Ukwakheka komzimba kowesifazane okhulelwe: Kusukela ekukhulelweni kuze kufike ekuzalweni

Ukukhulelwa kuletha izinguquko eziningi zesimo somzimba nangendlela umzimba osebenza ngayo kowesifazane. Nakuba ungase ungakwazi ukubona izinguquko endleleni umzimba osebenza ngayo, eziningi zezinguquko zesakhiwo somzimba ziba sobala ezigabeni zokugcina zokukhulelwa.

Isimo somzimba sowesifazane ngesikhathi sokukhulelwa sihlotshaniswa nengane ekhula esesibelethweni. Njengoba ingane ikhula ngosayizi, umzimba kamama uyaqhubeka nokushintsha ukuze uhlalise le ngane ekhula [1]. Ukuqonda indlela umzimba wesifazane okhulelwe owakhiwe ngayo kusiza umama okhulelwe ukunakekela yena nengane.

Kulesi sihloko, sizokhuluma ngendlela umzimba wesifazane okhulelwe owakhiwe ngayo nokuthi yiziphi izinguquko ezenzeka ezithweni ezahlukene ngesikhathi sokukhulelwa. Lesi sihloko siphinde sichaze nezinyathelo ezahlukene zokuthuthuka kwengane.

Uthini Umqondo we-Anatomy Yokukhulelwa?

I-anatomy yokukhulelwa ibhekisela ezivumelwaneni zesakhiwo nangendlela umzimba wowesifazane osebenza ngayo ngesikhathi sokukhulelwa — yisikhathi phakathi kokukhulelwa nokubeletha [2]. Lezi zinguquko emzimbeni wesifazane zisiza ukudala indawo enothando nenesondlo yengane ekhula esesibelethweni.

Izici ezibaluleke kakhulu zesimo somzimba wesifazane okhulelwe zihlanganisa izinguquko ezithweni zokuzala, ohlelweni lokujikeleza kwegazi, ohlelweni lokuphefumula, kanye nohlelo lwamathambo nemisipha [1]. Zonke lezi zinhlelo zezitho zisebenzela inhloso eyodwa, okuwukusekela ukukhula nokuthuthuka kwengane esesibelethweni.

Uma ubuka umdwebo wokukhulelwa noma umdwebo wesifazane okhulelwe, uUzokwazi ukubona eziningi zalezi zinguquko ezihlobene nokukhulelwa. Lezi zinguquko zihlanganisa indawo yesibeletho, ukususwa kwezitho zangaphakathi ezindaweni zazo, nendawo lapho ingane ekhula ikhona.

Izitho Zokuzala Ngesikhathi Sokukhulelwa

Njengoba izitho zokuzala zabesifazane zibamba iqhaza ngqo enqubweni yokukhulelwa, iningi lezinguquko zesimo somzimba zenzeka kulezi zitho zokukhulelwa. Nansi imininingwane ngezinguquko ezahlukene ezenzeka ezithweni zokuzala zabesifazane ngesikhathi bekhulelwe:

1. Isibeletho

Isibeletho yiso esiyitho eliyinhloko lokuzala kowesifazane uma kukhulunywa ngezinguquko ezihlobene nokukhulelwa. Sikhula sisuke kosayizi wophentshisi (i-orange) ngaphambi kokukhulelwa sifike kosayizi kakhabe (i-watermelon) ekupheleni kokukhulelwa [3].

Lokhu kukhula ngokweqile ngosayizi wesibeletho kwenzeka ukuze kuhlaliswe ingane esesibelethweni, i-placenta, kanye nesaka le-amniotic. Ekupheleni kokukhulelwa, isibeletho sowesifazane okhulelwe singanweba sifike emazinyweni enyama (emafubeni) futhi sibambe umthamo ofika kumalitha ama-5. Lokhu kunwebeka kwaso kushenxisa ezinye izitho zenyama phezulu nangaphandle, kwakhe isikhala sengane.

2. Umlomo wesibeletho

Umlomo wesibeletho, oxhumanisa isibeletho nesitho sangasese sowesifazane (ivagina), udlala indima ebalulekile ekulungiseleni umzimba ukukhulelwa. Ngaphambi kokukhulelwa, ukhipha umucu onobungani nokuzala ukusiza ukunyakaza kwesidoda kusuke esithweni sangasese sowesifazane kungene esibelethweni.

