Ukuphuka komlomo kubhekisela ezinkingeni zomzimba ezidinga ukwelashwa okuphuthumayo. Uma kungenjalo, kungenzeka ukuthi imiphumela ebulalayo ingenzeka. Ake sicabangele ukwephulwa ngokuningiliziwe, sibone izimbangela zayo, izici ezivusa amadlingozi, izindlela zokwelapha.
Ukuhlukaniswa kokuhlukana komlomo wesibeletho
Okokuqala, kufanele kuqashelwe ukuthi igebe lingenzeka ngokuzimela, ngezizathu ezihlukahlukene. Kodwa kaningi kwenzeka ngezinhlelo ezihlukahlukene zokuhlinzeka ohlelweni lokuzala nangesikhathi sokubeletha. Ukuphuka okungajwayelekile kungacasulwa:
- Ukwelula okuncane komlomo wesibeletho ekusebenzeni (kubonakala ku-primipara ngemva kweminyaka engu-30 ).
- Ukwelula ngokweqile ngesikhathi sokubeletha kuyisimo esiphezulu se-fetus, ukulethwa okusheshayo, izithelo ezinkulu.
- Ukucindezelwa isikhathi eside kwesibeletho ngenxa yesikhumba esincane - ukuhlukunyezwa okubudlova kwenzeka ngenxa yokulethwa kwesisu okusiza ukusheshisa ukubukeka kwengane:
- ukusebenzisa i-forceps;
- ukukhipha umfutho .
Ngaphezu kokuhlelwa ngokwezinhlobo zokuthuthukiswa (ukuhlukunyezwa nokuhlukumezeka), kukhona ukwahlukana ngokwamazinga okukhubazeka. Ngakho-ke, yamukelwa ukunikeza ama-degrees amathathu okuphuka kwentamo yesisu. Ngamunye unesithombe sakhe somtholampilo. Kulesi simo, isifo se-symptomatology sifana nalokhu. Ngenxa yalokhu, udokotela anganquma ngokunembile izinga, ngemuva kokuhlola isitho sobulili.
Ukuphuka komlomo wesi-1 degree
Ukuhlukana komlomo wesibeletho we-degree 1 ngesikhathi sokubeletha kuvela kaningi ngenxa yokungahambisani nemiyalelo kadokotela. Ngokuvamile lokhu kwenzeka uma owesifazane engaphumi empi. Ngesikhathi esifanayo kukhona ukwanda kwengcindezi yangaphakathi, ngenxa yentuthuko yengane eceleni komsele wokuzalwa. Le degree ihlelwe uma igebe lingadluli ku-1 cm. Litholakala kaningi ngakolunye uhlangothi.
Isithombe esitholakala emtholampilo ekuphukeni okuncane singabonakaliswa buthakathaka. Ngokuvamile odokotela bakhuluma ngenqubo engafani kahle yalolu hlobo lwezokwelapha. Ikakhulu uma igebe lingeqi 10 mm. Isibonakaliso esiyinhloko kuleli cala liphuma egazini. Ngokuhamba kwesikhathi, umthamo wayo unganda. Owesifazane uzwa ubuhlungu obuphansi kwesisu noma isisu, umlingisi we-skvatkobrznogo.
Ukuphuka komlomo wesibeletho sesi-2
Ukuphuka komlomo wesibeletho wezinga lesibili ngesikhathi sokubeletha kuvela lapho ingane ingahambisani nomthamo we-pelvis. Lokhu kungenzeka uma imingcele ye-anthropometric yane usungulwa ngokungalungile ngenkathi i-ultrasonography. Ngenxa yalokhu, odokotela bakhetha ngokungalungile amacebo okudiliva, okuholela ekuqhekekeni. Ngalesi sifo, igebe alidluli u-2 cm. Kulesi simo, sendawo kuphela esifundeni sesibeletho, ngaphandle kokuthinta ingxenye yesifazane.
Ukuphuka komlomo wesi-3 degrees
Ukuqedwa kwesisu somlomo wesibeletho sesigaba sesibili kubonakala ngokubandakanyeka kwesiswini kwindlela yokwelapha. Kulesi simo, igebe lihlanganisa ngokuphelele, akukho mingcele ecacile. Lolu hlobo lokuphulwa lubhekene nokukhishwa okuqinile, okuchichima okuvela emgodini wesisu, ngokuvamile ngezindwangu ezinkulu. Ezinye izimpawu zifaka:
- izithukuthuku ezibandayo;
- ukuphazamiseka kwezimpikiswano kanye nezinambuzane ezimangcwaba;
- ukunciphisa ukucindezelwa kwegazi;
- ukwanda kwenani lezinhliziyo.
