Ezabasebenzi Nokulethwa

-Delile

• Izimpawu zomsebenzi
• Izinciphiso zeBraxton Hicks
• Isigaba sokuqala somsebenzi
• Umsebenzi wokuqala
• Umsebenzi osebenzayo
• Umsebenzi wezinguquko
• Isigaba sesibili somsebenzi
• Ukulethwa
• Isigaba sesithathu sabasebenzi
• Ukulethwa kwe-placenta
• Ukudambisa izinhlungu
• Izidakamizwa
• I-nitrous oxide
• Epidural
• Izinketho zokudambisa izinhlungu zemvelo
• Ukwenziwa komsebenzi
• Isikhundla se-Fetal
• Isigaba se-Cesarean
• Ukuzalwa kwesitho sangasese sowesifazane ngemuva kwesigaba se-C (VBAC)
• Ukulethwa okusizwayo
• I-Episiotomy

Ukubuka konke

Ngenkathi kuthatha izinyanga eziyisishiyagalolunye ukukhula kwengane ephelele, ukubeletha nokubeletha kwenzeka ngezinsuku ezithile noma ngisho namahora. Kodwa-ke, inqubo yokusebenza nokubeletha okuvame ukuhlala ezingqondweni zabazali abalindele kakhulu.

Funda uma unemibuzo nokukhathazeka ngezimpawu nobude bomsebenzi, nokuthi ungabuphatha kanjani ubuhlungu.

Izimpawu zomsebenzi

Umsebenzi uqalile noma uyeza maduzane uma uhlangabezana nezimpawu ezinjengalezi:

• ingcindezi eyanda esibelethweni
• ushintsho lwamazinga kagesi
• ukukhishwa kwamafinyila anegazi

Umsebenzi wangempela kungenzeka ukuthi ufike lapho ukusikwa kuvamile futhi kubuhlungu.

Izinciphiso zeBraxton Hicks

Abesifazane abaningi babhekana nokuphambana okungajwayelekile esikhathini esithile ngemuva kwamasonto angama-20 ekhulelwe. Kwaziwa njengokufinyela kweBraxton Hicks, ngokuvamile kabuhlungu. Okungenani, abaneme futhi abajwayelekile.

Izinciphiso zeBraxton Hicks kwesinye isikhathi zingabangelwa ukwanda komsebenzi womama noma wengane, noma isinye esigcwele. Akekho oqonda ngokugcwele indima ebanjwa yizinciphiso zeBraxton Hicks ekukhulelweni.

Bangakhuthaza ukugeleza kwegazi, basize ukugcina impilo yesibeletho ngesikhathi sokukhulelwa, noma balungiselele isibeletho sokubeletha.

Ukuncipha kweBraxton Hicks akubangeli ukuthi umlomo wesibeletho uvuleke. Ukuphambana okubuhlungu noma okujwayelekile akunakwenzeka ukuthi kube yi-Braxton Hicks. Esikhundleni salokho, ziwuhlobo lwezinciphiso okufanele zikuholele ekubizeni udokotela wakho.

Isigaba sokuqala somsebenzi

Umsebenzi nokulethwa kwehlukaniswe izigaba ezintathu. Isigaba sokuqala somsebenzi sifaka ukuqala komsebenzi ngokubhebhetheka okuphelele komlomo wesibeletho. Lesi sigaba sihlukaniswe saba izigaba ezintathu.

Umsebenzi wokuqala

Lokhu kuvame ukuba yisigaba somsebenzi esinde kunazo zonke futhi esingaqinile. Umsebenzi wasendulo ubizwa nangokuthi isigaba sokucasha somsebenzi. Lesi sikhathi sifaka phakathi ukuncipha komlomo wesibeletho nokunwebeka komlomo wesibeletho kuya ku-3-4 cm. Kungenzeka ngemuva kwezinsuku ezimbalwa, amasonto, noma amahora ambalwa nje.

Iziphambeko ziyahlukahluka phakathi nalesi sigaba futhi zingahluka ukusuka kokuncane kuya kokuqinile, zenzeka ngezikhathi ezijwayelekile noma ezingajwayelekile. Ezinye izimpawu phakathi nalesi sigaba zingabandakanya iqolo, amajaqamba, nokukhishwa kwamafinyila anegazi.

Iningi labesifazane lizobe selikulungele ukuya esibhedlela ngemuva kokuphela kokubeletha. Kodwa-ke, abesifazane abaningi bazofika esibhedlela noma esikhungweni sokubelethisa lapho besabeletha ngaphambi kwesikhathi.

Umsebenzi osebenzayo

Isigaba esilandelayo sesigaba sokuqala somsebenzi senzeka njengoba umlomo wesibeletho usuka ku-3-4 cm uye ku-7 cm. Iziphazamiso ziyaqina futhi ezinye izimpawu zingabandakanya iqolo kanye negazi.

