Mangaki amathuba okuphuphunyelwa yisisu ngesikhathi sokukhulelwa?

Ukukhulelwa yisikhathi sokujabula nokuthokoza, kodwa futhi kuza nokukhathazeka nezingcuphe. Omunye wemibuzo emikhulu kubazali abalindele ingane ukulahlekelwa yisisu. Ukulahlekelwa yisisu kuwukulahleka kokukhulelwa noma ukufa kosana olusakhulayo ngaphambi kwesonto lama-20 [1].

Ezinye izimbangela zokulahlekelwa yisisu azinakugwemeka, njengeziphambeko zama-chromosome kusana. Nokho, unganciphisa kakhulu ingozi yokulahlekelwa yisisu okubangelwa izizathu ezifana nemikhuba yokuphila engemihle. Kulesi sihloko, sizohlola amathuba okulahlekelwa yisisu ngesikhathi sokukhulelwa, ezinye izimbangela ezivamile eziholela ekulahlekelweni yisisu, nokuthi ungayinciphisa kanjani ingozi yokulahlekelwa wukhuleko.

Ukuthi Kujwayeleke Kangakanani Ukulahlekelwa Yisisu?

Ukulahlekelwa yisisu kuvame kakhulu kunalokho abaningi abantu abakucabangayo. Kodwa, yisiphi isibalo sazo zonke izikhuleko esiphetha ngokulahlekelwa yisisu? Ucwaningo lukhombisa ukuthi cishe u-10 kuya ku-20% wezikhuleko ezaziwayo e-United States ziphetha ngokulahlekelwa yisisu [2]. Nokho, inani langempela lingase libe phezulu uma ucabangela iqiniso lokuthi ezinye izisu zilahleka kusenesikhathi kangangokuthi abesifazane bangaze babone nokuthi bakhulelwe.

Imibiko ikhombisa ukuthi ukulahlekelwa yisisu okuningi kwenzeka ngesikhathi kwekota yokuqala yokukhulelwa, okuyaphakathi kwamasonto angu-12 okuqala okukhulelwa [3]. Ingcuphe yehlisa kakhulu emva kwekota yokuqala yokukhulelwa. Isizathu esivame kakhulu sokulahlekelwa yisisu kule nkathi yokuqala yokukhulelwa yizinkinga ezihlobene ne-fetus, njengezinkinga zama-chromosome.

Yini Ebanga Ukulahlekelwa Yisisu?

Kungenzeka kube nezimbangela eziningi ezibangela ukulahlekelwa yisisu. Ezimweni eziningi, izinkinga ezihlobene ne-fetus ziba nomphumela ekulahlekelweni wukhuleko, kanti omama akusikho abangabangela lokho. Ngobufakazi, izimbangela ezivame kakhulu zokulahlekelwa yisisu zifaka:

1. Ukungajwayelekile Kwama-chromosome

Ucwaningo lubonisa ukuthi cishe u-50% wokulahlekelwa yisisu kwenzeka ngenxa yezinkinga ngama-chromosome osana [4]. Ama-chromosome athwala i-DNA, ebeka ukuthi usana lukhula kanjani. Usana luthola uhhafu wama-chromosome alo kumama nohhafu kuyise.

Ngesikhathi sokufakelwa kwamazinyane, isidoda neqanda kufanele linikeze ama-chromosome angu-23, okwenza kube ngu-46 sonke. Uma usana luthola amaningi kakhulu noma ambalwa kakhulu, lokho kungabangela izinkinga ekuthuthukisweni futhi kungaholela ekulahlekelweni yisisu [4].

2. Izinkinga Zamahomoni

Amahomoni okuzala abesifazane afana ne-estrogen ne-progesterone aseka ukukhulelwa ngokunakekela umcamelo wesibeletho. Uma kunokungalingani kwala mahomoni, lokho kuthinta kabi umcamelo wesibeletho, kanti umcamelo wesibeletho ungase ungakwazi ukusekela ukukhulelwa [5]. Ngaphezu kwamahomoni okuzala, ukungalingani kwamanye amahomoni njengamahomoni e-thyroid nakho kungafaka isandla ekulahlekelweni wukhuleko.

