Izimpawu zokuxwayisa, iziphakamiso nokuningi
Amagama abe ne-dystocia alethe ukwesaba inhliziyo yabo bonke odokotela nombelethisi. Lokhu kusho ukuthi, okubili, okungavamile kokubili, amahlombe omntwana angangeni esikhwameni ngesikhathi sokuzalwa njengoba kufanele. I-dystocia ye-shoulder iyenzeka ngaphansi kwe-1% yazo zonke izizukulwane ngokusho kwezinye izifundo. Lokhu kungaholela ekuhluphekeni okwenyuka kwengane nomama.
Izimpawu Eziyisixwayiso zeDystocia Ehlombe
Ngokuphambene nenkolelo evamile ayikho indlela eyodwa eqondile yokubikezela ukuthi ubani ozoba ne-dystocia ehlombe. Imibono eminingi ehlukene ihlolwe, ngayinye ibe nemiphumela ehlukahlukene. Sibheke abantwana abakhulu, omama abancane, ukukhulelwa okuyinkimbinkimbi, ikakhulukazi ngokuphathelene nezinkinga ezifana nesifo sikashukela sokugaya , ukukhulelwa , iminyaka yokugaya , izingane zangaphambilini ezinama-dystocia ehlombe, nabanye abaningi. Isibonelo usebenzisa isisindo somntwana yedwa njengesici, cishe ingxenye yesine yama-dystocia ehlombe kwenzeka ezinganeni ngaphansi kocabangela "isisindo sengozi." I-predictor engcono kakhulu ingaba inhlanganisela yezici ezihilelekile.
Wenzani uma wena nodokotela wakho uzizwa usengozini ye-dystocia ehlombe? Impendulo ayicacile kuzo zonke izibalo. Siyazi ukuthi izikhundla ezithile zingase ziholele e-dystocia ehlombe, isibonelo, isikhundla se-lithotomy (elele phansi emhlane wakho) singavimbela i-sacrum ukuba ihambe kahle ngesikhathi sokuzalwa, ngakho-ke inganciphisa inani lekamelo elisekhanda lakho lamahlombe .
I-episiotomy, ukusika okwenziwe endaweni yesikhumba phakathi kwe-vagina kanye ne-rectum, kuvame ukuphikisisana ngecala elilodwa ukuthi ukwenza i- episiotomy evulekile kuvumela ukuba udokotela enze indawo, omunye uhlangothi uthi i-perineum ayiyona into ebambe ngayo ingane emuva futhi kufanele ishiywe iminyene.
Futhi akuyona ingxenye yesigceme sokugcina noma ukufakelwa kwempendulo kubo bonke.
Iziphakamiso Zokusiza Ukunciphisa iDystocia
Kukhona izinto eziningana ezingenziwa ukusiza ukuxazulula inkinga ye-dystocia ehlombe. Njengoba ukuzalwa ngalunye kuhlukile akuzona zonke lezi zizosebenza njalo, ngakho-ke ukuhamba okuningi kungase kuvivinywe ngokulandelana okusheshayo ukusiza ukuxazulula isimo ngendlela enhle. Nazi ezinye zezindlela eziphakanyisiwe:
- Ukucindezela kwe-Suprapubic : Lo mshoshazo usetheni lesishicilelo , hhayi phezulu kwesibeletho. Lokhu kungase kuvumele ihlombe likwazi ukuhamba ngaphansi kwe-pubis symphysis.
- I-Gaskin Maneuver : Thatha owesifazane ezandleni nasemadolweni . Lokhu kuzophinde kuguqule ama-diameter we-pelvis yakhe, nakuba kungenakwenzeka njalo nge-anesthesia ye-epidural .
- UManeuver kaMcRobert : Flex imilenze yomama emahlombe akhe njengoba ehlehlisela emuva, ngaleyo ndlela ukwandisa umkhiqizo we-pelvic. Ucwaningo olulodwa lwabonisa ukuthi lokhu kunciphisa 42% kuwo wonke amacala e-shoulder dystocia.
- I-Woods Maneuver : Lokhu kwaziwa nangokuthi isikebhe sokugqoka, umlindi uzama ukuguqula ingane yakhe ngokubeka iminwe ngemuva kwehlombe futhi uphonseke emazingeni angu-180.
- URubin Maneuver : Njengomqhubi we-Woods, iminwe emibili ibekwe ngemuva kwehlombe lomntwana, futhi manje bayaphonsa ezindleleni zamehlo omntanakho, ukuhlanganisa amahlombe.
- I-Zavanelli Maneuver : Ukuphoqa ikhanda lomntwana emuva ngaphakathi kwesifazane bese wenza i-cearean. Lona luvame ukucelwa ukuthi lusetshenziswe kanjani kodwa futhi luyingozi kakhulu.
Ngemuva kokuzalwa
Ngemuva kokubeletha okunzima okubandakanya i-dystocia ehlombe, kungase kube nezinto ezengeziwe udokotela noma umbelethisi wakho ozofuna ukukubuka kuwe nomntanakho, kufaka phakathi:
- Ingane ephuza ukuqala futhi ingadinga usizo ngokuphefumula.
- Ama-fractures we-collar bone (i-clavicle) noma i-humerus.
- Ukulimala kwe-Fetal Brachial Plexus.
- Ukulungiswa kwe-episiotomy noma ukukhipha okwenziwe ngesikhathi sokuzalwa.
- Ukwehla kwesisu somama.
- Ukuphuka komzimba.
Nakuba i-dystocia ehlombe akuyona into ejwayelekile kakhulu, ukwazi ukuthi yiziphi izinto ezingabangela ingozi ukuthi wena nomntanakho zingakusiza wenze izinqumo ezihlakaniphile zomsebenzi wakho nokuzalwa kwakho.
Izinkomba:
Cohen B, Penning S, Major C, Ansley D, Porto M, Garite T (1996). 'Ukubikezelwa kweNdodana kaDystocia eNtsheni Yezinsana Emantanjeni Omama Ka-Diabetes', Izifo Zomzimba Nezifo Zamazinyo, 88, 10-13.
I-Gaskin IM, i-Meenan AL, i-Hunt P ne-Ball CA (2001.) 'IManeuver entsha / endala yokuphatha i-Dystocia'
Gherman RB, Goodwin TM, Souter I, Neumann K, Ouzounian JG, Paul RH (1997). 'Indlela kaMcRoberts' yokunciphisa ihlombe dystocia: Iphumelela kanjani? ', I-American Journal of Obstetrics and Gynecology, 176, 656-661.
U-Lee CY (1987). 'Shoulder dystocia', Imitholampilo e-Obstetrics and Gynecology, 30, 77.
UMashiburn J (1988). 'Ukukhomba nokuphathwa kwe-shoulder dystocia', Journal of Nurse Midwifery, 33, 5.
Ukumisa kabusha uR (1980). 'Ukuphathwa kwe-shoulder giry dystocia', Imitholampilo e-Obstetrics and Gynecology, 23, 559.