Kusho Ukuthini Ukuphuma Koketshezi Lombala Owolintshi Ngesikhathi Sokukhulelwa?

Isikhathi sokukhulelwa isikhathi lapho umzimba wowesifazane uthola khona izinguquko ezisheshayo, okuhlanganisa nokwanda kokuphuma koketshezi esithweni sangasese. Lolu ketshezi, olwaziwa ngokuthi i-leukorrhea, luvamise ukuba lucacile noma lube mhlophe. Lusiza ukugcina indawo yesitho sangasese ihlanzekile futhi luvikele ezifweni zokutheleleka [1].

Nokho, umbala, ukuma (consistency), noma iphunga loketshezi kwesinye isikhathi kungashintsha ngesikhathi sokukhulelwa [2]. Abesifazane bavame ukubona uketshezi olunombala wolintshi ngesikhathi sokukhulelwa, okwandisa ukukhathazeka kwabo ngekephilo yabo kanye nempilo yengane esesibelethweni.

Kulesi sihloko, sizohlola izimbangela zoketshezi olunombala wolintshi ngesikhathi sokukhulelwa, sihlole izinhlobo ezahlukene zoketshezi, futhi sixoxe ngeminye yemibiko okufanele umama ayibheke ngesikhathi sokukhulelwa. Lesi sihloko siphinde sifake namathiphu athile abesifazane abangawasebenzisa ukuthuthukisa impilo yabo ngesikhathi sokukhulelwa.

Izimbangela Zoketshezi Olunombala Wolintshi Ngesikhathi Sokukhulelwa

Uketshezi olunombala wolintshi ngesikhathi sokukhulelwa lungavela ngezizathu eziningana. Ezimweni eziningi, akuyona into okufanele ukhathazeke ngayo futhi luyingxenye yezinqubo zomzimba ezijwayelekile. Nokho, kwezinye izimo lungase lubonise izinkinga zempilo ezingathinta ukukhulelwa.

Nanka amanye amazizathu ajwayelekile okungase kwenze ubone uketshezi olunombala wolintshi ngesikhathi sokukhulelwa:

1. Ukuxubana Kwegazi Noketshezi Olijwayelekile

Uketshezi olunombala wolintshi lungavela uma inani elincane legazi lixubana noketshezi olucacile noma olumhlophe olujwayelekile. Imisebenzi efana nocansi, ukuhlolwa kwezokwelashwa, noma izinguquko kwamahomoni ingaholela ekuthukuthelekeni okuncane komlomo wesibeletho, okuba buthaka kakhulu ngesikhathi sokukhulelwa [3].

Lokhu kuthukutheka kwesibeletho kwesinye isikhathi kuholela ekuchichimeni kwegazi okuncane futhi kwenze uketshezi lubonakale lombala wolintshi. Kulesi simo, uketshezi olunombala wolintshi akuyona into okufanele ikukhathaze kakhulu, kodwa kufanele ubheke ezinye izimpawu ukuze uhlolisise ukuthi lolu ketshezi lujwayelekile yini.

2. Izifo zokutheleleka

Uketshezi olunombala wolintshi ngesikhathi sokukhulelwa lungaba uphawu lwesifo, ikakhulukazi uma uphinde uhlangabezana nezinye izimpawu ezifana nephunga elinamandla, ukuhuzuka noma ukungakhululeki. Izifo ezivamile ngesikhathi sokukhulelwa ezingaholela ekutheni ube noketshezi olunombala wolintshi zifaka phakathi:

• I-Bacterial Vaginosis (BV): Lokhu kwenzeka lapho ibhalansi yamagciwane esithweni sangasese sowesifazane iphazamiseka [4I-bacterial vaginosis ivame ukudala uketshezi oluncane olunuka njengezinhlanzi, olungabonakala mpunga noma olunsomi olukhanyayo olubomvana olubukeka nsomi wolintshi.
• Izifo Ezithathelwana Ngocansi (STIs): Ukuzibandakanya emisebenzini yocansi ngesikhathi sokukhulelwa kungaholela ezitshalweni zocansi ezithathelwanayo, okuhlanganisa i-chlamydia ne-gonorrhea [5]. Lezi zifo ezithathelwana ngocansi ngezinye izikhathi zingadala ukuphuma koketshezi okumbala owolintshi noma okuphuzi-okunsundu.

