Uqwalaselo olunzulu lweengxaki zokukhulelwa
Nangona ininzi yokukhulelwa ayinayo imiba ephambili, yonke inkqubo yokunakekelwa kwangaphambi kokubeletha yenzelwe ukukhenkcelela iingxaki ezinokubakhokelela kwaye inokuthintela abo abanokuphetshwa. Ngoluhlu lwesheke lokubeletha- ukujongana nomfutho wegazi, umchamo, igazi, kunye nesisindo; ukulinganisa i-fundus yakho (phezulu kwesibindi); kunye nezinye izinto ezahlukeneyo-ugqirha uzama ukugcina wena kunye nosana wakho uphilile, ukuze ukwazi ukukhulelwa nokukhusela okukhuselekileyo.
Ezi zihlolisiso zenza uncedo lwenkonzo yakho yezempilo ukuba uthembele kwaye uphathe iingxaki zokukhulelwa kwangaphambili, ngaphambi kokuba zibe ziingxaki ezinkulu.
Kukho iingxaki zokukhulelwa eziqhelekileyo kunezinye. Ngelixa besenokubachaphazela kuphela ipesenti encinci yabasetyhini abakhulelweyo, banokuba buhlungu kwaye banokuba yingozi kubo bobabini kunye / okanye umntwana.
Nantsi uluhlu lokuqala lweengxaki onokuyicingwa ngazo ngokukhulelwa okuphakathi.
-
IiNtsholongwane zentsapho kunye nokukhulelwa
-
Ukukhuselwa kweDirarha Ngethuba lokukhulelwa kunye nendlela yokujongana nayo
Yazi ke, ukuba ugqirha wakho okanye umbelethisi naye uphendule olu luhlu kuwe ngokusekelwe kwimbali yakho yezobugqirha kunye neentsapho ukuba kukubonelele ngononophelo olungcono.
Rh Factor
Wonke umntu unobumba beqela legazi kunye neR Rh factor. Ukongeza kwinqanaba legazi (A, B, O, AB), iR Rh ibhaliwe njengento enhle (ekhoyo) okanye engekho (engekhoyo). Uninzi lwabantu (ama-85 ekhulwini) yiR Rh positive. Le nto ayichaphazeli impilo yakho kwaye ayibalulekile-ngaphandle kokuba ukhulelwe.
Owesifazane okhulelwe usemngciphekweni xa ene-Rh engathandekanga kwaye iqabane lakhe linesimo esihle seR Rh. Olu dibana lunakho ukuvelisa umntwana onguRh positive.
Ukuba umama kunye negazi lokuxuba igazi, oku kunokubangela ukuba unina enze ama-antibodies ngokubhekiselele kwi-Rh factor, ngaloo ndlela wayiphatha umntwana njengomngcwabi emzimbeni wakhe. Ngokuqhelekileyo igazi elivela kumama nosana aluxubeki; kukho amaxesha athile kukho ithuba elincinane, njengokuba kuzalwa, ezinye iimvavanyo zangaphambi kokubeletha (njenge-amniocentesis), okanye emva kokusweleka kwesisu. Inkunkuma yeRhoGAM inikezelwa ukunceda ukukhusela oku kukhuthaza.
Ukuba wena kunye neqabane lakho nonke ninguRhin negative, oku akuyiyo into eya kuba yingxaki xa ukhulelwa. Ungakhathazeki ukuba awukwazi uhlobo lwakho lwegazi. Le nto iya kukhangela kwangethuba kwinkathalo yakho yokubeleka.
Isifo sikashukela
Isifo sikashukela se-Gestational (GD) ishukela ephezulu yegazi (amazinga e-glucose) ngexesha lokukhulelwa; malunga neepesenti ezi-4 zabafazi abakhulelweyo bakhula. Uninzi unina kuya kufuneka ukuba uhlolwe usebenzisa umsebenzi wegazi, oqhelekileyo ukwenzeka kwiveki ezingamashumi amabini anesibhozo zokukhulelwa . Ukuba udinga ukuhlolwa okongeziweyo kunye novavanyo lwe- glucose ukunyamezela (GTT) , kuya kwenziwa ngeli nqanaba.
Ukuba unayo i-GD, umsebenzi wakho unokunyanzelwa njengoko usondela kufutshane neeveki ezingama - 40 .
Uya kufuneka uhlole iswekile yegazi ukususela ekugqibeleni ukuxilongwa kwakho ukuphela kokukhulelwa kwakho ukuba unesifo sikashukela, kwaye ugqirha uya kukufundisa ukuba njani kwaye nini. Ukutya kunye nokuzilolonga kuya kuba yizinto ezibalulekileyo zesicwangciso sakho sokulawula ishukela segazi. Amayeza asetyenziswa kuphela xa ukutya kunye nokuzilolonga kungasebenzi. Ngokuqhelekileyo uza kubona isondlo sokuncedisa ngoncedo ngale nkqubo, ngaphezu kwecandelo lakho lezempilo.
