Atapanga chisankho chothetsa ntchito kuti athetse mimba, mayi nthawi zambiri amadera dokotala: momwe angachotse mimba, ndi njira ziti zomwe zilipo. Tiyeni tione mwatsatanetsatane ndondomekoyi, njira zogwirira ntchito, zotsatira zowonongeka ndi zovuta.
Kuchotsa mimba - Mitundu
Asanayambe kutenga mimba , madokotala amalankhula ndi wodwalayo za zotsatira zake zowonongeka. Ambiri atatha kuchotsa mimba ali ndi vuto la kutenga pakati. Pambuyo pa kupanga chisankho chomaliza, msungwanayo ayenera kupita ku zokambirana za amayi, kumene mungapeze zambiri zokhudzana ndi njira zomwe zilipo zokhudzana ndi kuchotsa mimba.
Mwachizoloŵezi cha amayi, njira zingapo zochotsa mimba zimagwiritsidwa ntchito. Posankha dokotala wina, amatsogoleredwa ndi nthawi ya mimba, zaka za wodwala, ndikuganizira kukhalapo kwa mimba m'mbuyomo. Mwa njira zomwe zilipo:
- Kuchotsa mimba - kumaphatikizapo kugwiritsa ntchito mankhwala osokoneza bongo omwe amachititsa imfa ya embryo ndi kuthamangitsidwa kuchokera ku chiberekero cha uterine;
- Kuchotsa mimba (aspirum aspiration) - kumachitika pogwiritsa ntchito chida chapadera, chomwe chimakhala chofanana ndi choyeretsa;
- Kuchotsa mimba (kupopera) - chiwalo cha uterine chimatsukidwa ndi zipangizo zapadera.
Mapiritsi ochotsa mimba
Pamene kuchotsa mimba kumagwiritsidwa ntchito, mankhwala osokoneza bongo amachititsa kuti imfa ya fetus, yomwe imachokera. Ndondomekoyi imagwiritsidwa ntchito pamagulu ang'onoang'ono, ali ndi kukula kwakukulu kwa mimba. Kulankhula za momwe chithandizo cha mimba chikugwirira ntchito, ziyenera kunenedwa kuti mphamvu yake ndi 98%. Ikuchitika mu mabungwe azachipatala, moyang'aniridwa ndi madokotala. Pa gawo loyambirira, amasonyeza kuti mumamwa mankhwala omwe amachititsa imfa ya mluza, kenako mankhwalawo amatulutsa mimba (Mifepreston ndi Misoprostol).
Kuchotsa mimba
Chotsani chilakolako, dzina lachiwiri la kuchotsa mimba, ndi njira yopaleshoni yosokoneza mimba. Amachitidwa pazinthu zing'onozing'ono. Opaleshoniyo sichitha mphindi 10. Mothandizidwa ndi aspirator yapadera ndi nsonga, madokotala amatha kuyamwa dzira la fetal kuchokera ku chiberekero cha uterine. Zimapangidwanso pakupanga mpweya wabwino. Chifukwa cha kusowa kwa mgwirizano wamphamvu pakati pa mluza ndi khoma la uterine, maselo ndi osavuta. Zopweteka za njirayi ndizotheka kuchotsedwa kwa matenda a fetus kuchokera ku chiberekero cha uterine. Chifukwa chake, pali chiopsezo cha matenda a chiberekero.
Kuchotsa mimba
Kuchotsa mimba koteroko kumagwiritsidwa ntchito panthawi yam'mbuyo, pamene mwana wosabadwayo sangathe kuchoka mu chiberekero chaumwini (chifukwa cha kukula kwake). Ntchitoyi imagwiritsidwa ntchito pogwiritsa ntchito anesthetics. Kulankhula za momwe kuchotsa mimbaku kumakhalira, madokotala amamvetsera odwala kuti agwirizane ndi ntchitoyi nthawi zonse pa njira yobereka. Pambuyo poika majekesero a amayi, perekani kuwonjezera kachilombo ka HIV. Pokhala ndi mwayi wopita ku uterine, curette imagwiritsidwa ntchito pozembera kwathunthu - kuchotsa dzira la fetus pamodzi ndi endometrium.
Kuchotsa mimba - kupereka kwapangidwe
Poyankhula za momwe kuchotsa mimba kumachitika kumapeto, madokotala amadziwa kuti sangakwanitse kuchita zomwe akufuna pokhapokha atakhala ndi mimba. Kuti achite zoterezi, zifukwa zabwino ndizofunikira. Kusankha njira zogwiritsira ntchito kumadalira mkhalidwe wa mkazi, kupezeka kapena kupezeka kwa matenda aakulu. Popanda kutsutsana, njira yothetsera (hypertonic sodium chlorin) imayikidwa mu amniotic fluid kudzera m'chiberekero, chomwe chimayambitsa fetus imfa. Gawo lotsatira m'magazi a mayi wapakati ali jekeseni ndi mankhwala omwe amawonjezera uterine contrac contracts.