3. Ukutheleleka

Ezinye izifo zingathinta isibeletho futhi ziholele ekulahlekelweni ukukhulelwa. Izifo ezifana norubella, i-cytomegalovirus, i-toxoplasmosis, nezinye izifo ezithathelwana ngocansi zingalimaza umntwana okhula ngaphakathi [6]. Lezi zifo zingabangela umkhuhlane, ukuvuvukala, noma buthaka ikhono lomzimba lokusekela ukukhulelwa.

4. Izifo Ezingapheli

Izifo ezifana nesifo sikashukela, umfutho wegazi ophezulu, nezifo ze-thyroid zingakhuphula ingozi yokuphuphunyelwa isisu. Uma umama okhulelwe ehluleka ukulawula lezi zimo, zingathinta ukugeleza kwegazi nokuhlinzekwa komoya-mpilo kumntwana.

Abesifazane abanemikhuhlane ye-autoimmune, njengesi-lupus, bangaba sengozini enkulu yokulahleka kokukhulelwa ngoba amasosha omzimba abo angase ahlasele ukukhulelwa ngokungafanele.

5. Izici Zendlela Yokuphila

Ukubhema, ukuphuza utshwala, nokusebenzisa izidakamizwa kungalimaza ukukhula komntwana futhi kwandise ingozi yokulahleka kokukhulelwa. Ukudla ikhofi eliningi noma ezinye izinto eziqukethe i-caffeine ngokweqile — ngaphezu kuka 200 mg ngosuku — kutholwe futhi kuhlotshaniswa nokulahleka kokukhulelwa [7]. Uma umama edla ukudla okungalungile okungenazo izakhamzimba ezanele, lokho kungathinta ukukhula komntwana futhi kwandise ingozi yokuphuphunyelwa isisu.

6. Ukwalimala Komzimba Nezingozi

Ukuwa okukhulu, ingozi yemoto, noma ukushayeka ngamandla esiswini kungaholela ezinkingeni zokukhulelwa. Nakuba imisebenzi emnene yomzimba iphephile futhi inempilo, ukucindezeleka ngokweqile noma ukuphakamisa izinto ezisindayo kungakhuphula ingozi yokulahleka kokukhulelwa kwezinye izimo. Uma kwenzeka ingozi, omama abakhulelwe kufanele bafune usizo lwezokwelapha ngokushesha ukuze kuhlolwe impilo yomntwana.

Ukuphuphunyelwa Isisu Kuvamise Ukwenzeka Nini?

Iningi lokuphuphunyelwa isisu kwenzeka ngesikhathi se-trimesta yokuqala, eqala ngesonto lokuqala kuze kufike esontweni le-12 lokukhulelwa [3]. Ingcuphe iphezulu emasontweni okuqala, ikakhulukazi ngaphambi kwesonto le-6 noma le-7. Ngemva kwe-trimesta yokuqala, amathuba okuphuphunyelwa isisu ehla kakhulu.

Kutrimesta yesibili, eqala ngesonto le-13 kuya kwele-26, ukuphuphunyelwa isisu akwenzeka kakhulu kodwa kusengenzeka ngenxa yezinkinga zezokwelapha, izifo, noma izinkinga zesibeletho. Kutrimesta yesithathu, ukulahleka kokukhulelwa kuyivelakancane futhi kuvamise ukubizwa ngokuthi ukufa komntwana esesibelethweni kunokuthi ukuphuphunyelwa isisu.

Izimpawu Zokuphuphunyelwa Isisu

Abesifazane kufanele bazi izimpawu eziyizexwayiso zokuphuphunyelwa isisu ukuze bakwazi ukuthatha isinyathelo masinyane ukugwema izinsongo empilweni nasemkhiqizweni wabo [8]. Izimpawu ezivamile zokuphuphunyelwa isisu zihlanganisa:

• Ukopha Okukhulu Kwesitho Sangasese Sowesifazane
• Ubuhlungu obukhulu besisu noma ukuxhuzula (ukubanjwa yisisu)
• Ukwelashwa kobuhlungu emhlane
• Ukuphela kwezimpawu zokukhulelwa njengesisu esibuhlungu/isiyezi nokubuhlungu kwamabele
• Ukuphuma kwezicubu noma amahlule egazini esithweni sangasese sowesifazane

Yini Ongayenza Ngemva Kokuphuphunyelwa Isisu?

