Ukubheka ngokucophelela ukuphepha kwama-anti-depressants njengoZoloft ngesikhathi sokukhulelwa
Ukucindezeleka kwemitholampilo kuyisifo esiyinkinga enkulu esithinta abantu ngokuhlukile. Ngokwe-March of Dimes, owesifazane oyedwa kwabahlanu abakhulelwe banezibonakaliso zokucindezeleka. Ukucindezeleka ngesikhathi sokukhulelwa kungaba nomthelela omubi kokubili umama nengane. Kukhona ingozi ephezulu yezimo zezokwelapha ezifana ne- preeclampsia kumama omcindezelekile, futhi kunengozi enkulu ukuthi umama ngeke azinakekele ngokufanele, ngeke ahlangane nomntanakhe, noma angabe engenawo ukuvakashelwa kokunakekelwa kokubeletha okunconywayo.
AmaMama abhekana nokucindezeleka ngesikhathi sokukhulelwa angase abe engozini enkulu yokucindezeleka kwe- postpartum . Phakathi kwabantu ngabanye, izimpawu nemiphumela yokucindezeleka okungaphenduliwe kungabuka komnene kuze kube nzima.
Ukuhlola nokuphatha ukucindezeleka ngesikhathi sokukhulelwa
Iningi lwakamuva, kuye kwanda isithakazelo kumqondo wokuhlola abesifazane abakhulelwe ukucindezeleka nokunikeza usizo lapho kudingeka khona. Usizo lungaba nokwesekwa kanye ne-psychotherapy, noma kwezinye izimo, imithi. Kodwa abesifazane abaningi bayazibuza ukuthi imithi yokuvimbela ukucindezeleka iphephile ngesikhathi sokukhulelwa. Ngaphezu kwalokho, omama abaye babhekana nokucindezeleka ngaphambi kokukhulelwa bavame ukuzibuza ukuthi kuphephile yini ukuhlala emithini yabo ngesikhathi sokukhulelwa. Ngeshwa, impendulo ayilula "yebo." Kunezinye izingozi ezingenzeka zokusebenzisa izidambisigciwane ngesikhathi sokukhulelwa. Lezi zingozi kufanele zilinganiswe esimweni esilandelayo ngokubhekene nezingozi zokungasebenzisi izidakamizwa zokucindezeleka ngesikhathi sokukhulelwa.
Ukuphepha Kwezinkinga Zokucindezeleka Ngesikhathi Ukukhulelwa Nengozi Yokushada Ngaphandle
Ama-antidepressants asetshenziselwa kakhulu awela ezigabeni ze-tricyclic antidepressants (TCAs) (njengegama lamagama e-Tofranil no-Elavil) kanye ne-serotonin reuptake inhibitors (SSRIs) ekhethiwe (njengegama lamagama we-Zoloft ne-Prozac). Zombili amakilasi ezidakamizwa zivame ukuqhubeka phakathi nokukhulelwa lapho omama bezisebenzisa bekhulelwa, kanti ngezinye izikhathi banikezwa abesifazane besifazane abakhulelwe abanokucindezeleka okukhulu ngesikhathi sokukhulelwa.
Ama-TCA asekude isikhathi eside kunama-SSRI futhi asetshenziswe kancane kancane, nakuba ucwaningo oluningi lusadingeka kuzo zombili izigaba.
Ubufakazi obutholakala bubonisa ukuthi ukutholakala kokubili kwama-SSRIs nama-TCA kungase kuhlotshaniswe nezimpawu zokuhoxiswa ezinganeni ezisanda kuzalwa, kodwa lezi zimpawu ngokuvamile zihamba isikhathi eside futhi azikho ukuphila okusemthethweni noma okulimazayo esikhathini eside. Ukucwaninga ngemiphumela yesikhathi eside kanye nokukhubazeka kokuzalwa kuhlanganisiwe, ikakhulukazi kuma-SSRIs.
