Njira imodzi yochepetsera chiwerengero cha kuchotsa mimba - pali njira zambiri zogwiritsira ntchito njira za kulera.
Kusankha njira ya kulera kumaphatikizapo kulingalira zinthu zambiri - osati zopanda pathupi zomwe zingagwiritsidwe ntchito kukonzanso thanzi la amayi ndikupewa matenda ambiri a amayi, kudalirika kwa njira, chitetezo chake, ndi momwe munthu alili ndi kachilombo ka HIV. Kupambana kwa njira iliyonse ya kulera kumasonyezedwa ndi ndondomeko ya Perl yomwe imayesedwa ndi chiwerengero cha amayi omwe ali ndi pakati pa amayi 100 omwe adagwiritsa ntchito njirayi pachaka.
Njira za kulera zimasiyanitsa:
- mahomoni
- zipangizo za intrauterine
- chotchinga
- opaleshoni
- Postcoital.
Njira yamakono ya kulera.
Kuti izi zitheke, njira zoterezi zimagwiritsidwa ntchito:
- kuphatikiza (estrogen-gestagenic) kulera kwachinsinsi;
- gestagenic contraceptive (mili-drank);
- Kuchulukitsa chithandizo chamakono nthawi yaitali;
- Kukhazikitsa njira za kulera.
Pali zigawo zikuluzikulu zomwe zili ndi progesin imodzi yokha komanso kuphatikizapo njira zothandizira kulera.
Kuphatikizana ndi njira zothandizira pakamwa (COCs) ndi mawonekedwe othandiza kwambiri omwe ali ndi chigawo cha estrogenic ndi progesational.
COC imaletsa kupanga mahomoni omwe amachititsa kuti ovulation ayambe. Kusintha kwa endometrium, pamene mutenga COC, musalole kuti dzira la umuna likhazikike. Komanso thandizo la COC kuti lichepetse magazi omwe atayika pa nthawi ya kusamba, kuchepetsa nthawi ya kusamba, kupweteka, kuchepetsa chiopsezo cha matenda ena opweteka.
Zofooka zikuphatikizapo mikhalidwe yomwe nthawi zina imapezeka pamene imatenga COCs. Poyamba, izi ndizopweteka kwambiri, kumutu, chizungulire, kuwonjezereka maganizo.
Ubwino wa njirayi ndi : Kuchita bwino, kugwiritsidwa ntchito mosavuta, kubwereza, zotsatira zabwino pa ntchito yobereka komanso makamaka pa thupi lachikazi (khungu, tsitsi). Akazi omwe nthawi zonse (zaka ziwiri) amatha kutenga COC amachepetsa kwambiri kuchuluka kwa matenda opatsirana a chiberekero, kupititsa patsogolo chisamaliro ndi matenda opatsirana m'mimba.
Kusiyanitsa kwa kugwiritsa ntchito COC ndikutenga mimba, mitsempha yambiri pamphindi kapena anamnesis (hypertension, thrombophlebitis, IHS, strokes). Simungathe kusuta akazi atakwanitsa zaka 35, ndi matenda a chiwindi omwe amatsutsana ndi ntchito zake, zotupa zowonongeka ndi mahomoni, kukhalapo kwa magazi osadziwika bwino, komanso kunenepa kwambiri.
Mankhwala opatsirana pogonana a Gestagenic .
Amaphatikizapo ma progesin okha. Mankhwala opatsirana pogonana ndi othandiza kwambiri kwa amayi achikulire. Kawirikawiri amauzidwa kuti azipita kumsasa komanso kupweteketsa msambo, mastalgia, matenda am'mbuyo. Chinthu chimodzi chofunika kwambiri ndi chakuti mankhwala amtundu wa gestagenic amatha kutengedwa panthawi yopuma.
Mankhwala opatsirana pogwiritsa ntchito nthawi yaitali.
