Ukuze uthole usizo lokwelashwa ngeFraxiparin ngesikhathi sokukhulelwa, i-IVF nokuzala kwengane

I-Fraxiparin isidakamizwa okusebenzisa kwayo ngesikhathi sokukhulelwa akunconywa yimiyalo.

Akukho datha eqondile ngomthelela onobuthi walesi sidakamizwa ku-fetus, noma kunjalo, ucwaningo lomtholampilo lukhombisile amandla weFraxiparin ukungena ekuvinjelweni kwe-placental, kanye nasengobisini lwebele.

Kodwa-ke, ezimweni lapho umphumela omuhle wokuthatha umuthi udlula khona emiphumeleni emibi engaba khona, i-Fraxiparin iyanezelwa ohlwini lwezidakamizwa ezithathwe ngesikhathi sokukhulelwa. Kukuziphi izimo lapho i-Fraxiparin ichazwa khona ngesikhathi sokukhulelwa, i-IVF kanye nokuzalwa kwengane?

Kungani uFraxiparin enqunywe?

Lapho uhlela ukukhulelwa

I-Fraxiparin iyi-anticoagulant esebenza ngempumelelo kakhulu. Isenzo somuthi sincike emgomweni we-calcium nadroparin oqukethwe kuwo ukuvimbela umsebenzi wezinto ezenziwa ngegazi, ngenxa yalokho ukuncipha kwegazi, ukuncipha kwegazi kuyathuthuka, futhi amathuba okuba nezifo zemithambo ancishisiwe.

Umuthi Fraxiparin

Kungamandla weFraxiparin ukuthinta kahle ukuphuma kwegazi okunquma ukusetshenziswa kwayo ngesikhathi sokuhlela ukukhulelwa. Ngempela, ukwakheka kweziqeshana kuphazamisa ukunikezwa kwegazi okujwayelekile, okwenza kube nzima ngezinto ezidingekayo ukufinyelela iqanda elivundisiwe.

Ukugeleza kwegazi okungekuhle kuvimbela iqanda ekuthini linamathele odongeni lwesibeletho. Ngaphezu kwalokho, ukunikezwa kwegazi okunganele kwenza kube nzima ukwakheka kwe-placenta futhi kungenza ukuthi ukukhulelwa kungenzeki.

Uma inqubo yokulungiselela ukukhulelwa, izivivinyo ziveze ukuqondana kwegazi lesiguli, ukuphuza njalo kweFraxiparin kukhulisa amathuba okuqamba okuphumelelayo ngo-30-40%. Lokhu kwenza kwanele ukusebenzisa leli thuluzi kwezokwelapha.

Ngesikhathi sokukhulelwa

Ngokuya ngezici zokuhlangana kwegazi, ukuthatha i-Fraxiparin kuyenziwa kuwo wonke ama-trimesters ahlukene nangaphakathi kokukhulelwa, ngaphandle kwe-trimester yokuqala.

Izinkomba zokusetshenziswa kwaso kokuzivikela - ukubonwa kwegazi ngokweqile kowesifazane okhulelwe.

Uma ukuhlolwa kwembula izigaxa zegazi esezivele zakhekile, iFraxiparin nayo isetshenziselwa ukubelapha. Imithamo kanye nemvamisa yokuthatha umuthi kukhethwa ngokuhlukile.

Njengoba umkhuba ukhombisa, ukunikezwa kwegazi okunganele isikhathi esiningi kuholela ezinkingeni nge-fetus. Ukuqhekeka kwegazi nokubonakala kwegazi kungaholela ekuphuthweni kwesisu, ekuqandeni i-fetus, nezinkinga ngokukhula kwengane.

Ezimweni eziphuthumayo, lapho imiphumela yokuhlolwa ikhombisa ukubukeka kwegazi okubucayi ngesimo se-fetus, noma lapho kuhlangana igazi lokuxinana kwegazi, okungeke kulimaze umntwana kuphela, kepha futhi kubeke impilo yesiguli uqobo, kusetshenziswa ukusetshenziswa okulinganiselwe kweFraxiparin ku-trimester yokuqala yokukhulelwa.

Njengoba umkhuba ukhombisa, ukuqapha okufanele isiguli kanye ne-fetus ngochwepheshe, kungenzeka ukunciphisa umphumela ongemuhle wesidakamizwa emzimbeni.

