Unogona Kushandisa IUD Kana Iwe Usati Wambopa Kuberekwa?
Apo ParaGard IUD yakatanga kutengeswa muUnited States muna 1988, chikwata chacho chaiva nechikamu chinoratidza kuti iyi IUD yakakurudzirwa kuvakadzi vane vana vangangodaro. Zvinosuruvarisa, chikwata ichi chinoregererwa IUD inoshandiswa mune vakadzi vasiri nhengo (vakadzi vasina kumbova nevana).
Muna 2005, FDA yakagamuchira tsamba itsva yemiti yeParaGard kuti isadzivirire kushandiswa kweIUD kushandiswa nevakadzi vasina kumboberekwa.
Ichi chitsva chakanyorwa chakabvisa chero ruzivo ruchireva kuti vashandi veIUD ndivo vanogona kuve kune avo vane vana kana vana.
Pari zvino, iyo zita reMirena IUD rinoramba richireva kuti rakakonzerwa nevakadzi vane mwana muduku, asi muiti anotaura zvakare kuti izvi ndezvokuti vazhinji vekutsvakurudza pamusoro peMirena kweDAA kugamuchirwa kwakaitwa kune vakadzi vaiva mwana mumwe.
Chii chinonzi ACOG?
Ikozvino Practice Bulletin yakabudiswa neAmerican College of Obstetricians uye Gynecologists (ACOG) inoratidza kuti vose vakadzi vakuru nevechiri kuyaruka vasina kuberekwa vanogona kubatsirwa nekushandisa IUD. Zvechokwadi, vanachiremba vazhinji uye kudzidzisa zvipatara vave vachiisa maIUDs kune vanhu ava kwemakore, saka mazano matsva eAACOG anonyatsoratidza izvo zvatove zvichiitika munyika chaiyo.
Maitiro eUnited Medical Eligibility Criteria for Contraceptive Use anoshandura kushandiswa kweIUD mumadzimai nevechiri kuyaruka vari pakati peParaGard neMirena pasi peChikamu 2.
Izvi zvinoreva kuti zvakanakira kushandisa chirongwa chekudzivirira zvinowanzopfuura zvinetso.
Kutsvakurudza Kunoti Chii?
Mazuva ano mabhuku anotsanangura kuti IUDs inoshanda zvakanyanya uye ine mazinga akakwirira ekugutsikana kuvakadzi vasina kumbova nemwana kana vachienzaniswa nepiritsi yekuzvidzivirira .
Muchidzidzo chemakore 1 (chevakadzi makumi maviri nemakumi mapfumbamwe nemakumi mapfumbamwe nemakumi mapfumbamwe nemashanu vari kutsvaga kubata pamuviri ), inenge hafu yevakadzi vakasarudza kushandisa Mirena uye imwe hafu yakasarudza mapiritsi. Kunyange zvazvo 27 muzana yevakadzi mupiritsi yekuberekwa kwekuberekwa yakamira kushandiswa mukati megore, 20% chete yevashandi veMirena vakaguma. Muchidzidzo ichi, vazhinji vevakadzi vari muboka reMirena (vese avo vaiva mupiritsi yekuberekwa kwepiritsi) vakataura kuti nzira yavo yekudzivirira kubata pamuviri yakanga yakaisvonaka zvakanaka. Nhamo yakanga iri chikonzero chinowanzotaurwa pamusoro peMirena IUD kubviswa uye kuregererwa, asi maitiro emadononi aiva chikonzero chikuru nei mapiritsi avasarudza vakasarudza kumira. Ichi chidzidzo chakagumisa kuti kuchengetedza uye kugamuchirwa kweMirena kuvakadzi vasina kumboberekwa kwakaratidzwa kuti kwakanaka sepiritsi, nehuwandu hunoramba huchishandiswa.
Kutsvakurudza kuno rumwe ruzivo rwakarongedza ruzivo rwakakosha pamusoro pekunyanya kwevakadzikadzi nehupfumi pamusoro pekushandisa kweIUD (sekubudirira, kuchengeteka, PID ngozi, migumisiro, nezvimwewo). Mushure mokuongorora tsvakurudzo dziripo, chidzidzo ichi chakawana kuti IUDs yakafanana nekuderera kukundikana kwemazana emadzimai evanhurume uye evanhu vanokonzera mhirizhonga (saka ivo vanoshanda zvakaenzana mune vanhu vose) uye havaiti kuti PID kana kuti kushaya simba .
