Ingabe uketshezi olunamanzi oluphuma esithweni sangasese kuyisibonakaliso sokukhulelwa? Ukuqonda izinguquko

Abesifazane abaningi bayaqaphela izinguquko ekuphumeneni kwangasese kwabesifazane phakathi nesikhathi sabo sokuya esikhathini. Enye imibuzo evame ukubuzwa ithi, “Ingabe ukukhipha uketshezi olubonakala lumanzi kuwuphawu lokukhulelwa?” Ukuqonda izinhlobo ezahlukene zokuphuma uketshezi nokuthi zihlobene kanjani nokukhulelwa kungasiza ukucacisa ukudideka. Ukuphuma uketshezi esithweni sangasese sowesifazane kuyashintsha ngenxa yokuguquguquka kwamahomoni, futhi ukuba khona kokuphuma uketshezi okumanzi ngokweqile okungaba uphawu lokukhulelwa kungaba ngolunye lwezimpawu zokuqala zokukhulelwa.

Ukuphuma Uketshezi Olumanzi Ekuqaleni Kokukhulelwa

Ngesikhathi sokuqala sokukhulelwa noma ukuphuma uketshezi ngaphambi kokuya esikhathini, izinguquko zamahomoni zenza kube nokwanda kokuphuma uketshezi esithweni sangasese sowesifazane. Lokhu kuphuma uketshezi, okubizwa ngokuthi i-leukorrhea, kuvame ukuba mncane, kucace, noma kube mhlophe okwesinkwa, futhi kunuka kancane. Umzimba ukhiqiza i-estrogen eningi kulesi sikhathi, evuselela umlomo wesibeletho nezindonga zesitho sangasese ukuze kukhishwe uketshezi oluningi. Ukuphuma uketshezi okumanzi ekuqaleni kokukhulelwa kungabonakala ngaphambi kokuba ulahlekelwe yisikhathi sokuya esikhathini, okwenza abanye babuze ukuthi ingabe kuwuphawu lokusondela kokuya esikhathini noma mhlawumbe lokukhulelwa [1].

Kulabo abalandelela umjikelezo wabo, kungaba nzima ukwehlukanisa phakathi kokuphuma uketshezi okuhlobene nokuqala kokukhulelwa nokuphuma uketshezi ngaphambi kokuya esikhathini. Lokhu kuholela embuzweni ojwayelekile othi, “Ingabe ukuzizwa umanzi kuwuphawu lokukhulelwa noma lokuya esikhathini?” Nakuba ukuphuma uketshezi okumanzi ngaphambi kokuya esikhathini kujwayelekile, ukuba khona kwako ekuqaleni kokukhulelwa kuvame ukuba sobala kakhulu futhi kungahlala isikhathi eside.

Ukuphuma Uketshezi Olumanzi vs. Izimpawu Zokuya Esikhathini

Njengoba kushiwo ngenhla, ukuphuma uketshezi okumanzi ngaphambi kokuya esikhathini okuyisibonakaliso sokukhulelwa kungaba umehluko oqapheleka kwabanye besifazane, ikakhulukazi uma uketshezi lubonakala lukhulu kunokujwayelekile. Nokho, ukuzizwa umanzi kungaba uphawu lokukhulelwa noma lokuya esikhathini kungadida ngoba lawo womabili amazinga abandakanya ukwanda kokuphuma uketshezi. Ukuze bahlukanise, abesifazane abaningi bagxila kwezinye izimpawu zokuqala zokukhulelwa ezifana nokukhathala, ukuncipha kobuhlungu bamabele ekuqaleni kokukhulelwa, noma isicanucanu. Uma uqaphela ukuphuma uketshezi okungaphezu kokujwayelekile futhi usola ukuthi ukhulelwe, ukulinda ukuthi ulahlekelwe yisikhathi sokuya esikhathini bese wenza ukuhlolwa kokukhulelwa kungakunikeza impendulo ecacile.

Ukuphuma Uketshezi Ngesigaba Sesibili Sokukhulelwa

Njengoba ukukhulelwa kuqhubekela phambili, izinguquko ekuphumeneni uketshezi esithweni sangasese ziyaqhubeka. Abesifazane abaningi baba nokuphuma uketshezi okumanzi ngesikhathi sesigaba sesibili sokukhulelwa, okuyinto evame ukuba yinto ejwayelekile. I-Estrogen ihlala iphezulu phakathi nokukhulelwa, okwenza kube nokwanda kwenani lokuphuma uketshezi. Ukuphuma uketshezi okumanzi ngesikhathi sesigaba sesibili sokukhulelwa kuyingxenye yenqubo yemvelo yomzimba yokuvimbela amagciwane ekufinyeleleni esibelethweni.

Nokho, kubalulekile ukuhlukanisa phakathi kokuphuma uketshezi okumanzi okujwayelekile nezimpawu ezikhathazayo. Nakuba iningi lokuphuma uketshezi okumanzi lingaphephile, ukuphuma uketshezi ngokweqile noma okuhambisana nephunga elibi noma ukuluma kungase kubonise ukutheleleka, njengokutheleleka amagciwane (bacterial vaginosis) noma isikhunta (yeast infection), okumele kwelashwe uchwepheshe wezempilo [2].

