Ukukhulelwa Kwesisu Sokhulelwa? Izimpawu, Izimbangela, Nokwelashwa

Ukukhulelwa kwesisu sokukhulelwa kwenzeka lapho ithusi okufanele libe yingane likhula ngokungavamile esizwini sakho esiswini. Le nkinga yokukhulelwa engaqondakali kwenzeka cishe ku-1 kuzo zonke izingane ezingu-1,000 ezikhulelwe, futhi nakuba kungase kuzwakale kukhulu ukufunda ngakho, kubalulekile ukwazi ukuthi ngokunakekelwa okufanele kwezokwelapha, abantu abaningi baqhubeka bekhulelwa impilo kamuva.

Kuyini ukukhulelwa kwesisu sokukhulelwa?

Ukukhulelwa kwesisu sokukhulelwa yiluhlobo lwesifo se-gestational trophoblastic lapho ithusi elingavamile likhula esizwini sakho esiswini esikhulu kunokukhulelwa okuvamile okukhula. Cabanga ngakho njengokuthi ama-hormone okukhulelwa omzimba wakho athola izimpawu eziphambene, okubangela ukuthi ithusi elifana ne-placenta likhule kakhulu noma ngendlela engafanele.

Lokhu kwenzeka ngqo ekuqaleni kokukhulelwa lapho kukhona into eyenzeka kabi nge-genetic material evela kwesikhumba ne-sperm. Umzimba wakho usakhiqiza ama-hormone okukhulelwa, ngakho-ke uzothola ukuhlolwa kokukhulelwa okuhle, kodwa ukukhulelwa akunakukhula ngokujwayelekile noma kuphile.

Ziyini izinhlobo zokukhulelwa kwesisu sokukhulelwa?

Kunezinhlobo ezimbili eziyinhloko zokukhulelwa kwesisu sokukhulelwa, nokuqonda umehluko kungakusiza ukwazi ukuthi yini okulindelekile. Ukukhulelwa okuphelele kwesisu sokukhulelwa kwenzeka lapho i-sperm likhulelwa iqanda elingenalutho elingenalo i-genetic material, likhiqiza kuphela ithusi elingavamile le-placenta elingenayo ingane noma isikhwama se-amniotic.

Ukukhulelwa okulinganiselwe kwesisu sokukhulelwa kwenzeka lapho ama-sperm amabili ekhulelwa iqanda elilodwa elijwayelekile, akhiqize ithusi elilodwa le-placenta elilodwa kanye nethusi elingavamile. Kulolu hlobo, kungase kube khona ithusi le-fetal elikhona, kodwa alinakukhula libe yingane enempilo ngenxa ye-genetic abnormalities.

Ziyini izimpawu zokukhulelwa kwesisu sokukhulelwa?

Izimpawu zokuqala zokukhulelwa kwesisu sokukhulelwa zivame ukuzwakala njengokukhulelwa okujwayelekile, yingakho kungase kudideke futhi kukhathaze lapho kukhona into ehluke kakhulu. Ungase ube nezibonakaliso eziqondene nokukhulelwa njengezinyanga eziphuthelwe, ukuncipha kwamabele, nokugula ekuseni ekuqaleni.

Kodwa-ke, izimpawu ezithile zingabonisa ukuthi kukhona into engaqondakali eyenzeka ngokukhulelwa kwakho:

• Ukuphuma kwegazi noma ukugqwala, ikakhulukazi igazi elibomvu noma elimnyama
• Ukugula okukhulu nokuhlanza okubi kakhulu kunokugula okujwayelekile ekuseni
• Ukukhula okusheshayo kwesisu esikhulu okukwenza ubukeke ukhule kakhulu kunamadethi akho
• Ukuphuma igazi elikhulu ngaphambi kwesikhathi esivamile ekukhulelweni
• Ukudlula ithusi elifana ne-grape noma ama-clots e-vagina yakho
• Ukuthwala noma ubuhlungu besiswini esikhulu okubukeka kuhlukile kunokungakhululeki okujwayelekile kokukhulelwa

Abanye abantu nabo baye bahlangabezana nezimpawu ezingavamile kodwa okubalulekile ukuzazi. Lokhu kuhlanganisa izinhlungu ezinzima kakhulu, ukushintsha kombono, noma ukukhula ezandleni nasebusweni bakho ngaphambi kwesikhathi esivamile sokukhula kokukhulelwa.

Kubalulekile ukuqaphela ukuthi izimpawu eziningi zingahambisana nezinye izinkinga zokukhulelwa, ngakho-ke ukuhlangabezana nazo akusho ukuthi une-molar pregnancy. Yingakho kubalulekile ukuhlala uxhumana nodokotela wakho mayelana nanoma yikuphi ukukhathazeka.

