Igama elithi "ukukhulelwa ngokukhukhulayo" kwiimbandezelo ngokuqhelekileyo kusetyenziswa ukubhekisela kwinkqubo yokunyanyiswa komzimba, apho kubakho ukufa komntwana. I-Pathology ikhula ngokukhawuleza, ukuya kwiiveki ezingama-20, kodwa kwezinye iimeko, ingxaki leyo inokwenzeka kwi-2 ne-3 trimesters. Isiphumo esingenakukhunjulwa kwentleba ngokukhipha isisu.
Kutheni ukukhulelwa kumisa?
Oogqirha abakwazi ukunika impendulo engabonakaliyo kumbuzo, kutheni umntwana eyeka. Kukho izinto ezininzi ezinokubangela le ngozi. Ngokuqhelekileyo, oogqirha bathi ngexesha elifanayo malunga nezizathu ezininzi ezibangele ukukhulelwa kokukhulelwa, kuba akunakwenzeka ukufumanisa ukuba yintoni eyabangela ukuba kukhuthazwe. Phakathi kwezizathu eziqhelekileyo zokukhubazeka, oogqirha bahlula:
- iinkqubo zentsholongwane kunye nokusuleleka emzimbeni;
- ukungahambelani kweR Rh ye-fetus nomama;
- ukuphulwa kwenkqubo yokweba igazi kumzimba womama ozayo;
- ubukho bentsholongwane yesisu;
- ubukho kwi-anamnesis yokukhupha isisu;
- imikhwa emibi (utywala, i-nicotine);
- imeko ezixinzelelekileyo;
- kuqhuba iiVF .
Ukukhulelwa kokukhulelwa kwinqanaba lokuqala - izizathu
Kwiimeko ezininzi, i-pathology ikhula kwizigaba zakuqala zokuphuhliswa kwe-intrauterine ye-embryo. Kule meko, oogqirha obuphambili obangela ukuba izifo ezithathelwanayo zikamama:
- umkhuhlane;
- herpes;
- chlamydia;
- i-mycoplasmosis;
- i-toxoplasmosis;
- ureaplasmosis.
Ukuchaza ukuba kutheni umntwana ekhulelwe kwiimpawu zokuqala zokukhulelwa, oogqirha kwelinye leendawo zokuqala zibeke phambili kunye neengxaki zofuzo kumntwana. Ngokuqhelekileyo zichaphazela iinkqubo zokuphuhliswa kwe-intrauterine kwezitho kunye neenkqubo. Ngenxa yoko, iimpawu zeenkqubo zomoya kunye neentsholongwane zithuthuka, ezingenakuhambelana nobomi. Usana lufa, kwaye ukhulelwe.
Ukukhulelwa komntwana kwi-trimester yesibini - izizathu
Ukukhulelwa okutshatyalaliswayo kwi-trimester yesibili kuninzi. Uphuhliso lwakhe luhlala lubandakanywa nokuziphatha kwabafazi abakhulelweyo ngokwabo. Ukungathotyelwa kolawulo olusisiseko, ukunganyaniseki kokuqeshwa kwezonyango, amava kunye neengcinezelo eziqhelekileyo zichaphazela kakubi uluntu jikelele kunye nenkqubo yokukhulelwa. Ngenxa yeemeko ezinjalo, ukuxhatshazwa kwezilonda ezingapheliyo kubakho rhoqo. Phakathi kweziphene ezingabangela ukukhulelwa kokukhulelwa:
- ukuphazamiseka kwesimo senhliziyo;
- isifo sesifo;
- ukungaphumeleli kwinkqubo ye-endocrine;
- isifo sikashukela.
