Bobabili Ukuhlinzwa Kuphela Ukukhulelwa Okungahambi kahle
Iningi lokukhulelwa lihamba ngaphandle kwe-hitch: Ngemva kwamasonto angu-40 noma ngaphezulu, ingane iphilile futhi umndeni ukhula ngomunye. Nokho, ngokudabukisayo, ngezinye izikhathi izinto azihambi ngendlela elindelekile: Kunenkinga eyenza kubalulekile ukuqeda ukukhulelwa noma iphela ngokuzenzekelayo ekukhulelweni kwesisu. Kuncike ekuthuthukiseni ukukhulelwa, lokhu kungase kutholakale ngenye yezinqubo zokuhlinza ezimbili: ukuhlenga nokukhishwa (i-D & E) nokwehlisa noma ukukhishwa (D & C.
I-D & C, lapho umlomo wesibeletho ukhuliswa khona ukwenza kungenzeka ukuthi udokotela asebenzise ithuluzi elibukhali elinengqondo elibizwa ngokuthi i-curette ukususa izicubu emgqonyeni wesibeletho. (Igama elithi D & C ngezinye izikhathi lisetshenziselwa ukubhekisela ekuthandweni kwe-vaccum, enye inqubo yokuqeda ukukhulelwa.)
Ukuphuza nokuphulukiswa kwenziwa phakathi kwamasonto ayisithupha okuqala okukhulelwa. Endabeni yokukhulelwa okuqhubekayo ngeD & E kuyadingeka. Ezinye izizathu ezijwayelekile owesifazane angase adinge i-D & E: Ingane inesimo esingavamile noma isifile esibelethweni futhi ingazalwa ; izibungu ziye zaphuka ngaphambi kwesikhathi; noma kunengozi enkulu empilweni yowesifazane uma ukukhulelwa kuqhubeka.
Yeka ukuthi i-D & E ifana kanjani
Kokubili i-D & C ne-D & Es ihilela ukukhipha umlomo wesibeletho nokususa isibeletho sokukhulelwa kwezicubu zokukhulelwa. Nakhu okukwenzeka ngesikhathi ngasinye salezi zinyathelo ku-D & E:
Isinyathelo 1: Ukuxuba
Isinyathelo sokuqala e-D & E silungiselela umlomo wesibeletho ngokunciphisa kancane kancane futhi ukuwuhlanza kusukela ngosuku noma ezimbili ngaphambi kwenqubo yangempela.
Ngokuvamile lokhu kwenziwa nge "dilator", eyenziwe ngamanothi omisiwe anqunywe ngamanzi (okuthiwa laminaria) noma ama-hydrogel izinduku ezibekwe emgodini womlomo wesibeletho lapho zithatha umswakama kancane kancane. Ukuthatha kancane kuyabalulekile: Ukukhuphuka okusheshayo okukhonjisiwe kuye kwaboniswa ukwandisa ingozi yokulahlekelwa kokubili kokukhulelwa ekukhulelweni okuzayo.
Izidakamizwa nazo zingasetshenziselwa ukulungisa umlomo wesibeletho ngosuku lwenqubo, kodwa aziphumelelanga njengezithazamisi ze-osmotic-okusho ukuthi ukuhlanza kwe-mechanical kungadingeka noma kunjalo uma kungenjalo ekuqaleni kwe-trimester yesibili.
Isinyathelo 2: Ukususwa
Isinyathelo sesibili ku-D & E yi-evacuation ye-fetus ne-placenta kusukela esibelethweni. Ngaphambi kwalokhu kwenzeka, lo wesifazane unikezwa i-anesthesia jikelele kanye nemithi elwa namagciwane ukuze kuvimbele ukutheleleka. Ngenkathi esaphansi kwe-anesthesia, udokotela ohlinzayo owenza i-D & E ngokujwayelekile uzosebenzisa inhlanganisela yokuluthwa, ukuphoqa, nokukhumula ukuvula lesi sizalo. Abanye odokotela basebenzisa umjovo ukuqinisekisa ukuthi ukufa kokubeletha kwenzeke ngaphambi kokuphuma, kepha lokhu kuyinkinga.
I-D & E inzima kepha ngokuvamile iphephile ngokuphelele. Izinkinga ezinjenge-laceration yomlomo wesibeletho; i-perforation yesibeletho; ukutheleleka, noma ukushaya isisu kungavamile. Ngaphezu kwalokho, abesifazane abane-D & E ababhekana nezinkinga ekukhulelweni okuzayo okuhlobene nenqubo.
Imithombo:
Ikhomishana YaseMelika Yezinambuzane Nezazi ZamaGynecologists. "Ukukhipha Isisu Kukhishwe." May 2015.