3. Ukuvuza Koketshezi Lombungu

Ezimweni ezingavamile, ukukhulelwa okuhambisana nokuphuma koketshezi okumbala owolintshi kungase kubonise ukuvuza okuncane koketshezi lombungu (amniotic fluid) — uketshezi oluvikela ingane. Uketshezi lombungu ngokuvamile luhlanzekile noma luphuzinyoni, kodwa uma luhlangana nolunye uketshezi noma igazi, lungabonakala luwolintshi. Ukuvuza koketshezi lombungu kungaba uphawu lwezinkinga ezinkulu zokukhulelwa, futhi kunconywa ukuthi uye kudokotela ngokushesha.

Eminye Imibala Yokuphuma Koketshezi Ngesikhathi Sokukhulelwa

Ngaphezu kombala owolintshi, kukhona neminye imibala ehlukahlukene yokuphuma koketshezi engavela ngesikhathi sokukhulelwa, ngayinye inencazelo yayo engaba khona. Eminye imibala evamile yokuphuma koketshezi esithweni sangasese sowesifazane ngesikhathi sokukhulelwa imi kanje:

1. Ukuphuma Koketshezi Okusobala Noma Okumhlophe

Ukuphuma koketshezi okusobala nokumhlophe ngesikhathi sokukhulelwa kujwayelekile futhi kuyimpilo enhle. Kubizwa ngokuthi i-leukorrhea, futhi kusiza ukuhlanza umsele wesitho sangasese sowesifazane ukuze kuvinjelwe ukungena kwamagciwane esibelethweni.

Nokho, uma lokhu ketshezi okusobala okumhlophe sekujiya, kufana nobisi lwesinkwa (cottage cheese), noma kubanga ukuluma, kungaba uphawu lokutheleleka ngamakhowe (yeast infection). Uma uqaphela lezi zimpawu, xhumana nodokotela wakho ukuze uthole isiqondiso.

2. Ukuphuma Koketshezi Okupinki

Ukuphuma koketshezi okupinki ekuqaleni kokukhulelwa kuvame ukubangelwa ukopha okuncane kokutshalwa kweqanda (implantation bleeding). I-implantation yisigaba sokukhulelwa lapho iqanda elichumiselekile lizimisa khona odongeni lwesibeletho. Lokhu kutshalwa kungadala ukuphuma koketshezi okupinki esithweni sangasese sowesifazane futhi akuvamile ukuba yinto ekhathazayo [6].

Ezinye izimbangela zokuphuma koketshezi okupinki ekuqaleni kokukhulelwa zingabandakanya izinguquko ku-mucus yomlomo wesibeletho noma ukucasuka kwesitho sangasese ngenxa yocansi. Nakuba imvamisa kungabi nabungozi, kufanele wazise udokotela uma sekuphumela kakhulu noma kuqhubeka kungapheli.

3. Ukuphuma Koketshezi Okuphuzi Noma Okuluhlaza

Ukuphuma koketshezi okuphuzi noma okuluhlaza kungaba uphawu lwezifo ezithathelwana ngocansi ezifana ne-gonorrhea noma i-trichomoniasis. Ngokuphuma koketshezi okuphuzi noma okuluhlaza, ungase futhi uqaphele iphunga elibi, ukuluma, noma ubuhlungu. Ukutholakala kusenesikhathi kwezifo ezithathelwana ngocansi kubalulekile ngoba imibiko ikhombisa ukuthi izifo ezithathelwana ngocansi zingakhuphula ingozi yezinkinga ngesikhathi sokukhulelwa [5].

4. Ukuphuma Koketshezi Onsundu

Ukuphuma koketshezi onsundu imvamisa kubangelwa igazi elidala elishiya umzimba. Akunabungozi futhi akuphazamisi ukukhulelwa noma impilo yengane. Nokho, uma lo mphumela onsundu uqhubeka isikhathi eside noma uphuma ngobuningi, kungase kube uphawu lwenkinga ethile efihlekile okufanele ubuzwe uchwepheshe ngayo.

5. Ukuphuma Koketshezi Okubomvu

Ukuphuma koketshezi okubomvu esithweni sangasese sowesifazane kuyuphawu lokopha okwamanje, okungase kubonise inkinga enkulu. Ukulahlekelwa yisisu (miscarriage) kanye nokukhulelwa kwangaphandle kwesibeletho (ectopic pregnancy) yizinye zezimbangela ezingaba khona zokuphuma koketshezi okubomvu, futhi lezi zimo zibeka impilo kanina engozini [7]. Kufanele ufune usizo lwezokwelapha ngokushesha uma ubona ukukhishwa okubomvu.

