Ingabe nawe ulahlekelwe yithemba? Singakhuluma ngokuphuphuma kwesisu?

Yilabo kuphela abaye babhekana nobuhlungu bokushabalala kwamathemba abo ngokuzumayo abaziyo ukuthi kubuhlungu kangakanani. Ngezinye izikhathi, izinto ezinjengalezi zingenzeka emavikini okuqala okukhulelwa ngesikhathi ongasilindele. Namuhla, sizokhuluma ngesihloko abantu abaningi abanqikaza ukukhuluma ngaso, kodwa sibaluleke kakhulu. Yilokho okushiwo ukuphuphuma kwesisu.

Kuyini ngempela ukuphuphuma kwesisu?

Kalula nje, ukuphuphuma kwesisu , abanye abantu bakubiza nangokuthi ' ukukhipha isisu okuzenzakalelayo' , ukulahlekelwa ukukhulelwa okungalindelekile phakathi kwamasonto okuqala angu-20 okukhulelwa, okungaba yizinyanga ezi-5. Ngisho noma kubizwa ngokuthi ' ukuphuphuma kwesisu ', kubalulekile ukukhumbula ukuthi lokhu akuyona into oyenzile kabi . Esikhathini esiningi, lezi zinto ziyizinto esingenakuzilawula, futhi zenzeka ngoba ingane esibelethweni iyayeka ukukhula .

Yiziphi izinhlobo zokukhipha isisu ezikhona?

Manje ungase uzibuze ukuthi lokhu kuphuphuma kwezisu kwenzeka ngendlela efanayo yini. Yebo, udokotela wakho angakutshela ngalezi zinhlobo zokuphuphuma kwezisu:

Ukuphuphuma Kwesisu Okungafanele

Okwenzekayo kulesi simo ukuthi awazi nokuthi uke waphuphuma isisu. Lokho kusho ukuthi azikho izimpawu ezivame ukwenzeka ngesikhathi sokuphuphuma kwesisu. Kodwa kuphela uma wenza i-ultrasound lapho uthola khona ukuthi akukho ukushaya kwenhliziyo enganeni. Cabanga ukuthi kumelwe ukuba kudabukisa kangakanani ukuthola into efana naleyo.

Ukukhipha Isisu Okuphelele

Kulesi simo, ukukhulelwa kulahleke ngokuphelele futhi isibeletho sakho singenalutho. Ungase uphume igazi, futhi izingcezu zezicubu zombungu nazo zingase ziphume . Udokotela angaqinisekisa ukuthi lokhu kuwukuphuphuma kwesisu okuphelele nge -ultrasound .

Ukukhipha Isisu Okuphindaphindiwe

Lokhu kwenzeka lapho uphuphunyelwa yizisu kathathu kulandelana. Kuthiwa lesi simo sithinta cishe u-1% wemibhangqwana. Kuvamile ukuzizwa ucindezelekile kakhulu lapho kwenzeka into efana nale.

Ukulahlekelwa Yisisu Okusengozini

Kulesi simo, noma ngabe umlomo wakho wesibeletho uvaliwe, ungase uzwe ukopha kanye nobuhlungu besisu esingezansi, okufana nokuya esikhathini. Kodwa isikhathi esiningi , ukukhulelwa kuyaqhubeka ngaphandle kwezinkinga . Kodwa-ke, udokotela wakho uzokuqapha eduze phakathi nokukhulelwa kwakho. Kubalulekile ukulandela imiyalelo kadokotela wakho ngaphandle kokwethuka ngalesi sikhathi.

Ukukhipha Isisu Okungenakugwenywa

Ungase uphume igazi, ube nobuhlungu esiswini esingezansi, futhi umlomo wakho wesibeletho ungase uqale ukuvuleka. Ungase futhi uvuza uketshezi lwe-amniotic , uketshezi lwamanzi oluzungeze ingane. Yilapho-ke amathuba okuba uphuze isisu ngokuphelele.

