Usongo lokukhulelwa kwesisu - yiziphi izimbangela nezimpawu zesimo, nendlela yokugcina ukukhulelwa?

Igama elithi "usongo lokuphuphuma kwesisu" okukhulunywe ngaso esiphethweni sesidokotela njalo lusiza ukwesaba esikhathini esizayo. Ababelethisi bayashesha ukuqinisekisile abesifazane abakhulelwe ukuthi lokhu akuyona i-pathology futhi ngezokwelapha ezifanelekayo, kungenzeka ukugwema ukuphazamiseka kokukhulelwa.

Usho ukuthini ukususwa kokukhulelwa kusho?

Usongo lokuqeda ukukhulelwa luyinhlanganisela yezici, izinqubo ezithinta izinkinga ezingathinti umfutho, inqubo yokubeletha. Ngokwezibalo, u-20% wazo zonke ukukhulelwa okuzayo kuzophela ekukhulelweni komzimba. Kulesi simo, ukuphazanyiswa kungenziwa ngezikhathi ezahlukene zokubeletha. Ngokuvamile kubonakala emavikini okuqala, ku-trimester yokuqala.

Uma isongo sokukhulelwa kwesisu singakapheli amasonto angama-28 okukhulelwa, izidakamizwa zikhuluma ngokukhipha isisu okuzenzekelayo. Uma amathuba okuthuthukisa le-pathology ehlonishwa ngesikhathi esilandelayo, esikhathini esingaphakathi kwamasonto angu-28-37, odokotela basebenzisa igama elithi "usongo lokuzalwa ngaphambi kwesikhathi". Lokhu kubangelwa ukuba khona kokubeletha usana olusanda kuzalwa, oluzalwa ngemuva kwamasonto angu-28. Endabeni yokukhipha isisu ngokuzenzekelayo kokukhulelwa okwesikhashana, ukufa kwezingane kungenakugwema.

Isongo sokukhipha izisu - izizathu

Izinto ezibangela ukuthuthukiswa kwalesi sifo zihlukile. Esikhathini sokuxilongwa ngemuva kokukhipha isisu, odokotela abahlali njalo bekwazi ukucacisa imbangela. Lokhu kuchazwa yi-multifactority, ukutholakala ngesikhathi esisodwa ngezizathu eziningana, ngokuhlanganisa ukukhulisa ingozi yokukhipha isisu. Ekucabangeni le nkinga, odokotela bavame ukubiza izizathu ezilandelayo zokusongela kwesisu:

1. I-genetic pathology ye-fetus. Ukuthuthukiswa kwezimo eziphuthumayo ekwakheni kwama-chromosomes, ukwanda kwenani labo kwandisa kakhulu ingozi yokukhipha isisu. Ngokuvamile, usongo lubangelwa ukuguqulwa kwezakhi zofuzo.
2. I-Hyperandrogenia - okuqukethwe okwandisiwe egazini lama-hormone wesilisa ocansini. Ngokwe-pathology, ukwehla kwe-estrogens kanye ne-progesterone, okubangela ukuthuthukiswa okujwayelekile kokukhulelwa.
3. Ukungasebenzi komzimba we-adrenal android - ukwanda noma ukwehla ekuhlungeni kwamahomoni okwenziwa ngawo.
4. I-Rhesus-conflict is a pathology lapho umama ongenawo uRher ethwala ingane, igazi layo linguRh-positive.
5. Ubukhona bokukhipha isisu ku-anamnesis.
6. Ukudla okungajwayelekile kwemithi namakhemikhali - ama-hormonal, ama-analgesics, amakhambi okwelapha (ama-tansy, ama-nettles, iSt John's Wort) angandisa ingozi yokwenza isongo sokukhulelwa kwesisu.
7. Ukulimala esiswini.
8. Umsebenzi womzimba wesikhathi eside.

Ngokuhlukile kuyadingeka ukuqaphela izifo ezithathelwanayo. Ngokuphathelene nosongo lokukhulelwa kwesisu, bahlukaniswe ngokuthi:

• okuqondile - i-gonorrhea, i-chlamydia, i- trichomoniasis , i-toxoplasmosis;
• okungajwayelekile - i-hepatitis, i-pneumonia, i-influenza, i-appendicitis, i-pyelonephritis.

