Ukunakekelwa Kombelethisi Ezimweni Zezifo Ezizimele
I-Pendahuluan
Izifo ezihlasela umzimba ziwuhlobo lwezimo lapho amasosha omzimba ahlasela khona izicubu zawo. Kwabesifazane, ikakhulukazi labo abaseminyakeni yokuzala, izifo ezihlasela umzimba zivame kakhulu futhi zingathinta impilo ngaphambi kokukhulelwa, ngesikhathi sokukhulelwa, ukubeletha, kanye nesikhathi sokubeletha kanye nokuncelisa. Lesi simo sidinga ukunakekelwa okuphelele kokubeletha ngenxa yengozi ehambisanayo yezinkinga zikamama nomntwana, isidingo sokuqapha eduze, kanye nokuxhumana phakathi kochwepheshe. Lesi sihloko sixoxa ngezimiso zokunakekelwa kokubeletha ezimweni zezifo ezihlasela umzimba, ngokugcizelela ekuhlonzeni ubungozi, ukuqapha, imfundo, kanye nokunakekelwa ngokubambisana.
Ukubuka Konke Kwezifo Ezizimele Ekukhulelweni
Ezinye izifo ezibangelwa ukuzivikela komzimba ezivame ukuhlangana nazo ngesikhathi sokukhulelwa zifaka phakathi i-systemic lupus erythematosus (SLE), i-rheumatoid arthritis, i-antiphospholipid syndrome (APS), isifo se-thyroid esibangelwa ukuzivikela komzimba (isifo sikaHashimoto/Graves), isifo samathumbu esivuvukalayo, kanye ne-scleroderma. Umthelela wokukhulelwa ezifweni ezibangelwa ukuzivikela komzimba uyahlukahluka: ezinye ziyathuthuka, ziyaqhubeka, noma ziphinde zibuyele esimeni sazo. Ngakolunye uhlangothi, izifo ezibangelwa ukuzivikela komzimba zingandisa ingozi ye-preeclampsia, amahlule egazi, ukuvinjelwa kokukhula kwesisu (IUGR), ukuzalwa ngaphambi kwesikhathi, ukuphuphuma kwesisu okuphindaphindiwe, kanye nezinkinga zezitho ezifana nezinkinga zezinso, inhliziyo, namaphaphu kumama.
Indima yababelethisi ibalulekile ekwenzeni ukuhlolwa kokuqala, ukuhlolwa kwezingozi, ukwesekwa kwengqondo, ukukhuthazwa kwempilo, nokuqinisekisa ukuthi omama bathola izinsizakalo zokudluliselwa kanye nokuhlolwa kokulandelela njengoba kudingeka.
Izimiso Zokunakekelwa Kwababelethisi: Ukuhlolwa Okuphelele
Ukunakekelwa kwababelethisi beziguli ezinezifo ezihlasela amasosha omzimba kuqala ngokuhlolwa okuphelele. Ababelethisi badinga ukuthola umlando wezokwelapha onemininingwane: uhlobo lwesifo esihlasela amasosha omzimba, ubude besikhathi sokugula, ukuphindaphindeka kokubuyela emuva, izitho zomzimba ezihilelekile, umlando wokulaliswa esibhedlela, kanye nemithi esetshenzisiwe. Umlando wokubeletha nawo ubalulekile, okuhlanganisa noma yimuphi umlando wokuphuphuma kwesisu, ukubeletha ngaphambi kwesikhathi, i-preeclampsia, isisindo sokuzalwa esiphansi, noma ukufa komntwana osanda kuzalwa.
Ukuhlolwa ngokomzimba kwenziwa njengokujwayelekile, kodwa kugxilwe kakhulu ezimpawini zesifo esibi kakhulu, njengokuvuvukala okukhulu, umfutho wegazi ophakeme, ukuqubuka, ubuhlungu bamalunga, ukuphefumula okunzima, noma ukwehla kokukhishwa komchamo. Ngaphezu kwalokho, ababelethisi kufanele baqaphele izimpawu zokuxwayisa ngokukhulelwa ezingase zihambisane nezimpawu zokuzivikela komzimba ukuze kugwenywe ukubambezeleka kokwelashwa. Ukuhlolwa okusekelayo kanye nemiphumela yokubonisana nodokotela (isib. ukusebenza kwezinso, ama-antibodies athile, amazinga e-thyroid hormone, noma isimo sokujiya kwegazi) kufanele kuqoshwe futhi kuqashwe njalo njengengxenye yokuqhubeka kokunakekelwa.
