Kodi Mungagwiritse Ntchito Zopanda Phindu Ngati Simunaperekepo Kubadwa?
Pamene ParaGard IUD idagulitsidwa koyamba ku US mu 1988, chizindikiro cha mankhwalacho chinali ndi chigawo chosonyeza kuti IUD iyi ikuvomerezedwa kwa amayi omwe ali ndi mwana mmodzi. Mwamwayi, chilembo cha mankhwalawa chimalepheretsa kugwiritsa ntchito IUD muzimayi omwe sali ndi ana.
Mu 2005, a FDA adavomereza chizindikiro cha ParaGard kuti asathenso kugwiritsidwa ntchito kwa amayi omwe sanaberekepo.
Dzina lachilendoli linachotsa chidziwitso chilichonse chosonyeza kuti anthu omwe ali ndi chiwerengerochi amafunika kukhala ochepa kwa omwe ali ndi ana kapena ana ambiri.
Pakalipano, chizindikiro cha Mirena IUD chimanenabe kuti cholinga cha amayi omwe ali ndi mwana mmodzi yekha, komabe wopanga amatinso izi ndi chifukwa chakuti kufufuza kwambiri pa Mirena kwa FDA kuvomerezedwa kwa amayi omwe anali ndi mwana mmodzi.
Kodi ACOG Imati Chiyani?
Maphunziro Amakono Opangidwa ndi American College of Obstetricians ndi Gynecologists (ACOG) amasonyeza kuti amayi akulu ndi achinyamata omwe sanabereke angapindule ndi ntchito ya IUD. Ndipotu, madokotala ambiri ndi zipatala zophunzitsa akhala akuyika ma CDs kwa anthuwa kwa zaka zambiri, choncho ndondomeko zatsopano za ACOG zimakhala zenizeni za zomwe zakhala zikuchitika mu dziko lenileni.
Njira Zogwiritsira Ntchito Zamankhwala Zovomerezeka Zogwiritsira Ntchito Kugonana zimagwiritsira ntchito ntchito ya IUD mu akazi omwe ali ndi nulliparous komanso achinyamata kwa ParaGard ndi Mirena pansi pa Gawo 2.
Izi zikutanthauza kuti ubwino wogwiritsira ntchito njira za kulera ndi wosiyana kwambiri ndi zoopsa.
Kodi Kafukufuku Amati Chiyani?
Mabuku atsopano amanena kuti ma IUDs ndi othandiza kwambiri ndipo ali ndi chiwerengero chokwanira kwa amayi omwe alibe mwana poyerekeza ndi mapiritsi oletsa kubereka .
Mu kafukufuku wa zaka 1 (azimayi 200 osakwatiwa omwe ali ndi zaka 18-25 akufuna njira zobereka ), pafupifupi theka la amayi adasankha kugwiritsa ntchito Mirena ndipo theka lina anasankha mapiritsi. Amayi 27% pa gulu la mapiritsi oletsa kubala analeka ntchito pachaka, koma 20% mwa osuta a Mirena anasiya. Mu phunziro ili, amayi ambiri mu gulu la Mirena (motsutsana ndi iwo omwe anali mu gulu la mapiritsi oletsa kubadwa) adanena kuti njira yawo yoberekayo inali yabwino kwambiri. Ululu ndi chifukwa chomwe chimatchulidwa chifukwa cha Mirena IUD ndikuchotseratu , pamene zotsatira za mavitamini zinali chifukwa chachikulu chomwe olemba mapiritsi akusankha kuti asiye. Phunziroli linatsimikizira kuti Mirena ndi otetezeka mwa amayi omwe sanaberekepo anawonedwa kuti ali ngati mapiritsi, omwe ali ndi chiwopsezo chachikulu chogwiritsa ntchito.
Kafufuzidwe kafukufuku wina adafufuza deta yomwe ilipo pokhudzana ndi nkhawa za amayi omwe sagwiritsidwa ntchito pa ntchito ya IUD (monga mphamvu, chitetezo, ngozi ya PID, zotsatira zake, etc.). Pambuyo pofufuza kafukufuku amene alipo kale, kafukufukuyu anapeza kuti ma IUDs ali ndi chiwerengero chochepa chotere cholephera ku nulliparous ndi azimayi amodzimodzi (kotero iwo ali othandiza mofanana pakati pa anthu onse) ndipo samayambitsa PID kapena infertility .
Komanso, akazi omwe sagwiritsa ntchito mankhwalawa amapitiriza kugwiritsa ntchito njira zawo zogwiritsira ntchito poyerekeza ndi amayi omwe amagwiritsira ntchito njira zina zowononga. Olembawo akusonyeza kuti Mirena IUD ikhoza kuloledwa bwino kwambiri kwa akazi omwe ali ndi nulliparous kuposa ParaGard chifukwa cha kuchepa kwa chiwopsezo chotsika (pamene IUD pang'onopang'ono kapena kuchoka mu chiberekero) komanso kutaya magazi ( monga mbali yotsatira ). Ayeneranso kuchenjeza kuti kulemba kwa IUD kungakhale kovuta kwambiri kwa akazi omwe sali nawo. Koma, mwachidule, phunziroli linalangiza kuti amayi omwe sali ndi vuto lofuna kubereka ayenera kuonedwa kuti ndi ovomerezeka ku Mirena kapena ParaGard ndipo chifukwa cha ubwino wogwiritsira ntchito mankhwalawa , madokotala sayenera kukhumudwa kupereka zopereka zapadera monga chithandizo choyamba choletsa kulera chiwerengerochi.
