Njira zothandizira kuchotsa mimba

Njira zothandizira kuchotsa mimba

Njira ziwiri zimagwiritsidwa ntchito pochotsa mimba mwakufuna:

  • mankhwala njira
  • njira ya opaleshoni

Ngati n'kotheka, amayi ayenera kusankha njira, mankhwala kapena opaleshoni, komanso njira ya opaleshoni, yapafupi kapena yachilendo.16.

Njira yamankhwala

Kuchotsa mimba kwachipatala kumachokera ku kumwa mankhwala omwe amalola kuthetsa mimba ndi kuchotsedwa kwa mwana wosabadwayo kapena mwana wosabadwayo. Itha kugwiritsidwa ntchito mpaka milungu 9 ya amenorrhea. Ku France, mu 2011, oposa theka la kuchotsa mimba (55%) kunachitika ndi mankhwala.

Pali mankhwala angapo "ochotsa mimba", koma njira yodziwika kwambiri ndi yoperekera:

  • anti-progestogen (mifepristone kapena RU-486), yomwe imalepheretsa progesterone, hormone yomwe imalola kuti mimba ipitirire;
  • kuphatikiza ndi mankhwala a banja la prostaglandin (misoprostol), omwe amayambitsa kukangana kwa chiberekero ndikulola kuti mwana wosabadwayo atuluke.

Chifukwa chake, WHO imalimbikitsa, kwa oyembekezera azaka zakubadwa mpaka masabata 9 (masiku 63) kumwa kwa mifepristone kumatsatiridwa 1 kwa masiku a 2 pambuyo pake ndi misoprostol.

Mifepristone amatengedwa pakamwa. Mlingo woyenera ndi 200 mg. Kugwiritsa ntchito misoprostol kumalimbikitsidwa masiku 1 mpaka 2 (maola 24 mpaka 48) mutatha kumwa mifepristone. Zitha kuchitidwa ndi nyini, buccal kapena sublingual njira mpaka masabata 7 a amenorrhea (masabata 5 a mimba).

Zotsatira zake zimakhala zogwirizana kwambiri ndi misoprostol, zomwe zingayambitse magazi, mutu, nseru, kusanza, kutsegula m'mimba komanso kupweteka kwa m'mimba.

M'malo mwake, kuchotsa mimba kwachipatala kumatha kuchitidwa mpaka 5st sabata la mimba popanda kuchipatala (kunyumba) mpaka 7st sabata la mimba ndi maola ochepa kuchipatala.

Kuyambira 10 milungu amenorrhea, mankhwala njira salinso bwino.

Ku Canada, mifepristone silololedwa, chifukwa cha zoopsa zomwe zingapatsidwe (ndipo palibe kampani yomwe yapempha kuti igulitse molekyuluyi ku Canada, mpaka kumapeto kwa 2013). Kusagulitsa kumeneku kumatsutsana ndipo kumatsutsidwa ndi mabungwe azachipatala, omwe amaona kuti kugwiritsa ntchito mifepristone kukhala otetezeka (amagwiritsidwa ntchito m'mayiko a 57). Chifukwa chake, kuchotsa mimba kuchipatala sikofala kwambiri ku Canada. Zitha kuchitidwa ndi mankhwala ena, methotrexate, otsatiridwa ndi misoprostol, koma osagwira ntchito. Methotrexate nthawi zambiri amaperekedwa ndi jekeseni, ndipo patatha masiku asanu kapena asanu ndi awiri, mapiritsi a misoprostol amalowetsedwa kumaliseche. Tsoka ilo, mu 35% ya milandu, chiberekero chimatenga masiku angapo kapena masabata angapo kuti chitulutse (poyerekeza ndi maola angapo ndi mifepristone).

