Izwi rokuti "kutyisidzika kwekuparara kwepamuviri" rinotaurwa munharaunda yechiremba rinogara richikonzera kutya mune mumangwana mune ramangwana. Vananyamukuta vanokurumidzira kuvimbisa vakadzi vane pamuviri kuti iyi haisi chirwere uye ine kurapa kwakakodzera yekunyora, zvinogona kuitika kudzivisa kukanganiswa kwehutumbi.
Chinotyisa chekuregererwa kwepamuviri chinorevei?
Kutyisirwa kwekuregererwa kwekuita pamuviri ndeyekubatana kwezvikonzero, zvirwere zvehutachiona zvisingabatsiri kwete fetus, chirongwa chekuita mimba. Maererano nehuwandu, 20% yehutano husati hwauya huri kupera pakuparara. Muchiitiko ichi, kukanganisika kunogona kuitika panguva dzakasiyana-siyana. Kazhinji inowanikwa mumavhiki ekutanga, mumutambo wekutanga.
Kana kutyisidzika kwekuparara kwepamuviri kunowanikwa musvondo makumi matatu nematatu ekuberekwa, vanachiremba vanotaura nezvekubvisa pamuviri kamwechete. Apo mukana wekuvandudza hutano uku hunoonekwa pane imwe nguva inotevera, munguva yevhiki dzema 28-37, vanachiremba vanoshandisa shoko rokuti "kutyisidzira kwekuberekwa kusati kwaitika". Izvi zvinokonzerwa nekuvapo kwekugona kwekuyamwisa mwana achangoberekwa, akaberekwa mushure memavhiki makumi mana. Mukuda kwekubvisa pamuviri kamwechete kwekudzivirira munguva shoma, kufa kwechecheche hakugoneki.
Dambudziko rekubvisa pamuviri - zvikonzero
Zvinhu zvinokonzera kukura kwehutano uku zvakasiyana. Mukati yekuongororwa mushure mokubvisa pamuviri, vanachiremba havawanzogoni kuziva kuti chii chinokonzera. Izvi zvinotsanangurwa ne-multitifactority, nguva imwechetepopopopo kwezvikonzero zvakasiyana-siyana, pamwe chete kuwedzera ngozi yekubvisa pamuviri. Pakuongorora dambudziko iri, vanachiremba vanowanzoreva zvikonzero zvinotevera zvekutyisidzika kwekuparara kwepamuviri:
- Genetic pathology ye fetus. Kubudirira kwezvisina kukwana mumagadzirirwo emakromosomes, kuwedzera kwenhamba yavo kunowedzera dambudziko rekubvisa pamuviri. Kazhinji, kutyisidzika kunokonzerwa nekuchinja kwemajini.
- Hyperandrogenia - kuwedzera kwehuwandu muropa revarume vemadhemoni evanhukadzi. Nehutachiona, pane kuderera mumatambudziko eestrogens uye progesterone, iyo inokonzera kukura kwekudzivirira kwepamuviri.
- Kusagadzikana kwechirwere chechirwere uye chetachiona - kuwedzera kana kuderera muhuwandu hwemhomoni inogadzirwa navo.
- Rhesus-kukakavadzana kunorwara umo amai vaRh-negative vanotakura fetus, ropa iro iro Rh-positive.
- Kuvapo kwekubvisa pamuviri muam anamnesis.
- Kunyanya kunwa kwemishonga nemishonga - hormonal agents, analgesics, mishonga yemishonga (tansy, nettles, St. John's Wort) inogona kuwedzera mungozi yekuita dambudziko rekuparara kwepamuviri.
- Kukuvara kumimba.
- Kuita zvekuita kwenguva refu.
Zvimwe zvakakosha kuziva zvirwere zvinotapukira. Mukusangana nekutyisidzika kwekuparara kwepamuviri, iyo yakakamurwa kuva:
- zvakananga - gonorrhea, chlamydia, trichomoniasis , toxoplasmosis;
- nonspecific - hepatitis, pneumonia, fenza, appendicitis, pyelonephritis.