Kusokonezeka kwa mimba ndi mankhwala amtunduwu
Kuchotsa mimba panyumba ndi njira yoopsa, yoopsya. Njira monga kusamba ndi madzi a mpiru, kuyendera kusamba, kukweza zolemera, zingakhudze thanzi la amayi. Zochitazi zimapangitsa kuti magazi alowe m'thupi. Kuwonjezeka kwapakati mkati mwa ziwiya zazing'ono zazing'ono, zomwe zimapwetekedwa ndi ziwalo za uterine, chifukwa cha kamwana kamene kamatulutsa kunja.
Ziyenera kuganiziridwa kuti zigawo zochotsa mimba sizigwiritsidwa ntchito nthawi zonse. Chotsatira chake, pali chiopsezo cha matenda opatsirana - m'mimba mwa mimba yomwe imakhalabe mu chiberekero imayamba kufota. Izi zimafuna thandizo lachipatala, kuyeretsa chiberekero cha uterine. Kuonjezera apo, pali chiopsezo chokhala ndi magazi ochizira pamene mukugwiritsa ntchito njira zowonongeka ndi njira. Kupanda kusamalidwa bwino kwa magazi kungapangitse imfa.
Zizindikiro za kuchotsa mimba
Kuchotsa mimba kwafupipafupi kumachitika kawirikawiri pampempha kwa mkaziyo. Komabe, palinso zomwe zimatanthawuza kuchotsa mimba. Iwo amagawidwa mu zachipatala ndi chikhalidwe. Yoyamba imaphatikizapo matenda omwe sagwirizana ndi moyo wa mwana wosabadwa - pali kupititsa padera, mwanayo amabadwa ndi zolakwika komanso zoipa. Kuchotsa mimba kukhoza kuperekedwa kwa mankhwala, pamene njira yokhayo ya mimba ndi yosafunika kwa thupi la mkazi - chotupa mu pakhosi laling'ono, kuperewera kwaposachedwapa.
Zifukwa za chikhalidwe zimagwiritsidwa ntchito ponena za zifukwa zomwe ziyenera kutero, pokhudzana ndi thanzi la amayi, komanso ku zikhalidwe za moyo wake - mabanja osagwira ntchito, kukhalapo kwa matenda opatsirana pogonana. Zikatero, komiti ya zamankhwala imasankha kuchotsa mimba. Pankhaniyi, chilakolako cha mkazi mwiniwake chimaganiziranso. Mndandanda wa zizindikiro za kuchotsa mimba chifukwa cha zifukwa zosiyana ndizosiyana ndi mayiko osiyanasiyana, ndipo zimatanthauzidwa mu dongosolo la Ministry of Health.
Kusokonezeka kwa mimba chifukwa cha matenda
Kusokonezeka kwa mimba mwachisomo chodziwika kumaperekedwa komanso chifukwa cha zachipatala. Izi zikuwonetsedwa m'malemba ovomerezeka a Ministry of Health. Ngati mayi ali ndi matenda aakulu kapena sangathe kunyamula mwana, tsiku la ntchitoyo laikidwa. Kusankha njira kumadalira nthawi yokhala ndi bere, kukhalapo kwa concomitant pathologies. Zina mwazochitika zachipatala zomwe zimagwiritsidwa ntchito posokoneza mimba ndi izi:
- chiwopsezo cha chifuwa chachikulu;
- rubella - kulankhulana ndi wodwalayo mpaka masabata 12 a mimba, kusowa chitetezo;
- matumbo oyipa, mankhwala omwe amagwiritsidwa ntchito pogwiritsa ntchito X-ray;
- matenda a shuga ali ndi mawonekedwe amphamvu (ndi kuwonongeka kwa nkhumba);
- kupweteka kwa m'magazi;
- matenda aakulu;
- kusuta mankhwala;
- meningitis, encephalitis;
- matenda a khunyu ali ndi chizoloŵezi chogonjetsa kawirikawiri;
- zofooka za mtima;
- zilonda zamimba ndi kutuluka magazi;
- chiwindi ndi chiwindi;
- glomerulonephritis.
Kusokonezeka kwa mimba malinga ndi chikhalidwe cha anthu
Pamaso pa umboni wotero, kusokonezeka kwa mimba ndi mapiritsi kumachitika kuchipatala. Mndandanda wa zochitika za anthu zimasiyana, ndipo zimadalira dziko la kukhala ndi amayi oyembekezera. Kotero, mu maiko a CIS, zizindikiro zazikulu za kuchotsa mimba ndi izi:
- kulumala kwa mwamuna (gulu la 1,2);
- imfa ya wothandizira pa nthawi ya mimba;
- Kukhala ndi mayi wokwatiwa kapena mkazi wake pamalo omwe amalephera ufulu, chigamulo chotsutsa ufulu wa makolo;
- kusudzulana pa nthawi yomwe ali ndi pakati;
- kukhalapo kwa othawa kwawo;
- kusowa kwawo;
- ndalama zochepa zapakhomo (zosakwana chiwerengero cha ndalama).
