Zoyambitsa Ntchito Zakale: Chithandizo cha Chiberekero Chopanda Mphamvu

Zamkati

• Kodi Cerclage Imachitika Bwanji?
• Kodi Cerclage Imachitika Liti?
• Kodi Ndizovuta Zotani Zomwe Zingakhalepo?
• Chimachitika Ndi Chiyani Pambuyo pake?
• Chimachitika Ndi Chiyani Pambuyo pake?
• Kodi Cerclage Ndi Yabwino Bwanji?

Kodi mumadziwa?

Khola loyambirira la khomo lachiberekero lidanenedwa ndi Shirodkar mu 1955. Komabe, chifukwa njirayi nthawi zambiri imabweretsa magazi ambiri ndipo ma suture anali ovuta kuchotsa, madotolo adafunafuna njira zina.

Cerclage ya McDonald, yomwe idayambitsidwa mu 1957, idachita bwino poyerekeza ndi njira ya Shirodkar-komanso idachepetsa kuchuluka kwa kudula ndi kutaya magazi, kutalika kwa opareshoni, komanso zovuta kuchotsa ma suture. Pazifukwa izi, madokotala ambiri amakonda njira ya McDonald. Ena amagwiritsa ntchito njira ya Shirodkar, yosavuta komanso yotetezeka kuposa njira yoyambirira.

Ngati wothandizira wanu akukayikira kuti muli ndi chiberekero chokwanira, atha kulangiza kuti alimbikitse khomo lachiberekero pogwiritsa ntchito njira yotchedwa khomo lachiberekero. Khomo lachiberekero lisanalimbikitsidwe opaleshoni adotolo amayang'ana zovuta zam'mimba pochita ultrasound.

Kodi Cerclage Imachitika Bwanji?

Cerclage imagwiridwira mchipinda chogwiririra, pomwe wodwalayo amakhala pansi pa dzanzi. Dokotala amayandikira chiberekero kudzera kumaliseche. Gulu la masokosi (ulusi, ulusi kapena zinthu zina) limasokedwa kuzungulira khomo pachibelekeropo kuti likhale lotseka. Suture imayikidwa pafupi ndi os wamkati (kumapeto kwa khomo lachiberekero lomwe limatsegulira chiberekero).

Cerclage ya transabdominal ndi mtundu winawake wa cerclage womwe umafunikira kutsekula m'mimba mwamimba. Njirayi itha kugwiritsidwa ntchito ngati mulibe minofu yokwanira ya khomo lachiberekero yosungira suture kapena pomwe cholembera choyambirira sichinapambane. Kwa mayi yemwe ali ndi mbiri yakuchepetsa mimba zingapo, dokotala amatha kuyika cerclage m'mimba asanakhale ndi pakati.

Kodi Cerclage Imachitika Liti?

Ma cerclages ambiri amachitika pa trimester yachiwiri yapakati (pakati pa masabata 13 mpaka 26 atakhala ndi pakati), koma amatha kuikidwanso nthawi zina, kutengera chifukwa cha cerclage. Mwachitsanzo:

• Makola osankhidwa Nthawi zambiri amaikidwa mozungulira sabata la 15 la mimba, nthawi zambiri chifukwa chazovuta zomwe zidachitika kale.
• Ma cerclages ofulumira imayikidwa pomwe mayeso a ultrasound akuwonetsa khomo lachiberekero lalifupi, lotambalala.
• Zadzidzidzi kapena zamphamvu? makola nthawi zambiri amaikidwa pakati pa sabata la 16 ndi 24 la mimba ngati khomo lachiberekero latambasula kupitirira 2 cm ndikutha kale, kapena ngati nembanemba (thumba lamadzi) lingawoneke kumaliseche kunja kwa os (khomo lachiberekero lotsegulira kumaliseche ).

Kodi Ndizovuta Zotani Zomwe Zingakhalepo?

Ma cerclages osankhidwa ndi otetezeka. Makola achangu kapena achangu amakhala ndi chiopsezo chachikulu chazovuta, kuphatikizapo kuphulika kwa nembanemba zomwe zimazungulira mwanayo, kufinya kwa chiberekero, ndi matenda mkati mwa chiberekero. Ngati matenda amapezeka, suture imachotsedwa ndipo kubereka kumapangitsa kuti apereke mwanayo nthawi yomweyo. Kwa amayi omwe akupita kuchipatala chadzidzidzi, palinso chiopsezo kuti njirayi ingowonjezera pakati mpaka milungu 23 kapena 24. Pamsinkhu uwu, makanda amakhala pachiwopsezo chachikulu cha zovuta zazitali.

Kafukufuku wasonyeza kuti azimayi omwe amafunikira chibelekero cha khomo lachiberekero ali pachiwopsezo chowonjezeka chogwirira ntchito asanakwane msanga ndipo amafunikira kuchipatala nthawi yayitali.

