Indlela usayizi wesibeletho oshintsha ngayo isonto nesonto ngesikhathi sokukhulelwa

Ukukhulelwa kungazwakala njengomoya oshubile wezinguquko. Esinye isinguquko esibalulekile sihlanganisa usayizi wesibeletho ngeviki, okunikeza umqondo wokuthi ingane ikhula kahle kangakanani. Abanye abazali abalindele ingane bacabanga ngesibeletho kuphela uma bezwa amagama afana no\-usayizi wesibeletho sokukhulelwa esamasonto ayi-12 noma usayizi wesibeletho amasonto ayi-16 odokotela. Abanye bangazifunela bona imininingwane, benesifiso sokwazi ukuthi umzimba uzivumelanisa kanjani. Iqiniso liwukuthi, uhambo lomuntu ngamunye lwehlukile, ngakho abanye abantu babona izinguquko ezinkulu zisavela kusenesikhathi, kanti abanye babona ukukhula kuhamba kancane.

Isigaba Sokuqala: Amasonto 1 kuya kwayi-9

Ekuqaleni, isibeletho sisamncane kakhulu. Uma ucabanga ngosayizi wesibeletho amasonto ayi-9, asikakhuphuki kakhulu ngaphezu kwethambo le-pelvic. Abanye abantu ngisho abazi nokuthi bakhulelwe kuze kufike cishe lesi sikhathi. Umzimba wona usematasa ulungiselela, yize kungabonakali lutho kakhulu ngaphandle. Abanye abantu bangase bazwe ingcindezi ethambile noma amakhremu abuthakathaka njengoba isibeletho siqala ukwanda [1]. Kodwa abantu abaningi abasaboni umehluko omkhulu ngalesi sikhathi.

Ukuya emasontweni ayishumi nanye kuya kwayi-12

Cishe amasonto ayisishiyagalombili sekudlule, ungase uzwe kukhulunywa ngosayizi wesibeletho uma ukhulelwe amasonto ayi-11. Sisekhona phansi kakhulu, yize sisakhula. Ngokushesha ngemuva kwalokho kuba nokushintsha okudonsela ukunaka okuningi: ukuphela kwe-trimester yokuqala. Ngaleso sikhathi, kungavela ezinye izisho, ezifana no\-usayizi wesibeletho uma ukhulelwe amasonto ayi-12 noma usayizi wesibeletho amasonto ayi-12. Odokotela bavame ukuwuqhathanisa ne-grapefruit. Abanye abazali abalindele ingane bayabuza, “Isibeletho sami singakanani uma ngikhulelwe amasonto ayi-12?” Sikhulu ngokwanele ukuba singazwakala kancane ngaphezulu kwethambo le-pubic [2].

Uzothola namanye amagama ahlobene, afana no\-usayizi wesibeletho amasonto ayi-12, usayizi wesibeletho evikini le-12, noma usayizi wesibeletho evikini le-12. Wonke la magama aphathelene nalelo windi elifanayo, eliseduze nokuphela kwe-trimester yokuqala. Enye inguqulo ingaba wusayizi wesibeletho uma ukhulelwe amasonto ayi-12, okuyinto echaza leso sigaba sokukhula. Abanye abantu baphinde babone igama elithi usayizi wesibeletho sokukhulelwa esamasonto ayi-12 emashadini.

Ukudlulela esigabeni sesibili sokukhulelwa (Second Trimester)

Uma usudlule amasonto ayishumi nambili, isibeletho siqala ukukhuphukela phezulu esiswini sakho. Kuyamangaza ukubona ukuthi izinto zikhula ngokushesha kangakanani. Lapho usufika ekubhekeni usayizi wesibeletho evikini le-13 noma ucabangela usayizi wesibeletho amasonto ayi-13, ungase uzwe umehluko emhlane wakho noma ethangeni lesinqe. Abanye abantu babona izingubo zabo ziqala ukuba zincane, kanti abanye abacaceli noma yikuphi ukushintsha okwamanje [3].

Abaningi maduzane baqala ukubuza ukuthi “emasontweni angu-14 isibeletho sami sikhulu kangakanani” noma babone izikhombo ku-14 week size uterus. Ngemavikini ayishumi nane, isibeletho sesinyuke ngaphezu kwe-pelvis. Odokotela bangase basebenzise imishwana efana nokuthi usayizi wesibeletho emasontweni angu-14 noma usayizi wesibeletho emasontweni angu-14 ukuze balinganisele lokho okubhekwa njengokujwayelekile. Ungase uhlangabezane futhi nemishwana ethi “usayizi wesibeletho emasontweni angu-14” emihlahlandleni yokukhulelwa. Yonke le mibhalo iveza ukuthi isibeletho siyakhuphuka phezulu. Ngezinye izikhathi ungathola nencazelo ethi uterus size 14 week pregnancy emihlahlandleni.