Ngingazi kanjani ukuthi ngiphuphunyelwa yisisu? (Izimpawu)

Ngezinye izikhathi ungase ungaqapheli nokuthi uphuphunyelwa yisisu. Kodwa kulabo ababhekana nezimpawu ngesikhathi sophuphunyelwa yisisu, lezi yizimpawu ezivame kakhulu:

• Ukopha okwanda kancane kancane. Ngezinye izikhathi izingcezu zezicubu ezimpunga noma amahlule egazi angaphuma.
• Ubuhlungu besisu esingezansi kanye nokuqaqamba. Lokhu kuvame ukuba nzima kakhulu kunobuhlungu obuzwayo phakathi nesikhathi sakho senyanga.
• Ubuhlungu bomhlane. Lokhu kungaqala kancane kancane futhi kube nzima kwabanye abantu, futhi kungaba mnene kwabanye.
• Izimpawu zokukhulelwa ziyancipha kancane kancane. Isibonelo, izinto ezifana nesiyezi kanye nesicanucanu zingase ziphele.

Uma unezinye zalezi zimpawu, kufanele ushayele umhlinzeki wakho wokunakekelwa kwangaphambi kokubeletha ngokushesha . Uzokutshela ukuthi uze ehhovisi noma uye egumbini lezimo eziphuthumayo. Kunzima ukungesabi ngesikhathi esinjengalesi, kodwa kubalulekile ukuthatha isinyathelo ngokushesha.

Yini ebangela ukuphuphuma kwesisu?

Abantu abaningi bayazibuza, "Kungani lokhu kwenzeke kimi?" "Ingabe ngenze into engalungile?" Kodwa iqiniso liwukuthi, ukuphuphuma kwezisu okuningi akubangelwa yiphutha lakho. Ake sibheke izimbangela eziyinhloko.

Ukukhubazeka kwe-Chromosomal

Ukukhubazeka kwe-chromosome kubangela cishe u-50% wokuphuphuma kwesisu ku-trimester yokuqala, okusele cishe amasonto ayi-13 ukukhulelwa. Khumbula, ama-chromosome ayizinto ezincane ngaphakathi kwamaseli ethu ezithwala zonke izakhi zofuzo zethu. Konke kusukela ebulilini bomuntu kuya kumbala wezinwele zakhe, umbala wamehlo, kanye nohlobo lwegazi kunqunywa yilezi zakhi zofuzo.

Uma iqanda nesidoda kuhlangana ukwakha umbungu, amasethi amabili ama-chromosome ayahlanganiswa. Cabanga nje, uma iqanda noma isidoda sinama-chromosome ambalwa noma amaningi kunokujwayelekile, umbungu ophumayo uzoba nenani elingavamile lama-chromosome. Ngemuva kwalokho, njengoba umbungu ukhula, amaseli ayahlukana futhi aphindaphindeke, futhi ukukhubazeka kuleyo nqubo nakho kungabangela ukuphuphuma kwesisu. Esikhathini esiningi, lezi zinkinga zama-chromosome azihleliwe. Akukaziwa kahle ukuthi kungani lokhu kwenzeka.

Yiziphi ezinye izimbangela zokukhishwa kwesisu?

Ngaphandle kokuphazamiseka kwe-chromosomal, ezinye izici eziningana zingabangela ukuphuphuma kwesisu:

• Izifo ezahlukahlukene.
• Ukuchayeka ezifweni ezingaphansi kweqembu lezifo ze-TORCH.Lezi ezinye zezinhlobo zokutheleleka ezingaba yingozi ngesikhathi sokukhulelwa. (Isibonelo: i-Toxoplasmosis, i-Rubella, i-Cytomegalovirus, i-Herpes simplex)
• Ukungalingani kwama-hormone.
• Ukufakelwa okungalungile kweqanda elivundisiwe odongeni lwesibeletho.
• Iminyaka yakho. Ingozi yokuphuphuma kwesisu iyanda kancane njengoba ukhula.
• Ukukhubazeka kwesibeletho (isib., izinguquko esimweni sesibeletho, ama-fibroids)
• Umlomo wesibeletho ongafanele: Yilapho umlomo wesibeletho uqala ukuvuleka kusenesikhathi ngesikhathi sokukhulelwa.
• Ezinye izinto ezibangela indlela yokuphila. Isibonelo, ukubhema, ukuphuza utshwala, nokusebenzisa izidakamizwa ezingekho emthethweni.
• Izifo zesimiso somzimba sokuzivikela, njenge -lupus .
• Isifo Sezinso Esibi Kakhulu.
• Isifo Senhliziyo Esizalwa Naso.
• Isifo sikashukela esingalawulwa.
• Isifo Se-thyroid.
• Ukuchayeka emisebeni.
• Eminye imithi. Isibonelo, imithi efana ne -Isotretinoin (Isotretinoin / Accutane®) ye-acne.
• Ukungondleki Okubi Kakhulu.

