Nhumbu yechando

Frozen pamuviri nderimwe rematambudziko makuru muobstetrics uye gynecology. Zvinosuruvarisa, mukadzi chero upi zvake anogona kutarisana nechirwere chakadaro. Chii chekuita munyaya iyi uye kana iwe uchigona kuronga pamuviri zvakare, tinobata nayo obstetrician-gynecologist Marina Eremina.

Chii chinonzi nhumbu yarohwa nechando

Pane mazwi akati wandei anotsanangura mamiriro akafanana: kupfupfudzika, nhumbu isiri kukura uye kubva pamuviri. Vese vanoreva chinhu chimwe – mwana ari mudumbu akangoerekana amira kukura (1). Kana izvi zvikaitika kusvika kumavhiki e9, vanotaura nezvekufa kwemucheche, kwemavhiki makumi maviri nemaviri - fetus. Muchiitiko ichi, kuparara kwepamuviri hakuitike, fetus inoramba iri mu uterine cavity.

Vanachiremba vazhinji vanobvumirana kuti 10-20 muzana yevose vane pamuviri vanofa mumavhiki ekutanga. Panguva imwecheteyo, vakadzi vakawana mimba isiri kukura vanowanzotakura mwana pasina matambudziko mune ramangwana. Zvisinei, pane mamiriro ezvinhu apo mimba mbiri kana kupfuura mumutsara inotonhora. Zvadaro vanachiremba vanotaura pamusoro pekugara pamuviri, uye kuongororwa kwakadaro kunotoda kutarisa uye kurapwa.

Zviratidzo zvepamuviri chando

Mukadzi haatombozvizivi kuti nhumbu yamira here kana kuti kwete. Kubuda ropa kwakawanda, sepakubvisa pamuviri, hakusi pano, hapana marwadzo. Kazhinji murwere anonzwa zvikuru, uye zvinonyanya kumurwadza kuti anzwe kuongorora kwachiremba.

Dzimwe nguva unogona kuramba uchifungidzira dambudziko. Zviratidzo zvinotevera zvinofanira kuchenjerera:

• kupera kwekusvotwa;
• kupera kwemazamu engorgement;
• kuvandudzwa kwehutano huzhinji; dzimwe nguva kuonekwa kweropa daub.

- Nehurombo, hapana zviratidzo zvepamuviri wakapotsa, uye chete ultrasound inogona kuita kuongororwa kwakaringana. Zviratidzo izvi zviri subjective zvikuru. obstetrician-gynecologist Marina Eremina.

Nezviratidzo izvi, vanachiremba vanorayira kuita ultrasound, chete panguva ye ultrasound iwe unogona kuona kana embryo yakaomeswa nechando kana kwete. Dzimwe nguva michina yechinyakare kana nyanzvi isina kunyatso hunyanzvi inogona kukanganisa, saka vanachiremba vanopa zano kuti vaende kunoongororwa ultrasound munzvimbo mbiri zviri nani nemusiyano wemazuva 3-5-7), kana nekukurumidza sarudza kiriniki ine tekinoroji yemazuva ano uye inonyatso hunyanzvi. vanachiremba.

Nyanzvi ye ultrasound inoongorora nhumbu yakarasika nezviratidzo zvinotevera:

• kushayikwa kwekukura kwe fetal egg mukati memavhiki 1-2;
• kusavapo kwe embryo ine fetal zai saizi inosvika 25 mm;
• kana coccyx-parietal size ye embryo iri 7 mm kana kupfuura, uye hapana kurova kwemoyo.

Dzimwe nguva unoda kutora ongororo yeropa yakawanda yehCG kuti uone kana chiyero chehomoni iyi chiri kuchinja. Nepamuviri yakajairika, inofanira kuwedzera.

Frozen early pregnancy

Ngozi yekutadza kubata pamuviri yakanyanya kunyanya mufirst trimester.

