IYO panguva yekuzvitakura

Kazhinji, mishonga yemisumbu yemubereki panguva yekuzvimba inopfigirwa muchengeti wakaoma, kunonoka zvishoma nezvishoma sezvo nguva yekusvika inoswedera pedyo. Kana chiitiko ichi chikaitika nguva isati yasvika, chibereko chechivharo chinotanga kupfupisa uye kuzarura. Mumamiriro ezvinhu aya, vanotaura nezvekuvandudzwa kweeschemic-cervical insufficiency (ICI). Dambudziko iri rinowanikwa munenge 1-9% yevakadzi vane pamuviri, kusanganisira 15-40% yavo inotambura nemafambiro ekushaya maturo, i.e. 2 uye mimwe mimba yepamuviri yakapera yakaguma pakubvisa pamuviri.

IYO paunenge uchiita pamuviri kunotungamirira pakuwedzera kwemutsipa weUterine, semugumisiro wechechi yemukomana inowira, iyo inopera nekuvhura kwayo. Uyezve, basa rebasa rinokura, izvo zvinotungamirira kumucheto kuenda shure kana kuberekwa nguva isati yasvika.

Nei ICI ichiitika?

Zvimwe zvinokonzera kukonzera kukurudzirwa kweCI panguva yekuzvitakura ndezvi:

• kushungurudzika kwechibereko chemuviri (misodzi, kukuvadzwa) panguva yekuzvarwa kwepakutanga kana nekuguma kwekuita kwekuita pamuviri;
• kusagadzikana mukugadzirwa kwenhengo dzinobereka;
• kushandiswa kwebasa muzvibatanidza zvinonzi dysplasia, hyperandrogenia, nekushayikwa kwehomoni dzepabonde;
• kuita IVF;
• multiple fetus, polyhydramnios, fetus yakakura.

Ndezvipi zviratidzo zvikuru zveNIH?

Zviratidzo zveII panguva yekudzivirirwa zvakavanzwa mumatambudziko akawanda, saka zvinenge zvakaoma kuziva kuti kune chirwere chemukadzi ane pamuviri pachavo. Saka pamutambo wekutanga wekutakura fetus (1 trimester) havakwanisi zvachose. Gare gare, apo zvingaita sezvakanaka zvekudzivirirwa kwezvino, vanaamai vanouya vanocherechedza kuonekwa kwezviratidzo zvakadaro zveI ICI:

• kuonekwa kwechidiki chekuona;
• chimiro chekubuda mumucheka neropa remvura;
• kurwadziwa munharaunda yekumusoro kwekumusoro uye mudumbu rezasi;
• kuonekwa kwekunzwa kwe "raspiraniya" mumudzimai.

Zvisinei, mumatambudziko mazhinji, sezvatotaurwa, chirwere chacho hachirevi, uye kuti uongorore ICI panguva yekubata pamuviri, chiremba anoita sarudzo yechibereko chechivharo nekubatsirwa nemirazi, uyewo kushandisa shanduro ye ultrasound.

Nokudaro, nekunzwa kwechirwere chechibereki chechibereko, gynecologist inogona kuona kugadziriswa kwakanyanya kwechibereko, pamwe nekuderedzwa kwehurefu hwechirwere, uye kuvhurwa kwemukanzira wayo umo mucheche wechechi unoonekwa. Mukuona kwekuti mumadzimai ekutanga maitiro ekunze anokwanisa kuvharwa, kuongororwa kunosimbiswa ne ultrasound kushandiswa kwechitinha chinonzi transvaginal. Izvi zvinotevera zvinotorwa:

1. Kureba kwechirwere. Pamasvondo mavhiki 24-28 yakaenzana ne 35-45 mm, uye pashure pemasvondo makumi maviri nemaviri ekuberekwa - 30-35. Kana mumavhiki makumi maviri nemakumi matatu ekureba kwayo iri pasi pe25 mm, zvino inotaura nezvekuvandudzwa kweII.
2. Kuvapo kwevhudziro yakaita seV yakagadzirwa nechomukati chephenyn.

I ICI inobata sei?

Pakazara, kune nzira mbiri dzokurapa ICI panguva yekuzvitakura:

• chirurgic;
• rakachengetedza.

Yokutanga ndiyo kushandiswa kwe sutures kune chikamu chemuviri wechibereki. Panguva imwecheteyo, mukati mehuro yechiberekero inogadziriswa ichigadziriswa uye chibereko chekunze chinonamirwa, iyo inonyanya kuderedza mikana yekuberekwa nguva isati yasvika. Nguva yekushanda kwakadaro inogadziriswa mumwe nomumwe, asi kuitira kuti isabve kufambira mberi kwegadziriro iyi, vanachiremba vanoedza kuita basa racho kusvika kumavhiki masere kana kukanganisa kunoonekwa pakutanga kwepamuviri, asi kwete mushure memavhiki makumi mana.

Nzira yekuchengetedza ndiyo yekuisa obstetric pessary (Ring yeMeyer). Iko rudzi rwechigadzirisa runopa hutachiwana hwemucheche uye hunobatsira chivharosi kuchengetedza. Kuiswa kwepessaries kunobudirira chete kana zvichifungidzirwa neNIH kana mumatangiro ayo. Nezviratidzo zvakakomba, iyi nzira inoshandiswa, pane kudaro, sevabatsira.