Ukukhulelwa nesisindo yinto evame ukukhulunywa ngayo, nakuba iningi lezingxoxo livame ukuqala phakathi kokuthola isisindo ngenkathi ukhulelwe. Olunye udaba oluzoxoxwa yilokho okwenzeka kowesifazane nokukhulelwa kwakhe lapho eqala ukukhulelwa ngezigaba ngokweqile noma ezikhuluphele. Iqiniso yilokhu kuyinkinga ehlukahlukene, hhayi nje ukuphathwa kwezokwelapha noma kwesisindo.
Ukuthi Ukukhuluphala Kuchazwe Kanjani Ekukhulelweni
Ukukhuluphala ngokweqile kuyinkinga ekhulayo nabesifazane abaningana abaqala ukukhulelwa kakade emikhakha ekhuluphele noma ekhuluphele. Cishe amaphesenti angu-40 abesifazane besesimweni esiphakeme kakhulu futhi amashumi ayishumi nesishiyagalolunye abhekwa njengabantu abakhulu kakhulu ngokusho kwe-World Health Organization (WHO). Ukuqhathaniswa ngokweqile kuchazwa ngokuthi kune-index mass mass (BMI) phakathi kwamaphuzu angamashumi amabili nanhlanu nesishiyagalolunye nesishiyagalolunye, kuyilapho ukukhuluphala kuhlongozwa njenge-BMI engaphezu kwamashumi amathathu. Lezi izincazelo ezifanayo ezisetshenziselwa ukukhulelwa. I-BMI ngokuvamile ibalwa ngesisindo sokukhulelwa ngaphambi kokukhulelwa hhayi ukuzuza kwesisindo ekukhutheni.
Ukunakekelwa kokukhulelwa nangaphandle
Enye yezinkulu kodwa ezingavamile ukukhuluma mayelana nezindaba mayelana nokukhulelwa nesisindo ukuthi abesifazane abakhulelwe abalingani baphathwa kanjani. Siyazi ukuthi ngokuvamile, iziguli ezithwala ngokweqile noma ngokweqile zingazizwa zinganeliseki ngokunakekelwa kwazo noma zizwe sengathi azitholi ukunakekelwa okwanele.
Lokhu akumukeleki futhi akufanele ubekezelele ukuphathwa kabi ngenxa yesisindo sakho.
Njengomuntu okhulelwe, unelungelo lokuphathwa ngehlonipho nangokunakekelwa okufanele ukukhulelwa kwakho / noma izimo zezokwelapha. Lokhu kuhlanganisa ukuqinisekisa ukuthi unezinsiza zokwelapha okwanele esisisindo sakho-isibonelo esihle ukuphefumula kahle kwegazi.
Lokhu kusebenza ekuqinisekiseni ukuthi ukucindezelwa kwegazi kwakho kulinganiswa ngezibonelo ezanele ngokwanele: izilinganiso ezikukala ngokunembile kanye nefenisha okukufanele, kufaka phakathi umbhede womsebenzi kanye netafula lokuhlola.
Yeka ukuthi ukukhuluphala kuthinta kanjani ukukhulelwa
Ukukhishwa kokuqala umuntu angase ahlupheke kusukela lapho ezama ukukhulelwa ngenkathi ekhuluphele noma ekhuluphele kunenkathazo yokukhulelwa. Kukhona abesifazane abathile abazobhekana nezinkinga nge-polycystic ovarian syndrome (i-PCOS), engabangela ukungasebenzi noma ukukhathazeka ukukhulelwa. Kukhona nabesifazane abathile abanomqondo ophansi wokuzala obizwa nge-subfertility. Lokhu kuhlanganisa nezingozi ezingase zibe khona zokuzala okunzima ukubhekana nokucindezeleka kokukhuluphala ngokweqile, njengengcindezi ephakeme yegazi nesifo sikashukela.
Uma usukhulelwe, kunezinye izinkinga ezingase zibe khona kusukela esisisweni sokwanda okubandakanya:
- Ingozi ekhulayo yezifo ezithile zokuzalwa njengeziphambeko ze-neural tube
- Ingozi eyengeziwe yokukhulelwa kwesisu
- Ingozi yokwanda yesifo sikashukela sokugaya
- Ukwandisa ingozi yokuphefumula kwe-apnea
- Ingozi eyengeziwe yokutheleleka kwe-sac amniotic (chorioamnionitis)
- Ingozi eyengeziwe ye-preeclampsia
Ngayinye yalezi zinkinga inezingozi zayo ezihlobene nabo. Kungasho ukuthi udinga ukuba nenani elikhudlwana lokuvakashelwa kokubeletha , okudinga imithi noma ukuqapha okusheshayo.
