isisu okuzenzekelayo, ukubeletha, ukukhipha izisu), izindlela zokwelapha nezinye izinyathelo zokuhlinza, izifo zegazi.

Esikhathini sokuhlolwa kwemitholampilo, ukuhlolwa, ukuhlolwa kwesimo sesikhumba, ukugcoba kwe-thyroid nokukhuluphala ngokuhambisana nenani lomzimba lomzimba lwenziwa. Ngokusho kwenombolo ye-hirsut, izinga le-hirsutism lizimisele, isimo sezitho zangaphakathi sihlolwe, kanye nesimo somzimba. Ukungabi khona noma ukutholakala kwe-ovulation, isimo sokusebenza sama- ovari sihlaziywa ngokwekhalenda yokuya esikhathini nokushisa kwama-rectal.

I-laboratory kanye nezindlela ezibalulekile zocwaningo

Ukuxilongwa kokukhulelwa kwesisu kuqukethe izifundo ezilandelayo:

• I-Hysterosalpinography - eyenziwa ngemuva komjikelezo wokuya esikhathini ezinsukwini ezingu-17-13, ikuvumela ukuthi ungabandakanyi i-intachiyetine synechia, ukukhubazeka kwesibeletho, i-ICS.
• I-Ultrasound - inquma ukuba khona kwe-adenomyosis, i-cysts, i-myomas ye-uterine, ihlola isimo sama-ovari. Icacisa isimo se-endometrium: i-endometrial hyperplasia, i-polyps, i-endometritis engapheli.
• Ukuhlolwa okuphazamisayo - kuhlanganisa ukuhlolwa okuncane kakhulu kwesidumbu, i-urethra, umgogodla we-uterine kanye nokuhlolwa kwe-bacteriological komsele wesibeletho, ukuhlolwa kwe-PCR, nokuhlolwa kwegciwane eliphetheyo.
• Ucwaningo lwama-Hormonal. Yenziwa ngosuku lwesihlanu noma lwesi-7 lomjikelezo, ngokuya esikhathini sokuya esikhathini, ezigulini ezine-oligo ne-amenorrhea - nanoma yiluphi usuku. Okuqukethwe kwe-17-hydroxyprogesterone, i-DHEA sulfate, i-cortisol, i-testosterone, i-FGS, i-LH, i-prolactin inqunywa. I-progesterone inganqunywa kuphela ezigulini ezinomjikelezo ovamile: esigabeni sokuqala somjikelezo ngezinsuku ezingu-5-7, esigabeni sesibili somjikelezo - ngosuku lwesi-6-7 lwe-rectal lokushisa ukuphakama. Kulaba besifazane abane-hyperandrogenia engavamile, isampula encane ne-dexamethasone yenziwa ukuze kunqunywe umthamo wokwelashwa ophelele.
• Ukuze unqume ukuthi ingosi yokukhulelwa isisu ingaba yingozi, kubalulekile ukucacisa ukuba khona kwama-anticardiolipin antibodies, anti-HG nokuhlaziya izici zesistimu ye-hemostasis.
• Uma kukhona ukusola kwe- pathology ye-endometrium kanye / noma i-intrauterine pathology ngaphansi kokulawulwa kwe-hysteroscopy, ukucutshungulwa kwe-diagnostic kwenziwa .
• Uma ukusola kokuba nokucindezeleka kokunamathela emgodleni, ukukhubazeka kwama-tubes, i-endometriosis engokomzimba, ne-scleropolyakistoznye ovaries kanye ne-myoma ye-uterine iboniswa yi-laparoscopy yokusebenza.
• Ukuhlolwa komuntu kuhlanganisa nencazelo yomlando wefa, ukuhlaziywa kwe-spermogram eyandisiwe, ukutholakala kwezifo ze-neuroendocrine ne-somatic, kanye nokucaciswa kwezici zokuvuvukala nezigciwane.

Ngemuva kwezimbangela zokukhulelwa kokukhulelwa kokukhulelwa, kunqunywa izinyathelo zokwelapha.

Ukukhulelwa ukuhlolwa

Ukuqaphela ngesikhathi sokukhulelwa kufanele kuqale ngokushesha ngemuva kokuqala kwayo, futhi kuqukethe izindlela ezilandelayo zokucwaninga:

• Ukunqunywa kwe-DHEA-sulfate ne-DHEA.
• Ukuzimisela kwesikhashana kwe-HG egazini.
• Ukuskena kwe-Ultrasound.
• Uma kunesidingo, ukwelulekwa ngososayensi wezengqondo kanye nesazi sengqondo.

Ukuvimbela

Ngokusho kwedatha yemininingwane, ukukhubazeka kokungahambisani okuzenzakalelayo kungu-1 icala lokukhulelwa okungu-300. Naphezu kokuthi kungenzeka ukuthi ukukhulelwa kwesisu nokukhuphuka kwenkathi kunciphisa, ku-trimester yokugcina, lesi sibonakaliso sinama-30%. Kubuye kwenzeke nokuthi ukubeletha ngaphambi kwesikhathi futhi ukukhulelwa kwesisu kwabesifazane kwenzeka kaningi. Ngenxa yalokho, ukuxilongwa kutholakala - ukukhulelwa kwesisu okujwayelekile (ukwelashwa kuzocatshangelwa ngezansi).