Yini ebangela ukukhulelwa kwesisu sokukhulelwa?

Ukukhulelwa kwesisu sokukhulelwa kubangelwa amaphutha e-genetic aqhubeka ngesikhathi sokukhulelwa, hhayi yikho okwenzile noma awukwenzanga. La maphutha enzeka ngokungahleliwe lapho iqanda ne-sperm zihlangana, zidala ukuxuba okungavamile kwe-genetic material.

Ekukhulelweni okuphelele kwesisu sokukhulelwa, iqanda lilahlekelwa yi-genetic material yalo yonke ngaphambi noma ngesikhathi sokukhulelwa. Lapho i-sperm likhulelwa leli qanda “elingenalutho”, i-genetic material kayise kuphela elikhona, okubangela ukukhula okungavamile kwethusi esikhulu kunokukhula okujwayelekile kwesilwane.

Ngokuphathelene nokukhulelwa okulinganiselwe kwesisu sokukhulelwa, iphutha le-genetic liyenzeka lapho ama-sperm amabili ekhulelwa iqanda elilodwa elijwayelekile ngesikhathi esifanayo. Lokhu kudala ukukhulelwa okune-genetic material eningi kakhulu, okumisa ukukhula okujwayelekile futhi kubangela ukukhula okungavamile kwethusi.

Lezi zinhlekelele ze-genetic zingaqondakali futhi azinakuvimbeka ngokushintsha indlela yokuphila noma ukungenelela kwezokwelapha. Azibangelwa yikho konke endaweni yakho, ukudla, noma umlando wakho wezokwelapha wangaphambili.

Nini okufanele ubona udokotela ngokukhulelwa kwesisu sokukhulelwa?

Kufanele uxhumane nodokotela wakho ngokushesha uma uhlangabezana nokuphuma kwegazi e-vagina ngesikhathi sokukhulelwa, ikakhulukazi uma kuhambisana nokugula okukhulu noma ubuhlungu besiswini esikhulu. Nakuba ukuphuma igazi kungenzeka ekukhulelweni okujwayelekile, kubalulekile ukuhlolwa ukuze kutholakale imbangela.

Funani usizo lwezokwelapha oluphuthumayo uma udlula ithusi elibukeka njenge-grape noma amaqembu amancane, njengoba lokhu kungaba uphawu oluqondene nokukhulelwa kwesisu sokukhulelwa. Ngaphezu kwalokho, uma ukugula kwakho ekuseni kuya kubi kangangokuba awukwazi ukugcina ukudla noma amanzi, lokhu kudinga ukuhlolwa kwezokwelapha ngokushesha.

Ezinye izimpawu ezinkulu ezidinga ukunakekelwa kwezokwelapha ngokushesha zihlanganisa izinhlungu ezinzima ngokuzumayo, ukushintsha kombono, noma ukukhula ebusweni nasezandleni ngesikhathi sokukhulelwa sokuqala. Lezi zimpawu zingabonisa izinkinga ezidinga ukwelashwa ngokushesha.

Ziyini izimbangela zokukhulelwa kwesisu sokukhulelwa?

Nakuba ukukhulelwa kwesisu sokukhulelwa kwenzeka ngokungahleliwe, izici ezithile zingakhuphula kancane ingozi yakho yokuba nayo. Iminyaka idlala indima, ngabesifazane abaneminyaka engaphansi kuka-20 nabaneminyaka engaphezu kuka-35 abanephupho elikhulu lokukhulelwa kwesisu sokukhulelwa.

Isizinda sakho sobuzwe singase futhi sithinte ingozi, njengoba ukukhulelwa kwesisu sokukhulelwa kwenzeka kakhulu kwabesifazane base-Asia. Kodwa-ke, kubalulekile ukukhumbula ukuthi lezi zikhulelwa zingaba kubantu abangakwazi ukubheka.

Umlando wokukhulelwa wangaphambili nawo ubalulekile. Uma uke waba nokukhulelwa kwesisu sokukhulelwa, ingozi yakho yokuba nayo enye iyakhuphuka kancane, nakuba ingozi iyonke ihlala iphansi. Ukuba ne-miscarriages eminingi kungase futhi kukhuphule kancane ingozi yakho.

Izici zokudla, ikakhulukazi amazinga aphansi e-vitamin A ne-protein ekudleni kwakho, ziye zahlanganiswa nengozi ephakeme kwezinye izifundo. Kodwa-ke, uxhumano alucaci ngokuphelele, futhi ukukhulelwa okuningi kwesisu sokukhulelwa kwenzeka kwabesifazane abanokudla okujwayelekile.

