ʻO ka hoʻopaʻa keiki ka poho o ka embryo a i ʻole ka fetus i ka wā hāpai.

Hiki iā ia ke hana maʻamau, ʻo ia hoʻi ke hana ʻia me ka ʻole o ka noiʻi ʻana (pilikia olakino, genetics, etc.), a i ʻole hoʻonāukiuki a no laila he manawaleʻa.

• ʻO ka hoʻomake wale ʻana. Ke kamaʻilio pū nei mākou no ka hāʻule ʻana. Ma ka wehewehe ʻana, ʻo ia ka make a i ʻole kipaku ʻia mai ke kino makuahine o kahi embryo a i ʻole fetus ma lalo o 500 grams a i ʻole ma lalo o 22 mau pule o ka amenorrhea a i ʻole me ka manstruation (= 20 pule o ka hāpai ʻana). Inā hāʻule ka hāʻule ma hope o ka hāpai ʻana, ua kapa ʻia ʻo "fetal death in utero".

• THEhoʻokomo ʻia i ka ʻōpū, i kapa ʻia ʻo "hoʻopau manawaleʻa o ka hāpai ʻana" (a i ʻole ka hoʻohemo ʻana) hiki ke hoʻoulu ʻia ma nā ʻano like ʻole, ʻo ia hoʻi ma o ka lawe ʻana i nā lāʻau "abortive" a i ʻole ma muli o ka manaʻo o ke keiki. ʻOkoʻa nā kānāwai e pili ana i ka loaʻa ʻana (a i ʻole ka pāpā ʻana) i ka hoʻohemo ʻana mai kēlā me kēia ʻāina.

• Hoʻopau kauka o ka hāpai ʻana (IMG) ʻo ia ka hoʻokomo ʻana i ka ʻōpū, hana ʻia no nā kumu lāʻau lapaʻau, pinepine ma muli o kahi maʻi ʻino a i ʻole ka maʻi o ka ʻōpū e hoʻoweliweli i ke ola ma hope o ka hānau ʻana a i ʻole ke kumu o nā pilikia olakino, a i ʻole ke ola o ka pēpē i ka pilikia.

ʻO ka hoʻopaʻa ʻana maʻamau: prevalence a me nā kumu

He mea maʻamau ka hāʻule ʻana. ʻO lākou, no ka hapa nui, pili i kahi anomaly genetic a i ʻole chromosomal i loko o ka embryo, a laila kipaku maoli ʻia e ka makuahine.

Ma ka hoʻokaʻawale:

• ka hāʻule mua ʻana, e kū ana i ka wā mua o ka ʻōpū (ma lalo o 12 pule o ka hāpai ʻana). Hoʻopilikia lākou i ka 15 a 20% o ka hāpai ʻana akā i kekahi manawa ʻaʻole ʻike ʻia ke hana ʻia i nā pule mua loa no ka mea ua huikau lākou me nā lula.
• hāʻule hāʻule hope, i ka lua o ka trimester, ma waena o 12 a me 24 pule o ka hāpai ʻana. Loaʻa lākou ma kahi o 0,5% o nā hāpai¹.
• make fetal in utero, in the third trimester.

Nui nā kumu e hiki ai i ka hāʻule ʻana a i ʻole ka hāʻule ʻana.

Ma waena o kēia mau kumu, ʻike mākou ma kahi mua o nā genetic a i ʻole chromosomal abnormalities o ka embryo, i komo i ka 30 a 80% o ka hāʻule mua ʻana.².

ʻO nā kumu ʻē aʻe o ka hāʻule ʻana o ka hānau keiki:

• he mea ʻino ʻole o ka ʻōpū (e laʻa i ka ʻōpū i ʻoki ʻia, ka ʻōpū hāmama, nā fibroids uterine, synechiae uterine, a me nā mea ʻē aʻe), a i ʻole maʻi DES i nā wahine i ʻike ʻia i loko o ka ʻōpū i ka distilbene (hānau ʻia ma waena o 1950 a me 1977).
• nā maʻi hormonal, ka mea e pale ai i ka hāpai ʻana i ka wā lōʻihi (nā maʻi thyroid, metabolic disorders, etc.).
• hāpai nui e hoʻonui i ka pilikia o ka hāʻule ʻana.
• ka hiki ʻana o ka maʻi i ka wā hāpai. ʻO nā maʻi maʻi maʻi a i ʻole nā ​​​​maʻi parasitic hiki ke hoʻoulu i ka hāʻule ʻole, ʻo ia hoʻi ka maʻi malaria, toxoplasmosis, listeriosis, brucellosis, ʻāʻī, rubella, mumps, etc.
• ʻO kekahi mau ho'āʻo lāʻau, e like me ka amniocentesis a i ʻole ka biopsy trophoblast, hiki ke hana i ka hāʻule ʻole.
• ka loaʻa ʻana o kahi IUD i loko o ka ʻōpū i ka wā hāpai.
• ʻO kekahi mau mea kaiapuni (ka ʻai ʻana i nā lāʻau lapaʻau, ka waiʻona, ka paka, ka lāʻau lapaʻau, etc.).
• ʻO nā maʻi immunological (ʻo ka ʻōnaehana immune), pili pū i ka hāʻule ʻole ʻana.

