Isisu ekukhulelweni ekuqaleni: ebangela, uphethwe, uthintelo, unyango

Ukungaqiniseki kokukhulelwa akukona nje ukukhathazeka ngokomzimba kowesifazane, kodwa nokuziphatha kakuhle. Kungenxa yesi sizathu sokuba ubuninzi beenkcukacha malunga nokuxilongwa, izizathu, iimpawu, unyango, kwakunye nokuthintela ukukhupha isisu kulandelwe kwinqaku elilandelayo.

Ukukhulelwa kokukhulelwa kwangaphambili kubuhlungu kwaye, ngelishwa, into eqhelekileyo. Ngokwezibalo, ukukhulelwa komfazi wesibhozo kuphazanyiswa kwiiveki ezilishumi elinambini zokuqala. Abaninzi babo bafumana ukukhulelwa komzimba, ngelixa bengalindelekanga ukuba bakhulelwe. Yaye enye inokwenzeka yokuba ulahlekelwe ngumntwana sele isetyenziswe kwintlanganiso yokuqala kwaye icebise ukuba ulale ukuze ulondolozwe.

Ukukhipha isisu kutyalwa njengento encinci kumsebenzi wokuzala kunye nempilo yowesifazane. Kubalulekile ukuba ungaphuthelwa umhla wokugqibela.

Ukuphazamiseka kokukhulelwa akunakubonwa ngumfazi osekuqaleni. Ukuhlehliswa kwenyanga kuvele kubhalwe phantsi ngenxa yokulibaziseka, kwaye kuqala ukuphuma kwegazi elininzi, elihamba kunye nentlungu yentlungu. Xa umntwana sele ephele, ukuphuma kwegazi kunye nentlungu iphela, loo mfazi akanakho ukuba uyazi ukuba ukhulelwe.

Ukuba umntwana akayi kuphuma ngokupheleleyo, yintoni imbangela yokuphuma kwexesha elide, umfazi udla ngokubhekisela kwingcali echaza ukukhulelwa komzimba. Uninzi oogqirha, ukuze ubuyisele umzimba wesetyhini, emva kwimeko elolo hlobo lonyula ikhosi yeyeza.

Izizathu

Izizathu zokuphuphuma kwesisu zingenziwa ngale ndlela:

• Ukuhluleka kweHormon.
• Ukungaqhelekanga kwe-Genetic.
• Izifo ezithintekayo.
• Rhesus.
• Amalungiselelo omuthi.
• Ukulimala.
• Ukukhupha isisu ngexesha elidlulileyo.

Isongelo sokupheliswa kokukhulelwa kwisibini se-trimester sincitshiswa ngokucacileyo. Ngokwezibalo, kwi-trimester yesibini, kuphela omnye kwabafazi abalishumi elinesibini abahlukumezekile.

Ngoko, makhe siqwalasele ngokungakumbi iinkcukacha zilapha ngasentla.

Ukuhluleka kweHormon

Kwimizimba yabasetyhini, ama-hormones kunye nokulinganisela kwazo eziyimfuneko kubume abaqhelekileyo kwinkqubo yokukhulelwa. Kwezinye iimeko, ukungaphumeleli kwimvelaphi ye-hormonal kungabangela ukuphazamiseka. Iingcali zichonga i-progesterone njenge-hormone ebaluleke kakhulu, efunekayo ukuba iqhubeke nokukhulelwa. Ukuba ukusilela kwakhe kwafunyanwa ngexesha, loo mfazi umiselwe le hormone ngendlela yemichiza, ngenxa yoko, isiqhamo singasindiswa.

Ukongezelela, ibhalansi ye-fetal ichaphazelekayo ngemali ye-androgens. Ngenxa yobunzima babo emzimbeni wesifazane okhulelweyo, ukuveliswa kwe-estrogen kunye neprogesterone inqatshelwe, kwaye oku kusongela ukukhulelwa komzimba.