Ukukhula Okusheshayo Emasontweni Ayishumi Nanhlanu Nawayishumi Nesithupha

Ekuqaleni kwengxenye emaphakathi yesithathu sokuqala sokukhulelwa, abaningi bayazibuza ngosayizi wesibeletho emasontweni angu-15. Lokhu kungaba yisikhathi lapho abantu bezwa bekhululeke kakhudlwana uma bebenezicanucanu ekuqaleni, nakuba lokho kungahluka. Ngemva kwamaviki ayishumi nesithupha, umbuzo uba uthi, “isibeletho sikhulu kangakanani emasontweni angu-16?” Ngokuvamile, i-fundus (ingxenye engenhla) iba phakathi kwethambo le-pubic nenkaba. Lokhu kuyashintsha kakhulu, ngakho abanye sebekubona kahle ukubuya kwesisu somntwana manje [4]. Abanye bangase basengasesigabeni esiphakathi lapho bebukeka bevuvukele kancane noma besiswini esiyindilinga kancane.

Odokotela balandelela usayizi wesibeletho emasontweni angu-16 ngesikhathi sokuhlolwa. Kukhona futhi nesikhundla sesibeletho emasontweni angu-16, esivame ukukhombisa ukuthi sesinyuke safika kuphi esiswini. Ungase ubone imishwana efana nokuthi usayizi wesibeletho emasontweni angu-16 noma usayizi wesibeletho emasontweni angu-16 okhulelwe. Enye indlela wukuthi usayizi wesibeletho emasontweni angu-16, esetshenziswa eminye imithombo.

Ukuqhathanisa Izigaba Zangaphambili Nezangemuva

Ngezinye izikhathi uzobona abantu becabanga ngendlela ezizwa ngayo ngesikhathi sosayizi wesibeletho emasontweni angu-9 nokuthi lokho kuqhathaniswa kanjani nezikhathi ezilandelayo ezifana nosayizi wesibeletho emasontweni angu-18. Isibeletho sivame ukuba sikhulu kakhulu ngemavikini ayishumi nesishiyagalombili, futhi umuntu angase aqale ukuzizwa ukunyakaza okuncane komntwana. Futhi, uma ubheka emuva kusayizi wesibeletho emasontweni angu-13, uhluke kakhulu kunaleso sikhathi esiseduze nephuzu eliphakathi kokukhulelwa.

Abantu ababekhathazeke ekuqaleni bangathola induduzo uma umhlinzeki wabo wezempilo ethi konke kubonakala kuhamba kahle. Yingakho ingxenye yokukala usayizi wesibeletho ngeviki ingasiza odokotela babone kusenesikhathi uma kukhona okungahambi kahle, nakuba kungaphelele. Wonke umzimba uhlukile. Abanye bakalwa bekhulu, abanye bancane, kodwa basenezikhathi zokukhulelwa ezijwayelekile.

Iphuzu Elidumile Lamasonto Angamashumi Amabili

Uma kukhulunywa ngosayizi wesibeletho emasontweni angu-20, sivame ukuba siseduze nenkaba. Lokhu kubonisa iphuzu eliphakathi kohambo lokukhulelwa kubantu abaningi. Abahlinzeki bezempilo bavame ukukala ubude besibeletho (fundal height) ngalesi sikhathi ukuze baqinisekise ukuthi ukukhula komntwana kusebangingini evamile [5]. Abanye abazali bajabulela ukubona ukuthi sebehambe ibanga elingakanani selokhu baqala ukuzibuza, “isibeletho sami sikhulu kangakanani emasontweni angu-12?” noma befunda amatafula osayizi besibeletho emasontweni angu-12.

Lapho usufika emasontweni angamashumi amabili, isibeletho singase sicindezele ku-diaphragm. Abanye bangabona ukushintsha endleleni abaphefumula ngayo noma ekuthokomele kwabo kwezinye izindlela zokuhlala. Abanye bangabona nokuthi ukulala ngomhlane sekungasafanele kakhulu ngoba isisindo sesibeletho singacindezela imithambo yegazi.