Isongo sokukhulelwa kwesisu esikhathini sokuqala

Usongo lokuqeda ukukhulelwa kokuqala luvame ukuhambisana nokungalingani ohlelweni lwe-hormonal. Ngokuvamile, ikakhulukazi kwabesifazane abasebasha lapho sekuqala inqubo yokugaya, kukhona ukuntuleka kwe-progesterone ye-hormone. Lesi sici sinesibopho sokufakelwa okujwayelekile. Ngaphansi kwethonya laso, ukukhula kwamangqamuzana e-myterrium ye-uterine kwanda, okuqoqa ubukhulu obuhle bokufakelwa kweqanda lesisu. Ukungakwazi ukusebenza kwe-progesterone kuvimbela ukuthuthukiswa okuvamile kwe-endometrium, ngenxa yalokho ukukhulelwa kuphazanyiswa ngesikhathi esifushane.

Esikhathini sesibili phakathi kwezimbangela eziholela ekusongweni kokuphuphuma kwesisu esikhathini sokuqala, ziyizifo ezingapheli zesimiso sokuzala, izifo zocansi. Ngokumelene nesimiso sokunciphisa ekukhuseleni, okubonakala ekuqaleni kokukhulelwa, izimo ezihle zenziwa ukuguqulwa kwezinqubo ezingapheli, ezilukhuni zibe ifomu elimangalisayo. Phakathi kwezifo ezingaphazamisa inkambo evamile yokukhulelwa:

• i-chlamydia ;
• i-gonorrhea;
• i-syphilis;
• i- herpes yobulili.

Isongo sokukhulelwa kwesisu esikhathini esiyi-trimester yesibili

Ezimweni eziningi, ukwesatshiswa kokuqedwa kokukhulelwa ku-trimester yesibili kuhlotshaniswa nokuphulwa kwezitho zangaphakathi zowesifazane okhulelwe, hhayi u-fetus. Ngokuvamile, ukuphazanyiswa kokubeletha esikhathini esingaphakathi kwamasonto angu-13-24 kwenzeka ngenxa yokuphelelwa yisifo semithi yabesifazane abakhulelwe. Lesi sifo sihambisana nokuntuleka emzimbeni wensimbi, okuyingxenye ye-hemoglobin. Ngesizo salesi sici, i-oksijeni ithunyelwa ezithombeni nasezingxenyeni zomntwana. I-anemia ingaholela ekufeni kwesimo se-oksijeni somzimba omncane, okuthinta kabi ukuthuthukiswa kwe-intrauterine - isongo sokukhulelwa kwesisu.

Ukuphazamiseka kokukhulelwa phakathi nesikhathi kungenzeka futhi ngenxa ye-placenta previa. Ngalolu hlobo lokubekwa kwendawo yengane, enye yamaphethelo iseduze nomphimbo wangaphakathi wesibeletho. Ngenxa yalokho, ingozi yokuhlukumezeka kwe- placental ngokwengxenye iyanda, engabangela i-hypoxia engapheli nokufa komntwana. Futhi, isongo sokukhulelwa kwesisu singabhekwa njengesiphumo se-ischemic-insufficiency incervical. Ngalokhu kuphulwa, kunciphisa ukuqina kwethambo lomkhuhlane, okungukuthi, ukubhekana nokucindezeleka okukhulu emzimbeni womntwana, kungavulwa.

Isongo sokukhulelwa kwesisu ngemuva kokukhulelwa kwesikhathi eside

Usongo lokuqeda ukukhulelwa ngezikhathi zakamuva aluvamile. Ngokusho igama elisetshenziswe odokotela, likhula kungakapheli amasonto angama-28 okubeletha. Emva kwalesi sikhathi izidakamizwa zisebenzisa igama elithi "ukuzalwa ngaphambi kwesikhathi". Le ncazelo ibonisa ukuthi usana olungabonakala ngalesi sikhathi lungasebenza. Ngokwemibandela yamuva, ukuthuthukiswa kwalesi sixazululo kuqhubeka ngokuya kwesinye sezimo ezilandelayo:

