Ingabe Ukopha Okuncane Nokuqaqamba Kwesisu Ekuqaleni Kokukhulelwa Kujwayelekile?

Ukukhulelwa kuletha izinguquko eziningi emzimbeni wowesifazane. Ezinye zalezi zinguquko zingase zimdide, ikakhulukazi kulabo abakhulelwa okokuqala.

Ukopha okuncane nobuhlungu bokubamba esiswini (cramping) kuyizinto ezivamile ngesikhathi sokuqala sokukhulelwa. Kwezinye izimo, kujwayelekile ngokuphelele futhi kubangelwa izinguquko ezihlobene nokukhulelwa emzimbeni [1]. Nokho, kwezinye izimo, kungase kubonise inkinga ethile efihlekile engase ibe yingozi ekukhulelweni.

Kulesi sihloko, sizozama ukuqonda izimbangela zokopha okuncane nobuhlungu bokubamba esiswini (cramping) ezinsukwini zokuqala zokukhulelwa. Sizophinda sixoxe nangokuthi nini ukopha nokubamba esiswini ekuqaleni kokukhulelwa kujwayelekile, nokuthi nini kungase kukhathaze, lapho udinga ukunakwa kodokotela.

Kusho Ukuthini Ukopha Okuncane Ekuqaleni Kokukhulelwa?

Ukopha okuncane (light spotting) inani elincane legazi eliphuma esithweni sangasese sowesifazane. Abesifazane bangase baluqaphele kaningi lolu kopha phakathi nesikhathi sabo sokuya esikhathini, kodwa lolu kopha luvamile futhi nasekuqaleni kokukhulelwa. Isimo esivamile esingadala ukudideka wukuthi umuntu abe nesikhathi esibambezeleke kodwa kukhona ukopha okuncane, okungenzeka ngezinye izikhathi ekuqaleni kokukhulelwa noma ngenxa yezinye izinguquko zamahomoni. Abesifazane abakhulelwe bangase babone amabala abomvana, abomvu, noma ansundu ezingutsheni zangaphansi noma ephepheni lokuzisula. Imvamisa kuba kancane kunesikhathi sokuya esikhathini futhi akuhlali isikhathi eside.

Izimbangela zokopha okuncane ezinsukwini zokuqala zokukhulelwa zingabandakanya lokhu okulandelayo:

1. Ukopha Ngokufakwa Kwembewu (Implantation Bleeding)

Ukufakwa kwembewu (implantation) yisigaba lapho iqanda elichumiswe lifakwa odongeni lwesibeletho. Khumbula ukuthi ukukhulelwa kuqala ngemuva kokufakwa kwembewu, hhayi ngesikhathi sokuchumisana. Imvamisa kwenzeka emuva kwesonto noma amabili ngemuva kokuvuthwa kweqanda (ovulation).

Ukufakwa kwembewu (implantation) kuvame ukubangela ukopha okuncane, okubizwa ngokuthi ukopha kokufakwa kwembewu (implantation bleeding) [2]. Imvamisa umbala wayo uba mpunga ophephuli (light pink) noma onsundu futhi ingahlala usuku olulodwa noma amabili. Izibiko zibonisa ukuthi owesifazane oyedwa kwabathathu abakhulelwe uthola ukopha kokufakwa kwembewu (implantation bleeding) [2].

2. Izinguquko Zamahomoni

Izinguquko eziningi ezishintsha amahomoni zenzeka ezinsukwini zokuqala zokukhulelwa, ezingaphazamisa udonga lwesibeletho futhi zibangele ukuphuma kwegazi okuncane. Ngokwesibonelo, ngemuva kokufakwa kwembewu (implantation), kuthatha isikhathi ngaphambi kokuba i-placenta iqale ukukhiqiza ihomoni ye-progesterone yokusekela ukukhulelwa [3].

Kungenzeka ukuthi kube namazinga aphansi e-progesterone ngaphambi kokuba i-placenta iqale ukusebenza, okungaholela ezinguqukweni odongeni lwesibeletho nasekuphumeni kwegazi [4]. Amahomoni e-estrogen kanye ne-human chorionic gonadotrophin (hCG) nawo aqala ukwanda ezinsukwini zokuqala zokukhulelwa futhi angase abe negalelo ekuphashukeni kwegazi okuncane.

3. Ukuzwela Kwentamo Yesibeletho

Amahomoni okukhulelwa akhulisa ukugeleza kwegazi emlonyeni wesibeletho nasemathanjeni azungezile. Lokhu kwanda kokuhlinzekwa kwegazi ezigabeni zokuqala zokukhulelwa kwenza umlomo wesibeletho uzwele kakhulu [5].

