Ukukhutshwa kwesibeleko kungumonakalo owenzela umbane kwiindonga zawo, okukhokelela ekuphulaphuleni ukuthembeka. Ngenye yeengxaki eziqhelekileyo kunye neengxaki eziza kwenzeka ngexesha lokukhulelwa nangethuba lokuzalwa. Ukuqaphela ngokungaqhelekanga kunye nokuxilongwa kwe-uterine rupture kwi-93% yamatyala kubangela ukufa komama ekuzalweni. Inkxalabo ukuya kumhla iyinqabile kakhulu, kwaye ingaphantsi kwe-1% yazo zonke ukuzalwa.
Ulwahlulo lwe-uterine rupture
Kuxhomekeke kwixesha apho kukho ukukhulelwa kwesibeletho, oku kulandelayo:
- ukuphuka komzimba okwenzeka ngexesha lokukhulelwa;
- ukuphuka kwesisu, kuveliswe ngexesha lokubeletha;
- ukuphuka ngokukhawuleza kwesibeleko.
Uhlobo lokuqala loxinzelelo lubakho ngokuphindaphindiweyo, kwaye malunga ne-10% yazo yonke i-uterine rupture. Ngethuba lomsebenzi ukukhulelwa kwesibeleko kungenzeka kwixesha lokuqala okanye lesibini lokuzalwa. Oku kuchazwa lula ngento yokuba ngeli xesha i-uterus ibona uxinzelelo olukhulu kwiindonga zayo.
Ngokwezibonakaliso zekliniki, ezi zintlobo zeengxaki ziyahlukana:
- Isongela ukuphuka kwesisu. Ivela xa i-fetus ihamba phambili kwindlela yookhokho inqobo isithintelo esingavumele ukuba intloko iqhubeke.
- Ukuqala kwesithuba.
- Uterter rupture.
Izizathu zokupheka komzimba
Izizathu eziphambili zokukhulelwa kwesibeleko zi:
- Inkcenkcesho encinci yowesifazane. Kuyabonakala kwiimeko xa umthamo we-pelvis womama awuhambisani nobungakanani bentloko yomntwana.
- Ukufakwa okungalunganga kwentloko ye-fetal kwi-pelvis yowesifazane ekubelethweni. Umzekelo wezophulo ezinjalo unokuba yi-previa kwihlobo lokugqithisa.
- Ukuxhamla kwezitho zokuzala. Uphulo luya kwenzeka ngesifo ezifana ne- uterine fibroids , esentanyeni okanye kwicandelo elingaphantsi kwesisu.
- Izikrakra ezinzima. Ngokuphindaphindiweyo ngexesha lokuzalwa, inkathazo enjengokuphuka kwesibeletho kweso sikalo. Phantse i-90% yazo zonke ikhefu zenzeke ngokuchanekileyo kwi-cicatrix ekhoyo kwisibeleko okanye kwiindonga zesini. Utshintsho kwi-myometrium yomlingiswa wakhe ohlala kwindawo yokuqala, phakathi kwezinto ezinokubangela ukwanda kwe-uterine.
- Ukukhupha isisu rhoqo kwimbali yowesifazane. Umba wukuthi ngexesha lokukhipha isisu ukutshatyalaliswa kwe-fetus yenziwe, kwaye ngenxa yoko, umgca we-basal we-uterus uwonakaliswe ngokungabikho.
Iimpawu zegap
Ukuze kuhlolwe ubukho be-uterine ngexesha, ukukhulelwa kwangoku, umfazi kufuneka azi iziphumo ezilandelayo ezihambisana nale nkcenkceshela:
- isicefe
- ukuhlanza;
- iintlungu ezisekuhlaleni kwindawo epigastric, ngakwesokudla, yingako abaninzi banokudibanisa le nkxalabo kunye nokuvuvukala kwesihlomelo.
Naluphi ukukhulelwa okwenzeka emva kokuqhaqha kwesisu kufuneka kuhlolwe rhoqo ngugqirha.