Ukunakekelwa Kwababelethisi Ezimweni Zokukhipha Isisu
Ukukhipha isisu, noma ukuphuphuma kwesisu, ukuqeda ukukhulelwa ngaphambi kokuba ingane ikwazi ukusinda ngaphandle kwesibeletho, ngokuvamile ngaphambi kwamasonto angama-20 okukhulelwa. Izinga lokukhipha isisu liphezulu kakhulu, kanti cishe u-10-20% wabo bonke ukukhulelwa okwaziwayo okugcina ngokuphuphuma kwesisu. Ukunakekelwa kwababelethisi ezimweni zokukhipha isisu kubalulekile ukunciphisa izinkinga nokusekela impilo yomzimba neyengqondo kamama.
Izinhlobo Zokukhipha Isisu
Ukukhipha isisu kungahlukaniswa ngezinhlobo eziningana ngokusekelwe kuhlelo lwezikhathi kanye nembangela:
1. Ukukhipha Isisu Okusongelayo: Lesi simo sibhekisela ekuphuphumeni kwesisu okusongelayo lapho kukhona ukopha kwesitho sangasese sowesifazane ngaphandle kokukhula komlomo wesibeletho. Ingane isaphila futhi itshalwe ngempumelelo.
2. Ukukhipha Isisu Okusaqalayo: Ukukhipha isisu okuqhubekayo lapho kukhona ukopha okukhulu kanye nokuvulwa komlomo wesibeletho.
3. Ukukhipha Isisu Okungaphelele: Ukukhipha isisu okungaphelele lapho ezinye zezicubu zokukhulelwa zihlala esibelethweni.
4. Ukukhipha isisu okuphelele: Zonke izicubu zokukhulelwa ziyakhishwa esibelethweni, futhi inqubo yokuphuphuma kwesisu ibhekwa njengephelele.
5. Ukukhipha Isisu Okungaphumelelanga: Umbungu ufela esibelethweni kodwa azikho izimpawu zokuphuphuma kwesisu (njengokopha noma ukufinyela).
6. Ukukhipha Isisu Okubangelwa Ukungcola: Ukukhipha isisu okuhambisana nokutheleleka kwesibeletho noma enye indlela yokuzala.
Ukuphathwa Kokukhipha Isisu
1. Ukuhlola
Ukuhlolwa kuqala ngokuthatha umlando ukuze kutholakale ulwazi mayelana nomlando wokukhulelwa, noma yiziphi izikhalazo, kanye nesimo samanje. Ezinye izici okufanele zicatshangelwe zifaka:
– Ukopha: Ubuningi, umbala, ukuba khona noma ukungabikho kwezicubu.
– Ubuhlungu: Ubukhulu, indawo, kanye nohlobo lobuhlungu.
– Umlando Wokukhulelwa: Wake wakhipha isisu ngaphambili, inani lezingane, izindlela zokuvimbela inzalo ezisetshenzisiwe.
– Umlando Wezifo Ezihambisana Nazo: Izifo ezingamahlalakhona ezingathinta ukukhulelwa njengesifo sikashukela, umfutho wegazi ophakeme.
– Ukuhlolwa Komzimba Nokusekela: Ukuhlolwa ngokomzimba kuhlanganisa ukuhlola izimpawu ezibalulekile, ukuhlolwa komchamo, i-hemoglobin, kanye nokuhlolwa kwe-ultrasound ukuhlola isimo sengane kanye nesibeletho.
2. Ukuxilongwa Kwabahlengikazi
Ezinye izifo ezivamile zokunakekelwa kwabahlengikazi ezingase zivele ezigulini ezikhipha isisu zifaka:
– Ingozi yokutheleleka ihlobene nezicubu zokukhulelwa ezisele esibelethweni.
– Izinkinga zobuhlungu obukhulu ezihlobene nokufinyela kwesibeletho kanye nokuphuma kwezicubu.
– Ingozi yokushaqeka kwe-hypovolemic okuhambisana nokopha okukhulu.
3. Ukungenelela
Ukungenelela kokubeletha kokuphathwa kokukhipha isisu kungahluka kuye ngohlobo lokukhipha isisu kanye nesimo sikamama. Ezinye izinqubo ezivamile zifaka:
Ukukhipha Isisu Okuseduze
– Ukuphumula Okuphelele: Yeluleka umama ukuthi aphumule embhedeni futhi agweme ukwenza umsebenzi onzima womzimba.
– Imithi: Ukusetshenziswa kwemithi efana ne-progesterone ukusiza ukugcina ukukhulelwa.
