Ngaba ukuKhupha isisu kunokubangela ukungachumi?

Umxholo

• Zithini iindidi zokuqhomfa?
• Ukuqhomfa ngonyango
• Ukukhupha isisu
• Zithini iingozi zokukhupha isisu?
• Yintoni i-Asherman syndrome?
• Ithini imbonakalo yokuzala emva kokukhupha isisu?
• Ukuthatha

Kwisigama sezonyango, igama elithi "ukukhupha isisu" linokuthetha ukupheliswa kokucwangciswa kokukhulelwa okanye ukumitha okuphela kokuphuma kwesisu. Nangona kunjalo, xa uninzi lwabantu lubhekisa ekuqhomfeni, bathetha ukukhupha isisu, kwaye yindlela elisetyenziswe ngayo eli nqaku kweli nqaku.

Ukuba ukhuphe isisu, unokukhathazeka malunga nokuba kuthetha ntoni ukuchuma kunye nokukhulelwa. Nangona kunjalo, ukukhupha isisu akusoloko kuchaphazela ukukwazi kwakho ukukhulelwa kwakhona ngelinye ixesha.

Ukungafani okungaqhelekanga kukuba unobungozi emva kokukhipha isisu, imeko ebizwa ngokuba yi-Asherman syndrome.

Eli nqaku liza kuphonononga iintlobo ezahlukeneyo zokukhupha isisu, ukuchuma kwixesha elizayo, kunye nokuba wenzeni ukuba unengxaki yokukhulelwa emva kokukhupha isisu.

Zithini iindidi zokuqhomfa?

Nangona kunqabile, ngamanye amaxesha uhlobo lokuqhomfa onalo lunokuchaphazela ukuzala kwakho kwixa elizayo. Ngokwesiqhelo, indlela yokuqhomfa iya kuxhomekeka ekubeni isisu siqhubele phambili kangakanani. Ixesha linokubangela ukuba umntu afune ukukhupha isisu ngonyango okanye ngotyando.

Ukuqhomfa ngonyango

Ukuqhomfa ngonyango kwenzeka xa owasetyhini ethatha amayeza ukukhupha isisu. Ngamanye amaxesha, owasetyhini unokuwathatha la mayeza kuba efumene isisu. Amayeza anceda ekuqinisekiseni ukuba zonke iimveliso zokukhulelwa zidlulisiwe ukunqanda ukosuleleka kwaye ukuze umfazi aphinde akhulelwe kwakhona kwixa elizayo.

Luluphi ukhetho lokukhutshwa kwesisu ugqirha anokumisela rhoqo kuxhomekeke kubudala bokukhulelwa okanye zingaphi iiveki zokukhulelwa umntu lowo.

Imizekelo yeendlela zokukhupha isisu ngonyango malunga nexesha zibandakanya:

• Ukuya kuthi ga kwiiveki ezisi-7 ukhulelwe: Amayeza e-methotrexate (i-Rasuvo, i-Otrexup) anokumisa iiseli kwimbungu ekubeni iphindaphinde ngokukhawuleza. Umfazi emva koko uthatha amayeza misoprostol (Cytotec) ukukhuthaza ukubetha kwesibeleko ukukhupha ukukhulelwa. Oogqirha abayeki ngokubanzi i-methotrexate - le ndlela ihlala igcinelwe abasetyhini abane-ectopic pregnancy, apho ukufakwa kombungu ngaphandle kwesibeleko kwaye ukukhulelwa kungasebenzi.
• Ukuya kuthi ga kwiiveki ezili-10 ukhulelwe: Ukuqhomfa ngonyango kungabandakanya ukuthatha amayeza amabini, kubandakanya i-mifepristone (Mifeprex) kunye ne-misoprostol (Cytotec). Ayingabo bonke oogqirha abanokuyalela i-mifepristone-uninzi kufuneka lube nesiqinisekiso esikhethekileyo sokwenza njalo.

Ukukhupha isisu

Ukukhupha isisu ngotyando yinkqubo yokuphelisa ukukhulelwa okanye ukususa iimveliso eziseleyo zokukhulelwa. Njengokukhupha isisu ngonyango, indlela inokuxhomekeka kwixesha.