"Kazhinji, pamuviri wakapotsa unoitika mumatanho ekutanga, pamavhiki matanhatu-6, muzviitiko zvisingawanzoitiki mushure memavhiki gumi nemaviri ekuzvitakura," anodaro obstetrician-gynecologist.

Chiitiko chinotevera chine ngozi mushure mekutanga trimester ndeye 16-18 mavhiki ekuzvitakura. Kashoma, kukura kwe embryo kunomira pane imwe nguva inotevera.

Zvikonzero zvepamuviri pakaita chando

Mukadzi anonzwa kunzverwa kwakadaro angafunga kuti chimwe chinhu hachina kumira zvakanaka paari. Zvisinei, vanachiremba vanovimbisa kuti 80-90 muzana yemimba yakarasika inokonzerwa ne embryo pachayo, kana kuti, nekuda kwekusagadzikana kwemajini. Sezvakazoitika, embryo yakazova isingagoneki. The grosser the pathology, nokukurumidza mimba inofa. Sezvo mutemo, embryo isina kujairika inofa kusvika kumavhiki matanhatu-6.

Zvimwe zvikonzero zvekubva pamuviri zvinongobata zvikamu makumi maviri kubva muzana (20). Izvi zvikonzero zvakatobatanidzwa naamai, uye kwete nemwana.

Chii chingava chikonzero chekubvisa mimba.

1. Kuputsika kweropa coagulation system, thromboses yakasiyana-siyana, pamwe chete ne antiphospholipid syndrome, umo ropa rinoputika zvakanyanya. Nemhaka yeizvi, placenta inogona kusakwanisa kurarama nemabasa ayo ekudyisa fetus, uye mune ramangwana mwana angafa.

2. Kukundikana kweHormonal. Chero mhando yekusaenzana, kungave kushaikwa kweprogesterone kana kuwanda kwemahomoni echirume, inogona kukanganisa kukura kweiyo embryo.

3. Zvirwere zvinotapukira, kunyanya zvirwere zvepabonde, cytomegalovirus, rubella, furuwenza nevamwe. Zvinonyanya kuipa kuvabata mukutanga kwetatu, apo nhengo dzose uye zvirongwa zvemwana asati aberekwa zvinoiswa.

4. Balanced chromosomal translocations muvabereki. Zvinonzwika zvakaoma, asi zvakakosha ndeizvi - masero emagetsi evabereki ane pathological set of chromosomes.

Basa rinokosha rinoitwa nemararamiro emukadzi, pamwe nezera rake. Ngozi yekusakura kwepamuviri inowedzera pazera rekupedzisira. Kana paavhareji yemakore 20-30 iri paavhareji 10%, zvino pamakore makumi matatu nemashanu yatova 35%, pamakore makumi mana - 20%, uye anopfuura makumi mana inosvika 40%.

Zvimwe zvinokonzeresa zvekutadza kubata pamuviri:

• kushungurudzwa kwekofi (4-5 makapu pazuva);
• kusvuta;
• kutora mimwe mishonga;
• folic acid kushomeka;
• kushushikana kwakarongeka;
• doro.

Pane zvinhu zvakati kuti zvinoonekwa zvisiri izvo kuti ndizvo zvikonzero zvekutadza kubata pamuviri. Asi handizvo! Haikwanise kuva chikonzero:

• air travel;
• kushandiswa kwekudzivirira pamuviri usati wabata pamuviri (hormonal contraceptives, spirals);
• kurovedza muviri (chero bedzi mukadzi wacho akapinda mumitambo nenzira imwechete asati abata pamuviri);
• bonde;
• kubvisa pamuviri.

Chii chekuita nenhumbu yechando

Kana iwe uri pasi pemakore makumi matatu nemashanu uye uku ndiko kutanga kwako kubva pamuviri, vanachiremba vanorayira kuti usagumbuke kana kuvhunduka. Kazhinji kazhinji iyi itsaona, uye kuedza kwako kunotevera kuva amai kunoguma mukuberekwa kwomwana ane utano. Iye zvino chinhu chekutanga chekuita ndechokubvisa fetal egg kuvhiyiwa kana mishonga.

