Isibali Sesikhathi Sokukhulelwa Sokubala Usuku Olulindelekile Lokubeletha

Ukukhulelwa yisigaba esijabulisayo kunoma yimuphi owesifazane, kodwa futhi kuza nezinselelo ezahlukene. Injabulo nobunzima phakathi nokukhulelwa kwenza owesifazane acabange ngosuku alindele ukubeletha ngalo. Izibali zosuku lokubeletha zisiza abesifazane balungiselele ukubeletha nokunakekelwa komntwana osanda kuzalwa. Uma ungowesifazane okhulelwe, zikhona izindlela eziningi ongabala ngazo usuku lokubeletha ngokunemba okukhulu.

Kulesi sihloko, sizoxoxa ngobude besikhathi sokukhulelwa, izigaba ezahlukene zokukhulelwa, nezindlela abesifazane abangabala ngazo usuku abalindele ukubeletha ngalo (EDD).

Ubude besikhathi Sokukhulelwa

Ngokwesilinganiso, ukukhulelwa okusezingeni eligcwele kuhlala cishe amaviki angu-40 noma izinsuku ezingu-280, kuqala ngosuku lokuqala lokuba nokuya esikhathini kwakho kokugcina (LMP) [1]. Ukuqonda ukuthi i-EDD ekukhulelweni isho ukuthini okusho usuku olulindelekile lokubeletha kungasiza abesifazane bahlele kangcono ukufika komntwana wabo futhi baphathe kahle izigaba zokukhulelwa kwabo. Kubalulekile ukukhumbula ukuthi amaviki angu-40 yisilinganiso sobude besikhathi sokukhulelwa, futhi ezinye izifazane zabelethela kancane ngaphambi kwalokho noma ngemva kwalokho.

Izibiko zibonisa ukuthi izingane ezizalwa phakathi kwamaviki angu-37 no-42 zivame ukuba nempilo enhle, futhi yingakho zibhekwa njengokuzalwa ngesikhathi esigcwele [2]. Uma owesifazane ezala umntwana ngaphambi kwamaviki angu-37, kubizwa ngokuthi ukuzalwa ngaphambi kwesikhathi (preterm). Ngokufanayo, uma owesifazane ezala umntwana ngemva kwamaviki angu-42, kubhekwa njengokuzalwa ngemuva kwesikhathi (post-term).

Kungani Ukukhulelwa Kukalwa Ngamaviki?

Abantu abaningi bayazibuza ukuthi kungani ukukhulelwa kulinganiswa ngamaviki kunokuba kube ngezinyanga. Sikalela ukukhulelwa ngamaviki ngoba lokhu kunikeza indlela enembile yokulandelela ukukhula nokuthuthuka komntwana wakho.

Ukuthuthuka komntwana esibelethweni sikamama kuyinqubo eqhubekayo kancane kancane. Umntwana okhula uthola izigaba ezithile masonto onke, futhi odokotela babala amaviki ukuze balandelele izinguquko [3]. Isikhathi esiphelele samaviki angu-40 sihlukaniswe izigaba ezintathu, ezibizwa ngokuthi ama-thrimesta amathathu.

Ama-thrimesta Amathathu Okukhulelwa

Ukukhula nokuthuthuka kombungu kuqala ngokushesha ngemva kokunamathiselwa kwe-embryo esibelethweni. Kulesi sigaba, ungaqinisekisa ukukhulelwa kwakho ngosizo lwe amakhithi okuzihlola ukukhulelwa ekhaya.

Njengokuhamba kwesikhathi, izinhlelo zamangqamuzana omzimba ziyakhula futhi ziqale ukusebenza njengoba usuku lokuzalwa lusondela. Lona inqubo eqhubekayo, kodwa siyayihlukanisa ibe ama-thrimesta amathathu ukuze kusilungele thina.

Ithrimesta yokuqala (Amaviki 1–12)

I-trimester yokuqala iqala ngokuchumiselwa noma ukungena komfuzo wesidoda eqandeni futhi iphele emasontweni angu-12. Kulesi sigaba, iqanda elichumile liyanamathiselwa esibelethweni, bese izitho zomzimba ziqala ukwakheka emzimbeni wengane. Ezinye izinguquko ezinkulu kulesi sigaba zifaka phakathi ukwakheka kwenhliziyo nobuchopho [4].