Ukuzwela okwandayo kusho ingozi enkulu yokucasuka, ikakhulukazi ngesikhathi semisebenzi efana nokwabelana ucansi. Ukuhlolwa kwe-pelvic ezinsukwini zokuqala zokukhulelwa nakho kungacasula umlomo wesibeletho kubangele ukopha okuncane.

4. I-Subchorionic Hematoma

I-Subchorionic hematoma yisimo lapho igazi liqoqeka phakathi kodonga lwesibeletho nengqimba ye-chorionic [6]. Kungabangela ukopha okuncane ngisho nokopha okuningi ngesikhathi sokuqala sokukhulelwa. I-subchorionic hematoma ivame ukuzelapha yona yodwa futhi ayilimazi impilo yengane.

Kusho Ukuthini Ukuqunjelwa Ngesikhathi Sokuqala Sokukhulelwa?

Ukuqunjelwa ngesikhathi sokuqala sokukhulelwa kuvame ukubangelwa izinguquko zomzimba (anatomical) ukuze zamukele usana olukhulayo. Kungazwakala njengoqunjelwa oluthambile lwesikhathi sokuya esikhathini futhi ngokuvamile akubi kakhulu.

Izimbangela ezivamile zokuqunjelwa ezinsukwini zokuqala zokukhulelwa yilezi:

1. Ukufakelwa (Implantation): Njengoba kuxoxwe ngaphambilini, ukufakelwa yisikhathi lapho iqanda elichumiswe linamathiselwa esibelethweni. Ngaphezu kokopha okuncane, ukufakelwa kungabangela nokuqunjelwa okuncane okuvame ukuba yisikhashana futhi okungenabungozi.
2. Izinguquko Esibelethweni: Isibeletho siba ngosayizi wewolintshi ngaphambi kokukhulelwa bese siya ngosayizi we-watermelon ekupheleni kokukhulelwa [7]. Lokhu kwandiswa nokukhula kosayizi wesibeletho ukuze samukele usana olukhulayo kungabangela ukungakhululeki okuncane noma ukuqunjelwa.
3. Uwelulo Lwemigqa (Ligament Stretching): Imigqa emibili eyindilinga, eyodwa ohlangothini ngalunye, ixhuma isibeletho emzimbeni. Le migqa iyelulwa ngesikhathi sokukhulelwa ngenxa yokukhula kosayizi wesibeletho futhi ibangele ubuhlungu. Ubuhlungu bemigqa yamaqakala bungesinye sezizathu ezivamile zobuhlungu besisu abesifazane ababuzwa ekuqaleni kokukhulelwa.
4. Ukuvuvukala Nokuqunjelwa Kwamathumbu:  Ukukhulelwa kubangela ukwanda kwamazinga e-progesterone ukweseka ungqimba lwesibeletho. Nokho, izifundo zikhombisa ukuthi leli homoni lingaphinde lithinte uhlelo lokugaya ukudla futhi lehlehlise inqubo yokugaya ukudla [8]. Yingakho ukuvuvukala nokuqunjelwa kwesisu kuyizimpawu ezivamile ezinsukwini zokuqala zokukhulelwa. Ungase uzwe ukuvuvukala njengokuqunjelwa okuncane esiswini.

Ufanele Ukukhathazeka Nini Ngokopha Okuncane Nokushwiba?

Nakuba ukuqunjelwa kuhambisana nokopha ekuqaleni kokukhulelwa kuvame ukuba kujwayelekile, ezinye izimo zingase zidinge ukunakwa ngokushesha kwezokwelashwa. Isibonelo, igazi elibomvu kakhulu noma amahlule egazi amakhulu kungakhombisa ukuphuphuma kwesisu noma esinye isimo esibucayi. Ngokufanayo, ukuqunjelwa okukhulu noma ubuhlungu obubukhali esiswini kungaba uphawu lokukhulelwa kwangaphandle kwesibeletho noma ezinye izinkinga.

Uma uzizwa unesifo somkhuhlane nomnqandayo kanye nokopha okuncane nokushwiba ekuqaleni kokukhulelwa, lokho kungase kukhombise ukutheleleka. Izimpawu ezinjalo ngesikhathi sokukhulelwa akufanele zinganakwa futhi kumele zihlolwe udokotela ukuze kugwenywe izinkinga ezinkulu zokukhulelwa.

