Ukwenyuka komsebenzi kungukuthi ukuhlinzwa kuqalwe ngaphambi kokuba kuqale ukuqala ngokwemvelo. Lokhu kwenziwa ngezizathu ezihlukahlukene, kodwa yisinqumo osenza nodokotela noma umbelethisi wakho, ngokuvamile ngemva kokukhulelwa kwakho. Lokho kusho ukuthi kunezimo ezimbalwa lapho ungase wazi ngaphambili ekukhulelweni kwakho ukuthi ukufakelwa kungase kube yinto engcono kunawe noma ingane yakho.
Kungani Ukusebenza Kukhishwa?
Imisebenzi ingadluliselwa ngezizathu eziningi. Imisebenzi kufanele isetshenziswe kuphela ngenxa yezizathu zempilo ezivumelekile ngenxa yezingozi ezihilelekile ekuqalisweni komsebenzi. Ezinye zezizathu zezokwelapha zihlanganisa:
- Ukutheleleka
Ukuba nesifo sofuba noma ukutheleleka kwe-sac amniotic (chorioamnionitis) yisisusa sokwenza. Awufuni ukuthi umntwana aphile endaweni enesifo. Ngokuvamile ukufakelwa kweqhwa kwenziwa ngesikhathi esifanayo ukwelapha isifo. Lokhu kungabangela ukuthi isikhwama se-amniotic sikhululwe ngaphambi kokuqala komsebenzi, ngaphandle kokubheka ubude besisu.
- Isifo sikashukela (Ukuzivocavoca noma Uhlobo I no-II)
Isifo sikashukela sofuzo noma isifo sofuba Iwesifo sikashukela yizizathu ezimbili ezivamile ukuthi omama baxoshwa ekupheleni kokukhulelwa kwabo, kodwa ngaphambi kweviki lesishiyagalombili . I-World Health Organization (WHO) ithi uma isifo sikashukela siwukuphela kwenkinga, ungase ucabange ukuya evikini langamashumi amane nanye lokukhulelwa, kodwa ochwepheshe abaningi bakhathazekile ngokukhula kwesisindo emntwaneni, amandla okuba ne-dystocia ehlombe, nokubeletha .
- Ukucindezelwa Kwegazi Eliphezulu KuMama
Uma umama ebhekana nokucindezeleka kwegazi ekukhulelweni angakwazi ukubeka impilo yakhe kanye nempilo yengane yakhe engozini. Lokhu kungenzeka nganoma yisiphi isikhathi lapho ukhulelwa, kodwa ngokuvamile kuvame ekugcineni. Kungenzeka kube into eyenzeka ngokuzumayo noma eyakha kancane kancane. Ukuba nomfutho wegazi ophakeme kungase kube uphawu lwe- preeclampsia noma i- eclampsia . Ukunganaki, ukucindezeleka kwegazi kungaholela ezinkingeni ezinzima kuhlanganise nokushaywa umama kumama, nokufa kumama noma umntwana. Uma ukukhulelwa sekufinyelele emasontweni angamashumi amathathu nesikhombisa , ngokuvamile kuvame ukubuza ukuthi ukufakelwa kuyoba nenzuzo kakhulu kunokulinda uma umama enegazi lokufunda. Udokotela wakho uzokusiza ukuthi uqonde ukuthi yimuphi umkhuba omuhle onikwe izimpawu zakho ezithile.
- Ukugcwaliswa Kweviki Ezingamashumi amane Nambili Zokukhulelwa
Ukukhulelwa okuqhubekayo kweviki elingamashumi amane nesithupha kubhekwa ukuthi kude kakhulu ukutholwa kwesilinganiso. Ngalesi sikhathi i-American College of Obstetricians kanye neGynecologists (i-ACOG) ithi, ngisho nangaphandle kwezizathu zezokwelapha kumama noma umntwana, isikhathi sokuzimela sinesiswane esanele sokwenza.
Kunezinye izizathu eziningana zokuthi kungani ukusebenza kungase kubangele futhi, kufaka phakathi ukukhulelwa ngaphambi kwesikhathi ngaphambi kwesikhathi (PROM), okungenzeka noma kungenzeki ngokutheleleka; kungabuye kuboniswe uma ingane yakho ingenzi kahle ekuvivinyweni kokuhlola njengokungabikho kokucindezeleka (NST) noma iphrofayili ye-bio-physical (BPP) , noma uma ingane yakho ibhekene nokuvinjelwa kwe-intrauterine (IUGR) .