Umama angaba nezimpawu ezifana nesicanucanu, ukukhathala, nokuguquguquka kwemizwa phakathi ne-trimester yokuqala. Izinguquko zamahomoni yizona ezibangela lezi zimpawu kumama ngesikhathi sokukhulelwa.

Itrimester Yesibili (Amasonto 13–26)

I-trimester yesibili ivame ukubizwa ngokuthi \"isigaba esilula\" sokukhulelwa. Kulesi sigaba, izimpawu ezifana nesicanucanu zivame ukuncipha, futhi isisu sokuqhwasha komntwana sesiyabonakala.

Umama angakwazi ukuzwa ukunyakaza kwengane phakathi ne-trimester yesibili. Izingxenye ezahlukene ezifana neminwe, izinzwane, nezimo zobuso nazo ziyakhula kulesi sigaba [5]. Umama angakwazi futhi ukwazi ubulili bengane phakathi ne-trimester yesibili ngokusebenzisa i-ultrasound.

Itrimester Yesithathu (Amasonto 27–40)

Ku-trimester yesithathu, ingane iyaqhubeka nokukhula nokuzuza isisindo. Izitho zomzimba ziyaqina ukuze zilungiselele impilo yengane ngaphandle kwesibeletho. Usayizi wengane ukhula kakhulu kulesi sigaba, okudala ukungakhululeki okukhulu kumama.

Ezinye izifazane ziba nemihlinzo ye-Braxton Hicks noma umsebenzi wamanga, okungadala ukwanda kokungakhululeki kukamama [6]. Yisikhathi lapho owesifazane edinga ukulungiselela ngokomzwelo nangokusebenziseka ukuze akwazi ukubeletha.

Izindlela Zokubala Usuku Lokubeletha

Iningi labesifazane liqala ukunokulangazelela ukwazi usuku lokubeletha ngesikhathi beqala ukukhulelwa, kuyilapho abanye beqala ukucabanga ngosuku abalindele ukubeletha ngalo kwe-trimester yokugcina.

Uma ungumama okhulelwe futhi ufuna ukwazi usuku lokubeletha, nanka amanye amasu asebenzayo azokusize:

1. Ukusebenzisa Usuku Lokugcina Lokuya Esikhathini

Indlela evame kakhulu yokubala usuku lokubeletha wukusebenzisa usuku lokuqala lokuya kwakho esikhathini kokugcina. Odokotela basebenzisa uMthetho ka-Naegele, okuthi:

• Thatha usuku lokuqala lokuya kwakho esikhathini kokugcina.
• Nezela izinsuku ezingu-280 (noma amasonto angu-40).
• Isibonelo, uma i-LMP yakho ibingu-1 uJanuwari, usuku olulinganiselwe lokubeletha luyoba cishe u-8 u-Okthoba.

Kubalulekile ukwazi ukuthi uMthetho ka-Naegele usiza kuphela ukubala amasonto noma ukulinganisa usuku lokubeletha futhi awunembile ngaso sonke isikhathi ekunqumeni usuku oluqondile lokuzalwa. Imibiko ikhombisa ukuthi cishe u-5% kuphela wokubeletha kwenzeka ngezinsuku eziqondile ezibalwe ngoMthetho ka-Naegele [7]. Conceive Plus Ukusekelwa Kokuzala Kwabesifazane, ocebisiwe nge-folate ne-magnesium, usize ukulawula ibhalansi yamahomoni futhi usekele impilo yokuzala ngesikhathi sokuzilungiselela ukukhulelwa.

2. Izilinganiso ze-Ultrasound

Ukusebenzisa i-ultrasound kuyindlela ethembekile kakhulu yokubala usuku oluhleliwe lokubeletha, ikakhulukazi ku-trimester yokuqala. Izifundo ze-ultrasound ezinyangeni zakuqala zokukhulelwa zinganikeza ulwazi olubalulekile ngobukhulu nokukhula komntwana [8]. Lezi zihlolo zokuskena zisiza ukunquma iminyaka yokukhulelwa, okuyisebenzisayo ukubala usuku lokubeletha.

