Kukuziphi izimo lapho ukuhlinzwa kokuhlinzwa?

Isigaba sokuhlinzwa esihleliwe: izimo ezihlukene

Ukuhlinzwa ngokuhlinzwa kuvame ukuhlelwa phakathi nesonto lama-39 le-amenorrhea, noma izinyanga eziyi-8 nengxenye zokukhulelwa.

Uma kwenzeka ukuhlinzwa kokuhlinzwa, ulaliswa esibhedlela ngosuku olwandulela ukuhlinzwa. Kusihlwa, udokotela obulala izinzwa wenza iphuzu lokugcina nawe futhi uchaza kafushane inqubo yokuhlinza. Udla kancane. Ngakusasa, akukho kwasekuseni, uziyela wena egumbini lokuhlinza. I-catheter yomchamo ifakwa unesi. Khona-ke udokotela obulala izinzwa uyakufaka futhi usethe indawo yokubulala izinzwa yomgogodla, ngemva kokuba eseyibambile endaweni yokulunywa. Ube ulele phezu kwetafula lokuhlinza. Izizathu eziningana zingase zichaze ukukhetha ukuhlela ukuhlinzwa: ukukhulelwa okuningi, isikhundla somntwana, ukuzalwa ngaphambi kwesikhathi, njll.

Isigaba sokuhlinzwa esihleliwe: sokukhulelwa okuningi

Uma zingekho izingane ezimbili kodwa ezintathu (noma ngisho nangaphezulu), ukukhethwa kokuhlinzwa kokuhlinzwa kudingekile kakhulu futhi ivumela ithimba lonke lokubelethisa ukuthi libe khona ukuze lamukele izingane ezisanda kuzalwa. Kungenziwa kuzo zonke izingane noma eyodwa nje yazo. Ngokwesinye isandla, uma kukhulunywa ngamawele, ukuzalwa kwesitho sangasese sowesifazane kungenzeka. Ngokuvamile, isikhundla sokuqala, esiqinisekiswe yi-ultrasound, esinquma indlela yokulethwa. Ukukhulelwa okuningi kubhekwa njengokukhulelwa okusengozini enkulu. Kungenxa yalesi sizathu ukuthi ziyisihloko se-a ukulandelela kwezokwelapha okuqinisiwe. Ukuze uthole ukungahambi kahle okungenzeka futhi ukunakekele ngokushesha ngangokunokwenzeka, omama abakhulelwe banama-ultrasound amaningi. Abesifazane abakhulelwe bavame ukululekwa ukuthi bayeke ukusebenza phakathi nenyanga yesi-6 ukuze banciphise ingozi yokubeletha ngaphambi kwesikhathi.

Ukuhlinzwa okuhleliwe ngenxa yokugula ngesikhathi sokukhulelwa

Izizathu zokuthatha isinqumo sokwenza ukuhlinzwa kokuhlinzwa kungase kube a ukugula komama. Lokhu kunjalo lapho umama okhulelwe ehlushwa isifo sikashukela futhi isisindo esingaba khona somntwana ozayo silinganiselwa ngaphezu kuka-4 g (noma 250 g). Kuyenzeka futhi uma umama ozayo enezinkinga ezinkulu zenhliziyo. nokuthi imizamo yokuxoshwa inqatshelwe. Ngokufanayo, lapho ukuqubuka kokuqala kwe-herpes yangasese kwenzeka ngenyanga ngaphambi kokubeletha ngoba ukuzalwa kwesitho sangasese sowesifazane kungangcolisa ingane.

