Ua loaʻa anei iā ʻoe kahi pēpē ma mua ma o ka ʻoki ʻoki cesarean? I kēlā manawa, ke kokoke ʻoe e loaʻa hou kahi pēpē, pono ʻoe e loaʻa kahi nīnau nui i loko o kou manaʻo, "E loaʻa anei iaʻu kahi hānau maʻamau i kēia manawa, ʻo ia hoʻi, ma o ka vagina (hānau vaginal)?" He nīnau kēia a nā makuahine he nui. No laila, i kēia lā, e kamaʻilio kākou e pili ana i ka loaʻa ʻana o kahi hānau maʻamau ma hope o ka ʻoki ʻoki cesarean, ʻo ia hoʻi, VBAC (Vaginal Birth After Cesarean).
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He aha ka VBAC (Hānau Vaginal ma hope o Cesarean)? I ka ʻōlelo maʻalahi...
I ka ʻōlelo maʻalahi, ʻo VBAC ka wā i loaʻa ai iā ʻoe hoʻokahi a ʻoi aku paha mau ʻoki cesarean ma mua (C-sections) a laila hānau ʻia kāu pēpē aʻe ma ke ʻano vaginal, ʻo ia ke ala maʻamau. ʻIke ʻoe, ʻo ka C-section ka wā e hana ai ke kauka i kahi ʻoki ʻoki ma kou ʻōpū a me ka uterus e wehe i ke pēpē.
ʻO ka pahuhopu nui o ka VBAC ka hāʻawi ʻana i kahi mea i loaʻa i ka ʻoki C ma mua i ka manawa kūpono e loaʻa ai kahi hānau maʻamau i kā lākou hāpai ʻana aʻe. Eia nō naʻe, i kekahi manawa, inā ua loaʻa iā ʻoe hoʻokahi a ʻoi aku paha mau ʻoki C ma mua, hiki i ka hānau maʻamau ke lilo i mea pilikia iki .
Aia kekahi mau mea e noʻonoʻo ai i ka hoʻoholo ʻana inā e hoʻāʻo a ʻaʻole paha i kahi VBAC. Eia kekahi laʻana:
- ʻO ke ʻano o ka ʻoki ʻana a ke kauka lapaʻau i hoʻohana ai i kāu ʻāpana C ma mua a me ka nui o nā ʻāpana C āu i loaʻa ai.
- Kou mōʻaukala olakino .
- Loaʻa iā ʻoe kekahi mau pilikia olakino ʻē aʻe i kēia manawa?
- Ke kūlana o ka pēpē a inā he mau pilikia olakino ko ka pēpē.
E nānā hou kāu kauka i kēia mau mea a pau a haʻi iā ʻoe inā palekana iā ʻoe ke hoʻāʻo i kahi VBAC. E wehewehe ʻo ia i nā pono a me nā pōʻino iā ʻoe. A laila, ma muli o kēlā kūkākūkā ʻana, hiki iā ʻoe ke hoʻoholo inā e hoʻāʻo i kahi VBAC a i ʻole he ʻoki C ʻē aʻe.
Ua hōʻike ʻia nā noiʻi ma kahi o 75% o nā wahine i loaʻa i hoʻokahi ʻoki C-section i loaʻa kahi hānau ʻana ma ka ʻōpū i ko lākou hāpai ʻana aʻe. Eia nō naʻe, inā ua loaʻa iā ʻoe ʻelua a ʻoi aku paha mau ʻoki C-section ma mua, e hāʻule paha kou manawa kūpono no ka VBAC holomua i kahi o 50% .
I kekahi manawa, kapa nā kauka i ka VBAC he TOLAC (Trial of Labor After Cesarean) . ʻO TOLAC kahi hoʻāʻo e hānau ma ke ʻano he ʻāpana ma hope o ka ʻoki ʻana i ka ʻōpū. Inā holomua kēia hoʻāʻo (TOLAC), ʻo ka hopena he VBAC. Inā ʻaʻole holomua, pono ʻia kahi ʻoki ʻē aʻe.
No ke aha i manaʻolana ai ka poʻe he nui i kahi VBAC ma hope o ka ʻoki ʻana o C-section?
He makemake pilikino kēia pinepine. Makemake kekahi poʻe e hānau ma ke ʻano he wahine, akā no kekahi kumu, ʻaʻole hiki iā lākou ke hana pēlā. A i ʻole makemake paha lākou i ka hānau ʻana ma ke ʻano he wahine no ka mea ua lōʻihi ka manawa e hoʻōla ai mai ka ʻoki ʻana ma hope o ka hana ʻoki ʻia.
