Uyini usayizi ojwayelekile wesibeletho ngaphambi nangemva kokukhulelwa?

Lapho sifunda isakhiwo somzimba wowesifazane okhulelwe, sigxila ikakhulukazi esibelethweni ngoba yiso lapho izinguquko eziningi zokukhulelwa ezenzeka khona. Isibeletho, esaziwa nangokuthi isizalo, sinendima emaphakathi ngesikhathi sokukhulelwa ngokunikeza indawo ephephile enganeni esakhulayo [1].

Ngesikhathi sokukhulelwa, isibeletho sidlula ezinguqukweni ezinkulu ukuze samukele i-fetus ekhulayo. Lezi zinguquko ikakhulukazi zifaka ukukhula kosayizi wesibeletho. Isibeletho sikhula sisuke kusayizi wewolintshi siye kusayizi we-watermelon ngesikhathi sokukhulelwa [2].

Kule ndatshana, sizohlola isakhiwo somzimba wowesifazane okhulelwe, ukuthi yini usayizi ojwayelekile wesibeletho, indlela usayizi wesibeletho oshintsha ngayo ezigabeni ezahlukene zokukhulelwa, namathiphu okusiza impilo yesibeletho.

Uyini Umsebenzi Wesibeletho?

Isibeletho yisitho esingenalutho, esimise ukhama lwamapheya, esitholakala emgodini we-pelvis phakathi kwesisu sokugcina umchamo nendunu [1]. Sinezinkonzo eziningi ezibalulekile, ikakhulukazi ngesikhathi sokukhulelwa. Lezi yilezi:

1. Ukondla Ingane

Umsebenzi oyinhloko wesibeletho ukunikeza indawo evikelekile nenondlayo ukuze ingane ikhule futhi ithuthuke. Ngaphambi kokukhulelwa, kuba nezinguquko ezahlukene esibelethweni ukuze senze silungele ukunamathiselwa kweqanda elichumisekile.

Lapho iqanda elichumisekile noma i-embryo selinamathiselwe esibelethweni, lisekela ukukhula nentuthuko ye-embryo ngokusebenzisa i-placenta [3].

2. Ukunamathiselwa Kwe-placenta

I-placenta isitho sesikhashana esinamathisela i-embryo odongeni lwesibeletho ngesikhathi sokukhulelwa [3]. Lesi sitho sidlulisa ukudla-mzimba nomoya-mpilo (oxygen) enganeni kusuka egazini likamama. Ngokufanayo, sihluza futhi sisuse imfucuza egazini lengane.

3. Ukusekelwa Kwemisipha

Isibeletho sakhiwe izingqimba ezintathu: i-perimetrium, i-myometrium, ne-endometrium [1]. I-perimetrium iwungqimba olungaphandle olunendima yokuvikela. I-myometrium iwungqimba oluphakathi olunemisipha lwesibeletho oluyalungisa ngesikhathi sokubeletha ukuze kuzalwe ingane. I-endometrium iwungqimba olungaphakathi lapho ingane izonamathiselwa khona ngesikhathi sokufakelwa.

Usayizi Ojwayelekile Wesibeletho Ngaphambi Kokukhulelwa

Imibuzo ethi, uyini usayizi ojwayelekile wesibeletho, uyini usayizi ojwayelekile wesibeletho ngama-cm, noma ukuthi ungakanani usayizi ojwayelekile wesibeletho, ivamise ukubuzwa ngabesifazane abalungiselela ukukhulelwa. Ngaphambi kokukhulelwa, usayizi ojwayelekile wesibeletho ucishe ulingane nosayizi wewolintshi [2]. Izilinganiso zosayizi ojwayelekile wesibeletho ngaphambi kokukhulelwa zifaka:

• Ubude: 7-8 cm (cishe amasentimitha ayi-3)
• Ububanzi: 4-5 cm (cishe ama-1.5-2 inches)
• Ububanzi: 2-3 cm (ngaphansi kuka-1 inch)

