Izinqubo zokungenelela zokukhipha isisu

Izinqubo zokungenelela zokukhipha isisu

Kusetshenziswa amasu amabili ukwenza ukunqanyulwa kokukhulelwa ngokuzithandela:

  • indlela yezidakamizwa
  • inqubo yokuhlinzwa

Noma nini lapho kungenzeka, abesifazane kufanele bakwazi ukukhetha indlela, yezokwelapha noma yokuhlinzwa, kanye nemodi yokubulala izinzwa, yendawo noma evamile.16.

Indlela yokwelapha

Ukukhipha isisu kwezokwelapha kusekelwe ekuthathweni kwezidakamizwa ezivumela ukuthi kubangele ukunqanyulwa kokukhulelwa kanye nokuxoshwa kombungu noma umbungu. Ingasetshenziswa kuze kube amasonto angu-9 we-amenorrhea. E-France, ngo-2011, ngaphezu kwesigamu sokukhishwa kwezisu (55%) kwenziwa ngemithi.

Kunemithi “yokukhipha isisu” eminingana, kodwa indlela ejwayeleke kakhulu ukusebenzisa:

  • i-anti-progestogen (i-mifepristone noma i-RU-486), evimbela i-progesterone, i-hormone evumela ukuthi ukukhulelwa kuqhubeke;
  • ngokuhambisana nomuthi womndeni we-prostaglandin (misoprostol), obangela ukufinyela kwesibeletho futhi uvumele ukuphuma kombungu.

Ngakho-ke, i-WHO incoma, ngokukhulelwa kwenkathi yokukhulelwa kuze kufike emasontweni angu-9 (izinsuku ezingu-63) ukuthathwa kwe-mifepristone kulandelwa usuku olu-1 kuya kwezi-2 kamuva nge-misoprostol.

I-Mifepristone ithathwa ngomlomo. Umthamo onconyiwe ngu-200 mg. Ukuphathwa kwe-misoprostol kunconywa osukwini olu-1 kuya kwezingu-2 (amahora angama-24 kuye kwangama-48) ngemuva kokuthatha i-mifepristone. Kungenziwa ngomzila wesitho sangasese sowesifazane, we-buccal noma we-sublingual kuze kufike kumaviki angu-7 we-amenorrhea (amaviki angu-5 okukhulelwa).

Imiphumela ihlobene kakhulu ne-misoprostol, engabangela ukopha, ikhanda elibuhlungu, isicanucanu, ukuhlanza, isifo sohudo kanye namajaqamba esisu abuhlungu.

Empeleni, ukukhipha isisu kwezokwelapha kungenziwa kuze kufike ku-5st isonto lokukhulelwa ngaphandle kokulaliswa esibhedlela (ekhaya) kuze kufike ku-7st isonto lokukhulelwa namahora ambalwa okulaliswa esibhedlela.

Kusukela emavikini angu-10 we-amenorrhea, indlela yomuthi ayisanconywa.

E-Canada, i-mifepristone ayigunyaziwe, ngenxa yezingozi ezithathelwanayo ezingaba khona (futhi ayikho inkampani eyenze isicelo sokumaketha le molekyuli eCanada, okungenani kuze kube sekupheleni kuka-2013). Lokhu okungamakethi kuyimpikiswano futhi kugxekwa izinhlangano zezokwelapha, ezicabangela ukusetshenziswa kwe-mifepristone ephephile (ivame ukusetshenziswa emazweni angu-57). Ngakho-ke ukukhishwa kwezisu ngokwezokwelapha akuvamile kakhulu eCanada. Zingenziwa ngomunye umuthi, i-methotrexate, ilandelwe yi-misoprostol, kodwa ngokusebenza okuncane. I-Methotrexate ivame ukunikezwa ngomjovo, futhi ezinsukwini ezinhlanu kuya kweziyisikhombisa kamuva, amaphilisi e-misoprostol afakwa esithweni sangasese. Ngeshwa, ezimweni ezingu-35%, isibeletho sithatha izinsuku ezimbalwa noma amasonto ambalwa ukuze siphume ngokuphelele (uma kuqhathaniswa namahora ambalwa nge-mifepristone).

