Ukuhluleka Kwe-Cervix? Izimpawu, Izimbangela, Nokwelapha

I-cervix engasebenzi kahle kwenzeka lapho i-cervix yakho ivuleka ngokushesha kakhulu ngesikhathi sokukhulelwa, ngokuvamile ngaphandle kokuphefumula noma ukuqina. Lesi simo sithinta cishe okukodwa kwaba khulelwe abangu-100 futhi singabangela ukulahleka kokukhulelwa noma ukuzalwa kwangaphambi kwesikhathi uma kungalawulwa kahle.

Cabanga nge-cervix yakho njengomnyango oqinile okumele uhlale uvaliwe ngesikhathi sokukhulelwa ukuze ugcine ingane yakho iphephile ngaphakathi. Ngokuhluleka kwe-cervix, lomnyango uqala ukuvula lapho kufanele uhlale uvaliwe ngokuqinile kuze kube yilapho usukulungele ukubeletha.

Iyini i-cervix engasebenzi kahle?

I-cervix engasebenzi kahle, ebizwa nangokuthi ukungasebenzi kahle kwe-cervix, kwenzeka lapho i-cervix yakho iqala ukufushaneka nokukuvula ngesikhathi sesibili sokukhulelwa. Lokhu ngokuvamile kwenzeka phakathi kwamasonto angu-16 kuya kwangu-24, ngaphambi kokuba ingane yakho ikulungele ukuzalwa.

I-cervix yakho ingxenye engezansi yesisu sakho exhuma esiphundu sakho. Ngesikhathi sokukhulelwa okunempilo, ihlala isikhathi eside, ebukhulu, futhi ivaliwe ngokuqinile kuze kube yilapho kuqala ukubeletha. Lapho ukungasebenzi kahle kwe-cervix kwenzeka, i-cervix ayikwazi ukubamba isisindo sengane yakho ekhula nesiminyaminya.

Lesi simo sivame ukubizwa ngokuthi “sothile” ngoba ngokuvamile alibangeli izimpawu ezivamile zokubeletha njengokuqina okuhlungu. Abesifazane abaningi abazi ukuthi kukhona okungalungile kuze kube yilapho bezwa ukucindezela noma beqaphela izinguquko ngesikhathi sokuvakasha okujwayelekile kokukhulelwa.

Ziyini izimpawu zokuhluleka kwe-cervix?

Into enzima mayelana nokungasebenzi kahle kwe-cervix ukuthi ngokuvamile ayibangeli izimpawu ezicacile ezigabeni zokuqala. Awungase ungabi nazimpawu ezivamile zokuqaphela ezihambisana nezinye izinkinga zokukhulelwa.

Nazi izimpawu ongaziqaphela:

• Ukuzwa ukucindezela noma ukugcwaliswa kwesifuba
• Ubuhlungu obuthambile emuva obuza futhi buyaphela
• Ukuphuma igazi okukhanyayo noma ukugqwala
• Izinqubo ekuphumeni kwesifuba
• Ukuqina okuncane esiswini sakho
• Ukuzwa ukuthi ingane yakho “icindezela phansi”

Ezigabeni eziphambili, ungase ube nokuzwa okufana nokuqina kokubeletha kwangaphambi kwesikhathi. Abanye abesifazane baqaphela ushintsho ekuphumeni kwabo kwesifuba, okungase kube bukhulu noma kube nombala noma iphunga elihlukile.

Ukungabikho kobuhlungu obukhulu yilokho okwenza lesi simo sikhathaza ngokukhethekile. Ngokungafani nokubeletha kwangaphambi kwesikhathi okujwayelekile, ukungasebenzi kahle kwe-cervix ngokuvamile kuqhubeka ngokuthula, kungakho ukuhlolwa okujwayelekile kokukhulelwa kubaluleke kakhulu ekutholeni kwangaphambi kwesikhathi.

Yini ebangela ukuhluleka kwe-cervix?

Ukungasebenzi kahle kwe-cervix kungathuthukiswa ngezizathu eziningi, futhi ngezinye izikhathi isizathu esiqondile asiqondakali. Ukuqonda lezi zizathu kungakusiza wena nodokotela wakho ukuhlola ingozi yakho nokuhlela ukunakekelwa okufanele.