Umsebenzi wezinguquko

Lesi yisigaba somsebenzi esishubile ngokwanda okukhulu kwezinciphiso. Ziyaqina futhi zenzeka cishe imizuzu emibili kuya kwemithathu ngokuhlukana, futhi ngokwesilinganiso amasekhondi angama-60 kuye kwangama-90. Ukujula kokugcina okungu-3 cm kuvame ukwenzeka ngesikhathi esifushane kakhulu.

Isigaba sesibili somsebenzi

Ukulethwa

Esigabeni sesibili, umlomo wesibeletho uvulekile ngokuphelele. Abanye besifazane bangazizwa benesifiso sokucindezela ngokushesha noma ngemuva nje kokuba sebekhululiwe ngokuphelele. Ingane isengaphakama phezulu okhalweni kwabanye abesifazane.

Kungathatha isikhathi esithile ukuthi ingane yehle nezingcindezi ukuze iphansi ngokwanele ukuthi umama aqale ukuyiphusha.

Abesifazane abangenayo i-epidural ngokuvamile banesifiso esinamandla sokududula, noma banengcindezi ebalulekile yemisebe lapho ingane iphansi ngokwanele ethangeni.

Abesifazane abane-epidural basengaba nesifiso sokucindezela futhi bangazizwa ingcindezi yemisebe, yize imvamisa ingenamandla kangako. Ukushiswa noma ukulunywa esithweni sangasese njengoba imiqhele yekhanda lengane nayo iyinsakavukela.

Kubalulekile ukuzama ukuhlala ukhululekile futhi uphumule phakathi kwezingqinamba. Yilapho umqeqeshi wakho wezabasebenzi noma i-doula angasiza kakhulu.

Isigaba sesithathu sabasebenzi

Ukulethwa kwe-placenta

I-placenta izobelethwa ngemuva kokuzalwa kwengane. Ukuncipha okuncane kuzosiza ukuhlukanisa i-placenta odongeni lwesibeletho bese kuyigudluza ibheke esithweni sangasese. Ukuthunga ukulungisa ukukhala noma ukusika kokuhlinzwa (i-episiotomy) kuzokwenzeka ngemuva kokulethwa kweplacenta.

Ukudambisa izinhlungu

Umuthi wanamuhla unganikeza ngezindlela ezahlukahlukene zokuphatha izinhlungu nezinkinga ezingenzeka ngesikhathi sokubeletha nokubeletha. Eminye yemithi etholakalayo ifaka phakathi okulandelayo.

Izidakamizwa

Imithi ye-narcotic isetshenziswa njalo ukukhulula ubuhlungu ngesikhathi sokubeletha. Ukusetshenziswa kunqunyelwe ezigabeni zokuqala ngoba zivame ukudala uketshezi okweqile komama, ingane, kanye nokuzalwa komntwana.

Ama-narcotic ngokuvamile anikezwa abesifazane abasebenzayo ngomjovo we-intramuscular noma ngomugqa we-intravenous. Ezinye izikhungo zinikeza ukuphathwa okulawulwa yisiguli. Lokho kusho ukuthi ungakhetha ukuthi uzowuthola nini umuthi.

Amanye ama-narcotic ajwayelekile afaka:

• morphine
• meperidine
• fentanyl
• ibutorolol
• nalbuphine

I-nitrous oxide

Imithi ye-analgesic ehogelwayo kwesinye isikhathi isetshenziswa ngesikhathi sokubeletha. I-nitrous oxide, evame ukubizwa ngokuthi igesi ehlekayo, isetshenziswa kakhulu. Inganikeza ukukhululeka okwanele kobuhlungu kwabanye besifazane lapho besetshenziswa ngezikhathi ezithile, ikakhulukazi ezinyathelweni zokuqala zomsebenzi.

Epidural

Indlela ejwayelekile kakhulu yokuphumula kobuhlungu ngesikhathi sokubeletha nokubeletha ukuvinjelwa kwe-epidural. Isetshenziselwa ukuhlinzeka nge-anesthesia ngesikhathi sokubeletha nokubeletha nangesikhathi sokulethwa kokuhlinzwa (isigaba se-C).

Ukuphulukiswa kobuhlungu kubangelwa ukujova umuthi wokubulala izinzwa esikhaleni se-epidural, esitholakala ngaphandle nje kolwelwesi limboza umgogodla. Isidakamizwa sivimbela ukudluliswa kokuzwa kobuhlungu ngezinzwa ezidlula kuleyo ngxenye yesikhala se-epidural ngaphambi kokuxhuma nentambo yomgogodla.

