Okujjamu olubuto neddagala kisobola okukolebwa ne Mifpristone ne Misoprostol mukudiringanwa oba Misoprostol yekka. Omutimbagano guno guwa bwino kunkozesa ya Misoprostol yekka nga obuweke obujjamu olubuto. Bwoba osobola okufuna mifepristone, laba endagiriro eno.
Nga tonatandika
Okukozesa Misoprostol kukola nnyo ebitundu {80-85/100} [1, 2] ku lubuto lwa wiiiki 13 nokukka wansi
Jjukira nti obubaka buno buyamba kukujjamu olubuto oluli wakati wa wiiki 13 nokukka wansi [1, 2, 3] okuva lwewasembayo okugenda munsonga. Olwokuba nti teuli batendeke kujjamu mbuto ezisukka wiiki 13, tujja kusindika mubakugu abatusingako.
Okukasa nga nti obubaka buno bulungi gyoli, tukubiriza osome ekitundu ekiriko ebiva mukujjamu olubuto nga tokozesaza buweke. Bwoba tokakaksa nti enkola eno nungi gyoli, tunonyeko.
Ebipimo bya Misoprostol ebijjamu olubuto
Wetaaaga obuweke bwa Misoprostol 12.
Bwekiba kizibu okufuna obuweke 12, kozesa 8 naye omutindo gujja kukenderamu era tukusaba olabe ba kansala.
Singa olubuto lwoli wakati wa wiiki 10-13, kozesa obuweke bwa Misoprostol 12.
Bbuli kaweke kalina kubeera ka 200mcg [7]
Empeke zokozesa bwezibela ne dose eyenjawulo, kyetagisa okuddamu okubala osobole okukozesa obuweke obusanidde. [8]
Bwobera olina ekibuuzo kyonna, togaaana kutwebuzaako. Tuli wano okuwanirira okujjamu olubuto obulungi
Okumira Misoprostol okujjamu obulungi olubuto
Obubonero obusinga butandika nga wakamala okukozesa Misoprostol era londa obuddde obulungi muntekateeka zo. Okubirirzibwa okumira mubiseera nga oli waka nga tolina buvunanyizibwa bwonna.
Omutendera ogusooka: Mira 800mg ez Ibuprofen
Omutendera guno gukubirizibwa kubanga Ibuprofen ajja kuyamba kukukendeeza obulumi nebiva mukukozesa Misoporostol. Jjukira nti Ibuprofen asobola okukozesebwa mumutendra gwonna. Abakyala abalina alagye wa Ibuprofen ne NSAIDs musobola okwebuuza kukibanja FAQs nemuyambibwa kungeri endala eyokukendezaamu obulumi.
Bwoba olina kuddgala eriziyiza okusindukirizibwa emeeme, likozese.
Lindamu esssawa 1
Omutendera 2: Teeka Misoprostol 4 wansi wolulimi lwo okumala eddakiika 30
Kikulu okuleeka obuweke kwa Misoprostol okumaaala eddakiika 30 wansi wolulimi busobole okuyingira mumubiri. Oluvanyuma nnywa ammazzi okumira ebisigalira byobuweke. [1]
Bwoseseme wakati mudddakiika 30 nga obuweke buli wansi wolulimi, awo emikisa mingi nti bubeeera tebujja kukola. Mumbeeera eno dddamu omutendera ogwookubiri.
Bwosesema nga obuweke buwezeza eddakiika 30 wansi wolulimi, tewetaaaga kuddamu mutendera gwa 2 kubanga eddagala libeera liyingi mumubiri.
Lindamu essaawa 3
Omutendera 3: Damu omutendera 2 oteeeke obuweke obulala 4 obwa Misioprostol wansi wolulimi okumala eddakiika 30
Lindamu esssawa 3
Omutendera 4: Damu omutendera 2 era oteeeke emepeke za Misoprostol 4 wansi wolulimi okumala eddakiika 30
Okuvaamu omusaaayi kutandika ebiseera ebisinga oluvanyuma lwe ssaawa eziwerako. Bwezitaba ssaawa 24 oluvanyuma lwobuweke obusooka era nga tolina kuvaaamu musaayi nakulumizibwa munseke, tunonyeko. Tokozesa buweke bulala okujjako nga tumaze kukwekenenya.