Izimbangela ezivamile zihlanganisa:

• Ukulimala kwangaphambili kwe-cervix okuvela ezindleleni njenge-LEEP, i-cone biopsy, noma izindlela eziningi ze-D&C
• Izici ze-genetic ezithinta ukukhiqizwa kwe-collagen, okwenza ukuthi i-tissue ye-cervix ibe buthakathaka
• Ukungaqondakali komzimba owazalwa nawo
• Ukuzalwa kwangaphambi kwesikhathi kwangaphambili noma ukulahleka kokukhulelwa ngesikhathi sesibili sokukhulelwa
• Ukuvezwa yi-DES (diethylstilbestrol) lapho usesiswini sikamama wakho
• Ukuqhekeka okukhulu kwe-cervix ngesikhathi sokubeletha kwangaphambili

Izimbangela ezingavamile zihlanganisa izifo ezithile ze-connective tissue njenge-Ehlers-Danlos syndrome, ethinta indlela umzimba wakho okwenza ngayo i-collagen. Abanye abesifazane bathuthukisa ukungasebenzi kahle kwe-cervix ngemuva kokuba nezindlela eziningi e-cervix yabo ukuze baphathe amaseli angavamile.

Ezimweni eziningi, ukungasebenzi kahle kwe-cervix kubonakala kuthuthukela emindenini, okubonisa izingxenye ze-genetic. Noma kunjalo, ukuba nalezi zici zengozi akusho ukuthi uzokuthuthukisa lesi simo ngokuqinisekile - abesifazane abaningi abanezici zengozi banokukhulelwa okujwayelekile ngokuphelele.

Nini okumele ubheke udokotela ngokuhluleka kwe-cervix?

Kufanele uxhumane nodokotela wakho ngokushesha uma uqaphela noma yiziphi izimpawu ezingavamile ngesikhathi sesibili sokukhulelwa, ikakhulukazi uma unezici zengozi zokungasebenzi kahle kwe-cervix. Ukuthola kwangaphambi kwesikhathi kungenza umehluko omkhulu ekuphumeni kokukhulelwa kwakho.

Shaya udokotela wakho ngokushesha uma uqaphela ukucindezela kwesifuba okufana nokuthi ingane yakho iyacindezela phansi, ngisho noma awunayo ukuqina. Lesi simo, ikakhulukazi uma sihlangene nobuhlungu emuva noma izinguquko ekuphumeni, sidinga ukuhlolwa ngokushesha.

Uma unembali yokulahleka kokukhulelwa ngesikhathi sesibili sokukhulelwa, xoxa nodokotela wakho ngokungasebenzi kahle kwe-cervix ekuqaleni kokukhulelwa kwakho. Bangase bancoma ukuqapha okuningi noma ukwelashwa okuvimbela ukuze kusize ukuvikela ukukhulelwa kwakho kwamanje.

Ungalindi ukubona ukuthi izimpawu ziyaqina. Ngokungasebenzi kahle kwe-cervix, isikhathi sivame ukubaluleka, futhi ukungenelela kwangaphambi kwesikhathi kungasiza ukuvimbela ukulahleka kokukhulelwa noma ukuzalwa kwangaphambi kwesikhathi kakhulu.

Ziyini izici zengozi zokuhluleka kwe-cervix?

Izici eziningi zingandisa amathuba akho okuthuthukisa ukungasebenzi kahle kwe-cervix, yize ukuba nalezi zici zengozi akusho ukuthi uzobhekana nalesi simo. Ukuqonda ingozi yakho siqu kusiza udokotela wakho ukunikeza ukunakekelwa okungcono kakhulu.