Into ebaluleke kakhulu ukuthi abukho ubufakazi besayensi bokuthi ukucindezeleka, ukuvivinya umzimba, ucansi, noma ukusebenzisa amaphilisi okuvimbela inzalo isikhathi eside kubangela ukuphuphuma kwesisu. Kungakhathaliseki ukuthi isimo sakho sinjani, ungazibeki icala uma uphuphuma kwesisu. Ukuphuphuma kwesisu okuningi akubangelwa yinoma yini oyenzile noma ongayenzanga. Ukuqonda lokhu kungakusiza ukuthi uthathe isinqumo.

Kubuhlungu kangakanani ukukhipha isisu?

Lokhu kuyahlukahluka ngempela kumuntu nomuntu. Abanye abantu bangase babe nobuhlungu obukhulu besisu esingezansi kanye nokuqaqamba. Abanye bangase babe nobuhlungu obufana nobokuya esikhathini. Inani lobuhlungu lingahlukahluka kuye ngohlobo lokukhulelwa kwesisu onalo. Isibonelo, uma 'unesisu esiphelele' ekhaya, ungase ube nobuhlungu obukhulu kunomuntu 'ophuze isisu' ngokukhishwa kwesisu ngokuhlinzwa.

Kwenzekani kuqala ngesikhathi sokukhulelwa kwesisu? Kuthatha isikhathi esingakanani?

Kunzima ukusho ngqo ukuthi kwenzekani kuqala ekuphuphumeni kwesisu, ngoba izimpawu zomuntu ngamunye ziyahluka. Ngezinye izikhathi, azikho nhlobo izimpawu, futhi i-ultrasound scan iyona kuphela indlela yokwazi ukuthi ukuphuphuma kwesisu kwenzeke yini. Iningi labesifazane lizwa ubuhlungu besisu kanye nokopha . Kodwa okwenzeka kuqala kuyahlukahluka kuye ngomuntu nomuntu.

Kuyafana nokuthi kuthatha isikhathi esingakanani ukukhulelwa, kuyahlukahluka kuye ngomuntu nomuntu.Abanye besifazane bangase babe nobuhlungu obukhulu kakhulu kanye nokopha okukhulu kunabanye. Udokotela wakho angakutshela ukuthi yini ongayilindela futhi akunike iseluleko sokuthi ungabuphatha kanjani lobu buhlungu nokungakhululeki.

Yiziphi izinto ezingabangela ukuphuphuma kwesisu?

Isici esiyingozi yisici noma ukuziphatha okwandisa amathuba okuthola isifo noma isimo. Kunezici eziningana eziyinhloko ezingabangela ukuphuphuma kwesisu:

• Ubudala bakho: Izifundo zikhombisile ukuthi ingozi yokuphuphuma kwesisu kwabesifazane abaseminyakeni yabo yama-20 iphakathi kuka-12% no-15%, ikhuphukela cishe ku-25% uma beneminyaka engu-40. Ukuphuphuma kwesisu okuningi okuhlobene nokuguga kubangelwa ukukhubazeka kwe-chromosome , okwenzeka lapho ingane isanda kuzalwa inama-chromosome amaningi kakhulu noma ambalwa kakhulu.
• Uma uke waphuphuma isisu ngaphambilini: Uma uke waphuphuma isisu ngaphambilini, unethuba elingama-25% lokuphinda uphuphume isisu (lokhu kuphakeme kancane kunomuntu ongakaze aphuphume isisu ngaphambilini).
• Izimo zempilo: Isifo sikashukela esingalawulwa, izifo ezahlukahlukene, noma izinkinga ezithile ngesibeletho sakho noma umlomo wesibeletho kungandisa ingozi yakho yokuphuphuma kwesisu.

Khuluma nodokotela wakho ngalezi zici eziyingozi. Uzobuyekeza umlando wakho wezokwelapha futhi akutshele ngengozi yakho.

Bangaki abesifazane abaphuphunyelwa yizisu? Iyini ingozi isonto nesonto?

