Ukukhulelwa Okusheshisiwe: Okufanele Ukwazi

Ukukhulelwa ngokuvamile kulandela umugqa wesikhathi obekiwe, kanti isikhathi esimaphakathi sokuthwala sihlala amasonto angaba ngu-40. Nokho, kwezinye izimo kuba nesivinini esingajwayelekile ekuthuthukeni kwe-fetus noma ekuqhamukeni kwezimpawu zokukhulelwa, okubizwa ngokuthi ukukhulelwa okusheshayo. Lo mkhuba awuvamile, kodwa ungaba yinto ehlukile kokuhlangenwe nakho kubo bobabili omama abakhulelwe nabahlinzayo bezempilo. Kulesi sihloko, sizohlola ngokuningiliziwe ukukhulelwa okusheshayo, izimpawu zako, izimbangela ezingaba khona, kanye nemithelela yakhona kukamama nasemntwaneni.

Izimpawu Zokukhulelwa Okusheshayo

Enye yezimpawu zokuqala zokukhulelwa okusheshayo ukwanda okusheshayo kokukhulelwa, lapho kokubili izinguquko zomzimba kukamama kanye nokuthuthuka kwe-fetus kubonakala kwenzeka ngesivinini esikhulu kunesilindelekile. Lokhu kungavela ngezindlela eziningana:

• Isibeletho esikhula kakhulu kusenesikhathi: Owesifazane angathola ukuthi isibeletho sakhe siyakhula ngokushesha kunokujwayelekile esigabeni esifanayo sokukhulelwa. Lokhu kukhula okusheshayo kungabangela ukuthi isisu sivele kusenesikhathi kunalokho obekulindelekile, okwenza ukukhulelwa kubonakale masisha kakhulu kunezimo eziningi.
• Ukuqala kusenesikhathi kwezimpawu ezivamile zokukhulelwa: Izimpawu ezivamile zokukhulelwa ezifana nesicanucanu sasekuseni, ukukhathala, noma ubuhlungu bezinsini zamabele zingaqala masisha noma zivele ziqine kakhulu. Lokhu kungadida umama, ikakhulukazi uma esasemavikini okuqala. Ukusebenzisa i-early response pregnancy test kungasiza ukuthola ukukhulelwa kusenesikhathi, kunikeze imininingwane ebalulekile esigabeni sokuqala sokukhulelwa okusheshayo.
• Amafetus afinyelela emigomeni yokuthuthuka ngokushesha: Ekukhulelweni okusheshayo, amafetus angafinyelela ezingeni elithile lokuthuthuka ngaphambi kwesikhathi okulindelekile. Ngokwesibonelo, ukushaya kwenhliziyo kungatholakala kusenesikhathi, noma i-fetus ibe nokunyakaza okuningi ekuqaleni kokukhulelwa [1].

Izimbangela ezingenzeka

Izizathu zokukhulelwa okusheshayo azikaqondakali ngokuphelele, futhi zingahluka kuye ngokuthi icala linjani. Nokho, ezinye izimo zempilo nezici zingaba negalelo:

• Ukukhulelwa okuningiUkuthwala amawele, amathathu noma ngaphezulu kungaholela ekukhuleni okusheshayo kokukhulelwa, njengoba umzimba wamukela amafetus angaphezu kwelilodwa. Isibeletho sandeka ngokushesha, kanti nezinguquko zamahomoni zingaba sobala kakhulu, okudala inqubekela phambili esheshayo.
• Izimo ezikhona ngaphambilini: Kwezinye izimo, izimo zezokwelapha ezifana nokungalingani kwamahomoni noma izimo ezifana ne-polycystic ovary syndrome (PCOS) zingase zithinte ukukhulelwa. Nakuba zingaholeli njalo ekukhulelweni okusheshisiwe, zingathinta indlela umzimba wowesifazane ophendula ngayo ekukhulelweni [2].
• Izinto zofuzo: Ezimweni ezingajwayelekile, izinto zofuzo zingaba negalelo ekutheni ukukhulelwa kuqhubeka ngokushesha kangakanani. Ezinye izinsizwa zingase zibe nomlando womndeni wokukhulelwa okuqhubeke ngokushesha kakhulu kunokujwayelekile.

Ukuqapha kwezokwelapha nemiphumela

Naphezu kokuthi ukukhulelwa okusheshisiwe kungase kuzwakale kwesabisa, akusho njalo ukuthi kuzovela izingqinamba. Noma kunjalo, ukuqapha ngokuseduze kwezokwelapha kubalulekile ukuqinisekisa ukuthi bobabili umama nengane bahlala benempilo. Ukuvakashelwa okuvamile kwangaphambi kokubeletha, ama-ultrasound, nokuhlolwa kungasiza ukulandelela ukuthuthuka kwengane nempilo kamama.