Preeclampsia
I-preeclampsia, okanye ukukhulelwa-kubangelwa ingozi yecembelelo (PIH), isifo sokunyuka kwengcinezelo yegazi yokukhulelwa. Sekude kube ngenye yeengxaki ezinzima zoomama ekukhulelweni, kwaye zichaphazela ama-7 ekhulwini labamama bokuqala. Umsebenzi unokunyanzelwa ngokukhawuleza ukuba unengxaki ye-PIH.
Ngokwezikhokelo ezibekwe yi-American College of Obstetricians kunye namaGynecologists, ukuxilongwa kwe-preeclampsia akufuneki ukufunyanwa kwamanqanaba aphakamileyo amaprotheni kumchamo (proteinuria), njengoko kwakunjalo.
Ubu bungqina bubonisa ukuba iingxaki ezinxulumene neentso kunye nesibindi zingenzeka ngaphandle kwempawu zeprotheni, kwaye ukuba inani leprotheni emcimbini alunakucaciseli ukuba isifo esiya kuqhubeka siphumelele kangakanani.
I-Preeclampsia ngoku ifunyaniswe ngophuculo oluphezulu lwegazi oluqhubekayo ngexesha lokukhulelwa okanye ngexesha lokuhamba emva kwexesha elixhamene neprotein ezininzi kumchamo okanye uphuhliso olutsha lweeplatelet zegazi, ukunciphisa iingtso okanye isibindi, imiphunga, okanye iimpawu zeengxaki zengqondo ezifana nokuxhwala kunye / okanye ukuphazamiseka okubonakalayo.
Ukuqwalasela izinto ezinokubaluleka kwezi ngxaki, ihlolwe ukususela ekuqaleni kokukhulelwa. Ekuqaleni kubonakala, ngakumbi kunzima ukuba. Ugqirha wakho uya kujonga uxinzelelo lwegazi kunye nezinye iimpawu kunye neempawu ukucacisa ixesha elide lokubonisa ukuba uvumele ukukhulelwa kwakho kuqhubeke. Kukho ngokucacileyo umnqweno wokuba uthwale umntwana wakho ngokukhawuleza ixesha elide kwaye ukhusele impilo yakho, ngoko ke ibhalansi elungileyo kufuneka ibethwe, eyahlukileyo kumfazi okhulelweyo.
-
Isikhokelo esibalulekileyo sokukhungula ekukhulelweni kokuqala
-
Ngaba Unokubamba Isisu Kwakho Isisombululo?
Placenta Previa
I-Placenta previa yiyo yonke into okanye inxalenye yepentecenta ihlanganisa umlomo wesibeleko okanye ukuvula kwesibeleko. I-placenta previa yangempela iyenzeka malunga neyodwa kwi-200 yokukhulelwa. Amaxesha amaninzi ama- ultrasound aqala ukubonakalisa i-placenta previa, kodwa imeko iyanqumla emva koko njengoko ukhula lukhula. Ukuba umcimbi usabakho ekupheleni kokukhulelwa, icandelo leCesarean lingaqhutyelwa ukukhusela igazi ngexesha lokuzalwa.
Uninzi unina akayi kuba nayo nayiphi na impawu okanye iimpawu ze-placenta previa, nangona abanye oomama banokuphuma igazi. Yingakho kubalulekile ukuthetha nodokotela wakho ukuba ufumana nayiphi na inqanaba lokukhupha ngexesha lokukhulelwa kwakho.
Oligohydramnios (i-Low Amniotic Fluid Volume)
I-Oligohydramnios , okanye i-amniotic fluid ephantsi, ifunyaniswa nge-ultrasound, kodwa loo ngqamane inokuyalelwa emva kokuba ugqirha wakho uqaphele umahluko ekukhuleni kwesibeletho sakho ukusuka kumilinganiselo ethathwe ekutyelelweni kwakho kokubeleka. Kukho ubungqina bokuthi ama-amniotic levels of fluid awela njengoko ixesha lokuzalwa liza kufuphi. Iingcali ezininzi ziza kukusela amanzi (ukuqinisekisa ukuba umbane ophantsi awukho ngenxa ye-hydration ephosakeleyo) kwaye uphinde uphinde uhlole kwakhona nge- ultrasound ngaphambi kokuba uqhubekele ukuthetha ngokuqulunqwa kwabasebenzi okanye ezinye iindlela zokungenelela .