ʻOiai inā makemake ʻoe i ka hānau maoli ʻana, hiki i kāu kauka ke ʻōlelo aku i ka ʻoki C ma muli o kekahi mau pilikia o ka VBAC. A i ʻole, e ʻōlelo paha lākou he mea maikaʻi ke hoʻāʻo i ka VBAC.
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Check Availability →He aha nā pōmaikaʻi o kahi VBAC?
Aia kekahi mau pono o ka VBAC i hoʻohālikelike ʻia me ka ʻoki ʻana o C. E nānā:
- Hoʻōla wikiwiki a hoʻemi ʻia ka noho haukapila: Ma hope o ka ʻoki ʻana o ka ʻōpū (C-section), nui ka hoʻomaha ma kahi moe a me ka manawa no ka hoʻōla ʻana o ka ʻoki. ʻAʻole maʻamau kēia mau mea me ka VBAC.
- ʻAʻole e hana i ke ʻoki ʻōpū: ʻO ka mea nui wale nō e pale aku ai, ʻo ia ke ʻoki nui.
- Ke pale ʻana a i ʻole ka hōʻemi ʻana i nā pilikia o ka ʻoki ʻana ma ke ʻoki C (e like me ke kahe koko nui, ka maʻi).
- Nā Pōmaikaʻi no ka pēpē: I ka wā hānau maʻamau, lawe ʻia ka wai amniotic i loko o nā māmā o ka pēpē i ka wā e hele ai ka pēpē ma ke kahawai hānau. Hoʻomākaukau kēia i ka pēpē no ka oxygen ma hope o ka hānau ʻana. Eia kekahi, hoʻoulu ʻia ka ʻōnaehana pale o ka pēpē i kona wā e hele ai ma ke kahawai hānau.
- He haʻahaʻa ka pilikia o nā pilikia (e like me ke kūkulu ʻia ʻana o nā ʻiʻo ʻeha - nā pipili, nā hōʻino ʻana i nā ʻōpū o loko) e hiki ke hana ma muli o nā ʻoki hana hou ʻia.
- Makemake pilikino: Makemake nui kekahi poʻe e hānau keiki maʻamau.
E noʻonoʻo e pili ana i ia mea, inā ʻoe e hoʻolālā ana e loaʻa nā keiki hou aku, ʻoi aku ka maikaʻi o ka loaʻa ʻana o kahi VBAC holomua ma mua o ka hoʻomau ʻana i ka hana ʻana i nā ʻoki C. No ka mea, hele mai kēlā me kēia ʻoki C me kekahi mau pilikia.
He aha nā pilikia o ka hoʻāʻo ʻana i kahi VBAC?
Waiho ka ʻoki ʻana ma ke ʻoki C i kahi ʻōpala ma ka ʻōpū. No laila, hiki i ke kaomi mai ka hānau ʻana ke hana i ka ʻōpū e haehae ma ke ʻano o ka ʻōpala ʻoki C (ʻoki ʻana o ka ʻōpū) . ʻO kēia ka pilikia nui o ka VBAC. Eia nō naʻe, ua hōʻike ʻia nā noiʻi hou i ka hapa nui o nā hihia, hiki ke hana palekana ʻia ka VBAC ma hope o ka ʻoki C.
He pilikia ka haki ʻana o ka ʻōpū akā he pilikia koʻikoʻi hiki ke hoʻoweliweli i ke ola . Inā nui kou pilikia o ka haki ʻana o ka ʻōpū, ʻaʻole e hoʻāʻo pinepine kāu kauka i kahi VBAC.
ʻO nā pilikia ʻē aʻe e kū mai ana i ka wā e hoʻāʻo ai i kahi VBAC:
- Ke kahe koko
- Maʻi
- ʻOi aku ka pilikia o kēia ma mua o ka ʻoki ʻana o C i hoʻolālā ʻia.
He aha ka pilikia o ka haki ʻana o ka ʻōpū?
ʻO ka pilikia o ka haki ʻana o ka ʻōpū no kekahi mea i hana ʻia ma ke ʻoki C- section ma mua, kahi i hana ʻia ai kahi ʻoki transverse haʻahaʻa , ma kahi o 0.9%, ʻoi aku ka liʻiliʻi ma mua o hoʻokahi i loko o 100. No laila, ʻoiai he haʻahaʻa loa kēia pilikia, he mea nui e makaʻala i kēia.
Ke hoʻopilikia nei anei ka ʻoki ʻia mai kahi ʻoki C-section ma mua i ka VBAC?