Izimbangela zokuphuka komlomo wesibeletho
Ezimweni eziningi, ukuhlukana komlomo ngesikhathi sokubeletha kubangelwa ukwephulwa kwendlela yokwenza isigqi-ukukhulula ukuphathwa. Noma kunjalo, lokhu kungenzeka ngenxa yezimo ezihambisana nesimo segciwane lesandulela ngculazi. Phakathi kwezimbangela eziyinhloko zesifo sokugula sezidokotela kukhona:
- kunciphisa ukuqina kwezinhlaka zomzimba wesibeletho - isici ngesikhathi sokubeletha emva kweminyaka engama-30;
- ukutholakala kwezibazi , izinqubo zokuvuvukala, ezibonakala entanyeni;
- ukuhlukumezeka kokuhlanjululwa komzimba okungaphelele komsebenzi wesibeletho, ukungafani nokulingana komntwana wesisu;
- Ukuzalwa okusheshayo - isigaba sokuthunjwa sithatha imizuzu embalwa kuphela;
- usayizi omkhulu wekhanda ebusweni, isisindo somzimba esingaphezulu kuka-4 kg.
Ukuphuka komlomo ngesikhathi sokubeletha
Ngesikhathi sokubeletha ukukhubazeka kwesimo esifanayo akulona njalo. Kwathukuthelisa ngokweqile emaphethelweni we-pharynx wesibeletho, ukwanda kobubanzi bomnyango wangaphandle. Ngenxa yalokho, umthwalo entanyeni ukwanda, futhi ubuqotho bawo buphulwa. Ukuqedwa ngokushesha kwe-pathology kuqeda imiphumela emibi. Ngokuvamile, ngegap enkulu, izinqumo zenziwa ngokuqhuba isigaba sokuphuthuma esiphuthumayo.
Ukuphuka kokubeletha komlomo wesibeletho kuncike ekutheni suturing ekamelweni lokulethwa. Ukufakwa uphawu kusenziwa ngokusebenzisa izintambo ezikhethekile, ezi-bioresorbable. Usizo olungalindelekile lubhekene nokuthuthukiswa kwegazi lomzimba, okungabangela umphumela obulalayo womama ekubelethweni. Ukuze unciphise isikhathi sokunakekelwa, i-anesthesia ayisetshenzisiwe.
Ukuphuka komlomo ngocansi
Ukukhishwa kwesibeletho ngesikhathi sokulala kungenzeka, kepha ngokusebenza lokhu kwenzeka ngokungajwayelekile. Kwenzeka lapho udlame oluvuthiwe, oluvuthayo, olunenjabulo yokungena. Ukuhlukumeza kwentamo kuholela ekuthuthukiseni ukuphuma kwegazi. Ngesikhathi esifanayo, owesifazane uzwa ukuwohloka okubukhali empilweni yakhe, ubuthakathaka, isizungu, ukuphathwa ikhanda. Izimpawu eziyinhloko zalesi sifo zihlanganisa:
- Ukwehla kwamanzi kusilimaza esiswini esingaphansi, emagqumeni angama-inguinal;
- ukuvela kwegazi kusuka kwesifazane (ngezinye izikhathi ngesamba esingenalutho);
- ukuzwa okubuhlungu esifundeni se-lumbar.
Izimpawu zokuphuka komlomo wesibeletho
Ukuphuka komlomo wesibeletho wezinga lesibili kanye nosayizi omncane awukwazi ukubonakaliswa emitholampilo. Kulesi simo, isiguli sigcizelela ukuwohloka okuthile kokuphila okuhle. Igazi elisuka kumgogodla womzimba cishe aligcini, kwezinye izimo, abesifazane bangakwazi ukuphaphaza. Bavame ukuwaxhuma ngokushintsha kwendawo yangemuva ye-hormonal futhi ungathinti ukubaluleka kubo. Kodwa-ke, njengoba isimo siqhubeka, isimo siyaqhubeka.
Uma igebe ngesayizi lidlula u-1 cm, kukhona ukuphuma kwegazi, okwenza udokotela akwazi ukubhekana nalokhu. Kulesi sabelo kukhona ama-clots egazi, okubonisa ukuqoqwa okuyingxenye emgodini wesisu. Ngaphansi komthelela wokushisa komzimba, igazi lihlanganisa futhi liphume kancane liphuma ngendlela yama-clots egazi. Ngaphandle kokuphuma, lezi ziguli zirekhoda:
- ubuthakathaka obungenakuqondakala;
- ukuwohloka kwenhlalakahle jikelele;
- ukujuluka ngokweqile.
