Ukutheleleka Kwamanxeba E-Post-Cesarean: Kwenzeke Kanjani Lokhu?

-Delile

• Izici ezinobungozi bokutheleleka kwesilonda se-C-section
• Izimpawu zokutheleleka kwesilonda se-post-cearean noma inkinga
• Kutholakala kanjani ukutheleleka kwesilonda?
• Izinhlobo nokubukeka kwezifo ngemuva kwesigaba se-C
• I-cellulitis
• Isilonda (esiswini) ithumba
• I-Thrush
• Izifo zomgudu womchamo nesinye
• Kufanele selashwe kanjani isifo sesilonda?
• Ungakuvimbela kanjani ukutheleleka kwesilonda se-C-section
• Izinkinga zalesi simo
• I-Outlook yokutheleleka kwesilonda se-post-cearean

Ukutheleleka kwesilonda se-post-cearean (C-section)

Ukutheleleka kokulimala ngemuva kokuhlinzwa kubangelwa ukutheleleka okwenzeka ngemuva kwesigaba se-C, esibizwa nangokuthi ukulethwa kwesisu noma kokuhlinzwa. Ngokuvamile kungenxa yokutheleleka kwebhaktheriya endaweni yokuhlinzwa yokuhlinzwa.

Izimpawu ezijwayelekile zifaka imfiva (100.5ºF kuye ku-103ºF, noma u-38ºC kuye ku-39.4ºC), ukuzwela kwesilonda, ukuba bomvu nokuvuvukala endaweni, nobuhlungu besisu obuphansi. Kubalulekile ukwelashwa ngokushesha ukuvimbela izinkinga ekuthelelekeni.

Izici ezinobungozi bokutheleleka kwesilonda se-C-section

Abanye besifazane banamathuba amaningi kunabanye okuthola ukutheleleka kwenxeba ngemuva kokuhlinzwa. Izici zobungozi zingabandakanya:

• ukukhuluphala ngokweqile
• isifo sikashukela noma i-immunosuppressive disorder (njenge-HIV)
• chorioamnionitis (ukutheleleka kolwelwesi lwe-amniotic nolwelwesi lombungu) ngesikhathi sokubeletha
• ukuthatha i-steroids yesikhathi eside (ngomlomo noma ngemithambo yegazi)
• ukunakekelwa okungalungile kokubeletha (ukuvakashelwa okumbalwa kudokotela)
• ukulethwa okwedlule
• ukungabi khona kwama-antibiotics okuxwayisa noma ukunakekelwa kwe-antimicrobial pre-incision
• umsebenzi omude noma ukuhlinzwa
• ukopha ngokweqile ngesikhathi sokubeletha, sokubeletha noma sokuhlinzwa

Ngokusho kocwaningo lwango-2012 olushicilelwe ku, abesifazane abathola imisipho yenayiloni ngemuva kokubeletha ngokuhlinzwa bakhona amathuba okuba batheleleke ngezifo. Ukuthungwa okuyisisekelo nakho kungaba yinkinga. Ama-Suture enziwe nge-polyglycolide (PGA) ayancomeka ngoba womabili ayamunca futhi aboliseka kalula.

Izimpawu zokutheleleka kwesilonda se-post-cearean noma inkinga

Uma uke wabeletha ngokuhlinzwa, kubalulekile ukuqapha ukubonakala kwesilonda sakho bese ulandela imiyalo kadokotela ngemuva kokuhlinzwa. Uma ungakwazi ukubona isilonda, funa othandekayo ahlole isilonda nsuku zonke ukuze abheke izimpawu eziyisixwayiso zokutheleleka kwesilonda. Ukulethwa ngokuhlinzwa kungakubeka engcupheni yezinye izinkinga, njengamahlule egazi.

Shayela udokotela wakho ukuthola iseluleko noma funa ukunakekelwa kwezokwelapha uma unezinye zalezi zimpawu ngemuva kokuphuma kwakho esibhedlela:

• ubuhlungu obukhulu besisu
• ububomvu esizeni sokusikwa
• ukuvuvukala kwesiza sokusika
• ukukhishwa kwe-pus kusuka kusayithi lokusika
• ubuhlungu esizeni sokusikwa esingasuki noma siba sibi kakhulu
• umkhuhlane uphakeme kuno-100.4ºF (38ºC)
• ukuchama kabuhlungu
• ukukhishwa kwesitho sangasese esinuka kabi
• ukopha okucwilisa iphedi lesifazane kungakapheli ihora
• ukopha okuqukethe amahlule amakhulu
• ubuhlungu bomlenze noma ukuvuvukala

Kutholakala kanjani ukutheleleka kwesilonda?