Umbuzo wokungenwa kwamaphesenti okungahambi kahle komzimba uye waphikisana. Ubufakazi obuphathelene nokuphepha kwama-SSRIs, ikakhulukazi, kuye kwaxubana nezifundo eziningi ezinamasayizi amancane esampula (inani elilinganiselwe labahlanganyeli ocwaningo); Kodwa-ke, ucwaningi olukhulu lwango-2010 lubonise ukuthi ukusetshenziswa kwe-SSRI ku- trimester yokuqala kubonakala sengathi kuhlotshaniswa nokukhushulwa kwe-68% engozini yokukhulelwa kwesisu. Ayikho isixhumanisi se-causal phakathi kokusetshenziswa kwe-SSRI nokukhulelwa kwesisu okuye kwafakazelwa, kodwa ngokwemvelo ukuthola lokhu kuyabangela abesifazane abaningi nodokotela babo. Akukho bufakazi obuxhumanisa ukusetshenziswa kwama-TCA ekukhulelweni kwengozi yokukhulelwa kwesisu.
Ingabe Kufanele Uthathe Ukucindezeleka Ngesikhathi Ukhulelwe?
Noma yisiphi isifundo esixhumanisa izidakamizwa zokucindezeleka ekungenikeleni ingozi yokukhulelwa kwesisu, ukukhubazeka kokuzalwa, noma ezinye izinkinga, kubalulekile ukuxazulula isizathu sokuthola.
Ngisho nangokulingana kwezibalo phakathi kwe-TCA noma i-SSRI ukuvezwa kwezinkinga nezinkinga ezihlukahlukene, kungaba nzima ukunquma ngokuqiniseka ukuthi lesi sidakamizwa yilokho okwenze umphumela omubi. Kungenzeka ukuthi lesi sidakamizwa silimaza ekukhuliseni abantwana, kodwa kungenzeka ukuthi abesifazane abasemilonyeni yokucindezeleka bacindezeleke kakhudlwana kusukela ekuqaleni futhi kukhona into ephilayo noma yokuziphatha kula ma mamama elandisa ukulungiswa okutholakala kulesi sifundo .
Kubalulekile futhi ukukala izingozi zokwelashwa ngokubhekene nezinselele zokuntuleka kokwelashwa. Noma yikuphi ukukhuphuka engozini kwengane kungesabeka, noma ngabe ingozi enkulu isincane.
Kodwa-ke, ucwaningo lubonisa ukuthi ukucindezeleka kubangelwa ukubuyela emuva ekukhulelweni, kanye nezingozi eziphezulu emama abashiya imishanguzo yabo - ngakho odokotela bavame ukungabaza ukuncoma ukuthi omama bayeke imishanguzo yabo, ikakhulukazi banikwe ukungabi nobufakazi obunzima bokufaka ingozi ekusebenziseni izidakamizwa ekukhulelwe. Ukucindezeleka okungabonakali ekukhulelweni kuhlotshaniswa nezingozi ezingaphezu kokubili komama nomntanami, kuye ngokuthi ubuhlungu be-depress, buba ngumbuzo wokuthi yiziphi izingozi ezinkulu. Impendulo kungenzeka ukuthi iyodwa futhi ixoxwe ngokucophelela nodokotela wakho.
Iziphakamiso Zokusebenzisa Ukucindezeleka Ngesikhathi Ukukhulelwa
Njengoba kushiwo ngenhla, ukucindezeleka okungaphenduliwe kubangela ingozi ecacile kumama olindelekile nengane. Oomama ocindezelekile abakwazi ukuhambela ukuvakashelwa kokubeletha okunconywayo , amathuba okusebenzisa kabi izidakamizwa, amathuba okubambisana nezinsana zabo, futhi kungenzeka ukuthi baphethwe ukucindezeleka kwangemva kokubeletha - konke okungathinta ikhono lomama lokunakekela umntwana ngaphambi futhi ngemva kokuzalwa.
Iningi ucwaningo oluze kube yimanje alukhombisi izingozi ezinkulu zesikhathi eside ezihlobene nokusetshenziswa kwezidakamizwa ze-TCA noma ze-SSRI ngesikhathi sokukhulelwa, nakuba ubufakazi buhlanganisiwe. Ingozi ebuswe kakhulu ibonakala sengathi izinsana ezisanda kuzalwa zingakwazi ukuthola ukuphumula kwesifo sokuphela kwesikhathi lapho zizalwa ngezibonakaliso ezifana nokukhala ngokweqile, ukulimala, ukukhathazeka kokudla, nokucasula - kodwa izimpawu ngokuvamile ziyahamba zingakapheli amasonto amabili.
