Isigaba sokuhlinzwa isinyathelo ngesinyathelo

NginoSolwazi Gilles Kayem, udokotela wokubelethisa nodokotela wabesifazane esibhedlela iLouis-Mourier (92)

Qondisa itshe

Kungakhathaliseki ukuthi ukuhlinzwa kuhleliwe noma kuyaphuthuma, owesifazane okhulelwe ufakwa ekamelweni lokuhlinza. Abanye abakhulelwe bayakwamukela, uma izimo zilungile, ukuthi ubaba ukhona eceleni kwakhe. Okokuqala, sihlanza isikhumba sesisu ngomkhiqizo we-antiseptic ukusuka phansi kwamathanga ukuya ezingeni lesifuba, ngokugcizelela inkaba. Khona-ke kufakwa i-catheter yomchamo ukuze ukhiphe ngokuqhubekayo esinyeni. Uma ngabe umama ozozala esekwi-epidural, udokotela obulala izinzwa wengeza umthamo owengeziwe wemikhiqizo yokubulala izinzwa ukuze aqedele i-analgesia.

Ukusikwa kwesikhumba

Udokotela wokubelethisa usengakwazi ukuhlinza. Esikhathini esedlule, ukusika umugqa ophakathi nendawo oqondile kwakwenziwa esikhumbeni nasesibelethweni. Lokhu kwabangela ukopha okuningi futhi isibazi sesibeletho ngesikhathi sokukhulelwa okulandelayo sasintekenteke kakhulu. Namuhla, isikhumba kanye nesibeletho ngokuvamile zisikwe ngokuphambene.. Lokhu okubizwa ngokuthi i-Pfannenstiel incision. Le nqubo iqinisekisa ukuqina okwengeziwe. Omama abaningi bakhathazeka ngokuba nesibazi esikhulu kakhulu. Kuyaqondakala lokhu. Kodwa uma ukusika kuyingcingo kakhulu, ukukhipha ingane kungase kube nzima kakhulu. Okubalulekile ukusika isikhumba endaweni efanele. Ububanzi obunconyiwe bakudala buyi-12 kuye ku-14 cm. I-incision yenziwa ngo-2-3 cm ngaphezu kwe-pubis. Iyini inzuzo? Kule ndawo, isibazi cishe asibonakali ngoba sisesibayeni sesikhumba.

Ukuvulwa kodonga lwesisu

Ngemva kokusika esikhunjeni, udokotela wokubelethisa usika amafutha bese kuba i-fascia (izicubu ezimboza imisipha). Indlela yokuhlinzwa ivele eminyakeni yamuva nje ngaphansi kwethonya loprofesa uJoël-Cohen noMichael Stark. Amafutha bese imisipha isakazwa eminweni. I-peritoneum nayo ivuliwe ngendlela efanayo evumela ukufinyelela emgodini wesisu kanye nesibeletho. Umgodi wesisu uqukethe izitho ezahlukahlukene ezifana nesisu, ikholoni noma esinyeni. Le ndlela iyashesha. Kuyadingeka ukubala phakathi kwemizuzu engu-1 no-3 ukuze ufinyelele emgodini we-peritoneal ngesikhathi sokuhlinzwa kokuqala. Ukunciphisa isikhathi sokuhlinzwa kunciphisa ukopha futhi mhlawumbe kwehlisa ingozi yokutheleleka, okungavumela umama ukuba alulame ngokushesha ngemva kokuhlinzwa.

Ukuvulwa kwesibeletho: i-hysterrotomy

Udokotela ube esengena esibelethweni. I-hysterrotomy yenziwa engxenyeni engezansi lapho izicubu ziyi-thinnest. Yindawo eyopha kancane uma ingekho i-pathology eyengeziwe. Ngaphezu kwalokho, isibazi se-uterine sinamandla kune-suture yomzimba wesibeletho ngesikhathi sokukhulelwa okulandelayo. Ukuzalwa okuzayo ngendlela yemvelo kungenzeka kanjalo. Uma isibeletho sesisikiwe, udokotela wezifo zabesifazane unweba ukusika eminweni futhi aphule isaka lamanzi. Ekugcineni, ukhipha ingane ngekhanda noma ngezinyawo kuye ngokuthi isethulo. Umntwana ubekwa esikhumbeni nomama imizuzu embalwa. Qaphela: uma umama esehlinzwe ngokuhlinzwa, ukuhlinzwa kungase kuthathe isikhathi eside ngoba kungase kube nokuhlangana, ikakhulukazi phakathi kwesibeletho nesinye. 

Delivery

Ngemva kokuzalwa, udokotela obelethisayo ususa i-placenta. Lokhu ukukhululwa. Khona-ke, uhlola ukuthi imbobo yesibeletho ayinalutho yini. Isibeletho siyavaleka. Udokotela ohlinzayo anganquma ukuyikhipha ngaphandle ukuze ayishuthe kalula noma ayishiye emgodini wesisu. Ngokuvamile, i-visceral peritoneum evala isibeletho nesinye ayivaliwe. I-fascia ivaliwe. Isikhumba sesisu sakho yona, ihlotshiswe ngokusho kwabasebenzi, umthungo okwazi ukumunca noma cha noma ngokuyisisekelo. Ayikho indlela yokuvala isikhumba ebonise umphumela wobuhle ongcono ezinyangeni eziyisithupha ngemuva kokuhlinzwa