Hoʻokomo ʻia i ka ʻōpū: inventory

He helu no ka hoʻokomo ʻana i ka ʻōpū a puni ka honua

Hoʻopuka mau ka World Health Organization (WHO) i nā hōʻike e pili ana i ka hoʻoulu ʻana i ka ʻōpū a puni ka honua. I ka makahiki 2008, ma kahi o hoʻokahi i loko o ʻelima hāpai ʻana ua hoʻopau ʻia ma ke kumu.

ʻO ka huina, kokoke i 44 miliona mau haʻalele i hana ʻia i ka makahiki 2008. ʻOi aku ka kiʻekiʻe ma nā ʻāina e ulu ana ma mua o nā ʻāina ʻoihana (29 abortions no 1000 wahine makahiki 15 a 44 i hoʻohālikelike ʻia me 24 no 1000, kēlā me kēia).

Wahi a kahi noiʻi i paʻi ʻia ma 2012³, ua hāʻule ka nui o ka hoʻohemo ʻana o ke ao holoʻokoʻa mai 35 a 29 no 1000 wahine ma waena o 1995 a me 2003. I kēia lā, aia ka awelika o 28 abortions no 1000 wahine.

ʻAʻole ʻae ʻia ka hoʻohemo ʻana ma nā wahi āpau o ka honua. Wahi a ka hui Ke kikowaena no nā pono hānau, ʻoi aku ma mua o 60% o ka heluna kanaka o ka honua e noho ana ma nā ʻāina kahi i ʻae ʻia ai ka hoʻopaʻa ʻana me nā kapu ʻole a i ʻole. ʻO ka mea ʻē aʻe, ma kahi o 26% o ka heluna kanaka e noho ana ma nā mokuʻāina kahi i pāpā ʻia ai kēia hana (ʻoiai ua ʻae ʻia i kekahi manawa inā pilikia ke ola o ka wahine no nā kumu olakino)⁴.

He helu no ka hoʻokomo ʻana ma Farani a me Quebec

Ma Palani, i ka makahiki 2011, ua hana ʻia nā 222 hoʻopau manawaleʻa o ka hāpai ʻana. Ua paʻa kēia helu mai ka makahiki 300, ma hope o ka hoʻonui ʻana o nā makahiki he ʻumi ma waena o 2006 a me 1995. Ma ka awelika, ʻo 2006 ka nui o ka hoʻoulu ʻana i hoʻokomo ʻia i nā wahine he 15.⁶.

Hoʻohālikelike ʻia ka pākēneka ma Quebec, me kahi kokoke i 17 abortions no 1000 wahine, a i ʻole 27 paha i kēlā me kēia makahiki.

Ma Kanada, ʻokoʻa ka uku ma waena o 12 a me 17 abortions i kēlā me kēia makahiki no 1 wahine o ka makahiki hānau, e hilinaʻi ana i ka panalāʻau (000 ka nui o nā hōʻailona i hōʻike ʻia ma 100)⁷.

Ma kēia mau ʻāina ʻelua, ma kahi o 30% o ka hāpai ʻana i ka hopena i ka hoʻohemo ʻana.

Ma Kanada e like me Farani, ʻo ka hoʻopau manawaleʻa o ka hāpai ʻana loio i. ʻO kēia ka hihia ma ka hapa nui o nā ʻāina ʻEulopa.

Ma Palani, hiki ke hana ʻia ka hoʻohemo ʻana ma mua o ka pau ʻana o ka pule 12 o ka hāpai ʻana (14 mau pule o ka amenorrhea). Ua like ia ma Belgium a me Switzerland.

ʻO Kanada, ʻo ia wale nō ka ʻāina komohana kahi ʻaʻohe kānāwai e kaupalena a hoʻoponopono paha i ka hoʻopaʻa ʻana i ka wā lōʻihi.⁷. Wahi a nā haʻawina i hoʻokō ʻia i ka makahiki 2010, ʻo ka hoʻopaʻa ʻana ma hope o 20 mau pule o ka hāpai ʻana e hōʻike ana i ka liʻiliʻi ma mua o 1% o nā hoʻohemo ʻana ma Quebec, a i ʻole he haneli mau hihia i kēlā me kēia makahiki.