1. Ukwesaba ukukhipha isisu - kubonakala ukwanda kwezwi le-musterature ye-uterine, i-bleeding kancane ukusuka emgodini we-uterine. Ngenkathi yokunakekelwa ngesikhathi esifanele futhi enekhono, i-fetus ingasindiswa.
2. Ukukhipha isisu kule nkambo - ukwephulwa kuhambisane nokuphazamiseka okuphazamisayo, ukuxoshwa komntwana okuvela emgodini wesibindi. Kuhambisana nokucindezeleka, ukuphuma kwegazi. Akunakwenzeka ukusindisa ukukhulelwa.
3. Ukukhipha isisu okungaqediwe - okubhekiswe ekukhululweni kwengxenye ye-fetus noma ukuqhekeka kwezingqimba. I-fetus isuswa ngokuhlinzwa.

Isongo sokukhulelwa kwesisu - izimpawu

Kunzima ukuqaphela usongo lokuphazanyiswa kowesifazane okhulelwe. Ngokwesilinganiso, i-10-15% yazo zonke izimo ze-pathology zihambisana nezimpawu ezivame ukuhamba noma ezilukhuni. Into yokuqala edingeka ukuba inakekelwe owesifazane okhulelwe ukuvela ngokungazelelwe kokukhipha igazi kusuka kumlenze. Ekuqaleni kungaba amaconsi ambalwa ezembatho zangaphansi zakho. Nokho, ngokuhamba kwesikhathi, izimpawu zanda. Owesifazane futhi urekhoda ezinye izimpawu zokusongela kwesisu:

• ukuzwa ubuhlungu, ukungakhululeki, ukuzwa ubuhlungu emathunjini aphansi;
• ukuwohloka kwenhlalakahle jikelele;
• ukunciphisa ukucindezelwa kwegazi;
• isicasuli;
• ukuhlanza.

Uma uhlolwe esihlalweni somzimba wegazi, okulandelayo kutholakala:

• Isibeletho asiphenduli ekuhloleni ngokukhulisa ithoni;
• i-sulcus yangaphandle ivaliwe noma kancane ajar;
• Kukhona igazi egazini lomzimba.

Ukunikezwa uma kwenzeka usongelwa ukukhulelwa kwesisu

Isongo sokukhulelwa kwesisu ekuqaleni kwezinyathelo zokukhulelwa ngaso sonke isikhathi sihambisana nokubonakala kwegazi kusukela emgodini wokubeletha. Esikhathini sokuqala, ivolumu yayo iyingcosana, okufana nalokho okubonwayo ngokuya esikhathini. Umbala wokukhishwa ungahluka kusuka obomvu obomvu kuya ku-serous-bloody. Ngokusho kokubheka odokotela, ku-12-13% amacala abulala igazi aholela ekususweni kokukhulelwa. Uma uphepha kakhulu, kukhona ingozi yokuthuthukisa ukuphuma kwegazi, okuhambisana nalokhu:

• ikhanda;
• ukuhlanza;
• ukunciphisa ukucindezelwa kwegazi;
• i-blanching yesikhumba;
• ukwanda kwentando yenhliziyo;
• ukulahlekelwa kokwazi.

Ubuhlungu uma kusongelwa ukukhulelwa kwesisu

Isongo sokuqedwa kokukhulelwa, izimpawu zazo okuxoxwe ngaso ngenhla, cishe njalo kuhambisane nobuhlungu esiswini esingaphansi. I-Symptomatology ihlotshaniswa nokwanda kwezwi le-myometrium yebele, okwandisa isivumelwano sayo. Lesi simo sihambisana nokuzwela okunzima, ukudonsa uhlamvu lomlingiswa (ukuvame ukudonsa noma ukuncipha). Ngesongo sokukhulelwa kwesisu, ubuhlungu buhlala endaweni yangasese e-suprapubic, kungabuyisa emuva emuva noma i-sacrum. Ubukhulu bezinhlungu abuxhomeki esimweni somzimba.

Yini okufanele uyenze uma usongelwa ukukhulelwa kwesisu?