Ukuzwa ukuphuphunyelwa yisisu kungaba nzima ngokomzimba nangokomzwelo. Nokho, kubalulekile ukuthi abesifazane bathathe izinyathelo ezidingekayo ngoba lokhu kungaba yingozi empilweni yabo uqobo. Nawa amanye amathiphu okufanele uwacabangele:

1. Cela Usizo Lwezokwelashwa

Ukufuna usizo lwezokwelashwa ngokushesha kubalulekile ngoba uwodokotela kuphela ongaqinisekisa ukuthi ukuphuphunyelwa yisisu kuphelile ngokuphelele noma ukuthi ukwelashwa kwezokwelapha kuyadingeka.

Ngezinye izikhathi, kungadingeka imithi noma inqubo encane ukuze kukhishwe izicubu zokukhulelwa ezisele. Ukuvakashela udokotela ngokulandela imiyalelo yakhe kusiza ukuqinisekisa ukuthi azikho izinkinga, njengokutheleleka noma ukopha kakhulu.

2. Nika Umzimba Isikhathi Sokululama Ngokwenyama

Umzimba udinga isikhathi sokululama ngemva kokuphuphunyelwa yisisu, futhi ukululama kungathatha amasonto ambalwa. Ungase uqhubeke uzwa izimpawu ezifana nokubamba izinkaba nokopha isikhashana, kodwa kufanele kwehle kancane kancane. Ukukhulelwa ngokushesha kakhulu ngemva kokuphuphunyelwa yisisu kungase kungabi umqondo omuhle futhi odokotela bavame ukuncoma ukulinda umjikelezo owodwa noma eminingi wokuya esikhathini ngaphambi kokuzama ukukhulelwa futhi.

3. Nakekela Impilo Yengqondo Nemizwa

Ukuphuphunyelwa yisisu kungaba nzima ngokomzwelo, futhi imizwa yokudabuka, ukucasuka ngawe siqu, noma usizi kujwayelekile ngaleso sikhathi. Ukukhuluma neqabane, umndeni, noma umeluleki kungasiza ukucubungula imizwa nokunciphisa ingcindezi. Amaqembu okweseka noma imiphakathi eku-inthanethi inganikeza induduzo ngokuxhumanisa nawe nabanye ababhekane nokulahlekelwa ukukhulelwa.

Ukuqonda indlela yokubhekana ngokomzwelo nangokwenyama ngemva kokuphuphunyelwa yisisu kubalulekile ekuphulukiseni nasekulungiseleleni ukukhulelwa okuzayo, njengoba kusiza abesifazane badlule kulesi sikhathi esinzima bekhuthazwa futhi benakekelwa.

4. Qonda Izimbangela Nezingozi

Ezimweni eziningi, ukuphuphunyelwa yisisu kwenzeka ngenxa yezinto ezingaphandle kolawulo lwesifazane. Uma ukwazi ukuqonda izimbangela ezaziwayo, lokho kungakusiza ukuhlela ukukhulelwa okuzayo. Ezimweni lapho owesifazane ebhekana nokuphuphunyelwa yisisu okuqhubekayo, odokotela batusa ukuhlolwa noma ukwelashwa ukuze kubhekwe inkinga uma kungenzeka.

5. Hlela Ikusasa

Ngemuva kokuphuphunyelwa yisisu, izifazane eziningi ziqala ukuhlela ukukhulelwa kwazo okulandelayo. Udokotela angakwazi ukunikeza izeluleko zokuthuthukisa impilo ngaphambi kokuzama futhi. Ukuthatha amavithamini abakhulelwe, ukuphatha izimo zempilo ezikhona, nokulandela indlela yokuphila enempilo kungandisa amathuba okukhulelwa okuyimpumelelo. Ama-supplement anjenge Conceive Plus Usekelo Lokuzala Kwabesifazane angasiza ukusekela impilo yokuzala nokulinganisela kwamahomoni, anikeze umzimba imisoco ebalulekile ukusiza ekululameni nasekulungiseleleni ukukhulelwa okuzayo ngemuva kokuphuphunyelwa yisisu.

Ungayinciphisa Kanjani Ingozi Yokulahlekelwa Isisu?

