Oonobangela Bomsebenzi Wangaphambi Kokusebenza: Unyango loMlomo weSibeleko

Umxholo

• Yenziwa njani iCerclage?
• Ngaba iCerclage yenziwa nini?
• Zithini iingxaki ezinokubakho?
• Kwenzeka ntoni emva koko?
• Kwenzeka ntoni emva koko?
• Ngaba iphumelela kangakanani iCerclage?

Ubusazi?

I-cerclage yokuqala ephumeleleyo yomlomo wesibeleko yaxelwa nguShirodkar ngo-1955. Nangona kunjalo, ngenxa yokuba le nkqubo yayihlala ikhokelela ekuphulukaneni negazi kwaye iisuture kwakunzima ukuzisusa, oogqirha bafuna ezinye iindlela.

I-cerclage kaMcDonald, eyaziswa ngo-1957, yayinempumelelo ethelekiswa nenkqubo yeShirodkar-kwaye yanciphisa inani lokusika kunye nokulahleka kwegazi, ubude botyando, kunye nobunzima ekususeni i-suture. Ngenxa yezi zizathu, oogqirha abaninzi bakhetha indlela kaMcDonald. Abanye basebenzisa indlela eShirodkar eguqulweyo, elula nekhuselekileyo kunendlela yoqobo.

Ukuba umboneleli wakho ukhathalela ukuba unesibeleko esaneleyo, unokucebisa ukuqiniswa komlomo wesibeleko kusetyenziswa inkqubo ebizwa ngokuba yi-cervix. Umlomo wesibeleko. Ngaphambi kokuba umlomo wesibeleko uqiniswe ngotyando ugqirha uya kujonga ukungahambi kakuhle komntwana ngokwenza i-ultrasound.

Yenziwa njani iCerclage?

I-cerclage yenziwa kwigumbi lokusebenza, kunye nesigulana phantsi kwe-anesthesia. Ugqirha usondela kumlomo wesibeleko kwilungu lobufazi. Ibhendi yemisonto (imithungo, umsonto okanye izinto ezifana nayo) ithungelwe ngapha komlomo wesibeleko ukuze ihlale ivaliwe. I-suture ibekwe kufutshane ne-os yangaphakathi (ukuphela komlomo wesibeleko ovula kwisibeleko).

I-cerclage ye-transabdominal luhlobo olukhethekileyo lwecerclage efuna ukusikwa kudonga lwesisu. Obu buchule bunokusetyenziswa xa kungekho sithuba saneleyo somlomo wesibeleko sokubamba i-suture okanye xa i-cerclage ebekwe ngaphambili ingaphumelelanga. Kumfazi onembali yokulahleka kokukhulelwa okuninzi, ugqirha unokubeka i-cerclage yesisu ngaphambi kokukhulelwa.

Ngaba iCerclage yenziwa nini?

Uninzi lweecerclages lwenziwa ngexesha lesibini lokukhulelwa (phakathi kweeveki ezili-13 ukuya kwezingama-26 zokukhulelwa), kodwa zinokubekwa ngamanye amaxesha, kuxhomekeke kwisizathu se-cerclage. Umzekelo:

• Iicerclages ezikhethiweyo zihlala zibekwa kwiveki ye-15 yokukhulelwa, zihlala zibangelwa ziingxaki ngexesha lokukhulelwa okudlulileyo.
• Iicerclages ezingxamisekileyo zibekwa xa kuvavanyo lwe-ultrasound lubonisa umlomo wesibeleko omfutshane, ohlaziyiweyo.
• Ingxamiseko okanye ubuqhawe? iicerclages zihlala zibekwa phakathi kwiveki ye-16 neye-24 yokukhulelwa ukuba umlomo wesibeleko udibene ngaphezulu kwe-2 cm kwaye sele ususwe, okanye ukuba inwebu (ibhegi yamanzi) inokubonwa kwilungu lobufazi kwi-os yangaphandle (ukuvulwa komlomo wesibeleko kwilungu lobufazi ).

Zithini iingxaki ezinokubakho?

Iicerclages ezikhethiweyo zikhuselekile noko. Iicerclages ezingxamisekileyo okanye ezingxamisekileyo zinomngcipheko ophezulu wokufumana iingxaki, kubandakanya ukwaphuka kweembumba ezijikeleze usana, iziphambano zesibeleko, kunye nosulelo ngaphakathi kwesibeleko. Ukuba usulelo lwenzeka, i-suture iyasuswa kwaye umsebenzi unyanzeliswa ukuba uhambise umntwana kwangoko. Koomama abafumana i-cerclage engxamisekileyo, kukho umngcipheko wokuba le nkqubo iyakwandisa kuphela ukukhulelwa ukuya kwiiveki ezingama-23 okanye ezingama-24. Kule minyaka, abantwana banomngcipheko ophezulu kakhulu weengxaki zexesha elide.

Izifundo zibonise ukuba abasetyhini abafuna i-cerclage yomlomo wesibeleko basemngciphekweni owandayo wokuba basebenze ngaphambi kwexesha kwaye ngokubanzi bafuna ukulaliswa esibhedlele ngexesha lokukhulelwa kwabo.

Kwenzeka ntoni emva koko?