Ziyini izinkinga ezingase zenzeke ngokukhulelwa kwesisu sokukhulelwa?

Inkinga ebaluleke kakhulu yokukhulelwa kwesisu sokukhulelwa yi-persistent gestational trophoblastic disease, lapho ithusi elingavamile liqhubeka likhula ngisho nasemuva kokwelashwa. Lokhu kwenzeka cishe ku-15-20% yokukhulelwa okuphelele kwesisu sokukhulelwa futhi kudinga ukwelashwa okwengeziwe nge-chemotherapy.

Ukuphuma igazi okukhulu yinkinga enkulu enye engase ibe khona ngesikhathi noma ngemuva kokususa ithusi le-molar. Iqembu lakho lezokunakekelwa kwezempilo lizokunakekela eduze ngezibonakaliso zokuphuma igazi okukhulu futhi lilungele ukulwelapha ngokushesha uma kwenzeka.

Ezimeni ezingavamile, ukukhulelwa kwesisu sokukhulelwa kungabangela izinkinga ezinzima kakhulu:

• I-Choriocarcinoma, uhlobo lomdlavuza olungase ukhule ethusi elingavamile
• Izinkinga zokuphefumula uma ithusi lisakazeka emaphashini
• I-Anemia enkulu ngenxa yokulahlekelwa igazi okuqhubekayo
• Izinkinga ze-thyroid ngenxa yamazinga aphezulu kakhulu ama-hormone okukhulelwa
• Izimpawu ezifana ne-Preeclampsia kuhlanganise ukuphakama kwegazi ne-protein emathisini

Nakuba lezi zinkinga zizwakala zesabekisa, kubalulekile ukwazi ukuthi ngokunakekelwa okufanele kwezokwelapha nokubhekwa, abantu abaningi bayaphila ngokuphelele. Ikhona ukuxhumana neqembu lakho lezokunakekelwa kwezempilo nokulandela isimiso sabo sokubhekwa esinconywayo.

Ukukhulelwa kwesisu sokukhulelwa kuhlonzwa kanjani?

Ukuhlonzwa kokukhulelwa kwesisu sokukhulelwa ngokuvamile kuqala ngokuhlolwa kwesisu esikhulu ne-ultrasound lapho ubika izimpawu ezinkulu. I-ultrasound izobonisa izibonakaliso eziqondene nezinto ezibukeka ezihlukile kunokukhulelwa okujwayelekile, ngokuvamile zichazwa njengokubonakala “kweqhwa” esikrinini.

Udokotela wakho uzohlola namazinga akho egazi e-hCG (human chorionic gonadotropin), i-hormone yokukhulelwa. Ekukhulelweni kwesisu sokukhulelwa, la mazinga avame ukuphakama kakhulu kunalokho okulindelekile ngokuthi ukhule kangakanani, okunikeza izeluleko ezibalulekile zokuhlola.

Izivivinyo ezengeziwe zingase zihlanganise ukubalwa kwegazi okuphelele ukuze kuhlolwe i-anemia, ukuhlolwa komsebenzi we-thyroid njengoba i-hCG ephakeme ingathinta i-thyroid yakho, kanye ne-chest X-rays ukuqinisekisa ukuthi ithusi elingavamile alikaze lisakazeke emaphashini akho.

Ngezinye izikhathi ukuhlonzwa akucaci ngokuphelele kuze kube emva kwesenzo esibizwa ngokuthi i-dilation and curettage (D&C), lapho ithusi eliqediwe lihlolwa ngaphansi komkhiqizo. Lokhu kuhlalutya okuqinile kwethusi kuqinisekisa ukuhlonzwa futhi kusiza ukuqonda uhlobo oluthile lokukhulelwa kwesisu sokukhulelwa.

Ukuphathwa kokukhulelwa kwesisu sokukhulelwa kuyini?

Ukuphathwa kokukhulelwa kwesisu sokukhulelwa kuhilela ukususa yonke ithusi elingavamile esizwini sakho esiswini ngesenzo esibizwa ngokuthi i-suction curettage noma i-dilation and curettage (D&C). Lesi senzo sangaphandle senziwa ngaphansi kokwelashwa futhi ngokuvamile kuthatha imizuzu engu-15-30.