Ngisho nangemva kokukhulelwa, lwenza izinguquko eziningi, njengokwanda ngesikhathi sokubeletha, ukusekela inqubo yokukhulelwa. Uboya obukhishwa umlomo wesibeletho benza i-mucus plug ngesikhathi sokukhulelwa ukuvimba ukungena kwamagciwane ayingozi esibelethweni [4]. Lokhu kwehlisa kakhulu ingozi yokutheleleka enganeni.

3. Ama-ovari

Ama-ovari yizitho zokuzala zabesifazane ezitholakala ohlangothini lwesobunxele nolwesokudla lwesibeletho. Lezi zitho zikhipha iqanda namahomoni okuzala ngesikhathi somjikelezo wokuya esikhathini.

Ngesikhathi sokukhulelwa, aziningi kakhulu izinguquko zesakhiwo ezenzeka ema-ovari, kodwa yaqhubeka nokukhiqiza amahomoni abalulekile njenge-progesterone. Le progesterone ezinsukwini zokuqala zokukhulelwa isiza ukugcina ukukhulelwa kuze kube yilapho i-placenta ithatha umthwalo wokukhiqiza amahomoni [5].

Indlela Ingane Ekhula Ngayo Esiswini

Kuyukukhula nokuthuthuka kwengane esiswini okudala izinguquko esakhiweni somzimba womuntu okhulelwe. Ukukhula kwengane esiswini kuhilela izigaba ezahlukene njenge-embryo bese kuba yi-fetus. Abesifazane abaningi badideka phakathi kwe-embryo ne-fetus futhi basebenzise la magama ngokushintshisana.

Nokho, i-embryo ibhekisela esigabeni sokuqala sokuthuthuka, ngokuvamile kusukela ekuchanyushelweni kuze kufike evikini lesishiyagalombili lokukhulelwa [6]. Ngakolunye uhlangothi, igama elithi fetus lisetshenziswa kusukela evikini lesishiyagalolunye kuya phambili, njengoba izitho nezakhi ezisekela ukukhulelwa ziqala ukuthuthuka enganeni.

Izigaba Ezintathu Zokukhulelwa

Ukuze kugwemeke ukudideka futhi kube khona ukuqonda okungcono ngezinyathelo zentuthuko ye-fetus, izinyanga eziyisishiyagalolunye zokukhulelwa zihlukaniswe zibe izinyanga ezintathu [7]. Lezi yilezi:

• Inyanga Yokuqala (Amasonto 1-12): Kulesi sikhathi, iqanda elichanyushelwe lizimisa esibelethweni bese likhula libe i-embryo. I-embryo bese iqala ukwakha izitho ezinkulu nomzimba. Ngeviki lesi-8, i-embryo iba yi-fetus. Abesifazane abaningi babona isicanucanu sasekuseni kanye nokukhathala ngesikhathi sokukhulelwa ngesikhathi senyanga yokuqala yokukhulelwa.
• Inyanga Yesibili (Amasonto 13-26)Usayizi nesisindo sengane kuyanda ngokushesha ngesikhathi senyanga yesibili yokukhulelwa. Umama uvamise ukuqala ukuzizwa ukunyakaza kwengane ngalesi sikhathi. I-fetus yakha amathambo, imisipha, nezitho ezisebenzayo. Ezimweni eziningi, omama bazizwa bekhululekile ezintweni ezazibonakala ekuqaleni kokukhulelwa ngesikhathi senyanga yesibili.
• Inyanga Yesithathu (Amasonto 27-40)Ngesikhathi senyanga yesithathu yokukhulelwa, izitho zangaphakathi ziyavuthwa ukuze zilungiselele ukuphila ngaphandle kwesisu. Ingane ihamba iye esimweni sokuthi ikhanda libheke phansi, ilungiselela ukuzalwa. Omama bavame ukubona ukungakhululeki ngokomzimba okukhulu kulesi sigaba njengoba ingane ikhula ikhule.