Izimbangela zalesi sifo zivame kakhulu, ezimweni eziningi, ukulethwa ngaphambi kokubeletha noma ukukhulelwa kwesisu kungaholela ekubunjeni kwabo bonke. Kulesi simo, isenzo sabo singaba sequential noma ngesikhathi esisodwa. Owesifazane onomsebenzi okhandlayo ngokubambisana nokucindezeleka ngokweqile nangokwenyama noma isikhundla esiphansi sezenhlalakahle ngokuzenzakalelayo uba ngaphansi kweqembu eliyingozi.

Ngaphezu kwalokho, isifo sikashukela, isifo sezinso, isifo sokuphefumula kwesifo sikashukela, isifo senhliziyo nesifo senhliziyo, ukuphuza ngokweqile ngezidakamizwa, utshwala, ukubhema ugwayi ziphakathi kwezinto ezikhulisa amathuba okugula. Uma owesifazane enezinkinga zokukhulelwa, noma umlando wokuvinjelwa wesibindi, lokhu kusebenza nakwezinye izimo ezingozini zokukhulelwa komzimba noma ukukhipha isisu. Kubalulekile ukukhumbula ukuthi ngezikhathi ezincane ukuphazanyiswa okungahle kube yindlela yokuphila yokukhethwa kwemvelo, ngenxa yalesi sizathu, ukukhulelwa kwesisu akukona okwenziwa ukukhulelwa okungapheli.

Empeleni, ukuvimbela ukukhulelwa kwesisu kuncishisiwe kube amaphuzu amakhulu amabili:

1. Ukuhlolisisa ngesikhathi somzimba wesifazane nendoda.
2. Ukuphila okunempilo.

Kubaluleke kakhulu ukucacisa ukuba khona komuntu wezifo ezifuywayo, izifo, ukuhlaziywa kwesidoda nokuqeda ukwelashwa kwazo zonke izinkinga ezikhona.

Owesifazane ubhekene nomsebenzi onzima kakhulu. Kumele kucaciswe ukuthi ngabe kunezifo ezithathelwanayo, ze-neuroendocrine, izifo ezingokwemvelo, njengoba kunjalo nangama-pathologies wefa.

Futhi, izici zokuzala nokuya esikhathini zifundwa ngohlaka lwe-prophylaxis, ukutholakala kokukhuluphala kanye nezinga layo kubonakala, isimo sesikhumba siyahlolwa.

Kunconywa ukufaka isicelo sokuhlolwa kwezinto ezisemthethweni. Ilwazi eliphelele li-hysterosalpingography, elenziwa engxenyeni yesibili yokujikeleza kokuya esikhathini. Ngenxa yalokho, kunokwenzeka ukunquma ukuthi isiguli sine-intrauterine pathologies. Imiphumela ye-ultrasound yezitho zangasese ivumela ukuxilonga ukuba khona kwe-endometriosis, fibroids, i-cysts, kanye nokuhlola isimo se-ovaries.

Kubalulekile ukutadisha ama-smears avela ku-urethra, umgogodla wesibeletho kanye nesiswini. Ucwaningo lwe-Hormonal lufisa ukwenza esikhathini sokuqala somjikelezo wokuya esikhathini. Ngaphezu kwalokho, udinga ukucabanga ngokuqhuba ukuhlolwa kwegazi, okuzobandakanya izici ze-coagulation. Lokhu kuzovumela ukucacisa ukuba khona kwama-antibodies njenge-anti-HC, i-anticardoidolipin ne-lupus.

Ukwelapha

Ukwelashwa kokukhipha isisu kwenzeka ngokulandelana okulandelayo: ukucaciswa nokuqedwa okulandelayo kwalesi sizathu.

Esinye sezizathu ukutheleleka kwe-fetus, okubangelwa ukutheleleka kwe-amniotic fluid noma ukungena ngamagciwane we-placenta. Kulesi simo, ukuqeda ngokuzenzekelayo kokukhulelwa kwenzeka ngemuva kokusebenza kwesivumelwano esibelethweni, okubangelwa ukuphuza ngokweqile noma ukuchithwa kwe-amniotic fluid ngaphambi kwesikhashana, okubangelwa ushintsho esakhiweni sezinambuzane ngaphansi kwesenzo samagciwane asetshenziswayo. Ukwelashwa esimweni esinjalo kungaphumelela, ngoba ikhono lomntwana lokulwa nezimo ezingalungile landa ngokukhula ngesikhathi sokukhulelwa.

Ekuvinjeni kwalesi sifo, kubalulekile ukuhlanganisa ukubonisana kwe-endocrinologist, ngoba ukulahlekelwa kwe-hormonal kungaholela ekuvuselelweni okungavamile kwe-endometrium nokuqothulwa kwayo, okubhekwa njengento ebalulekile yokukhipha isisu. I-Hyperandrogenism (isimo se-pathological) ibuye ibonakale nge-hormonal futhi ingaba imbangela yokuphazamiseka okuzenzekelayo.

Ukwelashwa okuphilayo okutholakala noma okufakwe ngaphakathi kwezingxenye zesimiso sokuzala nakho kuyimbangela yokukhulelwa kwesisu. Ngaphezu kwalokho, izimbangela zalesi sifo zihlanganisa ukugqithisa kwengqondo, ukucindezeleka, imiphumela yemithi ethile, izifo ezihlukahlukene, impilo esondelene nokukhulelwa.

Ngisho uma kutholakala ukuthi ukukhulelwa kwesisu okujwayelekile, ukukhubazeka okuzenzekelayo kunganciphisa kakhulu uma ngabe ochwepheshe beqashwe njalo futhi kuvinjelwa okuyinkimbinkimbi.