Ulwazi, Izimbangela, Ukwelashwa, Izinkinga, Nokuletha
Uma sekuyisikhathi sokubeletha nokubeletha, ingxenye yengane idokotela ezwa ngayo eduze nomsele wokuzalwa ibizwa ngokuthi yingxenye yokuveza. Yingxenye yomzimba womntwana ozelwe kuqala. Esikhathini esiningi, ikhanda lomntwana liyingxenye eveza (vertex iphrezentheshini). Kodwa, ngenani elincane lokudiliva, phansi noma izinyawo zomntwana zizalwa kuqala. Lapho izinyawo noma izinyawo zisesikhundleni sokuphuma kuqala, kubizwa ngokuthi isethulo se-breech.
Izethulo ze-Breech zivame kakhulu ekubelethweni ngaphambi kwesikhathi sokuzalwa okuzayo. Njengoba ukukhulelwa kuqhubeka, cishe umntwana uzophendukela, futhi ikhanda lizokwehla uma sekuyisikhathi sokudiliva. Ngakho-ke, njengoba ukukhulelwa kusondela eduze nesikhathi, amathuba okuzalwa kwe-breech ahla.
- Ngaphambi kweviki lama-28 lokukhulelwa , amaphesenti angama-20-25 ama-baby are breech.
- Ngeviki lama-34 lokukhulelwa , iningi lezingane zizophenduka, kanti amaphesenti angaba ngu-5-7 azoba yi-breech.
- Ngesikhathi esigcwele, kuphela amaphesenti angu-3-4 kuphela ezinsana (3 noma 4 kuzo zonke izinhlobo zokubeletha eziyi-100) yi-breech.
I-Frank Breech Baby
I-frank breech iyisisindo esivame kakhulu sokusakaza ngokukhethekile uma ingane izalwa ngesikhathi esigcwele. Ezingamaphesenti angu-3-4 okuzalwa kwe-term breech, izinsana zisesikhathini esiphambanweni sokuphefumula okungama-50-70 amaphesenti wesikhathi. I-frank breech yilapho ingane isezansi, kodwa imilenze yakhe iqonde phezulu ngezinyawo zayo eduze kwekhanda lakhe. Ingxenye yokuveza yizinkinobho.
Ezinye izethulo ze-bree zifaka:
Gcwalisa i-Breech: Uma ingane isesikhathini esiphelele se-breech phansi phansi, kodwa amadolo akhe ahlotshisiwe, ngakho-ke izinyawo zakhe nazo zisehla eduze nezinyawo zakhe. Ingxenye yokwethulwa akuyona nje ngezansi kodwa zombili izinyawo. Ekubelethweni, cishe amaphesenti angu-10 ezinsana ze-breech asezingeni eligcwele lokuphefumula.
I-Breech engapheleleki noma ye-Footling: Isibhamu sokuhamba ngezinyawo lapho imilenze yengane inwetshiwe futhi ibheke ngqo phansi. Esikhundleni sezansi, ingxenye yokuveza iyinyawo elilodwa (inyawo elilodwa) noma zombili izinyawo (i-footling double). Cishe amaphesenti angu-25 okudiliva okuphefumulayo awaphelele.
Indlela Yokutshela Uma Ingane Yakho Ihamba Breech
Njengoba ukukhulelwa kwakho kuqhubeka, udokotela wakho uzokuhlolisisa futhi alandele isikhundla somntanakho. Ungase ukwazi ngisho ukubona ukuthi ingane yakho isesibelethweni sakho yedwa. Nazi ezinye zezindlela wena nodokotela wakho ongasebenzisa ukutshela ukuthi ingane yakho ibhekene nani.
- Ungazizwa lapho ingane yakho ikukhahlela khona . Izingane zikhahlela imilenze, ngakho-ke kuye ngokuthi uzwa kuphi ukukhahlela ungagweba isikhundla sakhe jikelele. Uma uzizwa ukukhahlela kwesikhumba sakho esincane, khona-ke ingane ayizange iphendule phansi. Kodwa, uma ukukhahlela kuphakama kumabhande akho nangaphezulu kwesibeletho sakho, ikhanda lomntwana cishe libheke phansi.
- Udokotela noma umhlengikazi ozokuhlola ngesikhathi sokuvakashela kwakho ngaphambi kokubeletha uzohlola isikhundla somntanakho ngokushaya noma ukuzwa isisu sakho ukuthola ikhanda, emuva, nangaphansi kwengane.
- Ukulalela ukushaya kwenhliziyo kwengane kungenye indlela yokutshela ukuthi ingane yakho ikuphi esibelethweni sakho. Ngokuthola indawo yokushaya inhliziyo, udokotela angathola umbono olungcono wesimo somntwana.
