He aha kēia mīkini a nā kauka e hoʻopili ai i kahi pēpē ke kokoke lākou e hānau? E aʻo kākou i nā mea āpau e pili ana i ka Electronic Fetal Monitoring (EFM)!

Inā ʻoe e kali ana i kahi pēpē, ua ʻike paha ʻoe iā ia ma kahi kiʻiʻoniʻoni a i ʻole ma ke TV, kahi i kau ʻia ai ʻelua mau kaula ma ka ʻōpū o ka makuahine ma ka lumi hānau, a piʻi a iho kahi laina ma kahi pale kokoke me ke kani 'beep... beep...'. Manaʻo ka poʻe he nui kēia e nānā i ka puʻuwai o ka makuahine. Akā ʻo ka ʻoiaʻiʻo, ʻo kēia ke nānā i ʻelua mau mea i ka manawa hoʻokahi. ʻO kekahi ka puʻuwai o ka pēpē liʻiliʻi i loko o ka ʻōpū. ʻO kekahi nā ʻūlū āu e loaʻa nei. ʻO kēia ka mea a mākou e kapa nei he Electronic Fetal Monitoring i ka lāʻau lapaʻau, a i ʻole EFM no ka pōkole e like me ka ʻike o nā mea a pau. No laila, i kēia lā e kamaʻilio mākou e pili ana i kēia me ka maʻalahi loa, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

I ka ʻōlelo maʻalahi, he aha ka EFM?

E noʻonoʻo, he huakaʻi nui ka hānau ʻana o kahi pēpē no ka makuahine a me ka pēpē. ʻO kēia EFM ke ala maikaʻi loa no nā kauka a me nā kahu maʻi e ʻike ai inā he pilikia ka pēpē i kēia huakaʻi a inā e holomua maikaʻi ana ʻo ia.

I ka ʻōlelo maʻalahi, he mea hana ka EFM e nānā mau ana i ka puʻuwai o kāu pēpē a me ke ʻano o kāu mau ʻūlū ʻana i ka manawa maoli.

I kēia manawa, ke noʻonoʻo nei paha ʻoe, "No ke aha ʻoe e nānā pū nei i kēia mau mea ʻelua?" Eia ke kumu. Ke hānau keiki ʻoe, ʻūlū nui kou ʻōpū. I kēia manawa, ʻūlū iki nā kīʻaha koko e lawe ana i ka oxygen i kāu pēpē. Ua like ia me ke ʻūlū ʻana i kahi paipu wai. I ka hapa nui o ka manawa, ʻaʻole kēia he pilikia no nā pēpē olakino, a hiki iā lākou ke lawelawe maikaʻi i kēia ʻūlū ʻana. Akā i kekahi manawa, hiki ke emi iki ka nui o ka oxygen i loaʻa i kāu pēpē. Inā hana ʻia kēlā, hiki ke hoʻopilikia i ka puʻuwai o ka pēpē.

No laila, ʻo ka hana a ka EFM, ʻo ia ke nānā mau i ke ʻano o ka loli ʻana o ka puʻuwai o ka pēpē i ka wā e hele mai ai a hele aku ai nā ʻūmiʻi. Hiki i kēia i ke kauka ke ʻike mua inā pilikia ka pēpē i ka fetal.

Pono anei nā kānaka a pau i kēia EFM?

ʻAʻole. ʻAʻole pono nā wahine hāpai a pau i ka nānā mau ʻana i ka EFM. ʻO kekahi mea i loaʻa kahi hāpai olakino me ka ʻole o nā pilikia, ʻaʻole paha e pono i kēia. Eia nō naʻe, i kekahi mau hihia kūikawā, he mea nui ia no ka palekana o ka pēpē a me ka makuahine. E nānā kākou i kēlā mau hihia.

Pehea e hana ai kēia mīkini EFM?

ʻElua mau ʻano nui no ka nānā ʻana i ka EFM. ʻO ke ʻano mua ka mea i hoʻohana pinepine ʻia.

1. EFM Waho

ʻO kēia ka mea āu e ʻike pinepine ai i nā kiʻiʻoniʻoni. He mea maʻalahi loa ia e hana ʻia.