Ukuhlonza Ingozi Nokuhlela Ukunakekelwa
Ngemva kokuhlolwa, umbelethisi uzokwakha uhlelo lwezinkinga zokubeletha kanye nezingozi ezingaba khona. Ezifweni zokuzivikela komzimba, ukugxila okuyinhloko ukuvimbela izinkinga ngokutholakala kusenesikhathi. Ukuhlela ukunakekelwa kuhlanganisa ukwandisa ukuvama kokuvakashela ngaphambi kokubeletha, ukuqapha umfutho wegazi, ukuhlola ukukhula kombungu, ukufundisa ngezimpawu eziyingozi, kanye nokuhlela indawo ephephile yokubelethisa (ngokuvamile indawo yokudlulisela).
Ababelethisi kudingeka bahlole ukunamathela emithini futhi baqinisekise ukuthi omama bayaqonda izinzuzo nezingozi zokwelapha. Eminye imithi yokuzivikela komzimba iphephile ngesikhathi sokukhulelwa, kanti eminye ingaba yingozi noma yandise izinkinga. Ngenxa yokuthi igunya lokushintsha imithi lisezandleni zodokotela, ababelethisi badlala indima ekuqinisekiseni ukunamathela, ukuhlonza imiphumela emibi, kanye nokuqinisekisa ukudluliselwa kwanoma yiziphi izinkinga.
Ukunakekelwa Kwangaphambi Kokubeletha (Ukukhulelwa)
Ngesikhathi sokukhulelwa, ukunakekelwa kwababelethisi kugcizelela ukuqapha komama kanye nomntwana osanda kuzalwa.
1. Ukuqapha isimo sikamama: umbelethisi uhlola umfutho wegazi, isisindo, izimpawu zokuvuvukala, izikhalazo zobuhlungu, ukukhathala, noma izimpawu ezithile zesifo. Uma kusolwa ukuthi i-preeclampsia, i-thrombosis, noma i-autoimmune flare, umbelethisi kufanele adlulisele umama ngokushesha.
2. Ukuqapha umbungu: Ukulinganisa njalo ukuphakama kwesibeletho, izinga lokushaya kwenhliziyo yombungu, kanye nokunyakaza kombungu kubalulekile. Ingozi ye-IUGR kanye nokuvuthwa ngaphambi kwesikhathi kwenza ukuhlolwa kokukhula kombungu kube yinto ebalulekile, ngokuvamile ngokubambisana nodokotela ukuze kuhlolwe i-ultrasound ngokulandelana.
3. Imfundo Yendlela Yokuphila: Omama bayelulekwa ukuba baphumule ngokwanele, balawule ukucindezeleka, futhi balondoloze ukudla okulinganiselayo. Kwezinye izifo (njenge-lupus), ukuchayeka elangeni ngokweqile kungabangela ukubuyela emuva kwesifo, ngakho-ke imfundo yokuvikela isikhumba kufanele icatshangelwe, kuye ngesimo.
4. Ukuvimbela ukutheleleka: Ezinye iziguli zithola ukwelashwa okucindezela amasosha omzimba, okwenza zibe sengozini enkulu yokutheleleka. Ababelethisi bafundisa iziguli ngezimpawu zokutheleleka (umkhuhlane, ukuchama okubuhlungu, ukuphuma koketshezi lwesitho sangasese sowesifazane okunuka kabi) kanye nokubaluleka kokuhlanzeka komuntu siqu nokuhlolwa okusheshayo.
5. Ukwelulekwa ngokwengqondo: Izifo ezingamahlalakhona zivame ukubangela ukukhathazeka ngesimo sombungu kanye nenqubo yokuzalwa. Ababelethisi banganikeza ukwesekwa, basize ukusekelwa komndeni, futhi badlulisele iziguli uma bebona izimpawu zokucindezeleka noma izinkinga zokukhathazeka.
Ukuphathwa Kokubambisana kanye Nokudluliselwa
Ukunakekelwa kwababelethisi bezifo ezizimele kungcono kubambisane nodokotela bezifo zokuzivikela komzimba, odokotela bamazinyo/odokotela bamathambo, kanye nochwepheshe abahlobene nabo (odokotela bezifo zenhliziyo, odokotela bezifo zenhliziyo, kanye nodokotela bezifo ze-endocrinologists). Umbelethisi usebenza njengomxhumanisi, eqinisekisa ukuthi ukuhlolwa okuhleliwe kuyahlangatshezwa, imiphumela yokuhlolwa ibhaliwe, futhi ukuxhumana phakathi kwezikhungo kuyasebenza. Izinkomba zokudluliselwa ngokushesha zifaka: umfutho wegazi ophakeme, ukopha, ubuhlungu besifuba, ukuphelelwa umoya, izinga lokuqonda elinciphile, ubuhlungu bemilenze kanye nokuvuvukala ohlangothini olulodwa (okusolwa ukuthi kubangelwa i-thrombosis), noma ukuncipha kokunyakaza komntwana osanda kuzalwa.