- I-ultrasound inikeza ulwazi oluhle kakhulu. Kubonisa ukuthi wena kanye nethimba lakho lokunakekelwa kwezempilo isithombe somntwana kanye nesimo sakhe esiqondile esibelethweni sakho. Uma ingane yakho ibhekwa, i-ultrasound inganquma uhlobo lwesibhakabhaka ingane yakho ingaphakathi kuyo, njenge-frank noma ephelele.
- Ngesikhathi sokubeletha, udokotela angasho ukuthi ngabe umntwana uyisibhakabhaka ngokwenza ukuhlolwa kwe-pelvic. Uzokwazi ukuzwa ukuthi ikhanda lomntwana noma umhlane wakhe noma izinyawo zakhe zikhona emgodini wokuzalwa.
Izimbangela
Ubukhulu bendodana, ingakanani amniotic fluid isisu, futhi inani lesikhala ngaphakathi kwesibeletho yizo zonke izici ezingasiza ekutheni zikwazi ukuhamba.
Ngakho, ezinye zezizathu ezinganeni zingase zibe yi-breech:
- Ingane engakafiki isincane futhi inegumbi elingaphezulu ngaphakathi kwesibeletho ukuhamba. Isizathu esivame kakhulu sesethulo se-breech yi-prematurity.
- Uma ukhulelwe ngamawele noma ngaphezulu , abantwana banegumbi elingaphansi kwesibeletho sokuthi bajikeleze futhi bafike endaweni ephezulu yokudiliva.
- Izinkinga ze-uterine ezifana ne-fibroids noma isibeletho esinjengenhliziyo zingangena endleleni yokukwazi komntwana ukuziphendulela.
- Uma intambo ye-umbilical imfushane kakhulu, ingane ingase ingakwazi ukuhambisa nokuguquka.
- Amanothi amaningi amniotic anika ingane ikhono lokuhamba ngokukhululekile esibelethweni. Njengoba ekhula, angase akwazi ukufiphaza futhi aphenduke. Amanzi amniotic amancane kakhulu angavimbela umntwana ukuba angene endaweni ephansi njengoba efika isikhathi esiphelele.
- Lapho i-placenta iphansi futhi ihlanganisa konke noma ingxenye yomlomo wesibeletho, ibizwa ngokuthi i- placenta previa . Njengoba i-placenta ithatha ikamelo ngaphansi kwesibeletho, kwenza kube nzima ukuba ingane iphenduke.
- Okunye okungavamile kokubeletha kungathinta ikhono lomntanakho lokuthuthela ekhanda phansi. Lezi zimo ngokuvamile akuzona isimanga ekulethwa ngoba zivame ukubonwa ekuhlolweni kwe-ultrasound ngesikhathi sokukhulelwa.
Lezi zimbalwa ezimbalwa ezingabangela. Ezinye izinto zicatshangelwa ukuthi zifaka isandla ekubonisweni kwe-breech, futhi. Yiqiniso, ngezinye izikhathi isizathu asikwaziwa.
Ukwelapha
Abesifazane basebenzisa izindlela eziningi ukuzama ukuguqula izingane zabo. Kusukela ku-yoga nokulungiswa kwe-chiropractic kumculo nokuzivocavoca, kunezinto eziningi ongayenza ukuze uzame ukuthola umntwana wakho ahambe ekhanda ukwenzela ukulethwa .
Enye yezindlela udokotela wakho angase asize ngayo ngokwenza inqubo ebizwa nge-cephalic version yangaphandle (i-ECV). Uma kungekho izinkinga ekukhulelwe kwakho futhi ingane ingakaze ivule eyedwa ngeviki lama-36 noma lama-37, udokotela wakho angase azame ukuvula umntwana usebenzisa le nqubo. I-ECV isebenza cishe ngamaphesenti angu-60 yesikhathi. Uma kuphumelele, amathuba okuba ne-cearean aphansi kakhulu.
Izinkinga
Iningi lezinsana ezibelethwa yi-breech ziphilile. Kodwa, lapho ingane isesikhathini sokuphefumula noma noma yikuphi ukuma kwesibhakabhaka kunamathuba amaningi okuba umsebenzi nokulethwa kungaba nzima. Ezinye zezinkinga zokuzalwa kwe-breech yizi:
I-Umbilical Cord Iphunduka: Ngesikhathi sokubeletha kwe-breech breech, kunethuba lokuthi intambo yomlomo izokwehla ngomlomo wesibeletho ngaphambi kokuba umntwana azalwe. Njengoba ingane ifika emgodini wokuzalwa, umzimba nomkhonto wakhe bangafaka ucingo futhi banqume ukuhlinzekwa kwegazi nomoya okwenziwe intambo. Kungathinta izinga lenhliziyo yengane kanye nokugeleza kwe-oxygen negazi ebuchosheni bomntwana. Ingozi yensimu ephuthumayo inkulu kakhulu nge-breech yezinyawo kanye ne-breech ephelele. Ingozi ingaphansi uma ingane isesimweni esivulekile.
