Chiberekero Cerclage
Cervical cerclage, yomwe imadziwikanso kuti cervical stitch, ndi njira yopangira opaleshoni yolimbitsa khomo lachiberekero ndikuletsa kutsegula msanga panthawi yomwe ali ndi pakati. Njirayi imagwiritsidwa ntchito poyang'anira kusakwanira kwa khomo lachiberekero, pomwe khomo lachiberekero limakhala lofooka kapena silingathe kuthandizira mwana yemwe akukula. Nkhaniyi ikufotokoza mfundo ya cervical cerclage, kufunika kwake pakulimbikitsa mimba yabwino, komanso njira yodzitetezera.
Cervical cerclage ndi njira yopangira opaleshoni yomwe imagwiritsidwa ntchito kulimbikitsa chiberekero pa mimba, kuchepetsa chiopsezo cha kubadwa msanga kapena kupititsa padera kwa amayi omwe ali ndi mbiri ya kusakwanira kwa chiberekero kapena nkhani zina za khomo lachiberekero. Khomo la chiberekero ndi gawo lakumunsi la chiberekero lomwe limatseguka panthawi yobereka kuti mwanayo adutse njira yoberekera. Njira imeneyi imaphatikizapo kusokerera khomo pachibelekeropo kuti chithandizire ndikulimbitsa kukhulupirika kwake.
Sungitsani MisonkhanoZokhudza Cervical Cerclage
Cervical cerclage ndi njira yomwe imagwiritsidwa ntchito kulimbikitsa khomo lachiberekero ndikuletsa kuti chiberekero chisachedwe msanga. Khomo la khomo pachibelekeropo limagwira ntchito yofunika kwambiri pochirikiza mimba mwa kukhala wotseka mpaka pamene nthawi yobala yayamba. Ngati khomo la chiberekero silikwanira, khomo lachiberekero limatha kuyamba kufutukuka kwambiri, zomwe zimapangitsa kuti pakhale ngozi yobereka mwana asanakwane kapena kupita padera. Cervical cerclage imachitidwa kuti ipereke chithandizo chokhazikika ku khomo lachiberekero ndikusunga umphumphu wake panthawi yonse ya mimba.
Njirayi imachitidwa pansi pa anesthesia ya msana kapena wamba ndipo imaphatikizapo kuyika ma sutures (stitches) kuzungulira khomo lachiberekero. The cerclage nthawi zambiri amachotsedwa pafupi masabata 37 a bere kapena kale ngati pali zizindikiro za ntchito kapena zovuta zina.
Ngakhale cervical cerclage ingachepetse kwambiri chiopsezo cha kubadwa msanga, sikuli koopsa. Mavuto omwe angakhalepo ndi matenda, kutuluka magazi, kutuluka msanga kwa nembanemba, kapena kukwiya kwa khomo pachibelekeropo.
Mitundu ya Cervical Cerlage
Pali mitundu yosiyanasiyana ya cervical cerclage:
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Prophylactic kapena Elective Cerclage: Amachitidwa kumayambiriro kwa mimba, kawirikawiri pakati pa masabata 12 mpaka 14, kwa amayi omwe ali ndi mbiri ya kusakwanira kwa khomo lachiberekero koma palibe zizindikiro zamakono za kusintha kwa khomo lachiberekero.
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Cerclage yadzidzidzi kapena yopulumutsa: Zimachitika pamene zizindikiro za kusintha kwa khomo lachiberekero, monga kufupikitsa kapena kufutukuka, zimawonedwa pakapita mimba. Izi nthawi zambiri zimakhala zowopsa, koma cerclage imatha kukhala yothandiza popewa kubadwa kwanthawi yayitali.
- Transabdominal Cerclage: Zosungidwa nthawi zomwe njira zachikhalidwe za cerclage sizingatheke kapena zalephera. Kumaphatikizapo kuika bande mozungulira khomo pachibelekeropo kudzera m'mimba.
Njira ya Cervical Cerclage
Cervical cerclage ndi njira yopangira opaleshoni yomwe imachitidwa pofuna kulimbikitsa khomo lachiberekero panthawi yomwe ali ndi pakati, kuchepetsa chiopsezo cha kubadwa msanga kapena kupititsa padera kwa amayi omwe ali ndi vuto la khomo lachiberekero kapena mavuto ena a khomo lachiberekero. Ndondomekoyi imaphatikizapo njira zotsatirazi:
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Nthawi: Cervical cerclage nthawi zambiri imachitika pakati pa masabata a 12 ndi 14 a mimba, ngakhale kuti ikhoza kuchitidwa mpaka sabata la 24 nthawi zina. Nthawiyi imadalira mbiri yachipatala ya munthu komanso kuwunika kwa kutalika kwa khomo lachiberekero.
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Ochititsa dzanzi: Cervical cerclage ikhoza kuchitidwa pansi pa anesthesia wamba, anesthesia ya m'dera (monga epidural kapena spinal anesthesia), kapena anesthesia yapafupi, malingana ndi zomwe wodwalayo ndi wothandizira zaumoyo angakonde.
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Njira Yopangira Opaleshoni: Njirayi imatha kuchitidwa pogwiritsa ntchito njira zosiyanasiyana, kuphatikiza njira ya McDonald kapena Shirodkar. Mu njira ya McDonald, suture imayikidwa kuzungulira khomo lachiberekero ndikumangika kuti ipereke chithandizo. Njira ya Shirodkar imaphatikizapo opaleshoni yowonjezereka, pomwe gawo laling'ono la chiberekero limadulidwa kuti lipange ngalande ya suture.
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Kusamalira Pambuyo pa Ndondomeko: Pambuyo pa cervical cerclage, wodwalayo angalangizidwe kuchepetsa kuchita masewera olimbitsa thupi, kupewa kunyamula katundu, ndi kupewa kugonana kuti achepetse chiopsezo cha zovuta. Kupimidwa nthawi ndi nthawi ndikuyang'anitsitsa kutalika kwa khomo lachiberekero kudzachitidwa panthawi yonse ya pakati.
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Kuchotsa Cerclage: Nthawi zina, cervical cerclage imachotsedwa kumapeto kwa mimba, mwina kudzera mu ndondomeko yokonzekera kapena panthawi yobereka. Zimenezi zimathandiza kuti khomo pachibelekeropo kufutukuka mwachibadwa kuti mwana abereke.
Njira Yochotsera Cervical Stitch
Kuchotsa khomo lachiberekero, komwe kumachitika kumapeto kwa mimba kapena pamene chiwopsezo cha kubereka chacheperachepera, chimaphatikizapo njira yachangu komanso yosapweteka. Pogwiritsa ntchito speculum, wothandizira zaumoyo amafika pachibelekero, amadula mosamala ndikuchotsa nsonga zomwe zimayikidwa pa cervical cerclage. Kuchotsa kumeneku nthawi zambiri kumakhala njira yolunjika, yomwe imakhalapo kwa mphindi zingapo, ndipo kawirikawiri imaloledwa bwino ndi wodwalayo popanda kufunikira kwa anesthesia. Pambuyo pochotsa, khomo lachiberekero limayang'aniridwa kuti likhale lotsekedwa, ndipo njira zina zodzitetezera zingalangizidwe kupewa kubereka msanga.
