Noma yikuphi ukubonakaliswa kobuhlungu nokuphuza ngesikhathi sokukhulelwa kudinga ukunakekelwa ngokushesha. Lokhu kungase kube isignali sokuqala kokuphuma kwesisu. Umbuzo wokuqala womunye wesifazane osongelwa ukukhulelwa kwesisu ngesikhathi sokukhulelwa yenzeni? Impendulo ingukuthi - ungethuki kusengaphambili kwesikhathi! Uma konke kwenziwa kahle, ukukhulelwa kwesisu kungagwenywa, ngemuva kokubeletha ingane enempilo.
Ukungathathi-mshado kuyinkimbinkimbi yokukhulelwa nokulahla okuncane ingane yakho ngesikhathi sokuthi ingane ingenakwenzeka ngaphandle kwesibeletho. Umehluko phakathi kokukhipha isisu nokubeletha kusengaphambili kulula: ngemuva kokubeletha ingane ingasindiswa, njengoba izitho zakhe zingasebenza futhi zakhiwe, ngemuva kokukhulelwa kwesisu - ukusinda komntwana kungenakwenzeka. Ngenxa yokuphumelela kwemithi yesimanje, ikhono lokulondoloza impilo ngaphandle kwesibeletho somama, ngisho nasesithombeni esincane kakhulu, selukhuphuke kakhulu. Emazweni athuthukile, abantwana abazalwa ngesonto lama-25 lokukhulelwa sebevele benakekelwa kahle. Kulesi simo, izinsana ezingakabiphi ngemuva kwalokho azilahlekelwa amandla okukhula futhi kuvamile ukuthuthukisa.
Ochwepheshe bahlukanisa ukuhlukumeza okuzenzakalelayo, kubangelwa izimbangela zemvelo, kanye nokufakelwa isisu (isisu noma isisu). Lezi zinsuku zingacasulwa, isibonelo, ngezizathu zezokwelapha. Okulandelayo sizokhuluma ngamaphutha amancane.
Izimbangela zokuhlukumeza
Zingahluka, kuye ngokuthi impilo yowesifazane, umlando wakhe wokukhulelwa kwangaphambili, ukutholakala kokukhipha isisu njalonjalo. Amaphesenti angaphezu kwezingu-60% aphethwe yi-blastocyst pathology, futhi ngezinye izikhathi izici zomama nezinye izimbangela zidlala indima ebalulekile. Ku-10-15% kokukhulelwa, ukuhlukumeza kwamaphutha kuyingozi, kungekho okushiwo ngaphambili.
I-Blastotcystosis yiyona imbangela evamile kakhulu yokusongela kokukhulelwa kwesisu ngesikhathi sokukhulelwa. Lokhu kuhlanganisa ukungasebenzi kwe-fetus, engabonakali ukuthi kungenzeka ukuvuthwa kwayo. I-Blastocystosis ivame ukuvela ngokuhlanganiswa kwamaseli "ocansi" wesondo nonina. Kulezi zimo, ukukhulelwa kwesisu kuvame ukuqala ekuqaleni kwamaviki ayisithupha kuya ku-6 kuya kokukhulelwa. Ukwenza nalokhu, cishe lutho alukwazi. Futhi akufanele, ngoba ingane ngenxa ye-blastocystosis ayiyona into evamile. Ngenxa yalokho, uma unina enempilo futhi kungekho okuphikisanayo, ungakwazi ukuhlela ngokushesha ukukhulelwa okulandelayo. Amathuba okuphindaphinda kokuphuma kwesisu ngenxa yesizathu esifanayo ayinaki.
Izimbangela zokukhulelwa kwesisu ekuthuthukiseni i-fetus:
- i-pathology yamagciwane ama-germ (ama-oocyte ne-spermatozoa) - kaningi ngamaphutha aphindaphindiwe;
- impikiswano ye-serological;
- amaphutha we-chromosomal we-fetus;
- amaphutha okuthuthukiswa (amaphutha wesistimu yezinzwa, isifo senhliziyo, ukukhubazeka kwamakhemikhali, njll)
- amaphutha ekuthuthukiseni intambo yomlomo;
- Imfucuza ebangelwa ukufa kwe-chorionic fetter
Izimbangela zokukhulelwa kwesisu kumbuso kamama:
- izinguquko zendawo ezithombeni zokubeletha, ezifana nokukhubazeka kwezibeletho, ukulimala kwayo, izicubu, ama-fibroids, ama-cervical lesions. Futhi, ukukhulelwa kwesisu kuthinteka ukukhukhula (okuvame ukubangela ukukhulelwa kwe-ectopic), ama-polyps, umdlavuza womlomo wesibeletho, ukunamathela ngemuva kwezilonda ezivuthayo. Isongo sokukhulelwa kwesisu ngesikhathi sokukhulelwa singabangelwa ukungajwayelekile ekuthuthukiseni i-placenta. Abesifazane ababenokukhubazeka okufanayo kufanele babe ngaphansi kokulawulwa kwezokwelapha okuqinile phakathi nonyaka. Ukukhulelwa phakathi nalesi sikhathi kuqiniswe ngokuphambene.