Ezinye izinto ezithinta indlela usayizi obonakala ngayo

Akusona wonke umuntu ozobukeka ngokufanayo evikini elifanayo. Abanye banezingalo zomzimba ezinde noma imisipha yomgogodla eqinile, okungenza isisu sikhanye ngefomu ehlukile. Yingakho, isibonelo, uma uqhathanisa abantu ababili evikini le-14 uthi size besibeletho sami sikhulu kangakanani, ungabona osayizi ababili abahlukene. Bobabili bangase babe sejwayelekile ngokuphelele.

Kuvamile futhi ukubuza ukuthi usayizi wakho uhambisana kanjani nemihlahlandlela efana nosayizi besibeletho emasontweni angu-14 noma usayizi besibeletho uma ukhulelwe amasonto angu-16. Kodwa le mibandela ilinganiselayo nje. Imizimba yangempela ayihambisani njalo nezincwadi. Uma udokotela noma umbelethisi ethi izinto zibukeka zilungile, kuvamise ukuba kulungile [ 6].

Izinguquko zezimpawu nokungakhululeki

Njengoba isibeletho sikhula siba sikhulu, imisipha emise imichilo iyeluleka futhi ingabangela imivimbo noma izinhlungu ebizwa ngokuthi round ligament pain. Lokhu kungenzeka maphakathi kwalelo banga lobukhulu besibeletho kusukela evikini le-13 kuya phezulu. Kungaba kubi uma ushukuma ngokushesha noma ujikisa umgogodla wakho. Futhi abanye abantu bazwa imizwa yokudonswa engahleliwe esiswini esingezansi. Ngokuvamile, lokhu kujwayelekile, kodwa uma ukhathazekile, kuhlakaniphe ukukusho emihlanganweni yokunakekelwa kwangaphambi kokubeletha.

Engxenyeni yokugcina ye-trimester yesibili, abanye bathola ukuthi abasaziboni kalula izinyawo zabo uma bemi. Abanye baqaphela izinhlungu emhlane noma izinguquko zesitho sangasese sowesifazane ngesikhathi sokukhulelwa. Lokho kuyingxenye yokuthi umzimba uzivumelanisa kanjani nokusatshalaliswa kwesisindo okusha.

Ingabe isibeletho siyaqhubeka sikhula ngendlela efanayo kubo bonke abantu?

Cha. Umuntu ngamunye unazo izinto ezingafani—izakhi zofuzo, ukuqina kwemisipha, inani lokukhulelwa ngaphambilini, nokunye. Umuntu okukhulelwe okwesibili noma okwesithathu angabona isisu sikhula masinyane, ngenxa yokuthi imisipha yamathumbu isivele yanwebeka. Ngesikhathi sinye, umuntu okhulelwe okokuqala angabonakala emncane ngesonto elifanayo. Ngakho uma kwenzeka ufunda ngobukhulu besibeletho emasontweni angu-12 bese uzifanisa nomngane naye okwi-12 weeks, kungenzeka ningabukeki ngokufana ncamashi.

Ukukala Isibeletho Ngemva Kwamaviki Ayishumi Nesithupha

Kusukela cishe emasontweni ayishumi nesithupha kuya phezulu, ochwepheshe bezempilo bavame ukukala i-fundal height njalo. Lokhu kusiza ukulandela ukukhula ngendlela elula, kodwa akusoze kwaba yikho konke. Ama-ultrasound, ukuhlolwa kwenhliziyo yengane esesiswini, nezinye izivivinyo nakho kusiza ekulinganiseni impilo enhle yengane. Abanye abazali abasha bakhumbula ukuthi bafunda ngezinga losayizi wesibeletho ngeviki ezincwadini zokukhulelwa futhi babona ukuthi kuwumbono obanzi nje kunokuba kube ifomula enembile [7].

Futhi khumbula, amagama afana nokuthi usayizi wesibeletho sokukhulelwa kwamaviki angu-14 noma indawo yesibeletho emasontweni angu-16 angavela ezincwadini nasezinsizeni ezahlukene, ngayinye inikeza usayizi olinganiselwe noma ukuqhathanisa nesiqhamo. Ahlose ukunikeza ulwazi, hhayi ukudala ukwethuka uma isisu sakho silingana ngokuhlukile nge-centimeter noma ezimbili.

Okubalulekile Ekugcineni

Lapho ususondela ekugcineni kokukhulelwa, isibeletho singakhula sifinyelele phezulu eduze kwamangqamu (rib cage). Kuyamangalisa ukubona ukuthi sisuka kusayizi wesibeletho emasontweni angu-9 sifinyelele cishe ekupheleni kwesikhathi. Ukulandela usayizi wesibeletho ngeviki kuyindlela eyinhloko yokubheka ukukhula nokuthuthuka kwengane ngesikhathi sokukhulelwa. Ngemva kokubeletha, isibeletho siyazikhipha sibuyele emuva kungakapheli amasonto ambalwa, inqubo abanye abayichaza ngokuthi i-involution. Ukuncelisa kungayisheshisa kancane leyo nqubo [8].

