Ukuphathwa Kokutheleleka Kwangemva Kokubeletha
Ukutheleleka kwangemva kokubeletha, okwaziwa nangokuthi ukutheleleka kwe-puerperal, kuyinkinga enkulu yezempilo kwabesifazane ngemva kokubeletha. Lokhu kutheleleka kungenzeka zingakapheli izinsuku kuya emavikini ngemva kokubeletha futhi kungathinta izingxenye ezahlukene zomzimba, njengesibeletho (i-endometritis), i-episiotomy wound, noma indawo yokusikwa uma kwenziwe ukuhlinzwa. Njengoba kunomthelela omkhulu empilweni kamama kanye namathuba aphezulu okugula nokufa, ukuphathwa ngempumelelo kwezifo zangemva kokubeletha kubalulekile.
Izimbangela kanye Nezici Zengozi
Ukutheleleka kwangemva kokubeletha kubangelwa yizinhlobo ezahlukene zamagciwane, okuhlanganisa kokubili amagciwane e-aerobic kanye ne-anaerobic. Amanye amagciwane avame ukuhileleka yi-Escherichia coli, i-Staphylococcus aureus, i-group B Streptococcus, kanye ne-Clostridium perfringens. Ukutheleleka okuningi kubangelwa izitshalo ezivamile emgudwini wokuzala, ezingaba yizifo ngaphansi kwezimo ezithile.
Izici eziningana eziyingozi zingandisa amathuba okutheleleka ngemva kokubeletha. Ezinye zalezi zifaka:
1. Ukubeletha Okude: Inqubo yokubeletha ende ingandisa ingozi yokutheleleka ngoba ulwelwesi lwe-amniotic lungaqhuma isikhathi eside kakhulu ngaphambi kokuzalwa.
2. Ukuhlinzwa Kwesibeletho: Ukutheleleka kuvame kakhulu kwabesifazane abahlinzwa ngokuhlinzwa uma kuqhathaniswa nokubeletha okuvamile.
3. Ukwanda Kwesibeletho Ngemva Kokubeletha: Lesi simo singenza kube lula ukuthi amagciwane angene esibelethweni.
4. I-anemia: Ukuntuleka kwensimbi kunganciphisa ukumelana komzimba nokutheleleka.
5. Ukuhlanzeka Okubi: Imikhuba emibi yokuhlanzeka ngesikhathi sokubeletha nangemva kokubeletha ingandisa ingozi.
6. Umlando Wokutheleleka Kwangaphambilini: Abesifazane abake baba nokutheleleka kwangemva kokubeletha basengozini enkulu.
Izimpawu Nokuxilongwa
Izimpawu zokutheleleka ngemva kokubeletha zingahluka kuye ngendawo kanye nohlobo lokutheleleka. Kodwa-ke, ezinye izimpawu ezivamile zifaka:
– Umkhuhlane (≥ 38°C) emahoreni okuqala angu-24 ngemva kokubeletha.
– Ubuhlungu nokuvuvukala endaweni engezansi yesisu noma endaweni yokusikwa.
– Uketshezi olungcolile lwesitho sangasese sowesifazane olungajwayelekile, olunuka kabi.
– Ubuhlungu lapho uchama.
– Ubuthakathaka noma ukukhathala ngokweqile.
– I-toxic shock syndrome ezimweni ezimbi kakhulu.
Ukuxilongwa kokutheleleka kwangemva kokubeletha kuvame ukuqala ngokuhlolwa ngokomzimba kanye nomlando onemininingwane. Udokotela angenza izivivinyo zelebhu ezifana nokubalwa kwegazi okuphelele, ukukhuliswa kwegazi, noma ukukhuliswa komchamo ukuze kutholakale igciwane elihilelekile. Kwezinye izimo, izivivinyo zezithombe ezifana ne-ultrasound zingenziwa ukuze kuhlolwe ithumba noma izingcezu ze-placenta ezigciniwe.
Ukuphathwa Nokwelashwa
Ukuphathwa kwezifo zangemva kokubeletha kuncike ohlotsheni kanye nobukhali bokutheleleka. Indlela ehlukahlukene ivame ukudingeka, ehilela odokotela bezifo zabesifazane, odokotela abajwayelekile, kanye namanye amalungu eqembu lokunakekela. Nazi ezinye zezinyathelo ezibalulekile ekuphathweni kokutheleleka kwangemva kokubeletha:
1. Ama-antibiotic
– Ama-antibiotic avame ukuba yisinqumo sokuqala ekwelapheni izifo zangemva kokubeletha.
