Okokuqala, sizozama ukuqonda ukuthi emva kokuzalwa kwesikhathi sokuya esikhathini kufanele siqale. Uma sikhuluma ngemvelo yezilwane, umzimba wonke wesifazane, ngesikhathi nangemva kokubeletha, uhlangabezana nezinguquko ezinkulu. Isizinda se-hormonal wesifazane siyashintsha. Esikhathini se-postpartum, i-pituitary gland yowesifazane (i-gland ephethe umsebenzi ojwayelekile wesistimu ye-endocrine) ifihla i-hormone ye-prolactin. Yilo-hormone elifaka isandla ekubukeni ubisi kumuntu wesifazane. Ngokufanayo, i-prolactin (i-hormone yobisi), iyathinta ukwanda kokuvuthwa kwamaqanda, okuvimba ukuvuthwa, futhi, ngenxa yalokho, njalo ngenyanga.
Kungenxa yalesi sizathu, ukubuyisela umjikelezo wokuya esikhathini, kubalulekile ukubuyisela imvelaphi yayo ye-hormonal. Ngakho-ke, isikhathi sokuqala kokuya esikhathini emva kokubeletha kuncike, okokuqala, ekubuseni kanye nomyalelo wokunakekela ingane. Into yukuthi, njalo ngenyanga akufanele iqale ngaphambi kokuphela kwesikhathi sokukhishwa kwesifazane kumuntu wesifazane. Ngaphezu kwalokho, ngisho neminyaka engu-20-30 edlule, inkathi yowesifazane yaqala ngemva kweminyaka engu-2-3 emva kokubeletha. Kwakungenxa yokuthi bekufinyelele kulo nyaka ukuthi ingane idluliselwe ekudleni "okudala" okugcwele.
Ngokufika kokudla kwezingane, futhi kanye nokusungulwa kokuqala kokudla okuhambisanayo, ukusebenzisa izakhi zokubeletha kwe-hormonal, kanye nezidakamizwa zokusekela nokukhulelwa okuvamile, ukukhulelwa kwengane ngaphambi kokubeletha, zonke lezi zici zithinta ukunciphisa esikhathini sokuthola isikhathi sokuya esikhathini. Ngaphezu kwalokho, kuze kube yimanje, ochwepheshe abaningi bathi ukuqala kokuya esikhathini ngaphambi kokuphela kwesikhathi sokulahlwa kuyisiko. Kumele kuqashelwe ukuthi abesifazane abaningi, ikakhulukazi esemncane, ngezizathu ezihlukahlukene, banqabe ukuncelisa. Kulesi simo, umjikelezo wanyangazonke ungavuselelwa kungakapheli inyanga ngemuva kokubeletha.
Ngakho-ke, kungenzeka ukuba uthole ubuhlobo obuseduze phakathi komyalelo wokudla kwengane nokubuyiselwa komjikelezo wanyangazonke kowesifazane.
- Uma ukudla komntwana kuqukethe ubisi lwebele kuphela kuphela, umjikelezo wanyanga zonke awufanele uphinde ubuyiselwe kuze kube sekupheleni kwesikhathi sokukhipha umama.
- Uma ukondla kwengane kuhambisana, okungukuthi, kancane kancane uqala ukusebenzisa ubisi lwebele ngamanani amancane kunokudla okunemvelo, umjikelezo wesimeni ungabuyiselwa kuze kube sekupheleni kwesikhathi sokukhwabanisa.
- Uma ukondla ingane kusukela ekuzalweni, okufaka kokubili ukudla okunomsoco, nobisi lomama, inyanga zonke kufanele zibuyiselwe enyangeni yesithathu emva kokubeletha.
- Endabeni yokungondli ingane ngobisi lwebele, inyanga zonke izobuyiselwa ngaphakathi kwamasonto 10-12 emva kokubeletha.
Kumele futhi kuthiwa ukubuyiselwa kwesizinda semvelo, futhi futhi, umjikelezo wesimiso awukho nganoma iyiphi indlela kuxhomeke ekuzalweni kokuzalwa. Kungakhathaliseki ukuthi bangokwemvelo noma babe nesigaba se-cearean. Ukuqala kokuya esikhathini kuncike kuphela endleleni ingane edla ngayo.
