Amanqanaba we-Human Chorionic Gonadotropin (hCG) nokukhulelwa kwesisu: Okudingeka Ukwazi

-Delile

• Ukubuka konke
• Amazinga e-HCG ekukhulelweni
• Amazinga e-HCG ekukhulelweni kwesisu
• Ingabe amazinga aphansi asho ukususwa kwesisu?
• Ingabe amazinga okwehla asho ukuthi ukukhulelwa kwesisu?
• Ingabe ukukhuphuka kancane kusho ukuthi ukukhulelwa kwesisu?
• Udokotela usiqinisekisa kanjani isisu
• Ukuthola amazinga we-hCG abuyele ku-zero ngemuva kokukhulelwa kwesisu
• Ukuthatha

Ukubuka konke

I-chorionic gonadotropin (hCG) yihomoni ekhiqizwa ngumzimba ngesikhathi sokukhulelwa. Isekela ukukhula kombungu.

Odokotela bahlola amazinga e-hCG emchameni nasegazini ukuqinisekisa ukukhulelwa. Basebenzisa nokuhlolwa kwegazi kwe-hCG ukusiza ukuthola ukuthi umuntu angaba nokukhulelwa kwe-ectopic noma ukukhulelwa kwesisu.

Ukukhulelwa, ukukhulelwa kwe-ectopic, nokukhulelwa kwesisu ngeke kuze kutholakale ngokusekelwe ezingeni elilodwa le-hCG kuphela, kodwa kuyasiza ukwazi ukuthi la mazinga asebenza kanjani ezimweni ezinjalo.

Amazinga e-HCG ekukhulelweni

Uma ucabanga ukuthi ukhulelwe, udokotela uzohlola igazi elithathwe emthanjeni ukuze ahlole amazinga akho e-hCG.

Uma ungenayo i-hCG ekhona egazini lakho, lokhu akusho ukuthi awukhulelwe. Ungase usheshe kakhulu ekukhulelweni kwakho ukuze amazinga akho e-hCG akhule.

Amazinga e-HCG aphakeme kunamayunithi wamazwe angamamiliyoni ayisihlanu ngemililitha (mIU / mL) ethile ekhombisa ukukhulelwa. Umphumela wakho wokuqala wokuhlolwa ubhekwa njengezinga lokuqala. Leli zinga lingasuka kumanani amancane kakhulu we-hCG (njenge-20 mIU / mL noma ngisho nangaphansi) kuya kumanani amakhulu (njenge-2,500 mIU / mL).

Izinga eliyisisekelo libalulekile ngenxa yomqondo odokotela ababiza isikhathi esiphindwe kabili. Emavikini amane okuqala okukhulelwa okusebenzayo, amazinga e-hCG azoba kabili cishe njalo ezinsukwini ezimbili kuya kwezintathu. Ngemuva kwamasonto ayisithupha, amazinga azophindeka cishe njalo emahoreni angama-96.

Ngakho-ke, uma izinga lakho lesisekelo liphakeme kune-5 mIU / mL, udokotela wakho angalawula ukuhlolwa okuphindiwe ezinsukwini ezimbalwa kamuva ukubona ukuthi inombolo iphindwe kabili yini.

Lapho kungekho zingozi ezithile, lokhu (noma ileveli eyodwa eyengeziwe) kunganele ukunquma ukukhulelwa. Ezimweni eziningi, udokotela wakho uzobe esencoma ukuthi ube ne-ultrasound ngesinye isikhathi phakathi kwamasonto ayisishiyagalombili kuya kwayi-12 njengengxenye yokunakekelwa kokukhulelwa kokuqala kwezinyanga ezintathu zokuqala.

