Funda Ukuhlukana Phakathi Kokulahlekelwa Kwegazi Okuvamile Neqile
Kungani kufanele wazi ngegazi noma ukugaya okukhulu okuhlobene nokukhulelwa kwesisu ? Iphuma nini evamile futhi nini kakhulu? Yiziphi izimbangela zokugaya isisu ngesikhathi sokukhulelwa kwesisu, kuphathwa kanjani, futhi yiziphi izinkinga ezingase zibe khona?
Kubalulekile ukuqaphela izimpawu nezimpawu zokulahlekelwa ngokweqile kwegazi ukuze ukwazi ukuthola usizo lwezokwelapha ngokushesha uma kudingeka.
Ukwehla kwesisu ngesikhathi nangemva kokukhulelwa kwesisu akuvamile kakhulu kodwa kuyimbangela ephezulu yokufa okuhlobene nokuhlukumeza, ikakhulukazi ukuhlukumeza okuyisithupha kwesibili.
Ukuphulukiswa ngenxa yokushada
Ukukhipha isisu kuvamile ngemuva kokukhulelwa kwesisu, kodwa ungazi kanjani ukuthi ukuphuma kwegazi kuningi kangakanani?
Ukuthatha isisu kuhlathulula njengokukhulelwa kokubeletha okwenzeka ngaphambi kweviki 20 lokubeletha nangaphambi kokuba ingane ikwazi ukuhlala ngaphandle kwesibeletho. Uma ukukhulelwa kulahlekile nganoma yisiphi isikhathi phakathi kwenkathi ephuthelwa namaviki angu-20, imithwalo yegazi embelethweni iye yanda futhi izicubu zakhiwe ukusekela ukukhulelwa. Uma ukukhulelwa kwesisu kwenzeka, lokhu kudluliswa.
Ngesikhathi sokubeletha kwesisu "okuvamile", ukuphuma kwegazi lomzimba ngokuvamile kunzima kakhulu kunesikhathi esivamile sokuya esikhathini, ngakho ungazi kanjani ukuthi ungakanani kakhulu? Yini efaneleka ngokuthi "ukuphuma okujwayelekile" nokuthi yini ebeka "isisu?"
Sizokukhuluma kabanzi mayelana nencazelo yokumisa isisu, kodwa kubalulekile ukuba ucele usizo lwezokwelapha ngokushesha uma ukuphuma kwegazi kunzima ngokwanele ukugcoba ngezikhathi zokuhamba esikhathini (njalo, hhayi maxi noma mini) ngaphansi kwehora. Kubalulekile futhi ukufuna usizo lwezokwelapha ngokushesha uma unayo izimpawu ezingase ziphakamise ukukhulelwa kwe - ectopic , kungakhathaliseki ukuthi uyaphila.
Izimpawu zokukhulelwa kwe-ectopic zingase zifake ukuqala okungazelelwe kobuhlungu esiswini sakho noma emuva, ukushayela okusheshayo, ikhanda elikhanyayo noma ukulahlekelwa ulwazi.
Incazelo yeHemorrhage
Ukushona kwegazi kusho ukulahlekelwa ngokweqile kwegazi futhi kuhlukaniswe ngezigaba esekelwe amaphesenti egazi okwamanje emzimbeni wakho
- Isigaba I - kufika kumaphesenti angu-15 wegazi lomthamo
- Isigaba II - ukulahlekelwa ngamaphesenti angu-15 kuya kwangu-30 egazi
- Isigaba III - ukulahlekelwa kwamaphesenti angama-30 kuya kwangu-40 egazi
- Isigaba IV - ukulahlekelwa kwamaphesenti angu-40 egazi
Ukulinganisa Ukulahlekelwa Kwegazi (kanye Nokungabikho Kwemiphumela Yokwelapha) Ngokwemishado
Njengoba abantu abaningi bengenayo indlela elula yokubala iphesenti legazi lomzimba wabo balahlekile, kunezindlela eziningi zokulinganisa ukulahlekelwa kwegazi.