Nge-IVF

Ukukhulelwa kuhlale kungumthwalo obalulekile womzimba wowesifazane. Owesifazane uthwala umthwalo omkhulu kakhulu ngesikhathi sokukhulelwa kwe-vitro.

Ngempela, ngaphezu kokuqina kwemvelo kwegazi ngaphansi kwethonya lokushintsha komzimba okuguquliwe, lesi sici sithonywa wukudla okungapheli kwezidakamizwa zehomoni ezenziwa nge-IVF.

Konke lokhu kuholela ekuqineni okukhulu kwegazi, okusho izingozi ezinganeni. Owesifazane uthola imithamo yokuqala ye-Fraxiparin cishe ngokushesha ngemuva kokudluliswa kwe-umbungu. Lokhu kuyadingeka ngokulungiswa kwayo okuvamile odongeni lwesibeletho, kanye nokuvikela ukubonakala kwe-thrombophlebitis.

Ngamazinga amahle wokuhlaziya, inkambo yokuphatha ikhawulelwe kumthamo we-4-5 womuthi. Uma, ngemuva kokudlulisela umbungu, ukuxinana kwegazi kuqala ukwanda kakhulu, ukuphathwa kwomuthi kuyaqhubeka kuze kube yilapho isithombe somtholampilo sejwayelekile.

Uhlelo olujwayelekile lokuthatha i-Fraxiparin ye-IVF liqukethe isifundo sezinsuku eziyishumi. Umuthi uphathwa kanye ngosuku, usebenzisa i-sindringe injection, esibayeni esingaphansi kwenkaba.

Umthamo ojwayelekile womjovo owodwa yi-0.3 ml yesidakamizwa.

Ngokuya ngokusabela ekuphatheni kwe-Fraxiparin, umthamo kanye ne-algorithm yokuphatha kungashintshwa.

Imithamo elandelayo yesidakamizwa iyatholakala kuma-injector alahlwayo:

• Ama-millilitha ayi-0,3;
• Ama-millilitha ayi-0,4;
• Amamilimitha angama-0.6.

Ngakho-ke, ukwethulwa kwemithi kaningi ngosuku ngosuku akudingeki - kuthathwa umthamo ofanele.

Ekuzalweni

Isibonakaliso esiyinhloko sokusetshenziswa kwesidakamizwa ngesikhathi sokubeletha yi-congenital noma i-genetic thrombophilia. Ukuqagela komfazi ukubonakala kokuqhekeka kwegazi kungenzeka kungathinti impilo yakhe isikhathi eside futhi kube yingozi ngesikhathi sokukhulelwa.

I-Thrombophilia (i-damu)

Noma inkambo enhle, ukukhulelwa ngokumelene nesizinda se-thrombophilia kuyaqabukela kuqhubeke amasonto angama-40. Ukulethwa ngeviki lama-36 noma lama-37 kubhekwa njengomphumela ophumelelayo - umuthi wanamuhla uyakwazi ukunciphisa kahle imiphumela yokuthambekela enganeni.

IFraxiparin ivame ukukhanselwa amahora angama-12 ngaphambi kokulethwa. Lokhu kugwema ukopha okukhulu ngenxa yokulimala okutholakele ngesikhathi sokuzalwa kwengane, kepha kungaholeli ekwandeni ngokweqile kokubona kwegazi. Ukusetshenziswa okwengeziwe kwesidakamizwa kuncike ekusebenzeni kokuhlolwa kwangemva kokubeletha.

Uma kukhona ukuqina kwegazi ngokulinganayo, ukuthatha i-Fraxiparin akwenziwa.

Ngemuva kwakho konke, ngaphansi kwezimo ezithile iyakwazi ukungena kubisi lwebele, futhi nalo - emzimbeni wosana olusanda kuzalwa.

Ngasikhathi sinye, uma umsebenzi wama-coagulants wemvelo ephakeme kakhulu kangangokuba ungadala ukuxabana kwegazi nezinkinga ngohlelo lwesifo senhliziyo nesiguli, umuthi uyaqhubeka.

