Bobabini Iingcaphephe Zokuphelisa Ukukhulelwa Okungahambiyo
Ininzi yokukhulelwa iyahamba ngaphandle kwe-hitch: Emva kweveki ezingama-40 okanye kunjalo, umntwana ophilileyo uyazalwa kwaye intsapho ikhula enye. Ngokubuhlungu kukuba, ngamanye amaxesha izinto azihambeli kulindeleke: Kukho ingxaki eyenza kubalulekile ukuphelisa ukukhulelwa okanye iphela ngokukhawuleza ekuphumuleni. Ngokuxhomekeka kwindlela ekhuselekileyo yokukhulelwa, oku kuya kuphunyezwa ngeendlela ezimbini zokuhlinzwa: ukuhluthwa nokukhutshwa (iD & E) kunye nokuhluthwa okanye ukukhutshwa (iD & C.
I-D & C, apho umlomo wesibeleko ukwandiswa ukwenza ukuba kunokwenzeka ukuba ugqirha asebenzise isicatshulwa esicacileyo esibizwa ngokuthi i-curette ukususa izicubu ukusuka kwimbumba yesisu. (I-D & C ngexesha eliqhelekileyo isetyenziselwa ukubhekisela kwi-vaccum aspiration, enye inkqubo yokuphelisa ukukhulelwa.)
Ukuxilwa kunye nokuhluthwa kwenziwa kwimizuzu eyi-13 yokukhulelwa. Kwimeko yokukhulelwa okuqhubekayo kunye neD & E iyadingeka. Ezinye izizathu eziqhelekileyo umfazi angadinga i-D & E: Umntwana unesimo esingavamile okanye ufile kwisibeleko kwaye uya kuzalwa ; iimbumba ziye zaphuka kwangaphambili; okanye kukho ingozi enkulu kwimpilo yowesifazane ukuba ukhulelwe.
Yintoni i-D & E efana nayo
Zombini zeD & C kunye ne-D & Es ziquka ukunciphisa umlomo wesibeleko nokucima isibeleko sokukhulelwa kwezicubu zokukhulelwa. Nantsi eyenzekayo ngexesha ngalinye lala ma nyathelo kwi-D & E:
Inyathelo 1: Ukuxuba
Isinyathelo sokuqala kwi-D & E silungiselela umlomo wesibeleko ngokunciphisa ngokuthe ngcembe kunye nokuyinciphisa ukususela emini okanye ezimbini phambi kwenkqubo yangempela.
Oku kufuthi kwenziwa nge "dilostic dilator," eyenziwe kwimijelo enxwemeni (ebizwa ngokuba yi-laminaria) okanye i-hydrogel sticks ezibekwa kwinqanawa yomlomo apho zifumanisa ukunyuka kwandisa kancane. Ukuthabatha okubalulekileyo kubalulekile: Ukuhluthwa ngokukhawuleza kwindlela okuye kwaboniswa ukwandisa umngcipheko wokulahlekelwa kwexesha lesibini ukukhulelwa xa ukhulelwe.
Iziyobisi nazo zingasetyenziselwa ukulungiselela umlomo wesibeleko ngosuku lwenkqubo, kodwa awanako ukusebenza njenge-dilmotic osmotic-ukutshintshwa kwendlela yokuchithwa kwemishini kunokuba kuyimfuneko ngaphandle kokuba kusekuqaleni kwekota yesibini.
Inyathelo 2: Ukukhutshwa
Isinyathelo sesibini kwi-D & E kukukhutshwa kwe-fetus kunye ne-placenta ukusuka kwisibeleko. Ngaphambi kokuba kwenzeke oku, le ntokazi inikwe i-anesthesia jikelele kunye ne-antibiotics ukukhusela usulelo. Nangona ephantsi kwe-anesthesia, ugqirha owenza iD & E ngokuqhelekileyo uya kusebenzisa ukudibanisa, ukuxhamla, kunye nokukhupha ukukhupha isisu. Abanye oogqirha basebenzisa umjovo ukuqinisekisa ukuba ukufa komntwana kufakile ngaphambi kokuba kuphunyezwe, kodwa oku kuphazamiseka.
I-D & E inzima kodwa ngokubanzi ikhuselekile ngokupheleleyo. Iingxaki ezinjenge-lacerity; ukuguqulwa kwesisu; ukusuleleka, okanye ukubola kwegazi kuyabunqabile. Ngaphezu koko, abafazi abane-D & E abanakuhlangabezana neengxaki kwixesha lokukhulelwa ezizayo ezihambelana nenkqubo.
Imithombo:
Ikholeji yase-American College of Obstetricians kunye neGynecologists. "Ukukhupha isisu." Meyi 2015.