Ukukhulelwa kokukhulelwa kwisithathu sesithathu
Xa ukukhulelwa okukhukhulayo kukhula kwi-trimester yesithathu, izibangela zayo zidla ngokudibanisa nokutshintshwa kwangoko kwimeko yempilo kamama. Ngokuqhelekileyo, ukukhubazeka kwenzeka kubasetyhini abaneenkqubo ezivuthayo zokuvuvukala emzimbeni. Ukukhokelela ekwenzeni ukukhulelwa emva komhla ozayo, ukuphazamiseka kwenkqubo ye-endocrine kwakhona kunokwenzeka: isifo sikashukela, ukungasebenzi kwesifo se-thyroid - zidlalwa njengezona zinto ezibangela ukugula. Nangona kunjalo, asikwazi ukukhuphela ngokupheleleyo ngaphandle kwezizathu ezingekho ngqo zokukhula:
- sisifo somzimba;
- utywala;
- uxinzelelo olunzima;
- umlutha weziyobisi.
Ungayiqonda njani ukuba umntwana okhutshiwe?
Into ebonakalayo ye-pathology kukungabikho kwezibonakaliso kumanyathelo okuqala. Iimpawu zokuqala zokukhulelwa okhenkce zingabonakala kwiintsuku ezimbalwa, kwaye emva kweveki ezimbini. Ukuze uhlolisise ukuphulwa ngexesha, umfazi okhulelweyo kufuneka alumkele imeko yakhe yempilo, ukuba azi iimpawu zokukhulelwa okukhukhulayo. Ekuqaleni, kukho ukusola okusoloko kuyimfuneko ukujongana nodokotela.
Ukukhulelwa okukhukhulayo - iimpawu kwi-trimester yokuqala
Kwiimeko ezininzi, ukukhulelwa okukhenkcelayo kuhamba kunye nembonakalo yeempawu ezithile ezikunceda ukukrokra into engalunganga. Izibonakaliso zokukhulelwa okhenkcekileyo kumanyathelo okuqala azikho izinto ezizodwa, ngoko oomama ngokwabo bangathabatha ukuba zenzeke ngexeshana. Iimpawu zokuqala zokukhulelwa ngokukhawuleza ngexesha elifutshane zivela ngale ndlela:
- Ukupheliswa ngokukhawuleza kwe-toxicosis - ukuhlanza okuqhubekayo kunye neentlanzi, ezinokubandezela isibini esithweleyo iintsuku eziliqela, zilahlekile.
- Ukubonakala kobuhlungu obubukhali kwisisu esisezantsi, ezinokungazinzi, zinobunzima obuphantsi kwaye zinokuqiniswa.
- Ukutshatyalaliswa kokuvuvukala kweengcambu ze-mammary kunye nokunciphisa umthamo wabo - isifuba siyafana nobukhulu obufanayo, uvelwano lweentlobo luyancipha.
- Ukukhutshwa kwamanzi okuphuma kumfazi - kudibene nokukhishwa kweqanda lomntwana.
- Ukunciphisa kokunciphisa ukushisa kwe-basal - ngokuqala kokukhulelwa, esi sibonakaliso sisetyenziswe kuma-degrees ama-37, kodwa ngokunyuka kwehlisiwe kuye kwaba ngu-36.7-36.8.
- Ukwanda kweqondo lokushisa komzimba, ukubola, ubuthathaka kubangelwa kukutshatyalaliswa kweembrane zomntwana.
Ukukhulelwa okukhuselekileyo kwi-trimester yesibini - iimpawu
Ukuba umntwana sele efile kwi-trimester yesi-2, iimpawu zowesifazane zifana nezo zichazwe ngasentla. Ngelo xesha, iimpawu ezinjengokupheliswa ngokukhawuleza kweentshukumo zentsholongwane zongezwa kubo. Ukuba ngaba ngaphambili umama okhuselekileyo wayejonge iindubhu kunye ne-fetal flips kwisisu, ngoko kuphuhliso lwezilwanyana abakhoyo. Ukuze uhlolisise ukuphulwa ngexesha kwaye uthathe inyathelo, oogqirha bacebisa ukuba baqhagamshelane neziko lonyango ukuba le ntombazane ingenzi ukuvakalelwa kwiiyure ezili-12 ngokulandelana.