Izici eziyinhloko zengozi zihlanganisa:

• Ukulahleka kokukhulelwa kwangaphambili phakathi kwamasonto angu-16-24 ngaphandle kwesizathu esicacile
• Umbali wokubeletha kwangaphambi kwesikhathi, ikakhulukazi uma i-cervix yakho ivuleke ngaphandle kokuba nokuqina
• Izindlela zangaphambili ze-cervix njenge-LEEP, i-cone biopsy, noma i-cold knife conization
• Ukuphela kokukhulelwa okuningi noma izindlela ze-D&C
• Ukuzalwa ngokungaqondakali kwesisu noma i-cervix
• Ukusetshenziswa yi-DES umama ngesikhathi sokukhulelwa
• Izifo ze-connective tissue ezithinta ukukhiqizwa kwe-collagen

Abanye abesifazane bane lokho odokotela abakubiza ngokuthi “ukungasebenzi kahle kwe-cervix okutholwe,” okuthuthukela ngemuva kokulimalala kwe-cervix. Abanye bane-insufficiency “yokuzalwa,” okusho ukuthi bazalwa ne-cervix ebuthakathaka noma emfushane kunokujwayelekile.

Ingozi yakho ingase ibe phezulu uma uthwala abaningi njengezintandane noma iziqongo ezintathu, njengoba isisindo esengeziwe sibeka ukucindezela okuningi e-cervix yakho. Noma kunjalo, abesifazane abaningi abanezici eziningi zengozi baqhubeka benokukhulelwa okuphumelelayo ngokuqapha okufanele nokunakekelwa.

Ziyini izinhlanganisela ezingaba khona zokuhluleka kwe-cervix?

Lapho ukungasebenzi kahle kwe-cervix kungatholakali noma kungaphathwa ngokushesha, kungabangela izinkinga ezinkulu zokukhulelwa. Ukuqonda lezi ziphumo ezingaba khona kusiza ukuchaza ukuthi ukubona kwangaphambi kwesikhathi nokuphathwa kubaluleke kangakanani.

Izinhlanganisela ezinkulu kakhulu zihlanganisa:

• Ukulahleka kokukhulelwa kwesikhathi sesibili (ukuphulukana nokukhulelwa ngemuva kwamasonto angu-16)
• Ukuzalwa kwangaphambi kwesikhathi kakhulu (ngaphambi kwamasonto angu-28)
• Ukuqhekeka kwangaphambi kwesikhathi kwangaphambi kwesikhathi kwemiminyaminya (amanzi aphuma ngokushesha)
• Ukutheleleka kwesiminyaminya (chorioamnionitis)
• Izinhlanganisela ezinzima ezihlobene nokuzalwa kwangaphambi kwesikhathi kakhulu kwingane yakho

Izingane ezazalwa ngokushesha kakhulu zibhekene nezinselele ezinkulu, kuhlanganise nezinkinga zokuphefumula, ubunzima bokuqopha, nokulibaziseka ekuthuthukiseni. Ukuzalwa kwangaphambi kwesikhathi, lezi zinhlanganisela ziyaqina.

Ezimweni ezingavamile, lesi simo singabangela lokho okuthiwa “ukwehla kwe-cervix,” lapho imiminyaminya iphuma nge-cervix evulekile. Lesi simo sidinga ukunakekelwa kwezokwelapha ngokushesha futhi ngokuvamile ukungenelela okusheshayo ukuze kuvivinyelwe ukusindisa ukukhulelwa.

Izindaba ezinhle ukuthi ngokuxilongwa okufanele nokuphathwa, izinhlanganisela eziningi zingaqalekelwa noma ubukhulu bazo bunciphise kakhulu.

Ukuhluleka kwe-cervix kungavikeleka kanjani?

Nakuba ungakwazi ukuvimbela zonke izimo zokungasebenzi kahle kwe-cervix, kunezinyathelo ongazithatha ukuze unciphise ingozi yakho, ikakhulukazi uma unezici zengozi ezaziwayo. Ukuvimbela ngokuvamile kugxila ekuvikeleni i-cervix yakho ekulimala okungadingekile nokuthola ukunakekelwa okujwayelekile kokukhulelwa.

Uma udinga izindlela ze-cervix ngezizathu zezokwelapha, xoxa nodokotela wakho ukuthi unganciphisa kanjani umthelela ongafanele ezikhulelweni zesikhathi esizayo. Ngezinye izikhathi ukwelashwa okunye noma amasu ashintshiwe kunganciphisa ingozi yokuthambisa kwe-cervix.

Kwabesifazane abalahlekelwe ukukhulelwa kwangaphambili noma abanezici zengozi ezaziwayo, ukunakekelwa okujwayelekile kokukhulelwa kwangaphambi kwesikhathi kubalulekile. Udokotela wakho angase ancome ukuqapha ubude be-cervix uqale cishe ngamasonto angu-16 ukuze abone noma yiziphi izinguquko ngaphambi kokuba zibe nzima.