Ezinye Izimpawu Ezikhathazayo Ekukhulelweni

Ukukhulelwa inqubo ebucayi, futhi izinto eziningi zingahamba kabi phakathi nesikhathi sezinyanga eziyisishiyagalolunye zokukhulelwa. Ukutholwa kwezinkinga kusenesikhathi nokuholwa kochwepheshe kungasiza ekuqinisekiseni ukuphepha kukamama nengane.

Nazi ezinye izimpawu okufanele uzibheke ngesikhathi ukhulelwe:

1. Isicanucanu Nokuhlanza Okukhulu: Isicanucanu nokuhlanza okuncane akukhathazi kakhulu ngoba kuyingxenye yezimpawu zokuqala zokukhulelwa emzimbeni. Kodwa-ke, ukuhlanza ngokweqile kungase kubonise isimo esibizwa nge-hyperemesis gravidarum, esingaholela ekuphelelweni amanzi emzimbeni nasekushodayo imisoco [9].
2. Ukudumba Ezandleni Noma Ebusweni: Isikhathi sokukhulelwa yisikhathi lapho ukugcinwa koketshezi emzimbeni kuba phezulu, okungaholela ekudumbini okuncane. Nokho, ukudumba okuzumayo nokukhulu kungaba uphawu lwe-preeclampsia, okuyisifo sokukhulelwa esibucayi. Ungase futhi ube nezinhloko ezibuhlungu kakhulu nezinguquko embonweni uma une-preeclampsia.
3. Ukwehla Kokunyakaza Kombungu: Ukuzizwa kushukuma umbungu kuba sobala kakhulu esigabeni sesibili sokukhulelwa. Lokhu kushukuma kukhombisa ukuthi ingane inempilo. Uma kuba nokwehla okubonakalayo ekunyakazeni kwengane, kufanele ukubike kudokotela.
4. Ukuchama Okubuhlungu: Ukuchama kaningi kuwuphawu olujwayelekile lokukhulelwa, kodwa uma uzwa ubuhlungu lapho uchama, lokho kungase kube inkomba yokutheleleka emgudwini womchamo (UTI). Ukutholwa kusenesikhathi nokuphathwa kwe-UTI kubalulekile ukuze kunqandwe ukusabalala kwayo.

Ungasekela Kanjani Ukukhulelwa Okunempilo?

Impilo embi kamama ingalimaza ukuthuthuka kwengane futhi inyuse ingozi yezinkinga zokukhulelwa. Uma ungumama olindele, nansi eminye imiqondo engakusiza uthuthukise impilo yakho ukuze usekele ukukhulelwa okunempilo:

1. Yidla Ukudla Okulingene

Izidingo zokudla okunomsoco emzimbeni womfazi zanda ngesikhathi ekhulelwe ngoba futhi kumele wondle ingane [10]. Udinga imisoco efana ne-folic acid, insimbi, ikhalshiyamu, ne-ayodhini ukuze agcine impilo yakhe futhi asekele ukuthuthuka okunempilo kwengane. Owesifazane okhulelwe angathola le misoco ngokuhlanganisa izithelo, imifino, okusanhlamvu okuphelele, kanye namaprotheni anenoni elincane ekudleni kwakhe.

2. Thatha Amavithamini Angaphambi Kokubeletha

Ukudla okunempilo akuhlali kwanele ukuhlangabezana nezidingo zokudla okunomsoco zomzimba wakho ngesikhathi ukhulelwe. Yingakho ochwepheshe bencoma ukuthatha amavithamini angaphambi kokubeletha ukuze ugweme ukushoda kokudla okunomsoco okungase kubeke ukhulelongo engozini. Amaphuzu okudla abizwa nge-prenatal vitamins ayizithasiselo zokudla ezinikeza umzimba wakho imisoco ebalulekile ngesikhathi sokukhulelwa, njenge-folic acid, insimbi, ikhalshiyamu, i-ayodhini, ne-omega-3.

3. Hlala Uphephile Ngamanzi

Isidingo samanzi emzimbeni sikhula kakhulu ngesikhathi sokukhulelwa. Ucwaningo lwe-American Heart Association lubonisa ukuthi owesifazane ukhiqiza igazi elingaba ngu-40% ngaphezu kokujwayelekile ngesikhathi ekhulelwe [11]. Ukuphuza amanzi amaningi kungasiza ukuvimbela ukoma futhi kusekele isidingo somzimba wakho esikhulayo soketshezi.