Panguva ino, mukadzi anoda kutsigirwa nevadikani. Saka usachengeta manzwiro ako mukati mako, taura nezvemanzwiro nemurume wako, amai, musikana.

Kuti iwe pachako uve nerunyararo rwepfungwa, hazvizove zvakanyanyisa kuongororwa hutachiona - zvese izvo zvinotapurirana pabonde, furu uye zvimwe zvirwere. Kana pasina chinowanikwa, unogona kubata pamuviri zvakare.

Chimwe chinhu ndechekuti kana iyi iri yechipiri kana kupfuura mimba yakarasika, saka iwe unoda kuziva zvikonzero zvechinetso uye uzvibvise.

Kubata pamuviri mushure mekusununguka kwechando

Kubata pamuviri kwakaoma 一 nguva dzose chikonzero chekushungurudzika. Asi, imwe nguva gare gare, mukadzi anopora uye anotanga kuronga kuedza kutsva kubereka mwana. Unogona kubata pamuviri zvakare mushure memwedzi 4-6 (3). Munguva iyi, zvakakosha kupora kwete chete mumuviri, asiwo mupfungwa. Mushure mezvose, mukadzi wacho akanzwa ane pamuviri, uye mararamiro ake ehomoni akachinja. 

akakurudzira kuti:

• kurega kusvuta uye doro;
• usashandisa zvisina kunaka zvigadzirwa zvine caffeine;
• usadya zvakakora uye zvinonaka;
• do sport;
• famba kakawanda.

Zvinotorawo nguva kuti endometrium ive yakagadzirira kugamuchira fetal zai idzva. 

Usati waronga kubata pamuviri patsva, zvinofanirwa kuongororwa akati wandei:

1. Ongorora kuvepo kwekuratidzwa kune zvinokuvadza zvinhu: mushonga, zvakatipoteredza, zvirwere, nezvimwe.
2. Kudzidza nhaka yehama. Ingave pane zviitiko zvekurasikirwa nepamuviri, thrombosis, kurwisa kwemoyo kana sitiroko pazera diki.
3. Wongororwa zvirwere zvepabonde, mahomoni uye kugwamba kweropa.
4. Bvunza naana mazvikokota.
5. Ita ultrasound yenhengo dzepelvic.
6. Ongorora kuenderana kwevadyidzani.

Kazhinji kazhinji, kurapwa hakudiwi, sezvo kupfupfudzika kunowanzova mugumisiro wekukanganisa kwemajini. Zvisinei, kana izvi zvisingaitike kwekutanga, kubvunzurudza kwechiremba uye kugadzwa kwehutano hunokosha hunodiwa. 

Kubata pamuviri mberi kwemwedzi ye4 mushure mekusununguka kwepamuviri kunoora mwoyo zvikuru, pasinei nokuti zvinogoneka. Muviri unofanirwa kupora zvakakwana kuitira kuti pasave nechiitiko chinodzokororwa chekubva pamuviri. Nokudaro, nzira dzakavimbika dzekudzivirira pamuviri dzinofanira kushandiswa. Kana mimba ikaitika, iwe unofanirwa kushanyira chiremba uye kutevera mazano ake ose. 

bvunzo dzinodiwa

Kana wakafirwa nevana vaviri kana kupfuura, unofanira kunyatsoongorora. Kazhinji, vanachiremba vanokurudzira runyorwa runotevera rwebvunzo uye maitiro:

• karyotyping yevabereki ndiyo ongororo huru icharatidza kana vakaroorana pachavo vane genetic abnormalities; - kuongororwa kweropa coagulation system: coagulogram (APTT, PTT, fibrinogen, prothrombin nguva, antithrombin lll), D-dimer, platelet aggregation kana thrombodynamics, homocysteine, kuonekwa kwekuchinja kwemajini eiyo coagulation system;
• HLA-typing - kuongororwa kweropa kune histocompatibility, iyo inotorwa nevabereki vose; - TORCH-yakaoma, iyo inoona antibodies kune herpes, cytomegalovirus, rubella uye toxoplasma;
• kuongororwa kwezvirwere zvepabonde; - kuongororwa kweropa kwemahomoni: androstenediol, SHBG (hormone yebonde inosunga globulin), DHEA sulfate, prolactin, yakazara uye yakasununguka testosterone, FSH (follicle-stimulating hormone), estradiol, uye thyroid mahormone: TSH (thyroid stimulating hormone), T4 (thyroxine ), T3 (triiodothyronine), thyroglobulin.