Ukuqeda izindlela ezingadingekile ze-cervix nokuvimbela inani lokuphela kokukhulelwa kungasiza futhi ekuvikeleni i-cervix yakho. Uma udinga lezi zindlela, qiniseka ukuthi zenziwa ngabahlinzeki abanolwazi abaqonda ukuthi unganciphisa kanjani ukulimala kwe-cervix.

Ukuhluleka kwe-cervix kuhlonzwa kanjani?

Ukuhlonzwa kokungasebenzi kahle kwe-cervix ngokuvamile kuhilela ukuxuba komlando wakho wezokwelapha, ukuhlolwa komzimba, nokuqapha kwe-ultrasound. Udokotela wakho uzobheka izinguquko ezithile e-cervix yakho ezibonisa ukuthi iqala ukuvula ngokushesha kakhulu.

Amathuluzi ayinhloko okuxilonga ahlanganisa i-transvaginal ultrasound, elinganisa ubude be-cervix yakho futhi ibheke ukufunwa (lapho ingxenye yangaphakathi ye-cervix iqala ukuvula). Ubude be-cervix obuphansi kune-25mm ngaphambi kwamasonto angu-24 kubhekwa njengokukhathaza futhi kungabonisa ukungasebenzi kahle.

Udokotela wakho uzoqhuba futhi ukuhlolwa komzimba ukuze ahlole ukuthi i-cervix yakho ithambe, imfushane, noma ivuleke ngokuyinhlanganisela. Bazokubuzisa imibuzo eminingi mayelana nezimpawu zakho futhi bahlole umlando wakho wokukhulelwa nganoma yiziphi izindlela ezibonisa ukungasebenzi kahle kwe-cervix.

Ezimweni ezithile, ukuhlonzwa kwenzeka ngemuva kwesikhathi - okusho ukuthi odokotela baqaphela ukuthi ube nokungasebenzi kahle kwe-cervix ngokusekelwe kulokho okwenzeke ekuthathweni kokukhulelwa kwangaphambili. Lolu lwazi bese lusiza ukuqapha nokuphatha izikhulelwa zesikhathi esizayo ngokuphumelelayo.

Iyini ukwelashwa kokungasebenzi kahle kwe-cervix?

Ukwelashwa kokungasebenzi kahle kwe-cervix kugxila ekuhlinzekeni ngokusekela okwengeziwe ukuze kugcinwe i-cervix yakho ivaliwe kuze kube yilapho ingane yakho ikulungele ukuzalwa. Izindlela eziyinhloko zokwelapha ziyahlukahluka kuye ngesimo sakho esithile nokuthi ukhulelwe kangakanani.

Ukwelashwa okuyinhloko kuhlanganisa:

• I-cervical cerclage - inqubo yokwelapha ebeka izintambo e-cervix yakho ukuze ihlale ivaliwe
• Ukusetshenziswa kwe-progesterone ukuze kusize ukugcina ukukhulelwa
• Ukunciphisa umsebenzi noma ukulala ebethe
• Ukuqapha okuvamile nge-ultrasounds
• I-cervical pessary - idivayisi ye-silicone efakwe ukusekela i-cervix

I-cervical cerclage ngokuvamile iyindlela yokwelapha ephumelelayo futhi ngokuvamile ifakwa phakathi kwamasonto angu-12-14 okukhulelwa uma unembali yokungasebenzi kahle kwe-cervix. Le nqubo ngokuvamile yenziwa ngaphansi kokwelashwa kwe-spinal noma okuphelele futhi ithatha cishe imizuzu engu-30.

Udokotela wakho angase ancome futhi izithasiselo ze-progesterone, njenge-vaginal suppositories noma ukugonywa. I-progesterone iyasiza ekugcineni ukukhulelwa futhi ingaqinisa i-cervix. Ukushintsha komsebenzi akusho ukulala ebethe ngokuphelele kodwa kunalokho ukugwema ukuphakamisa okukhulu nemisebenzi enzima.

