Esinye isizathu sokuba ukusetshenziswa kwe- IUD kuye kwadimazeka kubafazi abangaboniyo kunye nokukhathazeka ngengozi ye-epvicm disease inflammatory disease (PID) kunye nokungabikho komntwana. Oku kusekelwe kwinto yokuba abesetyhini okanye abatsha abangazange babe nabantwana kwaye abangatshatanga banokuba namaqela amaninzi ezesondo, ababeka emngciphekweni ophezulu kwintsholongwane yesondo (STI).
Ukongezelela, uphando lwe-IUD kwiminyaka ye-1970 neye-1980 lwaludideka kwaye ludukisa. Ezi zifundo zivimbela abafazi ekusebenziseni i-IUD kuba bathi i-PID yengozi yanda nge-60% kwabasetyhini abasebenzisa ii-IUD. Kanti ezi zifundo zazingenayo imilinganiselo efaneleko (umzekelo, abazange baxubushe imbali ye-PID, ezinye iindlela zokulawula ukuzalwa okanye abo bafazi abasenokuba yingozi enkulu yokuphuhlisa i-PID). Kwakhona basebenzisa iindlela zokuhlalutya.
Uphando olucwangcisiweyo oluthile olusebenzisa ubuchule bokuhlalutya kwedatha oluninzi luye lwafumanisa ukuba akukho nonyuka ephezulu kwengozi ye-PID kunye nokusetyenziswa kwe- IUD .
IUDs kunye nePID
Isifo sokuvuvukala sepelvic (PID) sibhekisela kwintsholongwane ebangela ukuvuvukala kwesibindi sesisu, ama-tublopian tubes okanye ama-ovari. Iimbangela eziqhelekileyo zePID yi-bacterial chlamydia kunye ne-gonorrhea. Ukusebenzisa ikhondom ( indoda okanye ibhinqa ) ngexesha lokwabelana ngesondo kunokunceda ukukhusela ekubanjeni isifo.
Uphando lubonisa ukuba iziganeko ze-PID phakathi kwabasetyhini abasebenzisa i-IUD ziphantsi kakhulu kwaye zihambelana nokuqikelela kwe-PID iziganeko kubantu bonke.
Oko kuthethwa, kubonakala ukuba kukho ubudlelwane phakathi kokusetyenziswa kwe-IUD kunye nesifo sokunyuka kwe-pelvic xa kuthelekiswa nabasetyhini abangasebenzisi naluphi na ukukhulelwa .
Ubungqina kwiincwadi, nangona kunjalo, uchaza ukuba lo mngcipheko we-PID awuhambelani nokusetyenziswa kwe-IUD yangempela; Kunoko, kuhlangene neebhaktheriya ezikhoyo ngexesha lokufakwa kwe- IUD . Emva kwenyanga yokuqala yokusetyenziswa (malunga neentsuku ezingama-20), umngcipheko we-PID awukho ngaphezulu kwabesetyhini abangasebenzisi ii-IUD. Uphando luye lwagqiba ekubeni ukungcola kwebhaktheriya ehambelana nenkqubo yokungenisa i-IUD yimbangela yokusuleleka, kungekhona i-IUD ngokwayo.
Nangona idatha ingahambelani, kubonakala ukuba ukusebenzisa i- Mirena IUD (xa kuthelekiswa ne- ParaGard IUD ) inokuthi inganciphise umngcipheko we-PID. Kucatshangelwa ukuba i-progestin levonorgestrel kule nkqubo ye-IUD ibangele i-mucus yocervical eyinqaba, utshintsho lwe-endometrial kunye nokunciphisa ukuhlaselwa kwelanga (xa igazi lexesheni liphuma kwii-tublopian tubes) kwaye ukuba le miqathango ingabangela ukukhuselwa kokukhuselwa.
IUDs kunye nokungenzi
Esinye sezizathu eziqhelekileyo zokungabikho komntwana kukukhutshwa kwe-tubal. Phantse izigidi ezi-1 zeziganeko zokungabikho kwezifo zibangelwa isifo se-tubal. Ukuba ishiywe ingaphendulwanga, i-PID ingabangela ukuvuvukala kunye nokuvalwa okusisigxina kwama-tublopian tubes. Kubonakala kungekho bungqina bokuba ukusetyenziswa kwe-IUD kudibaniswa nexesha elingenasiphelo.
Uphando lubonisa ukuba ukusetyenziswa kwangaphambili okanye ukusetyenziswa kwangoku kwe-IUD akuhambelananga nobungozi bokukhutshwa kwe-tubal. Iziphumo ezivela kwizifundo ezingaphelelwanga, ukulawulwa kwimeko yamabhinqa angama-1,895 anesifo sokungabikho kolwazi lwe-tubal (ukusebenzisa amaqela amaninzi okulawula ukunciphisa ubuhlanga - kubandakanywa nabasetyhini abangenasifo ngenxa yokucinywa kwe-tubal, abasetyhini abangenabantwana abangenayo i-tubal block and pregnant women okokuqala), kuboniswe:
- Ukusetyenziswa kwangaphambili kobhedu lwe-IUDs (njengo-ParaGard), xa kuthelekiswa nabasetyhini abangenakho ukusetyenziswa kwexesha lokuqala, akuzange kudibaniswe nobungozi obuncitshiweyo bokucinywa kwe-tubal.