Dambudziko rekuparara mushure mokutanga katatu
Kutyisidzira kwokutanga kwekuita pamuviri kunowanzobatanidzwa nekusawirirana muhomoni. Kazhinji, zvikurukuru kuvasikana vaduku vane kutanga kwekuita gestation, kune urombo hwehomoni inonzi progesterone. Ichi chinhu chinokonzera kushandiswa kwemazuva ose. Pasi pemutungamiri waro, kukura kwemasero eUterine myometrium inowedzera, iyo inounganidza hutete hwakakwana hwekugadziriswa kwema fetal egg. Progesterone kusagadzikana kunodzivirira kugadzirwa kwechigarire kwe endometrium, semugumisiro wekuti kubata kunoparadzaniswa kwenguva pfupi.
Munzvimbo yechipiri pakati pezvinokonzera kutyisidzirwa kwekuparara kwepamuviri mukutanga kwetatu, zvirwere zvisingaperi zvekubereka, zvirwere zvepabonde. Mukurwisana nemamiriro ekuderera kwehutachiona, iyo inowanikwa pakutanga kwekuzvimba, mamiriro ezvinhu akanaka anogadzirirwa kushanduka kwekusingaperi, maitiro anonyengera mumhando yakaoma. Pakati pezvirwere zvinogona kuvhiringidza mararamiro akaenzana ekudzivirira:
- chlamydia ;
- gonorrhea;
- syphilis;
- genital herpes .
Dambudziko rekuputira mumutambo wechipiri
Muzviitiko zvizhinji, kutyisidzirwa kwekuregererwa kwekuita pamuviri mune chechipiri chetatu kunobatanidzwa nekuputsa kwemuviri wemukadzikadzi, uye kwete fetus. Kakawanda, kukanganisa kwemuviri mukati kwemavhiki 13-24 kunoitika semugumisiro wekushaya ropa kwevakadzi vane pamuviri. Chirwere chinosangana nekushayikwa mumuviri wesimbi, iyo inhengo ye hemoglobin. Nekubatsira kwechinhu ichi, okisijeni inotakurirwa kune nhengo uye mishonga ye fetus. Anemia inogona kutungamirira kune nzara ye okisijeni yemuviri mutsva, iyo inoshungurudza zvakanyanya intrauterine kukura - kutyisa kwekuparara kwepamuviri.
Kukanganiswa kwepamuviri mukati mezwi kunokwanisika uye nekuda kweparcenta previa. Nemhando iyi yekuisa nzvimbo yemwana, imwe yemiganhu iri pedyo nekati mukati mehuro yechibereko. Somugumisiro, njodzi yekuparadzana kwepasecental inowanda inowedzera, izvo zvinogona kukonzera kusingaperi hypoxia nekufa kwekufa. Uyewo, kutyisidzika kwekumuka kwepamuviri kunogona kutaridzirwa sechikonzero cheichosicic-cervical insufficiency. Nekuputsa uku, kune kuderera kwekudzika kwehuro yeutterin, iyo, ine kukura kukuru kubva mumuviri wemwana, inogona kuvhurwa.
Njodzi yekuparara pamuviri pakupera kwepamuviri
Kutyisidzirwa kwekuregererwa kwekuita pamuviri munguva dzinotevera hazviwanzoitiki. Maererano neshoko rinoshandiswa navanachiremba, rinokura mushure memavhiki makumi maviri nemasere ekuberekwa. Mushure mekunge panguva iyi vana vanochera zvipembenene vanoshandisa izwi rokuti "kuberekwa nguva isati yasvika". Iyi tsanangudzo inoratidza kuti mucheche wakaonekwa panguva ino unogona. Mukutaura kwekupedzisira, kukurudzirwa kwezvinetso zvinowedzera maererano nezvimwe zvezviitiko zvinotevera:
- Kutyisidzira kubvisa pamuviri - kunoratidzwa nekuwedzera kwekutaura kwemuviri weutter, mushure mutsva uchibva kuUterine cavity. Nekuchengetedza panguva yakakodzera uye nounyanzvi, fetus inogona kuponeswa.