Ukunakekelwa Kwangaphambi Kokubeletha (Ukubeletha)
Ngesikhathi sokubeletha, ukuphepha kukamama nomntwana kubekwa phambili ngokuqapha eduze. Ababelethisi kudingeka baqaphe izimpawu ezibalulekile kaningi, bahlole izimpawu zokukhathala, futhi baqinisekise ukuthi izinhlungu ziyalawuleka. Ezinye iziguli ezinesifo sokuzivikela komzimba zinezinkinga zokujiya kwegazi noma zisebenzisa imithi yokunciphisa igazi; lokhu kungathinta ukukhetha izinqubo kanye ne-anesthesia. Ngakho-ke, ukubeletha kuvame ukuhlelwa ezibhedlela ezinezikhungo ezigcwele. Ababelethisi basekela inqubo yokubeletha ngokomzimba noma nini lapho kungenzeka, kodwa kumele balungele ukunikeza izinkomba noma ukubambisana ezimweni zokucindezeleka kombungu, ukopha kwegazi, noma ukwehluleka ukuthuthuka.
Ukunakekelwa Kwangemva Kokubeletha Nokuncelisa
Isikhathi sangemva kokubeletha yisikhathi esisengozini yokubuyela emuva kwezinye izifo ezihlasela amasosha omzimba. Ababelethisi baqapha ukopha, ukuguquka kwesibeletho, izimpawu zokutheleleka, umfutho wegazi, kanye nezimpawu ezibonisa ukusha, njengobuhlungu obukhulu bamalunga, ukuqubuka, noma ukukhathala okukhulu. Ukusekelwa kokuncelisa nakho kubalulekile, kodwa ukuphepha kwemithi kamama kufanele kucatshangelwe. Uma umama ethatha imithi engase idlulele obisini lwebele futhi ibe yingozi enganeni, umbelethisi kufanele adlulisele umama kudokotela ukuze anqume inketho engcono kakhulu (ukuqhubeka nokuncelisa, ukushintsha ukwelashwa, noma ezinye izindlela zokuncelisa).
Ngaphezu kwalokho, ababelethisi bangasiza ngokuhlela ukuvimbela inzalo ngemva kokubeletha. Ukukhetha ukuvimbela inzalo kufanele kucabangele ingozi ye-thrombosis, umfutho wegazi, kanye nokusebenzisana kwezidakamizwa. Izindlela ezithile zingase zinconywe kakhulu kunezinye, ngakho-ke ukwelulekwa komuntu ngamunye kanye nokubambisana kubalulekile.
Imibhalo, Imfundo, kanye Nokuqhubeka Kokunakekelwa
Isihluthulelo sokunakekelwa okuphumelelayo kwababelethisi bezifo ezizimele yimibhalo enembile kanye nokuqhubeka kokunakekelwa. Ababelethisi kudingeka babhale phansi imiphumela yokuhlola, izinhlelo zokunakekelwa, imfundo enikeziwe, izimpawu zesixwayiso ezidluliselwayo, kanye nokulandelela kokudluliselwa. Imfundo kufanele inikezwe ngolimi olulula ukuluqonda futhi kufanele ifake: ukubaluleka kokuhlolwa okuvamile, ukunamathela emithini, ukuqaphela izimpawu zesixwayiso, ukuqapha ukunyakaza kombungu, ukudla okunempilo, ukuphumula, kanye nokusekelwa komndeni.
Isiphetho
Ukunakekelwa kwababelethisi bezifo ezibangelwa amasosha omzimba kudinga indlela ephelele, egxile ekuvimbeleni izinkinga kanye nokutholakala kusenesikhathi. Ababelethisi badlala indima ekuhlolweni okuphelele, ukuqapha umama nomntwana, imfundo, ukwesekwa kwengqondo, kanye nokuxhumana kokudluliselwa nethimba lezokwelapha. Ngokunakekelwa okuhleliwe nokubambisana, abesifazane abanezifo ezibangelwa amasosha omzimba banethuba elikhulu lokukhulelwa nokubeletha okuphephile, kanye nempilo enhle kamama nosana.