Ukuze siqonde incazelo "yegazi" ake siqale ukukhuluma ngegazi elijwayelekile. Phakathi nenkathi evamile yokuya esikhathini, uzodlula cishe ama-cc 80 wegazi. Elinye isipuni lilingana nama-ccs amahlanu, ngakho-ke isikhathi esivamile singabangela izipuni eziyi-16 noma izipuni eziyi-5 zegazi. Ngokuphambene nalokho, inani lokuphuma ngegazi elijwayelekile lokulethwa kwezidakamizwa liyi-500 cc. Ukuphuphuma kwesisu ngokuvamile kuholela ekulahlekelweni kwegazi phakathi kwalezi zinombolo, kodwa kuseduze naleso sikhathi esivamile.
Ukuphuma kwegazi ngokweqile kuchazwa kalula ngokwemigomo yokuya esikhathini. Uma upheqa nge-pad ngaphansi kwamahora angu-2, ukuphuma kwakho kungase kube ngokweqile. Uma ugeleza nge-pad enkulu ngaphansi kwehora, udinga ukufuna usizo ngokushesha.
Ungase uzwe ngezinye izimpawu ezingabonisa ukulahleka kwegazi, kodwa kubalulekile ukufuna usizo lwezokwelapha ngaphambi kokuba lezi zimpawu zenzeke.
Isibonelo, ungase uzwe ukuthi ngokukhipha ngokweqile izinga lokushaya kwenhliziyo yakho liyokwandisa (i-tachycardia.) Kodwa cishe amaphesenti angu-30 egazini lakho angase alahleke ngaphambi kokushaya kwenhliziyo ngokushesha. Okufanayo nakweminye izimpawu kanye nezimpawu zokulahleka kwegazi kanye nokuphelelwa kwegazi. Uma ukucindezela kwegazi kwakho kwehla, noma wena uma ubonakala uphahla futhi uphukile, usuvele ulahlekile kakhulu igazi futhi kufanele ubize 911.
Izimbangela Zokulimaza Ngokushada Ngaphandle
Kunezimbangela eziningana zokwelapha emva kokukhulelwa kwesisu, kodwa ngokujwayelekile kakhulu imikhiqizo egcinwe yokukhulelwa noma ukukhulelwa kwesisu okungaphelele . Uma imikhiqizo yokukhulelwa ihlala esibelethweni sakho, inkontileka evamile yesibeletho sakho eyenzeka emva kokuphuphuma kwesisu kungenzeki.
(Uma lokhu kungenzeki emva kokulethwa kwesikhathi esigcwele kuthiwa u-uterine atony.) Ukuze igazi lakho lime, ukususwa kwemikhiqizo yokukhulelwa kufanele kwenzeke.
Ngaphezu kokukhulelwa kwesisu okungaphelele, ezinye izimbangela ezingavamile kodwa ezibalulekile zihlanganisa:
- Ukuphazamiseka kwezifo ezifana ne-hemophilia nesifo se-von Willebrands (isifo se-von Willebrands sithinta amaphesenti angu-1.3 abantu futhi abesifazane abaningi abazi isimo baze bavele ngokweqile ngemuva kokukhulelwa noma ukubeletha)
- Imithi yokwelapha igazi (izidakamizwa ezifana neHeparin, nakuba kubalulekile ukuqaphela ukuthi amanye amalungiselelo emithi angabangela ukuphuma kwegazi)
- Ama-cysts ase-Ruptured ovarian
- I-fistula ye-AV (lapho imishanguzo ixhuma ngqo emithanjeni embelethweni yakho noma esibelethweni)
- Ukwethuka okulandelwa yi-coagulation ye-intravascular (DIC)
- I-choriocarcinomas (isisu esingavamile kakhulu esibelethweni)
Ukuqaphela ukushona kwegazi ngokuthatha isisu
I-ultrasound ingasisiza ekutholeni ukukhulelwa kwesisu okungaphelele, ngokubonakala kwendonga yobubelethi. Ukwenza ucwaningo udokotela wakho uzophinde abheke emlandweni wakho (ikakhulukazi iminyaka yobubele bokukhulelwa kwakho) nokuhlola ngokomzimba (ngabe ngabe umlomo wesibeletho uvulekile nokuthi ngabe kukhona imikhiqizo yokukhulelwa.)