Kana kuongorora kuchiratidza dambudziko ne coagulation, ungada kuonana nehemostasiologist, kana ine genetics - geneticist, kana ine mahomoni - gynecologist uye endocrinologist.

Zvichida mudiwa wacho achafanira kushanyira anrologist uye kupasa nhevedzano yebvunzo.

- Zvinoshamisa kuti, chikonzero chekutadza kubata pamuviri kazhinji kacho chikonzero chemurume. Izvi zvinokonzerwa kwete chete netsika dzakaipa, dzakadai sedoro uye kusvuta, asiwo nekushaya zvokudya zvinovaka muviri, semuenzaniso, kushandiswa kwezvinhu zvakaderera, mararamiro ekugara, uye zvimwe zvikonzero zvakawanda, zvinojekesa. obstetrician-gynecologist Marina Eremina.

Murume angangopihwa zano rekuita spermogram yakawedzerwa uye, kana teratozoospermia iripo mukuongororwa, obva aongororwa kumwezve kwekuparadzaniswa kweDNA muspermatozoa kana electron microscopic bvunzo yespermatozoa - EMIS.

Anenge ese aya maitiro anobhadharwa. Kuti urege kuenda wakaputsika, uchivapa zvose, teerera mazano echiremba. Zvichienderana nenhoroondo yako yezvekurapa, nyanzvi ichaona kuti ndedzipi bvunzo dzinokosha.

Zvinosuruvarisa, kuchine mamiriro ezvinhu apo vanachiremba havakwanisi kuwana chikonzero chechinetso.

Ndeipi nzira yekuchenesa?

Kana mimba ikamira kukura uye pasina kubvisa pamuviri, chiremba anofanira kutumira murwere kuti acheneswe. Kuvapo kwe fetus kwemavhiki anopfuura 3-4 muchibereko kune ngozi zvikuru, inogona kutungamirira pakubuda ropa kukuru, kuzvimba uye mamwe matambudziko. Vanachiremba vanobvumirana kuti haufaniri kumirira kubvisa pamuviri, zviri nani kuita curettage nokukurumidza sezvinobvira.

Izvi zvinogona kuva vacuum aspiration kana kubvisa pamuviri nemishonga inobvumira embryo kudzingwa pasina kuvhiyiwa.

"Sarudzo yenzira ndeyemunhu, zvichienderana nenguva iyo mimba yakamira kukura, pakuvapo kwezvinopesana kune imwe kana imwe nzira, kuvapo kwepamuviri uye kubereka munhoroondo, uye, chokwadi, chido chemukadzi pachake. inorangarirwa,” anotsanangura kudaro obstetrician-gynecologist Marina Eremina.

Saka, kubvisa pamuviri kwechiremba, semuenzaniso, hakuna kukodzera kuvakadzi vane adrenal insufficiency, acute kana kusingaperi renal kukundikana, uterine fibroids, anemia, zvirwere zvinoputika zvehutano hwevakadzi.

Nzira yekuvhiya inokurudzirwa kubvisa pamuviri kusvika kumasvondo gumi nemaviri Munyika Yedu ivacuum aspiration, apo zai re "fetus" rinobviswa uchishandisa kuyamwa uye catheter. Nzira yacho inotora 12-2 maminitsi uye inoitwa pasi peanesthesia yemunharaunda kana yakazara.