Kubwereza kwa zolembedwa za ntchito yamkuwa ya mkuwa pakati pa akazi osakwatiwa anachitidwa kuti afufuze zambiri zokhudza kuchotsedwa ndi kuchotsedwa chifukwa cha magazi ndi ululu. Zotsatira zimasonyeza kuti chiwopsezo cha Mirena ndi ParaGard ndi chimodzimodzi mwa akazi omwe sali paulendo komanso amodzi. Izi zikunenedwa, zikuwoneka kuti kuchuluka kwa kuthamangitsidwa kungakhale kochepa kwambiri kwa ogwiritsa ntchito omwe sagliparous omwe amagwiritsa ntchito ParaGard poyerekeza ndi ogwiritsa ntchito omwe amagwiritsira ntchito mankhwalawa.
Zotsatira zambiri zomwe zimawoneka kuti ntchito ya ParaGard mwa amayi omwe sali paulendo ndikumva kupweteka komanso kuwonjezeka kwa msambo. Azimayi omwe sagwiritsa ntchito mankhwala omwe ankagwiritsa ntchito Mirena nthawi zambiri amawauza kuti palibe nthawi kapena kutuluka kwa magazi kumaliseche, koma nthawi yosadziwika. Kafukufuku amasonyeza kuti akazi omwe ali ndi HIV amatha kukhala ndi chiwerengero chachikulu cha ParaGard kuchotsedwa chifukwa cha magazi ndi ululu poyerekeza ndi amayi omwe abereka. Mitengoyi inalipo 9.1% mpaka 24% mu maphunziro ambiri. Komabe, amayi omwe sali paulendo amapereka umboni wokhutira ndi kugwiritsa ntchito mankhwala osokoneza bongo.
Kugwirizana?
Chiwerengero cha kafukufuku wokhudzana ndi chiwerengero cha amayi omwe alibe mwana ali pamwamba. Kuwonjezera apo, ParaGard ikuwoneka kuti ndi njira yoyenera yobereka njira yoyenera kubereka kwa amayi omwe sangathe kapena sakufuna kugwiritsa ntchito mankhwala opatsirana pogonana .
Machitidwe a ACOG amavomereza kuti ngakhale ngati mayi asanabadwe, akhoza ndipo ayenera kupatsidwa njira zowonetsera njira zowononga nthawi yaitali monga IUDS. Mapindu ndi ubwino wa ParaGard ndi / kapena Mirena IUD amagwiritsidwa ntchito mwa amayiwa nthawi zambiri kuposa zovuta zenizeni kapena zowonetsera, kotero izi ndi zabwino, njira zoyenera zothandizira kubereka zomwe ziyenera kuyamikiridwa kwa amayi ngati alibe kapena ayi.
Zotsatira:
Kalasi ya Amerika Yotsutsa Amayi ndi Amuna a Gynecologists. "Muzigwiritsa Ntchito Bulletin # 121 - Kuchita Kubereka Kotheka Kwambiri Kuyambira Kale: Implants ndi Devotuterine Devices." Zovala zamaliseche & Gynecology . July 2011. 118 (1): 184-196. Idapezeka kudzera mwachinsinsi.
Hubacher, D. "Chitsulo cha intrauterine chomwe chimagwiritsidwa ntchito ndi amayi omwe sali pakati pawo: Kubwereza zotsatira zoyipa." Kulera . 2007. 75 (6): S8-11. Idapezeka kudzera mwachinsinsi.
Mndandanda wa Njira Zowonetsera Zokonza za Pakhomo 20092. "Kugwiritsira ntchito Mirena LNG-IUS ndi Paragard CuT380A zipangizo zamakina operekera m'mimba mwa amayi omwe sali operewera." Kulera . 2010. 81 (5): 367-371. Idapezeka kudzera mwachinsinsi.
Suhonen S, Haukkamaa M, Jakobsson T, Rauramo I. "Kupititsa patsogolo ntchito ya levonorgestrel-kutulutsa intrauterine ndondomeko ndi njira zothandizira kulera m'mimba mwa atsikana omwe sali achikazi: Kuphunzira mofanana. 2004. 69 (5): 407-412. Idapezeka kudzera mwachinsinsi.
Bungwe la World Health Organization. "Njira zoyenera zachipatala zogwiritsira ntchito njira za kulera. "4th ed. Geneva: WHO; 2009. Inapezeka pa July 12, 2011.