I-episiotomy iyinkimbinkimbi yokuhlinzeka e-perineum (indawo yesikhumba phakathi kwe-vagina ne-anus). Kuyinto impikiswano enkulu ekubelethweni namuhla.
Ama-episiotomi anilinganiswa ngamadigri - okuvamile kakhulu okuyi-2 degree (phakathi kwe-vagin kanye ne-anus) futhi okungenani okujwayelekile kube yi-4th degree (Ukwandisa i-rectum, ebizwa ngokuthi i-episiorectoprotomy).
Kunezinhlobo ezahlukene ze-episiotomy. I-midline iyona evame kakhulu e-USA (ithoma ngokuqondile ukuya ku-anus), futhi i-mediolateral iyinqamu ehlukaniswe ngakwesinye icala ukuvimbela ukungena kwi-rectum.
UDkt. JM Thorp, e- Episiotomy: Ingabe ukusetshenziswa kwayo okujwayelekile kungavunyelwa? , uthi, "Kukhona ubufakazi obuncane bokusekela ukusetshenziswa kwe-episiotomy ngokujwayelekile. Le nqubo ingase ikhulise kakhulu izigameko zokuhlukumeza okwesithathu nesesine. Kunezinombolo ezimbalwa zokusekela ukuthi le nqubo ivimbela ukuphumula komzimba."
I-American College of Obstetricians kanye namaGynecologists bathi i-episiotomy "ayidingi njalo" futhi "akufanele ibhekwe njengokujwayelekile."
Izinzuzo
Kuthiwa ama-episiotomi ukunikeza izinzuzo ezilandelayo:
- Shesha ukuzalwa
- Vimbela ukuvuthwa
- Ivikela ukungaziphathi kahle
- Ivikela ukuphumula kwe-pelvic floor
- Uphulukisa lula kunezinyembezi
Lezi zonke zibonakala ziyisizathu esizwakalayo.
Iqiniso liwukuthi ucwaningo lwezokwelapha aluzange lubonise noma iyiphi yalezi zinzuzo. Empeleni, kwamanye amacala, okuphambene empeleni kuyiqiniso. Ama-episiotomi angabangela ukulimala. Nakuba kuzohlale kunamaphesenti amancane kwabesifazane abanikeza i-episiotomy inzuzo.
Okuqhamuka uma udla imishanguzo
Okulandelayo kuye kwabikwa njengemiphumela emibi ye-episiotomy:
- Ukutheleleka
- Ubuhlungu obandayo
- Ukwandisa ama-laceration angama-3 kanye no-4-degree (okubizwa ngokuthi izandiso)
- Isikhathi eside sokuphulukisa
- Ukungahambi kahle uma ubulili buqala kabusha
Umamakazi omncane uMH Bromberg uthi kuhle kakhulu, "Ukubukeza kwezincwadi ezise-episiotomy kubonisa ukuthi kungenzeka ukuthi kusetshenziswe ngokweqile, futhi kulungiswa kahle kakhulu. Kubonakala kunengqondo ukufakazela ukuthi i-episiotomy ephakathi ayinzuzo enkulu ngaphezu kokuqala (esikhumbeni ) noma i-second degree (ibe ngaphansi kwemisipha engaphansi) lapho kungekho khona izinkomba ezingaphezu kwezingane. "
Ama-episiotomi akudingeki ngaso sonke isikhathi, futhi kuningi ongakwenza ukuze unciphise amathuba okuba nokutholakala lokhu kokuhlinzwa. Ezinye izinyathelo zokuvimbela ziyi:
- Ukudla okunempilo (isikhumba esinempilo sihamba kalula)
- I-Kegels (ukuzivocavoca kwemisipha yakho ye-pelvic)
- Ingxoxo ngaphambi kokubeletha nomhlinzeki wakho wokunakekela mayelana ne-episiotomy
- Ukusikhipha komzimba wePrenatal Perineal
- Isiteji sokuqhuma esincane (isigaba sesibili)
- Ukucindezela okufudumele, ukusikhipha umzimba, nokusekela ngesikhathi sokubeletha
Khumbula, njenganoma iyiphi inqubo yezokwelapha, kukhona njalo isikhathi nendawo lapho kuyindlela evumelekile yilapho ukuxhumana okuhle nodokotela wakho kungena khona.
Njengoba njalo, ukwazi amalungelo akho njengesiguli / iklayenti nokwazi ngomzimba wakho kanye nenqubo ehlongozwayo kuzokuthatha indlela ende.
Inhlanhla nokuzalwa okuhle !
Imithombo:
U-Alperin, M, Krohn, MA, Parviainen, K. Episiotomy futhi Ukwandisa Engozini YokuLawulwa Okungavumelani KwezokuVikelwa KwamaVaginal. I-Obstet Gynecol 2008 111: 1274-1278.
Althabe F, Buekens P, Bergel E, Belizán JM, Campbell MK, Moss N, Hartwell T, Wright LL; Iqembu Lezinkombandlela Zokuhlola. Ukungenelela kokuziphatha ukuthuthukisa ukunakekelwa kwezinkinga. N Engl J Med. 2008 Meyi 1; 358 (18): 1929-40.
Mikolajczyk RT, Zhang J, Troendle J, Chan L. Izici zengozi zokuzalwa komsele ongabesifazane abakhulu. Am J Perinatol. 2008 Meyi; 25 (5): 259-64.
I-Sze EH, uCiarleglio M, Hobbs G. Izici zengozi ezihambisana nokuhlukumeza kwe-anal sphincter ukuhlukana kwezinyembezi phakathi kombelethisi, isazi sezinkinga zangasese, kanye nokudiliva abahlali. I-Int Urogynecol J Isitembu Sasesisithombeni Esincane. 2008 uMashi 13.
Ukusetshenziswa kwe-Episiotomy kanye ne-Forceps Ngesikhathi sokubeletha kwezingane, ama-C-Section Rates Up. Izindaba ze-AHRQ noNomboro, ngo-Ephreli 28, 2011. I-Agency for Research Health and Quality, eRockville, MD. http://www.ahrq.gov/news/nn/nn042811.htm
I-Yildirim G, i-Beji NK. Imiphumela yokuphoqa amasu ekubelethweni komama ne-fetus: ukutadisha okungahleliwe. Ukuzalwa. 2008 Mar; 35 (1): 25-30.