Ungayisebenzisa i-IUD Ukuba awunakuze uzalwe?
Xa i- ParaGard IUD yaqala ukuthengiswa e-US ngo-1988, ileyibhile yecandelo liqulethe icandelo elibonisa ukuba le ncwadana ye-IUD yayinconywe kubasetyhini abanomntwana omnye. Ngelishwa, le ileyibhile yemveliso iyanqanda ukusetshenziswa kwe- IUD kumabhinqa angama-nulliparous (abasetyhini abangazange babe nabantwana).
Ngo-2005, i-FDA yavuma iileyile entsha yomkhiqizo we-ParaGard ukukhusela ukukhutshwa okungaphezulu kwe-IUD ngabasetyhini ababengakaze bazalwe.
Le bhile entsha isuswe nayiphi na ingcaciso ebonisa ukuba abaviwa be-IUD banqunyelwe kulabo abanezingane okanye ngaphezulu.
Okwangoku, iilebuli ye- Mirena IUD isasithi ikwajoliswe kubasetyhini abanomntwana omncinci omnye, kodwa umenzi uchaza ukuba oku kungenxa yokuba ininzi yophando kwi-Mirena ye-FDA imvume yaqhutyelwa kwabasetyhini abanobuncinane omnye umntwana.
Yintoni i-ACOG ithi?
I-Recent Practice Bulletin ekhutshwe yi-American College of Obstetricians kunye ne-Gynecologists (ACOG) ibonisa ukuba ababini abafazi abadala kunye nabaselula abangazange bazalwe bangazuza kwi-IUD. Enyanisweni, oogqirha abaninzi kunye nezibhedlele zokufundisa baye bafake ii-IUD kule miba iminyaka, ngoko ke iingcebiso ezintsha ze-ACOG zibonakalisa oko kwenzeke kwihlabathi lenene.
Iimpawu zoLungiso lweMpilo zoBucala be-US zoNyango yokuLawula ulwahlulo lusebenzisa i-IUD ekusebenziseni kwabasetyhini kunye nabaselula kunye nabaselula kunye no-ParaGard kunye neMirena phantsi kweCandelo 2.
Oku kuthetha ukuba inzuzo yokusebenzisa imithwalo yokukhusela ngokubanzi ixhomekeke kwiingozi.
Uthini Uphando?
Uncwadi olutsha lucebisa ukuba ii-IUD ziphumelele kwaye zinamazinga aphezulu okwaneliseka kubasetyhini abangenabo umntwana xa befaniswa nepilisi yolawulo lokuzalwa .
Kwisifundo seminyaka eyi-1 (ngamabhinqa angama-200 aneminyaka engama-18-25 efuna ukukhulelwa kwe-contraception ), malunga nesiqingatha sabasetyhini bakhetha ukusebenzisa i-Mirena kunye nesiqingatha sakhetha i pilisi. Nangona i-27% yabasetyhini kwiqela leepilisi lokulawula ukuzalwa layeka ukusebenzisa kulo nyaka, kuphela i-20% yabasebenzisi baseMirena bayeka. Kule sifundo, abaninzi besetyhini kwiqela le-Mirena (ngokumalunga nalabo babesecaleni lokulawula iipilisi lokuzalwa) babika ukuba indlela yabo yokukhusela yayilungileyo ngokufanelekileyo. Ubunzima beyona nto echazwe ngokuqhelekileyo yezizathu zokususwa kweMirena IUD kunye nokuyeka, ngelixa iimiphumo ze-hormonal zizathu esona sizathu esenza ukuba abasebenzisi beepilisi bakhethe ukuyeka. Olu pho nonongo luphelile ukuba ukhuseleko kunye nokwamkeleka kweMirena kwabasetyhini abangakaze bazalwe kubonwa njengento efanelekileyo njengepilisi, ngezinga eliphezulu lokusetyenziswa.
Uphando oluvela kwelinye uphando luhlolisise iinkcukacha ezifumanekayo malunga neenkxalabo zabesetyhini abachaphazelekayo malunga nokusetyenziswa kwe-IUD (njengokusebenza kakuhle, ukhuseleko, ingozi ye-PID, imiphumo emibi, njl.). Emva kokuvavanya uphando olukhoyo, olu pho nonongo lufumene ukuba ii-IUD zinezinga elifanayo lokungaphumeleli ngokufanayo kumabhinqa angama-nulliparous kunye namaqabane (ngoko asebenza ngokulinganayo kumabini) kwaye angabangeli i-PID okanye ukungabikho komntwana .
Kwakhona, abesetyhini abasebenzisanayo bayaqhubeka nokusetyenziswa kwabo kwe-IUD kwinqanaba elithelekisayo okanye eliphakamileyo lokusetyenziswa xa kuthelekiswa nabasetyhini abasebenzisa ezinye iindlela zokukhulelwa. Ababhali bacetyisa ukuba i-Mirena IUD inokunyamezeleka ngakumbi kubasetyhini abangenayo i-ParaGard ngokusekelwe kwizinga eliphantsi lokuxoshwa (xa i-IUD ingenayo okanye ikhuphe ngokupheleleyo kwisibeleko) kwaye ingaphantsi kwegazi ( njengempembelelo yecala ). Baye baqaphele ukuba ukufakwa kwe-IUD kunokuba nzima nakwabesetyhini abangenanto. Kodwa, ngokubanzi, olu cwaningo lucetyisa ukuba abafazi abangenanto abanqwenela ukukhulelwa ngokweqile kufuneka babhekwe njengabaviwa kwi-Mirena okanye eParaGard kwaye ngenxa yeenzuzo zokusetyenziswa kwe- IUD , oogqirha akufanele badikibala ekunikezeni i-IUD njengendlela yokuqala yokukhulelwa komnxeba lala manani.