Ngemva kokususa ithusi, uzodinga ukunakekelwa okuqhubekayo kokulandelela amazinga akho e-hCG. Udokotela wakho uzohlola la mazinga ama-hormone masonto onke ekuqaleni, bese uqhubeka nenyanga yonke, ukuqinisekisa ukuthi abuyela ezingeni elijwayelekile futhi bahlale khona.

Isikhathi sokulandelela sibalulekile futhi ngokuvamile sihlala izinyanga eziyi-6-12. Ngalesi sikhathi, uzodinga ukugwema ukukhulelwa ukuze uqinisekise ukulandelela okuqondile kwamazinga akho ama-hormone. Iqembu lakho lezokunakekelwa kwezempilo lizoncoma izindlela zokuvimbela ukukhulelwa ezinokwethenjwa ngalesi sikhathi.

Uma amazinga akho e-hCG engahluli njengoba kulindelekile noma aqale ukukhuphuka futhi, ungase udinga ukwelashwa okwengeziwe nge-chemotherapy. Nakuba lokhu kuzwakala kesabekisa, imithi esetshenziswayo isebenza kakhulu kule nkinga, futhi abantu abaningi bayaphendula kahle ekwelapheni.

Indlela yokuphatha ukuphulukiswa ekhaya?

Ukuphulukiswa ekhaya ngemuva kokwelashwa kokukhulelwa kwesisu sokukhulelwa kugxile ekuphulukiseni komzimba nasempilweni yengqondo. Ungalindela ukuphuma kwegazi e-vagina nokubamba isikhathi esingaba yisonto elilodwa ngemuva kwesenzo, kufana nesikhathi esinzima somjikelezo wenyanga.

Nakekela umzimba wakho ngokuthola ukuphumula okuningi, ukudla ukudla okunomsoco, nokugcina umzimba uqinisile. Gwema ama-tampons, ukugqwala, noma ubuhlobo bobulili cishe amasonto amabili noma kuze kube yilapho udokotela wakho ekunikeza imvume yokuvimbela ukutheleleka.

Ukuphatha izici zengqondo zokubuyela empilweni kubalulekile ngokulinganayo. Kuyinto evamile ukuzwa usizi, ukudabuka, noma ukudideka ngemuva kokulahlekelwa ukukhulelwa ngale ndlela. Abantu abaningi bathola usizo ekukhulumeni nomxhumanisi, ukubamba iqembu lokusekela, noma ukuxhumana nabanye abaye bahlangabezana nokulahlekelwa okufanayo.

Gcina yonke imiqhudelwano yakho yokulandelela, ngisho noma uzizwa kahle. Lezi zivivinyo zibalulekile ekuqondeni ukuphulukiswa kwakho nokubamba noma yiziphi izinkinga ezingase zenzeke ekuqaleni. Unganqikazi ukubiza udokotela wakho uma unemikhathazo phakathi kwemiqhudelwano.

Kufanele ulungiselele kanjani umhlangano wakho nodokotela?

Ngaphambi komhlangano wakho, bhala zonke izimpawu zakho, kuhlanganise nokuthi zaqala nini nokuthi zazinzima kangakanani. Faka imininingwane mayelana nomjikelezo wakho wenyanga, lapho ubuye ube nesikhathi sakho sokugcina, nanoma yikuphi ukuhlolwa kokukhulelwa okuye wakwenza.

Lungiselela uhlu lwemibuzo ofuna ukuyibuza udokotela wakho. Ungase ufune ukwazi ngezindlela zokwelapha, ukuthi yini okulindelekile ngesikhathi sokubuyela empilweni, lapho ungazama ukukhulelwa futhi, nokuthi yikuphi ukunakekelwa kokulandelela okuzodinga.

Letha umuntu okusekelayo nawe uma kungenzeka, njengoba ungase uthole ulwazi oluningi futhi ukuba nomuntu lapho kungakusiza ukukhumbula imininingwane ebalulekile. Kusiza futhi ukuba nokusekelwa ngokomzwelo ngesikhathi esingase sibe yisikhathi esinzima.

Qiniseka ukuthi utshela udokotela wakho mayelana nanoma iyiphi imithi oyithathayo, kuhlanganise nemithi yokuthengisa ngaphandle komthetho kanye nezinsiza. Khumbula nanoma yiziphi izifo zokuzalwa noma izimpendulo zangaphambili emithi noma e-anesthesia.

Iyini into ebaluleke kakhulu mayelana nokukhulelwa kwesisu sokukhulelwa?

Into ebaluleke kakhulu okumele uyiqonde ngokukhulelwa kwesisu sokukhulelwa ukuthi iyisimo esingaphathwa esineziphumo ezinhle uma siphathwa kahle. Nakuba kunzima ngokomzwelo ukulahlekelwa ukukhulelwa ngale ndlela, abantu abaningi baqhubeka bekhulelwa impilo esikhathini esizayo.