Kwesinye isikhathi siyesaba ingozi yokopha njengalapho i-placenta ifakwe iphansi kakhulu futhi ivala umlomo wesibeletho (placenta previa). Udokotela wezifo zabesifazane uzokwenza ngokushesha a UKhesari ngisho noma ukuzalwa kufanele kube ngaphambi kwesikhathi. Lokhu kungase kube njalo ikakhulukazi uma umama ozayo ehlushwa i-pre-eclampsia (i-arterial hypertension nokuba khona kwamaprotheni emchameni) ongazweli ekwelapheni futhi uba kubi, noma uma ukutheleleka kwenzeka ngemuva kokuphuka ngaphambi kwesikhathi (ngaphambi kwamaviki angama-34 we-amenorrhea) yesikhwama samanzi. Icala lokugcina: uma umama etheleleke ngamagciwane athile, ikakhulukazi i-HIV, kungcono ukuthi abelethe ngokuhlinzwa, ukuze kuvinjwe ukusuleleka kwengane ngesikhathi sokudlula emgudwini wesitho sangasese sowesifazane.

Kuhlelwe nokuhlinzwa uma i-pelvis kamama incane kakhulu noma inokukhubazeka. Ukuze silinganise i-pelvis, senza umsakazo, obizwa ngokuthi i-pelvimetry. Kwenziwa ekupheleni kokukhulelwa, ikakhulukazi lapho umntwana ethula nge-breech, uma umama wesikhathi esizayo emncane, noma uma esevele ebelethe nge-cesarean section. I Ukuhlinza okuhleliwe kuyanconywa uma isisindo somntwana singu-5 kg ​​noma ngaphezulu. Kodwa njengoba lesi sisindo sinzima ukusihlola, kubhekwa ukuthi isigaba sokuhlinzwa kufanele sinqunywe, icala ngecala, uma ingane inesisindo esiphakathi kuka-4,5g no-5kg. Ukwakheka komzimba kamama

I-Caesarean Ehleliwe: Umthelela WamaKhesariya Amadala

Uma umama esevele enezingqimba ezimbili zokuhlinzwa, ithimba lezokwelapha ngokushesha lisikisela ukuhlinzwa kwesithathu.. Isibeletho sakhe sibuthakathaka futhi ingozi yokuqhekeka kwesibazi, ngisho noma ingavamile, ikhona uma kwenzeka ukubeletha ngokwemvelo. Icala lokuhlinzwa kokuhlinzwa okudlule okulodwa lizoxoxwa nomama kuye ngembangela yokungenelela kanye nezimo zamanje zokubelethisa.

Qaphela ukuthi sibiza ukuhlinzwa kokuhlinzwa okuphindaphindiwe ngokuthi ukuhlinzwa okwenziwa ngemva kokubeletha okokuqala ngokuhlinzwa.

Isimo somntwana singaholela ekuhlinzweni okuhleliwe okuhleliwe

Ngezinye izikhathi, yisimo se-fetus esibeka ingxenye yokuhlinzwa. Uma u-95% wezingane zizalwa zibheke phansi, abanye bakhetha izikhundla ezingavamile ezingakwenzi kube lula kodokotela ngaso sonke isikhathi. Isibonelo, uma ephambene noma ikhanda lakhe esikhundleni sokuguquguquka emthonjeni wesifuba liphambukile ngokuphelele. Ngokunjalo, kunzima ukubalekela ukuhlinzwa uma umntwana ezinzile evundlile esibelethweni. Icala lokuvimbezela (3 kuya ku-5% wokudiliva) unquma phezu kwecala necala.

Ngenjwayelo, singaqale sizame ukucebisa umntwana ngokuzilolongela inguqulo ngama-external maneuvers (VME). Kodwa le nqubo ayisebenzi ngaso sonke isikhathi. Nokho, ukubeletha okuhleliwe akuhlelekile.

Isiphathimandla Esiphakeme Sezempilo sisanda kucacisa kabusha izinkomba zesigaba sokuhlinzwa esihleliwe, lapho umntwana wethula i-breech: ukubhekana okungekuhle phakathi kwe-pelvimetry kanye nesilinganiso sezilinganiso zombungu noma ukuchezuka okuqhubekayo kwekhanda. Uphinde wakhumbula ukuthi kuyadingeka ukuqapha ukuphikelela kokwethulwa nge-ultrasound, ngaphambi nje kokungena egumbini lokuhlinza ukwenza isigaba sokuhlinzwa. Kodwa-ke, abanye odokotela bokubelethisa basancamela ukugwema ingozi encane futhi bakhethe ukuhlinzwa ngokuhlinzwa.