- ubukhulu bomama. Ukufika kwesikhathi sokufika kokubeletha kokuqala emva kweminyaka engu-38 kuthathwa njengokuphuza.
- ukugula kumama. Lokhu kufaka phakathi: izifo ezivamile ezivamile, izifo ezibangelwa amagciwane ezibangelwa umkhuhlane ophezulu, izifo ezingapheli (njenge-syphilis noma i-toxoplasmosis), i-endocrine function pathology (isib. Isifo sikashukela), ukuhlukunyezwa komshini, ukushaqeka, ukukhathazeka kwengqondo kanye ne-hormone, e.
- ukuhlukana kwezibilini kanye nokutheleleka kwe-intrauterine.
- izinkinga ngenxa yezinqubo zokuxilonga (ezenzeka ezimweni ezingavamile): lapho uhlola i-fetus nge-endoscope ekhethekile, ngokuhlolwa kwe-amniocentesis, nge-biopsy ye-fetal (ehlukanisa ubhedu obungaphandle lwezingqimba ze-fetal embryo - ukukhishwa kwe-veillical vein).
- ukuphazamiseka kokudla.
- izici ezingokomqondo nezingokomzwelo, ezifana nokwesaba ukukhulelwa, ukukhathazeka kwengqondo.
Ingozi eyengeziwe yokwehlukaniswa kwesisu kwabesifazane kwenzeka emva kokwelashwa kokubeletha, ekukhulelwe okuningi nakwabesifazane abaphuza utshwala nokubhema ngesikhathi sokukhulelwa. Ngokuvamile, ukusongelwa kokukhulelwa kwesisu kwenzeka ngemuva kokukhipha isisu - kudala ukukhulelwa kwesisu (ukulahlekelwa okungu-3 noma ngaphezulu kokukhulelwa okulandelana).
Kubalulekile ukucacisa ukuthi i-myoma ayifuni njalo ukukhulelwa kwesisu. Ngokuvamile akubonakali kubantombazane abasebasha (okuvame kakhulu kulabo abaneminyaka engu-40 ubudala). Abesifazane abaningi abane-myoma ye-uterine abangenayo izinkinga bakhulelwe, kodwa ku-trimester yesibili noma yesithathu yokukhulelwa kungase kube nezinkinga. Ngokubheka odokotela, ithuba lokubeletha ingane enempilo likhulu ngokwanele. Ngaphezu kwalokho, i-myoma ayibangele ukuthi izimbangela eziphuthumayo ziphindaphindiwe.
Izimpawu zokukhulelwa kwesisu
Izimpawu zokuhamba kwesisu okudlulayo zihamba ngegazi elingenabuhlungu emzimbeni wokuqala okhulelwe (kuze kube sekupheleni kweviki le-16). Izimpawu zokukhulelwa kwesisu zivame ukuwela esikhathini sokuya esikhathini esijwayelekile emasontweni angu-4, 8 no-12 okukhulelwa. Futhi, ukukhubazeka okuvame ukuvela ngeviki le-14 lokukhulelwa, ngesikhathi i-placenta ikhiwa, futhi ukukhiqizwa kwamahomoni emzimbeni ophuzi kuncishiswe kakhulu.
