Abafazi abane- arthritis kunye nezinye izifo ze-rheumatic bangakhathazeka ngokukhulelwa okanye babe neengxakini nangemva kokuba bekhulelwe. Abanye abafazi abanezifo zesifo se-rheumatic bangacetyiswa ukuba bangakhulelwa.
Abafazi abakhulelweyo abane-Arthritis ne-Rheumatic Diseases
Ixhala livela kukungaqiniseki malunga nendlela imeko yesimo senzululwazi iya kuthintela ngayo ukukhulelwa kunye nendlela ukukhulelwa kuya kuthintela ngayo imeko yakhe yesifo sengqondo.
Ukuba une-arthritis kwaye ukhulelwe okanye ukuba ukhulelwe ingqalelo, nantsi izinto ezibalulekileyo omele wazi.
1. Ngokuqwalaselwa ngokuthe ngqo kunye nokulawulwa kwezempilo olufanelekileyo, abafazi abanesifo se-arthritis okanye ezinye izimo ze-rheumatic bangaba nokukhulelwa okuphumelelayo.
Kubalulekile ukuba abafazi abakhulelweyo abane-arthritis babephantsi kokunyamekela kokuthintela izidakamizwa ukuba baphathe ukukhulelwa kwabo kunye ne- rheumatologist ukulawula imeko yabo yesifo se-rheumatic. Ukukhulelwa okuphumelelayo kunokwenzeka ngeqela leqela, kodwa akukho ukukhulelwa konke kuya kuba ngaphandle kweengxaki.
2. Imiphumo yokukhulelwa kwisifo se-rheumatic iyahluka ngokwemiqathango ethile.
Ukukhulelwa okuhambisana ne- rheumatoid arthritis , lupus , antiphospholipid syndrome , kunye nezinye iimeko ze-rheumatic zinemimandla eyahlukeneyo kunye neenkxalabo ezinxulumene nazo.
- Abasetyhini abane-rheumatoid arthritis bafumana iimpawu eziphucula ngexesha lokukhulelwa kodwa ziphinde ziphinde zibuye emva kokuzalwa komntwana. Ngethuba lexesha lokuphucula, kunokwenzeka ukuba kuncitshiswe okanye kunqunywe amayeza e-arthritis.
- Nge-lupus, ngokuqhelekileyo kukho iirhaphu ezinomlinganiselo oza kuqhubeka ngexesha lokukhulelwa, kunye nangemva kokuzalwa.
- I-Antiphospholipid syndrome yinkinga yokuzimela komzimba apho umzimba wenza ama-phospholipids okanye amaprotheni e-plasma. Isifo singenzeka nge-systemic lupus erythematosus okanye esinye isifo se-rheumatic. Kule meko, kukho ingozi eyongeziweyo yokuqhawula igazi, ukukhulelwa kwesisu, okanye uxinzelelo lwengqondo ngexesha lokukhulelwa. Ixesha elizungeze ukuhanjiswa libaluleke kakhulu.
- I-pulmonary hypertension edlalwa ngamanye amaxesha ne- scleroderma , isifo se-Sjogren , i-lupus, kunye ne-antiphospholipid syndrome inokuba nzima ngokukhulelwa; Yingakho ukukhulelwa kungacetyiswa ngale mqathango.
- Ezinye izimo ze-rheumatic, kubandakanywa i-scleroderma ngaphandle kwe-pulmonary hypertension, i-polymyositis, i-dermatomyositis, kunye ne- vasculitis , ngokuqhelekileyo ayichaphazelwanga ngokukhulelwa xa izifo ziphantsi kolawulo.
3. Abasetyhini abanezifo zesifo ezinxulumene ne-vasculitis, i-scleroderma, okanye i-lupus zengozi eyingozi yokuxinzeleleka kwengozi kunye ne-preeclampsia.
Ubunzima bokukhulelwa okuphumelelayo nokusempilweni luphezulu xa umsebenzi wezintso kunye nokunyanzelelwa kwegazi ziqhelekileyo kwaye isifo sesifo se-rheumatic isingasebenzi okanye ukuxolelwa okungenani ezintandathu kwiinyanga ngaphambi kokuba ukhulelwe. Oku kubaluleke kakhulu kubasetyhini abane-lupus. Ngokwahlukileyo, abafazi abaneentsholongwane ezingaqhelekanga, uxinzelelo lwegazi olungalawulwayo, kunye nesifo se-rheumatic esebenzayo basicetyiswa ukuba bangakhulelwa.
4. Iibhloko zebhendi zengqondo zingaphinda zenzeke kwipesenti eziphantsi zezinsana ezizalwe ngabasetyhini abanezilwanyana ezichasene ne-Ro.
Iintsholongwane ze-anti-Ro ziqhelekileyo kwizigulane ezine-lupus ne-Sjogren's syndrome. Ama-antibodies angena kwi-circulation circulation kwaye awonakalise intliziyo yengane ekhulayo, ekhokelela kwisantya senhliziyo esengozini.