Uma uzibuza ukuthi isibeletho sisinda malini, isibeletho esingakhulelile sisinda cishe amagremu angama-50 kuya kwangu-60 — ama-ounce angu-1.7 kuya ku-2.1. Ngalesi sikhathi, sisesendaweni ejulile esinqeni futhi asenzi i-bump ebonakala ngesikhathi sokukhulelwa. Ukuze uthole incazelo ebonakalayo enemininingwane yesistimu yokuzala yabesifazane, hlola i-picture of womb and uterus ukuze uqonde ukwakheka kwaso nezinguquko ngesikhathi sokukhulelwa.

Indlela Ushintsha Ngayo Usayizi Wesibeletho Ngesikhathi Sokukhulelwa?

Ngesikhathi sokukhulelwa, isibeletho esivamile sikhula kakhulu ngosayizi, sishintshe umumo waso, futhi sinwebe ukuze samukele umntwana okhula ngaphakathi. Nansi eminye imininingwane ngezinguquko ezahlukene kusayizi wesibeletho ezigabeni ezahlukene zokukhulelwa:

I-Trimester Yokuqala

Phakathi ne-trimester yokuqala, usayizi wesibeletho esijwayelekile uqala ukwanda ukuze sekela umbhungu okhulayo. Kodwa yisiphi isayizi esijwayelekile sesibeletho ku-trimester yokuqala?

Imibiko ikhombisa ukuthi ekupheleni kweviki le-12, usayizi ojwayelekile wesibeletho ufana nosayizi we-grapefruit futhi uqala ukukhuphuka ngaphezu kwesinqe [2]. Nokho, sisahlala singena esinqeni ekupheleni kwe-trimester yokuqala.

I-Trimester Yesibili

Ku-trimester yesibili, isibeletho siyaqhubeka nokwanda ngokushesha ngoba umntwana ukhula kakhulu ngosayizi kulesi sikhathi sokukhulelwa. Ngeviki lama-20, isibeletho sifinyelela ezingeni lenkinobho yesisu futhi sifana nosayizi we-melon encane.

I-Trimester Yesithathu

Kuma-trimester wesithathu, isibeletho siba sikhulu ngokwanele ukuba sigcwalise iningi lesikhala esisendaweni yamathumbu. Kodwa, isibeletho sisinda malini ekupheleni kokukhulelwa? Noma, isibeletho sakho sikhulu kangakanani ekupheleni kwe-trimester yesithathu?

Ekupheleni kokukhulelwa, isibeletho sisinda cishe phakathi kwamaphawundi angu-2 kuya ku-4 futhi siphethe amalitha angama-600 kuya ku-800 e-amniotic fluid kanye nomntwana ne-placenta [4]. Ekupheleni kwalesi sigaba, i-myometrium — ungqimba oluphakathi lwesibeletho — liqala ukucindezela, okuyisibonakaliso sokuthi isikhathi sokubeletha sesisondele.

Kwenzekani ngosayizi wesibeletho ngemva kokukhulelwa?

Ngemva kokubeletha, isibeletho siqala inqubo yokubuyela kusayizi waso wangaphambi kokukhulelwa, inqubo ebizwa ngokuthi ukuncipha kwesibeletho [5]. Emasontweni okuqala ambalwa emva kokukhulelwa, isibeletho siyacindezela ukuze sikhiphe noma yikuphi igazi nethishu esisele. Le mivimbo yokucindezela, evame ukubizwa ngokuthi izinhlungu zangemva kokubeletha, isiza ukunciphisa usayizi waso ukuze ifinyelele osayizini ojwayelekile wesibeletho esivamile.

