Kwi-trimester yesibini, oogqirha baqhubela phambili ukuhlola iimvavanyo zokubeleka ezingaphantsi kokubeletha ezingakwazi ukubona iindidi ezahlukeneyo ze-chromosomal kunye ne-congenital in the fetus. Iimeko ezihlolwayo ziyakwazi ukuhluka ngokubanzi kwi-prognosis yazo. Abantwana abanezinye zeemeko, ezifana ne-Down syndrome kunye neempembelelo ze-neural tube , abaza kuzalwa bephila kwaye baphila ubomi obuqhelekileyo-nangona banokukhubazeka okuphuhlisayo, ngokomzimba okanye kwengqondo.
Ezinye iimeko ezifunyenwe ekubonisweni kokubeleka kwangaphambi kokubeletha zingaba zibulale okanye zithwale ukuhlaselwa ngokusesikweni. Ngokomzekelo, isiqingatha seentsana ezelwe nge- anencephaly asiyi kuphila ukuzalwa kwaye esinye isiqingatha siphelelwa kwiiyure okanye iintsuku. Imeko ye- chromosomal efana ne-trisomy 13 okanye i-trisomy 18 ingabangela umntwana ngokuphila okufutshane; Iipesenti ezingama-90 zeentsana kunye nale miqathango ayinakuphila kwiminyaka elidlulileyo ubudala kwaye zihlala zixhatshazwa ngeengxaki zempilo kunye nokungenelela kwezonyango ubomi babo bonke.
Ukuphela kweMpawu
Xa ukuhlolwa kokubeleka kokuqala kunye nokuhlolwa kokulandelelana kokubuyisela ukubuyisela ukuxilongwa ngokucacileyo kwimeko kunye nokunyanzeliswa okubi, abazali banokujamelana nesigqibo sokuba ingaqhubeka nokukhulelwa. Ukupheliswa kwexesha lokukhulelwa phantsi kwezi meko ngezinye iimeko kuthiwa ngokusekelwe kumachiza okanye ngokugqitywa kwemithi kubonisiwe. Abazali banokugqiba nokuqwalasela ukupheliswa komzimba xa ukukhulelwa okungaqhelekanga okanye ezinye iinkathazo zempilo zibeka ingozi ebomini kubomi xa eqhubeka nokukhulelwa.
Xa abazali bekhetha ukunqanda ukukhulelwa ngenxa yeemeko ezinzulu zonyango kwintsana, inkqubo yezokwelapha iyisistim ye-second-trimester okanye i-"late-term" yokukhipha isisu-kwaye yinto ekhethekileyo ngenxa yokuba abazali bangakhetha ukuba bavumele ukuba imvelo ithathe ikhosi okanye ukuphelisa ukukhulelwa.
Ngokuchasene nokupheliswa kwexesha elikhethiweyo, nangona kunjalo, ininzi intsana ikhulelwe emva kwexesha lokukhulelwa izizathu zonyango zazifunwa kakhulu kwaye abazali banokuba buhlungu kakhulu ngokulahlekelwa ngumntwana.
Izopolitiko kunye nemizwelo
Ukupheliswa kokukhulelwa kwanoma yiluphi uhlobo luba ngumbahlulo nolwaphulo-mthetho, bobabini kunye nezopolitiko. Abantu abafihliweyo okanye benkolo ngokuchasene nokukhupha isisu banokubheka konke ukukhupha njengokungalunganga-kungakhathaliseki ukuba imeko. Amaqela amacandelo ngamanye amaxesha aphikisana ngokunyanisekileyo nakwixesha lokupheliswa kwezonyango, kwaye amaninzi amaninzi e-intanethi enza ityala elo lonke umntwana kufuneka liziswe kwikota. Abantu abanesigqibo sokhetho oluqhelekileyo abanakho ukuchasana nokupheliswa kwemithi ngokusisigxina.