Amazinga e-HCG ekukhulelweni kwesisu

Uma usengozini yokukhulelwa kwesisu noma ukukhulelwa kwe-ectopic, kungenzeka ukuthi ube namazinga e-hCG angaphindi kabili. Zingancipha ngisho. Ngakho-ke, udokotela wakho angakucela ukuthi ubuyele ehhovisi labo ezinsukwini ezimbili kuya kwezintathu ngemuva kokuhlolwa kwegazi kwakho okuyisisekelo ukuze ubone ukuthi izinga lakho liphindwe kabili ngokufanele yini.

Uma amazinga akho e-hCG angasondeli ekuphindeni kabili ngemuva kwamahora angama-48 kuya kwangu-72, udokotela wakho angaba nokukhathazeka ukuthi ukukhulelwa kusengozini. Ngokwezokwelapha, lokhu kungabizwa ngokuthi “ukukhulelwa okungenakuvinjelwa” okungenzeka kube khona.

Uma amazinga akho ehla noma ekhuphuka kancane, uzothunyelwa nakokunye ukuhlolwa. Lokhu kungafaka ukuhlolwa kwegazi le-progesterone kanye ne-transvaginal ultrasound ukuhlola isizalo sakho ukuthi sinaso yini isikhwama sokukhulelwa. Ezinye izimpawu, njengokuphuma kwegazi noma ukucinana, nazo zizobhekwa.

Uma kwenzeka ukukhulelwa kwesisu, amazinga e-hCG ngokuvamile ancipha kusuka ezilinganisweni zangaphambilini. Isibonelo, ileveli eyisisekelo ye-120 mIU / mL eyehliselwe ku-80 mIU / mL ezinsukwini ezimbili kamuva ingakhombisa ukuthi umbungu awusakhuli futhi umzimba awukhiqizi ama-hormone amaningi ukuxhasa ukukhula kwawo.

Ngokunjalo, amazinga angaphindaphindeki futhi akhula kancane nje - ngokwesibonelo, kusuka ku-120 mIU / mL kuya ku-130 mIU / mL esikhathini esiyizinsuku ezimbili - kungakhombisa ukukhulelwa kwesibeletho okungavikeleki lapho ukukhulelwa kwesisu kungenzeka khona kungekudala.

Amaleveli aphuza ukukhuphuka angakhombisa nokukhulelwa okungewona isibeletho, okwenzeka lapho ukufakelwa kweqanda elikhulelisiwe kwenye indawo ngaphandle kwesibeletho (imvamisa amashubhu e-fallopian). Ngoba ukukhulelwa kwe-ectopic kungaba yisimo esiphuthumayo sezokwelapha, kubalulekile ukuthi udokotela akukhombe lokhu ngokushesha okukhulu.

Ngakolunye uhlangothi, kungenzeka futhi ukuba namazinga e-hCG aphindwe kabili ngokukhulelwa kwe-ectopic. Yingakho amazinga e-hCG kuphela enganele ukunquma ukuthi kwenzekani ngokunemba okungamaphesenti ayi-100.

Ingabe amazinga aphansi asho ukususwa kwesisu?

Isisekelo esiphansi empeleni asiyona inkomba yanoma yiziphi izinkinga ngokwazo. Ububanzi obujwayelekile be-hCG ezindaweni ezahlukahlukene zokukhulelwa bukhulu kakhulu.

Isibonelo, usuku olulodwa nje ngemuva kwesikhathi sakho esilahlekile, izinga lakho le-hCG lingaba yi-10 noma i-15 mIU / mL. Noma kungaba ngaphezu kwama-200 mIU / mL. Ukukhulelwa ngakunye kwehlukile kulokhu.

Okubaluleke kakhulu ushintsho ngokuhamba kwesikhathi. Abantu abehlukene bazoba nezisekelo ezihlukile futhi basazokhulelwa okungapheli.

Ingabe amazinga okwehla asho ukuthi ukukhulelwa kwesisu?

Uma amazinga akho ehla, umbono wokukhulelwa kwakho akuvamile ukuthi ube muhle.

Kungenzeka ukuthi ilabhorethri ibingenza iphutha. Kungenzeka futhi ukuthi isimo esivele sikhona, njenge-ovarian hyperstimulation syndrome (OHSS) kulandela ukwelashwa kokuzala, sithinta amazinga akho e-hormone.

