Mgbasawanye oghere akpa nwa
Mgbasawanye oghere akpa nwa (ma ọ bụ mgbasawanye oghere akpa nwa) bụ mmepe nke oghere akpa nwa, ọnụ ụzọ mbata nke akpa nwa, n'oge ịmụ nwa, ime ọpụpụ, ite ime, ma ọ bụ ịwa ahụ. Mgbasawanye nke akpa nwa nwere ike ime n'ụzọ okike, ma ọ bụ site na ịwa ahụ ma ọ bụ ọgwụ.
N'ọmụmụ nwa[dezie | dezie ebe o si]
N'oge ikpeazụ nke ime ime, akpa nwa nwere ike imepelarị ruo 1-3 cm (ma ọ bụ karịa n'ọnọdụ ndị a na-adịghị ahụkari), mana n'oge ịmụ nwa, mkpi nke akpa nwa ugboro ugboro na-eduga mbawanye nke oghere akpa nwa ruo ihe dị ka sentimita 6. Site n'oge ahụ, nrụgide sitere na ngosi nke akụkụ (isi na ọmụmụ vertex ma ọ bụ ala na ọmụmụ breech), tinyere mkpi akpa nwa, ga-agbasawanye cervix ruo sentimita 10, nke bu "ozuzu". Mgbasawanye oghere ọmụmụ na-esonye effacement, ịhịa aka n'ahụ nke oghere ọmụmụ.
Ntuziaka n'ozuzu maka ịgbasa oghere akpa nwa:
- Oge zoro ezo: 0-3 sentimita
- Ọrụ siri ike: 4-7 sentimita
- Mgbanwe: 8-10 sentimita
- Zuru ezu: sentimita iri. Ịmụ nwa ahụ na-ewere ọnọdụ n'oge na-adịghị anya mgbe a ruru ọkwa a (ọ bụ ezie na nne anaghị achụpụ ya ozugbo).
Mgbaàmà[dezie | dezie ebe o si]
N'oge ime, os (mmeghe) nke oghere akpa nwa na enwe mgbochi site na oké nkwunye imi na-eme ka nke ghara ịbanye n'akpa nwa. ime ime N'oge mgbasawanye, Nkwunye a na atọ hapụ. Ọ nwere ike ịpụta dị ka otu akụkụ, ma ọ bụ dị ka nnukwu mmiri na-esi n'ahụ nwanyị apụta. Mgbe nke a mere, ọ bụ ihe na-egosi na akpa nwa na-amalite ịgbasa, ọ bụ ezie na ọ bụghị ụmụ nwanyị niile ga-ahụ ka Nkwunye a na-ahapụ.
Ihe ngosi ọbara bụ ihe ọzọ na-egosi na oghere akpa nwa na-agbasa.Ihe ngosi ọbara na-esonyekarị ihe nkwunye imi, ma nwee ike ịga n'ihu n'oge niile a na-arụ ọrụ, na-eme ka ihe nkedo na-acha pinki, ọbara ọbara ma ọ bụ nchara nchara. Ọbara ọhụrụ anghi ejikọta na mgbasawanye oghere akpa nwa, kama ọ bụ nsogbu siri ike dị ka abruption placenta, ma ọ bụ placenta previa. placenta abruption tupu placenta Ọbara ọhụrụ dị nta na-agbasokarị ule.
Ihe mgbu a na-enwe n'oge mgbasawanye oghere akpa nwa yiri nke ịhụ nsọ (ọ bụ ezie na ọ dị oke njọ), ebe a na-eche na ihe mgbu oge ịhụ nsọ bụ n'ihi na endometrium na-agafe n'oghere akpa nwa. Ọtụtụ ihe mgbu oge ime ime sitere na mkpi oghere akpa nwa iji gbasaa akpa nwa.