Kwiimeko apho imeko efunyanwe ngayo ingabi yingozi, abanye abachasayo ukukhupha isisu emva kokuxilongwa ngaphambi kokubeleka besaba ukuba abazali abanakufumana ulwazi olupheleleyo. Iziphumo ziye zaphucula ngaphezu kweminye imimiselo, njenge-Down syndrome, kwaye bayesaba ukuba abazali bangayifumana ingcamango nengalunganga yinto efana nokukhulisa umntwana ngokukhubazeka ngokomzimba okanye ukuphuhliswa.
Ngaphandle komongo wezopolitiko, kwaye kubaluleke kakhulu kule miba, ngaba iimvakalelo zabazali.
Kunokuba sibe mnyama kunye nomhlophe (njengoko iimbono zezopolitiko ziba njalo), iimvakalelo zabazali kaninzi ziwela kwindawo ethile kwibala. Abanye abakwazi ukuqonda ingcamango yokuba nokukhupha isisu emva kwexesha elide, nangona emva kokuxilongwa kweziphene zokuzalwa, xa abanye bexabana nombono kodwa ekugqibeleni bafuna ukupheliswa, kwaye kunjalo, abanye abakwazi ukulwa nesigqibo nangona bebuhlungu ukulahlekelwa ngumntwana. Kuzo zonke iimeko, kuyisigqibo esinzima sokuba abazali benze kwaye bahlala behamba kunye nokudabuka okukhulu nentlungu.
Ukugqiba kwiNkqubo yoKhusela ukuKhipha isisu
Xa abazali begqiba ukuphelisa izizathu zonyango, isigqibo sinokuba neqela lezinto.
Kwiimeko ezingafaniyo, abazali banokuvakalelwa kukuba bayagula baxhotyiswe ukuphatha umntwana kunye neemfuno ezizodwa. Ngamanye amaxesha isigqibo sokuphelisa sichaphazela ukukhathazeka kwengane. Ngokomzekelo, kwimiqathango yimeko efana ne-trisomy 18 equka iingxaki ezinzulu zonyango kunye nexesha elifutshane kakhulu lobomi, abazali bangafuna ukuphepha ukubeka umntwana ngentlungu engadingekile xa kungekho nethemba lesiphumo esihle. Aba bazali banokuvakalelwa kukuba ukupheliswa kwezona zinto zimbini.
Ukuphelisa izibonakaliso zonyango kunokubandakanya ukuxhalabisa ngempilo yengqondo yomama ngokunjalo. Xa befumana iindaba zokuxilongwa kwezokwelapha eziphazamisayo, oomama abanokungafuni ukuhlangabezana neenyanga ezongezelelweyo zokukhulelwa kuphela ukubona umntwana wabo ofunayo kakhulu efa esibhedlele. Oomama bangadinga ukuphelisa inkqubo yenyama ukuze baqale ukulila nokuphulukiswa ngendlela efanelekileyo kubo kunye neentsapho zabo.
Ekugqibeleni, ezinye iimeko zingabandakanya umngcipheko omkhulu kubomi bomama, njengento engavumelekanga yokukhulelwa ngamawele okubandakanya umntwana omnye oqhelekileyo kunye ne- hydatidiform mole (apho umama ubhekene nengozi engama-60 yokuphuhlisa isifo esibuhlungu besifo se-trophoblastic ekupheleni kwayo lokukhulelwa xa evula ukuqhubeka). Kule meko, impilo yomama kunye nempilo inokukhuselwa ngokupheliswa-nokuba umntwana wayefuna kakhulu.
Ukuthatha isigqibo ngokuchasana nokukhupha isisu
Ukufumana iingxaki zeengxaki ezingafaniyo, ezifana ne-Down syndrome, abazali banokugqiba isigqibo sokuba bakulungele kwaye bazimisele ukumkela umntwana eneemfuno ezizodwa. Kwaye kwimiba enokuba neyona nto iphosakeleyo kakhulu yokunyanzela umntwana okanye umama, abanye abazali banokukhetha ukulwa nokupheliswa ngenxa yeenkolelo zonqulo okanye iinkolelo zokufihla isisu.