Uyezve, vakadzi vasingasviki vanoenderera mberi vachishandisa maitiro avo ekuenzanisa kana kuwedzerwa kwekushandisa sekuenzaniswa nevakadzi vanoshandisa dzimwe nzira dzokudzivirira kubata pamuviri. Vanyori vanoratidza kuti Mirena IUD inogona kubvumirwa zviri nani muvakadzi vasina nulliparous kupfuura ParaGard zvichienderana nekudzingwa kwepasi kuderera (apo IUD zvishoma kana kuti inopera zvachose mukati mechibereko) uye kuderera kudarika ( semagetsi ). Vanonyeverawo kuti IUD kuisa inogona kuva yakaoma kune vakadzi vasiri nhengo. Asi, zvakazara, chidzidzo ichi chakarayira kuti vakadzi vasiri nhengo vanoda chibereko chekudzivirira kwakanaka kunofanirwa kuonekwa sevatsva veMirena kana ParaGard uye nekuda kwezvibatsiro zvekushandisa kweUUD , vanachiremba havafaniri kuora mwoyo kubva kupa IUDs sarudzo yekutanga yekudzivirira kubata pamuviri ichi chizvarwa.
Kuongororwa kwemabhuku emhangura yekushandisa IUD pakati pevakadzi vasina kukwana kwakaitwa kuti vaongorore ruzivo pamusoro pokudzingwa kwemazinga uye kubviswa nekuda kwekubuda ropa nekurwadziwa. Migumisiro inoratidza kuti kudzingwa kwemitemo yeMirena neParaGard yakangofanana zvakafanana nevakadzi vasiri nhengo uye vanopesana. Izvo zvataurwa, zvinoratidzika kuti muzinga wekudzingirwa ungave wakanyanya kudarika kune vashandisi vese vasingashandisi vanoshandisa ParaGard kana vachienzaniswa nevashandisi vanonyadzisa vanoshandisa iyi IUD iyo.
Zvipembenene zvinowanzoonekwa zvinoshandiswa pakushandiswa kweParaGard mumadzimai asingaverengeki marwadzo uye kuwedzera kumwedzi kunobuda ropa. Vakadzi vasingasviki vakashandisa Mirena kazhinji vaiudza kuti hapana nguva kana kujekesa kuenda kumwedzi kunopa ropa, asi kunonoka kuonekwa pakati pezviitiko. Kutsvakurudza kunoratidza kuti vakadzi vane nulliparous vanogona kunge vane mazinga akakwirira eParaGard kubviswa nekuda kwekuchenesa uye kurwadziwa kana vachienzaniswa nevakadzi vakaberekerwa. Izvi zviyero zvakabva pa9.1% kusvika ku24% mune zvidzidzo zvakawanda. Zvisinei, vakadzi vasingasviki vanowanzoburitsa huwandu hwekugutsikana huwandu nekushandiswa kweIUD.
The Consensus?
Izvo zvakanyanya kutsvakurudza kubvumirana ndeyokuti IUD kuenderera mberi kwehuwandu hwevakadzi vasina kumbova nevana vakakwirira. Uyezve, ParaGard inoratidzika seyakanaka yekutanga yekudzivirira kubata pamuviri kuvakadzi vasingakwanisi kana vasingadi kushandisa mushonga wokudzivirira kubata pamuviri .
ACOG inodzidzisa mazano anobvumirana kuti kunyange kana mukadzi asati aberekwa, anogona uye anofanira kupiwa nzira dzekuita zvekudzivirira kwenguva refu dzakadai seIUDS. Izvo zvinobatsira uye zvinobatsira zveParaGard uye / kana Mirena IUD zvinoshandiswa mune vakadzi ava kazhinji zvinopfurikidza nezvengozi dzedzidziso kana kuti dzinopupurirwa, naizvozvo izvi zvakanaka, nzira dzakanaka dzekuberekwa kwekuberekwa dzinofanira kukurudzirwa kuvadzimai kana vasina vana.
Sources:
American College yezvipfeko uye Gynecologists. "Practice Bulletin # 121 - Kubata-Kubata Kwekuita Zvokudzivirira Kuberekwa: Implants uye Intrauterine Devices." Obstetrics & Gynecology . July 2011. 118 (1): 184-196. Inowanikwa kuburikidza nehurumende yekunyoresa.
Hubacher, D. "Copper intrauterine device inoshandiswa nevakadzi vasiri nhengo: Ongororo yemigumisiro." Kubata pamuviri . 2007. 75 (6 kubatsira): S8-11. Inowanikwa kuburikidza nehurumende yekunyoresa.
Society of Family Planning Guideline 20092. "Kushandiswa kweMirena LNG-IUS neParagard CuT380A zvishandiso zvemukati zvevakadzi mukati mevakadzi vasingaverengeki." Kubata pamuviri . 2010. 81 (5): 367-371. Inowanikwa kuburikidza nehurumende yekunyoresa.
Suhonen S, Haukkamaa M, Jakobsson T, Rauramo I. "Kushandiswa kwekliniki yevhevonorgestrel-kubudisa intrauterine system uye zvirongwa zvekudzivirira pamuviri kune vakadzi vechidiki vasiri vana: Kuenzanisa." Kubata pamuviri . 2004. 69 (5): 407-412. Inowanikwa kuburikidza nehurumende yekunyoresa.
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