Ukukhuluma nodokotela noma umbelethisi wakho kubalulekile ukuqonda ukuthi kungani kuphakanyiswa ukukhishwa kwezabasebenzi nokuthi yiziphi ongakhetha kuzo.
Kuyini Ukuxoshwa Komphakathi Komsebenzi?
Ukufakelwa kwezenhlalakahle kuyaziwa nangokuthi kungeniswa ngokulula kukadokotela, umbelethisi, noma umndeni; kungenye futhi igama lokungeniswa kokukhetha. Kungenziwa ukuze uthole udokotela oyifunayo, ukusiza ekuhleleni komndeni, noma ukuzama ukukhetha usuku lokuzalwa oluthile. Lokhu kudangele kakhulu ngenxa yezingozi ezengeziwe zokungeniswa kwabasebenzi (ngaphezulu ngalokhu ngezansi).
Ukukhishwa kwemisebenzi nganoma yisiphi isizathu akufanele kucatshangelwe kuze kube ngemva kwamasonto angamashumi amathathu nesishiyagalolunye uma kunokwenzeka.
Yiziphi Izingozi Zokukhipha Umsebenzi Wakho?
Kunezingozi eziningana ezihlobene nokusebenza ngokujwayelekile okungase kuvame kakhulu nokufakwa kwezenzo zabasebenzi . Ngenxa yalesi sizathu, kufanele kube nezinzuzo ezicacile nezicacile zokudlula lezi zingozi kuwe noma ingane yakho ngaphambi kokuvuma izinqubo eziphakanyisiwe. Izingozi zokungeniswa zingabandakanya:
- Ingozi eyengeziwe yokwelashwa kwangaphambi kwesikhathi, ngisho noma ukholelwa ukuthi ingane yakho iyisikhathi : Ukukhulelwa kwakho kungenzeka, uthi, amasonto angamashumi amathathu nesishiyagalolunye, kodwa ingane yakho ingaphendula okuningi njengengane ezalwe emavikini angamashumi amathathu nesithupha. Lokhu kungaba inkinga kakhulu futhi kusho noma yini ngokuhlala ekunakekelweni okukhulu kwezingane ezibhekene nezinkinga zokuphefumula ezinkingeni zokugcina izinga lokushisa komzimba nokudla.
- Ukuphazamiseka kwamapulazi : Lapha lapho ingxenye ye-placenta yonke ihlukanisa ngaphambi kwesikhathi odongeni lwesibeletho. Ngenxa yalokho, umama uthola ukuphuma kwangaphakathi futhi umntwana akakwazi ukuthola i-oksijeni ngoba ukunikezwa kunqunywe kusuka esibelethweni.
- Ukucindezeleka kwe-Fetal : Yilapho ingane ingavumi ukubekezela kahle. Lokhu kuvame ukutholakala nokuqapha kwenhliziyo ye-fetal. (Enye yezinqubo ezengeziwe lapho ukhipha inqubo yokuqapha okuqhubekayo kokubheka ukubuka izibonakaliso ukuthi isilinganiso senhliziyo yengane yakho siyashesha kakhulu noma sihamba kancane, noma senza ngokungaqondakali ngokuphathelene nokuphikisana.)
- Ukuphuka komzimba: Lapha lapho amandla okuqhekeka komsebenzi angabangela ukukhipha isisu. Lokhu kungase kwenzeke uma uye waba nokuhlinzwa kwangaphambili kwesibeletho, njengesigaba seCesare, kodwa ezimweni ezingavamile kungenzeka ngaphandle kokuyingozi.
- Ingozi yokwandisa isigaba se- Caesarea : Ukuhlukaniswa kungaqala ngokusungulwa kwemithi, kodwa umlomo wakho wesibeletho awukwazi njalo ukuqiniseka ukuthi uvula. Ngezinye izikhathi ukungeniswa kumisiwe futhi umama uthunyelwa ekhaya ukuze azame futhi emva kwesikhathi; ngezinye izikhathi, udinga ukuletha ngokushesha, futhi isigaba C-kuyindlela engcono kakhulu. Izizathu zokugcina zingabandakanya izinkinga ezivela ekufakweni, njengokucindezeleka komntwana, ukuphazamiseka, noma ukuhlukana komzimba.
