Ngenkathi izimbangela ze-second trimester ukukhulelwa kwesisu (noma "ukukhulelwa kwesisu okuphuthumayo") zingase zenzeke ngokuhlukumeza kokuqala kwe-trimester ("ukukhulelwa kwesisu kwangaphambili") kanye nokubeletha kokubeletha , ukwelashwa kwesisu sokubili kwesisu okuphindwe kabili kuvame ukuhlukana nokukhulelwa kwesisu sokuqala.
Ngokungafani nokukhulelwa kwesisu kwangaphambili, kungenzeka ukuthi awunakho ukhetho oluningi ezinketho zakho zokwelapha. Uhlelo lwakho lokunakekelwa lunganqunywa ngezimo ezingaphandle kokulawula kwakho, njengokutheleleka noma ukuqedwa kokuqala kwamagundane (okubizwa nangokuthi isikhwama samanzi).
Udokotela wakho uzokutshela mayelana nanoma yiziphi izinketho onakho futhi akusize wenze isinqumo esinolwazi mayelana nemithi yokwelapha yezidingo zakho ngabanye.
Sicela uqaphele ukuthi lezi zonyango zingasebenza nakwabesifazane abadinga ukuphela komuthi okuveziwe.
I-D & E (i-Dilation ne-Evacuation)
I- D & E yindlela yokuhlinza ehilela ukuhlanza umlomo wesibeletho, ovame ukwenziwa ngosuku lokuqala. Ngosuku lwenqubo, udokotela wakho uzosebenzisa idivayisi ekhethekile yokuhlinza ukususa okuqukethwe kwesibeletho. Le nqubo ibandakanya i-anesthesia; I-D & E ingase ingenzeki kuye ngokuthi ubude kangakanani ekukhulelwe kwakho nalapho ukufa kwe-fetus kutholakala. Akuwona wonke odokotela abaqeqeshwe ukwenza iD & E; Kodwa-ke, odokotela abaningi bazokudlulisela kumuntu okhona uma lokhu kungokwelashwa okufanele kuwe.
Ukuphathwa Kwezokwelapha
Ukuphathwa kwezokwelapha uhlobo oluthile kakhulu lwezokwelapha oluphakanyisiwe kwabesifazane abahlukumezekile ku-trimester yesibili.
Ukuphathwa kwezokwelapha kuhilela ukuthatha imithi eyodwa noma ngaphezulu ukudala ukukhuliswa komlomo wesibeletho futhi uvumele ingane ne-placenta ukuba ihambisane nomama. Imithi evame ukusetshenziselwa yi-misoprostol kanye ne-mifepristone.
I-Misoprostol ingathathwa ngomlomo, egcinwe esihlathini ize ichithe noma ifakwe emlonyeni wesibeletho ngudokotela ukuze akhiqize iziphambano.
I-Misoprostol ingasetshenziswa yodwa noma ihlanganiswe ne-mifepristone.
Phakathi ne-trimester yesibili, i-misoprostol ivame ukuphathwa esibhedlela lapho ungabhekwa khona ngabahlengikazi nodokotela uma kunesidingo esengeziwe sokwelashwa okudingekayo.
I-Mifepristone (ngezinye izikhathi eyaziwa ngokuthi i-RU-486 noma i-Mifeprex) ingahle isetshenziswe njenge "ukuxilongwa" kwe-misoprostol ukulungisa umlomo wesibeletho ngenxa yezinqamulelo ezenziwe. Akubona bonke abahlinzeki bezokwelapha noma izakhiwo ezisebenzisa i-mifepristone.
Ukulawula ubuhlungu
Ukukhathazeka kuvame kakhulu ukukhulelwa kwesisu esikhathini esisheshayo kunokuqala. Ngenxa yokuthi ukulahlekelwa okuphindwe kabili kwe-trimester kwenzeka esibhedlela, izinketho zakho zokulawula ubuhlungu ziyahlukahluka. Ungakwazi ukuxoxa ngezinketho zakho nomhlengikazi wakho, udokotela kanye ne-anesthesiologist ocingweni.
I-PCA (i-analgesia elawulwa isiguli): Imithi yokwelapha njenge-morphine, i-dilaudidi noma i-fentanyl enikezwe nge-IV ingathunyelwa ngepom ekhethekile evumela ukuthi usebenzise inkinobho ukuze uzinike umthamo wemithi uma uyidinga
I-Epidural: Imithi yokwenza izidakamizwa kanye nemithi yokuhlunguphazwa inganikezwa nge-tube encane ebekwe ngemuva kwakho ngumuntu onesi-anesthesiologist.
Ezinye zokwelapha
Esinye sezimbangela ezivame kakhulu zokukhulelwa kwesisu okuphelile yisifo. Ukutheleleka kuvame ukuphumela kokuphuza amanzi ngaphambi kwesikhathi.
Kulezi zimo, ukwelashwa kwakho kungabandakanya imithi elwa namagciwane ukuphatha ukutheleleka, ukungena ekamelweni lesibhedlela kanye nokuma okukhethekile ukuze kukhuthazwe ukuthi ukukhulelwa kuqhubeke ngenkathi kutholakala ama-antibiotic.
Nakuba ukukhulelwa kungagcinwa ngezingqimba eziphukile, ingozi yokutheleleka iphezulu, futhi ukuphuphuma kwesisu ngezinye izikhathi kwenzeka naphezu kokungenelela. Izikhathi eziningi, lezi ziphutha zivele ngokushesha futhi ngaphandle kokungenelela kudokotela, okufana "nokuhlukunyezwa kwezemvelo " abesifazane abaningi abahlangabezana nakho ku-trimester yokuqala.
Ukunakekelwa Okulandelwayo Ngemuva Kokuqothulwa Kwesibili Kwezinyanga ezintathu
Ukukhishwa kwesisu okwesithathu kwesibili kungavamile ukuthi udokotela wakho cishe uzotusa ukuhlolwa okulandelayo .
Uhlobo lokuhlolwa luxhomeke ekubambeni okubonakalayo noma okusolakala ukuthi lukhulelwe isisu futhi lungabandakanya ukuhlaziywa kwe-placenta noma i-fetus ngemuva kokubeletha, ukuhlolwa kwesibeletho sakho, ukuhlonza amabhaktheriya noma igciwane elibangele ukutheleleka nokuhlaziywa kwegazi lakho nganoma yikuphi ukuphazamiseka kwesiguli .
Udokotela wakho uzotusa ukuhlolwa okufanele okusekelwe emlandweni wakho. Kungase kube nezinto ongayenza ekukhulelweni okuzayo ukuze unciphise amathuba okuba nesisu esisodwa sekwephuzile.
Imithombo:
I-Michels, i-TC, i-Tiu, i-AY yesibili-yesithathu kokukhulelwa ukukhulelwa. I-American Family Physician 2007.
Puscheck, EE, Chelmow, D., Trupin, SR, et al. Ukwelashwa nokukhulelwa kokuqala kokukhulelwa nokukhulelwa. I-Medscape 2010.
Wildschut, H., kokubili, MI, Medema, S., et al. Izindlela zezokwelapha zokuphela kokuphakathi kwe-trimester kokukhulelwa. Izikhungo zezempilo zikazwelonke.