Ukufakwa kwekhanda : Inhloko yomntwana ingabanjwa ngesikhathi sokubeletha uma umzimba wezingane uzalwa ngaphambi kokuba umlomo wesibeletho uphazamise ngokugcwele . Lesi simo sinengozi kusukela ikhanda likwazi ukucindezela ngokumelene nentambo yomzimba futhi kubangele i-asphyxia noma ukuntuleka kwe-oxygen. Ukufakwa kwekhanda kuvame kakhulu ukudiliva ngaphambi kwesikhathi ngoba ikhanda lomntwana likhulu kakhulu kunomzimba.
Ukulimala Kwemvelo Kwangane: Ingozi yokulimala komntwana iphakeme uma ingane isuke ibhekwa uma kuqhathaniswa nalapho ingane ingenayo imvula. Izithasiselo zingase zilimaze ikhanda kanye nekhanda. Ukugquma, amathambo aphukile, kanye namajoyini ahlukanisiwe nawo angase ayenze ngokuya esikhundleni somntwana ngesikhathi sokuzalwa.
Ukulimala komzimba kuMama: Ukubelethwa kwesisu nge-breech baby kungabandakanya i-episiotomy nokusetshenziswa kwe-forceps okungabangela ukulimala endaweni yesisu. I-Breech isethulo ingenye yezizathu zesigaba se-cearean. I-cearean yindlela yokuhlinza nge-anesthesia . Ngaphandle kokufakwa kokuhlinzwa, umama angase azwe ubuhlungu, ukutheleleka, ukuphuma kwegazi, noma ezinye izinkinga.
Ukulethwa kwe-Frank Breech Baby
Izinsana eziningi zizobuyela ekhanda phansi ngaphambi kokuba kuqale ukusebenza. Kodwa-ke, uma ingane yakho isenesikhathi sokuphumula uma sekuyisikhathi sokuletha, wena nodokotela wakho kuzodingeka unqume ngohlobo lokuzalwa. Uma zingekho ezinye izinkinga, umntwana osesimweni esibucayi angase ahanjiswe ngamanzi uma:
- Ingane okungenani amasonto angu-36.
- Ingane ayikho enkulu noma encane kakhulu.
- Uhambise u-vaginally ngaphambili.
- Ubukhulu be-pelvis yakho bukhulu ngokwanele.
- Inhloko yomntwana isesimweni esifanele (iguquguquke).
- Ithimba lezokunakekelwa kwezempilo linokuhlangenwe nakho kokudilizwa kwe-breech.
- Kukhona ukuqapha okuqhubekayo kwengane .
- Izinsiza eziphuthumayo ziyatholakala.
Uma kukhona izinkinga ezivela ngesikhathi sokulethwa, ungase usadinga isigaba se-c esiphuthumayo.
Noma kunini lapho kunokwenzeka, ukukhetha okujwayelekile ukuletha noma yimuphi umntanakho ongakabi yisikhathi noma osizini ngokusebenzisa isigaba se-cearean . Futhi, kusukela kokudilizwa kwamasitini, ngisho noma zonke izindlela ezibalwe ngenhla, zingena engozini ephezulu yokulimala okunzima nokubeletha, odokotela abaningi bakhetha ukuletha zonke izethulo ze-breech nge-c-sigaba.
> Imithombo:
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> I-Cammu H, uDony N, Martens G, iColman R. Iziqunto ezivamile zokuveza isethulo ngesikhathi sokuzalwa kuma-singletons: isifundo esisekelwe kubantu. I-European Journal ye-Obstetrics & Gynecology ne-Biology Yokuzala. 2014 Jun 30; 177: 106-9.
> Johnson CT, Hallock JL, JL Bienstock, Fox HE, Wallach EE, abahleli. I-Johns Hopkins Manual of Gynecology and Obstetrics. I-Wolters Kluwer; 2015.
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> Karning RK, Bhanu BT. Indlela yokulethwa kanye nomphumela we-breech iphrezentheshini: isifundo sokutadisha esikhungweni esiphakeme > isikhungo >. I-International Journal Yokukhiqiza, Ukukhulelwa, I-Obstetrics > ne > Gynecology. 2017 Jul 26; 6 (8): 3409-13.