Owesifazane angeke akwazi ukuvimbela zonke izimbangela zokulahlekelwa isisu. Nokho, zikhona izinyathelo eziningi angazithatha ukuze yehlise ingozi:

1. Thola Ukunakekelwa Kwangaphambi Kokubeletha Njalo: Ukuvakashela udokotela njalo kusiza ukuqapha ukukhula kwengane nokuthola izinkinga ezingaba khona zisencane. Lokhu kungasiza ekunakekeleni nasekulawuleni kahle lezo zinkinga, kwehlise ingozi yokulahlekelwa isisu.
2. Yidla Ukudla Okunempilo: Ukudla okunesisindo esifanele okuhlanganisa izithelo, imifino, amaprotheni, nezinhlamvu eziphelele kuyisisekelo sempilo ngesikhathi sokukhulelwa. Lokhu kudla kungakunikeza imisoco ebalulekile efana ne-folic acid, insimbi, i-calcium, ne-vitamin D, konke lokhu kunikela ekukhuleni nasekuthuthukeni okunempilo kwengane [9].
3. Cabanga Ngama-Prental Vitamin: Ama-prenatal vitamin noma izithasiselo ze-prenatal akunikeza wonke amavithamini namaminerali abalulekile ahlotshaniswa nokukhulelwa okunempilo. Odokotela batusa ukuthi uqale ukuthatha ama-prenatal vitamin ngokushesha nje uma uhlele ukukhulelwa ukuze ugweme ukushoda kokudla okunomsoco okungaholela ezinkingeni.

4. Gwema Izinto Eziyingozi: Izinto eziyingozi ngesikhathi sokukhulelwa zifaka utshwala, ugwayi, ezinye izidakamizwa ezijwayele ukudakaza, nezinye izinhlobo zamakhemikhali. Lezi zinto azigcini nje ngokwehlisa amathuba okukhulelwa kodwa futhi zikhuphula ingozi yokulahlekelwa isisu uma ukhulelwe. Kubalulekile ukugwema ukusebenzisa lezi zinto, ikakhulukazi uma uhlela ukukhulelwa noma usuvele ukhulelwe.

5. Gcina Isisindo Esinempilo: Ukugcinwa unesibindi esingaphezu kwamandla noma ukuncipha kakhulu kungakhuphula ingozi yokulahlekelwa isisu. Uma uhlangabezana nezinguquko zesisindo ezisheshayo ngenxa yezinkinga zempilo, njengokuphazamiseka kwenhlaka yegilo (thyroid), kufanele uxhumane nochwepheshe bezempilo ukuze balawule lezo zinkinga eziyisisekelo.
6. Qaphela Uma Usebenzisa Imithi: Ezinye izidakamizwa zingalimaza ingane ngesikhathi sokukhulelwa, ngakho kubalulekile ukuba uqaphele. Ezinye ama-antibiotic, imithi yokwelapha isilonda sobuso (acne), nezinye izidakamizwa zokudangala zingadala izinkinga enganeni. Umkhuba omuhle wukuthi uhlale uxhumana nodokotela wakho ngaphambi kokuthatha noma iyiphi imithi ngesikhathi sokukhulelwa ukuze ugweme lezi zingozi.

Okubalulekile Ekugcineni

Amathuba okuphuphuma kwesisu ngesikhathi sokukhulelwa aphezulu kunalokho abantu abaningi abakucabangayo. Ngobufakazi esinabo siyazi ukuthi kuze kufike ku-20% wezikhulelo ezaziwayo ziphetha ngokuphuphuma kwesisu, okuyisibalo esethusayo kunoma yiliphi iphutha elihlelelwe ukuba nezingane noma eselinde umntwana.

Owesifazane kufanele aqonde izimpawu zokuphuphuma kwesisu ukuze akwazi ukuzibika ngokushesha kudokotela wakhe. Ukuphathwa nokunakekelwa ngendlela efanele ngemva kokulahlekelwa ukukhulelwa kungavimbela umama ekubeni nezinkinga ezimbi. Khumbula, umuntu akanakukwazi ukulawula bonke obungozi bokuphuphuma kwesisu, kodwa indlela yokuphila enempilo nokunakekelwa kwezokwelashwa okufanele kunganciphisa kakhulu leyo ngozi.