Mgbasawanye na-akpata n'oge ịmụ nwa[dezie | dezie ebe o si]
Prostaglandins (P2 na PGE2) na-enye aka na uto na mgbasawanye. Ahụ́ na-emepụta homonụ ndị a n'ụzọ okike. Mgbe ụfọdụ, a na-etinye prostaglandins n'ụdị ndị a na-emepụta kpọmkwem na oghere akpa nwa iji mee ka a mụọ nwa.[1] N'ime ụmụ nwanyị ndị nwere ngalaba ịwa ahụ n'oge gara aga, Ụlọ akwụkwọ Amerika nke Obstetricians na Gynecologists wepụtara akwụkwọ akụkọ na a gaghị eji misoprostol mee ihe maka nzube a. Nchoputa ACOG's kwubiri na collagen na-eme ka misoprostol dị nro nwere ike ịmịkọrọ site na oghere ọmụmụ na oghere akụkụ ahụ nwanyị n'ime obere akara nke akụkụ ahụ a na-ahụkarị, ma mee ka ihe ize ndụ nke mgbawa akpa nwa dịkwuo elu. Prostaglandins dịkwa na ọbara ọcha mmadụ, a na-atụkarịkwa aro inwe mmekọahụ maka ịkwalite mmalite nke ịmụ nwa, ọ bụ ezie na obere data dịnụ na-eme ka ịdị irè nke usoro a ghara ijide n'aka. Mmekọahụ ọbara[2]
Ụzọ ndị ọzọ e si eme ka akpa nwa na-eto eto na-agụnye mkpali nke ara, nke na-emepụta oxytocin, hormone nke dị mkpa maka mgbanaka akpa nwa. akpali akpali oxytocin Enwere ike iji aka mee ka ọkpụkpụ akpịrị na-akpali akpali, site na iji mgbapụta ara, ma ọ bụ site na ịmị ara. mgbapụta ara Henci Goer, n'akwụkwọ ya zuru oke, The Thinking Woman's Guide to a Better Birth, na-akọwa etu e si nyochaa omume a na ọmụmụ abụọ dị iche iche nke ụmụ nwanyị 100 na 200 n'etiti afọ iri na itoolu. E kenyere ụmụ nwanyị n'otu n'otu ìgwè abụọ. N'otu ìgwè, a na-akpali ara maka otu awa, ugboro atọ n'ụbọchị. N'ìgwè nke ọzọ, ụmụ nwanyị ga-ezere ụdị ọ bụla nke ịkpali ara ma ọ bụ mmekọahụ. Ndị na-eme nchọpụta kwubiri na nyocha abụọ ahụ na mkpali nke ara nwere ike ime ka akpa nwa too ma n'ọnọdụ ụfọdụ na-akpata mgbanaka akpa nwa. Mkpịsị akpa nwa Goer gara n'ihu kwuo na n'ime obere nnyocha ahụ, e ji ihe nyocha nwa ọhụrụ mee ihe, ọ dịghịkwa ihe ọ bụla a hụrụ na ọ bụ ihe na-akpali akpa nwa. nlekota ime ime ime n'èzí [isi iyi a na-apụghị ịdabere na ya]
Enwere ike ime ka dilata cervical site na itinye ngwaọrụ n'ime cervix nke ga-agbasa mgbe ọ dị. Enwere ike iji balloon catheter mee ihe. balloon catheter Ngwaahịa ndị ọzọ gụnyere osmotic dilators, dị ka laminaria stick (nke e ji ahịhịa mmiri kpọrọ nkụ mee) ma ọ bụ ihe hygroscopic synthetic, nke na-agbasa mgbe etinye ya na gburugburu ebe mmiri. osmotic dilators laminaria hygroscopic[1]
Nsonaazụ sitere na nyocha usoro nke akwụkwọ ahụ na 2021 ahụghị ọdịiche dị na ọmụmụ ọkpụkpụ, nwa ọhụrụ, ma ọ bụ nsonaazụ nne n'etiti ndị na-arịa ọrịa ma ọ bụ ndị na-anọghị n'ụlọ ọgwụ. Ịcha mkpụrụ obi ọta akara[3][4]
Na nlekọta ite ime[dezie | dezie ebe o si]