Ngemva kwesonto lesi-6 kuya kwelesi-8 lokubeletha, isibeletho ngokuvamile sibuyela kusayizi waso nasendaweni yaso yangaphambi kokukhulelwa ngaphakathi kwe-pelvis [6]. Kubalulekile ukukhumbula ukuthi konke ukukhulelwa kwehluka, futhi kwezinye izifazane isibeletho sangempela singase singabuyi sibe ngosayizi waso sangaphambi kokukhulelwa.

Izimo Ezingenza Isibeletho Sibe Sengozini

Kunezimo eziningana ezingathinta isibeletho namandla aso okusekela ukukhulelwa okunempilo. Lezi zifaka phakathi:

• Ama-fibroid esibeletho: Ama-fibroid ayizimila ezingawona umdlavuza ezingakhula odongeni lwesibeletho. Lokhu kubangela ubuhlungu, ukopha kakhulu, noma izinkinga ngesikhathi sokukhulelwa. Ama-fibroid avamile kakhulu, futhi imibiko ikhombisa ukuthi cishe u-70% wabesifazane bathola ama-fibroid ngesikhathi sokuphila kwabo [7].
• I-Endometriosis: Isimo lapho izicubu ezifanayo nomgodla wesibeletho zikhula ngaphandle kwesibeletho. Lokhu kubangela ubuhlungu kodwa futhi kungaholela ezinkingeni ezinzima njengokungabi nenzalo. I-Endometriosis ithinta cishe u-10% wabesifazane emhlabeni [8].
• I-Adenomyosis: I-Adenomyosis yisimo lapho izicubu ezakha umgodla wesibeletho ziqala ukukhula ngaphakathi esendlalweni semisipha yesibeletho. Lesi simo singaholela ekopha kakhulu ngesikhathi sokuya esikhathini, ekungakhululeki, futhi kwezinye izimo sibangele ukungabi nenzalo.
• Ukuphuma Kwesibeletho (Uterine Prolapse): Uma imisipha ye-pelvis ibuthaka futhi yehluleke ukusekela isisindo sesibeletho, isibeletho singase siyehlele emgodini wesitho sangasese sowesifazane. Lesi simo sivamise ukwenzeka ngemva kokukhulelwa, ikakhulukazi uma umuntu ekhulelwe izikhathi eziningi.
• Ukuzalwa Nesifo Esingajwayelekile Sesibeletho: Naphezu kokuthi iningi lezifo zesibeletho lithuthuka kamuva empilweni, ezinye ziyazalwa nazo (zingokuzalwa). Ezinye izifazane zizalwa nokuhlukahluka kwesakhiwo sesibeletho, njengokuthi isibeletho sibe i-septate noma i-bicornuate.

Isibeletho esine-septate kuba wukuthi isibeletho sihlukaniswe izingxenye umgoqo, kanti i-bicornuate kuba wukuthi isibeletho sinomumo wenhliziyo esikhundleni somumo wophentshisi obheke phansi.

Amathiphu Okusekela Impilo Yesibeletho

Uma uhlela ukukhulelwa, kubalulekile ukugxila ekugcineni impilo yesibeletho ngoba ibalulekile ekuzaleni, ekukhulelweni, nasekuphileni kahle ngokuphelele. Nansi eminye imihlahlandlela engakusiza usekele impilo yesibeletho:

1. Yidla Ukudla Okulinganiselayo

Ukudla okucebe ngezithelo, imifino, okusanhlamvu okuphelele, amaprotheni angenamafutha amaningi, namafutha anempilo kunikeza izakhamzimba ezisemqoka ezisekela impilo yesibeletho. Izakhamzimba ezifana namavithamini C no-E, atholakala ezifweni nasezimifinweni, ama-antioxidant avikela umgodla wesibeletho ekulimazweni [9].

Amafatty acid e-omega-3 avela ezinhlanzini noma emantongomane nawo anomphumela wokulwa nokuvuvukala futhi anganciphisa ukuvuvukala esibelethweni, ekhuthaza indawo enempilo yokumataniswa kombungu.