Kodwa-ke, ngokujwayelekile, ukwehla kwamazinga we-hCG ngemuva komphumela omuhle wokukhulelwa akusona isibonakaliso esihle. Amathuba okuthi ukukhulelwa akunakugwenywa, ngokusho kwephephabhuku i-Fertility and Sterility.

Ingabe ukukhuphuka kancane kusho ukuthi ukukhulelwa kwesisu?

Ukukhuphuka kancane kwamazinga e-hCG akusho ukuthi uyaphuphunyelwa yisisu, noma imvamisa izokhombisa ukuhlolwa okuqhubekayo ukubona ukuthi ukhona yini.

Odokotela basebenzisa idatha ngokususelwa ezifundweni ezincane kulabo abakhulelwe ngemuva kokwelashwa kokukhulelwa, ngokusho kwephephabhuku i-Fertility and Sterility. Izinombolo ze-hCG zingasiza ekuqondiseni izinyathelo ezilandelayo, kodwa aziyona inkomba ephelele yokukhulelwa kwesisu noma ukukhulelwa okusebenzayo.

Odokotela ngokuyinhloko basebenzisa izikhathi eziphindwe kabili ukuze qinisekisa ukukhulelwa, hhayi ukuxilonga isisu. Ngokusho kwephephabhuku, ukwanda ngamaphesenti angama-53 noma ngaphezulu kwamazinga e-hCG ngemuva kwezinsuku ezimbili kungaqinisekisa ukukhulelwa okusebenzayo kumaphesenti angama-99 okukhulelwa.

Isici esibalulekile okufanele usicabangele ngezikhathi eziphindwe kabili inani le-hCG yokuqala.Isibonelo, labo abanezinga le-hCG eyisisekelo elingaphansi kwe-1,500 mIU / mL bane "igumbi" elengeziwe lokukhulisa amazinga abo e-hCG.

Umuntu okungenzeka aqhubekele phambili kunokucabanga kwakhe futhi aqale ezingeni eliphakeme le-hCG elingu-5,000 mIU / mL noma ngaphezulu ngokuvamile akanalo inani elifanayo lokunyuka kwe-hCG, ngokusho kwe-.

Ukuthwala ama-multiples (amawele, ama-triplets, njll.) Kungathinta izinga lokunyuka kwe-hCG, nokuthi ukude kangakanani.

Ukukhulelwa kwe-Ectopic nokukhulelwa kwesisu kungaholela emazingeni aphansi e-hCG. Ukukhulelwa kwe-molar kungaholela emazingeni aphezulu.

Udokotela usiqinisekisa kanjani isisu

Odokotela bazosebenzisa izivivinyo ezahlukahlukene ukuqinisekisa ukuphuphunyelwa yisisu. Lokhu kufaka phakathi:

• ukwenza ukuhlolwa kwegazi, kufaka phakathi i-hCG ne-progesterone
• ucubungula izimpawu, njengokuqaqamba kwezitho zangasese noma ukuphuma kwegazi esithweni sangasese
• ukwenza ukuhlolwa kwesitho sangasese sowesifazane kanye nokuhlolwa okhalo
• ukwenza ukuskena kwenhliziyo kwengane (uma izinsuku zakho zikhombisa ukushaya kwenhliziyo kwengane kufanele kutholakale)

Udokotela wakho uzothatha izingcezu ezimbalwa zolwazi azibhekele ngaphambi kokuthola isisu. Uma ukukhulelwa kusheshe kakhulu, ukwehla kwamazinga e-hCG kungaba ukuphela kwendlela yokunquma ukuthi ukukhulelwa kwesisu kungenzeka kuze kudlule isikhathi esithe xaxa.