– I-spectrum kufanele ifaneleke kakhulu kulokho okubangela lesi sifo. Inhlanganisela yama-antibiotic ingasetshenziswa ukuhlasela kokubili amabhaktheriya e-aerobic kanye ne-anaerobic.
– Isibonelo, i-postpartum endometritis ivame ukwelashwa ngenhlanganisela ye-clindamycin ne-gentamicin.
2. Ukukhipha Amanzi kanye Nokungcoliswa Kwendle
– Ezimweni zamathumba noma amanxeba athelelekile, kungadingeka ukukhishwa kwamanzi kanye nokususwa kokungcola.
– Le nqubo ihlose ukususa izinto ezithathelwanayo kanye nezicubu ezifile, okusiza ekudaleni izimo ezingangcoliswanga kakhulu.
3. Ukunakekelwa Kwenxeba
– Ukunakekelwa kwamanxeba kubaluleke kakhulu, ikakhulukazi kwabesifazane abaye bahlinzwa ngokuhlinzwa noma nge-episiotomy.
– Amanxeba kumele agcinwe ehlanzekile, kuhlanzwe njalo futhi kushintshwe njalo amabhandeshi.
4. Ukwelashwa Ngezimpawu
– Ubuhlungu nomkhuhlane kungelashwa ngemithi yokwelapha izinhlungu kanye nemithi yokulwa nokuvuvukala efana ne-ibuprofen noma i-acetaminophen.
– Okunye ukunakekelwa okusekelayo kungahlanganisa nokuthola amanzi anele kanye nokuphumula okwanele.
5. Ukuqapha Nokulandelela
– Iziguli ezinezifo zangemuva kokubeletha zidinga ukubhekwa ngokucophelela ukuqinisekisa ukuthi ziyasabela ekwelashweni.
– Kubaluleke kakhulu ukuqapha njalo izimpawu ezibalulekile, ukuphuma komchamo, kanye nezimpawu zelebhu ukuze kuhlolwe inqubekela phambili yomtholampilo.
Ukuvimbela
Ukuvimbela ukutheleleka kwangemva kokubeletha kusebenza kahle futhi kuyasebenza kakhulu kunokwelapha izifo ezikhona. Ezinye izindlela zokuvimbela zifaka:
1. Imikhuba Emihle Yokuhlanzeka
– Ukuhlanzeka komuntu siqu ngesikhathi sokubeletha nangemva kokubeletha kubalulekile. Lokhu kuhlanganisa ukugeza izandla njalo ngumama, izisebenzi zezempilo, kanye nabanye abahilelekile ekubelethweni.
2. Ama-antibiotic Okuvimbela
– Ukunikezwa kwama-antibiotic okuvimbela ngaphambi kokubeletha kuye kwabonakala kunciphisa amazinga okutheleleka.
– Ama-antibiotic anganikezwa nabesifazane abanezici ezithile eziyingozi kakhulu, njengokubeletha isikhathi eside okuqhekeka ulwelwesi lwe-amniotic isikhathi esingaphezu kwamahora ayi-18.
3. Izinsizakalo Zezempilo Ezisezingeni Eliphezulu
– Ukufinyelela izinsizakalo zezempilo ezisezingeni eliphezulu ezingabhekana nezinkinga zokubeletha ngokushesha nangokufanele kungasiza ekuvimbeleni ukutheleleka.
– Lokhu kuhlanganisa ubuchwepheshe bokwenza ukuhlinzwa kokubeletha kanye nokwenza ukuphathwa kwamanxeba ngendlela efanele.
4. Imfundo
– Ukunikeza imfundo kwabesifazane abakhulelwe ngezimpawu zokutheleleka kwangemva kokubeletha kanye nokubaluleka kokuhlanzeka kungasiza ekwandiseni ulwazi kanye nokwelashwa kusenesikhathi uma kwenzeka ukutheleleka.
Isiphetho
Ukutheleleka ngemva kokubeletha kuyizifo ezinkulu zezokwelapha ezidinga ukunakwa okukhethekile. Indlela ebanzi, ehlanganisa ukuvimbela, ukuxilongwa kusenesikhathi, kanye nokuphathwa okufanele, ibalulekile ekunciphiseni ukugula nokufa okuhambisana nalezi zimo. Ukubambisana phakathi kwabahlinzeki bezempilo neziguli kubalulekile ekuqinisekiseni imiphumela engcono kakhulu komama abakhulelwe. Ngemfundo efanele kanye nokusekelwa okuqhubekayo, ukutheleleka okuningi kwangemva kokubeletha kungavinjelwa noma kwelashwe ngempumelelo, kuqinisekiswe impilo yesikhathi eside yabomama abasha.
