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Uzazi kwa operation na kujamiiana

Discussion in 'JF Doctor' started by gracious86, Mar 29, 2011.

  1. g

    gracious86 JF-Expert Member

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    wapendwa,hivi kama mwanamke amejifungua kwa operation,anaruhusiwa kujamiiana baada ya muda gani? Coz,kuna mshono tumboni, na hata kama mshono utakuwa umepona,kutabaki na kovu! Je,hii haitaathiri ktk kufanya mapenzi? Au mshono ukipona,inaruhusiwa? Help..

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  2. Riwa

    Riwa JF-Expert Member

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    Kimaumbile...hakuna tatizo lolote kuanza kujamiiana baada ya mama kumaliza arobaini (puerperium) ambazo kwa kawaida ni wiki 6. Ila kuna watu huwa wanachelewa zaidi kwa sababu za kimila, desturi, tamaduni etc.

    Mama anapojifungua kwa operation anakuwa na kovu tumboni (hili ni kovu la nje kwenye ukuta wa tumbo/ngozi) na kovu la kwenye kizazi (kovu la ndani). Tatizo ni hili kovu la ndani, na tatizo lake huwa iwapo mama huyo atapata ujauzito tena, kizazi huwa kinatanuka, na wakati wa kujifungua kina weza kuchanika kama madaktari wake hawatakuwa makini!

    Kovu hili la ndani halina tatizo lolote kwenye kujamiiana pindi inapopita aroabaini/puerperium, Uume hata uwe mkubwa vipi huwa unaishia kwenye uke tu, haungii kufikia kizazi kwani kuna shingo ya kizazi (cervix) ambayo utenganisha uke na kizazi. Kwa hiyo hamna jinsi yeyote uume ukaumiza kovu la ndani au kulichana.

    NB: Kubeba uja uzito mwengine kabla mtoto hajafikisha miaka miwili kunaweza sababisha matatizo katika ukuaji wa mtoto au hata kwako wewe wakati wa uzazi. Kwa hiyo kama una mpango wa kuanza kujamiiana mapema, tumieni kinga (condom) au njia nyingine ya uzazi wa mpango ili kuepusha ujauzito wa mapema.
     
  3. g

    gracious86 JF-Expert Member

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    Riwa
    asante sana Riwa! Umefafanua vzr mno. A note of thanks to u!
     
  4. R

    Rutakyamilwa JF-Expert Member

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    Elimu nzuri hii, sio watu tunachangia thread ya ngono kwa wingi kuliko educative kama hii.Wakatabahu
     
  5. Rose1980

    Rose1980 JF-Expert Member

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    ok na hii ya watu kupenda operation ninin skuiz ? et riwa?
     
  6. t

    tizo1 JF-Expert Member

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    nauliza tafadhal.je mwanamke aliyezaa kwa operation mimba ya kwanza anaweza kuzaa bila operation katika ujauzito wake wa pili?
     
  7. Kaka Mpendwa

    Kaka Mpendwa JF-Expert Member

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    Hivi hizi operations za uzazi wanachagua mabinti wenyewe?
     
  8. Lizzy

    Lizzy JF-Expert Member

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    Nadhani inategemea na sababu ya mtu kujifungua kwa kutumia operation.Kuna ndugu yangu alizaa mara tatu na zote kwa operation kwasababu ya complications..kwahiyo kama mtu anatatizo la kudumu inabidi atumie operesheni mara zote...ila wale wanaochagua kwasababu tu wamependa/taka wanaweza kwasababu uwezo wa kuzaa kawaida wanao.
     
  9. Lizzy

    Lizzy JF-Expert Member

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    Wanaochagua kufanya hivyo bila kua na matatizo wanakua hawataki yale maumivu ya kuzaa/kujifungua...na mabadiliko yanayoambatana na kuzaa kwa njia ya kawaida!Ila ubaya wa operation ni kwamba maumivu yanakuwepo kwa muda mrefu kuliko njia ya kawaida...bila kusahau kovu!
     