Ukukhulelwa okukhukhulayo kwi-trimester yesithathu
Ukuze ugweme iingxaki, ngamnye umama ozayo kufuneka acinge ukuba indlela yokugula ibonakaliswa ngayo ngokwemigaqo kamva kunye nantoni na ukuba impawu ziba zikhutshiwe. Ngexesha elide, umntwana akasasasebenzi, wenza izinto ezincinci zokunyuka, ngoko ukukhulelwa kowesifazane kungenziwa iphosakele ngenxa yezinto eziqhelekileyo zomzimba. Nangona kunjalo, kwiimeko ezininzi, uhambo olungabikho luhlangene:
- ukuphawula;
- ukunyamezela intlungu kwisisu esezantsi;
- ukuhlanza okukhulu;
- ukwanda kweqondo lomzimba;
- ukuwohloka kweentlalo-ntle;
- ukunciphisa uxinzelelo lwegazi;
- ukwanda kwenani lentliziyo;
- imeko yokuphelelwa amandla (ngegazi elininzi).
Ukukhulelwa okukhukhulayo - ukuxilongwa
Kwiimeko ezininzi, kufikelela kumfazi ukuba aqinisekise ukuba umntwana uyabanda, umfazi akanako. Owesifazane okhulelweyo unokucinga nje ukuphuhliswa kwezilwanyana, ngenxa yokufumanisa ukuba kuyimfuneko ukuthintana nodokotela. Xa ukukhulelwa okhenkcelayo kuvela emva komhla, umhlazi wayo wezilwanyana unokukwazi ukumisela ngexesha loviwo oluqhelekileyo. Ukuqinisekisa ukucinga kwakhe, ugqirha unikela ezi zilandelayo:
- Ukuhlolwa kwegazi ngenxa ye- hCG - kunye nokukhulelwa komntwana, ukuxinwa kwe-hormone egazini lomfazi okhulelweyo kuncinci kuneemimiselo ezibekwa lixesha lokukhulelwa;
- ukungqinelani kobukhulu besisu esibelethweyo;
- ukungabikho kwe-palpitation ye-fetus ngexesha lokuhlaselwa ngodonga lwangaphakathi lomzimba.
Ukukhulelwa okukhukhulayo - i-ultrasound
Olu vavanyo lwezinto ze-hardware lukuvumela ukuba ufumane ukuxilongwa kwe-pathology ekuqaleni kwentshukumo. Ukukhulelwa kwangaphambi kwangoko kusenokufumaneka kwiiveki ezi-6-7 zokukhulelwa. Ngethuba loviwo lobuncinci, ugqirha wenza i-diagnostic yokugqibela ngesiseko se-ultrasound findings. Kuthethwa ukukhulelwa okukhenkce ukuba:
- Iqanda le-fetal linomyinge we-20 mm okanye ngaphezulu, kodwa akukho mbryo (anembrionia) kuyo;
- akukho ziphazamiso zentliziyo emntwaneni omkhulu kunama-5 mm (i-ultrasound yangaphandle) okanye i-9 mm (kunye noviwo lwe-transabdominal).
Ukukhulelwa okukhukhulayo - iimvavanyo
Uvavanyo oluphambili lwebhubhoratri lokukhulelwa ngokukhawuleza luvavanyo lwegazi lwe hCG. Ukugxininiswa kwimiqathango encinci ikhula rhoqo. Nangona kunjalo, i-hCG ekukhulelweni kokufa iyancipha, kwaye kwezinye iimeko, iinguqu zokunyuka kwayo egazini ayikwazi ukulandelwa. Ukuze ekugqibeleni wenze ukuxilongwa, umfazi okhulelweyo unikezelwa iimvavanyo eziliqela ngokuphindaphindiweyo, kunye nexesha eli-1, kunye ne-ultrasound eyenziwa.