2. Hlala Umataniswa Amanzi

Ukuphuza amanzi amaningi kugcina izicubu zomzimba, kuhlanganise nesibeletho, zimanzi futhi zisebenza kahle. Ukunisela kahle kuthuthukisa ukugeleza kwegazi kuye esibelethweni, kuqinisekisa ukuthi sithola umoya-mpilo nemisoco esiyidingayo ukulungiselela ukukhulelwa nokusekela ingane ekhula ngesikhathi sokukhulelwa.

3. Zivocavoce Njalo

Ukuzivocavoca okubushelelezi njengokuhamba, i-yoga, noma ukubhukuda kuhle kakhulu empilweni yokuzala. Ukujima njalo kwandisa ukujikeleza kwegazi esifundeni samaphilisi, kuhlanganise nesibeletho. Lokhu kwanda kokugeleza kwegazi kusiza ukugcina umgodla wesibeletho unenempilo futhi kunciphisa ingozi yezimo ezifana nama-fibroid esibeletho [10].

4. Lawula Ingcindezi

Ingcindezi engapheli ingandisa i-hormone i-cortisol, okudala ukungalingani kwama-hormone futhi kuthinte isibeletho nomjikelezo wokuya esikhathini [11]. Amasu okulawula ingcindezi njengokuzindla nokuphefumula okujulile asiza ukulawula amazinga e-cortisol, okukhuthaza ibhalansi yama-hormone okuzala, njengama-estrogen nama-progesterone. La ma-hormone abalulekile empilweni yesibeletho ngaphambi nangemva kokukhulelwa.

5. Yenza Ukuhlolwa Njalo

Ukuhlolwa njalo kogqirha wesifazane (gynecologist) kuqinisekisa ukutholakala kusenesikhathi nokwelashwa kwezimo ezihlobene nesibeletho. Lokhu kungasiza ukubona izinkinga ezifana nama-fibroid, izifo zokutheleleka, noma i-endometriosis kusenesikhathi, kuvimbele izinkinga futhi kusekele impilo yesibeletho.

6. Cabanga Ngama-Supplement Okuzala

Izithasiselo ezifana ne-folic acid, insimbi, noma amafatty acid e-omega-3 zingase zisekele impilo yokuzala. I-folic acid isekela ukukhula kwamaseli emgodleni wesibeletho, insimbi ivimbela i-anemia, kanti amafatty acid e-omega-3 anciphisa ukuvuvukala okungalimaza izicubu zesibeletho. Ungathola yonke imisoco ebalulekile yokuzala kowesifazane iphaketheni elilodwa ngendlela izithasiselo zokuzala.

Isiphetho

Izinguquko kusayizi ojwayelekile wesibeletho ziyingxoxo ebalulekile ngesikhathi sokukhulelwa. Isayizi esimaphakathi sesibeletho sikhula sisuke kusayizi wolintshi ngaphambi kokukhulelwa sifike kusayizi we-watermelon ekupheleni kokukhulelwa.

Ukukhula okusheshayo kwesibeletho ngesikhathi sokukhulelwa kusiza ukwamukela usana olukhula ngokushesha esiswini. Ngasekupheleni kokukhulelwa, siqala ukuqumba ukuze sikhiphe usana nezinye izinto ezifana noplacenta. Isibeletho sibuyela kusayizi waso sangaphambi kokukhulelwa cishe emva kwesikhathi esingamasonto ayi-6 kuya kwayi-8 sokubeletha.

Isibeletho sibuthaka ezimweni eziningi ezingathinta impilo yokuzala nokukhulelwa. Imikhuba enempilo yokudla nesitayela sokuphila ingakusiza usekele impilo yesibeletho futhi wehlise amathuba okuba nalezi zimo.