- Ukusetshenziswa okuqhubekayo kwezinqubo kubandakanya ukukhululeka kobuhlungu, ukuqapha okuqhubekayo kokubeletha , kanye nokunye okungenelela (ngisho nalapho kungakalungi ekuqaleni): Ukusebenza okungajwayelekile nokusebenza okungaxhunyiwe kungabonakala kuhluke kakhulu. Lokhu kungase kusho ukuthi lokho obekuhlelwe ukukusebenzisa ukuze uthole izindlela zokubhekana kungenzeka ukuthi akufanele. Uma ukubeletha kusele isikhathi eside ngoba kuqalwe kahle, ungase ukhathele ngokweqile.
Abasebenzi bezokwelapha abakusizayo bazosebenza ukunciphisa izingozi uma kunokwenzeka. Lokhu kungase kusho ukunakekelwa okungeziwe (kufaka phakathi ukuqapha kwengcindezi yegazi nokuqapha kwesisu) noma imithi ukuqinisekisa ukuthi wena nomntwana uhlale unempilo ngangokunokwenzeka. Uma ukufakelwa kuyadingeka ngenxa yezizathu zezokwelapha, izinzuzo zokungeniswa zidlula lezi zingozi. Lesi sinqumo okufanele senziwe phakathi kwakho nodokotela wakho.
Ukusebenza Kwenziwe Kanjani?
Umsebenzi ungadalwa ngezindlela eziningana . Ezinye zezindlela ezivame kakhulu zihlanganisa:
- Ukuphuza isikhwama samanzi (amniotomy): Idivaysi encane efana ne- hoog isetshenziswa ngesikhathi sokuhlolwa kwesiswini ukuze nick kahle isikhwama se-amniotic futhi udale izinyembezi ukuze uvumele uketshezi lukhulule. Isikhwama asinayo imizwa, ngakho-ke wena noma umntwana ngeke uzizwe izinyembezi. Okuzozizwa ukuhlolwa kwesisu, ukukhululwa kwamanzi nokuhamba komntwana.
- Pitocin : Lena inguqulo yokwenziwa kwehomoni yemvelo ukuqala ukuphika. Inikezwa nge-IV line, futhi uzobe uhlolwe ukukala ukusebenza kwayo. Ukudosa kungenziwa ukwandisa ukudala iphethini yokwenqatshelwa kweqiniso.
- I-Prostaglandins: Lezi zivame ukuhanjiswa nge-vagin njengejel noma i-suppository, kodwa kunezinye izinhlobo. Umgomo lala mayeza ukuvumela umlomo wesibeletho ukuthobisa futhi ulungiselele ukuvula. Ngokuvamile kuyindlela yokuqala kamuva ehlanganiswe nenye inketho.
- I-catheter ye-Foley : Leli catheter elinabhaluni elifakwa emgodleni wesibeletho futhi landiswe.
- Ukufaka izinambuzane : Lena inqubo yehhovisi kanye neyodwa yezindlela ezingasetshenziswa esibhedlela. Ngesikhathi sokuhlolwa kwesisu, udokotela wakho noma umbelethisi uzofaka umunwe wakhe emlonyeni wakho wesibeletho bese uzama ukuwuhlukanisa nesigxobo se-amniotic ngaphandle kokuphula amanzi akho. Lokhu kungahle kwenzeke noma kungabangeli ukuphazamiseka kanye / noma ukuchoboza, futhi ngezinye izikhathi kubonakale.
Izindlela Zokwemvelo Zokukhishwa Kwezabasebenzi
Abaningi besifazane baphendukela ezenzweni eziningi zemvelo zokuqashwa kwabasebenzi kanye nempumelelo ethile. Incazelo yemvelo ihluke ngempela ngokwezinga lokungenela okudingekayo. Izindlela zokuqanjwa kwekhaya ezivame kakhulu zingabandakanya:
- Ukuvuselela kwe-ingono : Lokhu kungabandakanya ukugqugquzelwa komlomo noma ngomlomo wezinsipho. Abanye basebenzisa ipompo yebele ukuze basize ukukhulula i-oxytocin yemvelo ukuze kubangele ukusebenza kuqala.
- Amafutha e-Castor : Lokhu kubhekwa ngomlomo ezinhlobonhlobo zokupheka. Idala isifo sohudo futhi singase siphume amandla emzimbeni, ngakho kufanele sisetshenziswe kuphela ngeseluleko somsebenzi wakho.
- Ubulili : Nakuba izifundo zixubene ngokuthi ngabe ubulili buzoletha noma yini ekusebenzeni, i-orgasm yezinsikazi ikhulula i-oxytocin emzimbeni, kanti isilwane sinezinhlobo ezincane ze-prostaglandin. Uma nje kukhona into ofuna ukuyenza futhi amanzi akho aphukile, odokotela abaningi bacabanga ukuthi yindlela enhle yokuzama.