Lesi yisinye sezizathu zokuthi ukunakekelwa kokubeletha kubaluleke kakhulu futhi kungani kubalulekile ukuthi kube kuhle kuwe.
Ukukhulelwa kwesisindo somzimba
Into eyodwa ecacile, ngisho noma uqala ukukhulelwa ngesisindo esiningi kunokuba odokotela bakho bangathanda, kusadingeka ukuthi uzuze isisindo ekukhulelwe . Owesifazane osesiswini ogqamile noma obunamandla kakhulu uzodinga ukuthola isisindo esincane sokukhulelwa okunempilo, kodwa ukuzuza kwesisindo namanje okukhuthazwayo.
Kwabesifazane abakhuluphele ngokweqile, kunconywa inzuzo yesisindo samakhilogremu ayishumi nanhlanu kuya kwamashumi amabili nanhlanu, cishe amakhilogremu amabili kuya kwesithupha nesigamu avela ku-trimester yokuqala, futhi cishe isigidi samaphesenti esisindo sokuthenga ngesonto ngalinye emizimbeni yesibili nesithathu .
Lokhu kuzuza kwesisindo kwanda ngamawele ukuze kube ngamashumi amathathu nanye kuya kwamapounds amahlanu.
Uma ukhuluphele ekuqaleni kokukhulelwa, kunconywa ukuba ungatholi ngaphezu kwamakhilogremu amane kuphela ekupheleni kwe-trimester yokuqala, futhi uthole amaphilisi angama-2 ngesonto kumakhomitha wesibili nowesithathu. Umgomo wukuba nesilinganiso sokuzuza kwesisindo phakathi kwamakhilogremu ayishumi nanye namashumi amabili. Uma ulindele amawele, lelo nani likhuphuka libe ngamaphilenti amabili nanhlanu kuya kwamashumi amane nambili.
Ukulahlekelwa Isisindo Ngesikhathi Ekhulelwe
Akunconywa ukuthi noma ubani uzama ukunciphisa isisindo ekukhulelwe. Lokhu kuyiqiniso, kungakhathaliseki ukuthi isisindo sakho sokuqala sinjani. Ukudla ngesikhathi sokukhulelwa kunciphisa ingane yakho ngamakhilori adingekayo. Kucatshangwa ukuthi kubangele inkinga engase ibe khona ngokushisa amafutha omama okuvuthayo okungenzeka ukukhulula ubuthi emzimbeni. Lokhu akusho ukuthi kufanele udle noma yini oyifunayo, ukudla okunomzimba ogcwele futhi ogcwele ukudla okunomsoco kungcono kakhulu ukukhulelwa kwakho nomntwana kunokudla okunokhalori eliphezulu kanye nekhwalithi ephansi.
Ukusebenza Kwabesifazane Abakhulu
Kukhona izinto eziningi ezishiwo noma izinkolelo eziye zabanjwa mayelana nokusebenza nomfazi onamandla kakhulu noma okhuluphele. Ucwaningo olusanda kusanda lusisize sicacise le micabango futhi siyibeke endaweni engokwenyama yezokwelapha zanamuhla.
Ungase ube engozini eyengeziwe emisebenzini ye:
Abesifazane kulezi zigaba zesisindo bangase babe nesigaba sokuqala somsebenzi, ingxenye lapho umlomo wesibeletho ukhula khona. Udokotela uzolulekwa ukuba anikeze isikhathi esengeziwe kulesi sigaba somsebenzi futhi angangeneli uma nje unina nomntwana benza kahle.
I-epestural anesthesia kungenzeka kubantu besifazane esigabeni esiphakeme kwesisindo. Yize kungase kube yinkinga ngokwedlulele ngokombono we-anesthesiologist. Uma ungena kulesi sigaba, ungase uthande ukucabangela ukubonisana kwangaphambi komsebenzi nomnyango we-anesthesia esikhungweni sakho ukuze uthole ulwazi oluqondile kuwe. Umsebenzi awusiwo uma ufuna ukumangala kusakazeke.
