Ungayisebenzisa yini i-IUD Uma Ungakaze Uveze Ukuzalwa?
Ngesikhathi i- ParaGard IUD iqala ukudayiswa e-US ngo-1988, ilebula lomkhiqizo iqukethe isigaba esibonisa ukuthi le-IUD yanconywa ngabesifazane abaye okungenani babe nengane eyodwa. Ngeshwa, le ilebula yomkhiqizo ivinjelwe ukusetshenziswa kwe- IUD kumabhinqa angama-nulliparous (abesifazane abangakaze babe nabantwana).
Ngo-2005, i-FDA yamukele ilebula elisha lomkhiqizo we-ParaGard ukuvimbela okunye ukuvimbela ukusetshenziswa kwe-IUD ngabesifazane abangakaze babelethe.
Le ilebula entsha isuse noma yiluphi ulwazi olubonisa ukuthi abalingani be- IUD banqunyelwe kulabo abanezingane eziningi noma ngaphezulu.
Njengamanje, ilebula ye- Mirena IUD isacacisa ukuthi kuhloswe ngabesifazane abaye babe nomntwana oyedwa, kodwa umkhiqizi uphinde uthi lokhu kungenxa yokuthi iningi locwaningo olwenziwa eMirena lwe-FDA imvume lwenziwa kwabesifazane ababesencane ingane eyodwa.
Iyini i-ACOG?
I-Practice Bulletin yakamuva ekhishwe yi-American College of Obstetricians and Gynecologists (i-ACOG) iphakamisa ukuthi bobabili abesifazane abadala nabasakhulayo abangakwazi ukuzala bangathola inzuzo ekusetshenzisweni kwe-IUD. Eqinisweni, odokotela abaningi kanye nezibhedlela zokufundisa bebelokhu befaka ama-IUD kulezi zindawo iminyaka eminingi, ngakho-ke izincomo ezintsha ze-ACOG empeleni zibonisa lokho okwenzekile kakade ezweni langempela.
I-US Medical Eligibility Criteria Yokusebenzisa Ukukhulelwa Ihlukanisa ukusetshenziswa kwe-IUD kwabesifazane nabasakhulayo abangenawo wonke ama-ParaGard ne-Mirena ngaphansi kwesigaba 2.
Lokhu kusho ukuthi izinzuzo zokusebenzisa imithi yokwelapha ngokuvamile zidlula izingozi.
Ucwaningo Luthini?
Izincwadi zamuva ziphakamisa ukuthi ama-IUD asebenza kahle futhi abe namanani aphezulu okwaneliseka kwabesifazane abangenalo ingane uma kuqhathaniswa nephilisi lokulawula ukuzalwa .
Esicwaningweni sonyaka ongu-1 (samadoda angama-200 angama-nulliparous abaneminyaka engama-18-25 efuna ukukhulelwa kwezingane ), cishe ingxenye yabesifazane bakhetha ukusebenzisa i-Mirena kanti enye ingxenye yakhetha iphilisi. Njengoba amaphesenti angu-27 kulaba besifazane ekliniki yokulawula ibelethi ayeka ukusetshenziswa phakathi nonyaka, kuphela 20% yabasebenzisi baseMirena abayekile. Kulesi sifundo, abaningi besifazane eqembu leMirena (ngokumelene nalabo ababeseqembu lamaphilisi okulawula ukuzalwa) babika ukuthi indlela yabo yokukhulelwa yayisimweni esihle kakhulu. Ubuhlungu bekungesizathu esivame ukushiwo sokukhishwa kwe-Mirena IUD nokuyeka, ngenkathi imiphumela emibi ye-hormonal yimbangela enkulu yokuthi abasebenzisi bepilisi bakhetha ukuyeka. Lolu cwaningo luphetha ngokuthi ukuphepha nokwamukelwa kweMirena kwabesifazane abangakaze babelethe kubonakala sengathi kuhle njengephilisi, ngenani eliphakeme lokusetshenziswa okuqhubekayo.
Ukucwaninga kwesinye isifundo kuhlolisise idatha etholakalayo mayelana nokukhathazeka kwabantu besifazane ngokungahambisani nokusetshenziswa kwe-IUD (njengokusebenza kahle, ukuphepha, ingozi ye-PID, imiphumela emibi, njll). Ngemuva kokuhlola ucwaningo olukhona, lolu cwaningo luye lwathola ukuthi ama-IUD anezinga eliphansi lokungaphumeleli elingaphansi kwabesifazane abangenalutho futhi abahlukumezayo (ngakho basebenza ngokulinganayo kuzo zombili izimbangi ) futhi ababangeli i-PID noma ukungabi namuntu .