Uhlalutyo lomntwana ofile
I-hertology ye-fetus emva kokukhulelwa okukhukhulayo kubandakanya i-microscopy yeesampuli zeengxube zeembrane ze-fetal ze-embryo. Olu pho nonongo lujolise ekumiseni imbangela ebangela ukuba i-pathology. Ngokusekelwe kwiziphumo zohlalutyo, ibhinqa inokunikezelwa ngezifundo ezongezelelweyo ukuze ziqiniseke. Phakathi kwazo:
- Uhlalutyo losulelo lwe-TORCH - lwenziwa emva kweentsuku ezimbalwa emva kokutshiza;
- ukuzimisela kwinqanaba le-hormones yesini - i-progesterone, i-estradiol, i-thyroxine;
- i-immunogram;
- smears kwi microflora;
- ukuzimisela kweendlela eziphambili ze-blood coagulation system - i-fibrinogen, i- prothrombin , i-antithrombin.
Ukucoca ukukhulelwa okukhuni
Ukungenelela kwindlela yokuphanda akuyona indlela yodwa yokunyanga ukukhulelwa okukhukhulayo. Ngethuba elifutshane kakhulu, ukususwa kweqanda lomntwana ofayo kungenziwa ngokuthatha imishanguzo ekhuphayo. Ukucocwa emva kokukhulelwa okukhukhulayo kuboniswa ukuba ukukhubazeka kufumaneka kwiiveki ezi-7 okanye emva koko. Ingenelelo lotyando lwenziwa esibhedlele usebenzisa i-anesthesia jikelele okanye yendawo.
Ngethuba lokusebenza, ugqirha uyasusa intombazane enqabileyo, ngexesha elifanayo ukutsala i-endometrium ye-uterine. Iinqununu zomzimba zesibindi zifakwe kwisitya esingasinyanga kwaye sithunyelwa kwi-laboratory ye-histology. Ekupheleni kwenkqubo yokuqhwala, ibhinqa ilawulwa i-oxytocin, ebangela iziphene ze-uterine. Ngethuba lokuphucula, isigulane sithatha i-antibiotics ukuphepha umngcipheko weengxaki ezithintekayo.
Kubalulekile ukuba uqaphele ukuba emva kokutshitshisa bonke abesetyhini balungiselela umkhuhlane wabo wesisu. Ngokuqhelekileyo kufuneka babe yindawo yokubingelelwa kwaye angapheli ngaphezu kweveki enye. Ukubonakala kwegazi, kwanexabiso elincinci lokuchitha igazi, elinokuhamba kunye nentlungu kwisisu esezantsi, kufuneka sibe sisizathu sokuya kudokotela. Le mpawu zibonakalisa ukuphuma kwamanzi, okufuna unyango oluphuthumayo.
Ukukhulelwa emva kokukhulelwa okukhuni
Kuthatha ixesha lokubuyisela inkqubo yokuzala, ngoko ke oogqirha abacebisi ukukhulelwa kweenyanga ezintandathu. Inkqubo ye-hormonal kweli xesha libuyela kancinci kwilizwe langaphambili. Ukuvuthwa akunjalo ngaso sonke isikhathi, ngoko ke, kunye nenyanga emva kokukhulelwa okuxhambileyo akuzange kuqhubeke. Konke oku kuyinkqubo yokucwangcisa ukukhulelwa, ngoko ke oogqirha bancomela ukuba baqalise ikhosi yeyeza lokulungiselela ngaphambi kokuqala, okuquka:
- Ukukhutshwa kwezinto ezibangele ukukhulelwa ;
- ukuthatha iziyobisi ezijolise ekupheliseni izifo ezingapheliyo zenkqubo yokuzala;
- i-vitamin therapy kunye ne-physiotherapy.