Curettage inzira isingasarudzwe uye inofanira kushandiswa chete mumamiriro ezvinhu akakosha, semuenzaniso, kana paine tishu yasara muchibereko mushure mevacuum aspiration.

Mushure mekuchenesa, zviri mukati mechibereko zvinotumirwa kuongororwa kwe histological. Kuongorora uku kuchakubvumira kuti unzwisise zvikonzero zvekutadza kubata pamuviri uye kudzivisa kudzoka kwemamiriro ezvinhu mune ramangwana.

Uyezve, mukadzi anokurudzirwa kuti aite nzira yekudzorera. Inosanganisira anti-inflammatory therapy, kutora painkillers, mavitamini, kusabatanidzwa kwekuita muviri uye kuzorora kwakanaka.

Kana iwe wakatanga kunzwa kuongororwa kwe "mimba yakarasika" kubva kuna chiremba, zvinenge zvichida kuti kuedza kunotevera kuva nemwana kuchabudirira. Kazhinji kazhinji yaive tsaona yenguva imwe chete, kukanganisa kwemajini. Asi kunyange vakadzi, avo vatova wechipiri kana wechitatu mimba yakarasika, vane mikana yose yekuva amai.

Chinhu chikuru ndechokuwana chikonzero chechinetso, uye ipapo - kuongorora, kurapwa, kuzorora uye kugadzirisa. Kana nzira iyi yapfuura, unofanirwa kuita ultrasound yenhengo dzepelvic uye uve nechokwadi chekuti endometrium inokura zvinoenderana nekutenderera, hapana ma polyps, fibroids kana kuzvimba mukati mechibereko, shanyira murapi uye kurapa zviripo zvisingaperi zvirwere. . Mukufanana, iwe unofanirwa kutungamira mararamiro ane hutano, tora folic acid uye udye kudya kwakaringana, zvese izvi zvichawedzera mikana yako yekuve nepamuviri mune ramangwana uye kubereka mwana ane hutano.

Zvimiro zvekuenda kumwedzi panguva iyi

Mushure mokubvisa pamuviri, kuenda kumwedzi kuchadzokera kumukadzi. Kazhinji, zvinouya mavhiki 2-6 mushure mekuita. Zviri nyore kuverenga nguva yekusvika kwemazuva akaoma. Zuva rokubvisa pamuviri rinotorwa sezuva rokutanga, uye nguva yacho inoverengwa kubva pairi. Somuenzaniso, kana mukadzi ane chido chekutsvaira musi waNovember 1, uye kutenderera kwake mazuva makumi maviri nemasere, nguva yake inofanira kuuya musi waNovember 28. Kunonoka kunogona kukonzerwa nekukundikana kwehomoni. Kuenda kumwedzi mushure mekuita kwevacuum kuchave kwakashata kudarika nguva dzose, sezvo mucous membrane haizove nenguva yekupora zvachose.

Kana mukadzi aive "curettage", ipapo chibereko chinogona kunyanya kunetseka, saka kuenda kumwedzi kunogona kunge kusipo kwemwedzi miviri kana kupfuura.

Panguva ino, mukadzi anofanira kunyanya kuchenjerera uye kuzvidzivirira, nokuti muviri hausati wakagadzirira pamuviri wechipiri.

Kana iwe ukacherechedza kuti nguva yako mushure mekuchenesa yakareba kupfuura yaitarisirwa uye inoratidzika seyokubuda ropa, iva nechokwadi chekuonana nachiremba, izvi zvinogona kuva chiratidzo chekuputika.

Mibvunzo nemhinduro dzakakurumbira

Zvitubu zve

1. Stepanyan LV, Sinchikhin SP, Mamiev OB Kusakura pamuviri: etiology, pathogenesis // 2011
2. Manukhin IB, Kraposhina TP, Manukhina EI, Kerimova SP, Ispas AA Kusakura pamuviri: etiopathogenesis, kuongororwa, kurapwa // 2018
3. Agarkova IA Isiri-kukura pamuviri: kuongororwa kwezvinhu zvine njodzi uye kufungidzira // 2010