Isigaba sesibili sokusebenza, noma ukuxosha, sasiyicatshangwa ukuthi sisele isikhathi eside sabesifazane abakhuluphele ngokweqile noma abakhuluphele. Ucwaningo lwamuva alutholanga ukuthi kube njalo. Eqinisweni, isifundo esincane sibonisa ukuthi laba besifazane babe nezingcindezi ezifanayo zengculazi ezilinganisweni ezivamile zesisindo. Lokho kusho ukuthi ukunyuka kwamafutha nge-synthetic oxytocin kwakuvame kakhulu. Kuyinto iphuzu elibalulekile ukuphawula ukuthi i-BMI eyandayo ibonakala inomphumela wokuzivikela ekubhekaneni ne-laineation yesithathu noma yesine kwi-perineum.
Ukukhishwa Kwebasebenzi Nokuzalwa KwamaSareya
Isigaba se-Caesarea sinezinkinga zayo ezithinta abesifazane abakhuluphele ngokweqile. Yize kubalulekile ukuqaphela ukuthi isigaba esilungisiwe sokugcina isisindo sodwa asithuthukisi imiphumela yomntwana noma umama. Ingozi yokudinga i-cesarean akuyona into eqondile njengoba umuntu angase acabange.
Uma uqala ukusebenza ngokuzenzekelayo, amazinga esilinganiso sokugcina ngesikhathi sokubeletha afana nabesifazane bazo zonke izigaba zesisindo. Uma ingozi yokuba isigaba sezinyathelo ziphakanyiswe ngabomama emkhakheni wokuqhathanisa nokugqithisa kakhulu lapho kusetshenzwa umsebenzi noma kuqalwe ngendlela efanele. Ngenkathi kunezifundo zamanje zenziwa ukuze zibheke ukuthi yini engashintsha ukuze kulawulwe lokhu kuphakama, okwamanje akukho izincomo zokuthi uhlobo luni lokubambisa luzophumelela kakhulu.
Lokho esikwaziyo ukuthi abesifazane abakhuluphele ngokweqile noma abakhuluphele banesilinganiso esiphezulu sezinkinga ezizokwenza ukuba ukufakwa kwabasebenzi kube ukungenelela okufanelekile. Okuzayo okulandelayo ukulinganisa izingozi zokukhulisa ukukhulelwa kanye nezingozi zokungeniswa kanye nokuzalwa okungase kube khona.
Ukubeletha kwe-cerebral kuyinto enselele kakhulu kunombono weqembu le-anesthesia kanye nodokotela ohlinzayo. Lesi esinye isikhathi lapho imishini elungile ingaba usizo kakhulu kokubili odokotela nodokotela.
Ukuqalwa kwangaphambili Ukuhlela Ikusasa
Into eyodwa evame ukuphakanyiswa yukuthi ukukhuluphala ngokweqile kanye nezindaba ezihambisana nesisindo kusetshenzwa ngaphambi kokukhulelwa. Kodwa-ke, akubekho izifundo zangempela kulokho okuphumelelayo nokuthi yini engekho ngokwalokho okusemandleni. Noma yiziphi izazi ezivumelana ngazo ukuthi uma kwenzeka kungenzeka ukuthi ulahlekelwe isisindo, ngisho noma ungasombululi ngokuphelele umthwalo wesisindo, noma yisiphi isisindo esilahlekile kubhekwa njengenzuzo.
Uma unenkinga ngokulahlekelwa isisindo noma ukhethe ukungalindi, ke uqinisekise ukuthi usebenza ukuze ube nempilo enhle ngangokunokwenzeka. Ukweqisa ngokweqile noma ukugqwala kungaba nomthelela omubi empilweni yakho, kodwa akusona isithembiso sezinkinga. Ukuhlola kahle kwezempilo okungenakuqhathaniswa nakho kungabheka noma yiziphi izinkinga ezingenzeka futhi ungakwazi ukubhekana nalabo ngaphambi kokukhulelwa. Lokhu kakade kungasiza ukukhulelwa kwakho esikhathini esizayo kube yimpilo uma ungazama ukuthola futhi uphathe izinkinga ezengeziwe ngesikhathi ukhulelwe.
Konke lokhu kusho, kukhona ucwaningo olubonisa ukuthi ukulahlekelwa isisindo phakathi kokukhulelwa kungaholela ngokuyinhloko umphumela we-yo-yo ngesisindo, okungenzeka ngisho nokwenza owesifazane athole isisindo xa ekhulelwe noma phakathi kokukhulelwa kwakhe. Enye yezinto eziphumelela kakhulu ukukwenza ukubhekana nezifo ezihlobene nesisindo ngaphambi kokukhulelwa, umfutho wegazi ophezulu, nezindaba ze-glucose yegazi, eziningi zezinkinga ezibonwayo ekukhulelwe zivela kulezi zinkinga.