Ukwelashwa Kwemiphumela Yokushona Kwesizathu Ngenxa Yokuthatha Isisu
Ukwelashwa kwesisu ngemuva kokukhulelwa kwesisu kungahle kube yisimo esiphuthumayo sezokwelapha. Isinyathelo sokuqala ukuqinisekisa ukuthi uzinzile, uhlola izinyathelo eziphuthumayo ezivamile kunoma yiziphi izimo eziphuthumayo-ukuhamba emoyeni, ukuphefumula, nokusabalalisa.
Kwakuhanjiswa i-IV emikhulu futhi i-fluid intravenous. Igazi lakho lizodonselwa ngohlobo nokugqamuka ukuze igazi linikezwe uma kunesidingo.
Isinyathelo esilandelayo ukuhlola ngokushesha imbangela yokuphuma kwegazi (ukulawula izimbangela ezingavamile zokuphuma kwegazi njengokukhulelwa okunamandla ne-cyst ovarian break, ukuphazamiseka kwegazi, njll) bese uxazulula umthombo wokuphuma kwegazi. Ngokuvamile lokhu kusho ukuthi i- D & C ephuthumayo (ukuhlenga nokukhishwa) ukususa imikhiqizo yokukhulelwa. Imithi ingasetshenziselwa ukusiza ekuqhekekeni kwesibeletho sakho ngemuva kokuthi lokhu kususwe.
Izinkinga ze-Hemorrhage Secondary to Isisu
Ukuqeda ukukhulelwa ngokweqile kuyinkinga yokubulala impilo kanye nokunakekelwa kwezempilo okuphuthumayo kuyadingeka. Ngaphandle kosizo oluphuthumayo, ukushuswa ngisho nokufa kungenzeka. Ukulahleka kwegazi okunengi kungabangela ukugeleza kwegazi ukufika ebuchosheni, kanti izinkinga ezihlobene ne-hypoxia (ukungabi khona kwe-oksijini emathisini omzimba) kungenzeka uma ukwelashwa okuphuthumayo kuphuze.
Ngokunakekelwa kahle kwezokwelapha, izinkinga eziningi zihlobene nokuhlinzwa (i-D & C kanye ne-hysterectomy uma kunzima) noma ukumpompela igazi.
Ukulandela ukubola kwesisu okuhlobene nokukhulelwa kwesisu, kungathatha isikhathi sokuba igazi lakho libale ukuthi libuyele evamile, futhi kubalulekile ukuthatha kalula ngalesi sikhathi.
Qaphela : Uma ubheka izincwadi ungesabi uma ubona ama-athikili ekhuluma ngokukhipha isisu. Ukusebenzisa udokotela igama elithi "ukukhipha isisu" ukuchaza kokubili ukukhipha isisu nokukhubazeka, ngokukhipha izisu ngokuzithandela kubizwa ngokuthi "ukukhipha isisu okukhethwayo" kanye nokuhlukunyezwa okubizwa ngokuthi "ukukhipha isisu okuzenzakalelayo."
Ukuphuza Kuze Kuphele Kangakanani Ngokushada?
Ngesikhathi sokukhulelwa kwesisu, ukuphuma kwegazi kanye nezinhlungu zomzimba ezibuhlungu (esinye isibonakaliso esiyinhloko sokukhulelwa kwesisu) kuvame ukwenza okungcono kakhulu uma udlula i-placenta nesigqila ngesisu sakho. Le nqubo ingathatha noma yikuphi ukusuka kumaminithi angu-60 kuya emahoreni ambalwa. Uma ungeke ukwazi ukudlula lezo zicubu ngokwemvelo, udokotela angakusiza ukukususa ngokusebenzisa inqubo yezokwelapha ebizwa ngokuthi i-dilation ne-curettage (ngokuvamile ebizwa ngokuthi i-D & C).
