Njalo ngonyaka e-United States, intsha engaba ngu-750,000 ikhulelwa, futhi iningi lalezi zikhukhumba azihlelwe. Ukuze ukulawula ukubeletha kuphumelele, intsha idinga izinketho ezingayisebenzisa kalula. Intsha ingase iqhubeke isebenzisa izindlela zokuvimbela ukubeletha, ezifana nokulawulwa kwe- IUD noma i- Nexplanon . Labo abasha abenza ucansi futhi basebenzise ukulawula ukubeletha ngokuvamile babika ukusetshenziswa okungavumelani.
Lokhu kuye kwaholela i-American College of Obstetricians kanye neGynecologists (ACOG) ukuthi ihlose ukuthi kunenzuzo yini ukuhlinzekela ukulawulwa kwezidakamizwa ze-IUD noma i-Nexplanon yezingane.
Ngokudabukisayo, ukuhlola kwezintsha ezise-United States kubonisa ukuthi intsha ikwazi ulwazi oluncane kakhulu ngama-IUDs. Ucwaningo olulodwa lwamantombazane angu-72 oluphakathi kweminyaka engu-14 kuya ku-18 lubonise ukuthi nakuba amaphesenti angama-74 ayesebenzisa ukulawulwa kokubeletha, kuphela amaphesenti angu-19 awake wezwa nge-IUDs. Ngemva kokufundiswa ekulawuleni i-IUD, iningi lezingane zithi zithande iqiniso lokuthi ukusetshenziswa kwe-IUD :
- Akulimazanga kamuva ukuzala
- Kudinga ukusetshenziswa kwansuku zonke
- Kwakungadingeki ngesenzo ngasinye socansi
- Wayehlakaniphile
Intsha kudingeka ifundiswe ngokuphumelela okuphezulu kwezinqubo zokuvimbela ukukhulelwa ezindala ezinjenge-IUD zokulawulwa kokuzalwa, kanye ne-Nexplanon.
Okushiwo odokotela
I-ACOG isanda kubuyekezwa i-Practice Bulletin yayo yokubhekana nesidingo sezinyathelo zokuvimbela ukukhulelwa ezingasetshenziswa isikhathi eside ezinganeni.
Ngokusho kwe-ACOG, i-Nexplanon kanye ne-IUD ukusetshenziswa kokulawulwa kokuzalwa kungasiza intsha. Nakuba lezi zindlela zokukhokha zishaya, umkhuba wangempela wokufaka i- IUD ne-Nexplanon osemusha awunjalo. Intsha eningi isivele inikezwe ngalezi zinketho zokulawula ukuzalwa, ngakho-ke imihlahlandlela yomkhuba ekugcineni ibambelele kulokho okwenziwe umphakathi wezokwelapha iminyaka.
IUD Ukulawula Ukuzalwa Kusetshenziswa Kwabancane
I-ParaGard , i- Skyla , i- Kyleena , ne- Mirena - la ma-IUD ahlukaniswa ngaphansi kweSigaba 2 se-US Medical Eligibility Criteria yokusetshenziswa kokukhulelwa. Lokhu kusho ukuthi izinzuzo zokusebenzisa lezi zindlela zokuvimbela ukuvimbela izingozi. Ukusetshenziswa kwe-IUD sekuthole isigaba sesibili ngenxa yokukhathazeka okuthile ngenhlekelele yokuxoshwa (lapho i-IUD ingena noma ishicilela ngokuphelele ngaphakathi kwesibeletho), okungabangelwa yi- nulliparity (engakaze ibelethe), kanye nengozi ye-STI ukuziphatha kocansi okuyingozi uma kuqhathaniswa namaqembu ezindala. Ukusetshenziswa kwe-Nexplanon ebusheni sekuthole ukuhlukaniswa kwesigaba 1 - lokhu kusho ukuthi akukho mingcele yokusebenzisa indlela yokulawula ukuzalwa.
Okushiwo Ucwaningo
Ngeshwa, kunamabhuku amancane kakhulu ku-Nexplanon noma ku-IUD ukusetshenziswa kokulawulwa kokuzalwa kubantu abasha, ngakho-ke ucwaningo oluningi luyadingeka ukuze kube nemiphumela engcono, eningiliziwe. Lokhu kuthiwa, ezinye izifundo zikhona, futhi imiphumela yabo iyathembisa.