Ngokuvamile, emasontweni okuqala ngemva kokuzalwa, abesifazane abavela emgodini wokubeletha baqala ukuphuma, okuyiwona omama abancane abadibanisa nesikhathi sokuqala sokuphuma esikhathini, ngakho-ke kubaluleke kakhulu ukwazi ukuhlukanisa phakathi kokuya esikhathini nokuphuma ngemuva kokubeletha. I-postpartum hemorrhage yinto evamile, ngoba inani legazi emzimbeni wesifazane ngesikhathi sokukhulelwa liba ngu-1.5 ngaphezulu. Umzimba wesifazane ngokwawo ulungele ukuphuma kwegazi ngemuva kokubeletha.
Ukukhishwa kwindlela yokubeletha okuqhubekayo kusukela ngesikhathi sokuzalwa kuze kufike amasonto ayisithupha kuya ku-8 yilo lochia okuthiwa. Into yukuthi ngesikhathi sokuzalwa odongeni lwesisu, i-placenta ihlukanisa. Ngokwemvelo, inqubo enjengokuhlukaniswa kwe-placenta ayidluli ngaphandle kwemiphumela: ifomu elikhulu elivulekile elivulekile odongeni lwesisu, okuphaphayo.
Phakathi nezinsuku zokuqala emva kokuzalwa, ukukhishwa egazini lomzimba kudla igazi. Emva kwalokhu, i-lochia ithola umbala ongcwele, kamuva, lapho inani labo liyancipha, ukukhishwa kuba mhlophe. Ngakho-ke, uma phakathi kwamasonto ayisithupha kuya ku-8 kusukela ngesikhathi sokuzalwa, kukhona ukukhishwa okuvela emkhakheni wezocansi, wazi ukuthi akusiyo esikhathini.
Kodwa, naphezu kokuthi ukwabiwa kwe-lochia kubhekwa njengokujwayelekile, kubalulekile ukuthi ungakhohlwa ngemithetho ethile. Uma ngemuva kokunyamalala kwe-lochia, ukukhishwa kwegazi okugqamile kuphinde kubonakale, lokhu kuyisibonakaliso sokuthi udinga ukuphumula okwengeziwe. Futhi, ngisho nangemva kokuphela kwezinsuku ezimbalwa ukuphuma kwe-postpartum akukaze kwanyamalala, kubalulekile ukubonana nodokotela.
Kumele ubuye nodokotela wakho uma:
- I-lochia ebomvu ekhanyayo ayishintshi umbala wabo ngisho nangosuku lwesine ngemuva kokubeletha
- ngesikhathi ukwabiwa kwe-lochia kwakukhona ukushisa noma umkhuhlane noma i-lochia ibe nephunga elimnandi
- unegazi eliningi kangangokuthi i-pad igcwele igazi ngehora elilodwa.
Futhi ngesikhathi sokuhamba kwesikhathi, kungenzeka ukuthi ukuphuma kwegazi, phambi kwezinhlayiyana zezicubu ezisekhaleni noma izibeletho zesisu embelethweni. Into ewukuthi izitsha zohlobo lwe-uterine ezixhuma isibeletho kuya e-placenta zidilizwa ngesikhathi sokubeletha. Kodwa okwehlukile kwesakhiwo salezi zitsha kuwukuthi lapho ekuqhekekeni ngokushesha kancane. Ngokunciphisa izitsha ze-uterine, zijula ezingxenyeni zemisipha, lapho ziqhubeka zicindezelwa izicubu zomzimba zesisu. Kanye nalokhu, kukhona ukwakheka kwe-thrombi kulezi zitsha, okuholela ekumiseni ukuphuma kwegazi. Kodwa konke okushiwo ngenhla kuchaziwe, kwenzeka kuphela uma isikhathi sokuthutha sivamile.
Uma ngemuva kokubeletha esibelethweni sesibindi kuhlala izingcezu zezingqimba noma i-placenta, ziphazamisa izinqubo zokuqeda nokucindezela izitsha ze-uterine, okuholela ekuphumeni okukhulu kwegazi.
Kulokhu, kukhona ukuphuma kwegazi okuningi, okubonakala ngokungazelelwe. Ukuvimbela ukuphuma okunjalo ukuhlola isimo sesibindi ngosizo lwemishini ye-ultrasound ngosuku lwesibili ngemuva kokubeletha. Futhi ukwelashwa okuphoqelekile kudokotela uma kwenzeka uphelelwa isikhathi eside.