Ukuhlaziywa kweencwadi zethusi Ukusetyenziswa kwe-UUD phakathi kwamabhinqa angamaqabane ayenziwe ukuhlalutya ulwazi ngezinga lokuxoshwa kunye nokususwa ngenxa yokuphuma kwegazi kunye nentlungu. Iziphumo zibonisa ukuba amazinga okuxoshwa kweMirena kunye neParaGard afana ngokufanayo nakwabesetyhini kunye nabasetyhini. Oko kuthethwa, kubonakala ukuba izinga lokuxoshwa lingaba liphezulu kunabasebenzisi abasebenzisa i-ParaGard xa kuthelekiswa nabasebenzisi abasebenzisayo abasebenzisa le-IUD efanayo.
Imiphumo echaphazelekayo echazwe kwi-ParaGard ekusebenziseni kwabasetyhini abangenayo iintlungu kunye nokunyuka kwexesha lokuphuma kwexesha. Abafazi abasebenzisa i-Nulliparous abasebenzisa i-Mirena ngokubanzi babika ukuba akukho zihlandlo okanye ukuphuma kwexesha lokuphuma kwindoda, kodwa ukuphawula okungaqinisekiyo phakathi kwamaxesha. Uphando lubonisa ukuba abasetyhini abangenayo imilinganiselo ephakamileyo yokususwa kweParaGard ngenxa yokuphuma kwegazi kunye nentlungu xa kuthelekiswa nabasetyhini ababeletheyo. Ezi xabiso zivela kwi-9.1% ukuya kwi-24% kwizifundo ezininzi. Nangona kunjalo, abasetyhini abangaboniyo baphinda baxela amanqanaba aphezulu amanelisayo ngokusetyenziswa kwe-IUD.
Imvumelwano?
Ingqungquthela ngokubanzi yophando kukuba i-IUD yokuqhubeka kwezinga labesetyhini abangenabantwana abaphezulu. Ukongezelela, i-ParaGard ibonakala iyindlela efanelekileyo yokukhulelwa kwindlela yokukhulelwa kwabasetyhini abangakwaziyo okanye abangafuni ukusebenzisa ukukhulelwa kwe-hormonal .
I-ACOG izikhokelo zenkqubo zivuma ukuba nangona ibhinqa lingakazalelanga, unako kwaye lifanele linikezelwe ngeendlela zokukhusela ezinokuguqula ixesha elide njenge-IUDS. Iingeniso kunye neenzuzo zeParaGard kunye / okanye iMirena IUD basebenzisa kula mabhinqa ngokubanzi ngokugqithiseleyo ingozi okanye ingqiqo, ngoko ke oku kulungile, okukhethwa kukho ukulawulwa kokuzalwa okufuneka ukuba kunconywe kubasetyhini nokuba ngaba bengabantwana.
Imithombo:
Ikholeji yase-American College of Obstetricians kunye neGynecologists. "Yenza i-Bulletin # 121 - Ukukhulelwa okuKhuselekileyo okuPhatha ixesha elide: Izimpembelelo kunye namadivayisi ase-Intrauterine." I-Obstetrics & Gynecology . Julayi 2011. 118 (1): 184-196. Kufumaneka ngokubhalisa kwangasese.
I-Hubacher, D. "Isixhobo sokusetyenziswa kwesibindi sokusetyenziswa kwe-intrauterine ngamabhinqa angama-nulliparous: Ukuhlaziywa kwemiphumo emibi." Ukukhulelwa . 2007. 75 (6 i-suppl): S8-11. Kufumaneka ngokubhalisa kwangasese.
Umbutho woKhokelo loNxibelelwano loNtsapho ka-2009. "Ukusetyenziswa kweMirena LNG-IUS kunye neParard CuT380A izixhobo zangaphakathi kwintombikazi." Ukukhulelwa . 2010. 81 (5): 367-371. Kufumaneka ngokubhalisa kwangasese.
USuhonen S, u-Haukkamaa M, Jakobsson T, uRauramo I. "Ukusebenza kliniki ye-levonorgestrel-ukukhulula inkqubo ye-intrauterine kunye nokukhulelwa komlomo kwabasetyhini abasetyhini: Ucwaningo olulinganiswayo. 2004. 69 (5): 407-412. Kufumaneka ngokubhalisa kwangasese.
Umbutho WezeMpilo Wehlabathi. "Inkqubo yokufaneleka yezokwelapha malunga nokusetyenziswa kokukhulelwa. "4th ed. Geneva: WHO; 2009. Kufumaneka ngoJulayi 12, 2011.