Ukubuyekezwa okujulile okubheke ekusetshenzisweni kwe-IUD kwabasencane bathola ukuthi amazinga okuxoshwa ahlala kabanzi - kusuka kuma-5% kuya kuma-22 amaphesenti. Lezi zindleko zingahle zidukise ngoba amanani abonakala ashintshwe yiminyaka yakho nokuthi ngabe uke wakhulelwa noma cha.
Ngaphezu kwalokho, ucwaningo olutholakalayo lubonisa imiphumela engavumelaniyo. Isibonelo, ezinye izifundo ziveza ukuthi abesifazane abangakaze babelethe banezimo eziningi zokuxoshwa kwe-IUD, kanti ezinye iziphakamiso zisho ukuthi labo ababelethile babika izinga eliphezulu lokuxoshwa. Akekho kulezi zifundo ezicatshangelwe ukuthi inhlanganisela yobudala kanye nomlando wokukhulelwa kungenzeka ukuthi uthonye kanjani imiphumela.
Intsha nayo ingase iqhubeke nokusebenzisa ukusetshenziswa kwe- IUD kokuzalwa kunokunye nezinye izindlela. Inani labasha abasasasebenzisa i-IUD ngonyaka ongu-1 liphakeme (kusukela kumaphesenti angu-48 kuya kuma-88%), futhi ukusetshenziswa kwabo kwe-IUD kunciphise kancane isikhathi.
Intsha iqhubeka nokusetshenziswa kwayo kwe-IUD ngesilinganiso esifanayo noma ngisho nangaphezulu kunabasha abasebenzisa amaphilisi okulawula ukuzalwa .
Ukukhulelwa kwakungavamile phakathi kwabasebenzisi abasebasha be-IUD yokulawula izingane. Ucwaningo oluthile oluqhathanisa izinga lokukhulelwa kwentsha lithole ukuthi (emva kwezinyanga ezingu-24 zokusetshenziswa okuqhubekayo), intsha esebenzisa i-IUD yethusi (i-ParaGard) ibike ukuthi ayikho ukukhulelwa, kuyilapho amaphesenti amathathu wabasebenzisi bepilisi yokubeletha abasha asekhulile. Olunye ucwaningo lwathola ukuthi izinga lokukhulelwa kwentsha lenyuke ngamaphesenti amabili emva kwezinyanga eziyisithupha ze-IUD zisebenzisa ama-11 amaphesenti ezinyangeni ezingu-48 zokuba i-IUD.
Esinye sokukhathazeka kokugcina ukuthi ucwaningo luye lwaveza mayelana nokusetshenziswa kwe-IUD lokulawula izingane zokuzalwa kwentombazane. Ucwaningo lubonise ukuthi ukufakwa okubuhlungu noma okunzima kwe-IUD kuyinkinga enkulu kubasha. Lokhu kungaba ngoba ingane engakaze ibelethe ngaphambili. Kunezenzo odokotela abangayithatha ukuze basize ekunciphiseni abanye balabu buhlungu, kodwa lezi zindlela azange ziboniswe ukuthi zihlale zihlinzeka ukuphumula kobuhlungu ngesikhathi sokufaka i-IUD. Ama-IUD amasha ama-Iike Skyla no-Kyleena anezibhamu ezincane zokufaka, ngakho-ke ubuhlungu obufakiwe bungase bube buncane ngalezi zikhetho.Ukuhlola kubonise nokuthi ubuhlungu nokuphuma kwegazi yizizathu eziningi zentsha yokuba iParaGard IUD yabo isuswe. Ucwaningo olulodwa lwaqokomisa ukuthi abasebenzisi abaningi be-IUD bakhononda kanjani ngezinkinga zokuphuma kwegazi kunokusebenzisa abasebenzisi bepilisi abasha.
Ukucwaninga Nge-Teenage Nexplanon Ukusetshenziswa Kungaphezu Kakhulu
Ngo-2010, isifundo senziwa kwabangu-137 abasha (abaneminyaka engu-12-18 ubudala) ababevele babeletha. Kwaqhathanisa ukubekezelelana, ukuqhubeka, nokuphindaphinda izinga lokukhulelwa kwabasilisa abasebenzisa i-Implanon, amaphilisi okulawula ukuzalwa , uDepo Provera , izindlela zokuvimbela (njengezikhondomu kanye ne- spermicide ), noma lutho.