Kulinganiselwa ukuthi phakathi kuka-10% no-20% wabo bonke ukukhulelwa okwaziwayo kugcina ngokuphuphuma kwesisu . Iningi lalokhu kuphuphuma kwesisu (cishe u-80%) kwenzeka ezinyangeni ezintathu zokuqala zokukhulelwa (okungukuthi, phakathi kwamasonto angu-13). Ngemva kwamasonto angu-20, kungaphansi kuka-5% ukuphuphuma kwesisu okwenzekayo.

Ngezinye izikhathi, leli phesenti lingaba phezulu nakakhulu uma ucabanga ngokuphuphuma kwesisu okwenzeka ngokushesha ngemva kokufakelwa. Ezimweni ezinjalo, ukuphuma kwegazi kungase kwenzeke kaningi njengasesikhathini esivamile sokuya esikhathini, ngakho umuntu angase angazi nokuthi ukhulelwe. Lokhu kubizwa nangokuthi 'ukukhulelwa kwamakhemikhali' .

Izindaba ezinhle ukuthi ingozi yakho yokuphuphuma kwesisu iyancipha njengoba ukhula . Kulinganiselwa ukuthi cishe u-15% wokukhulelwa uphela ngokuphuphuma kwesisu. Ingozi yokuphuphuma kwesisu ku-trimester yesibili (amasonto 13 kuya ku-19) iphakathi kuka-1% no-5%. Izici eziningi, njengobudala bakho kanye nempilo yakho, zithinta le ngozi. Kodwa-ke, uma ungenazo ezinye izinkinga zempilo, ingozi yakho yokuphuphuma kwesisu iyancipha njengoba ukhula.

Ukuthola kanjani ngokunembile ukukhulelwa kwesisu?

Ukuqinisekisa ukukhulelwa kwesisu, udokotela wakho angenza lezi zivivinyo ezilandelayo:

• I-Ultrasound: Lokhu kuhlola ukuthi ingane inenhliziyo eshayayo noma kukhona yini 'isikhwama se-yolk', esingabonakala ezigabeni zokuqala zombungu.
• Ukuhlolwa kwegazi:Lokhu kuhlola izinga lehomoni ebizwa ngokuthi 'i-Human Chorionic Gonadotropin' (hCG) . Lena yihomoni ekhiqizwa yi-placenta. Amazinga aphansi e-hCG angaqinisekisa ukukhulelwa kwesisu.
• Ukuhlolwa Kwesibeletho: Lokhu kuhlola ukuthi umlomo wesibeletho sakho uvulekile yini.

Kulashwa kanjani ukuphuphuma kwesisu?

Uma uphuphunyelwa yisisu, umbungu kumele ususwe esibelethweni sakho. Uma kusala noma yiziphi izingxenye zokukhulelwa emzimbeni wakho, ungase ube nezifo, ukopha okukhulu, noma ezinye izinkinga .

Uma ukuphuphuma kwesisu sekuphelile, okusho ukuthi zonke izicubu zombungu sezisusiwe esibelethweni, ngokuvamile akudingeki ukwelashwa okwengeziwe. Udokotela wakho uzokwenza i-ultrasound ukuqinisekisa ukuthi akukho lutho olusele esibelethweni.

Kodwa-ke, uma umzimba wakho ungakasusi zonke lezi zicubu, noma uma ungakaqali ukopha, udokotela wakho angase akuncome ukususa lezi zicubu ngomuthi noma ngokuhlinzwa.

Ukwelashwa Okungahlinzwa

Udokotela wakho angakutshela ukuthi ulinde umzimba wakho ukhiphe ukukhulelwa. Lokhu kuyiqiniso ikakhulukazi ezimweni zokuphuphuma kwesisu okuphuthelwe. Kodwa ukulinda ukuthi ukukhulelwa kudlule kungathatha izinsuku eziningana. Uma kungaphephile ukwenza kanjalo, noma uma ufuna ukuqeda ukukhulelwa ngokushesha okukhulu, udokotela wakho angakunikeza umuthi wokusiza ukukhulelwa kudlule. Le ndlela ivame ukutholakala kuphela uma uphuphunyelwe yisisu ngaphambi kwamasonto ayi-10 okukhulelwa kwakho.