Imibuzo evame ukubuzwa

1. Isikhulu kangakanani isibeletho?

Imibuzo efana nokuthi ubungakanani bosayizi ojwayelekile wesibeletho ingasiza ukuqonda izinguquko emzimbeni ngesikhathi sokukhulelwa. Usayizi ojwayelekile wesibeletho ungaba ngu-7 kuya ku-8 cm ngaphambi kokukhulelwa. Ngokuvamile sincane kakhulu uma siqhathaniswa nosayizi waso omkhulu ngesikhathi sokukhulelwa.

2. Ungakanani usayizi ojwayelekile wesizalo ekupheleni kokukhulelwa?

Usayizi ojwayelekile wesibeletho noma isizalo ekupheleni kokukhulelwa cishe ufana nosayizi wekhabe elikhulu. Lokhu kwanda ngosayizi kuqala ukubonakala kusukela kwithemesta yesibili ngendlela yokuphakama kwesisu sokukhulelwa.

3. Yini ebhekwa njengesibeletho esikhulu ngosayizi we-cm?

Isibeletho sibhekwa njengesikhulu uma ubude baso bude budlula u-8 cm noma ububanzi baso budlula u-5 cm. Lesi simo saziwa ngokuthi i-nucleus ekhulisiwe futhi sivame ukubangelwa izimo zempilo ezifana nama-fibroid ne-endomyosis.

Imithombo esetshenzisiwe

1. Gasner, A., & A, A. P. (2023, July 30). IFizioloji, isibeletho. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557575/ 
2. Usayizi ojwayelekile wesibeletho ngesikhathi sokukhulelwa. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/uterus-size-during-pregnancy/ 
3. Griffiths, S. K., & Campbell, J. P. (2015). Isakhiwo se-placenta, umsebenzi wayo nokudluliselwa kwemithi. Continuing Education in Anaesthesia Critical Care & Pain, 15(2), 84-89. https://doi.org/10.1093/bjaceaccp/mku013 
4. Uketshezi lwe-amniotic: MedlinePlus Medical Encyclopedia. (n.d.). https://medlineplus.gov/ency/article/002220.htm 
5. Ukubuyela emuva kwesibeletho. (2024b, May 1). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22655-uterus-involution 
6. Lopez-Gonzalez, D. M., & Kopparapu, A. K. (2022, December 11). Ukunakekelwa kukamama omusha ngemuva kokubeletha. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK565875/ 
7. Yang, Q., Ciebiera, M., Bariani, M. V., Ali, M., Elkafas, H., Boyer, T. G., & Al-Hendy, A. (2021b). Ukubuyekezwa okuphelele kwama-fibroid esibeletho: umsuka wokuthuthuka, indlela isifo esenzeka ngayo, nokwelashwa. Endocrine Reviews, 43(4), 678–719. https://doi.org/10.1210/endrev/bnab039 
8. Najmi, Z., Moradi, Y., Shams-Beyranvand, M., Khateri, S., Gharahjeh, S., Tehrani, S., Varse, F., & Tiyuri, A. (2021). Ukubuyekezwa okuhlelekile ngobuningi be-endometriosis kwabesifazane. The Indian Journal of Medical Research, 154(3), 446. https://doi.org/10.4103/ijmr.ijmr_817_18 
9. Traber, M. G., & Stevens, J. F. (2011). Amavithamini C no-E: imiphumela ewusizo ngokombono womshini wendlela asebenza ngayo. Free Radical Biology and Medicine, 51(5), 1000–1013. https://doi.org/10.1016/j.freeradbiomed.2011.05.017 
10. Johnson, L. (2022, January 12). Ama-fibroid nokuzivocavoca. Ukwelashwa kwama-fibroid esibeletho nge-embolization (UFE). https://fibroids.com/blog/health-information/fibroids-and-exercise/ 
11. Karunyam, B. V., Karim, A. K. A., Mohamed, I. N., Ugusman, A., Mohamed, W. M. Y., Faizal, A. M., Abu, M. A., & Kumar, J. (2023b). Ukungazali kanye ne-cortisol: ukubuyekezwa okuhlelekile. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1147306