Kuchotsa mimba - nthawi
Osati nthawi zonse, ngati pali chilakolako cha mkazi wapakati, kuchotsa mimba kumatha - nthawi ya opaleshoniyi imatsimikiziridwa. Ngati palibe chithandizo cha mankhwala, kuchotsa mimba kumaloledwa mpaka masabata 12. Kuchotsa mimbayo kumaonedwa kuti ndikumayambiriro. Kodi madotolo angathe ndipo kenako - milungu 12 mpaka 22, pamene pali mankhwala. Malinga ndi nthawi ya mimba, njira yothandizira opaleshoni imasankhidwa. Kulankhula za momwe kuchotsa mimba kumathera panthawi yochepa, madokotala amatcha mankhwala ndi zochotsa mimba.
Kuchotsa mimba yoyamba
Pamene mayi akufuna kuthetsa mimba kumayambiriro, madokotala amagwiritsa ntchito kuchotsa mimba, zomwe zimaphatikizapo milungu isanu yokhala ndi pakati. Madokotala amatha kuzindikira kuti ali ndi pakati ndi ultrasound pamasabata atatu. Ngati mukuganiza kuti pali mimba yomwe si yofunikanso, muyenera kuonana ndi mayi wanu wamayi. Kupanda opaleshoni, hardware intervention ndi ubwino wochotsa mimba, zotsatira zake sizing'ono kwa thupi.
Kuchotsa mimba n'kotheka mpaka masabata 7 . Ali ndi mphamvu yoposa yapamwambayi, koma pali ngozi zachisokonezo kwa makoma a uterine. Kawirikawiri, kwa kanthawi kochepa, chilakolako chingagwiritsidwe ntchito ngati kulamulira medabort. Kuchotsedwa kwathunthu kwa zotsalira za minofu ya embryonic kumateteza kukula kwa mavuto a kutupa ndi matenda opatsirana.
Kuchotsa mimba kumapeto kwa nthawi
Kufotokozera za momwe tingatulutsire mimba kumayambiriro oyambirira, tikuwona kuti n'zotheka mu 2-3 trimesters. Kusokonezeka kwa mimba kumapeto kokha kungatheke chifukwa cha zachipatala. Ndondomeko yokha ikufanana ndi kubadwa - kukondweretsa njira yoberekera kumachitanso. Ngati pali chosowa cha feteleza mwachangu, mchere (kawirikawiri) ungagwiritsidwe ntchito. Pogwiritsira ntchito mankhwala opatsirana pogwiritsa ntchito transabdominal kapena transcervical zowonjezera njira zothetsera (kupyolera mu khomo la m'mimba kapena khosi la uterine).
Musanachotse mimba, kathetta yapadera imalowetsedwa mu khola la khosi, pambuyo pake chikhodzodzo cha fetus chimafikira ndikuponyedwa, yankho la hypertonic limajambulidwa. Kuwerengera kwa madzi oyenera kumaphatikizapo kuganizira nthawi yothandizira - 6 ml kwa sabata imodzi. Mmalo mwa hypertonic sodium chloride solution, shuga nthawi zambiri amagwiritsidwa ntchito 20%. Zitatha izi, mankhwala osokoneza ubongo amayamba.
Kuchotsa mimba - zovuta
Mavuto pambuyo pochotsa mimba amachitika masiku angapo pambuyo poyendetsa. Zingathe kugwirizanitsidwa, zonsezi ndi kukhazikitsidwa kolakwika kwa kuchotsa mimba, komanso nthawi yochira. Zina mwa zovuta zomwe zimachotsa mimba:
- magazi;
- kuponyedwa kwa khoma la uterine;
- mzere wosakwanira;
- njira yotupa mu njira yoberekera.
Zotsatira za kuchotsa mimba
Palibe njira yabwino yochotsera mimba. Pa nthawi yomweyo, palibe kudalira kwa zotsatira za momwe kuchotsa mimba kwachitidwa. Sizowonjezera kutchula mimba zachipatala, zotsatira zake zomwe zingakhale zovuta pambuyo pa miyezi ingapo kapena zaka zingapo. Kawirikawiri, pokhala ndi mbiri yochotsa mimba, amayi amapereka madandaulo okhudzana ndi kuphwanya kwa msambo: nthawi zonse imatayika, kusintha kwa voliyumu. Kulephera kwa Hormonal kumachitika nthawizonse, mosasamala kanthu momwe mkazi amachotsedwera. Amathyola mwachindunji glands kugwira ntchito. Kulephera kwawo kumayambitsa matenda ndi mavuto ena:
- endometriosis;
- myoma ;
- kumaliza;
- polycystic;
- njira zokhudzana ndi chilengedwe mu njira yoberekera;
- kuphwanya ntchito yobereka (infertility);
- Kufooka kwa zipangizo zam'mimba za chiberekero;
- Kupanga zipsera pamakoma a uterine (pambuyo potira).