4. Zivocavoce Ngokuphephile

Kuyinkolelo-engamanga ukuthi ukuzivocavoca ngesikhathi sokukhulelwa kuhlala kulimaza ingane, kodwa empeleni, ukuzivocavoca okuphakathi nendawo kungathuthukisa impilo ngesikhathi sokukhulelwa futhi kwehlise ingozi yezinkinga ngesikhathi sokubeletha. Isibonelo, imisebenzi efana nokuhamba noma i-prenatal yoga ingathuthukisa ukujikeleza kwegazi futhi yehlise ukucindezeleka. Nokho, khumbula ukuzigwema izivocavoco ezinzima ngoba zingalimaza ingane.

5. Lalela Umzimba Wakho

Uma uzizwa ungaphilile noma uqaphela izimpawu ezingajwayelekile, njengokuchaphaza okuqhubekayo kwegazi okuhambisana nokuqunjelwa okukhulu kunokujwayelekile, ungabaze nhlobo ukuxhumana nodokotela wakho. Khumbula ukuthi ukuqaphela kusenesikhathi izinkinga zokukhulelwa kungasiza ekuphathweni kangcono futhi kuholele emiphumeleni emihle.

Okubalulekile

Ukuchaphaza kwegazi okuncane kanye nokuqunjelwa yizinto ezimbili ezivame kakhulu okuhlangabezwana nazo owesifazane okhulelwe ezinsukwini zokuqala zokukhulelwa. Ezimweni eziningi, ukuqunjelwa nokuchaphaza kwegazi kuyingxenye yezinguquko ezijwayelekile zokukhulelwa emzimbeni futhi akukho lutho okufanele kukhathaze.

Nokho, uma uqala ukuqaphela izimpawu ezifana nokuhlanza okubi kakhulu, ukuvuvukala kungazelelwe, nobuhlungu lapho uchama kuhambisana nokuchaphaza kwegazi okuncane kanye nokuqunjelwa ezinsukwini zokuqala zokukhulelwa, kuwumqondo omuhle ukwabelana ngalezi zimpawu nodokotela wakho. Lezi zimpawu zingase zibonise izimo ezimbi ezifana ne-hyperemesis gravidarum kanye ne-preeclampsia ezingase zibeke engcupheni impilo kamama kanye nempilo yengane ngesikhathi sokukhulelwa.

Imithombo esetshenzisiwe

1. Soma-Pillay, P., Nelson-Piercy, C., Tolppanen, H., & Mebazaa, A. (2016b). Physiological changes in pregnancy. Cardiovascular Journal of South Africa/Cardiovascular Journal of Southern Africa, 27(2), 89–94. https://doi.org/10.5830/cvja-2016-021 
2. Kuyini Ukopha Kokufakwa Kombungu Esibelethweni (Implantation Bleeding)? American Pregnancy Association. https://americanpregnancy.org/pregnancy-symptoms/what-is-implantation-bleeding/ 
3. Shah, M. (n.d.). Low Progesterone and Its Impact on Early Pregnancy: NOVA IVF: Fertility Specialists. https://www.novaivf.com/blog/low-progesterone-and-its-impact-on-early-pregnancy 
4. Bataa, M., Abdelmessih, E., & Hanna, F. (2024). Exploring Progesterone Deficiency in First-Trimester Miscarriage and the Impact of Hormone Therapy on Foetal Development: A Scoping Review. Children, 11(4), 422. https://doi.org/10.3390/children11040422 
5. Professional, C. C. M. (2024, August 27). Bleeding During Pregnancy. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/22044-bleeding-during-pregnancy 
6. Bondick, C. P., Das, J. M., & Fertel, H. (2023, July 31). Subchorionic Hemorrhage. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559017/ 
7. Usayizi Ojwayelekile Wesibeletho Ngesikhathi Sokukhulelwa. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/uterus-size-during-pregnancy/ 
8. Alqudah, M., Al-Shboul, O., Al-Dwairi, A., Al-U´Dat, D. G., & Alqudah, A. (2022). Progesterone Inhibitory Role on Gastrointestinal Motility. Physiological Research, 2, 193–198. https://doi.org/10.33549/physiolres.934824 
9. Jennings, L. K., & Mahdy, H. (2023, July 31). Hyperemesis Gravidarum. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK532917/ 
10. Jouanne, M., Oddoux, S., Noël, A., & Voisin-Chiret, A. S. (2021). Nutrient Requirements during Pregnancy and Lactation. Nutrients, 13(2), 692. https://doi.org/10.3390/nu13020692 
11. Sanghavi, M., & Rutherford, J. D. (2014). Cardiovascular Physiology of Pregnancy. Circulation, 130(12), 1003–1008. https://doi.org/10.1161/circulationaha.114.009029