Ekuqaleni kokukhulelwa, akuvamile ukuba namabala, okusho ukuthi ukopha okuncane, ngaphandle kokuba kubi kakhulu. Kunoma yisiphi isigaba sokukhulelwa, noma kunjalo, kubalulekile ukubonisana nanoma yikuphi ukopha ukuze kutholakale inkinga edinga ukwelashwa okusheshayo ngokushesha ngangokunokwenzeka.

Ukopha okuncane esithweni sangasese kubizwa ngokuthi i-spotting. Zingenzeka phakathi nomjikelezo, kodwa futhi ngesikhathi sokukhulelwa, ngokuvamile ku-trimester yokuqala, lapho ukukhulelwa kuqala.

Owesifazane oyedwa kwaba-1 okhulelwe uyopha ku-trimester yokuqala yokukhulelwa. Lezi metrorrhagia ekuqaleni kokukhulelwa zingaba nezimbangela ezihlukene, ngakho-ke imiphumela ehlukene kukho konke ukukhulelwa.

• ukopha kokufakelwa : Lapho iqanda lifaka ulwelwesi lwesibeletho (cishe izinsuku ezingu-7-8 ngemva kokukhulelwa), ukopha okuncane kakhulu kungase kwenzeke. Zinobuhle futhi azinawo umthelela ekuqhubekeleni phambili okuhle kokukhulelwa.
• i-ectopic pregnancy (EGU) : esikhundleni sokutshala nokuthuthukiswa emgodini wesibeletho, iqanda likhula ngaphandle, ngokuvamile e-fallopian tube, okungavamile kakhulu ku-ovary, odongeni lwesisu noma emlonyeni wesibeletho. I-GEU ivamise ukubonakala njengokulahleka kwegazi okumnyama okungenzeka ngaphambi kosuku olunqunyiwe lwesikhathi sakho (futhi kungase kube iphutha isikhathi esithile), okulandelwa ubuhlungu obunzima ngaphansi kwesisu. I-GEU ayikona ukukhulelwa okusebenzayo, futhi kufanele ilawulwe ngokushesha ngemithi noma ngokuhlinzwa ukuze kuvinjwe ishubhu ukuthi lonakaliswe unomphela.
• ukuphuphuma kwesisu : lokhu kunqanyulwa kokukhulelwa okuzenzakalelayo okuthinta u-15% wokukhulelwa ngokwesilinganiso, ngokuvamile kubonakaliswa ukulahlekelwa igazi okuhambisana nobuhlungu ngaphansi kwesisu, kancane kancane noma sekwephuzile phakathi ne-trimester yokuqala. Ngezinye izikhathi umkhiqizo wokukhulelwa ukhishwa ngokwemvelo; kwezinye izimo ukwelashwa ngezidakamizwa noma ukulangazelela kuyodingeka.
• i-hematoma ye-decidual (noma i-placenta abruption ingxenye): ngesikhathi sokufakelwa, i-trophoblast (i-placenta yesikhathi esizayo) ingase ihlukane kancane futhi ibangele ukwakheka kwe-hematoma okungaholela ekopheni okuncane okunsundu. I-hematoma ngokuvamile ixazulula ngokuzenzakalelayo, ngaphandle komphumela ekuqhubekeleni phambili kokukhulelwa. Nokho, ngezinye izikhathi kuba kubi kancane kancane futhi kugcine ngokuphuphuma kwesisu.
• ukukhulelwa kwe-molar (noma imvukuzane ye-hydatidiform): akuvamile, le nkinga ibangelwa ukungavamile kwe-chromosomal. Ibonakala ngokukhula okungavamile kwe-placenta ngendlela yama-cysts kanye nokungabikho, izikhathi ezingu-9 kwezingu-10, zombungu. Ngakho-ke ukukhulelwa akuqhubeki. Ngendlela yayo evamile, ukukhulelwa kwe-molar kubonakala ngokopha okubalulekile okunomthwalo wemfanelo kanye nokwanda kwevolumu yesibeletho, ngezinye izikhathi ngokugcizelela izimpawu zokukhulelwa. Kwezinye izimo, kuholela ekuphuphumeni kwesisu okuzenzakalelayo.