Ezinye Izimpawu Ongazibheka Ngesikhathi Sokukhulelwa

Ngaphezu kwezinguquko ekukhishweni kokuqala kokukhulelwa, ezinye izimpawu zingakusiza uqaphe impilo yakho futhi ubone noma yiziphi izinkinga ngesikhathi sokukhulelwa. Lezi zihlanganisa:

1. Ubuhlungu Noma Amakramps

Amakramps amancane ajwayelekile ngesikhathi sokukhulelwa, futhi angadalwa izinguquko zamahomoni noma ukwanda kosayizi wesibeletho ngesikhathi sokukhulelwa. Kodwa uma lawa makramps eqina kakhulu noma engapheli, lokho kukhombisa izinkinga ezifana nokubeletha ngaphambi kwesikhathi noma ukulahlekelwa isisu.

2. Ukuvuvukala Okungajwayelekile

Ukuqoqeka koketshezi olwengeziwe emzimbeni ngesikhathi sokukhulelwa kujwayelekile, futhi kubangela ukuvuvukala okuncane ezandleni nasezinyaweni. Lokhu kuvuvukala kuyanyamalala ngokwalo ngemva kokuzalwa kwengane. Nokho, uma uqaphela ukuvuvukala okusesisinyeni noma okukhulu, ikakhulukazi ebusweni noma ezandleni, kungaba uphawu lwe-preeclampsia — isimo sezokwelapha esibucayi esithinta abanye besifazane maphakathi nokukhulelwa.

3. Umkhuhlane

Imibiko ikhombisa ukuthi umkhuhlane ungomunye wezizathu ezinkulu zokuphuthunyiswa kudokotela ngesikhathi sokukhulelwa [8]. Lokhu kungenxa yokuthi umkhuhlane ngesikhathi sokukhulelwa ungabonisa ukutheleleka emzimbeni. Umkhuhlane ophakeme wona uqobo uba nemithelela emibi enganeni ekhula [8]. Uma uqaphela ukukhuphuka okungajwayelekile kokushisa komzimba, kunconywa ukuthi uxhumane nodokotela wakho.

4. Ukuncipha Kokunyakaza Komntwana Esesesiswini

Ukunyakaza komntwana esesesiswini kuba sobala ngekota yesibili yokukhulelwa. Lokhu kunyikinyeka kuwuphawu lokuthi ingane iphilile [9]. Uma ukunyakaza kwengane yakho kwehla kakhulu, thinta udokotela wakho ngokushesha.

Amacebiso ukuze Uthuthukise Impilo Yesikhathi Sokukhulelwa

Impilo enhle kamama ngesikhathi sokukhulelwa ingavimbela izinkinga futhi isekele ukukhula komntwana. Nanka amacebiso angasiza umama athuthukise impilo yakhe futhi asekele ingane ekhula phakathi nokukhulelwa:

1. Yidla Ukudla Okulinganiselayo: Izidingo zokudla okunomsoco zomama zanda kakhulu ngesikhathi sokukhulelwa njengoba kudingeka ondle ingane ekhula [10]. Ukuze uhlangabezane nale mfuno eyandayo yokudla okunomsoco, kufanele ufake izinhlobonhlobo zezithelo, imifino, okusanhlamvu okuphelele, amaprotheni angenamafutha kanye namafutha anempilo ekudleni kwakho. Lolu hlobo lokudla luzokunikeza amavithamini nezakhi ezibalulekile njenge-ayoni, i-calcium, i-folate ne-iodine.
2. Hlala Unamanzi Emzimbeni: Imibiko ikhombisa ukuthi abesifazane abakhulelwe bakhiqiza kufika ku-50% igazi eliningi kunokuvamile ukuze bahlangabezane nezidingo zomzimba [11]. Phuza amanzi amaningi ukweseka lokhu kwanda kwegazi nokugcina ingane yakho iphilile.
3. Thatha Imithi Yokubeletha (Prenatal Vitamins): Ngezinye izikhathi, ngisho nokudla okulinganiselayo akukwanelisi zonke izakhamzimba ozidingayo ngesikhathi sokukhulelwa. Ezimeni ezinjalo, odokotela bayeluleka ukuthatha imithi yokwengeza i-prenatal vitamin ukugwema noma yisiphi isikhala ekutholeni izakhamzimba. Imithi yokubeletha inikeza izakhamzimba ezibalulekile, kuhlanganise ne-folic acid, insimbi, i-calcium, ne-iodine, ezisiza ukuvimbela izinkinga zokukhulelwa.