  10. Riwa

    Riwa JF-Expert Member

    #10
    Mar 30, 2011
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    Rose...sababu za kujifungua kwa operation hazijabadilika ukilinganisha zamani na siku hizi. Japo vifo vya kina mama wakati wa uzazi bado ni vingi, lakini zamani vilikuwa vingi zaidi. Kujifungua kwa operation ni njia mojawapo ya kupunguza vifo vya akina mama wakati wa uzazi, matatizo ya fistula, na kupunguza vifo vya watoto pia. Zamani kina mama waliokuwa na 'obstructed labour', watoto kuchoka (fetal dustress) etc walikuwa wanaachwa muda bila kufanyiwa operation..na matokeo ni vifo vya kina mama na watoto.

    Siku hizi kuna mipango mabali mabali ya kupunguza vifo vya kina mama, mmojawapo ni huu wa huduma za dharura kwa mama anayejifungua na watoto wachanga (Emergency Obstetric and Newborn Care) ambapo vituo mabli mabli vimewezeshwa kuwa na uwezo wa kufanya operations za uzazi pindi inapoonekana ni muhimu.

    Pia wataalamu wenye kuweza kufanya hizi opearations wamekuwa wengi kulinganisha na zamani, ndio maana huduma hizi zinapatikana kwa wingi kidogo kulinganisha na zamani.

    Watu wengi wanafikiri wanawake wamekuwa wazembe/kushindwa kuzaa kawaida ndio maana kuna muongezeko wa hizi operation..sio kweli, ni kuboreka tu kwa huduma za mama wazazi na watoto, Japo hatujafika tunapopaswa kuwa.
     
  11. Riwa

    Riwa JF-Expert Member

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    Nilishajibu hili swali kwa kirefu humu JF..kama anvyosema dada Lizzy: inategemea na sababu ya mama huyu kujifungua kwa operation kwa mara ya kwanza. Kuna sababu zinazojirudia rudia mfano maumbile yasiyokidhi ya nyonga ya mama mara nyingi kwa kina mama wafupi (150cm or below), ulemavu unaothiri nyonga etc...na kuna sababu zisizojirudia mfano mtoto mkubwa, mtoto kuchoka, mama kuchoka, mtoto kufungwa na kitovu shingoni, kifafa cha mimba etc.

    Kama mama alifanyiwa operation uzazi wa kwanza kutokana na sababu zisizojirudia, huwa anapewa nafasi ya kujifungua kawaida kwenye uzazi wa pili lakini chini ya uangalizi wa karibu wa daktari, kwani kovu la ndani linaweza chanika wakati wa uchungu na kuhatarisha maisha ya mama na mtoto. Wapo wengi tu wanajifungua kawaida baada ya operation katika uzazi wa kwanza.

    Lakini kama alifanyiwa opeartion kutokana na sababu zinazojirudia, basi uzazi wake wote utakuwa wa operation, na inashauri afunge kizazi baada ya kuzaa mara tatu kwa operation!

    Ni kweli wapo kimna mama kadhaa wanaoamua kujifungua kwa operation, kama unaweza mudu gharama unalipia na unajifungua kwa operation bila kuonja adha ya uchungu. Ila madhara yake ni kama niliposema hapo juu, unakuwa na kovu kwenye kizazi ambalo mara zote litahatarisha maisha yako na ya mtoto wakati wa kujifungua!
     
  12. B

    BABAPAMA Member

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    Riwa
    Bw. Liwa nimepata kusikia kuwa kama Mwanamama mjamzito akigundulika ana VVU pendekezo pekee la uzazi wake ni kwa njia ya upasuaji ili kuepusha maambukizi ya VVU kwenda kwa mtoto? unasemaje juu ya hili?
     
  13. Susy

    Susy JF-Expert Member

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    riwa thanks!!
     
  14. Riwa

    Riwa JF-Expert Member

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    Mama mjamzito mwenye maambukizi ya VVU anaweza kujifungua kwa njia ya kawaida au kwa operation kutokana na sababu kama nilizozitaja kwenye thrad zangu zilizopita. Inajulikana kisayansi kwamba mtoto anaweza akaambukiwa VVU toka kwa mama wakati akiwa tumboni (kiasi cha 10%), wakati wa kujifungua (njia ya kawaida kiasi cha 25 - 30%), na wakati wa kunyonya.

    Kwa hiyo basi, mama akijifungua kwa operation anapunguza uwezekano wa maambukizi kwa mtoto wake, ndio maana kuna kina mama/familia nyingine ambazo wameathirka huwa wanaamua kujifungua kwa operation. Lakini challenge ni kuwa hatujawa na uwezo wa kupima mtoto VVU kabla hajazaliwa, kwa hiyo waweza fanay operation wakati mtoto keshaambukizwa tumboni!