- Kubvisa pamuviri mukati - kukanganisa kunoperekedzwa nekuputsika kwepabonde, kubviswa kwe fetal kubva kuhutachi uterine. Icho chiri pamwe chete nekupwanya marwadzo, kubuda ropa kunorema. Hazvibviri kuchengetedza pamuviri.
- Kubvisa pamuviri kusina kukwana - kunoonekwa nekubudiswa kwechikamu chemucheche kana kuputika kwemukati. Iyo fetus inobviswa nekuvhiyiwa.
Dambudziko rokuparara-zviratidzo
Izvo zvakaoma kuziva mungozi yekuvhiringidza kune mukadzi ane pamuviri. Paavhareji, 10-15% yezviitiko zvose zvehutano zvinowirirana nezviratidzo zvishoma kana zvisinganzwisisiki. Chinhu chokutanga chinoda kubhadharwa kumukadzi ane pamuviri ndichokuonekwa kamwe kamwe kwekubuda ropa kubva mumukadzi. Pakutanga inogona kuva madonhwe mashomanana pamapurasitiki ako. Zvisinei, nekufamba kwenguva, zviratidzo zvinowedzera. Mukadzi wacho anonyorawo zvimwe zviratidzo zvekutyisidzira kwekuparara kwepamuviri:
- kunzwa kushungurudzika, kusagadzikana, kurwadziwa kunorwadza mudumbu rezasi;
- kuora kwehupenyu hwakanaka;
- kuderedza ropa;
- nausea;
- kurutsa.
Painoongororwa pachigaro chechiremera, zvinotevera zvinowanikwa:
- Icho chibereko hachipinduri kune kuongorora nekuwedzera inzwi;
- the outer sulcus is closed or slightly ajar;
- Pane ropa muhutano hwebonde.
Kugoverwa pamusana pekutyisidzika kwekuparara
Dambudziko rekupererwa pamuviri mumavambo okutanga ekudzivirira nguva dzose rinowirirana nekuonekwa kweropa kubva pamagadzirirwo emukadzi. Pakutanga kwekutanga, ivhu rayo duku, zvakangofanana nezvinoonekwa nekuenda kumwedzi. Mucherechedzo wekuyerera unogona kubva kubva pakutsvuka kwakajeka kusvika serous-bloody. Maererano nekucherechedza kwechiremba, muna 12-13% yematambudziko ekubuda ropa kunotungamirira kumagumo ekudzivirira. Nekubuda ropa kwakanyanya, pane ngozi yekuita uterine kubuda ropa, iyo inofambidzana ne:
- headache;
- kurutsa;
- kuderedza ropa;
- blanching ganda;
- kuwedzera kwenhamba yemwoyo;
- kurasikirwa kwekuziva.
Marwadzo pamusana pekutyisidzika kwekuparara kwepamuviri
Dambudziko rekuregererwa kwekuita pamuviri, zviratidzo zvaro zvinokurukurwa pamusoro, zvinowanzosangana nemarwadzo mumimba pasi. Symptomatology inobatanidza nekuwedzera kwezwi reuterine myometrium, iyo inowedzera contractil yayo. Ichi chinoshamisa chinosangana nemarwadzo anorwadza, kukwevera unhu hweshungu (kashoma kazhinji kunodhonza kana kupwanya). Nekutyisidzika kwekumuka kwepamuviri, marwadzo anowanikwa munzvimbo inowanikwa munzvimbo inopupubic, inogona kudzokera kumashure kumashure kana sacrum. Kukura kwekutambudzika hakubvi pane chinzvimbo chemuviri.
Chii chaunofanira kuita kana pane ngozi yekuparara kwepamuviri?
