Ukwelashwa Kwezabasebenzi Bangaphambi Kokusebenza: I-Tocolytics

-Delile

• Imithi ye-Tocolytic
• Uhlobo luni lomuthi onobuthi okufanele usetshenziswe?
• Ngikusiphi isikhathi lapho ngikhulelwe engingayisebenzisa khona imishanguzo enobuthi?
• Imishanguzo ye-tocolytic kufanele iqhubeke isikhathi eside kangakanani?
• Iphumelela kangakanani imithi ye-tocolytic?
• Ubani okungafanele asebenzise imishanguzo ye-tocolytic?

Imithi ye-Tocolytic

I-Tocolytics yizidakamizwa ezisetshenziselwa ukubambezela ukulethwa kwakho isikhathi esifushane (kufika emahoreni angama-48) uma uqala ukubeletha kusenesikhathi sokukhulelwa kwakho.

Odokotela basebenzisa le mithi ukubambezela ukulethwa kwakho ngenkathi udluliselwa esibhedlela esikhethekile ukunakekelwa kwangaphambi kokubeletha, noma ukuze bakunikeze i-corticosteroids noma i-magnesium sulfate. Imijovo ye-corticosteroid isiza ukuvuthwa kwamaphaphu engane.

IMagnesium sulfate ivikela ingane engaphansi kwamasonto angama-32 ekukhubazekeni kobuchopho, kodwa futhi ingasetshenziswa njenge-tocolytic. I-Magnesium sulfate nayo isetshenziselwa ukuvikela ukuquleka kwabesifazane abakhulelwe abane-preeclampsia (umfutho wegazi ophakeme).

Ezinye izidakamizwa ezingasetshenziswa njenge-tocolytic zifaka:

• i-beta-mimetics (isibonelo, terbutaline)
• ama-calcium channel blockers (ngokwesibonelo, i-nifedipine)
• izidakamizwa ezingezona ukuvuvukala noma ama-NSAID (ngokwesibonelo, indomethacin)

Imininingwane ejwayelekile ngalezi zidakamizwa inikezwe ngezansi.

Uhlobo luni lomuthi onobuthi okufanele usetshenziswe?

Ayikho idatha ekhombisa ukuthi umuthi owodwa uhlala ungcono kunomunye, futhi odokotela ezingxenyeni ezahlukene zezwe banokuthandwa okuhlukile.

Ezibhedlela eziningi, i-terbutaline inikezwa ikakhulukazi uma owesifazane esengozini encane yokusheshe abelethe ingane yakhe. Kwabesifazane abasengozini enkulu yokubeletha kungakapheli isonto elizayo, i-magnesium sulfate (efakwa ngemithambo yegazi) imvamisa iyisidakamizwa esizikhethelayo.

Ngikusiphi isikhathi lapho ngikhulelwe engingayisebenzisa khona imishanguzo enobuthi?

Imithi ye-Tocolytic yomsebenzi wokuqala ngaphambi kwesikhathi ayisetshenziswa ngaphambi kwamasonto angama-24 okukhulelwa. Ezimweni ezithile, udokotela wakho angayisebenzisa uma unamasonto angama-23 ukhulelwe.

Odokotela abaningi bayayeka ukunikeza i-tocolytics ngemuva kokuthi owesifazane efinyelele esontweni lakhe lama-34 lokukhulelwa, kepha abanye odokotela baqala i-tocolytics ngemuva kwamasonto angama-36.

Imishanguzo ye-tocolytic kufanele iqhubeke isikhathi eside kangakanani?

Udokotela wakho angazama kuqala ukwelapha umsebenzi wakho wokuqala ngaphambi kokuphumula kombhede, uketshezi olwengeziwe, umuthi wezinhlungu, kanye nomthamo owodwa wemithi ye-tocolytic. Bangase futhi benze ukuhlolwa okuqhubekayo (njengokuhlolwa kwe-fetal fibronectin ne-transvaginal ultrasound) ukuthola kangcono ubungozi bakho bokulethwa ngaphambi kwesikhathi.

Uma ukucindezela kwakho kungapheli, isinqumo sokuqhubeka nemithi enobuthi, nokuthi isikhathi esingakanani, sizosuselwa engcupheni yakho yangempela yokulethwa ngaphambi kwesikhathi (njengoba kunqunywe ukuhlolwa kokuhlolwa), iminyaka yengane, kanye nesimo sengane amaphaphu.

Uma izivivinyo zibonisa ukuthi usengozini enkulu yokulethwa ngaphambi kwesikhathi, udokotela wakho mhlawumbe uzokunika i-magnesium sulfate okungenani amahora angama-24 kuye kwangama-48 kanye nemithi ye-corticosteroid yokuthuthukisa umsebenzi wamaphaphu womntwana.

Uma ama-contractions eyeka, udokotela wakho uzonciphisa bese eyeka i-magnesium sulfate.

Uma izingqinamba ziqhubeka, udokotela wakho angalawula izivivinyo ezengeziwe ukukhipha ukutheleleka okuyisisekelo esibelethweni. Udokotela angenza futhi isivivinyo ukuthola isimo samaphaphu engane.

Iphumelela kangakanani imithi ye-tocolytic?

Awukho umuthi we-tocolytic okhonjiswe ukubambezela ukulethwa isikhathi esithile esibalulekile.

Kodwa-ke, imishanguzo ye-tocolytic ingabambezela ukulethwa okungenani isikhashana (imvamisa izinsuku ezimbalwa). Lokhu kuvame ukunikeza isikhathi esanele sokuthola inkambo ye-steroids. Imijovo ye-corticosteroid inciphisa ubungozi enganeni yakho uma ifika kusenesikhathi.

Ubani okungafanele asebenzise imishanguzo ye-tocolytic?

Abesifazane akufanele basebenzise imishanguzo ye-tocolytic lapho izingozi zokusebenzisa imithi zidlula izinzuzo.

Lezi zinkinga zingabandakanya abesifazane abane-preeclampsia noma i-eclampsia (umfutho wegazi ophakeme okhula ngesikhathi sokukhulelwa futhi ongadala izinkinga), ukopha kakhulu (ukopha), noma ukutheleleka esibelethweni (chorioamnionitis).

Imithi yeTocolytic nayo akufanele isetshenziswe uma ingane ishonele esibelethweni noma uma ingane inokukhubazeka okungaholela ekufeni ngemuva kokubeletha.

Kwezinye izimo, udokotela angaqaphela ngokusebenzisa imishanguzo ye-tocolytic, kepha angayinikeza ngoba izinzuzo zidlula izingozi. Lezi zimo zingafaka lapho umama ene:

• preeclampsia emnene
• ukopha okuzinzile phakathi ne-trimester yesibili noma yesithathu
• izimo ezibucayi zezokwelapha
• umlomo wesibeletho osuvele unwebe ngamasentimitha ama-4 kuye kwayi-6 noma ngaphezulu

Udokotela usengasebenzisa i-tocolytics lapho ingane inesilinganiso esingajwayelekile senhliziyo (njengoba kukhonjisiwe kumonitha we-fetus), noma ukukhula kancane.