I-Polyhydramnios (i-High Amniotic Fluid Volume)
I-Polyhydramnios yinto echasene ne-oligohydramnios, oku kuthetha ukuba kukho ubude be-amniotic fluid. Oku kwenzeka kwingaphantsi kwepesenti zonke zokukhulelwa.
Nangona abanye becinga ukuba i-polyhydramnios yimbangela yokubaluleka komsebenzi ngenxa ye-uterine distension, i-high amniotic fluid kwaye ngokwayo yinto enjalo. Kunoko, iyakwazi ukubonisa ukuba okanye ukukhulelwa kuya kufikelela kwikota.
I-Polyhydramnios iyakwenzeka xa kwenzeka:
- Kukho ukuthotyelwa kwamanani amaninzi
- Kukho isifo sikashukela sesifo sikashukela
- Kukho i-malformation ye-congenital okanye iziphoso ezithile zokuzalwa
Nangona abanye oogqirha bazama ukucoca ezinye izikhuhlane kwi-uterus ngokusebenzisa inaliti, oku akusoloko isisombululo sesikhathi eside, njengoko umlambo ubeka endaweni. Oku kunokuthetha ukuba akukho nto eninzi eyenziwa ukunyanga umcimbi ngexesha lokukhulelwa. Njengoko i-polyhydramnios inokunyusa umngcipheko wento efana nentambo ephucukileyo xa amanzi ephuka ngexesha lobasebenzi, uya kuhlolwa xa uqala umsebenzi.
I-Breech kunye nezinye izilwanyana
Iintsana ze-Breech azikho kwindawo eqhelekileyo yokuma kwekhanda. Oku kwenzeka malunga neepesenti ezingama-3 ukuya kuma-4 ekhulwini kubo bonke abantwana bokuzalwa ekupheleni kokukhulelwa. Iintsana zivame ukuxhatshazwa ngezizathu ezahlukeneyo, kuquka:
- Izifo ezingasebenzi
- Imiba ye-Fetal
- Ezininzi
- Ezinye iimeko
Kukho indawo eyaziwa ngokuba ngamangqina ajikelezayo , oku kuthetha ukuba umntwana ulele ecaleni kwesibindi. Ekubeni kunzima ukuzala umntwana ngale ndlela, uyingcali yakho ingenza inguqu yangaphandle , apho umntwana usuka ngaphandle, okanye uncoma ukuba ube neCesarean section . Kukho nabanye oogqirha abaza kwenza ukuzalwa kwezibeleko zesisu kunye namabhinqa athile kwizikhundla ezithile.
Umsebenzi wokuqala
Umsebenzi we-Preterm yinto enzima kakhulu yokukhulelwa. Ukufumanisa kwangaphambili kunokunceda ukukhusela ukuzalwa ngaphambi kokuzalwa, mhlawumbi kukuvumela ukuba uthwale ukukhulelwa kwakho kwithuba, okanye unike umntwana wakho ithuba lokuphila. Kukho izizathu ezininzi zomsebenzi wokuqala, kubandakanya ukusuleleka, iingxaki zesisu, iintsana ezininzi kunye nesifo somama. Kungakhathaliseki ukuba yintoni imbangela yomsebenzi wokuqala , kubalulekile ukwazi ukuba ziphi iimpawu ukuze ukwazi ukunyamekela ngokukhawuleza.
Ufanele ubize ugqirha okanye umbelethisi ukuba unayo nayiphi na impawu elandelayo yomsebenzi wokuqala :
- Ulwahlulo okanye ukutyumba
- Ukuphuma kwamanzi obomvu
- Ukukhupha okanye ukukhukhuma kobuso okanye izandla
- Ubuhlungu ngexesha lokuchama
- Ukugquma okanye ukutywala ixesha elide esiswini sakho
- Ukuhlanza okuqhelekileyo okanye okuqhubekayo
- Ukukhupha ngokukhawuleza okucacileyo, amanzi amanzi
- Backache
- Uxinzelelo olunzulu lweplavic
Kukho ezinye iimpawu zakho ezibonisa ukuba ufuna; qi niseka ukuba ungabiza ukuba unomdla. Ukuba awukwazi ukufumana ingcali yakho, unokufuna unonophelo kwisebe elingxamisekileyo.