Ithebula Eliphezulu-Ingozi
Abesifazane abaningi abakhuluphele ngokweqile noma abakhuluphele bathola ukuthi baphoqelelwe ukuba benze imikhuba yezokwelapha okuyizo zonke izingozi ezinkulu, ngisho nokungabikho kwezinkinga ezingapheli futhi baphoqelelwe ukwamukela ukungenelela noma ukuhlolwa okungase bangakufuni. Lokhu kungenxa yokuthi iningi labesifazane besigaba esiqine ngokweqile futhi esiphelele ngokuvamile sibhalwe njengeziguli eziphezulu kakhulu .
Nakuba ukugqithisa ngokweqile noma okweqile kungandisa izinkinga ezithile, iningi lezinkinga ezenzeka ngesikhathi sokukhulelwa ngaphakathi kwalezi zigaba zesisindo zikhona ngenxa yesimo esingapheli, okungenzeka noma esingathinti isisindo. Isibonelo esihle sizoba nezinkinga zengcindezi yegazi ngaphambili. Nakuba kuyiqiniso nokuthi abesifazane abaningi abaqondi ukuthi ukubizwa ngokuthi ubungozi obukhulu akuyona into efana nokuthi uzothola izinkinga ekukhutheni, nje ukuthi kukhona ithuba elikhulu lokuthi kwenzeke.
Ngisho nelebuli ephakeme kakhulu, inani eliningi labesifazane kufanele likwazi ukukhulelwa okuncane nokubeletha. Lokhu kuxhomeke kakhulu kumsebenzi owakhethile nefilosofi yabo eqondisayo. Njengomuntu okhulelwe, unamalungelo futhi ungawasebenzisa, lokhu kungahlanganisa ukuthola udokotela omusha uma kufanelekile.
Okufanele Ukwenze Uma Uzizwa Uthathwa Ngokwempofu Ngenxa Yokwesisindo Sakho
Kufanele kuqala kuqala ukukhuluma. Udokotela noma umbelethisi wakho angase angaqapheli ukuthi uzizwa kabi ngokukhathalela kwakho. Lokhu kukuvumela ithuba lokusula umoya. Uma ungakhululekile ukwenza lokhu ngomuntu, cabangela ukubhala incwadi kumhlinzeki wakho. Uma ukukhathazeka kwakho kungakhulunywa ngendlela oyithandayo, cabanga ngokufuna ukunakekelwa kwelinye iqembu labadokotela.
> Imithombo:
> Garretto D, Lin BB, Syn HL, uMahluleli N, Beckerman K, Atallah F, Friedman A, Brodman M, Bernstein PS. Ukukhuluphala Kungase Kuvikelwe Ekubhekaneni Nezicucu Ezinzima Zomzimba. J Obes. 2016; 2016: 9376592. i-doi: 10.1155 / 2016/9376592.
> U-Ruhstaller K. Induction of Labour in the Patient Obese. I-Semin Perinatol. 2015 Okthoba; 39 (6): 437-40. doi: 10.1053 / j.semperi.2015.07.003. I-Epub 2015 Sep 26.
> Shree R, Park SY, Beigi RH, Dunn SL, Krans EE. Ukwelashwa Kwamasayithi Okuhlinzeka Ukulandela Ukwelashwa KwezaseKhaya: Isiguli, Umhlinzeki, kanye Nezinqubo-Eziqondile Zezici Zingozi. Am J Perinatol. 2016 Jan; 33 (2): 157-64. i-doi: 10.1055 / s-0035-1563548. I-Epub 2015 Sep 7.
> Isisindo sithola ngesikhathi sokukhulelwa. Ukwahlukaniswa kweMpilo Yokuzala, Isikhungo Sikazwelonke Sokuvimbela Ukugula Nokuguqulwa Kwezempilo. Isikhungo Sokulawulwa Nokuvimbela Izifo. Ngo-Okthoba 14, 2016.
> Ukunyuka kwesisindo Ngesikhathi sokukhulelwa: Ukuhlola kabusha izinkombandlela. UKathleen M. Rasmussen no-Ann L. Yaktine, Abahleli; Ikomidi Lokuhlola kabusha I-IOM Yokukhulelwa Isisindo Sezinkomba; I-Institute of Medicine; Umkhandlu Wocwaningo Lwezwe; 2009.
> I-World Health Organization. Ukuqhathanisa ngokweqile nokwephuza ngokweqile Umshicileli N 311. http://www.who.int/mediacentre/factsheets/fs311/en/ [kufinyelelwe 2016] NgoJuni 2016.