Eminye imibiko ibonise ingozi ephakeme yesimo esibizwa ngokuthi i -pulpary pulmonary hypertension yengane esanda kuzalwa (i-PPHN) ezinganeni ezitholakala kuma-SSRI ekukhulelweni. I-PPHN ingaba ingathí sina, kepha ingozi enkulu yalesi simo iphansi ngisho nasezinswaneni ezivelele, ngakho odokotela banganquma ukuthi izinzuzo zokuqhubeka nomuthi osebenzayo zingase zibe nzima kakhulu. Eminye imibiko ibonisa ukuthi ingozi yokukhulelwa kwenhliziyo yokuzalwa engenayo isetshenziswa ngokusetshenziswa kwe-paroxetine (Paxil), kodwa futhi, ingozi enkulu ihlala iphansi futhi omama abakhulelwe ngenkathi usebenzisa i-Paxil bangakhetha ukuqhubeka nomuthi.
Iningi ucwaningo alubonakali izinkinga zokuziphatha noma ezinye izimo ezimbi zesikhathi eside ezinganeni ezazitholela izidakamizwa zokucindezeleka e-utero, nakuba kudingeka ucwaningo olungaphezulu. Kodwa ucwaningomqondo olufanayo alutholakali emithethweni yokuziphatha yesikhathi eside ezinganeni ezizalwa ngamama ngokucindezeleka okungaphenduliwe, futhi kubonakala sengathi ukucindezeleka okungaphenduliwe kungabangela ngokulinganayo noma okulimazayo kunokuba kutholakale imishanguzo yokucindezeleka.
Nakuba ukuhlolwa kuka-2010 kubonise ukuthi ukusetshenziswa kwe-SSRI ekukhulelweni kwakuhambisana nokukhuphuka kwengozi engama-68% yokukhulelwa kwesisu , kungathi futhi ukwanda kwengozi kungase kuvezwe yizinzuzo zokusebenzisa izidakamizwa zokucindezeleka. Uma umphakathi jikelele unengozi engu-15% yokukhulelwa kwesisu, ukukhuphuka kwengozi engama-68% kungasho ukuthi ingozi engama-25% yokukhulelwa kwesisu kwabesifazane abasebenzisa imithi. Amama omlando wokucindezeleka okukhulu anganquma kanye nodokotela bawo ukuthi ingozi ihlala iyamukeleka. Kumele futhi kugcinwe engqondweni ukuthi inhlangano ekucwaningweni ihlala ihlangene ngaphandle kobufakazi bokuthi izidakamizwa ze-SSRI zibhekele ingozi yokungeyona isisu.
Izizathu Zokuvimbela Ukucindezeleka Ngesikhathi Ukukhulelwa
Ehlangothini le-flip, amamama amaningi alindelekile angabuka idatha yokuphepha futhi anqume ukuthi noma iyiphi ingozi eyongeziwe ezinganeni zabo-kungakhathaliseki ukuthi encane - ayamukeleki. Nakuba izimpawu ze-neonatal behavior syndrome zihamba isikhathi eside, imiphumela efana nezinkinga ze-heart congenital kanye ne-PPHN ingaba nemiphumela yesikhathi eside. Abanye besifazane bangase babe nomuzwa wokuthi uma izingane zabo zihlakulela lezi zinkinga, ngeke zikwazi ukwamukela ukuthi izinkinga zingase zivinjelwe.