N'ịgwọ ite ime na-enweghị isi ma ọ bụ nke a na-akpata, nkwadebe (ịdị nro na ịgbasa) nke akpa nwa na-enye ohere ka ọchịchọ nke cannulae vacuum gafee n'ụzọ dị mfe n'ime akpa nwa, nke nwere ike ime ka usoro ahụ dị mkpụmkpụ, dịkwuo mma maka onye ọrịa, ma dịkwuo mfe ịrụ ọrụ. ọchịchọ ime ime na-enweghị isi[5][6] Nkwadebe nwekwara ike belata nsogbu ndị a na-adịghị ahụkebe nke oghere akpa nwa na mmerụ ahụ cervical.[5][7] Nhọrọ maka nkwadebe akpa nwa tupu usoro ite ime gụnyere osmotic dilators na ọgwụ ọgwụ. Osmotic dilators na-emepụta dilation sara mbara nke akpa nwa n'ụzọ a na-ahụ anya ma na-ejikarị ya eme ihe na ime ime dị elu.[5][7] Ndị na-ahụ maka ọgwụ, dị ka misoprostol na mifepristone, na-eme ka cervix dị nro ma na-eme gore cervical dilation dị mfe, ma nwee ike iji ya mee ihe naanị ya na mbido ime, ma ọ bụ na njikọta ya na osmotic dilators tupu dilation na evacuation. misoprostol mifepristone dilation na evacuation[5][7]
N'ime hysteroscopy[dezie | dezie ebe o si]
Na hysteroscopy, dayameta nke hysteroscope na-adịkarị ukwuu iji gafee oghere akpa nwa ozugbo, si otú a na-achọ ka a gbasaa oghere akpa nwa tupu etinye ya. Enwere ike ime mgbasawanye oghere akpa nwasite na ịgba tị oghere akpa nwa nwa oge na usoro (gbasara oghere akpa nwa) ihe mgbasawanye nke na-abawanye dayamita.[8] Misoprostol tupu hysteroscopy maka mgbasawanye oghere akpa nwa yiri ka ọ na-eme ka usoro dị mfe na-enweghị mgbagwoju anya naanị na ụmụ nwanyị hụ chara nsọ ha.l[9]
Ebemsi dee[dezie | dezie ebe o si]
- ↑ 1.0 1.1 Rai (5 December 2007). "Cervical Ripening". Retrieved on 2008-05-04.
- ↑ Tenore JL (May 2003). "Methods for cervical ripening and induction of labor". Am Fam Physician 67 (10): 2123–8. PMID 12776961. Retrieved on 2008-05-04.
- ↑ McDonagh (2021). "Outpatient Cervical Ripening: A Systematic Review and Meta-analysis" (in en). Obstetrics & Gynecology 137 (6): 1091–1101. DOI:10.1097/AOG.0000000000004382. ISSN 0029-7844. PMID 33752219.
- ↑ McDonagh (2021). Cervical Ripening in the Outpatient Setting, AHRQ Comparative Effectiveness Reviews. Rockville (MD): Agency for Healthcare Research and Quality (US).
- ↑ 5.0 5.1 5.2 5.3 Kapp (2010-02-17). "Cervical preparation for first trimester surgical abortion". Cochrane Database of Systematic Reviews (2): CD007207. DOI:10.1002/14651858.cd007207.pub2. ISSN 1465-1858. PMID 20166091.
- ↑ Overview | Abortion care | Guidance | NICE. www.nice.org.uk (25 September 2019). Retrieved on 2020-07-21.
- ↑ 7.0 7.1 7.2 Newmann (2010-08-04). "Cervical preparation for second trimester dilation and evacuation". Cochrane Database of Systematic Reviews (8): CD007310. DOI:10.1002/14651858.cd007310.pub2. ISSN 1465-1858. PMID 20687085.
- ↑ Laparoscopy and Hysteroscopy. A Guide for Patients, Revised 2012. From the American Society for Reproductive Medicine, Patient Education Committee
- ↑ Polyzos (2012). "Misoprostol prior to hysteroscopy in premenopausal and post-menopausal women. A systematic review and meta-analysis". Human Reproduction Update 18 (4): 393–404. DOI:10.1093/humupd/dms014. PMID 22544173.