Ukusetshenziswa kwama-spinal-epidurals ahlanganisiwe noma i-epidural ehamba ngezinyawo sekutholile ukuthandwa eminyakeni yamuva. Lokhu kufaka ukudlulisa inaliti yamapensela amancane kakhulu ngenaliti ye-epidural ngaphambi kokubekwa kwe-anesthetic ye-epidural.

Inaliti encane idlulele esikhaleni esiseduze nentambo yomgogodla futhi kufakwa umthamo omncane we-narcotic noma i-anesthetic yendawo esikhaleni.

Lokhu kuthinta ukusebenza kwezinzwa kuphela, okwenza ukwazi ukuhamba nokuhambahamba ngesikhathi sokubeletha. Le ndlela ivamise ukusetshenziswa ngesikhathi sokuqala komsebenzi.

Izinketho zokudambisa izinhlungu zemvelo

Kunezinketho eziningi zabesifazane abafuna ukukhululeka kobuhlungu obungelona ezokwelapha ngokulethwa nokubeletha. Bagxila ekwehliseni umbono wezinhlungu ngaphandle kokusebenzisa imithi. Ezinye zazo zifaka:

• ukuphefumula okunephethini
• Lamaze
• i-hydrotherapy
• i-transcutaneous electrical nerve stimulation (TENS)
• ukuluthwa
• ukutshopa
• ukubhucungwa umzimba

Ukwenziwa komsebenzi

Umsebenzi ungenziwa ngokufakelwa ngezindlela eziningana. Indlela ekhethiwe izoncika ezintweni eziningana, kufaka phakathi:

• ulungele kangakanani umlomo wakho wesibeletho
• noma ngabe ingane yakho yokuqala yini lena
• kukude kangakanani lapho ukhulelwe
• uma ulwelwesi lwakho ludabukile
• isizathu sokungeniswa

Ezinye izizathu udokotela wakho angancoma ukwenziwa yilezi:

• lapho ukukhulelwa sekungene esontweni lama-42
• uma ukuphuka kwamanzi kukamama nokubeletha kungaqali ngokushesha ngemuva kwalokho
• uma kunezinkinga nomama noma ingane.

Ukwenziwa kwabasebenzi akuvamisile ukuthi kunconywe lapho owesifazane enesigaba sangaphambilini se-C noma uma ingane ipholile (ezansi phansi).

Umuthi wehomoni obizwa nge-prostaglandin, umuthi obizwa nge-misoprostol, noma ithuluzi lingasetshenziselwa ukuthambisa nokuvula umlomo wesibeletho uma umude futhi ungathambisanga noma ungakaqali ukwelula.

Ukweqa ulwelwesi kungahle kudale umsebenzi kwabanye besifazane. Le yinqubo lapho udokotela wakho ehlola umlomo wakho wesibeletho. Bazofaka ngesandla umunwe phakathi kolwelwesi lwesaka le-amniotic nodonga lwesibeletho.

Ama-prostaglandin emvelo akhululwa ngokuhlukanisa noma ukukhumula ingxenye engezansi yolwelwesi odongeni lwesibeletho. Lokhu kunganciphisa umlomo wesibeletho futhi kubangele ukuphambana.

Ukweqa ulwelwesi kungafezwa kuphela uma umlomo wesibeletho usukhule ngokwanele ukuvumela udokotela wakho ukuthi afake umunwe wakhe futhi enze inqubo.

Imithi efana ne-oxytocin noma i-misoprostol ingasetshenziselwa ukudala abasebenzi. I-Oxytocin inikezwa ngemithambo yegazi. IMisoprostol yithebhulethi efakwa esithweni sangasese.

Isikhundla se-Fetal

Udokotela wakho uqaphe njalo isikhundla sengane yakho ngesikhathi sokuvakashelwa ngaphambi kokubeletha. Iningi lezingane liphenduka isikhundla sokubhekisa phansi ikhanda phakathi kwesonto lama-32 nesonto lama-36. Ezinye aziphenduki nhlobo, kanti ezinye ziphenduka indawo yonyawo- noma ezansi.

Odokotela abaningi bazozama ukuguqula umbungu obusayo ube sesikhundleni sokubhekisa phansi usebenzisa inguqulo yangaphandle ye-cephalic (ECV).

Ngesikhathi se-ECV, udokotela uzozama ukuhambisa umbungu ngobumnene ngokufaka izandla zakhe esiswini sikamama, esebenzisa i-ultrasound njengesiqondiso. Ingane izobhekwa ngesikhathi senqubo. Ama-ECVs avame ukuphumelela futhi anganciphisa amathuba okulethwa kwesigaba se-C.

Isigaba se-Cesarean

Isilinganiso sikazwelonke sokuzalwa ngesigaba sokubeletha sikhuphuke kakhulu kula mashumi ambalwa eminyaka edlule. Ngokusho, cishe amaphesenti angama-32 omama e-United States abeletha ngale ndlela, eyaziwa nangokuthi ukubeletha ngokuhlinzwa.

