Ukuphathwa kwezokwelapha kokuphutha kwesisu kusebenza kanjani
Eminyakeni embalwa eyedlule, sekuvame kakhulu odokotela ukunikeza imithi yokuphatha ukukhulelwa kwesisu uma imiphumela ye-hCG noma ukuhlolwa kwe- ultrasound kuqinisekisa ukutholakala kwesisu sokulahleka noma ukuvuthwa okwenziwe kabi . Lokhu kunikeza abesifazane ithuba lokuqeda inqubo yokuhlanza nokukhishwa ( D & C ) noma ukulinda okungakapheli isikhathi sokukhulelwa kwesisu ukuqala ngokwemvelo.
I-Misoprostol Yokusingatha Ukushada Ngaphandle
Isidakamizwa esivame kakhulu esetshenziselwa le njongo yimithi ebizwa ngokuthi i-misoprostol (igama elithi brand Cytotec), elibizwa ngokuthi imithi yesilonda kodwa litholakale liwusizo ekulawulweni kokukhulelwa kwesisu. Ngezinye izikhathi i-Misoprostol isetshenziselwa ukuhlanganiswa ne-mifepristone, imithi ye-antiprogesterone eyaziwa nangokuthi i-Mifeprex noma i-RU486. Enye indlela kungenzeka i-gemeprost, kodwa lesi sidakamizwa singabangela imiphumela emibi kakhulu kwezinye izimo.
Odokotela bangase basebenzise imithi yokuqeda ukukhulelwa okuqinisekisiwe kwe-ectopic y okungabonakali ingozi eseduze nempilo yowesifazane, kodwa izidakamizwa, kulokhu, ngokuvamile zibizwa nge-methotrexate.
Misoprostol ku-Trimester yokuqala
Ukulawulwa kwezokwelapha kokuphuphuma kwesisu kuveza umqondo omkhulu lapho kwenzeka khona ukuphulwa kwesisu kodwa ukuphuma kwegazi akukaqali. Indlela okusebenza ngayo: Udokotela wakho ubeka imithi eyodwa noma ngaphezulu okwenza umlomo wakho wesibeletho uphuthukise futhi uhlaka lwakho lwe-uterine lubekwe.
Le mithi ingase isetshenziswe noma isiswini, kuye ngokuthi yi-protocol ethile. Ukuphuma kwegazi okwenziwe ngesisu ngokweqile kuvame ukuqala phakathi nosuku noma ezimbili ekulawulweni kwezidakamizwa futhi kuqhubekela phambili ngendlela efanayo nangokwehlukana kwemvelo. Imiphumela emibi yezidakamizwa ingafaka ubuhlungu, isicanucanu, ukuhlanza, nokuhuda.
Ngokusho kocwaningo, izinga lokuphumelela lokuqeda isisu ngemuva kokusebenzisa i-misoprostol cishe ngamaphesenti angu-71 kuya kuma-84%. Abaningi besifazane abakhetha ukuphathwa kwezokwelapha ngenxa yokungaziphathi kahle kwabo banelisekile ngokukhetha lapho bexoxwa kamuva.
Izingozi Zokusebenzisa Imithi Yokuphatha Ukushada Ngaphandle
Izingozi zokusebenzisa imithi yokusheshisa isisu (kunokuba ne-D & C) zifana nezingozi zokulahlekelwa ngokweqile ngokwemvelo. Kukhona ithuba elincane lokugaya igazi, ukutheleleka, nokudinga i-D & C kamuva uma ngabe izicubu zihlala esibelethweni. Ngokusobala, i-D & C ithatha ezinye izingozi ezincane futhi, ngakho-ke ukhetho luya kuwe nodokotela wakho-ngaphandle kwalezo zenzakalo lapho eziphuthumayo zezokwelapha zidinga i-D & C. Ubude bokuphuma kwegazi ngenxa yokukhulelwa kwesisu okubangelwa yizidakamizwa kufana nokukhishwa kwesisu okwenzeka ngaphandle kokungenelela (cishe amasonto amabili).
Akuwona wonke udokotela ohlinzeka ngokuphathwa kwezokwelashwa kokuhlukunyezwa kokuqala kwe-trimester ngalesi sikhathi, kodwa abaningi benza. Uma uthola ukuthi unesisu futhi ungakenzi isinqumo sokwelashwa, khuluma nodokotela wakho uma ufuna ukuhlola ukuphathwa kwezokwelapha kokuphuphuma kwesisu. Le mithi kufanele isetshenziswe kuphela ngaphansi kokuqondiswa udokotela.
Ukusetshenziswa kwe-Misoprostol yesibili
Odokotela bangaphinde babone i-misoprostol, ngezinye izikhathi eceleni kwe-mifepristone, ukuze baveze ukubeletha kwesisu noma i- second-trimester yokukhulelwa kwesisu uma i-ultrasound yembula umntwana ongenhliziyo noma ubufakazi obucacile bokuthi ukukhulelwa akunakwenzeka. Kulezi zimo, okuhlangenwe nakho ngokuyinhloko ukukhishwa kwabasebenzi kanye nabesifazane kuzodinga ukuthi bahlole esibhedlela ngenqubo, kanti ukukhishwa kwezokwelapha kwezintathu zokuhlukumezeka kokuqala kungenziwa ngesikhathi esisodwa.
> Imithombo:
> Niinimäki M, Mentula M, Jahangiri R, Männistö J, Haverinen A, Heikinheimo O. Ukwelapha Kwemithi Yesibili Yokuqothulwa Kwezitho Zesibili; Ukuhlaziywa okubuyiselwayo. Dangal G, u-ed. PLoS ONE . 2017; 12 (7): e0182198. i-doi: 10.1371 / iphephandaba.pone.0182198.
> Saraswat L, Ashok PW, uMathur M. Ukuphathwa Kwezokwelapha Kwezokuthutha. Isazi Sokukhubazeka Ne-Gynecologist. 2014; 16: 79-85.
> Tulandi T, u-Al-Fozan HM. Ukukhipha Isisu Okungajwayelekile: Ukuphathwa. Kusesikhathini. Kubuyekezwe u-Agasti 7, 2017.