Ukuhlinzwa kokuhlinzwa kuhlelelwe ukubhekana nokubeletha ngaphambi kwesikhathi

Ekubelethweni ngaphambi kwesikhathi, a UKhesari ivimbela umntwana ekukhathaleni ngokweqile futhi imvumela ukuba anakekelwe ngokushesha. Kuyathandeka futhi lapho umntwana ekhubazekile futhi uma kunokucindezeleka okukhulu kwe-fetus. Namuhla, eFrance, U-8% wezingane uzalwa ngaphambi kwamasonto angama-37 okukhulelwa. Izizathu zokusebenza ngaphambi kwesikhathi ziningi futhi zihlukile ngokwemvelo. I izifo komama ziyimbangela evame kakhulu.  Umfutho wegazi ophakeme kanye nesifo sikashukela nakho kuyizici eziyingozi. Ukuzalwa ngaphambi kwesikhathi kungenzeka futhi lapho umama enokukhubazeka kwesibeletho. Lapho umlomo wesibeletho uvuleka kalula kakhulu noma uma isibeletho singalungile (i-bicornuate noma i-septate uterus). Umama okhulelwe okhulelwe izingane ezimbalwa naye unengozi eyodwa kwezimbili zokubeletha ngaphambi kwesikhathi. Ngezinye izikhathi kuba uketshezi oluningi lwe-amniotic noma ukuma kwe-placenta okungaba imbangela yokuzalwa ngaphambi kwesikhathi.

Ingxenye yokuhlinzwa yokuhlinzwa

Ukuhlinzwa ngokuhlinzwa lapho kudingeka kuhambisana nokuhlinzwa okufiswa owesifazane okhulelwe ngaphandle kwezinkomba zezokwelapha noma zokubelethisa. Ngokusemthethweni, eFrance, odokotela bokubelethisa benqaba ukuhlinzwa ngaphandle kwezinkomba zezokwelapha. Nokho, idlanzana lomama abakhulelwe liphusha ukubeletha lisebenzisa le nqubo. Izizathu zivame ukuba ngokoqobo (ukunakekela izingane ukuhlela, ukuba khona kukababa, ukukhetha kosuku…), kodwa ngezinye izikhathi zisekelwe emibonweni engamanga njengokunciphisa ukuhlupheka, ukuphepha okukhulu kwengane noma ukuvikela okungcono kwe-perineum. Ukuhlinzwa kokuhlinzwa kuyisenzo esivamile kwezokubelethisa, esihlanganiswe kahle futhi siphephile, kodwa sihlala siwukungenelela kokuhlinzwa okuhlobene nengozi eyengeziwe yempilo kamama uma kuqhathaniswa nokubeletha ngendlela yemvelo. Kukhona ikakhulukazi ingozi ye-phlebitis (ukwakheka kwehlule emithanjeni yegazi). Ukuhlinzwa kokuhlinzwa kungase futhi kube imbangela yezinkinga ekukhulelweni okuzayo (ukungami kahle kwe-placenta).

I-Haute Autorité de santé incoma ukuthi odokotela thola izizathu eziqondile zalesi sicelo, xoxani ngazo futhi nizisho efayeleni lezokwelapha. Uma owesifazane efuna ukuhlinzwa ngokuhlinzwa ngenxa yokwesaba ukuzalwa kwesitho sangasese sowesifazane, kuhle ukuba amnike ukwesekwa okuqondene naye. Ulwazi lokulawula izinhlungu lungasiza omama ukuthi banqobe ukwesaba kwabo. Ngokuvamile, isimiso se-cesarean section, kanye nezingozi ezivela kuso, kufanele zichazwe kowesifazane. Le ngxoxo kufanele yenzeke ngokushesha okukhulu. Uma udokotela enqaba ukuhlinzwa ngokuhlinzwa ngokwesicelo, kufanele adlulisele lowo ozozala komunye wozakwabo.