Sekunjalo, abanye abazali banokuvakalelwa ngokuvumela ukuba indalo ithathe ikhosi kunye nokuba nethuba lokubamba umntwana ngaphambi kokuba idlule, mhlawumbi ingakwazi ukunyamekela imbono yokuphelisa ubomi bomntwana.
Abazali abambalwa banokuqhubeka nokukhulelwa ngenxa yethemba elincinci lokuba ukuxilongwa kukuphosakele kwaye konke kuya kuhamba kakuhle. (Iiposiso zokuxilonga ziqabile kakhulu kwiimeko eziza kuphakamisa umbuzo wokupheliswa kwesigxina ngokwemithi; uphando lwe-chromosomal olufunyenwe ngo- amniocentesis , umzekelo, unama-100 ekhulwini oluchanekileyo kunye necala eliqhelekileyo lephulo lebhu.)
Isigqibo soBuntu kunye nesinye
Isigqibo sokuba okanye ukuphelisa ukukhulelwa okuchaphazelekayo yimeko enzulu yonyango ibaluleke kakhulu. Abanye abazali bathatha umgangatho ophakathi, ukukhetha ukuphelisa ukuba imeko leyo iya kuba yingozi ekuzalweni okanye kungekudala emva koko, kodwa ukhethe ukuqhubeka nokukhulelwa apho umntwana kulindeleke ukuba abe nesimo somzimba okanye uphuhliso kodwa nokuba nexesha elifanelekileyo lokuphila.
Amanye amazwe anemithetho kwiincwadi ezinokubangela ukuba kunqunyulwe ukupheliswa xa imeko ingasongela ubomi bomama, apho imeko yabesifazane banokunyanzeliswa ukuba bahambe umgama omde kwinkqubo okanye baqhubeke nokukhulelwa.
Ukugqitywa kweyesibili-sithathu kwezizathu zonyango ngokuqhelekileyo kubandakanya i- D & E (ukuhlanjululwa nokukhutshwa) okanye inkqubo ye-D & X (ukuhlanjululwa kunye nokukhutshwa) -kuninzi kunye nejoyi ngaphambili ukuyeka intliziyo yesana. Inkqubo ye-D & X, esetyenziselwa ezinye zezi zinto zokupheliswa kwayo, ixabana kakhulu. AbaLawuli bajolise kule nkqubo, ngamanye amaxesha kuthiwa "ukukhupha isisu ngokusesikweni" ngamajelo akhuselekileyo, kwiminyaka yamuva kwaye ikusasa le nqubo iyahlala ingaqiniseki.
> Imithombo
- I-FIGO (I-International Federation of Gynecology and Obstetrics) Ingxelo yeKomidi: Imilinganiselo yokuziphatha ngokuphathelele > ukupheliswa > kokukhulelwa emva kokuxilongwa kwangaphambi kokubeleka. "I- International Journal ye-Gynecology kunye ne-Obstetrics.- 102 (1): 97-98.
- > Ukupheliswa kokukhulelwa komntwana ongeyomntwana. Ikholeji yaseRoyal of Ostrijist and Gynecologists : 29-31. Meyi 2010.
- > Isizwe seSizwe soMngcipheko we-Neurological and Stroke, "i-Anencephaly Information Information." Ngo-13 uNgo-2007. Kufumaneke ngomhla we-7 Feb 2008.
- > IYunivesithi yaseVirginia yeNkqubo yeMpilo, "iTrisomy 18 no-13." ZoNyango lwezoNyango . 28 Januwari 2008. Kufumaneka ngomhla we-3 Feb 2008.
> Wertz, DC "Indlela abazali abachaphazelekayo abajonga ngayo ukukhupha isisu." Iingxaki zoLwazi lwezobugcisa I: I-Anthology Garland Publishing, ngo-1992. eNew York. Ufikelele kwi-7 Feb 2008.