Ukutholakala kwangaphambi kwesikhathi nokuphathwa kuyisihluthulelo sokuvimbela izinkinga. Uma uhlangabezana nezimpawu ezingavamile ngesikhathi sokukhulelwa, ikakhulukazi ukugula okukhulu, ukuphuma igazi, noma ukukhula okusheshayo, unganqikazi ukuxhumana nodokotela wakho ngokushesha.

Khumbula ukuthi ukukhulelwa kwesisu sokukhulelwa akuyona iphutha lakho futhi akunakuvimbeka. Kuyisenzo se-genetic esingaqondakali esenzeka ngesikhathi sokukhulelwa, futhi ayikho into obungayenza ngokuhlukile ukuze uyigweme.

Ngokunakekelwa okufanele kwezokwelapha, ukubhekwa, nokusekelwa, ungaphila ngokuphelele ekukhulelweni kwesisu sokukhulelwa. Hlala uxhumana neqembu lakho lezokunakekelwa kwezempilo, nakekela impilo yakho yengqondo, futhi wazi ukuthi kukhona ithemba lokukhulelwa okunempilo esikhathini esizayo.

Imibuzo evame ukubuzwa mayelana nokukhulelwa kwesisu sokukhulelwa

Ngingakhulelwa futhi ngemuva kokukhulelwa kwesisu sokukhulelwa?

Yebo, abantu abaningi bangaba nokukhulelwa okuphumelelayo ngemuva kokukhulelwa kwesisu sokukhulelwa. Kodwa-ke, uzodinga ukulinda kuze kube yilapho amazinga akho e-hCG ebuya ezingeni elijwayelekile futhi udokotela wakho ekunikeza imvume, okungokuvamile kuthatha izinyanga eziyi-6-12. Lesi sikhathi sokulinda sibalulekile ekuqondeni okuqondile nasekuqinisekiseni ukuphulukiswa okuphelele.

Ingabe ngizoba nengozi enkulu yokukhulelwa kwesisu sokukhulelwa ekukhulelweni kwesikhathi esizayo?

Nakuba ukuba nokukhulelwa kwesisu sokukhulelwa kwenye kukhuphula kancane ingozi yakho yokuba nayo enye, ingozi iyonke ihlala iphansi kakhulu cishe ku-1-2%. Iningi labantu abaye baba nokukhulelwa kwesisu sokukhulelwa baqhubeka bekhulelwa okujwayelekile. Udokotela wakho uzokunakekela eduze ekuqaleni kokukhulelwa njengokuqapha.

Ngingalindela isikhathi esingakanani ngemuva kokwelashwa?

Ukubhekwa ngokuvamile kuqhubeka izinyanga eziyi-6-12 ngemuva kokwelashwa, kuye ngokushesha amazinga akho e-hCG ebuya ezingeni elijwayelekile. Uzobe unezivivinyo zegazi masonto onke ekuqaleni, bese uqhubeka nenyanga yonke. Lokhu kulandela kubalulekile ekuqinisekiseni ukuphulukiswa okuphelele nokubamba noma yiziphi izinkinga ezingase zenzeke ekuqaleni.

Ingabe ukukhulelwa kwesisu sokukhulelwa uhlobo lomdlavuza?

Ukukhulelwa kwesisu sokukhulelwa ngokwakho akuyona umdlavuza, kodwa kuyiyingxenye yeqembu lezimo ezibizwa ngokuthi i-gestational trophoblastic disease. Ezimeni ezingavamile, uma kungaphathwa kahle noma kungabhekwa, kungase kuqhubeke kube yisimo somdlavuza esibizwa ngokuthi i-choriocarcinoma. Kodwa-ke, ngokunakekelwa okufanele kwezokwelapha, lo mkhuba ungavimbeka futhi uphathwe.

Kufanele ngenze nini uma ngicabanga ukuthi ngingase ngibe nokukhulelwa kwesisu sokukhulelwa?

Xhumana nodokotela wakho ngokushesha uma uhlangabezana nezimpawu ezinkulu njengokuphuma kwegazi e-vagina, ukugula okukhulu, noma ukudlula ithusi elifana ne-grape ngesikhathi sokukhulelwa. Ukuhlonzwa kwangaphambi kwesikhathi nokuphathwa kubalulekile ekutholeni imiphumela emihle. Ungalindi noma uzama ukuzihlonzela - ukuhlolwa kwezokwelapha okuqeqeshwe kubalulekile.