3. Ukulandelela Ukuvuthwa Kwamaqanda

Kunezindlela eziningi zokulandelela ukuvuthwa kwamaqanda, futhi imininingwane enembile ngosuku lokuvuthwa kwamaqanda isiza ukunquma usuku lokubeletha. Abesifazane bangalandelela ukuvuthwa kwamaqanda ngokulinganisa izinga lokushisa lomzimba eliyisisekelo, amakhithi okuhlola ukuvuthwa kwamaqanda, noma izibali zokuvuthwa kwamaqanda eziku-inthanethi ukubekisa ngqo usuku abakhiqize ngalo. Ukwenezela izinsuku ezingu-266 kosuku lokukhulelwa kunoma iyiphi ikhalenda lokukhulelwa kunikeza usuku okulindeleke ukuthi kubelethwe.

4. Izibali Zokukhulelwa Eziku-inthanethi

Kukhona amathuluzi amaningi aku-inthanethi nezinhlelo zokusebenza ezingakusiza ukubala usuku oluhleliwe lokubeletha. Udinga nje ukufaka i-LMP yakho noma usuku lokukhulelwa, bese zikunikeza usuku olulinganiselwe. Kodwa-ke, ukunemba kwalawa mathuluzi kuncike ekutheni unembe kangakanani nge-LMP yakho noma usuku lokukhulelwa.

Izinto Eziwathintayo Usuku Olkulindelekile Lokubeletha

Kuvamile ukuthi kube khona ukuzalwa ezinsukwini ezingaphambi noma ezingemva kosuku lokukhulelwa okulindelekile. Isizathu salokhu ukuthi kunezinto ezihlukahlukene ezingathinta ukunemba kosuku okulindelekile. Lezi izinto yilezi:

1. Imijikelezo Yokuya Esikhathini Engajwayelekile

Izimo zokungabi namandla okukhulelwa kowesifazane ezifana ne-PCOS zingaholela emijikelezweni yokuya esikhathini engajwayelekile [9]. Abesifazane abanemijikelezo yokuya esikhathini engajwayelekile bangathola kunzima ukusebenzisa indlela ye-LMP ngokunembile. Kulezi zimo, i-ultrasound noma ukulandelela ukuvuthwa kwamaqanda kungasiza ukunquma usuku okulindeleke ukuthi kubelethwe.

2. Ukuvuthwa Kwamaqanda Okuhamba Sekwephuzile Noma Kusenesikhathi

Abesifazane abaningi bathembele kumjikelezo wabo wokuya esikhathini ukuze banqume izinsuku zokuvuthwa kwamaqanda. Uma ukuvuthwa kwamaqanda kwenzeka ngaphambi noma emva kwalokho okulindelekile, kungashintsha usuku okulindeleke ukuthi kubelethwe.

3. Ukukhulelwa Okunezingane Eziningi

Imibiko ikhombisa ukuthi abesifazane abakhulelwe amawele bavame ukuzala ngaphambi kwamasonto angu-40, okushintsha umugqa wesikhathi wosuku okulindeleke ukuthi bazale [10]. Amawele afinyelela esigabeni sokukhulelwa okuphelele ngokuvamile cishe emasontweni angu-37, kanti abathathu bangazalelwa cishe emasontweni angu-34.

Lokhu kungenxa yokuthi isibeletho sifinyelela umthamo waso omkhulu masinyane, futhi ingozi yezinkinga iyanda njengoba ukukhulelwa kuqhubeka. Ukuhlolwa njalo ngudokotela kubaluleke kakhulu ekukhulelweni okunezingane eziningi ukuze kuqinisekiswe impilo kanina nezingane.

4. Izimo Zempilo Kamama

Izifundo zibonisa ukuthi izimo ezahlukene zempilo kamama zingaphinde zithinte usuku lokubeletha olulindelekile [11]. Izimo ezifana nesifo sikashukela noma umfutho wegazi ophezulu zingaholela ekuzalweni kusenesikhathi, okwenza kube kubalulekile ukuqapha ukukhulelwa kwakho eduze.

