ILI ngexesha lokukhulelwa

Ngokuqhelekileyo, iintambo ze-muscular of the cervix ngexesha lokukhulelwa zivaliwe ngendandatho eqinile, zikhulule ngokukhawuleza njengoko ixesha lokuhambisa lithetha. Kwimeko apho oku kwenzeka ngaphambi kwangoko, umlomo wesibeleko uqala ukufutshane kwaye uveze. Kule meko, bathetha malunga nokuphuhliswa kwe-ischemic-insufficiency (ICI). Le ngxaki ivela malunga ne-1-9% yabasetyhini abakhulelweyo, kuquka i-15-40% yabo ibhekene nokukhubazeka okuqhelekileyo, okokuthi. 2 kunye nokukhulelwa kwangaphambili kwaphela ekuphumuleni.

ILI ngethuba lokukhulelwa likhokelela ekunyuseni kwentamo ye-uterine, ngenxa yolu hlobo lwe-fetal bladder ewela, oluphela ngokuvula kwayo. Ukongezelela, umsebenzi wezabasebenzi ukhula, okhokelela ekuphumeni kwexesha elide okanye ukuzalwa ngaphambi kokuzalwa.

Kutheni kwenzeka i-ICI?

Izizathu ezibalulekileyo ezikhokelela ekuphuhliseni i-ICI ngexesha lokukhulelwa zi:

• intlungu yomlomo wesibeleko (iinyembezi, ukulimala) ngexesha lokuzalwa kwangaphambili okanye ngokupheliswa kokukhulelwa komzimba;
• ukungaqhelekanga ekuphuhlisweni kwezitho zokuzala;
• utshintsho olusebenzayo kwiisisiti ezixhamlayo zedysplasia, i-hyperandrogenia, kunye nokusilela kwe-hormone yesondo;
• ukwenza i-IVF;
• i-fetus ephezulu, i-polyhydramnios, i-fetus enkulu.

Ziziphi iimpawu eziphambili ze-NIH?

Iimpawu ze-ICI ngexesha lokukhulelwa zifihliwe kwiimeko ezininzi, ngoko kunzima ukucacisa ubukho besifo sesithandwa somfazi okhulelweyo. Ngoko kwinqanaba lokuqala lokuzala umntwana (1 trimester) abayikho ngokupheleleyo. Kamva, xa kubonakala kuyinto eqhelekileyo yokukhulelwa kwangoku, oomama baya kukhangela ukubonakala kweempawu ezifana ne-ICI:

• ukubonakala kwesincinci sokubala;
• ukubonakala kokukhutshwa kwamanzi kunye nemifuno yegazi;
• intlungu kwingingqi ye-lumbar yangasemuva nasezantsi kwesisu;
• ukubonakala kwesova "raspiraniya" kwisini.

Nangona kunjalo, kwiimeko ezininzi, njengoko sele zikhankanywe, isifo siyinto engabonakaliyo, kwaye ukuxilonga i-ICI ngexesha lokukhulelwa, ugqirha wenza uviwo lwe-cervix ngoncedo lwezibuko, kunye nokusebenzisa umshini we-ultrasound.

Ngaloo ndlela, ngokunyanzeliswa kwenzalo yomlomo wesibeleko, isifo somzimba siyakwazi ukubona ukuthotywa okukhulu kwesisu, kunye nokunciphisa ubude bomlomo wesibeleko, kunye nokuvulwa komgca wendlela apho kubonakala khona i-fetal bladder. Ngokujonga ukuba kubafazi abasemagqabini, i-pharynx yangaphandle ivalwe, ukuxilongwa kuqinisekiswa yi-ultrasound isebenzisa inzwa yecala. Ezi ndlela zilandelayo ziqwalaselwe ngqalelo:

1. Ubude bomlomo wesibeleko. Kwiiveki ezingama-24-28 zilingana no-35-45 mm, kwaye emva kweveki ezingama-32 zokukhulelwa - 30-35. Ukuba kwiiveki ezingama-20 ukuya ku-30 ​​ubude bayo bungaphantsi kwama-25 mm, ke bathetha malunga nophuhliso lwe-ICI.
2. Ubukho bovulo oluyi-V lwe-pharynx yangaphakathi.

I-ICI iphathwa njani?

Kuphela, kukho iindlela ezimbini zokuphatha i-ICI ngexesha lokukhulelwa:

• utyando;
• ekhuselekileyo.

Iyokuqala ukusetyenziswa kwe-sutures kwingxenye yomlomo wesibeleko. Ngelo xesha, umhombo ongaphakathi we-uterus unqanyuliwe kwaye umbeletho wangaphandle ugciniwe, oko kunciphisa kakhulu amathuba okuzalwa kwangaphambi kokuzalwa. Isikhathi sokusebenza okunjalo sisetyenziswe ngabanye, kodwa ukwenzela ukuba ugweme inkqubela phambili kwinkqubo, oogqirha bazama ukwenza umsebenzi ukufikelela kwiiveki ezili-17 ukuba ukuphulwa kufunyanwe ekuqaleni kokukhulelwa, kodwa kungekudala kweveki ezingama-28.

Indlela yokugcinwa kwe-Conservative ukufaka ipessary pessary (ring of Meyer). Olu hlobo lwesicatshulwa lunikela kwakhona ubunzima bomntwana kwaye luyakusiza umlomo wesibeleko ukuwugcina. Ukufakwa kwee-pessaries kusebenza kuphela xa kukhankanywa ukuba yi-NIH okanye kwiindawo zayo zokuqala. Ngeempawu ezinzima, le ndlela isetyenziswe, kunoko, njengomncedisi.