ʻO wai ka mea i hoʻopilikia ʻia e ka hoʻoulu ʻana?

Hoʻopilikia ka hoʻoulu ʻana i nā makahiki āpau ma waena o nā wahine hānau keiki, a me nā ʻano pilikanaka āpau.

Ma Farani a me Quebec, ʻoi aku ka kiʻekiʻe o ka hoʻomake ʻana i nā wahine ma waena o 20 a 24 mau makahiki.

I loko o ʻelua hapakolu o nā hihia, ma Farani, ua hana ʻia nā hoʻohemo ʻana i nā wahine i hoʻohana i ke ʻano contraceptive.

Loaʻa ka hāpai ʻana ma muli o ka hāʻule ʻole o ke ʻano ma 19% o nā hihia a ma muli o kāna hoʻohana hewa ʻana i 46% o nā hihia. No nā wahine i ka hoʻopaʻa ʻana waha, hoʻopoina ʻia ka pila i loko o 90% o nā hihia⁸.

I nā ʻāina e ulu nei, ʻoi aku ma mua o nā hemahema contraceptive, ʻoi aku ka nui o ka nele o ka contraceptive e alakaʻi i ka hāpai ʻana i makemake ʻole ʻia.

ʻO nā pilikia o ka hoʻohemo ʻana

Wahi a ka WHO, make ka wahine i kēlā me kēia 8 mau minuke ma ka honua holoʻokoʻa ma muli o nā pilikia o ka hoʻomake ʻana.

ʻO ka 44 miliona mau haʻalele ʻana i hana ʻia i kēlā me kēia makahiki ma ka honua holoʻokoʻa, hana ʻia ka hapalua ma nā kūlana palekana, e ke kanaka "ʻaʻole i loaʻa nā mākau kūpono a i ʻole i kahi ʻano kūpono ʻole i nā kūlana olakino liʻiliʻi. , a i ʻole nā ​​mea ʻelua ".

Ke minamina nei mākou ma kahi o 47 mau make i pili pono i kēia mau hoʻohemo ʻana, 000 miliona mau wahine i loaʻa i nā pilikia ma hope o ka hana, e like me ka hemorrhages a i ʻole septicemia.

No laila, ʻo ka hoʻopaʻa ʻana palekana kekahi o nā kumu maʻalahi hiki ke pale ʻia o ka make makuahine (ʻo lākou ke kuleana no ka 13% o ka make makuahine ma 2008)⁹.

ʻO nā kumu nui o ka make e pili ana i ka hoʻohemo ʻana:

• nā hemorrhages
• nā maʻi a me ka sepsis
• ʻona (ma muli o ka ʻai ʻana i nā mea kanu a i ʻole nā ​​​​lāʻau ʻawaʻawa)
• ʻeha ʻeha a me loko (ka ʻōpū perforated a i ʻole ʻōpū).

ʻO nā maʻi maʻi ʻole e pili ana i nā pilikia hoʻōla, infertility, urinary a fecal incontinence (pili i ka ʻeha kino i ka wā o ke kaʻina hana), etc.

ʻAneʻane hana ʻia nā hoʻopaʻapaʻa huna a palekana ʻole (97%) ma nā ʻāina ulu. ʻO ka ʻāina ʻo ʻApelika wale nō ka hapalua o ka make i pili i kēia mau hoʻohemo ʻana.

Wahi a ka WHO, "ua hiki ke pale ʻia kēia mau make a me nā kīnā inā i hana ʻia kēia mau hoʻohemo ʻana i loko o ke kānāwai a me nā kūlana palekana maikaʻi, a inā paha i mālama pono ʻia kā lākou mau pilikia i ke kahawai, inā hiki i nā mea maʻi ke komo i ka moekolohe. nā lawelawe hoʻonaʻauao a me ka hoʻolālā ʻohana ”.

Ma Palani a ma nā ʻāina kahi i mālama ʻia ai ka hoʻomake ʻana me ka palekana, ʻo ka make e pili ana ma kahi o ʻekolu mau make no hoʻokahi miliona mau hoʻohemo ʻana, he haʻahaʻa loa ia. ʻO nā pilikia nui, i ka wā i hana ʻia ai ka ʻokiʻoki ʻana:

• ʻūhā ʻōpū (1 a 4 ‰)
• he waimaka ma ka pūpū (emi iho ma mua o 1%)¹⁰.