Kubalulekile ukuthi odokotela bakhombe ukukhulelwa kwesisu noma ukukhulelwa kwe-ectopic ngokushesha okukhulu. Ukukhulelwa kwe-ectopic kungaholela ekuqhekekeni kweshubhu le-fallopian noma okunye ukulimala okusongela ukuzala kwakho nokuphila kwakho. Ukuphuphuma kwesisu okuholela kwizicubu ezigciniwe kwandisa ukutheleleka kanye nengozi yokopha.

Ngalezi zizathu, uma uhlangabezana nokulahlekelwa ukukhulelwa, udokotela wakho angancoma ukuthatha imishanguzo noma ukwelashwa okuthile ukuze unciphise izinkinga.

Ukukhulelwa kokukhulelwa nakho kungalimaza ngokomzwelo. Ukuxilongwa kunganikeza ukuvalwa futhi kuvumele ukudabuka kanye nenqubo yokuphulukisa iqale.

Ukuthola amazinga we-hCG abuyele ku-zero ngemuva kokukhulelwa kwesisu

Uma ukhipha isisu (futhi futhi nganoma yisiphi isikhathi lapho ubeletha), umzimba wakho awusakhiqizi i-hCG. Amaleveli akho ekugcineni azobuyela ku-0 mIU / mL.

Eqinisweni, noma yini engaphansi kwe-5 mIU / mL "inegethivu," ngempumelelo, i-1 kuye ku-4 mIU / mL nayo ibhekwa njenge- "zero" odokotela.

Uma unokukhulelwa kwesisu, isikhathi esithatha ukuthi amazinga akho aye ku-zero ayahluka ngokuya ngokuthi amazinga akho abephakeme kangakanani ngesikhathi sokuphuphuma kwesisu. Uma ukhipha isisu ekuqaleni kokukhulelwa kwakho futhi amazinga akho e-hCG awakhuphukile kakhulu, amazinga akho ngokuvamile azobuyela eqandeni ezinsukwini ezimbalwa.

Uma izinga lakho le-hCG lalisezinkulungwaneni noma emashumini ezinkulungwane lapho uphuphunyelwa yisisu, kungathatha amasonto ambalwa ukuthi amazinga akho abuyele ku-zero, ngokusho kwe-American Association for Clinical Chemistry.

Uma ufika kuziro, imvamisa uzoqala ukuba nesikhathi sakho futhi uvule futhi amaqanda.

Odokotela abavame ukuncoma ukuthi uzame ukukhulelwa futhi uze ube nesikhathi sokuqala ngemuva kokukhulelwa kwakho. Lokhu kwenza kube lula ukubala usuku lwakho olufanele.

Uma unenqubo ye-D no-C (i-dilation and curettage) njengengxenye yokukhulelwa kwakho kwesisu, udokotela wakho angancoma ukulinda imijikelezo emibili noma emithathu ngaphambi kokuzama ukukhulelwa futhi. Lokhu kungenxa yokuthi i-D no-C zinganciphisa ulwelwesi lwesibeletho, futhi ulwelwesi olujiyile lungcono ekukhulelweni. Ulwelwesi luzokwakha ngaphezulu kwezinyanga ezimbalwa.

Ukuthatha

Ukuphuphuma kwesisu kusenesikhathi kungaba yinto ebuhlungu engokomzwelo nengokomzimba. Uma usola ukuthi kungenzeka ukuthi uphuphunyelwa yisisu, khuluma nodokotela wakho. Udokotela wakho angalawula ukuhlolwa, kufaka phakathi ukuhlolwa kwegazi kwe-hCG, ukukunikeza eminye imininingwane.

Uma ngabe uphuphunyelwa yisisu, yazi ukuthi akusho ukuthi ngeke uqhubeke nokukhulelwa ngempumelelo. Eqinisweni, iningi labantu liyakwenza.

Futhi yazi ukuthi kunezinhlangano eziningi ezihlinzeka ukwesekwa kulabo abahlangabezane nokulahleka kokukhulelwa. Khuluma nodokotela wakho ukuthola eminye imininingwane.