Chimachitika Ndi Chiyani Pambuyo pake?

Kuyika cerclage ndi njira yoyamba pamayendedwe angapo omwe angafunike kuti muchite bwino ndikukhala ndi pakati. Pambuyo pa opaleshoniyi, adokotala angakupatseni mankhwala oletsa chiberekero chanu kuti chisatengeke. Mutha kumwa mankhwalawa tsiku limodzi kapena awiri. Mutatuluka kuchipatala, dokotala wanu akufuna kukuwonani pafupipafupi kuti mukayang'ane msanga ntchito.

Matendawa ndi omwe amakhudzidwa pambuyo pochita opaleshoni iliyonse. Ngati mwakhala ndi cerclage yachangu kapena yamphamvu, chiopsezo chotenga kachilombo chimakula.Izi ndichifukwa choti nyini ili ndi mabakiteriya omwe sapezeka mkati mwa chiberekero. Thumba lamadzi likamatsamira kumaliseche, pamakhala chiopsezo chowopsa cha matenda am bakiteriya mkati mwa chiberekero komanso mkati mwa thumba la amniotic lomwe limasunga mwana. Dokotala wanu angakupatseni maantibayotiki kuti muchepetse matenda. Ngati kachilombo kamapezeka mchikwama chamadzi, mimba iyenera kuthetsedwa kuti apewe zovuta zomwe zingachitike kwa mayi.

The suture nthawi zambiri amachotsedwa mozungulira sabata la 35 mpaka 37 la mimba, mwana atakwanira nthawi yonse. Cerclage yam'mimba siyingachotsedwe, ndipo azimayi omwe ali ndi ma cerclages m'mimba adzafunika magawo a C kuti apereke.

Chimachitika Ndi Chiyani Pambuyo pake?

Kuyika cerclage ndi njira yoyamba pamayendedwe angapo omwe angafunike kuti muchite bwino ndikukhala ndi pakati. Pambuyo pa opaleshoniyi, adokotala angakupatseni mankhwala oletsa chiberekero chanu kuti chisatengeke. Mutha kumwa mankhwalawa tsiku limodzi kapena awiri. Mutatuluka kuchipatala, dokotala wanu akufuna kukuwonani pafupipafupi kuti mukayang'ane msanga ntchito.

Matendawa ndi omwe amakhudzidwa pambuyo pochita opaleshoni iliyonse. Ngati mwakhala ndi cerclage yachangu kapena yamphamvu, chiopsezo chotenga kachilombo chimakula. Izi ndichifukwa chakuti nyini ili ndi mabakiteriya omwe sapezeka mkati mwa chiberekero. Thumba lamadzi likamatsamira kumaliseche, pamakhala chiopsezo chowopsa cha matenda am bakiteriya mkati mwa chiberekero komanso mkati mwa thumba la amniotic lomwe limasunga mwanayo. Dokotala wanu angakupatseni maantibayotiki kuti muchepetse matenda. Ngati matenda amapezeka mchikwama chamadzi, mimba iyenera kuthetsedwa kuti apewe zovuta zomwe zingachitike kwa mayi.

The suture nthawi zambiri amachotsedwa mozungulira sabata la 35 mpaka 37 la mimba, mwana atakwanira nthawi yonse. Cerclage yam'mimba siyingachotsedwe, ndipo azimayi omwe ali ndi ma cerclages m'mimba adzafunika magawo a C kuti apereke.

Kodi Cerclage Ndi Yabwino Bwanji?

Palibe mankhwala amodzi kapenanso kuphatikiza njira zosakwanira khomo pachibelekeropo lomwe lingakwaniritse kutenga pakati. Zomwe madokotala angachite ndikuchepetsa chiopsezo kwa inu ndi mwana wanu. Monga mwalamulo, ma cerclages amagwira ntchito bwino akaikidwa koyambirira ali ndi pakati komanso khomo pachibelekeropo litalitali komanso kulimba.

Mitengo yonyamula mimba mpaka kumapeto kwa cerclage imasiyanasiyana 85 mpaka 90%, kutengera mtundu wa cerclage womwe wagwiritsidwa ntchito. (Miyezo yopambana imawerengedwa poyerekeza kuchuluka kwa mimba zomwe zachitika kapena pafupi ndi nthawi ndi kuchuluka kwa njira zomwe zachitika.) . Cerclage ya transabdominal sichimachitidwa kawirikawiri ndipo chiwongola dzanja chonse sichinawerengedwe.

Ngakhale maphunziro angapo awonetsa zotsatira zabwino pambuyo pa cerclage, palibe kafukufuku wapamwamba yemwe wasonyeza kuti azimayi omwe amapita ku cerclage amakhala ndi zotsatira zabwino kwambiri kuposa omwe amagona.