Obubonero obusubirwa nga omaze okumira obuweke bwa Misoprostol
Oluvanyuma lwokumira Misoprostol ojja kufuna okulumizibwa munseke nokuvaamu omusaayi. Abakyala abamu bavaamu obutole bw’omusaaayi. Sikyangu okumanya okuvaamu omusaayi oba okulumizibwa munseke kutandika ddi, yade nga emirundi egisinga kijja mu sssaawa 24 ezisooka nga omize obuweke obusooka naye era kisobola okusukkamu [10]
Okuvaamu omusaayi kuno kulina okusinga ku ogwo oguvamu mumukyala ali munsonga oba wakiri nga gwenkana. Osobola okuvaamu omusaayi nga bwegugenda okumala enaku eziweerako oba wiiki nga omaze okumira obuweke. Obubonero bwokuvamu onusaaayi nobubonero bwolubuto birina okuterera olubvanyuma lwa wiiki ezidddako [11]
Eri abakyala abembuto eziri wakati wa wiiki 10-13, mujja kufuna obubonero bwokulumizibwa munseke nokuvaamu omusaayi naye era muyinza okulaba ekisindikirivwa okuva wansi wammwe [1]. Ekisindikiibwa kino kiyinza okubeeerako omusaayi nebutole bwomusaayi oba niyinza obutalabika. teweralikirira, osobola okukisulira mu pad oba mu kabuyonjo
Jjukira nti buli nvaamu yolubuto eyawukana era nobubonera bwawukana okuva kumukazi omu okudda ku mulala
Abakyala abasinga abalina obubonero bwolubuto balekera awo okulaba obunoero bwolubuto enaku 5 nga bamaze okumira obuweke bwa Misoprostol. Singa obubonero bwolubuto butandika okukendera nga omaze okumira obuweke era nebubula oluvanyuma lwebbanga, obeera tokyali lubuto. [12]
Ebiva Mukukozesa Misoprostol
Olumala Okukozesa Misoprostol, abakyala abamu bafuna obubonero buno okumala essaawa [13]. Mulimu buno wammanga:
- Omusujja
- Embiro
- Okusindukirirwa emeeeme oba okusesema
- okulumwa omutwe
- chills
Okwegendereza
Okwewala okuvaamu omusaayi mumisuwa egifunye obuvune n’okufuna ‘infection’ mu wiiki ezidddirira paka nga okufulumya omusaayi kukendedde, kikulu okwegendereza bino wammanga [14]
Ebintu eby’okwegendereza:
- Okukozesa paadi ngeri nnungi ey’okulondoola omusaayi gwo mu nnaku ezisooka ng’oggyamu olubuto, naye oluvannyuma osobola okukyusa n’odda ku tamponi oba akakopo akakwata omusaayi amangu ddala ng’owulira emirembe..
- Ddayo mu mirimu gyo egya bulijjo (dduyiro, okukola emirimu gyo n’ebirala.) amangu ddala ng’owulira nga weetegese.
- Osobola okwegatta buli lw’oba weetegese; ekisinga obukulu kwe kuwuliriza omubiri gwo n’ebyo by’oyagala..
- Nsaba okimanye nti osobola okuddamu okufuna olubuto nga wayiseewo akaseera katono nnyo ng’oggyemu olubuto, mu wiiki ntono nga bbiri.
Obubonero obulabula : Okufuna obuyambi
Bwofuna akamu kububonero buno, kabonero akalaga nti oyinza okuba olina obuzibu mumubiri era nonya abakugu:
- Bwojjuza paadi bbiri oba nokusukkawo nga zonna zijjudde bulungi omusaayi mussaawa etawera 1 nekimala esssaawa 2 nga tekisiriseemu.
- Okwokya omubiri okuwera digguli 38 okutakendera wadde okozeseza Ibuprofen nga okozesa akapima ebbugumu.
- Omusujja ogulimu okwokya kwa diguli 38 okutakendera oluvanyuma lw’essaawa 24 nga okozeseza obuweke bwa Misoprostol, nga okozesa akapima ebbugumu mumubiri
- Obulumi obutakendera yadde nga okozeseza Ibuorfen.
- Enfanana n’empunya y’omusaayi ogukuvaamu nga bwawukana kukyabulijjo.