Uma ufuna ukuqonda kangconoukuqonda kangcono ukukhula kosana ezikhathini ezahlukene zekota, izithombe zosana esibelethweni noma izithombe zefetus esibelethweni zingasiza.

I-Embryo Iba Nini Ifetus?

Njengoba kuxoxwe ekuqalenikepha, akubona omama abaningi abaqonda umehluko phakathi kwe-embryo ne-fetus. Yilokho okwenza imibuzo enjengokuthi, i-embryo iba nini ifetus, noma i-embryo iba nini ifetus, noma ifetus ibhekwa nini njengosana, ivame kubuzwa omama abalindele.

Amagama athi embryo nefetus kubhekisa ezigabeni ezahlukene zokukhulelwa futhi ukuguquka kusuke ku-embryo kuye kufetus kuyisigaba esibalulekile kakhulu sokukhulelwa [6]. Lapho iqanda elikhulelwe lizifaka esibelethweni, likhula libe yi-embryo. I-embryo bese iguquka ibe ifetus ekupheleni kwesonto lesishiyagalombili lokukhulelwa, lapho isakhiwo esiyisisekelo somzimba wengane sesimisekile.

Ukukhula Nokuma Kwefetus

Ifetus iyakhulaizigaba zokukhula nezinguquko kusakhiwo somzimba womfazi okhulelwe azilutho olungaphansi komlingo. Ekupheleni kwekota yokuqala, ifetus esibelethweni seyimbezele zonke izitho ezinkulu. Ngekota yesibili, ifetus esibelethweni iyakhula ngokushesha, futhi amathambo ayo, imisipha, nohlelo lwayo lwezinzwa kuyathuthuka. Ngekota yesithathu, usana lwanda isisindo futhi luthatha isikhundla sokuba ikhanda libheke phansi ngokuzilungiselela ukuzalwa.

Uma ubuka isakhiwo somzimba womfazi okhulelwe ngokubona phambili, ungabona ukuthi usana olukhulayo esiswini luyazisunduza ezinye izitho zenyuke futhi ziphumele ngaphandle. Lokhu kushintsha kwezitho kubangela izimpawu ezivamile zokukhulelwa ezifana nokushisa esifubeni nokuphelelwa umoya.

Izinguquko Kwezinye Izitho Ngesikhathi Sokukhulelwa

Izitho zokuzala yizo eziyinhloko ezithweni zomfazi okhulelwe eziba nezinguquko ezihlobene nokukhulelwa, kodwa azizona zona kuphela. Izakhiwo zomzimba womfazi okhulelwe zibuye zithinte nezinye izitho nezinhlelo zezitho. Lezi zifaka:

1. Amaphaphu: Isibeletho esikhulayo usayizi wesibeletho emasontweni angu-18 singafinyelela emathanjeni esifuba esigabeni sokugcina sokukhulelwa futhi sicindezele amaphaphu. Lokhu kungaholela ezinguqukweni kumaphethini okuphefumula ngisho nasekuphelelweni umoya kumama abalindele.
2. Inhliziyo: Izifundo zibonisa ukuthi umthamo wegazi wabesifazane abakhulelwe ukhula ngo-30% kuya ku-50% ukuze kusekelwe usana olukhulayo esibelethweni [8]
3. Uhlelo lokugaya ukudlaIzinguquko zamahomoni ngesikhathi sokukhulelwa zithinta futhi uhlelo lokugaya ukudla. Amazinga aphezulu e-progesterone ngesikhathi sokukhulelwa angabambezela ukugaya ukudla futhi uhlangabezane nezimpawu ezifana nokuvuvukala esiswini nokuhamba kancane kwendle (ukukonstipeitha) [9].
4. Isinye: Njengoba isibeletho sikhula njalo ngesonto ngesikhathi sokukhulelwa, lokhu kukhula ngosayizi sicindezela isinye. Lokhu kungaholela ekuchameleni kaningi, okuwuphawu oluvamile ngesikhathi sokukhulelwa.

