Ekukhulelweni kokuqala, kunamahomoni amabili avame ukwanda emzimbeni olandelayo ukufakelwa - i-progesterone ne -gonadotropin ye-chorionic yabantu (hCG) . Izinga lama-hormone womabili zivame ukukhuphuka kwabesifazane abanezikhumba ezikhulayo kodwa bewa kulabo besifazane abanesifo sokuphuphuma kwesisu. Futhi emashumini ambalwa eminyaka adlule, sekuvame ukuthi odokotela banikeze izithako ze-progesterone kwabesifazane abanokukhubazeka okuphindaphindiwe, ngombono wokuthi ukungakhiwa kweprogesterone kungase kube imbangela yokukhulelwa kwesisu.
Noma kunjalo, i-progesterone iyinkinga enkulu phakathi kwabadokotela, abaningi banomuzwa wokuthi i-progesterone encane ibonisa ukukhulelwa okungapheli kunokuba ibambe iqhaza ekukhulelweni okuhlulekile, futhi izithako ze-progesterone azikaze ziboniswe inzuzo kubesifazane abasengozini yokukhulelwa kwesisu .
Kunakekelwa kancane umqondo wokwengeza enye i-hormone yokukhulelwa - i-hCG - ukuvimbela ukuhlukumeza, yize i-hCG i-hormone elinganiselwa ekuhlolweni kokukhulelwa ekhaya kanye nodokotela abahlolwayo begazi ukuhlola ukukhulelwa kokuqala kokuqala. Kodwa ingabe kunengqondo ukuthi ukwengeza i-hCG kungase kuzuze abesifazane ngokuhlukunyezwa okuphindaphindiwe ? Ingabe ukukhiqizwa kwe-hCG kwangaphambilini kungafaka isandla ekukhulelweni kwesisu kunokuba nje kube isibonakaliso sokususwa kwesisu okuzayo?
Izifundo ezimbalwa empeleni ziye zaphenya lokhu kungenzeka. Nakhu okushiwo i- UpToDate , indawo ye-reference yezempilo ye-intanethi yezokwelapha neziguli, okwakufanele athi nge-hCG ukwengezwa njengokwelashwa kokuphuphuma komzimba:
"Ukwelapha kwe-chorionic gonadotropin (hCG) ngesikhathi sokubeletha kungase kube usizo ekuvimbeleni ukukhulelwa kwesisu kusukela i-hCG engapheliyo eyaziwa ukuthi idlale indima ebalulekile ekwakhiweni kokukhulelwa. Ukuhlolwa okuhlelekile kwezivivinyo ezine ezibandakanya abesifazane abangu-180 abane-RPL bethola ukwelashwa kwe-hCG okuhlobene isengozini esinciphile kakhulu sokukhulelwa kwesisu, ikakhulukazi kwabesifazane abane-oligomenorrhea. Kodwa-ke, kwakunobuthakathaka obuthakathaka obunemininingwane emikhakheni emibili yalezi zifundo. Kuze kube manje, akukho ubufakazi obanele bokuncoma ukusetshenziswa kwe-hCG ukuvimbela ukulahlekelwa ukukhulelwa kwabesifazane abanomlando ongachaziwe I-RPL. Izilingo ezinkulu ezilawulwa ngokungahleliwe ziyadingeka. "
Ngakho-ke, ngamanye amazwi, kuyaqondakala ukuthi izithako ze-hCG zingasiza ekuvimbeleni ukuhlukunyezwa. IHCG i-hormone idlala indima ebalulekile ekusizeni ukukhulelwa kuqiniswe, futhi kungenzeka ukuthi ukukhiqizwa kwe-hCG encishisiwe kungadlala indima ebangela ukuhlukumeza. Ucwaningo olukhona lubonise ukuthi ukwelashwa kungase kuzuze abesifazane ngezikhathi ezingapheli nezezikhathi (oligomenorrhea). Kodwa ngeshwa, lokho akusho ukuthi kufanele uhambe kudokotela wakho bese ucela ukuthi ubekwe kuma-hCG ukujova ekuqaleni kokukhulelwa kwakho okulandelayo, noma ngabe une-oligomenorrhea. Okuncane kakhulu kuyaziwa ngokuthi ngabe lelashwa isebenza noma cha nokuthi ngubani ozozuza. Ukucabanga ukuthi kusebenza ngisho nokusebenza, ucwaningo olwengeziwe luyadingeka ngaphambi kokuba ukwelashwa kungasetshenziswa kabanzi.