Opaleshoni njira kuchotsa mimba17-18

Kuchotsa mimba kochuluka padziko lapansi kumachitidwa ndi njira ya opaleshoni, nthawi zambiri kukhumba kwa zomwe zili m'chiberekero, pambuyo pa kutambasula kwa khomo lachiberekero (mwina mwamakani, poika ma dilators akuluakulu, kapena mankhwala). Zitha kuchitidwa mosasamala kanthu za nthawi yomwe ali ndi pakati, mwina ndi anesthesia wamba kapena opaleshoni. Kulowererapo nthawi zambiri kumachitika masana. Aspiration ndi njira yovomerezeka yochotsa mimba opareshoni mpaka nthawi yoberekera ya masabata 12 mpaka 14 oyembekezera, malinga ndi WHO.

Njira ina imene nthaŵi zina imagwiritsidwa ntchito m’maiko ena, kufutukuka kwa khomo la chiberekero kotsatiridwa ndi kuchiritsa (kumene kumaphatikizapo “kukolopa” mkangano wa chiberekero kuchotsa zinyalala). WHO ikulimbikitsa kuti njirayi ilowe m'malo ndi kulakalaka, komwe ndi kotetezeka komanso kodalirika.

Msinkhu woyembekezera ukakhala wokulirapo kuposa masabata 12-14, kukulitsa ndi kutulutsa komanso kumwa mankhwala kumatha kulimbikitsidwa, malinga ndi WHO.

Njira zochotsa mimba

M'mayiko onse omwe amavomereza kuchotsa mimba, ntchito yake imapangidwa ndi ndondomeko yodziwika bwino.

Choncho m'pofunika kudziwa za ndondomeko, masiku omalizira, malo ochitirapo kanthu, zaka zovomerezeka zovomerezeka (zaka 14 ku Quebec, mtsikana aliyense wamng'ono ku France), mfundo zobwezera (zaulere ku Quebec ndi 100% kubweza). ku France).

Muyenera kudziwa kuti njirazi zimatenga nthawi komanso kuti nthawi zambiri zimakhala zodikirira. Choncho ndikofunika mwamsanga kukaonana ndi dokotala kapena kupita ku malo kuchita kuchotsa mimba mwamsanga pamene chisankho wapangidwa, kuti asachedwe tsiku la mchitidwe ndi chiopsezo kufika pa mimba deti pakufunika. zidzakhala zovuta kwambiri.

Ku France, mwachitsanzo, kukaonana kuwiri kwachipatala ndi kokakamizika kusanachitike kuchotsa mimba, kusiyanitsidwa ndi nthawi yowonetsera osachepera sabata imodzi (masiku awiri pakagwa mwadzidzidzi). "Kukambirana-zoyankhulana" kungaperekedwe kwa amayi asanayambe kapena atatha opaleshoni, kuti alole wodwalayo kuti alankhule za momwe alili, opaleshoniyo komanso kuti adziwe zambiri za kulera.19.

Ku Quebec, kuchotsa mimba kumaperekedwa pamsonkhano umodzi.

Psychological kutsatira pambuyo kuchotsa mimba

Kusankha kuchotsa mimba sikophweka ndipo kuchitapo kanthu sikochepa.

Kukhala ndi pakati mosayembekezereka ndikuchotsa mimba kumatha kusiya malingaliro, kudzutsa mafunso, kusiya malingaliro okayikira kapena olakwa, chisoni, nthawi zina chisoni.

Mwachiwonekere, mayendedwe ochotsa mimba (kaya mwachibadwa kapena ochititsidwa) amakhala osiyanasiyana komanso achindunji kwa mkazi aliyense, koma kuwunika kwamalingaliro kuyenera kuperekedwa kwa onse.

Komabe, kafukufuku wambiri akusonyeza kuti kuchotsa mimba si vuto la maganizo lomwe limatenga nthawi yaitali.

Kusautsika kwamalingaliro kwa mkazi nthawi zambiri kumakhala kopitilira muyeso asanachotse mimba ndiye kumachepa kwambiri pakati pa nthawi yochotsa mimbayo ndi yomwe ikutsatira.10.

Siyani Mumakonda