Ngisho noma ukuphuphuma kwesisu kungaqinisekiswanga, uma unezimpawu zokuphuphuma kwesisu, udokotela wakho angase akuncome ukuthi ulale embhedeni izinsuku ezimbalwa. Ungagcinwa esibhedlela ubusuku bonke ukuze uhlolwe. Uma ukopha sekuphelile, ungaqhubeka nemisebenzi evamile. Uma umlomo wakho wesibeletho uvulekile, kutholakala ukuthi 'uyi-cervix engasebenzi kahle' futhi kungenziwa ukuhlinzwa kokuvala umlomo wesibeletho (okubizwa ngokuthi 'i-cervical cerclage') .

Ukwelashwa Kokuhlinzwa

Uma ingane yakho ingakaphumi esibelethweni sakho, noma uma wopha kakhulu, udokotela wakho angenza i-D&C (Dilation and Curettage) noma i-D&E (Dilation and Evacuation) . Uma ukhulelwe amasonto angaphezu kwe-10, ukuhlinzwa kungaba yindlela kuphela. Kule nqubo, umlomo wesibeletho sakho uyavulwa futhi noma yiziphi izicubu zokukhulelwa ezisele ziyasuswa esibelethweni sakho ngokuziklwebha noma ngokuzimunca. Le nqubo yenziwa esibhedlela, ngaphansi kwe-anesthesia.

Yiziphi izimpawu ngemva kokukhipha isisu? Kufanele ngibone udokotela nini?

Kuvamile ukuzwa amabala nokungakhululeki ngemva kokukhipha isisu.

Kodwa-ke, uma uhlangabezana nanoma yiziphi zalezi zimpawu, kufanele ushayele udokotela wakho ngokushesha , ngoba lezi zingaba izimpawu zokutheleleka:

• Kulungile ukopha kakhulu noma ukopha kakhulu.
• Ukuthola umkhuhlane.
• Ukugodola.
• Ubuhlungu obukhulu kakhulu.

Ungafaki lutho ngaphakathi kwesitho sakho sangasese sangasese okungenani amasonto amabili ngemva kokukhipha isisu. Lokhu kusho ukungasebenzisi ama-tampon, ukwenza ucansi, noma ukusebenzisa iminwe noma amathoyizi ocansi phakathi nalesi sikhathi. Udokotela wakho uzohlela i-aphoyintimenti yokulandelela ukuze ahlole ukululama kwakho kanye nanoma yiziphi izinkinga.

Yiziphi izivivinyo okufanele zenziwe uma uqhubeka nokuphuphuma kwesisu?

Uma usuphuphunyelwe yisisu izikhathi ezingaphezu kwezintathu zilandelana (lokhu kubizwa ngokuthi 'ukuphuphunyelwa yisisu okuphindaphindiwe'), khona-ke udokotela wakho angase akucele ukuhlolwa kwegazi noma ukuhlolwa kofuzo. Ezinye zalezi zifo zifaka:

• Ukuhlolwa Kwezakhi Zofuzo: Nobabili wena nomlingani wakho ningenza ukuhlolwa kwegazi, njenge -karyotyping, ukuze kuhlolwe ukukhubazeka kwe-chromosome. Uma izicubu ezivela kumbungu ophumile zitholakala, zingahlolwa futhi ukukhubazeka kwe-chromosome.
• Ukuhlolwa Kwegazi: Ukuhlolwa kwegazi kungenziwa ukuhlola izimo zokuzivikela komzimba noma izimo zamahomoni ezingase zibangele ukuphuphuma kwesisu.

Ngaphezu kwalokho, udokotela wakho angasebenzisa enye yalezi zindlela ukuhlola isibeletho sakho:

• I-Hysterosalpingogram: Lena inqubo esebenzisa udayi, ofana ne-X-ray, ukuhlola isibeletho sakho kanye namashubhu esibeletho.
• I-Hysteroscopy: Kule nqubo, udokotela ubheka ngaphakathi kwesibeletho ngethuluzi elincane, elifana ne-telescope.
• I-Laparoscopy: Kulokhu, udokotela ubheka izitho zangasese ngethuluzi elikhanyayo.

Ungakhulelwa futhi ngemva kokuphuphuma kwesisu? Kungakabiphi?