Okokuqala ukuphuma kwegazi kubuthakathaka, bese igazi liphenduka ubumnyama, liba mnyama. Ngezinye izikhathi lixuba ne-mucus. Ukukhipha igazi kungenziwa isikhathi esifushane futhi akubalulekile. Kubuye kwenzeke ukuthi kufana nomjikelezo ojwayelekile wokuya esikhathini. Ukuphuma kwamagciwane ngesikhathi sokukhulelwa kuqala futhi kuvame ukwenzeka kanye nokukhulelwa okuqinisekisiwe kokubili. Yiso njalo igazi likaMama, hhayi izithelo. Kwenzeka ukuthi ukuphuma kwegazi akubalulekile futhi kuxazululwe ngokuzenzekelayo ngesikhathi esifushane. Kodwa-ke, uma ukuphuma kwegazi kukhula futhi kuhambisane nobuhlungu obukhulu emathunjini aphansi - lokhu nakanjani ukuqala kokukhulelwa kwesisu. Uma kuqhubeka ukuqiniswa kwalezi zimpawu, ukwenqatshwa kwe-blastocysts noma izingxenye ze-uteri wesibeletho - isisu sokuphuphuma kwesisu sesivele sisekhona.
Ukuphelelwa kwesisu okungaphelele, okuphelele, okuphelele
Uma ukukhulelwa kwesisu sekusekhona futhi izicubu ze-placenta noma isisu sesisu (mhlawumbe ne-embryo) ziwela emkhathini - sibhekene nokukhulelwa kwesisu okungaphelele. Kulesi simo, ukukhulelwa kwesisu kusongela isimo sesisu, ubukhulu obuhambisana nokuthuthukiswa kokukhulelwa kanye nomsele womlomo wesibeletho uvulekile. Ngesisu esisodwa esingaphelele, ingxenye yezicubu ayifakiwe, futhi ingxenye ye-blastocysts nezingxenyana ezincane ze-chorion biopsy zihlala esibelethweni. Ukuhlala kubangela ukuphuma kwegazi, okungaqhubeka isikhathi eside. Kulokhu, ukuhlanzwa kwesibeletho kuyadingeka, ngoba ngaphandle kwalokho owesifazane usongelwa ukuphuma nge-intrauterine noma ukutheleleka. Ukuhlanzwa kwenziwa ngaphansi kwe-anesthesia.
Uma zonke izingxenye ze-fetus ne-placenta zixoshwa esibelethweni - ukukhulelwa kwesisu sekuphelile. Ngokuvamile kwenzeka kakhulu kakhulu - ngesonto lesikhombisa. Isibeletho asinalutho futhi sidinga ukuhlanzwa okwengeziwe.
Ukuthatha isisu kungukukhulelwa okubandayo. Kulokhu, umbungu usufile, kodwa ukukhulelwa kuyaqhubeka. Ingane efile ingahlala esibelethweni amasonto ambalwa, ngisho nezinyanga. Isibeletho siyeka ukukhula, kodwa intamo yayo ivalwe ngokuqinile. Imiphumela yokuhlolwa kokukhulelwa ingase ingaqiniseki phakathi kwamasonto ambalwa emva kokufa komntwana. Indlela engcono kakhulu yokuthola ukuthi i-embryo iyaphila i-ultrasound. Ngesonto lesihlanu lokukhulelwa, usuvele ubona ukushaya kwenhliziyo kwesisu. Uma udokotela wakho enquma ukuthi ukukhulelwa kubanda, umfanyana kufanele ususwe ngokushesha ngangokunokwenzeka.
Isizathu sokugaya singase sibe ukuhlukaniswa okuyingxenye ye-placenta noma izibilini kusukela odongeni lwe-uterine. Ngezinye izikhathi ukufa kwe-embryo futhi, ngenxa yalokho, ukukhulelwa kwesisu kwenzeka ngisho nokuntula okuncane kanye nokuphelelwa isikhathi esifushane. Abesifazane abakhulelwe abaye baqala ukuphuza kufanele bahlale begcina amasampula egazi esikhungweni sezincuzi ukuze udokotela angabatadisha.
Ukwelapha nokuvimbela ukukhubazeka
Kwezinye izimo, ukukhulelwa kwesisu kungavinjelwa ngempumelelo. Kulesi simo, ukwelashwa kuxhomeke ekubambeni kanye nemvelo yezinkinga zokukhulelwa. Imiphumela ehlukile kakhulu yengozi yokukhulelwa kwesisu ngesikhathi sokukhulelwa, lezo ziphetho azikwazi ukudonsa kusengaphambili. Ngezinye izikhathi ungakwazi ukubeletha ingane enempilo futhi esikhathini esizayo ngeke ube nezinkinga zokukhulelwa.