Indlela yokuhlinzwa yokukhipha isisu17-18

Ukukhishwa kwezisu okuningi emhlabeni kwenziwa ngendlela yokuhlinza, ngokuvamile ukulangazelela okuqukethwe kwesibeletho, ngemva kokunwetshwa komlomo wesibeletho (kungaba ngomshini, ngokufaka ama-dilators amakhulu, noma ngokwemithi). Kungenziwa kungakhathaliseki isikhathi sokukhulelwa, noma nge-anesthesia yendawo noma nge-anesthesia jikelele. Ukungenelela ngokuvamile kwenzeka phakathi nosuku. I-Aspiration iyindlela enconyiwe yokuhushula isisu ngokuhlinzwa kuze kufike enkathini yokukhulelwa esukela emasontweni ayi-12 kuya kwayi-14 okukhulelwa, ngokusho kwe-WHO.

Enye inqubo ngezinye izikhathi isetshenziswa kwamanye amazwe, ukunwetshwa komlomo wesibeletho okulandelwa ukucutshungulwa (okuhlanganisa “ukukhuhla” ulwelwesi lwesibeletho ukuze kukhishwe imfucumfucu). I-WHO itusa ukuba le ndlela ithathelwe indawo yi-aspiration, ephephile futhi enokwethenjelwa.

Uma iminyaka yokukhulelwa ingaphezu kwamaviki ayi-12-14, kokubili ukunwetshwa nokukhishwa kanye nemithi kunganconywa, ngokusho kwe-WHO.

Izinqubo zokuhushula isisu

Kuwo wonke amazwe agunyaza ukuhushulwa kwezisu, ukusebenza kwaso kumiswa ngephrothokholi echazwe kahle.

Ngakho-ke kuyadingeka ukuthola mayelana nezinqubo, izinsuku zokugcina, izindawo zokungenelela, iminyaka esemthethweni yokufinyelela (iminyaka engu-14 ubudala eQuebec, noma iyiphi intombazane encane eFrance), imigomo yokubuyisela (mahhala eQuebec kanye nokubuyiselwa kwe-100% eFrance).

Kufanele wazi ukuthi izinqubo zithatha isikhathi nokuthi zivame ukuba nezikhathi zokulinda. Ngakho-ke kubalulekile ukuthi usheshe uthintane nodokotela noma uye esikhungweni esikhipha izisu ngokushesha nje lapho isinqumo senziwe, ukuze ungalibali usuku lwesenzo kanye nengozi yokufika ngosuku lokukhulelwa lapho kudingekile. kuzoba yinkimbinkimbi.

E-France, isibonelo, ukubonisana kwezokwelapha okubili kuyimpoqo ngaphambi kokukhipha isisu, kuhlukaniswe isikhathi sokubonisa okungenani isonto elilodwa (izinsuku ezi-2 esimweni esiphuthumayo). “Izingxoxo-zokubonisana” zinganikezwa abesifazane ngaphambi nangemuva kokuhlinzwa, ukuze kuvunyelwe isiguli ukuba sikhulume ngesimo saso, ukuhlinzwa kanye nokuthola ulwazi ngokuvimbela inzalo.19.

E-Quebec, ukukhipha isisu kunikezwa emhlanganweni owodwa.

Ukulandelelwa kwengqondo ngemva kokukhipha isisu

Isinqumo sokuqeda ukukhulelwa akulula neze futhi isenzo asiyona into encane.

Ukukhulelwa okungafunwa nokukhipha isisu kungashiya imikhondo engokwengqondo, kuphakamise imibuzo, kushiye umuzwa wokungabaza noma wecala, ukudabuka, ngezinye izikhathi ukuzisola.

Ngokusobala, ukusabela ekukhishweni kwesisu (kungakhathaliseki ukuthi kungokwemvelo noma kwenziwa) kuyahlukahluka futhi kuqondile kowesifazane ngamunye, kodwa ukulandelela okungokwengqondo kufanele kunikelwe kubo bonke.

Nokho, ucwaningo oluningana lubonisa ukuthi ukukhipha isisu akuyona into ehlala isikhathi eside eyingozi engokwengqondo.

Ukucindezeleka ngokomzwelo kowesifazane kuvame ukuba kukhulu ngaphambi kokukhipha isisu bese kuncipha kakhulu phakathi nesikhathi esingaphambi kokukhipha isisu kanye nalokho esikulandelayo ngokushesha.10.

shiya impendulo