Okunye ukutheleleka kwesilonda ngemuva kokuhlinzwa kunakekelwa ngaphambi kokuba isiguli sikhishwe esibhedlela. Kodwa-ke, izifo eziningi aziveli kuze kube ngemuva kokuphuma esibhedlela. Eqinisweni, izifo eziningi zesilonda sangemva kokubeletha zivame ukuvela emasontweni ambalwa okuqala ngemuva kokubeletha. Ngalesi sizathu, iningi lalezi zifo litholakala ekuvakasheni okulandelayo.

Ukutheleleka kwamanxeba kutholakala nge:

• ukubonakala kwesilonda
• inqubekela phambili yokuphulukisa
• Ukuba khona kwezimpawu zokutheleleka ezivamile
• ukutholakala kwamagciwane athile

Udokotela wakho kungadingeka avule isilonda ukuze ahlolwe futhi akunikeze ukwelashwa okufanele. Uma ubovu bumunca esikhunjeni, udokotela angasebenzisa inaliti ukususa ubomvu enxebeni. Uketshezi kungathunyelwa ebhodini ukukhomba noma yimaphi amabhaktheriya akhona.

Izinhlobo nokubukeka kwezifo ngemuva kwesigaba se-C

Ukutheleleka kwesilonda ngemuva kokuhlinzwa kubekwe esigabeni sokulimala kwe-cellulitis noma ithumba lesilonda (esiswini). Lezi zifo zesilonda zingasakazeka futhi zidale izinkinga ngezitho, isikhumba, igazi nezicubu zendawo.

I-cellulitis

I-cellulitis yesilonda imvamisa ingumphumela wamagciwane we-staphylococcal noma we-streptococcal. Lezi zinhlobo ziyingxenye yamagciwane ajwayelekile atholakala esikhunjeni.

Nge-cellulitis, izicubu ezinegciwane ngaphansi kwesikhumba ziyavuvukala. Ububomvu nokuvuvukala kusakazeka ngokushesha kusuka ekuzihlinzeni okungaphandle kuya esikhunjeni esiseduze. Isikhumba esinegciwane sivamise ukufudumala futhi sithambile uma sithintwa. Ngokuvamile, ubomvu abukho kusike uqobo.

Isilonda (esiswini) ithumba

Ithumba lesilonda (esiswini) lidalwa amagciwane afanayo nasesilonda i-cellulitis namanye amabhaktheriya. Ukutheleleka endaweni yesikhumba sokuhlinzwa kuholela ekubomvu, ubumnene, nokuvuvukala emaphethelweni okusika. I-Pus iqoqa emgodini wezicubu obangelwa ukutheleleka kwebhaktheriya. Amathumba amaningi enxeba nawo aphuma ubomvu lapho kusikwa.

Amathumba angakheka ekusikeni kwesibeletho, izicubu ezibomvu, amaqanda, nezinye izicubu noma izitho eziseduze lapho ukutheleleka kukhona ngemuva kokuhlinzwa.

Amanye amabhaktheriya abangela ithumba lesilonda nawo angadala i-endometritis. Lokhu ukucasuka ngemuva kokuhlinzwa okwenziwe ngocingo lwesibeletho okungadala:

• ubuhlungu
• ukopha okungavamile
• ukukhipha
• ukuvuvukala
• imfiva
• ukulele

Ezinye izifo ezivamile ngemuva kwesigaba se-C azitholakali ngaso sonke isikhathi kwabesifazane abanesifo se-incision site. Lokhu kufaka phakathi ukutheleleka kwe-thrush ne-urinary noma yesinye:

I-Thrush

I-Thrush idalwa yisikhunta UCandida, okuvame ukuba khona emzimbeni womuntu. Le fungus ingadala ukutheleleka kubantu abathatha ama-steroids noma ama-antibiotics nakubantu abanamasosha omzimba abuthakathaka. Isikhunta singadala ukutheleleka kwemvubelo yesitho sangasese sowesifazane noma izilonda ezibuthakathaka ezibomvu nezimhlophe emlonyeni. Imithi ayidingeki ngaso sonke isikhathi, kepha umuthi wokubulala ukubola noma ukugeza umlomo kungakusiza ukulwa nokutheleleka. Yidla i-yogurt namanye ama-probiotic ukuvimbela ukwanda kwemvubelo, ikakhulukazi uma ngabe ubusebenzisa ama-antibiotic.