4. Zivocavoce Njalo: Imibiko ikhombisa ukuthi umzuzu engama-30 wokuzivocavoca ezinsukwini eziningi zangesonto ungathuthukisa impilo yakho ngesikhathi sokukhulelwa [12]. Zibandakanye emisebenzini emaphakathi njengokuhamba, ukubhukuda, noma i-prenatal yoga ukuze uhlale usempilweni enhle futhi wehlise ingcindezi.
5. Ukuhlolwa Kwandulela Ukubeletha Okuvamile: Ukuvakashelwa kwangaphambi kokubeletha kuvumela udokotela wakho ukuthi alandelele ukukhula komntwana futhi abhekane nanoma yiziphi izinkinga zisencane. Ochwepheshe batusa ukuhlela ukuvakashelwa okukodwa kokubeletha njalo emavikini amane phakathi kweviki 4 kuya ku-28 lokukhulelwa, njalo emavikini amabili kusukela evikini 28 kuya ku-36, bese njalo ngesonto kusukela evikini 36 kuya ku-40 [13].

Nini Okufanele Ubonane Nodokotela?

Yize ezinye izinguquko ekuphumeneni uketshezi esithweni sangasese zivamile ngesikhathi sokukhulelwa, ezinye izimo zidinga ukunakwa kodokotela. Kufanele uxhumane nodokotela wakho uma uhlangabezana nalokhu:

• Ukuphuma uketshezi okunamaphunga aqinile, angemnandi.
• Ukuphuma uketshezi okuhambisana nokulunywa, ukushisa, noma ukucasuka.
• Ukuphuma uketshezi olubomvu olunsomi/oluphuzi oluthi shange okuqhubekayo noma okuba kubi kakhulu.
• Uketshezi okuhlanganiswe nokopha okuningi.
• Izimpawu ezifana nomkhuhlane, ubuhlungu obukhulu, noma izimpawu zokubeletha kusenesikhathi.

Okubalulekile Ekugcineni

Ukuphuma uketshezi esithweni sangasese sowesifazane ngesikhathi sokukhulelwa kuvamile, kodwa izinguquko kumbala, ekubunjweni kwalo, noma ephungweni kungesinye isikhathi kubonise izifo ezifihlekile. Ukuphuma uketshezi olubomvu olunsomi/oluphuzi oluthi shange ngesikhathi sokukhulelwa kungaba nezimbangela ezahlukene, njengokuguquka entanyeni yesibeletho, ukutheleleka, noma ukuvuza kolwelo lwe-amniotic.

Ezinye izinhlobo zoketshezi oluphuma esithweni sangasese sowesifazane ngesikhathi sokukhulelwa zihlanganisa olubala onsundu, olupinki, oluhlaza, nolubomvu. Owesifazane okhulelwe kudingeka aqonde incazelo yemibala ehlukahlukene yoketshezi ngesikhathi sokukhulelwa. Lokhu kuzomsize ukuthi abone izinkinga zokukhulelwa kusenesikhathi futhi agweme izinkinga ezinzima ngokuvakasha kudokotela ngesikhathi.

Imibuzo Evame Ukubuzwa

1. Ingabe uketshezi olubomvu olunsomi/oluphuzi oluthi shange ngesikhathi sokukhulelwa kujwayelekile?

Ukuphuma uketshezi olubomvu olunsomi/oluphuzi oluthi shange ngesikhathi ukhulelwe kungaba into evamile kwezinye izimo, ikakhulukazi uma kubangelwa izizathu ezingeyona ingozi ezifana nokucasuka okuncane kwentamo yesibeletho noma izinguquko zama-hormone. Nokho, uma uqaphela izimpawu ezifana nephunga elibi, ukulunywa, noma ubuhlungu, lokhu kungase kubonise ukutheleleka noma olunye udaba oludinga ukunakwa kodokotela.