Izifo ezithintekayo

Xa ulungiselela ukukhulelwa, umfazi kufuneka anakekele zonke izifo ezingapheliyo. Ukongezelela, kucetyiswa ukuba ugweme izifo ezithathelwanayo. Emva kokungena kumzimba wesetyhini we-pathogen, iqondo lokushisa likwazi ukuphakama ngokukhawuleza, elikhupha nokukhulelwa kwesisu.

Isisongelo esisodwa kumntwana sisifo esasasazeka ngesondo. Ngoko ke, abazali abazayo ekulungiseni ukukhulelwa kufuneka bahlolisiswe kwaye baphumelele iimvavanyo kwezi zifo. Ngenxa yokuba olu hlobo losulelo luya kumntwana ngenxa yegazi, kumaxesha amaninzi phambi kwentsholongwane kunye nokufumanisa ukuphuphuma kwesisu.

Ukungaqhelekanga kwe-Genetic

Isabelo seengonyama sazo zonke izilahleko zenzeke ngokuchanekileyo kwesi sizathu. Oogqirha babiza isibalo se-73% seenani labo elipheleleyo. Kwihlabathi lanamhlanje, le nto ibambe indima enkulu. Iimveliso ezinobulunga obuphantsi, ukuchithwa kwe-radiation, ukungcola kwezinto eziphilayo-konke oku kuchaphazela umzimba wesifazana imihla ngemihla.

Kuze kube namhlanje, ukulungiselela ukukhulelwa, abaninzi abafazi bazama ukushiya isixeko esiqhelisayo kunye nokuchitha ixesha elifanelekileyo kwiimeko ezifanelekileyo. Nangona ukuba le miba ayinakupheliswa lula, iinguqu ezinxulumene nazo azibheki njengelifa, ukukhulelwa okulandelayo kuya kuphumelela.

Rhesus

Lo mbandela phantse unqwenela ukupheliswa kokukhulelwa sele kusekuqaleni kwamanyathelo. Ngenxa yesi sizathu, ukuba umfazi unendawo ye- Rh engenanto kwaye umntu unesimo esihle, le meko yezinto ingabangela ukuxabana kwe-Rh kwaye, ngenxa yoko, ukukhulelwa kwesisu.

Okwangoku, iyeza sele lifunde ukuhlangabezana nale ngxaki ngokusungulwa komzimba wesifazane weprogesterone. Ngaloo ndlela, umntwana okhuselweyo uyakhuselwa kwisistim sokuzivikela somzimba. Nangona kunjalo, kulo mzekelo, kunokubakho ingxaki yokukhulelwa kwesisu.

Mayeza

Iingcali zincoma ngeli xesha ukuba ziphephe ukuthabatha amayeza, ingakumbi kwizigaba zokuqala. Kubaluleke kakhulu ukukhuphela zonke i-analgesics nama-hormone. Kwakungathandeki ukusebenzisa iindlela zokupheka apho iSt John, i-nettle, i-cornflower kunye ne-parsley zikhona njengezithako.

Imiba yokuxinezeleka

Usizi olukhawulezileyo, ukuxabana kwintsapho, okanye uxinzelelo emsebenzini - zonke ezi zizathu zokukhulelwa kwesisu ekuqaleni. Kumele kube ncitshiswe okanye, ukuba kunokwenzeka, kugweme ezi zinto. Inendima ebalulekileyo ekwakheni indawo yokuzola yintokazi ibingumntu. Ukuba akunakwenzeka ukuba ugweme isenzo sezinto ezixinzelelekileyo, ngoko oogqirha babonelela ngokukhawuleza.

Imikhwa emibi

Ngaphambi kokuba ukhulelwe, kuyimfuneko ukuyeka ukuthwala utywala nokuyeka ukutshaya. Ukubhema kunokuchaphazela kakubi inkqubo ye-cardiovascular fetal. Kunconywa ukwakha inkqubo eqhubekayo yokutya okunempilo, kunye nesethi yamaminerali abalulekileyo kunye namavithamini. Kwakhona kuyimfuneko ukulungelelanisa imihla ngemihla.

Ukulimala

Ngokubambisana neemeko ezichazwe ngasentla, ukukhulelwa kwesisu ekuncinci kunokubangela isifo esibi, ukuwa okanye ukuphakamisa izinto ezinzima. Ngoko ke, kufuneka usebenze ngokucophelela ngokunokwenzeka.