Ngokufanayo, omama abahlukumezeka ngenkathi basebenzisa i-SSRI bese befunda ukuthi kungenzeka yini ukuxhumana phakathi kwe-SSRIs nokukhulelwa komzimba kungase kutholakale ukuthi kungenzeka ukuthi ingozi yokukhulelwa kwesisu ingafaki ngokulinganayo. Ucwaningo lubonisa ukuthi omama abanomlando wezingqondo odlule basengozini enkulu yokucindezeleka ukucindezeleka noma ukucindezeleka kokucindezeleka okulandela ngemuva kokuhlukumeza , futhi, ingozi eyengeziwe yokwehlukaniswa komama ekuphatheni ama-SSRIs akufanele inganakwa.
Okokugcina, imibuzo ihlala phezu kwenzuzo yama-anti-depressants ukuze kusetshenziswe izinhlobo zokucindezeleka ezinzima kakhulu - ucwaningo luye lwaxubene ekusebenzeni kwezidakamizwa ngaphezu kwe-placebo yokucindezeleka okungesilo. Abanye besifazane abathatha izidakamizwa bangakwazi ukuphatha ukucindezeleka kwabo ngaphandle kwemithi, nakuba labo abanenkinga yokucindezeleka okungase kube nzima ukubhekana nabo ngaphandle kokwelashwa.
Lapho Le Ndaba iqala khona
Azikho izimpendulo ezilula. Inkambo yesenzo esifanele kungenzeka ihluka yilowo muntu. Umama ogxeka kakhulu futhi ongakaze azibulale yena angase anqume ngeseluleko sikadokotela wakhe ukuze azame ukuphuza imithi yakhe. Kodwa ngokuphambene, kumama onomlando wokuzama ukuzibulala ongazange awuthuthuke ekuziphatheni kwengqondo futhi ngubani ozogcina ezinzile emithini yokuvimbela ukucindezeleka, izingozi zokuyeka ukwelashwa zingase zibe ngaphezu kwezingozi zokuqhubeka ukwelashwa.
Njengazo zonke izindawo zokunakekelwa kwezempilo, abesifazane kudingeka baxoxe ngezinzuzo kanye nezingozi zezozifundo zombili odokotela. Abesifazane asebevele benesifo sokucindezeleka futhi abakhathazekile ngemiphumela yezidakamizwa ngesikhathi sokukhulelwa kufanele baxoxe nodokotela babo ngaphambi kokukhulelwe, njengoba ukuhlolwa kokuyeka imithi kungase kube ngcono ngaphambi kokukhulelwa. Abesifazane abakhulelwe ngenkathi benesifo sokucindezeleka kufanele bangashiyi imishanguzo yabo ngaphandle kokubonisana nodokotela babo - noma ngabe isidakamizwa kufanele simiswe, kungcono kakhulu ukunciphisa kancane umthamo kunokumisa u-cold turkey. Udokotela wakho angakunikeza futhi amaqembu asekela noma amanye ama-non-drug treatment endaweni yakho engakusiza ukuphatha isimo sakho.
Futhi ekugcineni, abesifazane abakhetha ukuqhubeka nemithi yabo ngesikhathi sokukhulelwa akufanele bazizwe benecala ngokwenza kanjalo. Ukwelashwa ukwelashwa kokucindezeleka akuyona iphutha lomlingiswa, futhi ukuba umama omuhle kusho nokuzitholela ngokwanele ukuze ukwazi ukusebenza nokunakekela ingane yakho ngaphambi nangemva kokuzalwa. Ngisho noma ukukhulelwa kwesisu noma ukucindezeleka okunye kokukhulelwa kwenzeka ngenkathi uthatha izidakamizwa zokudambisa, isixhumanisi asikho ngokucacile ukuthi kufanele uthathe i-antidepressants yimbangela - ngokulinganayo noma ngaphezulu ukuthi kwakukhona enye incazelo. Phakathi naleso sikhathi, gwema izinhlobo zokugwema futhi ungacabangi ukuthi kufanele uvikele izinqumo zakho kunoma ubani. Naphezu kwemibono eminingi ethandekayo ngaphandle kwalokhu, wena nodokotela wakho basesimweni esihle kakhulu sokwazi okukuhle kuwe.
Imithombo:
Ukucindezeleka Phakathi Nokukhulelwa. March we-Dimes. Kufinyelelwe: 8 Jun 2010. http://www.marchofdimes.com/pnhec/188_15663.asp
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