– Ukuhlolwa Okuvamile: Ukuqapha ngokucophelela ngokuhlolwa kwe-ultrasound ukuqinisekisa isimo sengane esanda kuzalwa.
Ukukhipha Isisu Okungaphelele Noma Okungaphumelelanga
– Ukwanda Nokuchelela (D&C): Le nqubo iwukususa noma yiziphi izicubu zokukhulelwa ezisele esibelethweni.
– Imithi: Ukusetshenziswa komuthi i-misoprostol ukukhuthaza ukufinyela kwesibeletho ukuze izicubu ezisele zikwazi ukuphuma ngokwemvelo.
– Ama-antibiotic: Ama-antibiotic okuvimbela anikezwa ukuvimbela ukutheleleka.
Ukukhipha Isisu Okubangelwa Ukungcola
– Ama-antibiotic: Ukwelashwa ngama-antibiotic okunamandla kufanele kuqalwe ngokushesha.
– Ukuphathwa Koketshezi kanye Ne-Electrolyte: Ukumuncwa koketshezi ukuze kulondolozwe umthamo wegazi kanye nebhalansi ye-electrolyte.
– Ukususwa Kwezicubu: Izinqubo zokuhlinzwa ezifana ne-D&C zingadingeka ukuze kususwe izicubu ezinegciwane.
– Ukuqapha Okuseduze: Ukuqapha izimpawu ezibalulekile kanye nokusebenza kwezitho zomzimba ukuze kutholakale i-sepsis kusenesikhathi noma isimo esibi kakhulu.
Ukukhipha Isisu Okuphelele
– Ukuqaphela: Ukuqapha ukuqinisekisa ukuthi zonke izicubu zikhishwa esibelethweni futhi azikho ezinye izinkinga.
– Ukusekelwa Kwengqondo: Ukunikeza ukwesekwa ngokomzwelo kanye nokwelulekwa njengoba ukulahlekelwa ukukhulelwa kungaba yinto ebuhlungu kakhulu.
4. Imfundo Nokwelulekwa
Imfundo iyisici esibalulekile sokunakekelwa kwababelethisi bokukhipha isisu. Amanye amaphuzu emfundo okufanele axazululwe afaka:
– Ukuhlanzeka: Gcina inhlanzeko yezitho zangasese ukuze ugweme ukutheleleka.
– Imikhawulo Yemisebenzi: Gwema ukuya ocansini kanye nemisebenzi enzima ngesikhathi sokululama.
– Izimpawu Zengozi: Zikwazisa ukuthi kufanele uye nini esibhedlela ngokushesha, njengokuthi kukhona ukopha okukhulu, umkhuhlane, noma ubuhlungu obukhulu.
– Ukuvimbela Inzalo: Ukwelulekwa mayelana nezinhlelo zokukhulelwa zesikhathi esizayo kanye nokusetshenziswa okuphephile kokuvimbela inzalo.
– Ukusekelwa Kwengqondo: Kuhlinzeka ngolwazi mayelana nezinsizakusebenza zokusekelwa kwengqondo ezitholakalayo.
5. Ukusekelwa Kwengqondo
Ukukhipha isisu kuyinto ethinta ngokomzwelo nangokwesabekayo kwabesifazane abaningi. Ngakho-ke, ukwesekwa kwengqondo kuyingxenye ebalulekile yokunakekelwa kwababelethisi. Izinyathelo ezingathathwa zifaka:
– Ukuxhumana Okuzwelana Nabanye: Ukwakha ukuxhumana okuzwelana nokuzwelana ukuze kulalele imizwa nezikhalazo zeziguli.
– Ukwelulekwa: Nikeza ukwelulekwa kwengqondo uma kudingeka, futhi ubhekisele kudokotela wengqondo noma wengqondo uma kutholakala izimpawu zokucindezeleka noma ukukhathazeka ngokweqile.
– Ukusekelwa Komndeni: Fundisa umndeni ngesimo sesiguli kanye nokubaluleka kokusekelwa kokuziphatha okuvela kumalungu omndeni.
Isiphetho
Ukunakekelwa kwababelethisi bokukhipha isisu kudinga indlela ephelele nephelele. Ngokuhlolwa okuningiliziwe, ukungenelela kwezokwelapha okufanele, imfundo, kanye nokusekelwa kwengqondo, ababelethisi bangadlala indima ebalulekile ekunciphiseni izinkinga nokusiza umama ekululameni kwakhe ngokomzimba nangokomzwelo. Ukwelashwa okufanele nokusheshayo kubalulekile ukuqinisekisa impilo nenhlalakahle kamama kanye nokuhlinzeka ngokusekelwa akudingayo ukuze abhekane nalesi simo esibuhlungu.