Izifo zomgudu womchamo nesinye

Ama-Catheters asetshenziswa ngesikhathi uhlala esibhedlela angadala izifo zomgudu womchamo kanye nesinye. Lezi zifo ngokuvamile ziwumphumela we- E. coli bacteria futhi iyelapheka nge-antibiotic. Kungadala umuzwa ovuthayo ngesikhathi sokuchama, isidingo esivamile sokuchama, nomkhuhlane.

Kufanele selashwe kanjani isifo sesilonda?

Uma unesilonda se-cellulitis, ama-antibiotics kufanele aqede ukutheleleka. Ama-antibiotic aqonde ngqo kubhaktheriya be-staphylococcal ne-streptococcal. Esibhedlela, ukutheleleka kwamanxeba kuvame ukwelashwa ngemithi elwa namagciwane emithanjeni. Uma uphathwa njengesiguli esingalaliswayo, uzonikezwa noma unikezwe ama-antibiotic ozowathatha ekhaya.

Amathumba enxeba nawo aphathwa ngama-antibiotics futhi adinga ukunakekelwa okukhethekile. Udokotela wakho uzovula imbobo kuyo yonke indawo enegciwane, bese ekhipha ubomvu. Ngemuva kokuthi indawo igezwe ngokucophelela, udokotela wakho uzovimbela ukuqongelela kobovu ngokubeka isibulala-magciwane esine-gauze kuso. Isilonda sizodingeka sihlolwe njalo ukuqinisekisa ukwelashwa okufanele.

Ngemuva kwezinsuku ezimbalwa zokwelashwa kwama-antibiotic nokunisela, udokotela wakho uzophinda ahlole ukusikeka futhi. Kuleli qophelo, isilonda singavalwa futhi noma sivunyelwe ukuziphilisa sisodwa.

Ungakuvimbela kanjani ukutheleleka kwesilonda se-C-section

Okunye ukutheleleka kwendawo okuhlinzwa kungaphandle kokulawula kwakho. Uma uke waba nesigaba se-C, noma kunjalo, ungathatha izinyathelo ezithile ukunciphisa amathuba okuthola ukutheleleka. Uma ucabanga nge-C-section ekhethiwe, ungathatha izinyathelo zokuvimbela izinkinga.

Uma usuvele unalo lolu hlobo lokuhlinzwa, nazi ezinye izinyathelo ongazithatha:

• Landela imiyalo yokunakekelwa kwesilonda kanye nemiyalelo yemithi yokusebenza ngemuva kokuhlinzwa enikezwe udokotela wakho noma unesi. Uma unemibuzo, unganqikazi ukubiza udokotela wakho.
• Uma unikezwe ama-antibiotic ukwelapha noma ukuvimbela ukutheleleka, musa ukweqa amanani noma uyeke ukuwasebenzisa uze uqede yonke inkambo yokwelashwa.
• Hlanza isilonda sakho futhi ushintshe ukubopha isilonda njalo.
• Ungagqoki izimpahla ezimpintshayo noma ugcobe amafutha emzimbeni wesilonda.
• Cela izeluleko ngokubamba nokondla ingane ukugwema ingcindezi engaphatheki enxebeni lakho, ikakhulukazi uma uhlela ukuncelisa.
• Zama ukugwema ukuvumela amafolda esikhumba ukumboza nokuthinta indawo yokusika.
• Thatha izinga lokushisa lakho nge-thermometer yomlomo uma uzizwa uphethwe ngumkhuhlane. Funa ukunakekelwa kwezempilo noma ushayele udokotela wakho uma uhlangabezana nomkhuhlane ongaphezu kuka-100ºF (37.7ºC).
• Funa ukunakekelwa kwezempilo ngamasayithi okusika aqukethe ubomvu, ukuvuvukala, kube buhlungu kakhulu, noma kubonise ububomvu esikhunjeni esisakazeka kusuka kusiza sokusika.

