Isenzo esibalulekile ekuhlolweni kwe-gynecological gynecological, ukuhlolwa kwesitho sangasese sowesifazane kuvame ukwenziwa njalo ekuvakasheni ngakunye ku-gynecologist, futhi njalo ngesikhathi sokuqapha ukukhulelwa. Kodwa-ke, ukusebenziseka kwayo kanye nemvelo yayo ehlelekile kuye kwabuzwa eminyakeni yamuva.

Ukuthinta kuhlanganisa ukufaka iminwe emibili esithweni sangasese sowesifazane, ukuthinta kwesitho sangasese sowesifazane kwenza kube nokwenzeka ukunyakazisa izitho ze-pelvic zowesifazane ngaphakathi: isitho sangasese sowesifazane, isibeletho, isibeletho, ama-ovari. Nge-speculum evumela ukubona ngeso lengqondo umlomo wesibeletho, kuyisenzo esibalulekile sokuhlolwa kwezifo zabesifazane.

Udokotela (udokotela ohambelayo, udokotela wezifo zabesifazane noma umbelethisi) kufanele athole imvume yesiguli ngendlela ehlelekile ngaphambi kokwenza ukuhlolwa kwesitho sangasese sowesifazane.

Isiguli silele etafuleni le-auscultation, amathanga agobile nezinyawo zibekwe ku-stirrups, i-pelvis kahle emaphethelweni etafula. Ngemva kokufaka umbhede womunwe noma igilavu ​​engazali futhi egcotshiwe, udokotela wethula iminwe emibili ngaphansi kwesitho sangasese sowesifazane. Uqala ngokuzwa isitho sangasese sowesifazane, izindonga zaso, bese kulandela umlomo wesibeletho. Ngesinye isandla esibeke esiswini, uzobe esemboza isibeletho ngaphandle. Kuhambisana nokuthinta isitho sangasese sowesifazane, lokhu kushaywa kwenhliziyo kwenza kube nokwenzeka ukuqonda ubukhulu besibeletho, indawo yaso, ukuzwela kwaso, ukuhamba kwaso. Khona-ke ohlangothini ngalunye, ubamba ama-ovari efuna isisindo esingaba khona (i-fibroma, i-cyst, isimila).

Ukuwathinta esithweni sangasese ngokuvamile akubuhlungu, kodwa akujabulisi, ikakhulukazi uma isiguli sishubile. Isondelene futhi iyaxaka, lokhu kuhlolwa kwesatshwa abesifazane abaningi.

Ngesikhathi sokuhlolwa kwe-pelvic

Ukuhlolwa kwesitho sangasese sowesifazane kwenziwa ngesikhathi sokuvakasha kwezifo zabesifazane ukuze kuhlolwe umlomo wesibeletho, isibeletho nama-ovari ngokuvimbela. Ukuba wusizo kwayo kuma-systematics kuye kwangabaza eminyakeni yamuva nje izifundo ezihlukahlukene. Ngakho ucwaningo olwenziwa yi-American College of Physicians (ACP) lwaphetha ngokuthi ukuhlolwa kwesitho sangasese sowesifazane ngendlela ehlelekile okwenziwa phakathi nokuhlolwa kwabesifazane kwaminyaka yonke kwakungenamsebenzi, noma kuphambene, futhi kuncoma ukugcwaliseka kwakho kuphela lapho kunezimpawu ezithile: ukuphuma komchamo, ukopha okungajwayelekile, ubuhlungu, izinkinga zomgudu womchamo kanye nokungasebenzi kahle kwezocansi.

Kwabesifazane abakhulelwe

Ngesikhathi sokukhulelwa, ukuhlolwa kwesitho sangasese sowesifazane kukuvumela ukuba uhlole umlomo wesibeletho, ubude bawo, ukungaguquguquki nokuvuleka, kanye nobukhulu, ukuhamba, isikhundla nokuzwela kwesibeletho. Isikhathi eside, kwenziwa ngendlela ehlelekile ekuhambeleni ngakunye kokubeletha ukuze kutholwe ushintsho emlonyeni wesibeletho okungaba uphawu losongo lokubeletha ngaphambi kwesikhathi. Kodwa njengoba ezinye izifundo zingabaza ukufaneleka kwalesi senzo, odokotela abaningi baye babuyekeza ukwenza kwabo. Izincomo ze-HAS zika-2005 zokuqapha ukukhulelwa nazo ziya ngale ndlela.

