Maitiro ekupindira ekubvisa nhumbu

Maitiro ekupindira ekubvisa nhumbu

Nzira mbiri dzinoshandiswa kuita kubvisa pamuviri nekuzvidira:

  • mushonga unyanzvi
  • nzira yekuvhiya

Pese pazvinogoneka, vakadzi vanofanirwa kukwanisa kusarudza nzira, yekurapa kana yekuvhiya, pamwe neiyo nzira yeanesthesia, yemunharaunda kana general.16.

Mishonga nzira

Kubvisa pamuviri kwechiremba kunobva pakutora mishonga inobvumira kukonzera kubviswa kwepamuviri uye kudzingwa kwe embryo kana fetus. Inogona kushandiswa kusvika kumavhiki e9 e amenorrhea. MuFrance, muna 2011, inopfuura hafu yekubvisa pamuviri (55%) yakaitwa nemishonga.

Kune mishonga ye "kubvisa pamuviri" yakawanda, asi nzira inonyanyozivikanwa ndeyekupa:

  • anti-progestogen (mifepristone kana RU-486), iyo inodzivisa progesterone, iyo hormone inobvumira kubata pamuviri;
  • pamwe chete nemushonga wemhuri yeprostaglandin (misoprostol), iyo inokonzera kukanganiswa kwechibereko uye inobvumira kubudiswa kwe fetus.

Nokudaro, WHO inokurudzira, kune pamuviri wezera rekudzivirira kusvika kumavhiki e9 (mazuva 63) kutora mifepristone kunotevera 1 kusvika 2 mazuva gare gare nemisoprostol.

Mifepristone inotorwa nemuromo. Nhamba yakakurudzirwa ndeye 200 mg. Kutungamirirwa kwemisoprostol kunokurudzirwa 1 kune 2 mazuva (24 kusvika maawa 48) mushure mekutora mifepristone. Inogona kuitwa nenzira yevaginal, buccal kana sublingual kusvika kumavhiki manomwe eamenorrhea (masvondo mashanu ekuzvitakura).

Mhedzisiro yacho inonyanya kuenderana nemisoprostol, iyo inogona kukonzera kubuda ropa, kutemwa nemusoro, kuda kurutsa, kurutsa, manyoka uye kurwadza kwedumbu remudumbu.

Mukuita, kubvisa pamuviri kwekurapa kunogona kuitwa kusvika ku5st vhiki yekuzvitakura pasina kuchipatara (kumba) uye kusvika ku7st vhiki yekuzvitakura nemaawa mashomanana ekuiswa muchipatara.

Kubva pamavhiki gumi eamenorrhea, nzira yemishonga haisati yakurudzirwa.

MuCanada, mifepristone haina mvumo, nekuda kwenjodzi dzinotapukira (uye hapana kambani yakaita chikumbiro chekutengesa mamorekuru aya muCanada, kusvika pakupera kwa2013). Izvi zvisiri zvekutengesa zvinokakavadzana uye zvinoshorwa nemasangano ezvokurapa, anofunga kushandiswa kwe mifepristone yakachengeteka (inowanzoshandiswa munyika dze57). Kubvisa pamuviri pakurapa hakuna kunyanya kuwanda muCanada. Inogona kuitwa nemumwe mushonga, methotrexate, inoteverwa ne misoprostol, asi nekushanda kushoma. Methotrexate inowanzopiwa jekiseni, uye mazuva mashanu kusvika manomwe gare gare, mapiritsi emisoprostol anopinzwa mukati memukadzi. Nehurombo, mu35% yezviitiko, chibereko chinotora mazuva akati wandei kana mavhiki akati wandei kubuda zvachose (zvichienzaniswa nemaawa mashoma ne mifepristone).