Ukukhupha isisu ngexesha elidlulileyo

Oku akusiyo nje ingxabano esetyenziselwa ukusongela abasetyhini abaselula, kodwa kunye neyona nto ingxaki yexesha elizayo. Kwezinye iimeko, ukukhupha isisu kunokukhokelela ekungabikho komntwana kunye nokuphulukana nokungahambi kakuhle.

Ukuxilongwa

Ukutshatyalaliswa kokutshatyalaliswa kokukhulelwa kuyisifo esiphezulu apho izigulane ezininzi zidibanisa kunye nezifo ezininzi ngexesha elifanayo. Ngenxa yesi sizathu, ukuhlolwa kwezigulane kufuneka kwenziwe ngendlela epheleleyo kwaye kubandakanye zonke ii-laboratory zanamhlanje, izixhobo kunye neekliniki.

Ngethuba loviwo, kungekhona kuphela izizathu zokukhupha isisu, kodwa imeko yenkqubo yokuzala ihlolwe ngokuthintela ukulandelwa kwimeko enjalo.

Uviwo ngaphambi kokukhulelwa

Imbali ibandakanya ukucaciswa kobukho be-somatic, i-ecological, izifo ezifa kunye ne-neuroendocrine pathology. Imbali ye-Gynecologic ikuvumela ukuba ufumane ubungqina bentsholongwane yintsholongwane, izifo ezivuthayo ezithintekayo, izixhobo zokuzala kunye nokuya esikhathini (ukukhupha ngokukhawuleza, ukubeletha, ukukhupha isisu), iindlela zokwelapha kunye nokungenelela kwamanyathelo okugonywa, izifo zentsholongwane.

Kwinkqubo yoviwo lweklinikhi, uviwo, ukuhlolwa kwimeko yesikhumba, i-thyroid gland kunye nokukhuluphala ngokuhambelana nomlinganiselo wongxowankulu umzimba. Ngokutsho kwenombolo ye-hirsut, iqondo le-hirsutism lichongiwe, imeko yezitho zangaphakathi ihlolwe, kunye nesimo somzimba. Ukungabikho okanye ubukho be-ovulation, isimo somsebenzi wee- ovane sihlaziywa ngokwekhalenda yexesha lokuhamba kunye nokushisa kwamaritha.

ILebhu kunye neendlela eziphambili zophando

Ukuxilongwa kokungahambi kakuhle kubandakanya izi zilandelayo zifundo:

• I-Hysterosalpinography - eyenziwa emva komjikelezo wesini kwiintsuku eziyi-17-13, ikuvumela ukuba ungabandakanyi i-synechia yangaphakathi, ukungasebenzi kwe-uterus, i-ICS.
• I-Ultrasound - inquma ukuba khona kwe-adenomyosis, i-cysts, i-myomas ye-uterine, ihlola imeko ye-ovari. Icacisa isimo se-endometrium: i-endometrial hyperplasia, i-polyps, i-endometritis engapheliyo.
• Ukuhlolwa kwintsholongwane - kubandakanya ukuhlolwa kwe-microscopic ye-vaginal, urethra, isalath canal yomlomo kunye nokuhlolwa kwe-bacteriological kokuqukethwe kwinqanawa yomlomo wesibeleko, ukuxilongwa kwe-PCR, kunye nokuvavanywa kwezothutho lwe-viral.
• Uphando lweHormonal. Yenziwa ngomhla wesi-5 okanye wesi-7 womjikelezo, ngokuxhomekeka kwimihla yokuya esikhathini, kwizigulane ezine-oligo kunye ne-amenorrhea-nangayiphi na imini. Umxholo we-17-hydroxyprogesterone, i-DHEA sulfate, i-cortisol, i-testosterone, i-FGS, i-LH, i-prolactin ichongiwe. Iprogesterone inokumiselwa kuphela kwizigulane ezinomjikelezo oqhelekileyo: kwisigaba sokuqala somjikelezo weentsuku ezingama-5-7, kwisigaba sesibini somjikelezo - ngomhla we-6-7 ngosuku wokuphakama kwamaqondo okushisa. Kubasetyhini abane-hyperandrogenia e-adrenal, isampuli encinane kunye ne-dexamethasone yenzelwa ukuchonga i-dose yokwelapha eyiyo.
• Ukuqaphela umngcipheko wokukhulelwa kwesisu, kuyimfuneko ukucacisa ubukho be-anticardiolipin antibodies, anti-HG kunye nokuhlalutya impawu yenkqubo ye-hemostasis.
• Ukuba kukho i- pathology ye-endometriyo kunye / okanye i-intrauterine pathology phantsi kolawulo lwe-hysteroscopy, ukucoca ukuxilongwa kwenziwa .
• Ukuba ukukrokra kobunzima bokubambelela kwi-pelvis, ukukhubazeka kwezibhabhu, i-endometriosis yomzimba, kunye ne-scleropolyakistoznye ovari kunye ne-myoma ye-uterini iboniswa yi-laparoscopy yokusebenza.
• Uviwo lomntu lubandakanya inkcazo yelifa lemveli, uhlalutyo lwe-spermogram eyandisiweyo, ubukho bezifo ze-neuroendocrine kunye ne-somatic, kunye nokucaciswa kwezinto ezivuthayo kunye nezifo zokuzivikela.