I-HAS impela ikhombisa ukuthi ” esimweni samanje solwazi, azikho izimpikiswano zokwenza ukuhlolwa kwesitho sangasese sowesifazane okujwayelekile. Ukuhlolwa kwesitho sangasese sowesifazane okuhlelekile kowesifazane ongenazimpawu uma kuqhathaniswa nokuhlolwa okwenziwe ngenkomba yezokwelapha akwehlisi ubungozi bokuzalwa ngaphambi kwesikhathi.. I-ultrasound yomlomo wesibeletho nayo izonemba kakhudlwana ukuhlola umlomo wesibeletho.

Ngakolunye uhlangothi, uma kunezimpawu (ukufinyela okubuhlungu kwesibeletho), ” ukuhlolwa kwesitho sangasese sowesifazane ukuze kuhlolwe umlomo wesibeletho kubalulekile ukuze kutholakale usongo lokuzala ngaphambi kwesikhathi. Uhlola ukuvumelana komlomo wesibeletho, ubude bawo, ukunwebeka kanye nesimo. », Ukhumbula igunya.

Ngokusondela kokubeletha, ukuhlolwa kwesitho sangasese sowesifazane kwenza kube nokwenzeka ukubona izimpawu zokuvuthwa komlomo wesibeletho okubonisa ukubeletha okuseduze. Futhi kwenza kube nokwenzeka ukulawula ukuphakama kokwethulwa kombungu (okungukuthi ikhanda lomntwana noma izinqe zayo uma kwenzeka i-breech), nokuba khona kwengxenye engezansi, indawo encane evela ekupheleni kokukhulelwa phakathi komzimba kanye umlomo wesibeletho.

Ngosuku lokuzalwa komntwana, ukuhlolwa kwesitho sangasese sowesifazane kwenza kube nokwenzeka ukulandela ukuvulwa komlomo wesibeletho, kusukela ekusulweni kwawo kuze kufike ekuvuleni kwawo okuphelele, okungukuthi 10 cm. Ngaphambilini bezijwayezwa ngendlela ehlelekile ngesikhathi sokungeniswa ewodini lababelethayo, bese kuthi njalo ngehora elingu-1 kuye kwayi-2 ngesikhathi sokubeletha, ngo-2017 i-HAS ikhiphe izincomo ezintsha mayelana nokuphathwa kwesiguli ngesikhathi sokubeletha okuvamile:

• hlinzeka ngokuhlolwa kwesitho sangasese sowesifazane lapho emukelwa uma owesifazane ebonakala ebeletha;
• uma kwenzeka ukuphuka ngaphambi kwesikhathi kolwelwesi (RPM), kunconywa ukuthi ungakwenzi ukuhlolwa kwesitho sangasese sowesifazane ngokuhlelekile uma owesifazane engenakho ukufinyela okubuhlungu.
• phakamisa ukuhlolwa kwesitho sangasese sowesifazane njalo emahoreni amabili kuya kwamane esigabeni sokuqala sokubeletha (kusukela ekuqaleni kokufinyela okuvamile kuya ekuvulekeni ngokugcwele komlomo wesibeletho), noma ngaphambi kokuthi isiguli sikucela, noma uma kwenzeka kuba nophawu (ukuncipha komlomo wesibeletho). isigqi senhliziyo yengane, njll.).

Ngemva kokubeletha, ukuhlolwa kwesitho sangasese sowesifazane kusetshenziswa ukulawula ukuvela kwesibeletho, isigaba lapho isibeletho sithola khona usayizi waso kanye nomuthi waso wokuqala ngemva kokubeletha.

Uma ngesikhathi sokuhlolwa okujwayelekile kutholakala isigaxa ekuhlolweni kwesitho sangasese sowesifazane, kuzobekwa i-pelvic ultrasound.

Ngesikhathi sokukhulelwa, lapho kukhona ukuhlukunyezwa okubuhlungu okuhambisana nezinguquko emlonyeni wesibeletho, usongo lokubeletha ngaphambi kwesikhathi kufanele lwesatshwe. Abaphathi bayobe sebencike esigabeni sokukhulelwa.