Okwamanje, ukunaka usayizi wesibeletho sokukhulelwa samaviki angu-12, usayizi wesibeletho emasontweni angu-14, noma usayizi wesibeletho emasontweni angu-16, phakathi kokunye, kungaba yindlela ewusizo yokulandela intuthuko yengane. Khumbula nje: kuwumcezu oyedwa kuphela wephazili, umehluko ngabanye ujwayelekile. Uma kukhona ukukhathazeka noma nini, ukuxhumana nochwepheshe bezempilo kuhlale kuyisinqumo esihle.

Imibuzo evame ukubuzwa

Kwenzekani uma isibeletho sami silingana sincane kunesijwayelekile?

Kuyenzeka. Abanye babambe ukukhulelwa ngendlela encane. Umhlinzeki wakho wezempilo angase enze ezinye izivivinyo ezengeziwe ukuqinisekisa ukuthi konke kuhamba kahle.

Kujwayelekile yini ukuthi isisu singabonakali kakhulu emasontweni angu-14?

Yebo. Uma udokotela wakho engakhathazekile, kungenzeka ukuthi nawe akudingeki ukhathazeke. Imizimba ikhula ngezinga elihlukene.

Isibeletho sikhulu kangakanani ngqo emasontweni angu-16?

Ngokuvamile uba maphakathi phakathi kwethambo le-pubic nesisu (inavel), kodwa lokho kungumhlahlandlela ojwayelekile hhayi ukulinganisa okunembile.

Ingabe usayizi wesibeletho emasontweni angu-15 uhlale ufanela ishadi?

Akusilo njalo. Amashadi ayizinguquko zokulinganisa. Izilinganiso zomzimba wakho zingahluka kancane.

Ingcindezi ingawuthinta yini indlela isibeletho esikhula ngayo?

Ingcindezi yodwa ngokuvamile ayiguquli ukukhula kwesibeletho ngqo, kodwa impilo yomzimba iyonke ingaba nomthelela. Kuhlale kuwukuhle ukufuna ukuphumula nokwesekwa okufanele.

Izikhombo

1. Cunningham, F. G., Leveno, K. J., Bloom, S. L., et al. (2018). Williams Obstetrics, uhlelo lwe-25. McGraw Hill Education. Kutholakala ku: https://accessmedicine.mhmedical.com/content.aspx?bookid=1918&sectionid=185045008
2. Moore, K. L., Persaud, T. V. N., & Torchia, M. G. (2020). Umuntu Othuthukayo: I-Embryology egxile ekwelashweni, uhlelo lwe-11. Elsevier. Kutholakala ku: https://shop.elsevier.com/books/the-developing-human/moore/978-0-323-61154-1
3. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology (2018). ACOG Practice Bulletin No. 200: Ukulahleka kokukhulelwa kusenesikhathi. Obstetrics and gynecology. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/30157093/
4. Osterman, M., Hamilton, B., Martin, J. A., Driscoll, A. K., & Valenzuela, C. P. (2021). Ukuzalwa: Imininingwane yokugcina ka-2020. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/35157571/
5. Reddy, U. M., Abuhamad, A. Z., Levine, D., Saade, G. R., & Fetal Imaging Workshop Invited Participants (2014). Izithombe zombungu: isifinyezo esiphezulu somsebenzi ohlanganyelwe we Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, kanye ne-Society of Radiologists in Ultrasound Fetal Imaging Workshop. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/24764329/
6. Smith, G. C., & Fretts, R. C. (2007). Ukuzalwa ingane isivele ifile (stillbirth). Lancet (London, England). Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/18022035/
7. Thompson, J. L., Kuller, J. A., & Rhee, E. H. (2012). Ukuqapha kwangaphambi kokubeletha kokuncipha kokukhula kombungu. Obstetrical & gynecological survey. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/22990459/
8. Gavine, A., Shinwell, S. C., Buchanan, P., Farre, A., Wade, A., Lynn, F., Marshall, J., Cumming, S. E., Dare, S., & McFadden, A. (2022). Ukusekelwa kwabomama abancelisayo abaphilile abanabantwana abaphilile abazelwe ngesikhathi. The Cochrane database of systematic reviews. Kutholakala ku: https://pmc.ncbi.nlm.nih.gov/articles/PMC9595242/

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