Muchiitiko chekudzivirira kusingadikanwi vakadzi vakawanda vanotaurirana kuvadzidzisi vevakadzi nechinangwa chekubvisa pamuviri. Kana kuvhara kweiyo fetal yai kubva muuterine cavity inoshandiswa, izvi zvinowanzoitwa muimba yekushanda pasi peanesthesia yakawanda. Kupindira kwakadaro kunogona kuva nemigumisiro yakaipisisa: sechikonzero chekubvisa pamuviri kusina kubudirira, mukadzi angarasikirwa nemukana wekuva amai, asiwo hupenyu hwake. Izvi zvinokonzera vazhinji kutya kutya, uye vari kushamisika kana zvichibvira kubvisa pamuviri nemishonga, pasina chirwere uye anesthesia. Iyi nzira yekubvisa pamuviri inowanikwa, uye iyo, kana ini ndikataura kudaro, iri kunyanya kurega muviri.
Chii chinobvisa pamuviri nemapiritsi?
Mhando iyi yekugadziriswa kwepamuviri kwekuita pamuviri yakatanga munguva pfupi uye inozivikanwa munyika dzinopfuura makumi matatu. WHO inofunga terefesi, kana kuti kurapa, kubvisa pamuviri nzira yakachengeteka. Kutonga nezita racho, unogona kufungidzira kuti kubvisa pamuviri kunogadzirwa nokutora mishonga. Kubudirira kwahwo ndiko 95-98%, iyo inonyanya kubva pane purogiramu yakakodzera yemapiritsi uye nguva yehutumbi.
Varwere vakawanda vekukurukurirana kwevakadzi vanokurumidza kunetseka pamusoro penyaya iyo pavanenge vachiverenga kubvisa pamuviri kubvisa pamuviri, kune zuva ripi rinonzwisisika kushandisa naro. Mhando iyi yekuregererwa kwepamuviri inongopera mavhiki matanhatu kusvika ku7.
Mishonga yemishonga inowanikwa mune zvayo yakagadzirirwa iyo inoshandiswa inoshandiswa - viepristone - maitiro ekugadzirira hormone. Kupinda mumuviri, kunodzivirira chiito chehomoni huru inodzivirira kubata pamuviri, progesterone. Nokudaro, kukura kweiyo fetal yai ichavharwa. Muchikamu chechipiri chekubvisa pamuviri, mahwendefa ane prostaglandin (misoprostol) anoita kuti kuderera kwechibereko, zvinoreva kusununguka kwemimba, ndiko kuti, kusununguka kuberekwa kwemuviri.
Kubvisa pamuviri kubvisa sei?
Mukadzi anoda kuva nechirwere chekurapa anoshanyira nemudzimai wegynecologist uye chipinda chekuongorora chechi ultrasound kugadzirisa kuongororwa, chisarudzo chepamuviri wekuzvimba uye kubviswa kwe ectopic pregnancy. Kutora mimba yepabhesi inoitwa zvichienderana nechirongwa chinotevera:
- Pazuva rokutanga, mahwendefa 1-3 eepepristone anopiwa kwaari (mabhizimisi mazita ndiwo mifegin, miefeprex, mytholian). Kunwa mishonga, murwere anoramba ari muchipatara kweawa imwe pasi pekuongororwa kwachiremba kuzotarisa hupenyu hwake.
- 36-48 maawa mushure mekutora mifepristone, gynecologist anoongorora mukadzi uye anomupa misoprostol, inokonzera kubuda ropa. Mushure mekutarisa murwere kwemaawa 3-5, anosunungurwa kumba.
- Mushure memazuva gumi mukadzi anofanira kushanyira chiremba kwenguva yechitatu yekutevera-ultrasound, gynecological examination.
Tetesi Kubvisa pamuviri: zvinobatsira uye kusagadzikana
Sezvaunogona kuona, rudzi urwu rwekubvisa pamuviri runokwezva nekuti hahurevi kupindira kwekuvhiya uye kunogoneka mumatanho ekutanga. Nenzira, kuenda kumwedzi kunodzorerwa zvakakurumidza - mumwedzi. Mukuwedzera, kubvisa pamuviri kwepabonde ndiko kushungurudzika kwakanyanya, sezvo mucous membrane yechibereko haikuvadzi.
Zvisinei, iyi nzira haina kunaka. Paunenge uchishandisa mahwendefa emimba, migumisiro yemudzimai wechikadzi inomukawo. Kana, somuenzaniso, hapana kukanganwa kwema fetal egg, iwe unoda mini-kubvisa pamuviri (kubvisa aspirum). Nekudzingwa kweiyo fetal egg, pane dzimwe nguva kune uterine yakanyanya kubuda ropa iyo inotarisirwa kurapwa. Nenzira, pangava nemagumisiro emigumisiro: kusuruvara, kusuruvara, kurwadziwa mucheche pasi, kushandiswa kwegairo uye kuwedzerwa kweropa.
Kupindirana kwekuita kwekubvisa pamuviri kubvisa pamuviri kune ectopic pamuviri, hove, adrenal uye zvirwere zveropa, zvironda zvepamuviri, ropa, tumorori uye maitiro e cystic mumapata maduku, kuvhara pachibereko.