Abesifazane abanokubeletha kwabesifazane mancane amathuba okuthi bathole izifo zangemva kokubeletha. Kwezinye izimo, noma kunjalo, ukuzalwa kwesitho sangasese sowesifazane ngemuva kwe-C-section (VBAC) kuyingozi ngenxa yezinye izingozi kumama nasenganeni. Xoxa nodokotela wakho ngezici zakho zobungozi.

Uma ungazange ube nesigaba se-C, nazi ezinye izinyathelo ongazithatha:

• Gcina isisindo esinempilo. Uma ungakakhulelwa, zivocavoca umzimba bese ulandela indlela yokudla enempilo ukuze ugweme ukukhulelwa ngenkomba yokukhuluphala komzimba (BMI).
• Khetha ukuhlinzekwa kwesitho sangasese sowesifazane, okuzenzekelayo nokulethwa uma kungenzeka. Abesifazane abanokubeletha kwabesifazane mancane amathuba okuthi bathole izifo zangemva kokubeletha. (Lokhu kunjalo nakwabesifazane abake baba nesigaba se-C, kepha i-VBAC iyingozi kwezinye izimo. Kufanele ixoxwe nodokotela.)
• Phatha izimo esezikhona ezenza ukuthi amasosha omzimba akho abe buthakathaka. Uma unesifo noma ukugula, zama ukukuphatha ngaphambi kokukhulelwa noma ngaphambi kosuku lwakho olubekiwe uma kuphephile kuwe nasenganeni ukwenza kanjalo.

Kufanele futhi ukhethe indlela ephephe kunazo zonke yokuvalwa kwesilonda. Uma udokotela wakho ehlela ukusebenzisa ukudla okuyisisekelo, buza ukuthi ikhona yini enye indlela (efana ne-PGA sutures). Cela ama-antibiotic ngaphambi kokusika kanye nemiyalelo yokunakekelwa kwesilonda ngokuphelele kulabo abakwelapha esibhedlela. Futhi, cela ukuhlola izimpawu zokutheleleka ngaphambi kokuba uye ekhaya ubuya esibhedlela.

Izinkinga zalesi simo

Kwezinye izimo, ukutheleleka kwesilonda kungadala izinkinga ezinkulu. Izibonelo zifaka:

• necrotizing fasciitis, okutheleleka ngamagciwane okubulala izicubu ezinempilo
• ukuqhekeka kwe-fascia noma ukwehla kwesilonda, okuwukuvulwa kwesendlalelo sesikhumba nezicubu ezaxhunywa ngemuva kokuhlinzwa
• evisceration, okuwukuvulwa kwesilonda ngamathumbu eza ngokusebenzisa ukusikeka

Uma uthuthukisa enye yalezi zinkinga, bazodinga ukulungiswa kokuhlinzwa. Lokhu futhi kungaholela esikhathini esithe xaxa sokutakula. Ezimweni ezingavamile, izinkinga zingase zibulale.

I-Outlook yokutheleleka kwesilonda se-post-cearean

Uma welashwa kusenesikhathi, ungalulama ekungenweni yi-post-cearean ngemiphumela embalwa yesikhathi eside. Ngokusho komtholampilo iMayo, ukuphulukiswa okujwayelekile okusika imbobo kuthatha amasonto amane kuya kwayisithupha. Kodwa-ke, uma kutholakala ukutheleleka kwesilonda ngaphambi kokuba uphume esibhedlela, ukuhlala kwakho esibhedlela kungaba okungenani izinsuku ezimbalwa ubude. (Lokhu kuzokhuphula nezindleko zakho zokulaliswa esibhedlela.)

Uma usuvele ubuyiselwe ekhaya ngesikhathi isifo sakho sesilonda sangemva kokuhlinzwa sivela, kungadingeka ukuthi ubuyiselwe emuva ukuze uthole imithambo yegazi noma ukuhlinzwa okuqhubekayo. Ezinye zalezi zifo zingelashwa ngokugula okungapheli ngokuvakashelwa odokotela abengeziwe nemithi elwa namagciwane.