Ngemuva kwesigaba se-cesarean

Isigaba seKhesariya sisebenza ngokujwayelekile. Ikakhulu ikakhulukazi baphendukela kulo esimweni lapho ama-pathologies athile angenza ubunzima inqubo yemvelo yokuzalwa kwengane.

Ukwemukelwa kweFraxiparin, uma kunesidingo, isigaba se-cesarean senziwa ngokohlelo olukhethekile.

Okungenani amahora angama-24 ngaphambi kokuhlinzwa, imijovo yezidakamizwa imisiwe. Ezimweni ezijwayelekile, lokhu kwanele ukumisa isenzo se-anticoagulant, futhi ukuhlinzwa akubanga ukopha okukhulu okunzima.

Isikhathi esithile ngemuva kwesigaba se-cesarean, ngokuya ngesimo sesiguli, ukuphathwa kwe-Fraxiparin kuyaqaliswa. Imijovo engaguquki yalesi sidakamizwa yenziwa amaviki amahlanu kuya kwayisithupha ngemuva kokuzalwa kwengane.

Ngaphandle kwamacala angajwayelekile we-pathological, asikho isidingo sokwehliswa okwenziwe ngobunono kwegazi.

Indlela yokusebenza yesidakamizwa

Ngenxa yalokho i-Frakisparin inomphumela onamandla kangako wegazi? Njengoba sekushiwo, i-calcium nadroparin ifakiwe ekwakhiweni kwayo.

Le nto yi-heparin ebaliwe yesisindo. Ihluka nge-heparin ejwayelekile ngemicu yamangqamuzana "edwenguliwe".

Ngenxa yalokhu, isenzo sento esebenzayo simnene ngokwengeziwe, singena kancane ngokusebenzisa umgoqo we-placental, kubalulekile ukunciphisa imiphumela emibi yokuthatha i-Fraxiparin ngesikhathi sokukhulelwa. Umsebenzi we-antithrombotic we-Fraxiparin ususelwa kumandla we-calcium nadroparin ukusebenzisana ne-coagulation factor Xa.

Ngenxa yalokhu, lokhu okugcina kuvinjelwe, okuthinta ikhono lamapuleti ukunamathela. Umsebenzi ohlanganisiwe we-calcium nadroparin uvimbela ukwakheka kwezigaba zegazi futhi ubangele ukuncipha kwawo. Ngasikhathi sinye, umuthi uthinta kakhulu isikhathi sokuhlanganiswa kwegazi.

I-heparin yamandla amancane ephansi ibangela imiphumela emibi emincane evela ohlelweni lokujikeleza futhi ihlukaniswa ngomphumela omnene nangokuthi ukhethe.

Imiphumela yengane

Okwamanje, azikho izifundo ezijulile zomtholampilo zomphumela wazo ekwakhiweni kwengane.

Ngakho-ke, imibono yochwepheshe maqondana nezinga lemiphumela yezidakamizwa ku-fetus yehlukile. Iningi lochwepheshe basekhaya bakholelwa ukuthi ukuphathwa okulinganiselwe kwalesi sidakamizwa, okwenziwa ngaphansi kokuqondisa kukadokotela, akubangeli zinkinga nezimpawu ze-fetus zesibeletho.

Abanye odokotela baqinisekile ngokuphelele ukuthi i-Fraxiparin iphephe ngokuphelele enganeni nakwisiguli esikhulelwe. Iningi labodokotela baseNtshonalanga babheka ukuthatha lesi sidakamizwa ngesikhathi sokukhulelwa njengendlela engathandeki kakhulu. Kodwa-ke, umbono wabo, kanye nombono wabasekeli bomuthi, awusekelwa kunoma iyiphi idatha emangalisa kakhulu.

Amavidiyo ahlobene

Mayelana ne-thrombophilia kanye nokukhulelwa kuvidiyo:

Kuyafaneleka ukuphetha - I-Fraxiparin iyisidakamizwa, ukungena kwayo kufanele kube nesizathu senkambiso engathi sína yokuxinana kwegazi ekhula kowesifazane okhulelwe. Kufanele isetshenziswe kuphela uma ukuchitheka kwegazi nokungatholakali kwegazi kungaholela ekwehlulekeni kokukhulelwa. Ngaphandle kwalokho, kufanele wenqabe ukusebenzisa lesi sidakamizwa.