Ukupheliswa kokukhulelwa ngaphandle kokungenelela kwe-instrumental kwisigxina se-uterine, kuvamise ukunciphisa umngcipheko weengxaki emva kokukhipha isisu, okusoloko kukhokelela ekungabikho komntwana. Le nkqubo ibizwa ngokuba yimishanguzo (okanye i-pharmacological) yokupheliswa kokukhulelwa kwangoko.
Ukukhipha isisu: uyintoni na
Ngaphantsi kokuphazamiseka kwezidakamizwa zokukhulelwa kwiminyaka yokuqala, kuyisiko ukuthetha indlela yokukhipha isisu kwisigaba sokuqala ngoncedo lwamachiza akhethekileyo. Ukuphazamiseka kokukhulelwa okungafunekiyo kubonwa njengenye yeendlela ezikhuselekileyo kwilizwe lokukhupha isisu.
Imigaqo eyisiseko yokukhipha isisu
Ukuphelisa ukukhulelwa ngale ndlela, kubalulekile okokuqala ukuba ufumane ubungqina bokukhulelwa kunye nokutyhila i-term usebenzisa uvavanyo oluvakalayo, i-ultrasound ekhulelwe (usebenzisa isisenli sangasese) kunye nokuhlolwa kwegazi kwi-hCG.
Olu hlobo lokukhipha isisu lusebenza kuphela kwizigaba zokuqala (ukuya kwiiveki ezi-6). Le nqubo yokukhipha isisu ayifaki ngokupheleleyo ukungenelela kokungena. Emva koko konke oku, ukukhupha isisu kubandakanya kuphela ukusetyenziswa kwamachiza ngamayeza afana ne-Mifolian, Mifegin, Pencrofton kunye neMifeprex. Ukubunjwa kwezi zi yobisi kubandakanya isithako esisebenzayo mifepristone. Eli nyanga liyakwazi ukuthintela isenzo se progesterone (ihomoni exhasa ukukhulelwa). Xa umfazi engena emzimbeni, uqala ukuvuselela inkqubo ejoliswe ekususeni iqanda le-fetal, emva koko iyeza zenza ithotshi kwi-cervix, ivule. Ngenxa yoko, iqanda elalikhutshelwe ingenalo ikhono lokunamathela eludongeni lwesisu, oluye lwayeka ukuphuhliswa kwembungu.
Izinzuzo zokukhipha isisu kwizigaba zokuqala
Ukuphazamiseka okunjalo kokukhulelwa okungafuneki ngokupheleleyo akubandakanyi ukungenelelo okutyathwayo kwaye akudingi i-anesthesia. Ukongeza, umngcipheko wokusuleleka usulele kakhulu. Ukukhulelwa kunokumiswa kumgangatho omncinci. Kwaye okubaluleke kakhulu, ukukhupha isisu kunika isiqinisekiso esiphezulu sokusebenza, okumalunga ne-97%.
Ukuchasana nokukhipha isisu
Ukuphazamiseka kwezidakamizwa zokuphuhliswa komntwana kungavumelekanga, ukuba kufunyenwe ukukhulelwa kwe-ectopic, kukho izikrakra kwisibeleko, umfazi unesifo esingapheliyo sesifo esingenasiphelo okanye i-asthma ye-bronchial. Kwakhona lolu hlobo lokukhipha isisu luvinjelwe xa kunokunyanzelwana komntu, i-35 ubudala ubudala engumsi ukuze kuphephe uxinzelelo kunye nenkqubo ye-cardiovascular system.
Amanyathelo okukhipha isisu
Le nkqubo ibandakanye amanyathelo athile: phambi kogqirha, umfazi kufuneka athathe 600 mg yesilwanyana, kwaye emva kwamahora angama-36 ukuya ku-8 ukuya kwezi-8 ukuya kutsho kweyure (24 ukuya kwiiyure ezingama-8) isicatshulwa sithathwa ngokwe-prostaglandin regimen (izinto ezinjenge-hormone ezenza ukuba isibeletho sivumelanise kwaye sichitha iindawo eziseleyo zesisu). Kwaye emva kweeyure ezingama-4-8 emva kwezenzo ze-prostaglandines, ukukhulelwa komzimba kubangelwa ngenxa yokuphambana kwesibeletho. Emva kweentsuku ezingama-7 ukuya kwe-14, owesifazane kufuneka ahlolwe ukuqinisekisa ukuba iqanda le-fetal yeengqungquthela alihlali.
Le ndlela ayigcini nje ukuphazamisa ukukhulelwa ngokwemigangatho emancinci, kodwa kuthathwa njengento engenabuhlungu (intombazana inokuziva iintlungu ezincinci kummandla wesisu, ezifana nentlungu ngexesha lokuya esikhathini).
Emva kokukhipha isisu ebudeni bokuqala, umfazi ngokukhawuleza ubuyela kwimpilo yakhe eqhelekileyo. Ngendlela, ngeli xesha lokuthatha iziyobisi, ukuphumla kombhede kunqatshelwe, njengoko oku kunokubangela impembelelo yomntwana. Into efunekayo yokunyamekela ingqalelo ukuphuma kwegazi, eqala kwinkqubo yokuthatha iipilisi. Ubuninzi babo buhambelana nokuqheleka kokuya esikhathini okanye mhlawumbi liphezulu. Ulwabiwo lunokuhlala ixesha elide ukuya kwiintsuku ezili-12.
Kwaye ekugqibeleni, lolu hlobo lokukhipha isisu alukho ekungabikho komntwana, kuba ukuvimba kweepresterone receptors okwethutyana kwaye umfazi usenokuba sele ehamba ngomjikelezo wokuqala wokuya esikhathini. Ngaphezu koko, le misu iyakunyamezela lula kwiingqondo zengqondo.