Uma owesifazane okhulelwe etholakala enesongo sokukhulelwa kwesisu, ukwelashwa kuqala ngokushesha. Ukwelapha kwenziwa esibhedlela, kanti isisekelo saso sihambisana nokuphumula kombhede (ezimweni ezinzima, owesifazane okhulelwe akavunyelwe ukuphuma embhedeni). Ingozi yokukhipha izisu ibangela ukukhathazeka nokwesaba komuntu wesifazane, ngakho-ke abantu abalingiswa banqunyelwe ukuqedwa kwakhe. Odokotela bacebisa ukuba bahlale bezolile uma nje udinga ukucabanga ngemnandi.

Izincomo zezokwelapha ezisongela ukukhipha isisu

Ukuthi ukusongelwa kwesisu esikhathini esingaphambili akuzange kuholele ekuqedeni kokukhulelwa, odokotela batusa abesifazane ukuba bagcine lezi zimo ezilandelayo:

1. Ukuvivinya umzimba.
2. Ukuphumula okungaphezulu.
3. Ukuqeda ukucindezeleka nokukhathazeka.
4. Yeka ubulili.
5. Qaphela ukudla okuphansi kwekhalori.

Amathebulethi uma usongelwa ukukhulelwa kwesisu

Zonke izidakamizwa uma kwenzeka ukukhulelwa kwesisu kumele zibekwe kuphela udokotela. Uchwepheshe, ecabangela ubukhulu besimo, isimo sempilo wesifazane okhulelwe, ubeka imithi emithini edingekayo. Phakathi kwezidakamizwa ezisetshenziswa:

• antispasmodics (Papaverin, No-shpa, Drotaverin);
• Ama-gestagens (Dyufaston ekusongweni kokukhulelwa kwesisu ekuqaleni kwezigaba kusiza ukuqeda ukukhubazeka);
• i-glucocorticoids (i-Dexamethasone, i-Metipred);
• i-hemostatics (i-Dicinon, i-Vikasol, i-Ascorutin);
• amavithamini (folic acid, vitamin K, E).

Kusasa kusongelwa ukukhulelwa kwesisu akusetshenziswanga kaningi kunamanye ama-gestagens. Kulesi simo, odokotela batusa ukuwasebenzisa emakhandlela. Isilinganiso nokuphindaphindiwe kusethwe ngabanye, kodwa ezimweni eziningi, odokotela banamathele kulolu hlobo lwemithi yokwelapha olulandelayo:

• I-suppository ene-dosage ye-200 mg ngosuku;
• Amakhandlela angu-2 ngelilanga nomthamo we-100 mg.

Uma injected ngesongo sokukhulelwa kwesisu

Ukwelashwa kwesisindo sokukhipha isisu esibhedlela kuhilela ukusetshenziswa kwezinhlobo ezidakamizwa zezidakamizwa. Kulesi simo, izidakamizwa ezifanayo ezibalwe ngenhla ziyasetshenziswa, kodwa ngendlela yezixazululo. Indlela enjalo yokuphatha yenza kube khona ukufezekisa ukuqala kokuqala kokwelapha. Phakathi kwezidakamizwa ezisetshenziswe ngendlela yamajojo:

• I-magnesium sulphate ;
• Partusisten;
• I-Ritodrin;
• Apentage.

Indlela yokuvimbela usongo lokukhulelwa kwesisu?

Isondlo sokuvimbela isisu kufanele siqale esiteji sokuhlela ukukhulelwa. Ngaphambi kokukhulelwa kombhangqwana oshadile kubalulekile ukuhlolwa, ukudlulisa izivivinyo, ukuqhuba izifundo zokwelashwa ekutholeni izifo ezingapheli.

Izinyathelo zokuzivikela ezihloswe ekuqedeni ukusongelwa kokuphuma kwesisu zihlanganisa:

• ukubhaliswa ngesikhathi esifanele sokukhulelwa;
• ukunamathela ezincomo zodokotela;
• ukulahla imikhuba emibi;
• ukuqedwa kwezimo ezicindezelayo;
• ukwenqaba ekuzikhandla okukhulu ngokomzimba, ukuqeqeshwa kwezemidlalo;
• ukujwayelekile kombuso wosuku.