Isifiso sokubeletha ingane sinqume kubo bonke abesifazane, kodwa, ngeshwa, akusiyo njalo eyenziwa. Isizathu esivamile sokukhulelwa kwesisu ngokuzenzakalelayo ukungakwazi komlomo wesibeletho ukubhekana nomsebenzi wokuvimbela: ngaphansi kwethonya lokucindezeleka kwe-intrauterine, kukhishwa futhi kuvulwa, okwenza kube usongo lokuqeda ukukhulelwa . Odokotela babiza ukuphulwa okunjalo kwe-ICI, noma ukungaqiniseki kwesifo somlomo wesibeletho.
Ukungaqiniseki kwe-Isthmiko-kwesibeletho - izizathu
Ngokuvamile, ukungakwazi ukuvikelwa komlomo wesibeletho kutholakala ku-trimester yesibili yokukhulelwa, lapho kukhula ukukhula komntwana okukhulayo. Abesifazane abathole i-IVF noma abahlukumeze umlomo wesibeletho ngesikhathi sokukhipha isisu noma ukubeletha kwangaphambilini basengozini (isibonelo, ngokususwa ngokuzenzakalelayo kwe-placenta, ukuzalwa komntwana omkhulu noma ukusetshenziswa kwe-forceps obstetric).
Ngaphezu kwalokho, izimbangela ze-ischemic-insufficiency yomlomo ngu:
- ukukhubazeka kokubeletha kwesisu (ukuphinda kabili kwesibeletho, isibindi se-bicorne, njll);
- i-infantilism yesisu;
- Ukuntuleka kwe-progesterone kanye ne-androgens ngokweqile;
- okungajwayelekile kwe-cervix (kokuzalwa noma kokuthola);
- ishintshile isilinganiso sesishukela esixhumeneyo nesisu emlonyeni wesibeletho.
Ukungaqiniseki kwe-Isthmiko-kwesibeletho - izimpawu
Ingozi yokungaqiniseki kwe-Isthmico-umlomo wesibeletho ekukhulelweni yukuthi ayihambisani nanoma yiziphi izimpawu zangaphandle nokuzwela ubuhlungu. Ukusola ukuthi ukuvulwa komlomo wesibeletho okungenakufika kungase kube ukuvuthwa okusheshayo (okuyi-atypical in the trimester yesibili), ukufihla okulandelanayo (ukuhamba kwepulagi elikhukhulayo ngesikhathi sokukhulelwa ), ukungathandeki emkhathini.
Kunoma ikuphi ukusola kokuhluleka komlomo wesibeletho kubalulekile ukubhekana nodokotela ngokushesha futhi uqaphele ngokucophelela: kuleso simo, ukuqedwa kokukhulelwa kungathukuthelisa ngisho nokucasula.
Ukungakwazi kahle kwe-Isthmiko-kwesibeletho - ukuxilongwa
Ngeshwa, i-ICI ivame ukutholakala kuphela ngemva kokuphuma kwesisu okuzenzakalelayo. Ngaphambi kokukhulelwa, lesi sifo sinzima kakhulu ukubona, ngaphandle kwamacala okutholakala esibelethweni sesisindo esibi.
Ngaphambi kokuthola ukuxilongwa, udokotela uzozibuza ngokuphathelene nokukhubazeka nokulimala komlomo wesibeletho, kanye nokutholakala kwezifo ze-endocrine. Ngesikhathi sokuhlolwa kwegazi, kungenzeka ukuthi ukutholakala kwe-ischemic-insufficiency kungaboniswa ukuguqulwa, ukunciphisa nokunciphisa umlomo wesibeletho, futhi ngezinye izikhathi ukuvula kwawo. Uma kungabazeki, i-ultrasound yangaphandle noma i-hysterosalpingography (engewona okhulelwe) inqunyiwe.
Ukungakwazi kahle kwe-Isthmiko-wesibeletho - ukwelashwa
Uma owesifazane ethola ukuthi une-inchemic-syndemic-insufficiency, kunconywa ukuthi ukuphumula kombhede nokuphumula okuphelele, kuhlanganise nokulala ngokobulili, kubonwe.
Ukuze kusetshenziswe izindlela ze-NIC, izindlela zokuhlinza nezindlela zokuzivikela ziyasetshenziswa. Abesifazane abakhulelwe, njengombuso, benza ukuhlinzekwa kweplastiki yomlomo wesibeletho. Ukwakheka kulolu cala kungenziwa kuhlelwe kuphela izinyanga eziyisithupha emva kokusebenza, futhi ukubeletha kwenziwa ngosizo lwesigaba sokudla.
Ukungenelela okuhlinzekwayo kumama olindelekile ukubeka ama-sutures emgodini wesibeletho futhi kwenziwa kuze kube amasonto angu-16-18
Indlela yokwelashwa okulondolozayo kuyindlela yokusebenzisa ama-pessaries (izindandatho zikaGoj, Meyer) - amadivaysi akhethekile angaphansi kwe-silicone noma epulasitiki, okunciphisa umthwalo esibelethweni. I-pessary ingafakwa ekubonisaneni kowesifazane, ngokuvamile kuyenziwa ezinyathelweni zokuqala zokukhulelwa futhi isuswe ngaphambi kokubeletha, emavikini angu 37-38.
I-Pessary ayilimazi umlomo wesibeletho futhi ayifaki ingozi kumama ozayo nomntwana, kodwa ayinakuphumelela lapho umlomo wesibeletho uvuleka kanye nokuqhamuka kwesisindo sekhanda.