Ukubeka i-cerclage yeyokuqala kuthotho lwamanyathelo anokuba yimfuneko ukuqinisekisa impumelelo yenkqubo kunye nokukhulelwa kwakho. Emva kotyando, ugqirha wakho unokukunika amayeza ukuze unqande isibeleko sakho kwisivumelwano. Ungalithatha eli yeza usuku olunye okanye ezimbini. Emva kokukhutshwa esibhedlele, ugqirha wakho uya kufuna ukukubona rhoqo ukuvavanya umsebenzi wokuqala.

Usulelo yinkxalabo emva kwayo nayiphi na inkqubo yotyando. Ukuba ngaba une-cerclage engxamisekileyo okanye yeqhawe, umngcipheko wosulelo uyanda.Kungenxa yokuba ubufazi buqulethe iibhaktheriya ezingafumaneki ngaphakathi kwesibeleko. Xa ibhegi yamanzi ixhomeke ezantsi kwilungu lobufazi, kukho umngcipheko okhulayo wosulelo lwebacteria ngaphakathi kwesibeleko nangaphakathi kwesangqa se-amniotic esibambe umntwana. Ugqirha wakho unokukunika amayeza okubulala iintsholongwane ukunciphisa umngcipheko wosulelo. Ukuba usulelo lufunyenwe engxoweni yamanzi, ukukhulelwa kufuneka kupheliswe ukuze kuthintelwe iziphumo ezibi zempilo kunina.

I-suture isuswa ngokubanzi malunga ne-35 ukuya kwi-37 yeveki yokukhulelwa, xa umntwana sele efikelele kwinqanaba elipheleleyo. I-cerclage yesisu ayinakususwa, kwaye abasetyhini abaneecerclages zesisu baya kufuna amacandelo e-C ukuzisa.

Kwenzeka ntoni emva koko?

Ukubeka i-cerclage yeyokuqala kuthotho lwamanyathelo anokuba yimfuneko ukuqinisekisa impumelelo yenkqubo kunye nokukhulelwa kwakho. Emva kotyando, ugqirha wakho unokukunika amayeza ukuze unqande isibeleko sakho kwisivumelwano. Ungalithatha eli yeza usuku olunye okanye ezimbini. Emva kokukhutshwa esibhedlele, ugqirha wakho uya kufuna ukukubona rhoqo ukuvavanya umsebenzi wokuqala.

Usulelo yinkxalabo emva kwayo nayiphi na inkqubo yotyando. Ukuba ngaba une-cerclage engxamisekileyo okanye yeqhawe, umngcipheko wosulelo uyanda. Kungenxa yokuba ubufazi buqulethe iibhaktheriya ezingafumaneki ngaphakathi kwesibeleko. Xa ibhegi yamanzi ixhomeke ezantsi kwilungu lobufazi, kukho umngcipheko okhulayo wosulelo lwebacteria ngaphakathi kwesibeleko nangaphakathi kwesangqa se-amniotic esibambe umntwana. Ugqirha wakho unokukunika amayeza okubulala iintsholongwane ukunciphisa umngcipheko wosulelo. Ukuba usulelo lufunyenwe engxoweni yamanzi, ukukhulelwa kufuneka kupheliswe ukuze kuthintelwe iziphumo ezibi kumama.

I-suture isuswa ngokubanzi malunga ne-35 ukuya kwi-37 yeveki yokukhulelwa, xa umntwana sele efikelele kwinqanaba elipheleleyo. I-cerclage yesisu ayinakususwa, kwaye abasetyhini abaneecerclages zesisu baya kufuna amacandelo e-C ukuzisa.

Ngaba iphumelela kangakanani iCerclage?

Akukho lunyango olunye okanye indibaniselwano yenkqubo yomlomo wesibeleko engonelanga enokuqinisekisa ukukhulelwa ngempumelelo. Uninzi olunokwenziwa ngoogqirha kukunciphisa umngcipheko kuwe nakumntwana wakho. Njengomgaqo oqhelekileyo, ii-cerclages zisebenza kakuhle xa zibekwe kwangoko xa ukhulelwe naxa umlomo wesibeleko mde kwaye utyebile.

Iirhafu zokuthwala ukukhulelwa ukuya kwikota emva kwecerclage ziyahluka ukusuka kwiipesenti ezingama-85 ukuya kwezingama-90, kuxhomekeka kuhlobo lwecerclage esetyenzisiweyo. (Amanqanaba empumelelo abalwa ngokuthelekisa inani lokukhulelwa elethwayo okanye elisondeleyo kwinani elipheleleyo leenkqubo ezenziweyo.) Ngokubanzi, i-cerclage ekhethiweyo inelona zinga liphezulu lokuphumelela, i-cerclage yexesha likaxakeka iyeyona iphantsi, kwaye i-cerclage engxamisekileyo iwela ndawo phakathi . I-cerclage yesibeleko esinqabileyo ayifane yenziwe kwaye inqanaba lempumelelo lilonke alibalwanga.

Ngelixa uninzi lwezifundo lubonakalisile iziphumo ezilungileyo emva kwecerclage, akukho zifundo zikumgangatho ophezulu eziye zabonisa ukuba abasetyhini abafumana i-cerclage baneziphumo ezibaluleke ngakumbi kwabo balalayo.