Emva kokubangela ukukhulelwa komzimba kokukhulelwa komzimba kuqinisekiswe, kusetyenziswe amanyathelo okunyanga.

Ukukhulelwa kokukhulelwa

Ukuqwalasela ngexesha lokukhulelwa kufuneka kuqale ngokukhawuleza emva kokuqala kwayo, kwaye kuqulethwe kwezi ndlela zophando ezilandelayo:

• Ukuzimisela kweDHEA-sulfate kunye ne-DHEA.
• Ukumiselwa kwexesha le-HG egazini.
• Ukuskena kwe-ultrasound.
• Ukuba kuyimfuneko, ukucebisa ngengqondo ye-psychotherapist kunye nengcali yeengqondo.

Thintelo

Ngokwezibalo zedatha, iziganeko zokuphuphuma komzimba ngokukhawuleza zi-1 ze-300 zokukhulelwa. Nangona kunjalo ukuba amathuba okukhulelwa kwesisu kunye nokunyuka kwithuba liyancishiswa, kwi-trimester yokugqibela le ncwadana i malunga ne-30%. Kwakhona kwenzeka ukuba ukuzalwa kwangaphambi kokuqala kwaye ukuphuphuma kwesisu kwabesetyhini kubakho ngokuphindaphindiweyo. Ngenxa yoko, ukuxilongwa kusekwe - ukukhulelwa komzimba (unyango luya kuqwalaselwa ngezantsi).

Izibangela zezi zifo ziphindaphindiwe, kwiimeko ezininzi, ukuhanjiswa kwangaphambi kokuqala okanye ukuphuphuma kwesisu kunokukhokelela kwiinkathazo zonke. Kule meko, isenzo sabo sinokuthi silandelelanise okanye simxeshanye. Umfazi onomsebenzi okhuselayo ngokubambisana kunye neengxaki zeentlanzi nezomzimba okanye isikhundla esiphantsi kwezentlalo ngokuzenzekelayo siwela kwiqela elijongene nobungozi.

Ukongeza, isifo sikashukela, isifo sesifo, isifo se-asthma, isascular and heart disease, utywala kunye neengxaki zonyango, utywala, umsi wocuba ngenye yezinto ezibangela amathuba okugula. Ukuba ibhinqa inenkinga yokukhulelwa, okanye imingcipheko yembali, oko kusebenza nakwimingcipheko yokukhulelwa komzimba okanye ukukhipha isisu. Kubalulekile ukukhumbula ukuba ngamaxesha amancinci ukuphazamiseka ngokukhawuleza kunokuba yindlela yokuzikhethela ngokwemvelo, ngenxa yoko, ukukhulelwa kwesisu akukabikho i-harbinger yokukhulelwa okungapheliyo.