- Nga olina okumyuka eddiba, okusiyibwa oba okuzimba emikono, ensingo ne feesi, kitegeeza nti olabika olina allagye weddagala. Osobola okukozesa obuweke bu antihistamine naye bwofuna okutawanyizibwa mukussa, funa okujjanjabibwa mubwangu[15]
Bya ttimu ya safe2choose n’abakuggu okuva mu Carafem okusinzira kundagiriro ya Ipas 2012 nendagiriro y’ekitondongere kyebyobulamu munsi.
carafem akuwa amagezi amasuffu kukujjamu olubuto nenkola ya kizaala ggumba olwo abantu bewale okuzaala abaana bebatetegekedde.
Ipas kyekitongole kyensi yonna kyokka ekitadde essira kukujjamu embuto obulungi nokulabirira nenkola yakizaala ggumba.
WHO kitongole ekyatekebwawo ekitongolee ekigatta amawanga gonna ekya UN okukola kubyobulamu bw’abantu
[1] World Health Organization. Safe abortion: technical and policy guidance for health systems. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/70914/;jsessionid=AB2B02D2E41FB4F6CF95B5F59B0A9AF4?sequence=1
[2] Ipas. (2020). Clinical Updates in Reproductive Health. L. Castleman & N. Kapp (Eds.). Chapel Hill, NC: Ipas. Retrieved from: https://www.ipas.org/wp-content/uploads/2020/08/ClinicalUpdatesInReproductiveHealthCURHE20-English-digital.pdf
[3] World Health Organization. Clinical guidelines for safe abortion. 2014. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/97415/9789241548717_eng.pdf?sequence=1
[4] National Abortion Federation. 2020 Clinical Policy Guidelines for Abortion Care. Retrieved from: https://5aa1b2xfmfh2e2mk03kk8rsx-wpengine.netdna-ssl.com/wp-content/uploads/2020_cpgs_final.pdf
[5] Guttmacher institute. Early Pregnancy Failure: Misoprostol May Be Good Alternative to Surgery. Retrieved from: https://www.guttmacher.org/journals/psrh/2006/early-pregnancy-failure-misoprostol-may-be-good-alternative-surgery
[6] Platais I, Tsereteli T, Grebennikova G, Lotarevich T, Winikoff B. Prospective study of home use of mifepristone and misoprostol for medical abortion up to 10 weeks of pregnancy in Kazakhstan. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/?term=Prospective+study+of+home+use+of+mifepristone+and+misoprostol+for+medical+abortion+up+to+10+weeks+of+pregnancy+in+Kazakhstan
[7] Gynuity. Efficacy of Misoprostol Alone for First-Trimester Medical Abortion: A Systematic Review. Retrieved from: https://gynuity.org/resources/efficacy-of-misoprostol-alone-for-first-trimester-medical-abortion-a-systematic-review
[8] Elizabeth G. Raymond, Caitlin Shannon, Mark A, Weaver, Beverly Winikoff. First-trimester medical abortion with mifepristone 200 mg and misoprostol: a systematic review. Retrieved from: https://www.contraceptionjournal.org/article/S0010-7824(12)00643-9/fulltext
[9] Livshits, Anna et al. Fertility and Sterility, Volume 91, Issue 5, 1877 – 1880. Ibuprofen and paracetamol for pain relief during medical abortion: a double-blind randomized controlled study. Retrieved from: https://www.fertstert.org/article/S0015-0282(08)00176-3/fulltext
[10] Gynuity. providing medical abortion in low-resource settings: an introductory guidebook. Second Edition. Retrieved from: https://gynuity.org/assets/resources/clinguide_maguide2nd_edition_en.pdf
[11] Planned Parenthood. How does the abortion pill work? Retrieved from: https://www.plannedparenthood.org/learn/abortion/the-abortion-pill/how-does-the-abortion-pill-work
[12] Gynuity. Self-Assessment of Medical Abortion Outcome using Symptoms and Home Pregnancy Testing. Retrieved from: https://gynuity.org/resources/self-assessment-of-medical-abortion-outcome-using-symptoms-and-home-pregnan
[13] National Abortion Federation. Expected Side Effects of Medical Abortion. Retrieved from: https://prochoice.org/patients/using-abortion-pills-on-your-own-what-to-expect/
[14] A.R. Davis, C.M. Robilotto, C.L. Westhoff, S. Forman, J. Zhang. Bleeding patterns after vaginal misoprostol for treatment of early pregnancy failure. Retrieved from: https://academic.oup.com/humrep/article/19/7/1655/2356520
[15] NHS. Risks-Abortion. Retrieved from: https://www.nhs.uk/conditions/abortion/risks/
Enkozesa ya mifepristone ne misoprostol