Okuqukethwe
Umsebenzi ovinjiwe: yini i-dystocia yehlombe?
Ngesikhathi sokuxoshwa, kungase kwenzeke ukuthi amahlombe omntwana abhajwe ethangeni likamama nakuba ikhanda lakhe seliphumile. Inkinga engavamile kodwa engathi sína yokubeletha, le dystocia iyisimo esiphuthumayo esidinga ukuqondisa okunembe kakhulu kokubelethisa ukuze kukhishwe usana ngaphandle kwengozi.
Kuyini ukusebenza okuvimbile?
Greek i-dys okusho ubunzima futhi ukhokho, ukulethwa, ukulethwa okuvinjelwe yilokho okuvame ukubizwa ngokuthi ukulethwa okunzima, ngokuphambene nokulethwa kwe-eutocic, okungukuthi, okwenzeka ngokuhambisana nenqubo ye-physiological.
Kunezinhlobo ezimbili eziyinhloko ze-dystocia: i-dystocia kamama (ukufinyela okungavamile kwesibeletho, izinkinga zomlomo wesibeletho, i-placenta previa, i-pelvis ekhubazekile noma encane kakhulu ...) kanye ne-dystocia yemvelaphi ye-fetus (i-fetus enkulu kakhulu, ukwethula okungajwayelekile, i-dystocia yehlombe). Lezi zinkinga ezihlukahlukene zingadinga ukuphendukela ekuqhekekeni kolwelwesi okwenziwayo, ukufakwa kokufakwa kwe-oxytocin, ukusetshenziswa kwezinsimbi (ama-forceps, izinkomishi zokumunca), i-episiotomy, ingxenye yokuhlinzwa, njll.
Izinhlobo ezimbili ze-dystocia yamahlombe
- I-dystocia yamanga. Okuphinde kubizwe ngokuthi “ubunzima behlombe”, kuthinta ukuzala oku-4 no-5 ngo-1000. Uma limi kabi, ihlombe lengane elingemuva lishaya i-pubic symphysis.
- I-dystocia yangempela. Okubi nakakhulu, kuthinta phakathi kokubeletha oku-1 ngo-4000 kanye nokubeletha oku-1 ngo-5000 futhi kubonakala ukungabikho okuphelele kokubandakanyeka kwamahlombe ku-pelvis.
Indlela yokwelapha i-dystocia yehlombe?
Njengoba ikhanda lomntwana seliphumile kakade, akunakwenzeka ukuliletha ngokuhlinzwa. Akubuzwa ukudonsa ikhanda lakhe noma ukucindezela kanzima esibelethweni sikamama ukuze asikhulule ngokushesha okukhulu. Lezi zenzo zingaba nemiphumela emangalisayo. Ukumkhipha ngokushesha ngaphandle kwengozi, ithimba lezokwelapha linazo izinhlobo eziningana zokubelethisa, okuzokhethwa kuzo ngokuvumelana nesimo. Nazi ezidume kakhulu:
- Ukuqondisa kukaMac Roberts kwenziwa uma kwenzeka i-dystocia yehlombe yamanga. Umama ulele ngomhlane, amathanga abheke esiswini, izinqe zisemaphethelweni etafula lokubelethisa. Le hyperflexion yenza kube lula ukukhulisa umjikelezo we-pelvis nokukhuthaza ukujikeleza kwekhanda ukuze uvule ihlombe langaphambili. Izikhathi eziyisi-8 kweziyi-10, lokhu kuqondisa kwanele ukuvula isimo.
- Indlela kaJacquemier isetshenziswa uma kwenzeka i-dystocia yangempela yamahlombe noma uma kwenzeka ukwehluleka kokuqondisa kuka-Mac Roberts. Okuxakayo nakakhulu, le nqubo ihlanganisa, ngemva kokwenza i-episiotomy enkulu ohlangothini lomhlane wengane, ukungenisa isandla esithweni sangasese sikamama ukuze abambe isandla somntwana esihambisana nehlombe langemuva ukuze ehlise ingalo futhi ngaleyo ndlela akhulule elinye ihlombe.
Izici eziyingozi ze-shoulder dystocia
Uma ukuvela kwe-shoulder dystocia yeqiniso kuyisenzakalo esinzima kakhulu ukubikezela ngesikhathi sokubeletha, odokotela baye bahlonza izici eziningana eziyingozi: i-fetus macrosomia, okungukuthi ingane ecabangayo. ekugcineni ngaphezu kuka-4 kg; ukweqa; ukukhuluphala ngokweqile ngesikhathi sokukhulelwa ...
Izinkinga ze-shoulder dystocia
I-dystocia yamahlombe ibeka usana olusanda kuzalwa engcupheni yokuphuka kwethambo lekholomu futhi akuvamile ukuba i-humerus, kodwa futhi nokukhubazeka kwe-obstetric ye-plexus ye-brachial. Kunezigameko ezingaphezu kwe-1000 zokukhubazeka unyaka ngamunye ngenxa yokulimala kwemizwa ye-brachial plexus. Amakota amathathu ayalulama ngokuhlunyeleliswa kodwa ikota yokugcina kumele ahlinzwe. Ngenhlanhla, ukufa kwe-fetus ngenxa ye-asphyxia ebangelwa i-shoulder dystocia sekuyivelakancane kakhulu (4 kuya ku-12 kokungu-1000 okuqinisekisiwe kwe-shoulder dystocia).
I-dystocia yamahlombe ingaba yimbangela yezinkinga zomama, ikakhulukazi izinyembezi zomlomo wesibeletho, ukopha ngesikhathi sokubeletha, izifo, njll.