Uhlelo oluthile lokwelapha luzoxhomeka ezimweni zakho zomuntu siqu, kuhlanganise nomlando wakho wokukhulelwa, izimpawu zakho zamanje, nokuthi i-cervix yakho ibukeka kanjani e-ultrasound.

Ungayiphatha kanjani i-cervix engasebenzi kahle ekhaya?

Ukuphatha ukungasebenzi kahle kwe-cervix ekhaya kuhilela ukulandela iziphakamiso zedokotela wakho ngokucophelela ngenkathi uqaphela noma yiziphi izinguquko ezimpawu zakho. Uhlelo lwakho lokuphatha ekhaya luzolungiswa kuye ngesimo sakho esithile nendlela yokwelapha.

Uma udokotela wakho encoma ukushintsha komsebenzi, lokhu ngokuvamile kusho ukugwema ukuphakamisa okukhulu, ukuqina isikhathi eside, nemisebenzi enzima. Awudingi ukulala ebethe ngokuphelele, kodwa kufanele uzilawule futhi uphumule uma uzwa ukukhathala noma ukucindezela kwesifuba.

Qapha izimpawu zakho nsuku zonke futhi ugcine ulandelela noma yiziphi izinguquko ekuphumeni, ekuqineni, noma ekucindezela kwesifuba. Odokotela abaningi bancoma ukugcina ilog yendlela ozizwa ngayo nsuku zonke, okungasiza ekutholeni izindlela noma izinguquko.

Hlala uthambile futhi ugcine ukudla okuhle ukuze usekele impilo yakho jikelele nokukhulelwa. Gwema ukuvimbela ngokudla ukudla okunamafutha amaningi nokupha amanzi amaningi, njengoba ukucindezela kungafaka ukucindezela okwengeziwe e-cervix yakho.

Landela yonke imiqhudelwano ehlelwe ngokwethembeka, ngisho noma uzizwa kahle. Ukuqapha okujwayelekile kubalulekile ekutholeni noma yiziphi izinguquko ngaphambi kokuba zibe yizinkinga ezinkulu.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yedokotela?

Ukulungiselela i-aphoyintimenti yakho kusiza ukuqinisekisa ukuthi uthola ukunakekelwa okuphelele kakhulu futhi ubuzwe zonke imibuzo yakho. Woza ulungele ukuxoxa ngezimpawu zakho, ukukhathazeka, nomlando wokukhulelwa ngokuningiliziwe.

Bhala zonke izimpawu zakho, kuhlanganise nokuthi zaqala nini nokuthi yini ezenza zibe ngcono noma zibe zimbi. Qaphela noma yiziphi izindlela oziqaphile, njengezimpawu ezivela ngezikhathi ezithile zosuku noma ngemisebenzi ethile.

Letha uhlu oluphelele lwemithi yakho, izithasiselo, nanoma yiziphi izinkinga zokukhulelwa kwangaphambili. Uma uke waba nezindlela ze-cervix esikhathini esidlule, letha lezo zirekhodi noma wazi izinsuku nezinhlobo zezindlela.

Lungiselela uhlu lwemibuzo mayelana nezindlela zakho zokwelapha, ukunciphisa umsebenzi, nokuthi yiziphi izimpawu zokuqaphela okumele uzibone. Unganqikazi ukubuza nganoma yini ongayiqondi - udokotela wakho ufuna ukuba uqonde kahle ngesimo sakho.

Cabanga ngokuletha umuntu osekela, ikakhulukazi uma uzizwa ukukhathazeka ngokuxilongwa noma izindlela zokwelapha. Ukuba nomuntu lapho kungakusiza ukukhumbula ulwazi olubalulekile nokunikeza ukusekelwa ngokomzwelo.

Iyini into ebalulekile mayelana nokuhluleka kwe-cervix?

Into ebaluleke kakhulu okumele uyikhumbule mayelana nokungasebenzi kahle kwe-cervix ukuthi ukuthola kwangaphambi kwesikhathi nokuphathwa okufanele kungathuthukisa kakhulu imiphumela yokukhulelwa. Abesifazane abaningi abanesimo esinjalo baqhubeka beba nezingane ezine-mpilo ngokunakekelwa okufanele kwezokwelapha.