Okokuqala, uma ukukhulelwa kwesisu kusongela, kusetshenziselwa ukwelashwa okulondolozayo, lapho owesifazane kufanele ahlolwe ngokushesha bese ephuza imithi njengoba kunqunywe udokotela. Ngokuvamile, lezi zidakamizwa ze-diastolic, izidakamizwa, ama-painkillers, kanye nama-hormonal ngezinye izikhathi (kuhlanganise nezidakamizwa ezivimbela ukukhiqizwa kwe-prostaglandins). Ngezinye izikhathi owesifazane udinga nje ukunikeza umoya onobungane ngalesi sikhathi esinzima sokuba agweme ukuthatha izidakamizwa. Isiguli kumele silale njalo embhedeni.
Noma yikuphi, ngisho nokubona okuncane kancane ngesikhathi sokukhulelwa, kufanele uxhumane nodokotela wakho esikhathini esizayo esiseduze. Angenza iskena se-ultrasound ukucacisa ngalokhu ukuthi ngabe i-embryo iyaphila. Uma kunjalo, lo wesifazane uvame ukuya emnyangweni wezokukhulelwa ukuze aqhubeke nokukhulelwa. Amacala angu-90% adlule ngempumelelo, futhi ukukhulelwa kuphela ngokuzalwa kwengane enempilo, ngokuvamile ngesikhathi. Kodwa-ke, njengoba kunengozi yokubeletha ngaphambi kwesikhathi, ukukhulelwa kumele kuhlolwe ngokucophelela. Kwenzeka ukuthi owesifazane "uhlala" esigcemeni amasonto ambalwa, futhi ngezinye izikhathi izinyanga ezimbalwa.
Ngokukhubazeka komlomo wesibeletho ku-trimester yesibili yokukhulelwa, ukuqoqwa kwezigxobo ezithinta umlomo wesibeletho kwenziwa. Lokhu kunciphisa izinga lokuhluleka kwalo. Intamo kufanele ivaliwe ngesikhathi sokukhulelwa, ngaphandle kwalokho iqanda lingase liphume kwesibeletho. Ukwelashwa okunjalo kusebenza ngamacala angu-80%. Kubaluleke kakhulu ukuthi uma owesifazane okhulelwe evunyelwe ekuzalweni udokotela wamemezela ukuthi udale umthunzi onjalo!
Uma ngesikhathi sokukhulelwa kukhona ukuqhuma okusheshayo kwe-amniotic fluid noma owesifazane wabona ukuqhuma okuqhubekayo-lokhu kungaholela ekuqhekekeni kwekhanda. Esimweni esinjalo, owesifazane kufanele akhishwe esibhedlela ngokushesha. Ukuqala kokuzikhandla kwamathuba okusebenza kunzima kakhulu ukuma. Ekuthelelekeni kokubeletha, ukufakwa kwemisebenzi kuyadingeka. Ngezinye izikhathi i-membrane iphilisa ngokuzimela futhi ukukhulelwa kuhamba kahle.
Ukuvimbela ukulahlekelwa kokukhulelwa ngenxa yenkinga ye-serological (manje engavamile ukuthi imbangela yokukhulelwa kwesisu), ngezinye izikhathi ukudluliselwa kwegazi kuyenziwa ngesikhathi sokukhulelwa. Yenzelwe ukususa amaseli awonakele, ama-antibodies kanye ne-bilirubin engaphezulu. Ngenkathi yokushintshwa kwegazi, amaphesenti angama-75 egazi lomntwana atshintsha. Lokhu akugugu igazi lakhe empeleni, ngoba umntwana uzoqhubeka ekhiqiza amaseli egazi ngama-antigens alo. Iziguli nazo zithola ukwelashwa okusekelayo okufaka ukuphathwa okunamandla kwesisombululo se-albumin ukunciphisa ingozi ye-bilirubin yamahhala engena ebuchosheni.
Iziguli zokuvimbela ukungalingani zenziwa i-immunoglobulin i-Rh D 72 ngemva kokubeletha, ukukhulelwa nokukhipha izisu. Umkhiqizo uqukethe inani elikhulu le-anti-Rh. Isebenza ngokuqeda ama-Rh-positive amangqamuzana e-fetal e-blood ayingenele egazini legazi. Ukusetshenziswa kwalesi sidakamizwa kuvimbela izifo, futhi kuvikela ingane ngesikhathi sokukhulelwa okulandelayo. Le nqubo kufanele iphindwe emva kokuzalwa nokukhulelwa kwesisu.