Ukuhlukumeza okungaqondakali kuyinkimbinkimbi ukubhekana nayo, noma kunjalo, futhi bangaphakamisa imibuzo eminingi ... nansi okunye ukukhathazeka okuvamile.
Nginezinkinga zokuhlukumeza ezingu-5 kanti udokotela wami akakwazi ukungitshela ukuthi kungani. Ngifuna ukuzama lelashwa. Ngizozama noma yini kuleli phuzu.
Kunzima ukubekezela ngesisindo socwaningo lwezokwelapha. Kulula ukondliwa ngemithi yokwelashwa engase itholakale eminyakeni eyishumi lapho udinga usizo manje . Kodwa kubuye kuhlakaniphe ukungaqhubeki ezintweni. Noma kunjalo, abesifazane abaningi bakhetha ukuzama izindlela ezingelapheki zokungaziphathi kahle ezibonakala zingenakwenzeka ukuba zibe yingozi kunokuqhubeka nokuzama ngaphandle kokwelapha.
Khuluma nodokotela wakho mayelana nemizwa yakho mayelana nalokhu, futhi uma ungajabuli nodokotela wakho wamanje, funda umbono wesibili. Ungase futhi ufune ukubuza mayelana nokuhlolwa kwemitholampilo okungenzeka kwenzeke endaweni yakho.
Yiziphi izindlela zokwelashwa ezifakazelwa ekusizeni ngezimo eziphuthumayo eziphindaphindiwe?
Ngeshwa, bambalwa kakhulu. Kodwa uma uke wahamba ngamathambo amabili noma ngaphezulu, cela udokotela wakho mayelana nokuhlolwa kwe-antiphospholipid syndrome nezinkinga zesakhiwo esibelethweni sakho . Lezi yizimbangela ezimbili ezingabangela ukukhubazeka okuphindaphindiwe okunemithi yokwelashwa okunomsoco obonakala ukwandisa amathuba okukhulelwa okuphephile.
Uyini uhlobo oluhle kakhulu lochwepheshe ukuze ubone ukuthi ngabe nginezinkinga eziningi zokuhlukunyezwa?
I-OB / GYN ifanelekile kakhulu ukubhekana nezindaba ezihlobene nokukhulelwa, ngakho-ke uma ujabule nodokotela wakho wamanje, ungacela udokotela wakho okhona mayelana nokuhlolwa kokubangela ukukhulelwa kwesisu. Kodwa ungase futhi ufune ukucabangela i-endocrinologist yokubeletha, i-OB / GYN enezoqeqesho ezikhethekile ezengeziwe zokungabhubhi kanye ne-endocrinology yesistimu yokuzala. Laba odokotela kungenzeka basebenzise amaphesenti amakhulu ngesikhathi sabo abasebenzisana nabesifazane abanenkinga ehlobene nokuhlala nokukhulelwa, kuyilapho i-OB / GYN ingasebenzisa isikhathi esiningi sisebenzelana nabesifazane abakhulelwe ngokujwayelekile (futhi awunakukwazi ukubona abesifazane abathintekayo ekamelweni lokulinda lapho uhambela ama-aphoyintimenti akho).
Ufuna ukufunda kabanzi? Bheka isihloko se- UpToDate , "Ukuphathwa kwemibhangqwana ngokulahlekelwa ukukhulelwa okuphindaphindiwe," ukuze uthole olunye ulwazi olunzulu lwezokwelapha.
Umthombo:
Tulandi, Togas noHaya M Al-Fozan. "Ukuphathwa kwemibhangqwana nokulahlekelwa okukhulelwa njalo." Kusesikhathini.