• Ukuya kuthi ga kwiiveki ezili-16 ukhulelwe: Umnqweno wokuphefumla yenye yeendlela eziqhelekileyo zokuqhomfa. Oku kubandakanya ukusebenzisa izixhobo ezizodwa ukususa umbungu kunye ne-placenta kwisibeleko.
• Emva kweeveki ezili-14: Ukuhanjiswa kunye nokukhutshwa (D&E) kukususwa kotyando kosana olungekazalwa kunye neplacenta. Le ndlela inokudityaniswa nezinye iindlela ezinje nge-vacuum aspiration, ukususwa kwe-forceps, okanye i-dilation kunye ne-curettage. Oogqirha bakwasebenzisa i-dilation kunye ne-curettage (i-D & C) ukususa iimveliso eziseleyo zokumitha ukuba umntu wasetyhini uphulukene nesisu. I-Curettage ithetha ukuba ugqirha usebenzisa isixhobo esikhethekileyo esibizwa ngokuba yi-curette ukususa izicubu ezinxulumene nokukhulelwa kumngxunya wesibeleko.
• Emva kweeveki ezingama-24: Ukukhipha isisu yindlela engafane isetyenziswe eMelika, kodwa ibonakalisiwe kwinqanaba lokukhulelwa. Imithetho malunga nokuqhomfa emva kweeveki ezingama-24 iyahluka ngokwamazwe. Le nkqubo ibandakanya ukufumana amayeza akhuthaza ukuhanjiswa. Emva kokuzalwa komntwana, ugqirha uyakususa naziphi na iimveliso zokukhulelwa, njengeplacenta, kwisibeleko.

NgokweGuttmacher Institute, kuqikelelwa ukuba iipesenti ezingama-65.4 zokukhupha isisu zaqhutywa xa owasetyhini wayeneeveki ezisi-8 ekhulelwe okanye ngaphambili. Kuqikelelwa ukuba iipesenti ezingama-88 zokuqhomfa zivela kwiiveki ezili-12 zokuqala zokukhulelwa.

Xa isisu senziwe kwindawo ecocekileyo nekhuselekileyo yezonyango, uninzi lweenkqubo aluyi kuchaphazela ukuzala. Nangona kunjalo, soloko uthetha nogqirha wakho malunga nayiphi na inkxalabo onayo.

Zithini iingozi zokukhupha isisu?

Ngokwe-American College of Obstetricians kunye neGynecologists (ACOG), ukukhupha isisu yinkqubo enobungozi obuncinci. Umngcipheko wokufa emva kokukhipha isisu ungaphantsi kwe-1 kwi-100,000. Kamva ekukhulelweni kwakhe umfazi ukhupha isisu, umngcipheko omkhulu wokuba neengxaki; Nangona kunjalo, umngcipheko wokufa emva kokubeleka ungaphezulu amaxesha angama-14 kunengozi yokufa emva kokukhupha isisu kwangoko.

Ezinye zeengxaki ezinokubakho ezinxulumene nokukhupha isisu zibandakanya:

• Ukopha: Umfazi unokufumana ukopha emva kokukhupha isisu. Ngokwesiqhelo, ukulahleka kwegazi akulogqithisi kangangokuba yingxaki yezonyango. Nangona kunjalo, kunqabile ukuba, umntu wasetyhini angopha kakhulu ade afune utofelo-gazi.
• Ukuqhomfa okungagqitywanga Xa oku kusenzeka, izicwili okanye ezinye iimveliso zokukhulelwa zinokuhlala kwisibeleko, kwaye umntu angafuna i-D & C ukususa izicwili eziseleyo. Umngcipheko woku kunokwenzeka ngakumbi xa umntu ethatha amayeza okususa isisu.
• Usulelo: Oogqirha baya kuhlala benika i-antibiotics ngaphambi kokukhupha isisu ukukhusela lo mngcipheko.
• Ukwenzakala kumalungu angqongileyo: Ngamanye amaxesha, ugqirha usenokwenzakalisa ngengozi amalungu akufutshane nesisu. Imizekelo ibandakanya isibeleko okanye isinyi. Umngcipheko wokuba oku kuyakwenzeka ukonyuka ngakumbi xa umntu okhulelweyo ekhulelwe.

Ngokobuchwephesha, nantoni na ebangela ukudumba esibelekweni inokuba nefuthe lokuchuma kwixesha elizayo. Nangona kunjalo, akunakulindeleka ukuba oku kwenzeke.