Isigaba se-C imvamisa siyindlela ephephile futhi esheshayo yokulethwa kokulethwa okunzima noma lapho kuvela izinkinga.

Isigaba se-C sithathwa njengokuhlinzwa okukhulu. Ingane ibelethwe ngokusikeka odongeni lwesisu nasesizalweni kunokuba isitho sangasese sowesifazane. Umama uzonikezwa umuthi wokubulala izinzwa ngaphambi kokuhlinzwa ukuze indikindiki leyo ndawo isuke esiswini iye ngezansi kokhalo.

Ukuqhekeza cishe kuhlala kuvundlile, eceleni kwengxenye engezansi yodonga lwesisu. Kwezinye izimo, ukusikeka kungaba mpo kusuka maphakathi kuya ngezansi kwenkinobho yesisu.

Ukusikeka esibelethweni nakho kuvundlile, ngaphandle kwezimo ezithile ezinzima. Ukusikwa okuqondile mpo esibelethweni kubizwa ngokuthi yi-classical C-section. Lokhu kushiya imisipha yesibeletho ingakwazi ukubekezelela ukuphambana kokukhulelwa okuzayo.

Umlomo nekhala lengane lizomunzwa ngemuva kokubeletha ukuze bakwazi ukuphefumula okokuqala, bese kuthi i-placenta ihanjiswe.

Abesifazane abaningi ngeke bazi ukuthi bazoba nesigaba se-C kuze kuqale ukubeletha. Izigaba ze-C zingahlelelwa kusengaphambili uma kunezinkinga ngomama noma ngengane. Ezinye izizathu kungadingeka ukuthi isigaba se-C sifake:

• isigaba sangaphambilini se-C esine-classical, imbobo eqondile
• ukugula kwengane noma ukukhubazeka kokuzalwa
• umama unesifo sikashukela kanti ingane ilinganiselwa ukuba nesisindo esingaphezu kuka-4 500 g
• i-placenta previa
• Ukutheleleka nge-HIV kumama kanye nomthamo ophezulu wegciwane
• umoya opholile noma oguqukayo

Ukuzalwa kwesitho sangasese sowesifazane ngemuva kwesigaba se-C (VBAC)

Kwake kwacatshangwa ukuthi uma uke waba nesigaba se-C, uzodinga njalo ukuthola esisodwa sokuletha izingane ezizayo. Namuhla, ukuphinda izingxenye ze-C akudingeki ngaso sonke isikhathi. Ukuzalwa kwesitho sangasese sowesifazane ngemuva kwesigaba se-C (VBAC) kungaba yindlela ephephile kwabaningi.

Abesifazane abathole ukusikeka kwesibeletho okuhamba kancane (okuvundlile) okuvela esigabeni se-C bazoba nethuba elihle lokubeletha ingane ngokobulili.

Abesifazane abaye baba nokusikwa okuqondile okuqondile akumele bavunyelwe ukuzama i-VBAC. Ukusikwa okuqondile kubeka ubungozi bokuqhekeka kwesibeletho ngesikhathi sokuzalwa kwesitho sangasese sowesifazane.

Kubalulekile ukuxoxa ngokukhulelwa kwakho kwangaphambilini nomlando wezokwelapha nodokotela wakho, ukuze bakwazi ukuhlola ukuthi ngabe i-VBAC iyindlela ongayikhetha yini.

Ukulethwa okusizwayo

Kunezikhathi maqondana nokuphela kwesigaba sokucindezela lapho owesifazane engadinga usizo olwengeziwe olungeziwe ekubelethiseni ingane yakhe. Isikhombi se-vacuum noma i-forceps singasetshenziswa ukusiza ukulethwa.

I-Episiotomy

I-episiotomy ukusika okuphansi ezansi kwesitho sowesifazane sangasese kanye nemisipha yomgogodla ukukhulisa ukuvuleka kwengane ukuphuma. Kwakukholelwa ukuthi wonke umuntu wesifazane wayedinga i-episiotomy ukuze abelethe ingane.

Ama-episiotomi manje enziwa kuphela uma ingane icindezelekile futhi idinga usizo lokuphuma ngokushesha. Ziyenziwa futhi uma ikhanda lengane liletha kodwa amahlombe ayabhajwa (dystocia).

I-episiotomy nayo ingenziwa uma owesifazane kade ecindezela isikhathi eside kakhulu futhi engakwazi ukusunduza ingane idlule ingxenye engezansi kakhulu yokuvuleka kwesitho sangasese sowesifazane.

Ama-episiotomi ngokuvamile ayagwenywa uma kungenzeka, kepha isikhumba futhi kwesinye isikhathi imisipha ingadabuka. Izinyembezi zesikhumba azibuhlungu kakhulu futhi ziphola ngokushesha kune-episiotomy.