Ngezinyanga ezingu-24, amaphesenti angu-35 alabo asebasha asekhulelwe futhi. Abasebenzisi be-Teenage Nexplanon bekhulelwe kamuva kunamanye amaqembu okulawula ukubeletha (ngokukhulelwa kokuqala kokuqala ezinyangeni ezingu-23.8, uma kuqhathaniswa nezinyanga ezingu-18.1 zeqembu lesipilisi / depo kanye nezinyanga ezingu-17.6 zokuvimbela / iqembu elilodwa). Abasebenzisi base-Implanon nabo babekhona amathuba okuqhubeka nokusebenzisa i-Implanon ezinyangeni ezingu-24 kunabasebenzisi bephilisi / abasebenzisa i-depo.
Kulabo abasebasha ababenayo i-Nexplanon ngaphambi kwezinyanga ezingu-24 zokusetshenziswa, amaphesenti angu-40 athi ukuphuma okungavamile kwakuyisizathu sokuyeka. Lokhu kuthiwa, abacwaningi baphetha ngokuthi intsha enquma ukusebenzisa i-Nexplanon ayinamathuba amancane okukhulelwa futhi atholakele ukunamathela kule ndlela yokulawula ukubeletha isikhathi eside kunelabo abakhetha ezinye izindlela zokuvimbela ukukhulelwa.
Ukuhlaziywa kokugcina
Ngisho noma izincwadi ezise-Nexplanon kanye ne-IUD zokulawula izingane ziswele kakhulu, izifundo ezitholakalayo zikhomba ukuthi ama-IUD njengeMirena, Skyla, Kyleena, ne-ParaGard, kanye ne-Nexplanon, yizinketho ezisebenzayo ezinganeni zanamuhla. Ukukhuthaza ukusetshenziswa kwentsha yezinqubo zokulawula ukubeletha okuguquguqukayo isikhathi eside kungasiza ekunciphiseni inani lokukhulelwa okungakalungiselelwa kwentsha. Inombolo ephezulu yabasha abambelela kwi-Nexplanon kanye ne-IUD yabo isebenzisa ithemba, futhi intsha ingase ivumelane nalezi zindlela zokulawula ukuzalwa.
Imikhombandlela yomkhuba eyenziwe i-ACOG ibonisa ukuthi ama-IUD kanye ne-Nexplanon kufanele aphakanyiswe ezinganeni njengezinketho zokulawulwa kokuzalwa okungenzeka. Izinzuzo nezinzuzo ze-ParaGard, iMirena, Skyla, kanye / noma uKyleena intsha ngokuvamile zivimbela izingozi ezingenzeka, futhi ayikho imikhawulo ekusetshenzisweni kwe-Nexplanon entsheni. Ngenxa yalokhu, kubonakala sengathi lezi zindlela zokulawula ukubeletha okuphumelelayo nezinokwethenjelwa okufanele zinikezwe abasha abafuna ukukhulelwa kwemithi emitholampilo yokuhlela umndeni noma amahhovisi odokotela wendawo.
Imithombo:
Ikhomishana YaseMelika Yezinambuzane Nezazi ZamaGynecologists. "I-Bulletin Yokuzivocavoca # 121 - Ukubeletha Okubuyiselwayo Okude Kwakudala: Izimpande namadivayisi we-Intrauterine." I-Obstetrics & Gynecology . Julayi 2011. 118 (1): 184-196.
Ama-Dean, i-EI, ne-Grimes, i-DA "Amadivaysi E-Intrauterine Ye-Adolescents: Ukubuyekezwa Okuhlelekile." Ukubeletha . 2009. 79: 418-423.
Lewis, LN, Doherty, DA, Hickey, M., & Skinner, SR "Implanon njengoKhetho Lokukhulelwa Kwabesifazane Abasha: Ukuqhathaniswa Kwezinketho Zokukhulelwa, Ukwamukela futhi Ukuphinda Ukukhulelwa." Ukukhulelwa. 2010. 81 (5): 421-426.
I-World Health Organization. "Imithi Yokufaneleka Yokunakekelwa Kwezokwelapha Zokusetshenziswa Kokukhulelwa." I-4th ed. I-Geneva: WHO; 2009.