Ukubaluleka Kokuhlolwa Njalo Ngesikhathi Sokukhulelwa

Ukuhlolwa njalo nodokotela noma umbelethisi wakho kubalulekile ngesikhathi sokukhulelwa. Bazokala ukukhula kwengane yakho futhi bangehlisa noma bandise usuku lokuzalwa uma kudingeka, ngokuya nge-ultrasound noma ezinye izici. Lokhu kuqinisekisa ukuthi unohlelo lwesikhathi olunembe kakhulu lokukhulelwa kwakho.

Ukuhlolwa njalo nokubonisana nodokotela kusiza futhi omama ukubhekana nezinselelo zokukhulelwa ezifana nokushoda kokudla okunomsoco nengcindezi yengqondo. Ochwepheshe batusa ukuhlela izivakashi zokunakekelwa kwangaphambi kokubeletha njalo ezinsukwini ezine phakathi kwamaviki 4 kuya ku-28, njalo emavikini amabili kusukela evikini le-28 kuya kwangama-36, futhi njalo njalo ngesonto kusukela evikini lama-36 kuya kwangama-40 [12].

Ukulungiselela Usuku Olulindelekile Lokubeletha

Kubalulekile ukuqonda ukuthi usuku lokuzalwa olulindelekile wukulinganisa nje kuphela. Cishe u-5% kuphela wezingane ezizalwa ngosuku oluqondene nalolu abeluleki bakho abalubaleleyo [7]. Iningi lezingane lifika phakathi kwefasitela lamasonto amabili ngaphambi nangemva kosuku okulindelekile lokuzalwa.

Ukuqapha Izimpawu

Njengoba usondela osukwini okulindeleke ukuthi uzale ngalo, kubalulekile ukubuka izimpawu zokuthi sekuqala umsebenzi wokubeletha [13]. Lezi zimpawu zihlanganisa ukuquleka njalo, ukuphuma kwamanzi akho, noma ukuchitheka okubonakala njengomucu okubizwa ngokuthi “bloody show.”

Ukulungiselela Ngokwengqondo Nangokusebenza

Ukulungiselela kusenesikhathi ukubeletha kungakwenza uzizwe uqinisekile futhi ulungile. Qala ngokupakisha isikhwama sasebhedlela esinezinto ezibalulekile ezifana nezingubo, izinto zokuhlanza umzimba, nezinto zengane.

Hlela ukwesekwa ozokuthola kumlingani wakho, emndenini, noma kubangani abangakwelula isandla ngesikhathi sokubeletha nangemva kwalokho. Khuluma nodokotela wakho noma umhlinzeki wakho wezempilo mayelana nohlelo lwakho lokubeletha nanoma yiziphi izintandokazi okhethekile onazo mayelana nokuqaqamba nokubeletha.

Isiphetho

Ukukhulelwa uhambo olukhethekile kumfazi ngamunye, futhi lungaba yinselele enkulu kwabanye. Uma owesifazane ekhulelwe, kubalulekile ukuthi azilungiselele ngokomzwelo nangokusebenziseka ukuze ukubeletha kwengane kuhambisane kahle.

Into ebalulekile noma yimuphi owesifazane okhulelwe angathanda ukuyazi ukuze enze amalungiselelo wukwazi usuku okulindeleke ukuthi azale ngalo noma ikhalikhuleyitha yokubala usuku lokubeletha. Izindlela ezahlukene ezifana no-LMP, izinhlelo zokuhlolwa nge-ultrasound, nokulandelela isikhathi sokuvuthwa kwamaqanda zingasiza abesifazane balinganise usuku abalindele ukuba bazale ngalo.

Ukuhlolwa njalo nodokotela wakho noma umhlinzeki wakho wezempilo kubalulekile ngesikhathi sokukhulelwa, ikakh尤其 esigabeni sokugcina sokukhulelwa. Udokotela wakho uzokuhola ngosuku okulindeleke ukuthi uzale ngalo futhi aqaphe impilo yakho kanye nempilo yengane.