Uma unezici zengozi noma ube nokulahleka kokukhulelwa ngesikhathi sesibili sokukhulelwa, unganqikazi ukuxoxa nodokotela wakho wezokwelapha ngokuhluleka kwe-cervix ekuqaleni kokukhulelwa. Ukuqapha nokwelashwa okuqaphayo kungenza umehluko omkhulu.

Khumbula ukuthi ukuba nokungasebenzi kahle kwe-cervix akusho ukuthi awukwazi ukuba nezikhulelwa eziphumelelayo esikhathini esizayo. Ngokunakekelwa okufanele kwezokwelapha, abesifazane abaningi abanesimo esinjalo baletha izingane ezine-mpilo, ezigcwele.

Hlala uxhumene neqembu lakho lezokunakekelwa kwezokwelapha, landela iziphakamiso zabo, futhi ungawagcini noma yiziphi izimpawu ezikhathazayo. Indlela yakho eqaphayo yokuphatha lesi simo ingenye yezinto ezinhle kakhulu ongazenza kokubili wena nengane yakho.

Imibuzo evame ukubuzwa mayelana nokuhluleka kwe-cervix

Ingaphiliswa ngokuphelele yini i-cervix engasebenzi kahle?

Ukungasebenzi kahle kwe-cervix yisimo esithinta izikhulelwa zomuntu siqu kunokuthile okungaphiliswa ngokuphelele. Noma kunjalo, abesifazane abaningi bathwala ngempumelelo izikhulelwa kuze kube yilapho bebeletha ngokwelashwa okufanele nokuqapha. Ukuthathwa kokukhulelwa ngakunye kufanele kuhlolwe ngokuzimela, futhi ukwelashwa njenge-cerclage kungaba nempumelelo kakhulu ekuvimbeleni ukulahleka kokukhulelwa.

Ngingalahlekelwa yini ngokuqinisekile ukukhulelwa kwami uma ngine-cervix engasebenzi kahle?

Cha, ukuba nokungasebenzi kahle kwe-cervix akusho ukuthi uzophulukana ngokuzenzakalelayo nokukhulelwa kwakho. Ngokuthola kwangaphambi kwesikhathi nokuphathwa okufanele, abesifazane abaningi abanesimo esinjalo baletha izingane ezine-mpilo. Ikhona ukusebenzisana eduze nodokotela wakho ukuze uqaphe i-cervix yakho futhi ufake ukwelashwa uma kudingeka.

Ngingaba nokubeletha okujwayelekile ngemuva kwe-cervical cerclage?

Yebo, abesifazane abaningi abaye baba ne-cervical cerclage bangaba nokubeletha kwesifuba. I-cerclage ngokuvamile isuswa cishe ngamasonto angu-36-37 okukhulelwa, futhi ngokuvamile ungakwazi ukubeletha ngokujwayelekile ngemuva kwalokho. Udokotela wakho uzoxoxa ngohlelo lokubeletha oluhle kakhulu ngokusekelwe esimweni sakho esithile nendlela ukukhulelwa kwakho okuqhubeka ngayo.

Ukuhluleka kwe-cervix kungatholakala nini ekuqaleni kokukhulelwa?

Ukungasebenzi kahle kwe-cervix ngokuvamile kuqapha cishe ngamasonto angu-16-20 okukhulelwa, njengoba lokhu kuyilapho izinguquko ze-cervix ngokuvamile ziqala ukuvela. Uma unembali yesimo, udokotela wakho angase aqhube ukuqapha ngokushesha. I-transvaginal ultrasounds ejwayelekile ingathola ukufushaneka kwe-cervix ngaphambi kokuba ube nezimpawu.

Ingabe ukuhluleka kwe-cervix kuthinta ukukhulelwa noma ukukhulelwa?

Ukungasebenzi kahle kwe-cervix ngokuvamile akukuthinti ukukwazi kwakho ukukhulelwa, njengoba kuyinkinga ethile eyenzeka ngesikhathi sokukhulelwa kunokuthola. Noma kunjalo, uma uke waba nezindlela eziningi ze-cervix ezaholela esimweni, kungase kube nomthelela ekukhulelweni. Xoxa ngalokhu nodokotela wakho lapho uhlela izikhulelwa zesikhathi esizayo.