Okubalulekile Ekugcineni

I-anatomy yomzimba womfazi okhulelwe ikhombisa izinguquko eziyisimanga ezenzeka emzimbeni womfazi ngesikhathi esekhulelwe. Kusukela ezinguqukweni zamalunga omzimba ahlukene ngesikhathi sokukhulelwa kuya ku-fetus esibelethweni, yonke inguquko yenzeka ngenhloso yokusekela ukuthuthuka kwengane enempilo esiswini.

Amadiyagrami omzimba womfazi okhulelwe angakusiza uqonde ukuthi i-fetus ibekeka kanjani futhi ikhula kanjani esibelethweni. Amadiyagrami anjalo asiza abazali abalindelekile baqonde uhambo kusukela ekukhulelweni komntwana kuze kube sekuzalweni. Khumbula ukuthi uma uUma wazi kahle ngezinselelo zokukhulelwa, kungaba ezingokomzwelo noma ezingokwenyama, ungazilungiselela zisencane futhi usekele ukukhulelwa okunempilo.

Imibuzo Evame Ukubuzwa

1. I-fetus iba nini ingane?

Abesifazane abasakhulelwa okokuqala bavame ukudideka ngokuthi iyini i-fetus nokuthi i-fetus iba nini ingane. I-fetus iguquka ibe “ingane” lapho kuzalwa. Igama elithi “fetus” libhekisela esigabeni sokuthuthuka esisibelethweni, kanti “ingane” ngokuvamile libhekisela kusana seluzalwe.

2. Ungayenza kanjani ingane?

Ingane yakhiwa lapho isidoda sendoda sinothamela iqanda lomfazi. Lokhu kuhlanganiswa kwesidoda neqanda kwenzeka ngemuva kokulala ocansini. Isidoda sihamba siye eqandeni, kuthi lapho kuhlangene ndawonye, kuqale kwakheke ingane.

Izinsiza Ezisetshenzisiwe

1. Kazma, J. M., Van Den Anker, J., Allegaert, K., Dallmann, A., & Ahmadzia, H. K. (2020). Izinguquko zokwakheka komzimba nezisebenzayo ngesikhathi sokukhulelwa. Journal of Pharmacokinetics and Pharmacodynamics, 47(4), 271–285. https://doi.org/10.1007/s10928-020-09677-1 
2. La Marca-Ghaemmaghami, P., & Ehlert, U. (2020). Isikhathi sokukhulelwa (gestation). Ku-M. D. Gellman (Ed.), Encyclopedia of behavioral medicine (amakhasi 960–962). Springer. https://doi.org/10.1007/978-3-030-39903-0_20 
3. Usayizi ojwayelekile wesibeletho ngesikhathi sokukhulelwa. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/uterus-size-during-pregnancy/ 
4. Hansen, L. K., Becher, N., Bastholm, S., Glavind, J., Ramsing, M., Kim, C. J., Romero, R., Jensen, J. S., & Uldbjerg, N. (2013b). I-plagi yamafinyila omlomo wesibeletho ivimba, kodwa ayivimbi ngokuphelele, ukudlula kwamagciwane anyukayo avela esithweni sangasese sowesifazane ngesikhathi sokukhulelwa. Acta Obstetricia Et Gynecologica Scandinavica, 93(1), 102–108. https://doi.org/10.1111/aogs.12296 
5. Professional, C. C. M. (2024f, July 3). Corpus luteum. Cleveland Clinic. https://my.clevelandclinic.org/health/body/21849-corpus-luteum 
6. Healthdirect Australia. (n.d.-b). Ukukhulelwa komntwana (conception) nokuthuthuka komntwana esibelethweni. Ukukhulelwa, Ukuzeleka noSana. https://www.pregnancybirthbaby.org.au/conception-and-fetal-development 
7. Mayelana nokukhulelwa. (2024, May 29). https://www.nichd.nih.gov/. https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo 
8. Soma-Pillay, P., Nelson-Piercy, C., Tolppanen, H., & Mebazaa, A. (2016d). 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 
9. Alqudah, M., Al-Shboul, O., Al-Dwairi, A., Al-U´Dat, D. G., & Alqudah, A. (2022c). Indima evimbelayo ye-progesterone ekunyakazeni kwamathumbu esiswini. Physiological Research, 2, 193–198. https://doi.org/10.33549/physiolres.934824