Ngesikhathi sokukhulelwa, kubalulekile ukugcina ukuthuthukiswa okulungile kwe-placenta, ngoba kuyisisindo esikhulu somntwana ongakazalwa, futhi ukufaneleka kwendawo yayo kuyisiqinisekiso sendlela ejwayelekile yokukhulelwa kuze kufike ukulethwa. Ngokuvamile, i-placenta itholakala endaweni yomzimba noma ngaphansi kwesibeletho, eduze nodonga lwangemuva, ngokushintshela kuya kwe-lateral, njengalezi zindawo ukugeleza kwegazi kuhle kakhulu. Ngokuvamile kancane i-placenta ingase ibekwe odongeni langaphambili, ngoba libhekene nezinguquko kune-posterior.
I-Placenta previa yi-pathology ekhonjiswe ukunamathiswa okungajwayelekile kwe-placenta ezindongeni ezingxenyeni ezingezansi zesisu, ngenkathi ihlanganisa indawo ye-pharynx yangaphakathi.
Izinhlobo ze-placenta praevia
- indawo ephansi ye-placenta - engahlanganisi indawo yomphimbo wangaphakathi, umkhawulo we-placenta usezingeni elingezansi kunalokho okufanele kube yinto evamile;
- ukugcwalisa (noma okuphakathi) isethulo se-placenta - indawo yomphimbo wangaphakathi uvinjelwe ngokuphelele yi-placenta;
- isethulo esingaphelele (noma esinqunyiwe) se-placenta - i-placenta ihlanganisa ingxenye yengane yomlomo yangaphakathi.
Isethulo esingaphelele se-placenta sichazwa ngokuthi:
- emaphethelweni - emaphethelweni aphansi we-placenta itholakala ezingeni lomkhawulo we-pharynx yangaphakathi;
- i-lateral - umkhawulo we-placenta uhlanganisa ingxenye ye-pharynx yangaphakathi.
I-Placenta previa - izimbangela
Izinguquko ze-Dystrophic embranini yomsindo wesibeletho zingase zibe isizathu esiyinhloko sokwenzeka kwe-placenta previa ngesikhathi sokukhulelwa. Lokhu kungenzeka njengomphumela wokukhipha izisu zangaphambilini, ukutheleleka ngokocansi, ukuvuvukala noma ngenxa yezifo ze-septic zokuthutha. Izimbangela zalesi sifo zingase zibe yinhliziyo, isifo noma isifo sesibindi. Kumele kuqashelwe ukuthi ngokuvamile ngokuvamile i-placenta previa ivela kwabesifazane ababeletha hhayi okokuqala.
I-Placenta previa - izimpawu
Lezi zifo, njengoba kungeyona into emangalisa, ingaba yinto engavamile. Kodwa noma kunjalo, uphawu oluyinhloko phambi kwe-placenta previa luphuma. Lokhu kungachazwa ngeqiniso lokuthi izicubu zomzimba ezingenakulinganiswa, ngakho-ke zingadlulela lapho isibeletho sithulwa, okubangelwa ukuphuma kwegazi. Njengomthetho, lesi sibonakaliso sihamba ngokungenabuhlungu futhi singayeka kungazelelwe, kodwa emva kwesikhashana, vuka futhi.
Esinye isifo se-placenta previa singase sibe i-hypoxia ye-fetal. Izinga le-hypoxia lixhomeke ebukhulu bokuphazamiseka okuphazamisayo, ngenxa yalokho okuyingxenye yalokho okushiwo yi-part exfoliated ukuyeka ukubamba iqhaza ohlelweni lwe-utero-placental circulation system. Ukunquma ngokunembile i-placenta previa noma okunamathiselwe kwayo okuphansi kungenzeka ngesikhathi sokuhlolwa kwe-ultrasound.
I-Placenta previa - ukwelashwa
Uma i-placenta ikhona, owesifazane okhulelwe kufanele abe ngaphansi kokuqondiswa kwezokwelapha njalo. Ukwelashwa kuxhomeke ekutholakaleni, ubude namandla okukhishwa kwamanzi. Uma kwenzeka ukuphuma kwegazi ngesikhathi sokukhulelwa engaphezu kwamasonto angu-24, ukwelashwa kwenziwa esibhedlela lapho kuphumula khona ukulala kombhede, ngaphezu kwalokho, amalungiselelo anqunywe ukunciphisa ithonya lesibeletho futhi athuthukise ukujikeleza kwegazi. Ezimweni lapho ukuphuma kwegazi kungabonwa khona, owesifazane angaba ekhaya. Kodwa, ngokuqinisekile, kufanele ugweme ukuzikhandla ngokomzwelo nangokomzimba, futhi ungafaki ukuxhumana kocansi. Kubalulekile ukuchitha isikhathi esengeziwe emoyeni ovulekile, ukuphumula nokudla kahle.
Ukuzalwa nge-placenta praevia
Ukulethwa okungajwayelekile akunakwenzeka nge-placenta previa ephelele. Ukuhlinzekwa kwesigaba se-Caesarea kwenziwa njalo esikhathini samasonto angu-38, ngisho nangaphandle kokuphuma kwegazi.
Kungenzeka ukuqedela ukubeletha ngokwemvelo ngesethulo esinqunyiwe se-placenta, kodwa isinqumo sokugcina esizothathwa sizothathwa udokotela lapho umlomo wesibeletho uvula u-5-6 cm. Uma isethulo esincinci sincane futhi ukubonakala kungabalulekile, ukuvuleka kwesibindi sesisu kuyenziwa. Ngenxa yalokho, ikhanda lomntwana liyancipha futhi lishaya imithwalo yegazi ephuma. Kule ndaba, umsebenzi wokuzikhandla unokwenzeka, kepha uma ukuqhutshwa komsebenzi kungasebenzi, umsebenzi ugcwaliswa ngokushesha.