• Ukuhlolwa okuvamile: Abahlinzeki bezempilo cishe bazoncoma ukuhlolwa okuvamile okwengeziwe ukuze balandelele ukukhulelwa eduze. Lokhu kuqinisekisa ukuthi noma yiziphi izingozi ezingaba khona, njengokubeletha ngaphambi kwesikhathi, zikhonjwa kusenesikhathi.
• Ukusekelwa kokudla okunomsoco: Ukukhula kokukhulelwa okusheshayo kungafuna okuningi emzimbeni womama maqondana nokudla okunomsoco. Ngakho-ke, ukudla okulinganiselayo okunothe ngamavithamini nezinsimbi ezibalulekile kubalulekile ukusekela ukuthuthuka okusheshisiwe kombungu. Ukusebenzisa Conceive Plus Prenatal Vitamins, ocebile nge-folate, i-DHA, nezakhi-mzimba ezibalulekile, kungasiza ukusekela ukukhula nokuthuthuka okusheshayo okuhlobene nokukhulelwa okusheshisiwe.
• Izinhlelo zokunakekelwa ezenzelwe umuntu: Ukukhulelwa okusheshisiwe kungase kudinge izinhlelo eziklanyelwe bona zokunakekelwa kwangaphambi kokubeletha ezihlanganisa ama-ultrasound angeziwe, ukuhlolwa kwegazi, noma ngisho nokungenelela kusenesikhathi uma kudingeka. Isibonelo, uma umbungu ukhula ngokushesha kakhulu kunalokho okulindelekile, kungase kwenziwe izinguquko ukuze kuqinisekiswe ukuzalwa okuphephile nokunempilo. 

Umthelela wengqondo

Ngaphezu kwezinguquko zomzimba, abesifazane abahlangabezana nokukhulelwa okusheshisiwe bangase babhekane nezinselelo zengqondo. Ukuqhubeka ngokushesha kokukhulelwa kungadala ukukhathazeka noma ingcindezi, ikakhulukazi kwabesifazane abakhulelwe okokuqala abangase bazizwe bengakulungele.

• Ukusekelwa ngokomzwelo: Kubalulekile ukufuna ukusekelwa ngokomzwelo kubalingani, emndenini, noma kochwepheshe bezempilo ukuze ubhekane nezinguquko ezisheshayo. Ukubonisana ngaphambi kokubeletha kungasiza futhi ukuphatha noma yiziphi izinkathazo noma ukwesaba mayelana nesimo sokushesha sokukhulelwa.
• Ukuhlelela ukulethwa kusenesikhathi: Kwezinye izimo, ukukhulelwa okusheshisiwe kungaholela ekusebenzeni kwezibeletho kusenesikhathi noma ekulethweni kusenesikhathi. Ukulungiselela leli thuba kungasiza ukunciphisa ingcindezi, kuqinisekiswe ukuthi zonke izilungiselelo ezisemqoka zenziwe kusenesikhathi.

Isiphetho

Nakuba ukukhulelwa okusheshisiwe kungavami, kubalulekile ukuqaphela izimpawu futhi uqinisekise ukuthi ukunakwa kwezokwelapha okufanele kuyatholwa ukuze kuvikelwe kokubili umama nomntwana okhulayo esibelethweni. Ukhiye wokuphatha lolu hlobo lokukhulelwa ukuluthola kusenesikhathi, ukunakekelwa okuvamile ngaphambi kokubeletha, nokuqonda izimfuno ezihlukile ezibekwa emzimbeni. Uma uhlangabezana nokukhula okusheshayo kokukhulelwa noma ezinye izimpawu zokukhulelwa okusheshisiwe, ukubonana nochwepheshe kwezempilo kubalulekile ukuqinisekisa uhambo lokukhulelwa olubushelelezi nolunempilo.

Ngokuhlale unolwazi futhi ugcine ukuxhumana okusondelene nethimba lakho lezokwelapha, ungaqondisa kangcono izingqinamba nenjabulo yokukhulelwa okusheshisiwe, uqinisekise imiphumela engcono kumama nasengane.

Imithombo yolwazi

1. Elenis E, Wikström AK, Simic M. Ukukhula komntwana esesibelethweni okusheshisiwe ekuqaleni kokukhulelwa kanye nengozi yokubeletha kusenesikhathi: ucwaningo lweqoqo elubheke phambili. BMC Pregnancy Childbirth. 2020 Dec 9;20(1):764. doi:10.1186/s12884-020-03458-x. PMID: 33297996; PMCID: PMC7724842.
2. Jose Villar, Roseline Ochieng, Robert B Gunier, Aris T Papageorghiou, Stephen Rauch, Rose McGready, Julia M Gauglitz, Fernando C Barros, Manu Vatish, Michelle Fernandes, Victor Zammit, Verena I Carrara, Shama Munim, Rachel Craik, Hellen C Barsosio, Maria Carvalho, James A Berkley, Leila I Cheikh Ismail, Shane A Norris, Chrystelle O O Tshivuila-Matala, Francois Nosten, Eric O Ohuma, Alan Stein, Ann Lambert, Adele Winsey, Ricardo Uauy, Brenda Eskenazi, Zulfiqar A Bhutta, Stephen H Kennedy. Ukuxhumana phakathi kwemizila yokukhula kwesisu somntwana esesibelethweni, amasignesha e-metabolite kamama ekuqaleni kokukhulelwa, nokukhula kobuntwana nokunqwabelana kwamafutha omzimba: ucwaningo oluqhubekayo olubhekile, lwamazwe amaningi lwe-INTERBIO-21st mayelana nokukhula komntwana esesibelethweni. The Lancet Diabetes & Endocrinology. (Umqulu 10, Inombolo 10, 2022, Amakhasi 710-719). https://www.sciencedirect.com/science/article/pii/S2213858722002157