Enyanisweni, ukuthintela ukuphuphuma kwesisu kuyancitshiswa kwiingongoma ezibini ezibalulekileyo:

1. Uvavanyo olufanelekileyo ngexesha lomfazi kunye nendoda.
2. Indlela yokuphila ephilileyo.

Kubaluleke kakhulu ukucacisa ubukho bendoda yezifo ezifa, izifo, ukuqhuba uhlalutyo lwesidoda nokugqiba unyango lweengxaki zonke ezikhoyo.

Ibhinqa lijongene nomsebenzi onzima. Kufuneka icaciswe ukuba ngaba i-somatic, neuroendocrine, izifo ze-oncological, njengokuba kunjalo kunye ne pathologies.

Kwakhona, iimpawu zobuncwane kunye nokusebenza kwimihla zifundwa kwisikhokelo seprophylaxis, ubukho bokugqithisa kunye ne-degree libonakalisiwe, imeko yesikhumba iyahlolwa.

Kucetyiswa ukuba ufake izicelo zeemviwo. Ukwaziswa okukodwa kukuba i-hysterosalpingography, eyenziwa kwinqanaba lesibini lomjikelezo wesini. Ngenxa yoko, kunokwenzeka ukunquma ukuba isigulane sine pathologies ye-intrauterine. Iziphumo ze-ultrasound yeenxalenye ze-pelvic zivumela ukuxilonga ubukho be-endometriosis, i-fibroids, i-cysts, kunye nokuvavanya isimo se-ovari.

Kubalulekile ukufundela i-smears kwi-urethra, isalathisa yomlomo kunye nesondo. Uphando lweHormonal unqweneleka ukwenza kwisigqibo sokuqala sokuhamba kwakhe. Ukongezelela, kufuneka ucinge ngokuqhuba uphando lwegazi, oluya kubandakanya iziganeko ze-coagulation. Oku kuya kuvumela ukucacisa ubukho be-antibodies ezifana ne-anti-HC, i-anticardoidolipin kunye ne-lupus.

Unyango

Ukunyangwa kokuphuphuma kwesisu kulandelwa ngokulandelelana okulandelayo: ukucaciswa nokupheliswa kokubangela kwesi sizathu.

Esinye sezizathu usulelo lwe-fetus, olubangelwa usulelo lwe-amniotic fluid okanye ukungena kwi-pathogens. Kule meko, ukupheliswa ngokukhawuleza kokukhulelwa kwenzeka emva koko kwisenzo esiqhotyoshelweyo sesibeletho, esibangelwa ukuxiliswa ngokugqithiseleyo okanye ukukhupha i-amniotic fluid ngaphambi kwesikhathi, ebangelwa utshintsho kwisakhiwo seembrane phantsi kwezenzo zamagciwane athathakayo. Unyango kwimeko enjalo inokuphumelela, ekubeni amandla omntwana ukuxhathisa izinto ezimbi zinganda kunye nokwanda kwithuba lokukhulelwa.

Ekukhuselweni kwesi sifo, kubalulekile ukubandakanya iingxoxo ze-endocrinologist, kuba ukungazinzi kwe-hormonal kungakhokelela ekuhlaziyweni okungavamile kwe-endometrium kunye nokupheliswa kwayo, okuye kwacatshangwa ukuba kuyimfuneko yokukhulelwa kwesisu. I-Hyperandrogenism (imeko ye-pathological condition) nayo ibonakaliswe ngendalo yemimoya kwaye ingaba yimbangela yokuphazamiseka ngokukhawuleza.

I-pathology efunyenweyo okanye yobuncinci be-organic organ of organism system isona sizathu sokukhulelwa kwesisu. Ukongezelela, izizathu zesifo ziquka ukugqithisa kwengqondo, uxinzelelo, imiphumo yamachiza athile, izifo ezahlukahlukeneyo, ubomi obusondeleyo xa ukhulelwa.

Ngaphandle kokuphazamiseka kokukhubazeka kokukhulelwa komzimba, ukuphazamiseka kwangoku kwinto enokunciphisa kakhulu xa iingcali zihlala zihlolwe kwaye zithintela ukukhusela.