• ʻO ka hāmeʻa mua: E hoʻopili kekahi kahu maʻi i kahi gel i kou ʻōpū, e ʻimi i kahi kūpono loa e lohe ai i ka puʻuwai o ka pēpē, a kau i kahi hāmeʻa liʻiliʻi ma laila a nakinaki a puni kou ʻōpū me kahi kaula elastic. Hana kēia me ka hoʻohana ʻana i ka ʻenehana ultrasound , e like me ka mīkini scan. ʻO kēia ka mea e ana i ka puʻuwai o ka pēpē.
• ʻO ka lua o ka hāmeʻa:Hoʻokomo ʻia kekahi mea hana ʻē aʻe ma kou ʻōpū luna a hoʻopili ʻia i kekahi kaula ʻē aʻe. Ana kēia i ka nui o nā manawa e ʻūlū ai kou ʻōpū a me ka ikaika o nā ʻūlū. Ua kapa ʻia kēia he tocodynamometer .

Hōʻike ʻia ka ʻike mai kēia mau mea ʻelua ma ke ʻano he mau kiʻi ʻelua ma ka pale kamepiula. Hoʻopaʻa ʻia hoʻi ia ma kahi ʻāpana pepa lōʻihi. Hiki i nā kauka a me nā kahu maʻi ke nānā i kēia a loaʻa kahi manaʻo maikaʻi o ke kūlana o ka pēpē.

2. EFM Kūloko

ʻAʻole kēia he hana maʻamau loa. Hiki ke hana ʻia ma hope o ka haki ʻana o kāu 'ʻeke wai' . E hoʻohana ke kauka i kēia ʻano hana inā ʻaʻole hiki i kahi EFM waho ke hāʻawi i kahi kiʻi maopopo, a inā makemake lākou i ka ʻike pololei loa e pili ana i ka pēpē i ka wikiwiki.

• Ma kēia, hoʻokomo ke kauka i kahi uea lahilahi a liʻiliʻi ma o ka vagina a hoʻopili i kahi electrode liʻiliʻi i ke poʻo o ka pēpē. He mea weliweli paha kēia, akā ʻaʻole ia e hōʻeha i ka pēpē. Hiki i kēia ke ana i ka puʻuwai o ka pēpē me ka pololei loa.
• Eia kekahi, inā pono ʻoe e ana pololei i ke kaomi o ka ʻōpū, hiki ke hoʻokomo ʻia kahi ʻōmole lahilahi (catheter) i loko o ka ʻōpū.

Aia kekahi mau pōmaikaʻi a me nā pōʻino o ka EFM?

E like me nā mea lapaʻau a pau, loaʻa i ka EFM kona mau pono a me nā hemahema, a he mea nui e ʻike i kēia mau mea.

• Nā ʻōuli hoʻopunipuni: I kekahi manawa, hiki i kahi helu hewa i loko o ka mīkini ke hoʻoulu i kahi ʻōuli e kani. No ka laʻana, inā ʻoe e neʻe a puni ma kahi moe, a inā paha e neʻe iki ka sensor i ka wā e neʻe ana ka pēpē i loko o ka ʻōpū, e loli paha ka heluhelu ʻana a e kani paha kahi ʻōuli. ʻOiai inā ʻaʻohe pilikia maoli, hiki i kēia mau mea ke hoʻoulu i ka makaʻu a me ke kaumaha pono ʻole no nā mākua a me nā ʻohana.
• Ke kūʻokoʻa palena o ka neʻe ʻana: Ke hoʻopili mau ʻia ʻoe i ka EFM, ua kaupalena ʻia kou kūʻokoʻa e ala aʻe mai kahi moe, hele, a hoʻololi i nā kūlana. ʻO ka ʻoiaʻiʻo, hiki i ka hele wāwae a me ka hoʻololi ʻana i nā kūlana i ka wā hānau ke kōkua no ka hānau ʻana.
• Ke alakaʻi nei i nā hana lapaʻau pono ʻole: Ua hōʻike kekahi mau noiʻi e hoʻonui iki ana ka nānā mau ʻana i ka EFM, i kekahi manawa ma muli o nā hoʻopaʻa leo pololei ʻole, i ka hiki ke hoʻoholo e hana i ka ʻoki Caesarean , a i ʻole e hoʻohana i nā forceps a i ʻole ka vacuum e hānau i ka pēpē, ʻoiai inā ʻaʻole pono maoli.
• Nā pilikia o ka EFM kūloko:ʻOiai he mea kākaʻikahi loa kēia, aia kahi pilikia liʻiliʻi o kahi ʻōpala liʻiliʻi ma ke poʻo o ka pēpē a i ʻole ka maʻi i ka wā o ka hoʻokolokolo kūloko. Hiki iā ia ke hoʻonui i ka pilikia o ka laha ʻana o nā maʻi, e like me ka HIV, mai ka makuahine a i kāna pēpē.

