Unyango lwe-Preterm Labour: Tocolytics

Umxholo

• Amayeza Tocolytic
• Loluphi uhlobo amayeza tocolytic kufuneka isetyenziswe?
• Ngeliphi ixesha lokukhulelwa kwam ndingathatha amayeza e-tocolytic?
• Kufuneka kuqhubeke ixesha elingakanani amayeza e-tocolytic?
• Ngaba aphumelele kangakanani amayeza e-tocolytic?
• Ngubani ongafanele asebenzise amayeza e-tocolytic?

Amayeza Tocolytic

I-Tocolytics ngamachiza asetyenziselwa ukulibaziseka ukuhambisa kwakho ixesha elifutshane (ukuya kuthi ga kwiiyure ezingama-48) ukuba uqala ukubeleka kwangoko kakhulu xa ukhulelwe.

Oogqirha basebenzisa la mayeza ukulibazisa ukuhambisa kwakho ngelixa usiwa kwisibhedlele esigxile kukhathalelo lwangaphambi kwexesha, okanye ukuze bakunike i-corticosteroids okanye i-magnesium sulfate. Inaliti ye-corticosteroid inceda ukukhula kwemiphunga yosana.

I-Magnesium sulfate ikhusela umntwana ongaphantsi kweeveki ezingama-32 kwisifo sokukhubazeka kwengqondo, kodwa inokusetyenziswa njenge-tocolytic. I-Magnesium sulfate ikwasetyenziselwa ukuthintela ukuxhuzula kwabasetyhini abakhulelweyo abane-preeclampsia (uxinzelelo lwegazi).

Ezinye iziyobisi ezingasetyenziswa njenge-tocolytic zibandakanya:

• i-beta-mimetics (umzekelo, terbutaline)
• iicalcium block blockers (umzekelo, nifedipine)
• iziyobisi ezingekho-steroidal ezichasayo okanye ii-NSAID (umzekelo, indomethacin)

Ulwazi ngokubanzi malunga nala machiza lunikezwe apha ngezantsi.

Loluphi uhlobo amayeza tocolytic kufuneka isetyenziswe?

Akukho datha ibonisa ukuba ichiza elinye lihlala lingcono kunelinye, kwaye oogqirha kwiindawo ezahlukeneyo zelizwe banokhetho olwahlukileyo.

Kwizibhedlele ezininzi, i-terbutaline inikwa ngakumbi ukuba owasetyhini usemngciphekweni omncinci wokuhambisa usana lwakhe kwangethuba. Kwabasetyhini abasemngciphekweni omkhulu wokuhambisa kwiveki ezayo, i-magnesium sulphate (elawulwa ngemithambo) ihlala sisiyobisi esithandwayo.

Ngeliphi ixesha lokukhulelwa kwam ndingathatha amayeza e-tocolytic?

Amayeza e-Tocolytic asebenza ngaphambi kwexesha awasetyenziswanga ngaphambi kweeveki ezingama-24 zokukhulelwa. Kwiimeko ezithile, ugqirha wakho angayisebenzisa xa uneeveki ezingama-23 zokukhulelwa.

Oogqirha abaninzi bayayeka ukunika i-tocolytics emva kokuba umfazi efikelele kwi-34 yeveki yokukhulelwa, kodwa abanye oogqirha baqala ukuya kwi-tocolytics emva kweeveki ezingama-36.

Kufuneka kuqhubeke ixesha elingakanani amayeza e-tocolytic?

Ugqirha wakho unokuzama okokuqala ukunyanga umsebenzi wakho wokuqala kunye nokuphumla kombhede, ulwelo olongezelelekileyo, iyeza lentlungu, kunye nedosi enye yonyango lwe-tocolytic. Banokwenza uvavanyo oluthe kratya (njengovavanyo lwe-fetal fibronectin test kunye ne-transvaginal ultrasound) ukumisela ngcono umngcipheko wokuhanjiswa kwangaphambi kwexesha.

Ukuba ukusikwa kwakho akuyeki, isigqibo sokuqhubeka namayeza e-tocolytic, kwaye ixesha elingakanani, liya kusekelwa kumngcipheko wakho wokuhanjiswa kwangaphambi kwexesha (njengoko kumiselwe kuvavanyo lokuhlola), ubudala bomntwana, kunye nenqanaba lomntwana imiphunga.

Ukuba iimvavanyo zibonisa ukuba usemngciphekweni omkhulu wokuhanjiswa kwangaphambi kwexesha, ugqirha wakho uya kukunika i-magnesium sulphate okungenani iiyure ezingama-24 ukuya kwezingama-48 kunye nonyango lwecorticosteroid ukuphucula ukusebenza kwemiphunga yomntwana.

Ukuba ukucinywa kuyayeka, ugqirha wakho uya kunciphisa kwaye ayeke i-magnesium sulphate.

Ukuba ukucinywa kuyaqhubeka, ugqirha wakho angayalela iimvavanyo ezongezelelweyo ukulawula usulelo olusisiseko esibelekweni. Ugqirha usenokwenza uvavanyo ukufumanisa ubume bemiphunga yosana.

Ngaba aphumelele kangakanani amayeza e-tocolytic?

Akukho mayeza e-tocolytic abonakalisiweyo okulibazisa ukulibaziseka ukuhambisa ixesha elibalulekileyo.

Nangona kunjalo, amayeza e-tocolytic anokulibazisa ukuhanjiswa okungenani ixeshana elifutshane (ngesiqhelo iintsuku ezimbalwa). Oku kuhlala kunika ixesha elaneleyo lokufumana ikhosi ye-steroids. Inaliti ye-corticosteroid inciphisa umngcipheko kusana lwakho ukuba lufike kwangethuba.

Ngubani ongafanele asebenzise amayeza e-tocolytic?

Abasetyhini akufuneki basebenzise amayeza e-tocolytic xa umngcipheko wokusebenzisa amayeza ungaphezulu kwezibonelelo.

Ezi ngxaki zinokubandakanya abasetyhini abane-preeclampsia okanye i-eclampsia (uxinzelelo lwegazi oluphezulu olukhula ngexesha lokukhulelwa kwaye kunokubangela iingxaki), ukopha kakhulu (ukopha), okanye usulelo esibelekweni (chorioamnionitis).

Amayeza e-Tocolytic akufuneki asetyenziswe ukuba umntwana ubhubhile esibelekweni okanye ukuba umntwana unokungaqhelekanga okuya kuthi kukhokelele ekufeni emva kokubeleka.

Kwezinye iimeko, ugqirha unokulumka ngokusebenzisa amayeza e-tocolytic, kodwa angabayalela kuba izibonelelo zingaphezulu komngcipheko. Ezi meko zinokubandakanya xa umama:

• preeclampsia encinci
• ukopha okuzinzileyo ngexesha lekota yesibini okanye yesithathu
• iimeko zonyango ezinzulu
• umlomo wesibeleko osele uhlaziye iisentimitha ezi-4 ukuya kwezi-6 okanye ngaphezulu

Ugqirha usenokusebenzisa i-tocolytics xa umntwana enesilinganiso sentliziyo esingaqhelekanga (njengoko kubonisiwe kumlondolozi wosana olungekazalwa), okanye ukukhula kancinci.