Ekugcineni, kwenzeka ukuthi ukopha okuncane kwenzeka ezingeni lomlomo wesibeletho, ngemva kokuhlolwa kwesitho sangasese sowesifazane noma ukuya ocansini.

Uma ukopha kwenzeka ngosuku olunqunyiwe lokuya esikhathini ngemva kokuqala kokukhulelwa, kubizwa ngokuthi “inkathi yokuzalwa”. Lokhu ukopha okuncane okungabangeli buhlungu.

Asazi ngempela imbangela yale “mithetho yosuku lokuzalwa” okuyivelakancane, ngaphezu kwalokho. Kungase kube i-hematoma encane ebizwa ngokuthi i-decidual hematoma; ukopha okuncane ngenxa yokufakelwa; ukungalingani okuncane kwe-hormonal okuholela, ezinyangeni zokuqala ezingu-2-3 zokukhulelwa ukukhanya okuphuma ngosuku lwemithetho, ngaphandle kokuthi lokhu kube nomthelela ekuziphendukeleni kokukhulelwa.

Ekuqaleni kokukhulelwa, izimbangela ezimbi kakhulu zokopha ukuphuphuma kwesisu, ukukhulelwa kwe-ectopic, nokukhulelwa kwe-molar, konke okuholela ekunqanyulweni kokukhulelwa.

Ekupheleni kokukhulelwa, imbangela eyingozi kakhulu yokopha yii-hematoma ye-retro-placental (akufanele kudidaniswe ne-hematoma ye-decidual). Ngezinye izikhathi ku-trimester yesithathu, i-placenta iyaxebuka ngaphezu kwengxenye ebanzi kakhulu noma encane. Lokhu "kuhlukaniswa ngaphambi kwesikhathi kwe-placenta evame ukufakwa" kuzoholela ekwakhekeni kwe-hematoma phakathi kodonga lwesibeletho kanye ne-placenta. Ubuhlungu obungalindelekile be-pelvic, ukufinyela, ukopha bese kuvela.

I-hematoma ye-retro-placental iyisimo esiphuthumayo sokubeletha ngoba ukusinda kwengane kusengozini. I-placenta ayisadlali indima yayo yokondla ngendlela efanele (ngokomoya-mpilo nezakhi), umntwana usebunzimeni bengane. Umama usengozini yokopha. Ngakho-ke ukuhlinzwa kokuhlinzwa kwenziwa ngokushesha.

Omama abakhulelwe abane-hypertension noma isifo sikashukela sokukhulelwa banamathuba amaningi okuba ne-retro-placental hematoma. Umthelela onobudlova esiswini nawo ungabangela lolu hlobo lwe-hematoma. Kodwa ngezinye izikhathi, asikho isizathu esitholakalayo.

Okunye okungaba imbangela yokopha ngesikhathi sokukhulelwa sekwephuzile ikhekhe lokuqala, okungukuthi, i-placenta efakwe iphansi ngokungavamile. Ngaphansi komphumela wokufinyela ekupheleni kokukhulelwa, i-placenta ingaxebuka ingxenye eyodwa futhi ibangele ukopha okukhulu kakhulu noma okuncane kakhulu. Kubalulekile ukubonisana ukuze ulawule i-placenta. Ukuphumula okuphelele kuyodingeka kuze kube yilapho kuzalwa umntwana, okuyokwenziwa ngokuhlinzwa uma kuyi-placenta previa evalayo (ivala umlomo wesibeletho futhi ngaleyo ndlela ivimbele ukudlula kwengane).

Empeleni, konke ukopha kufanele kuholele ekubonisaneni ngesikhathi sokukhulelwa.

Ekuqaleni kokukhulelwa, udokotela wezifo zabesifazane noma umbelethisi ngokuvamile uzobeka ukuhlolwa kwegazi kwe-hormone bHCG kanye ne-ultrasound ukuqinisekisa ukuthi ukukhulelwa kuqhubeka kahle.