Incompetent Cervix
Umlomo wesibeleko ongenakulungele umlomo wesibeleko obuthathaka kakhulu ukuhlala uvaliwe ngexesha lokukhulelwa, okubangela ukuzalwa kwangaphambili kunye nokulahlekelwa yintsana (ngenxa yokunciphisa ubude bentsapho). Kukholelwa ukuba ukungaqondi kakuhle kwintsholongwane kubangelwa ipesenti ezingama-20 ukuya kuma-25 ekhulwini lazo zonke iindleko zokulahlekelwa kwe-trimester. Lo mbandela ubonisa ngokubanzi ekuqaleni kwekota yesibini, kodwa ingafunyanwa ngokukhawuleza njengokuqala kwekota yesithathu . Ukuxilongwa kungenziwa ngokomntu okanye nge-ultrasonography.
Ukuba Ingxaki ixhaswa
Ukuba wena okanye ugqirha wakho ucinga ukuba kukho ingxaki, incoko malunga nesicwangciso senzathelo senziwe. Oku kunokukhokelela kwiimvavanyo ezizodwa kwiimeko zakho ezithile okanye ezikrokrelwayo . Ingabandakanya nokulinda okulindileyo. Ngamanye amaxesha kunokuba nzima kakhulu. Ewe, ufuna ukwenza okuthile-kodwa oko akunakuhlala kulungile. Kungakhathaliseki ukuba, ukukhankanywa okanye ukuqinisekiswa kwengxaki kuza kubandakanya ukutyelela ngokunyamekela kokubeleka .
Yintoni eyenzekayo Ukuba Unenkinga
Iindaba ezilungileyo kukuba kukuba ngononophelo olungaphantsi kokubeletha, ezininzi iingxaki zinokuthintelwa, zichongwe kwangaphambili, kunye / okanye ziphathwe ngempumelelo. Abanye badinga ukunakekelwa okongeziweyo ngexesha okanye emva kokukhulelwa, ngamanye amaxesha nakwixesha lakho elizayo, ngelixa abanye bengenalo. Emva kokuba umntwana wakho azalwe, kukulungele ixesha lokuthetha nothando lwakho ngaphambi kokucwangcisa enye ukukhulelwa ukuze ubone into enokuyenza ngaphambi kokukhulelwa ukukunciphisa umngcipheko wakho wokuphindaphinda kwengxaki okanye ukuyilawula ngaphambili.
Iingcali eziphezulu
Ngamanye amaxesha, ukuba inkcenkceshe yakho ayikho yesiqhelo okanye inzima ngokwaneleyo ukuba ibhalwe ngobunzima bokukhulelwa , ungadinga izinga eliphezulu lokunyamekela. Ukuba usebenza nombelethisi, oku kuthetha ukuba usebenza ngokubambisana nodokotela okanye mhlawumbi utshintshe unyango lwakho kumgqirha ngokupheleleyo. Ukuba ubona i-OB / GYN, unokwenzela ukuba udlulisele unonophelo kwi-ingcali ephezulu eyaziwa njengengcali ye- fetalal fetal (MFM) .
> Imithombo:
> I-American Diabetes Association (ADA). Ngaphambi kokukhulelwa. Novemba 2013.
> Duley L, i-Henderson-Smart DJ, i-Walker GJA. Amanyathelo okuphulukana ne-pre-eclampsia kunye nemiphumo yakhe: iprotocol (generic protocol). I-Cochrane Database yeeNkqubo eziPhononongo zika-2009, iNqaku 2. Ubugcisa. Inombolo: CD007756. INGXELO: 10.1002 / 14651858.CD007756.
> Nabhan AF, Abdelmoula YA. I-Amniotic fluid index ngokubhekisele kwipokethi ebonakalayo ejulile njengolu vavanyo lokuhlola ukukhusela umphumo wokukhulelwa okubi. I-Cochrane Database yoVavanyo oluQinisekiso 2008, Inkcazo 3. Ubugcisa. Inombolo: CD006593. INGXELO: 10.1002 / 14651858.CD006593.pub2
> Neilson JP. Amanyathelo enokuthi akhankanywe kwi-placenta previa. I-Cochrane Database yeeNkqubo eziPhezulu 2000, Inkcazo 1. Ubugcisa. Inombolo: CD001998. INGXELO: 10.1002 / 14651858.CD001998
> Novikova N, uCluver C, iiKoopmans CM. Ukunikezelwa ngokumalunga nolawulo olulindelekileyo lweengxaki zexinzelelo eziphezulu ukusuka kwiiveki ezingama-34 ukuya kwekota (Protocol). I-Cochrane Database yeeNkqubo zoVavanyo zeNkqubo zeNkcazo zika-2011, iNqaku 8. Ubugcisa. Inombolo: CD009273. INGXELO: 10.1002 / 14651858.CD009273.
> I-Obstetrics: Iziqhelo eziqhelekileyo kunye neengxaki. Gabbe, S, Niebyl, J, Simpson, JL. I sixhenxe.