He aha kāu e hana ai inā hōʻike ka EFM ua pilikia ke pēpē?

ʻO ka mea mua, ʻo ka hoʻololi ʻana i ka EFM ʻaʻole ia he manaʻo ua pilikia nui ka pēpē. He hōʻailona ia i ka hui lapaʻau e "ʻAe, i kēia manawa pono mākou e makaʻala hou aku i kēia." Mai hopohopo i ka manawa e like me kēia. E ʻike ana kāu kauka a me kāu kahu maʻi i ka mea e hana ai.

ʻO ka maʻamau, hoʻāʻo lākou i nā mea maʻalahi e like me kēia:

• Ke hoʻololi nei i kou kūlana: Hiki iā ʻoe ke hana i nā mea e like me ka huli ʻana iā ʻoe iho ma kou ʻaoʻao hema a moe i lalo. Hiki i kēia ke hoʻomaikaʻi i ke kahe koko i ka ʻōpū a me ka placenta, e hoʻonui ana i ka nui o ka oxygen i loaʻa i kāu pēpē.
• E hāʻawi ʻia ʻoe i ka oxygen: Hiki ke hāʻawi ʻia iā ʻoe ka oxygen ma o kahi pale maka ma kou alo. E hoʻonui kēia i ka pae oxygen i loko o kou koko, kahi e hāʻawi pū ai i ka oxygen hou aʻe i kāu pēpē.
• Hāʻawi ʻia ka paʻakai (nā wai IV): Hoʻokomo ʻia kahi wai paʻakai i loko o kou lima e hāʻawi iā ʻoe i nā wai. Kōkua kēia i ka hoʻomaikaʻi ʻana i ke kahe koko.
• Ke hoʻololi nei i nā lāʻau lapaʻau: Inā ʻoe e lawe nei i kahi lāʻau lapaʻau e hoʻoulu ai i ka hānau ʻana (e like me Pitocin®) , hiki ke hoʻemi ʻia ka nui a hoʻōki paha no kekahi manawa.

I ka hapa nui o ka manawa, e kōkua kēia mau mea maʻalahi i ka hoʻihoʻi ʻana o ka puʻuwai o ka pēpē i ka maʻamau. Inā ʻaʻole ia e hana, a hoʻoholo ke kauka he paʻakikī loa no ka pēpē ke noho i loko o ka ʻōpū, e hana lākou i nā hana e hānau koke ai i ka pēpē. He hānau ʻana paha kēia ma ke ʻano he vaginal a i ʻole he cesarean section. E hoʻomanaʻo, ʻo ka mea nui loa ma ʻaneʻi ʻo ia ka palekana o ka makuahine a me ka pēpē.

Ke hoʻohana nei ʻoe i ka EFM ma mua o ka hānau ʻana?

ʻAe, i kekahi mau hihia. Aia kekahi mau manawa e hoʻohana ʻia ai ʻo EFM e hoʻoholo i ke olakino o ka pēpē i ka wā hāpai.

• Eia kekahi laʻana, inā loaʻa iā ʻoe kahi ulia a hāʻule paha i loko o kou ʻōpū ma hope o 20 mau pule, hiki iā ʻoe ke pili mau i ka EFM no kekahi manawa e hōʻoia ʻaʻole e hōʻeha ʻia ka pēpē.
• Eia kekahi, i kekahi manawa hiki i ka EFM ke kōkua i ka hōʻoia inā ʻoe e ʻike nei i nā ʻūmiʻi maoli a i ʻole nā ​​​​​​ʻūmiʻi wahaheʻe (Braxton Hicks contractions) .

Ke kokoke ʻoe i ka hopena o kou hāpai ʻana, he manaʻo maikaʻi e kūkākūkā i kēia EFM me kāu kauka. Ma kēia ala, hiki iā ʻoe ke loaʻa kahi ʻike maikaʻi aʻe ma mua o ka hānau ʻana a kūkākūkā i kāu mau makemake me kāu kauka.