Ukuzalwa ngokusakaza kwe-pelvic - indlela yokulungiselela umama?

Ukuzalwa nge-breech isethulo kubhekene nezingozi eziningi. Ngenxa yalokhu, ukulungiswa kwabesifazane abakhulelwe kule nqubo yokulethwa kwenziwa kusengaphambili. Ake sicabangele le ncazelo ngokuningiliziwe, sizochaza okukhethekile kokuphatha ukunakekelwa kwokhokho, kungenzeka izinkinga zenqubo yokubukeka komntwana.

I-Biomechanism yezabasebenzi nge-presentation ye-pelvic

Ngaphambi kokulungiswa kwezidingo, odokotela benza isifundo sokulawula izinsuku ezimbalwa ukuze bahlole ukuthi isimo se-fetus sishintshile yini. Lapho kuqala inqubo yokuzalwa, lo wesifazane uya ekamelweni lokulethwa. Indlela efanayo yokusebenza embukisweni wezintambo zilandelayo:

1. Ukufakela ama-gliti amancane emphethweni omncane womama futhi ahambisane nomsele wokuzalwa. Inqubo iqala ngeqiniso lokuthi umugqa wokugcoba ukufakwa kwesibindi somntwana. Khona-ke ukuphela kwakhe kokugwedla kudlulela emgodleni wesigqoko esincane. Ngenkathi yokulwa, izintambo ziyancipha phansi, futhi zijule ngokujulile ukufaka isikhumba esincane. Esinye isitho siwela ngaphansi kwesinye. Isebenza ngokuqondile njengephuzu lokubamba, njenge-fontanel encane ekubonisweni kwekhanda.
2. Ukuphenduka kwangaphakathi. Kukhona ukujikeleza kwezinkinobho. Ngesikhathi esifanayo, i-anterior isondela ekukhulumeni komuntu oyedwa, i-posterior eyodwa iqondiswa ku-sacrum.
3. Ukusika nokuphuphuka kwamazinyo. Kwenzeka emva kokulungiswa komzimba wangasese wengane ngesifunda se-aliac. Ngakho-ke ukuphela komzimba kuzalwa. Kulesi simo, umgogodla wenza ubugovu obuqinile be-lateral. Ngendlela ehlanganisiwe ye-breech presentation, imilenze eyodwa noma emibili iphuma.
4. Ukuzalwa kwebhande lehlombe. Ukujikeleza kwangaphakathi kwenzeka cishe kanyekanye nokugoba kwekhanda. Ibhande eliqhakazile lizalwa kanye ne-previa yekhanda - isici esithintanayo sifakwa ngaphakathi kwesikhumba sowesifazane wesifazane.
5. Ukuzalwa kwekhanda. Ivela esimweni esihle. I-suboccipitary fossa igxilwe yi-arc ye-boneal lateral. Ngemuva kwalokhu, isikhumba, ubuso bomntwana, ikhanda lakhe, umqhele nomhlane wekhanda kuzalwa kancane kancane.

Ukuqala kwe-breech kuqala kanjani?

Ama-precurse of labor in presentation ye-pelvic ahluke kulabo abandulela inqubo ejwayelekile emakhanda. Kwalezi zithimba zithi:

• ukuhamba kwesikhala ;
• iziphazamiso ezivamile;
• ukuphuma kwe-amniotic fluid.

Kodwa-ke, kunezinye izici zokuqala ngokushesha kwenqubo yokuzalwa. Ngakho inqubo yokuthunjwa ingaqala uma kungekho ukuvula okuphelele kwesibeletho. Lokhu kungenxa yobukhulu obuncane bokuphela kwe-pelvic, uma kuqhathaniswa nekhanda elilodwa. Ngenxa yalokhu, esikhathini sokuqala sokubeletha owesifazane uphoqeleka ukuba ahambisane nokuphumula kombhede. Lokhu kuvimbela ukuthuthukiswa kwezinkinga zenqubo yokulethwa kwezidingo.

Ukubeletha kanjani ekubonisweni kwe-pelvic?

Inkambo yokusebenza embukisweni we-pelvic ilawulwa ngokuphelele yizidakamizwa. Isimiso esiyinhloko ekuziphatheni kwesibonelelo sokuzalwa ukugcina isikhundla esifanele somntwana. Imilenze kufanele iswetshwe eceleni kwesiqu. Izithelo ezithathayo zibacindezela esifubeni. Okokuqala ingane izalwa inkaba, kuze kube sekugcineni komugqa ophansi we-scapula. Kuphela emva kwalokhu, izandla, ibhande lehlombe liphuma futhi ikhanda lizalwa.

Amaphuzu aphambili omsebenzi ezenzakalweni zentando yilezi:

• ukuvimbela ukulahlekelwa kwemilenze;
• ukusizwa ngesidingo sokususa izibambo kanye nekhanda (ukuvimbela ukuphefumula);
• ukuqaliswa kwe-episiotomy (ukuzalwa okusheshayo kwekhanda).