Imibuzo Ejwayele Ukubuzwa

1. Yimiphi amaphesenti okukhulelwa aphetha ngokuphuphuma kwesisu?

Iphesenti lokuphuphuma kwesisu liphezulu kakhulu kunalokho abantu abaningi abakucabangayo. Cishe u-10 kuya ku-20% wazo zonke izikhulelo ezaziwayo ziphetha ngokuphumela esihogweni ngenxa yezizathu eziningi ezihlukene.

2. Ngizame nini futhi ukukhulelwa ngemva kokuphuphuma kwesisu?

Ngemva kokuphuphuma kwesisu, umzimba wakho udinga isikhathi sokululama kahle futhi ulungiselele ukukhulelwa okulandelayo. Odokotela bavame ukuncoma ukuthi kulindwe umjikelezo owodwa noma emibili wokuya esikhathini ukuze kwehliswe ingozi yezinkinga, kodwa lokhu kuyehluka kumuntu nomuntu.

Izinsiza Ezisetshenzisiwe

1. Ukuphuphuma kwesisu: MedlinePlus Medical Encyclopedia. (n.d.). https://medlineplus.gov/ency/article/001488.htm 
2. Bardos, J., Hercz, D., Friedenthal, J., Missmer, S. A., & Williams, Z. (2015). Ucwaningo lukazwelonke mayelana nokubona komphakathi ukuphuphuma kwesisu. Obstetrics and Gynecology, 125(6), 1313. https://doi.org/10.1097/AOG.0000000000000859 
3. Cohain, J. S., Buxbaum, R. E., & Mankuta, D. (2017). Izinga lokuphuphuma kwesisu kwekota yokuqala ngokwemfazi oyibelethile oke wakhulelwa izikhathi ezingu-1 noma ngaphezulu amasonto angu-24 noma ngaphezulu. BMC Pregnancy and Childbirth, 17(1). https://doi.org/10.1186/s12884-017-1620-1 
4. Hardy, P. J., & Hardy, K. (2018). Ukungazinzi kwamakhromosomu ekuphuphumeni kwesisu kwekota yokuqala: Ingabe kuyimbangela ejwayelekile yokulahleka kokukhulelwa? Translational Pediatrics, 7(3), 211. https://doi.org/10.21037/tp.2018.03.02 
5. Bataa, M., Abdelmessih, E., & Hanna, F. (2024). Ukuhlola ukuntuleka kwe-progesterone ekuphuphumeni kwesisu kwekota yokuqala nokuthinta kwenkambiso yokwelashwa ngamahomoni ekuthuthukisweni komntwana ongakazalwa: Uhlolojikelele olubanzi. Children, 11(4), 422. https://doi.org/10.3390/children11040422 
6. Giakoumelou, S., Wheelhouse, N., Cuschieri, K., Entrican, G., Howie, S. E., & Horne, A. W. (2015). Indima yokutheleleka ekuphuphumeni kwesisu. Human Reproduction Update, 22(1), 116. https://doi.org/10.1093/humupd/dmv041 
7. Jafari, A., Naghshi, S., Shahinfar, H., Salehi, S. O., Kiany, F., Askari, M., Surkan, P. J., & Azadbakht, L. (2022). Ubudlelwano phakathi kokusetshenziswa kwe-caffeine nekhofi ngumama nokulahleka kokukhulelwa: ukuhlaziywa kwe-meta okuhlola ubufakazi ngobudlelwane phakathi kwemithamo nobungozi kusetshenziswa indlela ye-Grading of Recommendations Assessment, Development, and Evaluation (GRADE) ocwaningweni olubhekile. Frontiers in Nutrition, 9, 886224. https://doi.org/10.3389/fnut.2022.886224 
8. Healthdirect Australia. (2024b, May 8). Ukuphuphuma kwesisu. Izinhlobo, Izimpawu nokuthi Nini okufanele uye kudokotela | Ukukhulelwa, Ukuzalwa neNgane. https://www.pregnancybirthbaby.org.au/miscarriage 
9. UMtapo Wezincwadi Kazwelonke Wezokwelapha. (n.d.). Ukukhulelwa nokudla okunempilo. MedlinePlus. https://medlineplus.gov/pregnancyandnutrition.html