Uma, noma kunjalo, ingxabano ye-serological yenzeka e-trimester yesibili yokukhulelwa, ngakho-ke, njengoba umthetho, inqubo ingaphambi kokufa kwe-fetal, bese kuphuma isisu. Ukukhulelwa okulandelayo kulezi zimo, njengomthetho, kuhlolwe ngokucophelela futhi kuvame ukuphela ngokuzalwa okuphumelelayo kwengane enempilo.
Emva kokukhulelwa kwesisu
Okokuqala, kufanele ulinde ngokusungulwa kobulili okungenani amasonto amabili (ungasebenzisi ama-tampon ngalesi sikhathi). Abanye besifazane baphinde baqale umsebenzi wocansi kuphela emva kokuya esikhathini sokuqala emva kokukhulelwa kwesisu, okuvame ukuvela amasonto angama-4-6 emva kokukhulelwa.
Ukuvuthwa ngokuvamile kuhamba ngaphambi kokuya esikhathini, ukuze ngemuva kokukhulelwa kwesisu, kunengozi yokukhulelwa okusheshayo okulandelayo. Ochwepheshe batusa ukusebenzisa izindlela zokwelapha okungenani ezintathu, izinyanga ezine emva kokukhulelwa kwesisu. Kumele kuqaphele ukuthi kunezingozi ezaziwa ezihambisana nokukhulelwa okusheshayo kokukhulelwa okulandelayo ngemuva kokukhulelwa kwesisu. Kodwa ukulinda kungcono hhayi ngezizathu zezokwelapha, kodwa ngezizathu zengqondo. Owesifazane ngemuva kokulahlekelwa kokukhulelwa ukhathazekile ngalokho okuzokwenzeka ngokulandelayo. Uzwa ukwesaba futhi uyazibuza njalo ukuthi uzokwazi yini ukukhulelwa futhi abelethe ingane. Lesi isimo sengqondo esingavamile esingenzi isandla ekukhuleni okuhlelekile kokukhulelwa.
Ukungafani kahle ngokuvamile akubanga imbangela. Ukukhulelwa kwesisu kokuqala akusho ukuthi ngokukhulelwa okulandelayo kuzoba okufanayo. Ngemuva kokuhlukana okulandelana kathathu, amathuba okuba nomntwana angama-70%, amane - 50%. Uma ulahlekelwe ukukhulelwa kwakho kokuqala ezinyangeni ezintathu zokuqala, ingozi yokulahlekelwa ukukhulelwa okunye kuphela ephakeme kunayo yonke. Ngakho-ke, nakuba kungekho siqinisekiso sokuthi esinye ukukhulelwa kuzokwenzeka ngaphandle kokuphazanyiswa, ukukhulelwa kwesisu akukhanseli ithuba lokuba umama ojabulayo.
Kwenzeka kaningi kangakanani ukuhlukunyezwa?
Kukholelwa ukuthi enye yezinsuku eziyisikhombisa ezikhulelwe ezikhulelwe ziphumela ekukhulelweni okungahambi kahle. Ngokwesibonelo, e-UK, ukukhulelwa kulahlekelwa abesifazane abayi-100 000 ngonyaka. Lokhu kusho amakhulu wamathambo ngosuku. Lesi sikali sanda kakhulu lapho sicabangela ukukhulelwa okungaqinisekisiwe. Okusho ukuthi, lapho owesifazane ekhulelwe khona, ngaphambi kokuba aqaphele ukuthi ukhulelwe. Lokhu yizingxenye ezintathu kwilabo bonke abalahlekelwe yi-embryo.
Ku-20% abesifazane abakhulelwe ekuqaleni kokukhulelwa kukhona ukuphuma kwegazi, isigamu salo ubufakazi bokuphuphuma kwesisu. Ukukhulelwa okuyishumi kwezingu-10 kuphela ngokuphutha komzimba okuzenzakalelayo. Amaphesenti angama-75 e-miscarriages akhona ku-trimester yokuqala yokukhulelwa, isb. kuze kube amasonto angu-12 kusukela ekuqaleni kwayo. Isimo sezinkinga zokukhubazeka siphakeme kwabasikati abasebasha (ngaphansi kweminyaka engama-25) futhi ngaphambi kokuqala kokuya esikhathini.