Futhi, abesifazane abangenalutho baqhubeka nokusetshenziswa kwabo kwe-IUD kumazinga afanayo noma aphezulu okusetshenziswa uma kuqhathaniswa nabesifazane abasebenzisa ezinye izindlela zokuvimbela ukukhulelwa. Abalobi basikisela ukuthi i-Mirena IUD ingase ibekezeleleke kangcono kunabesifazane abangenayo i-ParaGard ngokusekelwe emazingeni aphansi okuxoshwa (lapho i-IUD ingena noma iphuma ngokuphelele ngaphakathi kwesibeletho) futhi iphuma kancane ( njengomphumela wecala ). Bayaqaphela nokuthi ukufakwa kwe-IUD kungase kube nzima kunabesifazane abangenalutho. Kodwa, ngokugcwele, lolu cwaningo lucacise ukuthi abesifazane abangenalutho abafuna ukukhulelwa ngokweqile kufanele babhekwe njengabazongena kwi-Mirena noma i-ParaGard nokuthi ngenxa yezinzuzo zokusetshenziswa kwe- IUD , odokotela akufanele badikibale ekunikezeni i-IUD njengendlela yokuqala yokukhulelwa kokubeletha lesi sibalo.
Ukubuyekezwa kwezincwadi ezenziwe ngethusi lwe-IUD phakathi kwabesifazane abangenalutho kwenziwa ukuhlaziya ulwazi ngokukhishwa kwamazinga nokukhishwa ngenxa yokuphuma kwegazi kanye nobuhlungu. Imiphumela ibonisa ukuthi amanani okuxoshwa kokubili iMirena ne-ParaGard afana ngokufanayo nabesifazane abangenasidlangalaleni kanye nabasondelene nabo. Lokhu kuthiwa, kubonakala sengathi izinga lokuxoshwa lingase liphakeme kangcono kubasebenzisi abasebenzisa i-ParaGard uma kuqhathaniswa nabasebenzisi abanobuqili abasebenzisa le-IUD efanayo.
Imiphumela emibi kakhulu ebikwe ukusetshenziswa kwe-ParaGard kwabesifazane abangenalutho kwaba nobuhlungu nokukhuphuka kokuya esikhathini. Abesifazane abahlukumezekile abasebenzisa i-Mirena ngokuvamile babika ukuthi akukho zikhathi noma ukuphuma kwesikhashana ukuphuma esikhathini, kodwa ukungaqapheli okungaqondakali phakathi kwezinkathi. Ukucwaninga kubonisa ukuthi abesifazane abangenalutho bangase babe namanani aphezulu okukhishwa kwe-ParaGard ngenxa yokuphuma kwegazi kanye nobuhlungu uma kuqhathaniswa nabesifazane ababelethile. Lezi zindleko zaqala kusuka ku-9.1% kuya ku-24% kwizifundo eziningi. Kodwa-ke, abesifazane abangenayo i-nulliparous ngokuvamile babika amazinga aphezulu okwaneliseka ngokusetshenziswa kwe-IUD.
Ukuvumelana?
Ukucwaninga okujwayelekile kocwaningo ukuthi i-IUD yokuqhubeka kwamazinga kwabesifazane abangenayo ingane aphezulu. Ukwengeza, i-ParaGard ibonakala iyindlela enhle yokwelapha yokuqala kokubeletha kwabesifazane abangakwazi noma abangafuni ukusebenzisa ukuvimbela ukubeletha kwe-hormonal .
Imikhombandlela yokusebenza ye-ACOG ivuma ukuthi ngisho noma owesifazane engakaze abelethe, angakwazi futhi kufanele anikezwe izindlela zokuvimbela ukukhulelwa okuqhubekayo ezinjenge-IUDS. Izinzuzo kanye nezinzuzo zeParaGard kanye / noma iMirena IUD esebenzisa kulaba besifazane ngokuvamile ngokungafani nezinselele zemfundiso noma ezifakazelwe, ngakho-ke lezi zilungile, izinketho zokulawulwa kokuzalwa okufanele zinconywe kwabesifazane ukuthi ngabe bangenayo ingane noma cha.
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. Kufinyelelwe ngokubhalisa kwangasese.
I-Hubacher, D. "Idivayisi ye-Copper intrauterine esebenzisa abesifazane abangenalutho: Ukubuyekezwa kwemiphumela emibi." Ukubeletha . 2007. 75 (6 okusekelayo): S8-11. Kufinyelelwe ngokubhalisa kwangasese.
Society of Guideline Planning 2009. "Ukusetshenziswa kweMirena LNG-IUS neParard CuT380A amadivaysi angaphakathi kwe-intrauterine kuma-nulliparous abesifazane." Ukwelashwa . 2010. 81 (5): 367-371. Kufinyelelwe ngokubhalisa kwangasese.
U-Suhonen S, u-Haukkamaa M, Jakobsson T, uRauramo I. "Ukusebenza kwemitholampilo ye-levonorgestrel-ukukhulula uhlelo lwe-intrauterine kanye nokukhulelwa komlomo kwabesifazane abasha abangenalutho: Ucwaningo lokuqhathaniswa. 2004. 69 (5): 407-412. Kufinyelelwe ngokubhalisa kwangasese.
I-World Health Organization. "Indlela yokufaneleka kwezokwelapha yokusetshenziswa kokukhulelwa. "4th ed. I-Geneva: WHO; 2009. Kufinyelelwe ngoJulayi 12, 2011.