Isethulo samafilimu - ukubeletha noma ukuzalwa kwemvelo?

Ngalolu hlobo lwelungiselelo lomntwana esibelethweni sikamama, njengokwethulwa kwe-fetus, ukubeletha noma i-cearean kunqunywa kuphela odokotela. Kulokhu, odokotela bakhuluma ngokubeletha kwemvelo. Kodwa akulona njalo lolu hlobo lokulethwa kuvunyelwe. Phakathi kwezinkomba zesigaba sokulahla ngesethulo se-pelvic, kubalulekile ukuphawula:

• ukuthwala isisu sesilisa;
• ukuqala kusenesikhathi kwenqubo yokuzalwa;
• ukunyathela izinyawo;
• i-pelvis encane yowesifazane ekubelethweni;
• ingozi yokwandiswa okuqinile kwekhanda ngesikhathi sokubeletha;
• ezinkulu noma ngokuphambene - isithelo esincane (ngaphansi kuka 2.5 kg noma ngaphezulu 4);
• ukutholakala kwezingcingo zomzimba;
• hypoxia engapheli;
• ukutholakala kwezinye izinkinga.

Ingabe ukubeletha kwemvelo kunokwenzeka ngesethulo se-pelvic?

Izithiyo ze-obstetricians ziphendula lo mbuzo ku-affirmative. Ukuzalwa ngokwemvelo ngekusakaza kwe-pelvic kwenziwa nge-glutealateral ne-gluteal ilungiselelo le-fetus. Kulesi simo, odokotela bacabangela ezinye izici zokubeletha, okuvumela ukuzalwa okuvamile:

• ukungabikho kokungena komgudu womlomo ;
• izithelo ezincane;
• usayizi ojwayelekile wesifuba;
• ukuvula ngesikhathi somlomo wesibeletho;
• ukukhulelwa kwesikhathi.

Ukuqhuba ukubeletha kweTovyanov ngezethulo zomzimba

Uma sicabangela izici zomsebenzi ezenzakalweni ezithintekayo, kufanele kuqaphele ukuthi ngokuvamile lezi zithimba zokuhlinza zisebenzisa incwadi kaZawvyanov. Inhloso yalokhu ukugcina ilungiselelo evamile lezingxenye zomzimba ekuzalweni kokubeletha. Ngakho ngesikhathi sokuxoshwa kwengane kudingekile ukuqinisekisa ukuthi imilenze iqondiswa ngaso sonke isikhathi futhi icindezelwe emzimbeni (thorax).

Ngesikhathi esifanayo, gcina izingalo zomntwana ziwela ngenkathi ziphethe imilenze. Lokhu kuvimbela ukuvala. Izinyawo zibekwe ezingeni lesobuso, okugcina isimo esifanele sekhanda. Kulesi sikhundla, umzimba we-fetal uthola ukuma kwe-conical. Ivolumu esiphezulu ifinyelelwa emazingeni ehlombe (42 cm ububanzi). Emva kokuzalwa kwamahlombe, ukubukeka kwekhanda kwenzeka ngaphandle kobunzima. Yile ndlela ukulethwa kwenzelwa ngayo isethulo se-pelvic.

Izinkinga zokulethwa kwe-breech

Ukukhethwa okulungile kwamaqhinga kanye nokugcina ukulandelana kwezibonelelo zesibonelelo kungabikho ukuthuthukiswa kwezinkinga. Noma kunjalo, lokhu akukwenzeka njalo. Phakathi kokuphulwa okungenzeka, odokotela babiza imiphumela elandelayo yokusebenza embukisweni wezintambo:

• ukukhishwa kusenesikhathi kwe-amniotic fluid;
• ukulahlekelwa izingxenye zomzimba kanye nentambo yomlomo;
• ubuthakathaka obuncane bokusebenza komsebenzi;
• ukufa komntwana (ngokunciphisa isikhathi eside kwendonga yomzimba emdongeni we-pelvic imizuzu engaphezu kwengu-10);
• isifiso nge-amniotic fluid;
• okungahleliwe, okuphrinta.

Isethulo samafilimu - ukulethwa ngaphambi kwesikhathi

Ukuzalwa nge-pelvic isethulo se-fetus ngokuvamile kuqala ngaphambi kwesikhathi esimisiwe. Lokhu kubangelwa ukucindezela ngokweqile kwengxenye ehloniphekile yesiqu esibelethweni. Njengoba kunikezwe leli qiniso, abesifazane abanobuhle basethulo basemakhaya bahanjelwa esibhedlela emavikini angu-38-39. Ukukhulelwa ngokucophelela ukulungiselela inqubo, landela ukuvulwa komlomo wesibeletho kanye nesisu. Lokhu kusiza ukugwema ukuthuthukiswa kwezinkinga ngesikhathi sokulethwa.