- Abasetyhini abasebenzisana nabo ngokwesini bawasebenzisa iikhondom banomngcipheko ongaphantsi kwe-50% wokukhutshwa kwe-tubal kunezo ezingasetyenzisanga ukukhulelwa.
- Ubuninzi bexesha lokusetyenziswa kwe-IUD, ukususwa kwe-IUD ngenxa yemiphumo emibi kunye / okanye imbali yeempawu ngexesha lokusetyenziswa kwe-IUD ayengahambelani nobungozi bokukhutshwa kwe-tubal.
Kuvavanyo lwabo lweScientific Group, i-World Health Organisation ibandakanyekile kwiinkxalabo zoluntu ngokubanzi ukuba ukusetshenziswa kwe-IUD kwakuxhomekeke engozini enkulu yokwanda kwe-PID kunye ne-tubal infertility. Isiphetho sabo siyavumelana neencwadi ezikhoyo ukuba iingxaki zendlela yokwenza uphando olwangaphambili zibangele ingozi echaphazelekayo ye-IID ye-PID. Ngubani na obiza ukuba akukho mngcipheko wokungabikho kwintsebenziswano phakathi kwabasebenzisi be-IUD abasemgangathweni, olwalamano ngokwesini.
Enyanisweni, yintoni uphando olubonisa ukuba ukungabikho kwentlupheko (ngenxa yokucinywa kwe-tubal) kuya kuba ngumphumo kwi-STI kwaye kungekhona kwi-IUDs. Izifundo zibonisa ukuba ubukho be-chlamydia antibodies kubasetyhini banxulumene nokucinywa kwe-tubal. Umzimba wenza ama-antibodies xa uboniswe kwi-chlamydia bhakteria ukukunceda ukulwa nale ntsholongwane. Ama-antibodies ahlala egazini nangona xa usulelo lususwe. Uphando lufumene ukuba ubukho be-chlamydia antibody ngokuchanekileyo bubungqina ngokucwangciswa kwe-tubal 62% yexesha, kanti ukungabikho kwe-chlamydia antibody kuqikelele ukungabikho komonakalo we-tubal 90% wexesha. Ingagqitywa ukuba ukungabi nantlungu eyenzeka emva kokusetyenziswa kwe-IUD ayinanto enxulumene ne-IUD - ukuba ukungabikho kwengqondo kubangelwa yi-STI engatshatanga.
Izikhokelo ze-ACOG kwi-IUDs kunye nee-STI
Kuphakanyisiwe ukuba abafazi abangenayo ingozi enkulu kwi-STIs (okt, iminyaka engama-25 ubudala kunye / okanye babe neqabane lamadoda amaninzi) kufuneka babe novavanyo lwe-STI olwenziwa ngosuku olufanayo njengoko kufakwe i-IUD. Ukuba iziphumo zokuvavanya zilungile, unyango lufanele lunikezwe kwaye i-IUD ingasala endaweni xa loo ntokazi ibonakala. Isilinganiselo sesi-2 (oko kukuthi, iinzuzo zokusebenzisa le ndlela yokukhusela ngokubanzi ngokugqithiseleyo ingozi) kunikwa umfazi onomngcipheko ophezulu we-STIs okanye ukuqhubeka nokusetyenziswa kwe-IUD kwindoda efunyenwe ukuba ne-chlamydia okanye igonorrhea isifo kwaye yanyangwa unyango olufanelekileyo lweyeza.
Udidi lwesigaba 3 (oko kukuthi, iingozi ezibonakalayo okanye ezivakalayo zigqithise ngaphezu kweenzuzo zokusebenzisa indlela) isetyenziswe kubafazi abanomngcipheko ophezulu kakhulu wokungcola kwi-gonorrhea okanye i-chlamydia. Abasetyhini abane-chlamydia okanye i-gonorrhea intsholongwane ngexesha lokufakwa kwe-IUD banokuthi bavelise i-PID ngaphezu kwabasetyhini abangenayo i-STI. Nangona kunjalo nakwabasetyhini abane-STI engaphelelwanga ngexesha lokufakwa, le mngcipheko usabonakala ncinane. Umngcipheko opheleleyo wokuphuhlisa i-PID wawuphantsi kumaqela amabini (0-5% kulabo abaneengxaki zoxinzelelo lweengculaza xa i-IUD ifakiwe, kunye ne-0-2% kwabangenayo intsholongwane).
Abasetyhini abanomkhuhlane ongaqhelekanga okanye ngamagumbi aqinisekisiwe of chlamydia okanye i-gonorrhea kufuneka baphathwe ngaphambi kokuba i-IUD ifakwe. Kubafazi abafumana ukuxilongwa kwe- chlamydia okanye i-gonorrhea, i-ACOG kunye namaziko okuLawula kunye nokukhusela izifo zincoma ukuvavanywa kwakhona kwiinyanga ezintathu ukuya ezintandathu ngaphambi kokufakwa kwe-IUD.
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