Ukuphuma Uketshezi Olumanzi Ngesigaba Sesithathu Sokukhulelwa

Lapho abesifazane bengena ezigabeni zokugcina zokukhulelwa, ukuphuma uketshezi okumanzi ngesikhathi sesigaba sesithathu sokukhulelwa kungaba sobala kakhulu. Lolu kwanda lokuphuma uketshezi luyingxenye yokulungiselela umzimba ukubeletha. Umlomo wesibeletho uyathamba, futhi umzimba ukhiqiza amafinyila amaningi ukusiza ukuvikela ingane ezintsheni.

Nokho, kukhona umehluko omkhulu phakathi kokuphuma uketshezi okumanzi nokuvuza kwamanzi e-amniotic, okungenzeka uma sekusondela isikhathi sokubeletha. Uma uqaphela ukuphuma uketshezi okuqhubekayo okufana namanzi ngesikhathi ukhulelwe okumanzi kakhulu aze amanzise izingubo zangaphansi, kubalulekile ukuthintana nochwepheshe wezempilo, ngoba lokhu kungasho ukuthi amanzi akho asephukile.

Ukuphuma Uketshezi Olumanzi Nezingqinamba Zokukhulelwa

Nakuba ukuphuma uketshezi okumanzi okufana namanzi ngesikhathi ukhulelwe kuvame ukuba yingxenye enempilo yokukhulelwa, kukhona izimo ezimbalwa lapho kungase kubonise inkinga. Isibonelo, uma uketshezi lukhuye ngokweqile, lunuka kabi, noma kuhambisana nokuluma noma ukuvuvukala, kungaba uphawu lokutheleleka. Ngaphezu kwalokho, uma uba nenani elikhulu lokuphuma uketshezi olufana namanzi ongakwazi ukulawula, kungaba uphawu lokuphuka kusenesikhathi kwezakhi zolwelwesi oluzungeze umntwana (premature rupture of membranes, PROM), isimo lapho isikhwama se-amniotic siphuka kusenesikhathi. Lokhu kudinga ukunakwa ngokushesha kwezokwelashwa [3].

Kuhle njalo ukukhuluma nochwepheshe wezempilo uma ungaqiniseki ngohlobo noma ngobuningi bokuphuma uketshezi okwenzeka ngesikhathi ukhulelwe.

Ukuhlukanisa Ukuphuma Uketshezi Okujwayelekile Nokukhathazayo

Ukuphuma uketshezi ngesikhathi ukhulelwe kufanele ngokuvamile kube mncane, kucace, noma kube mhlophe okwesinkwa futhi kungabi nephunga elinamandla. Kodwa-ke, ukuba khona kokuphuma uketshezi okumanzi okungenzeka kube uphawu lokukhulelwa kungakhathaza uma kubonakala kukhulu kakhulu noma kwenzeka ngokuzuma. Kwabesifazane abaningi, kuyasiza ukuqaphela ezinye izimpawu ezihambisana nakho. Isibonelo, uma uzizwa ungaphilile, unezinhlungu, noma uqaphela imibala engaqhelekanga (efana neluhlaza noma ephuzi), kungcono ukubonana nochwepheshe wezempilo.

Isiphetho

Ngakho, ingabe ukuphuma uketshezi okumanzi kuwuphawu lokukhulelwa? Impendulo ithi yebo, kungaba njalo. Izinguquko ekuphumeneni uketshezi esithweni sangasese sowesifazane zivamile ngesikhathi sokukhulelwa ngenxa yezinguquko zamahomoni, futhi ukuphuma uketshezi okumanzi ekuqaleni kokukhulelwa kungaba enye yezimpawu zokuqala zokuthi ukukhulelwa sekukhona. Njengoba ukukhulelwa kuqhubeka, ukuphuma uketshezi kungaqhubeka futhi kwande, ikakhulukazi esigabeni sesibili nasesigabeni sesithathu.

Yize iningi lokuphuma uketshezi okumanzi liyingxenye ejwayelekile nenempilo yokukhulelwa, ukunaka ukwakheka kwalo, iphunga, nanoma yiziphi ezinye izimpawu ezihambisana nalo kubalulekile. Uma uke waba nokungabaza ukuthi ukuphuma uketshezi okwenzayo kujwayelekile yini, ungangabazi ukubonana nochwepheshe wezempilo ukuze uthole isiqinisekiso.

Imithombo:

1. Sim M, Logan S, Goh LH. Vaginal discharge: evaluation and management in primary care. Singapore Med J. 2020 Jun;61(6):297-301. doi:10.11622/smedj.2020088. PMID: 32754764; PMCID: PMC7905126.
2. Sarah Rae Easter, Clark T. Johnson, A Case of Restrictions on Comprehensive Reproductive Health Care, NEJM Evidence, 2, 1, (2022). /doi/full/10.1056/EVIDe2200294
3. Khaskheli M, Baloch S, Baloch AS, Shah SGS. Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes. Pak J Med Sci. 2021 Sep-Oct;37(5):1302-1308. doi:10.12669/pjms.37.5.4187. PMID: 34475902; PMCID: PMC8377920.