    Ushauri wangu: Ni vyema mama akapima afya yake mapema (anapoanza clinic) ili kama ameathrika apewe ushauri na kujiungana huduma za kuzuia maambukizi ya VVU toka kwa mama kwenda kwa mtoto (PMTCT) ambayo yanapatikana bure katika vituo viingi tu vya kutolea huduma za afya hapa Tanzania. Huko atashauriwa jinsi ya kupunguza maambukizi wakati wa kujifungua na wakati wa kunyonysha.
     
  15. B

    BABAPAMA Member

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    Aksante sana nimekupata!
     
  16. c

    chetuntu R I P

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    Thanx Dr Riwa kwa kufafanua vizuri masuala ya operation in relation to kujamiiana. Vipi kuhusu wamama wanaopita lower caesarian section kwa sababu ya pregrant induced hypertension linaweza kuwa tatizo la kudumu kila mama akiwa mjamzito? Na je nini kifanyike kuzuia PIH?Endelea kubarikiwa sana.
     
  17. Riwa

    Riwa JF-Expert Member

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    Siku hizi caesarian section karibu zote (kama sio zote) zinafanywa kwa Lower Segment Caesarian Section (LSCS). Kizazi kina sehemu mbili...upper segment ambayo ni misuli, na hii ndio sehemu inayohusika kwenye uchungu ili kusukuma mtoto atoke...na lower segment ambayo si misuli na hivyo haihusiki kwenye kusukuma mtoto. Ukifanya LSCS kovu linakuwa kwenye lower segment na hivyo upunguza kupoteza damu nyingi (misuli inapata damu nyingi kwa hiyo upper segment huwa inapoteza damu sana) na pia upunguza uwezekano wa kizazi kuchanika kwa mimba itakayofuata kwani lower segment haihusiki kwenye kusukuma mtoto.

    Pregnancy Induces Hypertension (PIH) siyo sababu ya kumfanyia mama mjamzito operation, labda pressure iwe imepanda sana kiasi cha kusababisha/kutaka kusababisha kifafa cha mimba 'eclampsia'. PIH huwa inastop pindi mtoto anapozaliwa/anapotolewa mwilini mwa mama, kwa hiyo kama pressure itapanda sana kiasi cha kusababisha au kutaka kusababisha eclampsia (ambayo huua sana), basi uamuzi inakuwaga ni kumuokoa mama kwa kulazimisha mtoto azaliwe...hata kama hajakomaa/njiti. Mara nyingi njia inayotumikaga kulazimisha kuzalisha ni ku'induce labour' kwa maji ya uchungu na kumuacha mama azae kawaida. Mara nyingi mtoto huwa anakuwa mdogo (hajatimia) kwa hiyo si vigumu kujifungua kwa njia ya kawaida. Mara chache sana mama atafanyiwa LSCS ili kutoa mtoto sababu ya PIH/Eclampsia.

    Mama aliyepata PIH/Eclampsia katika uzazi mmoja anaweza AKAPATA au HASIPATE tena katika uzazi utakaofuatia. Bahati mbaya pamoja na maendeleo yote ya kitabibu bado hatuwezi kusema kwa uhakika yupi atapata tena au hatapata tena tatizo hilo katika uzazi unaofuatia. Lakini, mara nyingi kuna uwezekano mkubwa hali ile ikajirudia kama kila kitu kitabaki vile vile...nikiwa na maana baba/mume/mtia mimba ni yule yule. Kuna literature inasema kuwa kuna uwezekano wa kupungua tatizo kujirudia iwapo mtia mimba atabadilika (Dont quote me on this...it is still researched!).
     
  18. Aza

    Aza JF-Expert Member

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    hapo sasa bwana riwa ya "eclampsia" yani ndo naisikia hapa
    kumbe mtoto anaweza pata virus akiwa tumboni kwa 10%?nilifikiri sio
    ofkoz I won't quote you (tunaisubiri iyo reasearch)
     
  19. C

    Caroline Danzi JF-Expert Member

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    Riwa big up, tumekupata. Thanks.
     
  20. c

    chetuntu R I P

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    Riwa asante sana kwa elimu nzuri.:A S 41::A S 41:
     
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