Apo mukadzi ane pamuviri anoonekwa kuti ane dambudziko rokuparara pamuviri, kurapwa kunotanga pakarepo. Kurapa kunoitwa muchipatara, asi chikonzero chayo kuenderana nemubhedha wezororo (mumatambudziko akaoma, mukadzi ane pamuviri anoregererwa kuti abve pamubhedha). Ngozi yekubvisa pamuviri inokonzera kushushikana nekutya mumukadzi, saka zvigadziro zvinorayirwa kuti aparadze. Vanachiremba vanokurudzira kuti varambe vakanyarara kwenguva yakareba sezvamunofunga kufunga nezvakanaka.
Mishonga inorayira zvinotyisa kubvisa pamuviri
Kuti kutyisidzika kwepamuviri pamatambo ekutanga hauna kutungamirira kumagumo ekudzivirira, vanachiremba vanokurudzira vakadzi kuchengeta zvinotevera:
- Chiremera chiito.
- Kunyanya kuzorora.
- Bvisa zvinetso nekuzvidya mwoyo.
- Rega zvepabonde.
- Chengetedza kudya kwekoriori.
Matetetsi kana zvikashungurudzika
Zvose zvinodhaka mumutambo wekuparara kunofanira kurongedzerwa chete nachiremba. Muongorori, achitarisa kuoma kwemamiriro ezvinhu, mamiriro ezvehutano hwevakadzi vane pamuviri, anonyora mishonga mumutero unodiwa. Pakati pemishonga inoshandiswa:
- antispasmodics (Papaverin, No-shpa, Drotaverin);
- gestagens (Dyufaston pamusana wekutyisidzika kwekuchera pamuviri pamavambo ekutanga anobatsira kubvisa chirwere);
- glucocorticoids (Dexamethasone, Metipred);
- hemostatics (Dicinon, Vikasol, Ascorutin);
- vitamini (folic acid, vitamin K, E).
Mambakwedza mukutyisidzika kwekuparara kwechisimba haashandisi nguva shomanana kupfuura mamwe magestagens. Muchiitiko ichi, vanachiremba vanokurudzira kuishandisa mumakandulo. Nhamba uye yakawandisa inogadzirirwa mumwe nomumwe, asi mumatambudziko mazhinji, vanachiremba vanonamatira pamatare ekurapa anotevera:
- 1 suppository ine muyero we 200 mg pazuva;
- Mamwe makirosi maviri pazuva uye uwandu hwe 100 mg.
Apo inorovedzwa nekutyisidzika kwekumuka kwepamuviri
Kurapa kwekutyisidzirwa kwekubvisa pamuviri muchipatara kunosanganisira kushandiswa kwemajekisi emishonga yemishonga. Muchiitiko ichi, mishonga imwechete yakanyorwa pamusoro apa inoshandiswa, asi nenzira yemhinduro. Nzira iyo yehutano inoita kuti zvikwanise kuzadzikisa kutanga kwekutanga kunogona kuitika kwehutano hwehutano. Pakati pemishonga inoshandiswa nenzira yejojo:
- Magnesium sulphate ;
- Partusisten;
- Ritodrin;
- Alupent.
Nzira yekudzivirira sei dambudziko rekuparara kwepamuviri?
Kuchengetedza kugadzirisa kwekubvisa pamuviri kunofanira kutanga pamatanho ekuronga kwepamuviri. Musati mimba yekuroorana nemurume nomudzimai, zvakakosha kuongororwa, kupfuurira miedzo, kuenda kune imwe nzira yekurapa pakuonekwa kwezvirwere zvisingaperi.
Matanho ekudzivirira anotsvaga kubvisa kutyisidzika kwekusununguka kwepamuviri anosanganisira:
- kubhadhara panguva yakakodzera yekudzivirira;
- kunyatsokurudzirwa kwechiremba;
- kuramba tsika dzakaipa;
- kubviswa kwezvinokonzera mamiriro ezvinhu;
- kuramba kubva pakuedza zvakasimba mumuviri, kudzidzira zvemitambo;
- kumira kwehurumende yezuva racho.