Imibuzo Evame Ukubuzwa

1. Ukukhulelwa okuvamile kuthatha isikhathi esingakanani?

Ukukhulelwa okuvamile kuthatha cishe amaviki angu-40 noma izinsuku ezingu-280 kusukela osukwini lokuqala lokuya esikhathini kwakho kokugcina. Ungabala usuku olungalindelekile lokubeletha ngoMthetho kaNaegele noma ama-ultrasound scan.

2. Uyini Umthetho kaNaegele wokukhulelwa?

Umthetho kaNaegele usetshenziselwa ukunquma usuku olungalindelekile lokubeletha ngesikhathi sokukhulelwa. Uhlanganisa ukwengeza izinsuku ezingu-280 osukwini lokuqala lokuya esikhathini kwakho kokugcina.

3. Ingabe ukukhulelwa okuningi kuthinta usuku lokuzalwa olungalindelekile?

Yebo, abesifazane abakhulelwe amawele noma ngaphezulu bavame ukuzala ngaphambi kwamaviki angu-40, okuyiwona abhekwa njengokuzalwa okuphelele enganeni eyodwa. Ukuzalwa okufinyelele esiphethweni kwamawele ngokuvamile kuba cishe emavikini angu-37.

Imithombo esetshenzisiwe

1. Jukic, A., Baird, D., Weinberg, C., McConnaughey, & Wilcox, A. (2013). Ubude bokukhulelwa komuntu nezinto ezibangela ukwehluka kwabo kwemvelo. Human Reproduction. https://academic.oup.com/humrep/article/28/10/2848/620772 
2. Zazi Imigomo Yakho: Omama abazoba - NCMHEP. (2022, June 2). https://www.nichd.nih.gov/. https://www.nichd.nih.gov/ncmhep/initiatives/know-your-terms/moms 
3. Professional, C. C. M. (2024b, September 19). Ukuthuthuka komntwana esibelethweni. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/7247-fetal-development-stages-of-growth 
4. Ukuthuthuka komntwana esibelethweni: Kwenzekani ngesikhathi setrimester yokuqala? (n.d.). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302 
5. Healthdirect Australia. (n.d.). Itrimester yesibili. Pregnancy Birth and Baby. https://www.pregnancybirthbaby.org.au/second-trimester 
6. Raines DA, Cooper DB. Braxton Hicks Contractions. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Kutholakala ku-: https://www.ncbi.nlm.nih.gov/books/NBK470546/ 
7. Darwish, N. A., M. D., Thabet, S. M., M. D., Nasr, A. L. A., M. D., El Sharkawy, S., M. D., El Tamamy, M. N., M. D., & The Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University. (1994). Umthetho kaNaegele ohlungiwe wokunquma usuku olulindelekile lokubeletha kungakhathalekile ubude bomjikelezo. Ku Med. J. Cairo Univ.: Vol. Vol. 62 (Issue No. 1, amakhasi 39–47). https://applications.emro.who.int/imemrf/med_j_cairo_univ_1994_62_1_39.pdf 
8. Healthdirect Australia. (2024, April 11). Ama-ultrasound scan ngesikhathi sokukhulelwa. Izinzuzo, Mayelana | Pregnancy Birth and Baby. https://www.pregnancybirthbaby.org.au/ultrasound-scan 
9. Singh, S., Pal, N., Shubham, S., Sarma, D. K., Verma, V., Marotta, F., & Kumar, M. (2023). Isifo sePolycystic Ovary Syndrome: Izimbangela, Ukuphathwa Kwamanje, Nezindlela Zokwelapha Ezizayo. Journal of clinical medicine. https://www.mdpi.com/2077-0383/12/4/1454 
10. Dodd, J. M., Crowther, C. A., Haslam, R. R., & Robinson, J. S. (2010). Isikhathi esifanele sokubeletha kwezinsikazi ezikhulelwe amawele zizelwe ngesikhathi: ucwaningo olulawulwayo olungahleliwe. BMC pregnancy and childbirth. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-10-68
11. Li, X., Li, T. T., Tian, R. X., Fei, J. J., Wang, X. X., Yu, H. H., & Yin, Z. Z. (2023). Isifo sikashukela sokukhulelwa: Isikhathi esifanele kakhulu sokubeletha. World journal of diabetes, 14(3), 179–187. https://doi.org/10.4239/wjd.v14.i3.179 
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