- Ukuphumula nokufanekisa okubonakalayo : Lokhu kwenziwa njengendlela yokuphumuza uma uzizwa ukhathazekile kakhulu ngomsebenzi ozayo, ungumzali, noma ngabe yini engakuvimba ekukhulekeleni. Kungakhathaliseki ukuthi kuletha emisebenzini noma cha, kuyindlela enhle yokukhuthaza ukuphumula, okuzuzisa ekupheleni kokukhulelwa futhi kuzokusiza lapho umsebenzi uqeda ekugcineni.
Ukungenelela kokusebenza
Ngezinye izikhathi izitayela zomsebenzi noma zilibaleka ngezigaba ezihlukahlukene. Uma impilo yakho noma eyomntanakho iyozuza ekusebenzeni ngokuqhubekayo ngokushesha, udokotela wakho angase anikeze ukwandiswa kwemisebenzi yakho . Kunezindlela eziningi zokukhuphula imali, okufaka nokusetshenziswa kwe-Pitocin, i-amniotomy, namanye amasu angokwemvelo angasetshenziswa njengendlela yokutholwa okuyinhloko yendlela yokusebenza.
Okumele Ubuze Uma Ukukhishwa Kwezabasebenzi Kuphakanyisiwe
Uma ukukhishwa kwemisebenzi kuphakanyiswa, qiniseka ukuthi ubuza umculi wakho imibuzo oyidingayo izimpendulo ukuze uzizwe uqiniseka ngokuthatha isinqumo. Nazi ezinye okufanele uzicabange:
- Kungani ukhuthaza ukunconywa kwemisebenzi?
- Zikhona yini ezinye izindlela zokwehliswa kwemisebenzi?
- Yini eyokwenzeka uma ngilindele ukulanda ukuze ngiqale ngokwemvelo?
- Ingabe kukhona ukuhlolwa okwengeziwe esingakwenza?
- Kuyini ukukhishwa kwebasebenzi kubonakala sengathi usebenza? Ngesimo sami? Yiziphi izindlela ezingasetshenziswa?
- Ziyini izingozi zokungeniswa mina ngokwami? Ngomntwana wami?
- Uma kunezingozi ezengeziwe, yini engenziwa ukuze unciphise?
- Ngingaba nesikhathi esithile ngedwa ngicabanga ngalokhu futhi ngikhulume nomngane wami?
Lezi zingxoxo zibalulekile kuwe, ingane yakho, kanye nodokotela wakho. Lokhu kuzosiza ukuqinisekisa ukuthi wonke umuntu uyaqonda ukuthi kwenzekani nokuthi yini enhle kakhulu wena nomntanakho.
Imithombo:
> I-American College yezidakamizwa namaGynecologists. Ukukhishwa Kwezabasebenzi. Januwari 2012.
> Boulvain M, Stan CM, Irion O. Ukulethwa kwezikhetho kwabesifazane abakhulelwe abanesifo sikashukela. Cochrane Database Syst Rev 2001, Issue 2. Art. Inombolo: CD001997; I-DOI: 10.1002 / 14651858.CD001997.
> Boulvain M, Stan C, i-Irion O. Isikhwama siqhubekela phambili ekufakweni kwemisebenzi. Database Cochrane Yokuhlolwa Okuhlelekile 2010, Issue 1. Art. Cha: CD000451. I-DOI: 10.1002 / 14651858.CD000451.pub2
> Gülmezoglu AM, Crowther CA, Middleton P, Heatley E. Ukukhishwa kwemisebenzi yokuthuthukisa imiphumela yokuzalwa yabesifazane esikhathini noma ngaphezulu. Database Cochrane Yokuhlolwa Okuhlelekile 2012, Issue 6. Art. Cha: CD004945. I-DOI: 10.1002 / 14651858.CD004945.pub3
> Jozwiak M, Bloemenkamp KWM, Kelly AJ, Mol BWJ, Irion O, izindlela ze-Boulvain M. Izindlela zokufakelwa kwabasebenzi. Database Cochrane Yokuhlolwa Okuhlelekile 2012, Issue 3. Art. Cha: CD001233. I-DOI: 10.1002 / 14651858.CD001233.pub2
I-Obstetrics: Ukulungiswa Okuvamile Nezinkinga. IGabbe, S, Niebyl, J, Simpson, JL. Uhlelo lwesihlanu.