Okuqukethwe
Isikhathi "i-dystocia"Livela esiGrekini sasendulo"i-dys”, Okushiwo ubunzima, futhi“ukhokho”, Okusho ukuzala. Ngakho-ke lokho okubizwa ngokuthi ukuzalwa okuvinjiwe kuwukubeletha okunzima, ngokuphambene nokubeletha kwe-eutocic, okwenzeka ngokujwayelekile, ngaphandle kwesithiyo. Ngakho siqoqana ndawonye ngaphansi kwetemu lokuzalwa elivinjiwe konke ukulethwa lapho kuvela ubunzima, ikakhulukazi mayelana nokufinyela kwesibeletho, ukunwebeka komlomo wesibeletho, ukwehla nokuzibandakanya komntwana okhalweni, indawo lapho umntwana ebeletha khona (ngokuba ibhulukwe ikakhulukazi), njll. Kunezinhlobo ezimbili eziyinhloko ze-dystocia:
- i-dystocia eguquguqukayo, ehlotshaniswa nokungasebenzi kahle kwe-uterine "motor" noma ukunwetshwa komlomo wesibeletho;
- - kanye ne-mechanical dystocia, lapho ivimbekile, yemvelaphi yengane (usayizi kanye / noma ukwethulwa komntwana…) noma cha (isimila, i-placenta praevia, icyst…).
Qaphela ukuthi isibeletho esivimbekile ngezinye izikhathi sihlukaniswa ngokuya ngokuthi sivela kumama (ukuvuleka komlomo wesibeletho, ukufinyela kwesibeletho, i-placenta previa, i-pelvis encane kakhulu, njll.) noma imvelaphi yengane.
Umsebenzi ovinjiwe: lapho umsebenzi ovimbekile uguquguquka
Ngokwezilinganiso zodokotela wokubeletha nodokotela bezifo zabesifazane, umsebenzi ovimbezelekile onamandla umelela ngaphezu kuka-50% wezimbangela zokuthikamezeka komsebenzi. Ingahlotshaniswa ne ukungasebenzi kahle kwesibeletho, lapho ukufinyela kwesibeletho kungasebenzi ngokwanele ukuvumela umntwana ukuba akhishwe. Ngokuphambene, ukufinyela okunodlame kakhulu kungase futhi kubangele umsebenzi ovimbile. Ukufinyela “okungavamile”, okubuthakathaka kakhulu noma okukhulu kakhulu, nakho kungaba ukuvimbela ukuvuleka kahle komlomo wesibeletho, futhi ngenxa yalokho kube nzima ukubeletha. Umlomo wesibeletho ngokwawo ungase ube nezinto ezingavamile eziwuvimbela ukuthi unganwebeki kahle futhi ngokwanele.
Umsebenzi ovinjiwe: lapho umsebenzi ovimbekile ungowomshini
Kunezinhlobo ezintathu eziyinhloko ze-dystocia yemishini lapha, lapho kunesithiyo semishini esenza kube nzima ukulethwa kwesitho sangasese sowesifazane:
- -Sikhuluma ngakho i-bone dystocia lapho ukhalo lukamama ozoba ngunina luveza ukungafani kosayizi, ukwakheka noma ukuthambekela, okwenza kube nzima ukudlula kwengane emigudwini eyahlukene yomcengezi;
- -Sikhuluma ngakho i-dystocia yemishiniyemvelaphi ye-fetus uma kuyi-fetus eyenza kube nzima ukubeletha ngenxa yesikhundla sayo (ikakhulukazi ku-breech eqediwe noma engaphelele), ubukhulu bayo nesisindo sayo esibalulekile (sikhuluma nge-fetus macrosomia, lapho isisindo somntwana sikhulu kuno-4 kg) noma ukonakala (i-hydrocephalus, i-spina bifida, njll.);
- ekugcineni sikhuluma ngayo izicubu ezithambile dystocia mechanical lapho isibeletho esivimbekile kungenxa ye-placenta previa okungenani emboze umlomo wesibeletho, ama-ovarian cysts, izinkinga zesibeletho (ama-fibroids, ukukhubazeka, izibazi, njll.) njll.
Icala elikhethekile lokusikwa kwemishini okuvimbekile kwemvelaphi yombungu i-dystocia yehlombe, lapho ikhanda lomntwana selikhishiwe kodwa amahlombe azama ukungenela i-pelvis kamuva. Sikhuluma kabanzi mayelana i-dystocie d'engagement lapho i-fetus izabalaza ukubamba iqhaza ngendlela efanele ku-pelvis, naphezu kokuvuleka okuhle komlomo wesibeletho.
Ukubeletha okuvimbekile: ingabe ukuhlinzwa kokuhlinzwa kuyadingeka njalo?
Ngokuya ngohlobo nezinga lemihelo evimbekile ngesikhathi sokubeletha, ingxenye yokuhlinzwa ingase ikhonjiswe.
Qaphela ukuthi ukuthuthuka kwe-ultrasound namuhla kwenza kube nokwenzeka ukugwema ukubeletha okunezithiyo ezithile, ngokukhetha ukuhlinzwa okuhleliwe, lapho i-placenta previa evala umlomo wesibeletho, ngokwesibonelo, noma lapho ingane ngempela inkulu kakhulu ukuba ibe ububanzi inyonga kamama. Nokho, ukuzalwa kwesitho sangasese sowesifazane kungaba yimpumelelo naphezu kobunzima obalulwe ngenhla.
Lapho ubhekene ne-dystocia eguquguqukayo, ukuqhekeka okwenziwe kolwelwesi kanye nomjovo we-oxytocin kungenza kube nokwenzeka yenza ukufinyela kusebenze kahle futhi nomlomo wesibeletho uvuleke kakhulu.
Ukusetshenziswa kwezinsimbi ezifana ne-forceps noma izinkomishi zokumunca kungase kudingeke ku-dystocia ethile yemishini.
Kodwa uma lezi zinyathelo zinganele ukuletha umntwana, futhi / noma izimpawu zokucindezeleka kwe-fetus zivela, isigaba sokuhlinzwa esiphuthumayo senziwa.