Ukuze uhlolisise ukuwohloka komlomo wesibeletho, umjozi wezifo zogciwane uqhuba ukuhlolwa esihlalweni. Ngesikhathi esifanayo, ukuguqulwa usayizi nesakhiwo sesibeletho kubhaliwe. Isidumbu sinokuvuvukala, okungadlulela kancane emgodini. Uma ukuphuka kwenzeka ngesikhathi sokubeletha, ukulwa okuqhamukayo kuvela-okungazalisi, ukuphikisana okwesikhashana kwesibeletho. Emcinini, igazi lingase libe khona, futhi isiguli ukhononda ngokushisa okukhulu nobuhlungu esiswini esingaphansi. Ngenxa yalokho, ukukhathazeka kobuhlungu kuvela:
- isicasuli;
- ukuhlanza;
- ukujuluka okukhulu;
- isikhala sesikhumba;
- ukunciphisa ukucindezelwa kwegazi;
- ukushayela ngokushesha.
Ukuphuka komlomo wesibeletho - imiphumela
Kufanele kuqaphele ukuthi akunakwenzeka njalo ukuxilonga ukuhlukana komlomo ngesikhathi. Isizathu salokhu ukungabikho kokuphuma kwegazi noma ubuningi bayo obuphansi. Kwezinye izimo, udokotela akakwazi ukuthola ukuhlukunyezwa komlomo ngesikhathi sokubeletha, imiphumela okungaba kanje:
- ukuphazamiseka okukhulu ngenxa yokuphuma kwamanzi esikhathini sokuphela kwesikhathi sokuhamba kwesikhathi;
- Ukwakhiwa kwezilonda ze-postpartum, okunika amandla ekuthuthukiseni ukwelashwa kwentamo;
- ukwakheka kwezibazi;
- i-ectropion - ukuguqulwa komlomo wesibeletho;
- ukuthuthukiswa kwesifo sokukhuphuka - i-endometritis, i-adnexitis;
- I-ICN yinto engakwazi ukuyenza, ngenxa yokuhluleka kwezakhi zomzimba zomlomo wesibeletho.
Ukwelashwa kokuhlukana komlomo wesibeletho
Ukwelashwa kwalolu hlobo lokuphulwa kungenzeka kuphela ukuhlinzwa. Ukudilizwa komkhuhlane wesibeletho kwenziwa kuzo zonke izifo zokugula. Okuhlukile kungase kube ukuphazamiseka kwamanzi, okungekho ukulahleka kwegazi. Ezimweni ezimbi, ukuqubuka kwesisu kwenziwa. Isetshenziselwa ukususa i-hematoma, eyakhiwa ngesikhathi sokuguqulwa kwesiphakamitha (izicubu ze-adipose).
Ukukhulelwa emva kokuhlukana komlomo wesibeletho
Ngokuvamile ukutholakala komkhuhlane wesibeletho ku-anamnesis kuba yisithiyo ekuthuthukiseni ukukhulelwa okulandelayo. Lokhu kubangelwa inqubo yokunamathela emgodleni omncane, okuvimbela ukuvuthwa okujwayelekile nokukhulelwa. Kodwa ngisho nokukhulelwa kokuqala ngemuva kokuphuka komtamo akusiyo njalo ukuphuma. Ukungazi kahle kwemisipha yesibeletho kungabangela ukuvula ngaphambi kwesikhathi, okubangela ukusebenza ngaphambi kosuku olufanele. Ngenxa yalokhu, ngisho ne-gap encane emlonyeni wesibeletho ngesikhathi sokukhulelwa kungaphansi kokulawula nokubona.
Ngokuvamile ukwephula kungavinjelwa. Ngakho ukuvimbela ukuhlukumeza komlomo kuhlanganisa:
- ukuhamba ngesikhathi esifanele kwe-ultrasound;
- ukuqaliswa kwezincomo zezokwelapha;
- ukulethwa kwezivivinyo kanye nokuhamba kocwaningo.
Ukuzalwa kwesibili ngemuva kokuphuka komlomo wesibeletho
Ukuze kungabikho ukuvuthwa kwesibeletho ku-rumen ngesikhathi sokubeletha kwemvelo, ukudiliva kwesibili kanye nokulandela odokotela kwenziwa yi-cearean. Ukungenelela kokusebenza kuhlelwe kusengaphambili. Isikhathi esiphelele salo maviki angu 37-38 wokukhulelwa. Ukufakelwa kwe-Fetal kwenziwa nge-incision, eyenziwa phansi kwesisu. Ukusebenza kwenziwa ngaphansi kwe-anesthesia jikelele.