Nzira yekuvhiya yekubvisa pamuviri17-18

Kubvisa pamuviri kwakawanda munyika kunoitwa nehunyanzvi hwekuvhiya, kazhinji kushuvira zviri mukati mechibereko, mushure mekuwedzera kwemuromo wechibereko (zvichida nemakanika, nekuisa dilators akawedzera, kana nemishonga). Inogona kuitwa pasinei nenguva yekuzvitakura, kana neanesthesia yemunharaunda kana neanesthesia. Kupindira kunowanzoitika mukati mezuva. Aspiration ndiyo nzira inokurudzirwa yekuvhiya nhumbu kusvika pazera rekuzvitakura remasvondo gumi nemaviri kusvika gumi nemana emimba, maererano neWHO.

Imwe nzira inoshandiswa pane dzimwe nguva mune dzimwe nyika, kuwedzera kwemuromo wechibereko kunoteverwa nekugadzirisa (kunosanganisira "kukwenya" jira rechibereko kubvisa tsvina). WHO inokurudzira kuti nzira iyi itsiviwa neshuviro, iyo yakachengeteka uye yakavimbika.

Kana gestational zera rakakura kupfuura 12-14 mavhiki, zvese dilation uye kubuda uye mushonga zvinogona kukurudzirwa, maererano neWHO.

Kubvisa pamuviri

Munyika dzose dzinobvumira kubvisa pamuviri, kushanda kwayo kunorongwa neprotocol yakanyatsotsanangurwa.

Saka zvakakosha kuti uzive nezve maitiro, nguva dzekupedzisira, nzvimbo dzekupindira, nguva yepamutemo yekuwana (makore gumi nemana muQuebec, chero musikana wechidiki muFrance), mazwi ekubhadhara (mahara muQuebec uye 14% kudzoreredza. muFrance).

Iwe unofanirwa kuziva kuti maitiro acho anotora nguva uye kuti pane kazhinji nguva yekumirira. Saka zvakakosha kukurumidza kuonana nachiremba kana kuenda kune imwe nzvimbo inoita kubvisa pamuviri nokukurumidza kana sarudzo yaitwa, kuitira kuti usanonoka zuva rechiito uye njodzi inosvika panguva yekuzvitakura pazvinenge zvakakodzera. zvichanyanya kuoma.

MuFrance, semuenzaniso, kubvunzana kwekurapa kuviri kunosungirwa kusati kwabviswa pamuviri, kunoparadzaniswa nenguva yekufungidzira ingangoita vhiki imwe (mazuva maviri kana pane emergency). "Kukurukurirana-kubvunzurudza" inogona kupiwa kuvakadzi vasati vavhiyiwa uye mushure, kuitira kuti murwere ataure nezvemamiriro ake ezvinhu, kuvhiyiwa uye kugamuchira ruzivo pamusoro pekudzivirira pamuviri.19.

MuQuebec, kubvisa pamuviri kunopiwa mumusangano mumwe chete.

Psychological kutevera mushure mekubvisa pamuviri

Sarudzo yekubvisa pamuviri haisi nyore uye chiito hachisi chiduku.

Kuva nepamuviri pasingadiwi uye kubvisa pamuviri kunogona kusiya zviratidzo zvepfungwa, kumutsa mibvunzo, kusiya manzwiro ekusava nechokwadi kana mhosva, kusuruvara, dzimwe nguva kuzvidemba.

Zviripachena, maitiro ekubvisa nhumbu (angave echisikigo kana kuti akonzereswa) akasiyana uye akananga kumukadzi wega wega, asi kuongororwa kwepfungwa kunofanirwa kupihwa kune vese.

Zvisinei, nzvero dzinoverengeka dzinoratidza kuti kubvisa pamuviri hakusati kuri kwengozi yepfungwa yenguva refu.

Kushungurudzika mupfungwa kwemukadzi kunowanzova kwakanyanya kusati kwabvisa pamuviri kunoderera zvakanyanya pakati penguva isati yabvisa uye iyo pakarepo inoitevera.10.

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