Kwezinye iimeko, umntwana usenokufuna i-pacemaker ekugqibeleni. Abasetyhini abakhulelweyo abanezilwanyana ezinxamnye ne-anti-Ro kufuneka ziqwalaselwe ngokukhawuleza kwaye zihlolwe. I-anti-La iintsholongwane nazo zinokuba yingxaki ngexesha lokukhulelwa.
5. Ukuvuvukala, okuphawulekayo ngexesha lesifo esishukumisayo, kwaye ezinye iimyeza ezisetyenziselwa ukunyanyiswa ziyakunzima ngexesha lokukhulelwa.
Kuya kuba yinto efanelekileyo kubafazi abasayi kuthatha nawaphi na amachiza ade aqede ukukhulelwa kunye noongikazi. Akuyona imeko efanelekileyo kodwa ukuba ikhulelwe kwaye ibe nesifo se-rheumatic, ngoko kufuneka kucatshangelwe. Ukuba unyango olufunekayo ukugcina isifo somfazi phantsi kolawulo luyakususwa, umngcipheko wesifo esingalawulekiyo kufuneka ulinganiswe nemingcipheko enokuthi umntwana ongakazalwa.
6. Kukho isivumelwano malunga naluphi na imishanguzo yokulwa ne-rheumatic ekhuselekile okanye engakhuselekanga ukuyisebenzisa ngexesha lokukhulelwa kunye ne-lactation (ukuveliswa kobisi).
Iqela labagqirha, i-rheumatologists kunye nabafundi abanamava abaphatha abafazi abakhulelwe abanezifo zengqondo zavumelene ukuba iziphi izidakamizwa ezichasayo ziyamkeleka xa zisetyenziswa ngexesha lokukhulelwa kunye neloctation.
Iziyobisi ezivunyelweyo ukusetyenziswa ngexesha lokukhulelwa kunye ne-lactation ziquka:
- Ii-NSAID (izidakamizwa ezichasene ne-anti-inflammatory) kude kube ngeveki 32
- Azulfidine (sulfasalazine)
- Plaquenil (hydroxychloroquine)
- I-Corticosteroids (phantsi kwe-10 mg xa kunokwenzeka)
Iziyobisi ezivunyelwe ukusetyenziswa ngexesha lokukhulelwa kodwa zixutyushwa ngethuba lokukhutshwa ziquka:
- Cyclosporine A
- Imuran (azathioprin)
Iziyobisi ezingavumelekanga ngexesha lokukhulelwa kunye ne-lactation ziquka:
- Methotrexate
- Arava (i-leflunomide)
- CellCept (i-mycophenolate)
- I-Cytoxan (cyclophosphamide)
- Iziyobisi ezichasene ne-TNF
- Rituxan (rituximab)
(Qaphela; izidakamizwa ze-Anti-TNF ziyanconywa ngokukhuselekileyo ngexesha lokukhulelwa kwaye mhlawumbi i-lactation.)
7. Abafazi becinga ukukhulelwa kufuneka babe ne-rheumatic condition ngaphansi kolawulo lweenyanga ezintathu ukuya kwezi-6 ngaphambi kokuzama ukukhulelwa.
Kunconywa ukuba bonke abafazi abaneesifo se-rheumatic bacebiswe yi-rheumatologist kunye nomthinteli ngaphambi kokuba azame ukukhulelwa. Ngaloo ndlela ingozi yabo yoxinzelelo ingahlolwa kwaye isicwangciso sokulawula isifo sesifo se-rheumatic nokukhulelwa kungasungulwa kakuhle.
8. Abasetyhini abasemngciphekweni omncinci weengxaki kufuneka baqhubeke bebona i-rheumatologist kwiinyanga ezili-3 eziqhelekileyo ukugcina ukuhambelana nokuhlolwa kwezifo kunye nolawulo.
Abasetyhini ababhekwa njengengozi enkulu yeengxaki kufuneka babe neqela le-obstetric elijongene nokukhulelwa okukhulu. Ukutyelela kunye nokubeka iliso rhoqo kuzakufuneka njengoko ukhulelwe. Imiqathango eyenza ukhulelwe ukhuseleko oluphezulu luquka:
- Ukukhubazeka kweengso
- Iimeko zeentliziyo
- I-blood pressure
- Isifo sokukhupha umphunga
- isifo se-rheumatic disease
- In vitro fertilization
- Ukuzalwa amaninzi
- Ingxaki yangaphambili yomqobo
Imithombo:
Ukukhulelwa kunye neRheumatic Disease. Ikholeji yaseMerika yaseRheumatology. Matshi 2014.
http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Living-Well-with-Rheumatic-Disease/Pregnancy-Rheumatic-Disease
I-Kelley's Bookbook yeRheumatology. I-ninth edition. Elsevier. Ukukhulelwa kwiiRheumatic Diseases. Isahluko 39.
I ziPhulo zeMoto. Umbuso wobugcisa: Ukuzaliswa nokukhulelwa kwizifo ze-rheumatic. Meyi 2015.
http://www.ncbi.nlm.nih.gov/pubmed/25555818