Yintoni i-Asherman syndrome?

I-Asherman syndrome yinto enqabileyo enokuthi yenzeke emva kokuba owasetyhini enenkqubo yotyando, enje nge-D & C, enokuthi yonakalise ulusu lwesibeleko.

Le meko inokubangela ukuba ukonakala kuphuhle kwisibeleko. Oku kunokunyusa amathuba okuba umfazi abe nokukhulelwa kwesisu okanye abe neengxaki zokukhulelwa kwixesha elizayo.

I-Asherman syndrome ayenzeki rhoqo. Nangona kunjalo, ukuba iyenzeka, oogqirha banokuyinyanga le meko ngoqhaqho olususa iindawo ezinamanxeba ngaphakathi kwesibeleko.

Emva kokuba ugqirha eshenxisile isikhumba esibuhlungu, baya kushiya ibhaluni ngaphakathi kwesibeleko. Ibhaluni inceda isibeleko ukuba sihlale sivulekile ukuze sinyange. Nje ukuba isibeleko siphilise, ugqirha uya kuyisusa ibhaluni.

Ithini imbonakalo yokuzala emva kokukhupha isisu?

Ngokwe-ACOG, ukukhupha isisu akuchaphazeli ukubanakho ukukhulelwa kwixa elizayo. Ayikonyusi umngcipheko wokukhulelwa xa ukhetha ukukhulelwa kwakhona.

Oogqirha abaninzi bancomela ukusebenzisa uhlobo oluthile lolawulo lokuzalwa kwangoko emva kokukhipha isisu kuba kunokwenzeka ukuba umfazi angaphinda akhulelwe kwakhona xa eqala ukukhupha amaqanda.

Oogqirha baya kuthi kwakhona bacebise owasetyhini ukuba ayeke ukwabelana ngesondo ixesha elithile emva kokukhupha isisu ukuvumela umzimba ukuba uphile.

Ukuba unengxaki yokukhulelwa emva kokukhupha isisu, kubalulekile ukuba uqwalasele ezinye zezinto ezinokuthi zichaphazele ukuzala kwakho, kuba ukukhupha isisu okudlulileyo akunakubangela iingxaki zokukhulelwa. Ezi zinto zinokuchaphazela nokuzala:

• Ubudala: Njengoko uneminyaka yobudala, ukuzala kwakho kuyancipha. Oku kuyinyani ngakumbi kwabasetyhini abadala kuneminyaka eyi-35, ngokwe.
• Indlela yokuphila: Indlela yokuphila, njengokutshaya kunye nokusebenzisa iziyobisi, inokuchaphazela ukuzala kwakho. Kuyafana nakwiqabane lakho.
• Imbali yezonyango: Ukuba unembali yosulelo olosulela ngokwabelana ngesondo, njenge chlamydia okanye gonorrhea, ezi zinokuchaphazela ukuzala kwakho. Kuyafana nakwizifo ezinganyangekiyo ezinjengesifo seswekile, ukuphazamiseka komzimba, kunye nokuphazamiseka kwehomoni.
• Ukuzala kweqabane: Umgangatho wobudoda unokuchaphazela amandla omfazi wokukhulelwa. Nokuba ukhulelwe iqabane elifanayo kwixesha elidlulileyo, imikhwa yokuphila kunye nokuguga kunokuchaphazela ukuzala kweqabane lakho.

Ukuba ufumana iingxaki zokukhulelwa, thetha ne-gynecologist yakho. Banokukucebisa ngeendlela zokuphila ezinokukunceda, kunye nokucebisa ngengcali yokuchuma enokukunceda uchonge izizathu ezinokubangela kunye nokhetho olunokwenzeka.

Ukuthatha

Ukukhupha isisu nayiphi na inkqubo yonyango okanye ukuthatha amayeza ukuphelisa ukukhulelwa. NgokweGuttmacher Institute, kuqikelelwa ukuba iipesenti ezili-18 zokukhulelwa e-United States ngo-2017 yaphela ngenxa yokuqhomfa. Nokuba yeyiphi na le ndlela, oogqirha bajonga ukukhupha isisu njengeenkqubo ezikhuselekileyo.

Ukukhupha isisu akuthethi ukuba awukwazi ukukhulelwa kamva. Ukuba unengxaki yokumitha, ugqirha wakho wezifo zabasetyhini unokukunceda.