Yebo, ungakwazi. Iningi labesifazane abaphuphunyelwa yisisu (cishe u-87%) bayaqhubeka nokukhulelwa okuvamile kanye nezingane ezinempilo. Ukuphuphunyelwa yisisu akusho ukuthi unenkinga yokuzala. Khumbula, ukuphuphunyelwa yisisu okuningi kubangelwa ukungasebenzi kahle kwe-chromosome, hhayi into oyenzile.

Isinqumo sokuthi uzozama nini ukukhulelwa futhi yinto wena nodokotela wakho okufanele niyenze ndawonye. Iningi labesifazane lingakhulelwa futhi ngemva kokuya esikhathini 'okuvamile'.

Into ebaluleke kakhulu ukuzinika isikhathi sokululama ngokomzimba nangokwengqondo ngemva kokukhipha isisu.Ukwelulekwa kuyatholakala ukukusiza ukubhekana nalokhu kulahlekelwa. Amaqembu okusekela lapho ungakhuluma khona ngokulahlekelwa yisisu kungaba umthombo owusizo kuwe nakumlingani wakho. Cela udokotela wakho ulwazi olwengeziwe mayelana nokwelulekwa kanye namaqembu okusekela anjalo. Ngaphezu kwakho konke, ungazibeki icala ngokuphuphuma kwesisu. Zinike isikhathi sokulila.

Uma uke waphuphuma izisu kathathu kulandelana, buza udokotela wakho mayelana nokuhlolwa ukuze uthole imbangela eyisisekelo. Kungcono ukusebenzisa izindlela zokuvimbela inzalo uze uthole imiphumela yalezo zivivinyo. Udokotela uzobuyekeza imiphumela yokuhlolwa, bese ekutshela ukuthi uyeke ukusebenzisa izindlela zokuvimbela inzalo bese uzama ukukhulelwa futhi.

Ingabe ukuphuphuma kwesisu kungavinjelwa futhi?

Eqinisweni, ngokuvamile akunakwenzeka ukuvimbela ukuphuphuma kwesisu. Uma uke waphuphuma kwesisu, akusikho ngoba wenze noma yini eyabangela lokho. Into engcono kakhulu ongayenza ukunakekela umzimba wakho kahle. Nazi ezinye izindlela ongazinakekela ngazo:

• Ukuya njalo ekunakekelweni kwakho kokubeletha.
• Ukugcina isisindo esinempilo esikufanele.
• Ukugwema izinto ezingabangela ukuphuphuma kwesisu, njengokuphuza utshwala nokubhema.
• Ukuthatha i-vitamin ngaphambi kokubeletha.
• Ukuzivocavoca njalo kanye nokudla okunempilo.

Ungabhekana kanjani nosizi lokuphuphuma kwesisu? ( Okokugcina, khumbula lokhu )

Ukulahlekelwa ukukhulelwa kuyinto ebuhlungu kakhulu, ephakamisa imizwa nemibuzo eminingi. Ukululama ngokomzwelo ngemva kokuphuphuma kwesisu kuvame ukuba isikhathi eside kakhulu futhi kube nzima kunokululama ngokomzimba. Zinike isikhathi osidingayo ukuze ukhalele ukulahlekelwa kwakho. Khuluma ngemizwa yakho nomlingani wakho, abangani nomndeni. Noma thola iqembu lokusekela ukulahlekelwa ukukhulelwa ku-inthanethi. Zizungeze nabantu abakusekelayo, noma funa usizo lochwepheshe ukuze bakusize ubhekane nokulahlekelwa.

Ukukhulelwa kwesisu kuyisikhathi esithinta imizwa kakhulu kubazali abalindele, futhi kungokwemvelo ukulila ngokulahlekelwa. Khumbula, ukukhulelwa kwesisu akukwazi ukuvinjelwa, futhi akuyona into oyenzile kabi. Akusho ukuthi awukwazi ukuphinda ube nabantwana, noma ukuthi uzophinde uphuze. Kuvamile ukuzizwa udangele. Thola ukwesekwa emndenini, kubangani, emaqenjini okusekela aku-inthanethi, noma kumeluleki onelayisensi. Uma uhlela ukukhulelwa futhi, khuluma nodokotela wakho ngokukhulelwa kwakho okulandelayo, isikhathi, kanye nanoma yimiphi imibuzo ongase ube nayo.

Ukuphuphuma Kwesisu , Ukukhulelwa, Impilo Yabesifazane, Izimpawu, Izimbangela, Ukwelashwa, Ukukhipha Isisu