Pali kuphatikizapo estrogen-gestagenic yojambulira kulandira mankhwala ndi zigawo chimodzi, zomwe zimaphatikizapo progestogens zachitali chokhalitsa. Mu gulu la mankhwalawa, omwe amavomereza kwambiri ndi depot-provera.
Posachedwapa, amagwiritsa ntchito mankhwala osokoneza bongo . Kukonzekera kumeneku monga ma kapsules amamangidwa pansi pa khungu. Izi zimapereka chithandizo cha kulera kwa zaka zisanu.
Kuchiza makina opangira mankhwala (IUD).
Uterine "spirals" amagwiritsidwa ntchito pa intrauterine kulera. Amachepetsa kukula kwa spermatozoa, kulimbikitsa ziwalo zam'mimba za endometrium, kuchepetsa kuyenerera kwa dzira, kulimbikitsa antiperistalsis ku mazira a fallopian.
Ngati feteleza zachitika, kuyambira kwa mimba kumayendetsedwa ndi: Kusintha kwa mavitamini ndi machitidwe ogwirizana a chiberekero, kusintha kwa zamagetsi mumapeto a endometrium.
Mankhwala opatsirana pogonana (Mirena), kuphatikizapo, amatulutsa mahomoni ndipo amachititsa kuti pakhale njira zowonongeka za mahomoni.
Kusamvana kwa IUD: sikungagwiritsidwe ntchito pathupi, khansa ya chiberekero kapena chiberekero, kutuluka m'magazi, matenda opatsirana pogonana. Ngati pangakhale ectopic pregnancy mu anemnesis, ndiye kuti kugwiritsa ntchito ma IUD kungatheke ngati njira zina zothandizira kulera zimatsutsana.
Njira zothetsera kulera.
Izi zikuphatikizapo: makondomu amphongo, ziwalo za m'mimba, zipewa za khomo lachiberekero komanso zam'mimba.
Njira zolepheretsa kubereka zimapangitsa kuti umuna ufike kumaliseche (kondomu), ndipo kachilombo ka HIV kamatulutsa umuna (spermicide). Mankhwala otchedwa spermicides alipo mu mitundu yosiyanasiyana - mapiritsi, jellies, mapiritsi opopuka, spongesi.
Njira yabwino ya njira zolepheretsa kubereka ndi yakuti ali ndi malo okwanira kufalitsa kufalikira kwa matenda opatsirana pogonana. Makondomu amapangidwa ndi latex ndipo amathandiza kwambiri polimbana ndi kachilombo ka HIV ndi matenda a hepatitis B ndi C.
Mankhwala opanga opaleshoni amagwiritsidwa ntchito kwambiri m'mayiko ambiri padziko lapansi. Mphamvu ya mtundu uwu wa kulera imafikira 100%, ngakhale kuti mimba ya mimba ndi pambuyo yobereka imafotokozedwa. Kuberekera kwazimayi kumachitika pogwiritsa ntchito miyendo yamagetsi mwa opaleshoni ya laparoscopic, ndi yamuna mwa kuvala zofufuzira. Kuipa kwa njira iyi ndizosagwirizana.
Kubereka kwa postcoital kumagwiritsidwa ntchito pamene kugonana, kosatetezedwa ndi njira zina, kwachitika kale. Gwiritsani mapiritsi a COC - 2-4, osapitirira maola 72 mutagonana mobwerezabwereza maola 12.
Dinazol, postinor imagwiritsidwa ntchito maola 72 oyambirira kawiri m'maola 12.
Palinso njira ya kutentha yoberekera . Zimachokera pa kudziletsa kugonana masiku atatu kale ndi masiku 3-4 pambuyo pa kuvuta. Kuti mudziwe tsiku la ovulation gwiritsani ntchito kuyesayesa kwapakati ndi tebulo. Mapulogalamu apadera angathe kumasulidwa pa intaneti ndikungotentha kutentha tsiku lililonse. Pulogalamuyo imadziwitsa tsiku la ovulation.