2. Ingabe izifo zingabangela uketshezi olubomvu olunsomi/oluphuzi oluthi shange ngesikhathi sokukhulelwa?

Izifo ezifana ne-bacterial vaginosis, i-trichomoniasis, noma izifo ezithathelwana ngocansi zingaholela ekuphumeneni uketshezi olunombala owolintshi ngesikhathi sokukhulelwa. Ungase futhi uhlangabezane nezimpawu ezengeziwe ezifana nokuluma, ukushisa, noma iphunga elinamandla.

Imithombo esetshenzisiwe

1. Kaur, J., & Kapoor, A. (2014, March 1). Imibono Nolwazi mayelana ne-leukorrhea emphakathini waseNingizimu Asia ohlala ezindaweni eziyiziphango. https://pmc.ncbi.nlm.nih.gov/articles/PMC4064755/ 
2. Da Fonseca, T. M. M. V., Cesar, J. A., Mendoza-Sassi, R. A., & Schmidt, E. B. (2013). Ukuphuma koketshezi lwesitho sangasese sowesifazane okungajwayelekile kwabesifazane abakhulelwe: iphethini yokwenzeka nokuxhumana kukho ocwaningweni olususelwe kubantu. Obstetrics and Gynecology International, 2013, 1–7. https://doi.org/10.1155/2013/590416 
3. Ukopha Ngesikhathi Sokukhulelwa. (n.d.). ACOG. https://www.acog.org/womens-health/faqs/bleeding-during-pregnancy 
4. Kairys, N., Carlson, K., & Garg, M. (2024b, May 6). I-Bacterial Vaginosis. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK459216/ 
5. Grant, J. S., Chico, R. M., Lee, A. C., Low, N., Medina-Marino, A., Molina, R. L., Morroni, C., Ramogola-Masire, D., Stafylis, C., Tang, W., Vallely, A. J., Wynn, A., Yeganeh, N., & Klausner, J. D. (2020). Izifo ezithathelwana ngocansi ngesikhathi sokukhulelwa: ukubuyekezwa kokulandisa ngemigudu, izikhala, nezinselelo zocwaningo lomhlaba wonke, kanye namathuba akhona. Sexually Transmitted Diseases, 47(12), 779–789. https://doi.org/10.1097/olq.0000000000001258 
6. Kuyini Ukopha Kokufakelwa (Implantation Bleeding)? American Pregnancy Association. https://americanpregnancy.org/pregnancy-symptoms/what-is-implantation-bleeding/ 
7. Vlachou, F., Iakovou, D., Daru, J., Khan, R., Pepas, L., Quenby, S., & Iliodromiti, S. (2024). Ukulahlekelwa umntwana esesiswini kanye nokugula isikhathi eside nokufa kwamama: ukubuyekezwa okuhlelekile nokuhlaziywa okuhlanganisayo. PLoS Medicine, 21(2), e1004342. https://doi.org/10.1371/journal.pmed.1004342 
8. Egloff, C., Sibiude, J., Couffignal, C., Mandelbrot, L., & Picone, O. (2020). Izimbangela nemiphumela yomkhuhlane ngesikhathi sokukhulelwa: Ucwaningo lokubuyekeza emnyangweni wezimo eziphuthumayo wezifo zabesifazane. Journal of Gynecology Obstetrics and Human Reproduction, 49(9), 101899. https://doi.org/10.1016/j.jogoh.2020.101899 
9. Huecker, B. R., Jamil, R. T., & Thistle, J. (2023, February 5). Ukunyakaza komntwana esesiswini. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470566/ 
10. Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J., & Thornburg, K. L. (2021). Ukubaluleka kokudla okunempilo ngesikhathi sokukhulelwa nokuncelisa: imiphumela yempilo yempilo yonke. American Journal of Obstetrics and Gynecology, 226(5), 607–632. https://doi.org/10.1016/j.ajog.2021.12.035 
11. Soma-Pillay, P., Nelson-Piercy, C., Tolppanen, H., & Mebazaa, A. (2016c). Izinguquko zomzimba ngesikhathi sokukhulelwa. Cardiovascular Journal of South Africa/Cardiovascular Journal of Southern Africa, 27(2), 89–94. https://doi.org/10.5830/cvja-2016-021 
12. Ukuzivocavoca Ngesikhathi Sokukhulelwa. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/is-it-safe/exercise-during-pregnancy/ 
13. Clinic, C. (2024d, June 27). Ukukhulelwe? Nansi imvamisa ongase ubonane ngayo nodokotela wakho. Cleveland Clinic. https://health.clevelandclinic.org/prenatal-appointment-schedule