Ukulandela ukukhulelwa kwesisu, ungase uphuze kancane emasontweni amabili alandelayo noma kunjalo, kodwa inani legazi kufanele liye kancane kancane. Umjikelezo wakho ojwayelekile wokuya esikhathini kumele ubuyele ngaphakathi kwamasonto ayisithupha
Izimbangela Zokungashadi
Iningi lokuhlukunyezwa libangelwa izinkinga zomshuwalense okungahleliwe. Uma amangqamuzana ase-fetus aqukethe ama-chromosomes amaningi kakhulu, ambalwa kakhulu, noma ayenokukhubazeka kwesakhiwo, isisu sangasese singase senzeke. Ukungahambi kahle kwempahla kungase kwenzeke ngenxa ye-ovum ebangele (uma amaqanda afundiswa embelethweni kodwa engakaze abe ngumntwana), izidakamizwa, utshwala, ukubhema, futhi mhlawumbe nokudla ngokweqile kwe-caffeine ngesikhathi sokukhulelwa. Ngezinye izikhathi izimo zezempilo zomama nazo zingafaka isandla, njenge-lupus, isifo se-thyroid, isifo sikashukela, izifo, nezinkinga ze-hormone.
Uma ungaqiniseki ukuthi unesisu, udokotela angasebenzisa i-ultrasound, ukuhlolwa kwe-pelvic, nokuhlolwa kwegazi (ukukala izinga lakho le-griadotropin noma i-hCG ye-chorionic yabantu) ukuze uphendule lo mbuzo.
Uma Ube Nesisu
Ukukhulelwa kwesisu kungaba ubuhlungu obukhulu kakhulu ngokomzimba nangokomzwelo. Kungokwemvelo ukuzizwa ucindezelekile , udidekile, futhi uthukuthele iqiniso, futhi ukukhuluma nabanye besifazane abaye baba khona nakho kungakusiza ukuba ubhekane nakho. Buza udokotela wakho ngolwazi oluthe xaxa, futhi uma ebona iqembu lenkxaso yendawo. Kunemiphakathi eminingi enhle kakhulu yokusekela inthanethi etholakalayo ukusiza labo abaye bahlangabezana nokukhulelwa kokukhulelwa, nezinhlangano eziningana ezisekela abantu abaye bahlangabezana nokukhulelwa kwesisu.
Okubaluleke kakhulu, zinike isikhathi sokulila . Kungenzeka ukuthi uzwe izimpendulo eziningi ezivela kubangane nomndeni okungase kusebenze ukukwenza ube nomuzwa obi nakakhulu. Siyazi ukuthi akusizi ukuzwa ukuthi usemusha noma ukuthi ungazama futhi. Udinga ukudabuka lokhu kukhulelwa. Zizenzele ngalesi sikhathi.
Imithombo
- > Kim, C., Barnard, S., Neilson, J., Hickey, M., Vazquez, J., noL. Dou. Ukwelapha Ukwelashwa Okungaqediwe. I-Cochrane Database yezibuyekezo ezihleliwe . 2017. 1: CD007223.
- Lane, B., Wong-You-Cheong, J., Javitt, M. et al. I-ACR Ukufaneleka Ukulinganisa ® Ukuqothula kokuqala kweThathu. I-Ultrasound ngekota . 2013. 29 (2): 91-6.
- > Rydze, R., Dixon, K., Greely, J., noS S. Hawkins. Ukusetshenziswa kweBalloon ye-Obstetric yokuHlukana nokuKhulelwa kokuHlelwa kweMvelo ngokuSakazwa kwe-Intravascular Coagulation. I-Obstetrics ne-Gynecology . 2015. 126 (5): 1019-21.