ʻAe, hana maoli nō ia. Aia kekahi mau ʻano ʻoki i hana ʻia i ka wā o ka ʻoki ʻana o C-section:
- ʻOki ʻoki haʻahaʻa: He haʻahaʻa ka pilikia o ka haki ʻana o ka ʻōpū. Hana ʻia kēia ʻoki ma ka ʻaoʻao haʻahaʻa a lahilahi hoʻi o ka ʻōpū.
- ʻOki kū pololei haʻahaʻa: ʻOi aku ka nui o ka pilikia o ka haki ʻana o ka ʻōpū ma mua o ka ʻoki transverse. Hana ʻia kēia ma ka lōʻihi ma ka ʻaoʻao haʻahaʻa a lahilahi o ka ʻōpū.
- ʻO kahi ʻoki lōʻihi ma ka ʻaoʻao o luna o ka ʻōpū ("ʻoki Classical"): ʻO kēia ke ala weliweli loa e haehae ai i ka ʻōpū. Pono paha nā kauka lapaʻau e hana i kēia ʻano ʻoki i ka wā hānau mua ʻole o ka pēpē a i ʻole ke kūlana paʻakikī o ka pēpē e hānau ai.
ʻO kahi mea nui loa ma ʻaneʻi, ʻo ka wahi a me ke kuhikuhi o ka ʻeha i ʻike ʻia mai waho o kou ʻōpū, ʻaʻole ia e like me ka wahi a me ke kuhikuhi o ka ʻoki ʻia i loko o kou ʻōpū. No ka laʻana, ʻoiai he transverse kou ʻeha ʻōpū, hiki ke lōʻihi ka ʻoki ʻia ma kou ʻōpū.
Pono kāu mau moʻolelo lapaʻau e komo i nā kikoʻī e pili ana i kahi a me ke kuhikuhi o ka ʻoki ʻana i loko o kou ʻōpū. Ke kamaʻilio ʻoe me kāu kauka e pili ana i ka palekana o kahi VBAC, e hōʻoia e nānā ʻo ia i kāu mau moʻolelo lapaʻau a me nā ʻoki C ma mua.
ʻO wai ka mea i ʻoi aku ka maikaʻi o ka loaʻa ʻana o kahi VBAC holomua?
E kamaʻilio me kāu kauka e pili ana i kou mōʻaukala olakino, ka hāpai ʻana i kēia manawa, a me nā kumu i alakaʻi ai i ka ʻāpana C-section ma mua.
Loaʻa paha iā ʻoe kahi manawa kūpono no ka VBAC holomua inā ʻoe:
- Inā hoʻokahi a ʻelua paha āu i hana ai ma mua i ka ʻoki ʻana o ka ʻōpū (C-section), ua hana ʻia kēlā mau mea me nā ʻoki ʻoki haʻahaʻa ma ka ʻaoʻao haʻahaʻa o ka ʻōpū .
- Inā ua loaʻa iā ʻoe kahi hānau ʻana ma mua.
- Inā ʻaʻole ʻoe i hana i kekahi ʻoki ʻōpū ʻē aʻe (e like me ka myomectomy ).
- Inā ʻaʻohe ou moʻolelo mua o ka haki ʻana o ka ʻōpū.
- ʻAʻohe ou kūlana olakino e hoʻoweliweli ai i ka hānau maʻamau (e like me nā fibroids uterine, nā pilikia me ka wahi o ka placenta).
- Inā hoʻomaka ka hānau ʻana me ka manaʻo ʻole, ma mua o kou lā hānau.
Inā ua loaʻa iā ʻoe kahi VBAC holomua ma mua - me ka ʻole o nā pilikia e like me ka haki ʻana o ka ʻōpū - ʻoi aku ka nui o kou loaʻa ʻana o nā hānau ʻana ma ke ʻano he wahine i ka wā e hiki mai ana.
I nā kūlana hea e hoʻemi ʻia ai ka manawa kūpono o ka holomua ʻana o kahi VBAC?
I kekahi manawa, hiki ke hoʻemi ʻia nā kūlana o ka holomua ʻana o ka VBAC no nā kumu e like me:
- Ua hana ʻia ka ʻoki C-section ma mua no ka mea, ʻaʻole i holomua ka hānau ʻana.ʻO ia hoʻi, inā ʻaʻole i wehe (dilate) a holoi pono paha kou cervix i ka wā hānau maʻamau.
- Inā ʻoe ma luna o 35 mau makahiki.
- Inā he momona a momona paha ʻoe.
- Inā ʻoe e kali ana i kahi fetus nui a i ʻole e kali ana i nā keiki he nui.
- Inā ua hala kou lā palena.
- Inā hāpai hou ʻoe ma lalo o 18 mau mahina ma hope o ka hānau ʻana o kāu pēpē ma mua (manawa pōkole ma waena o nā hāpai ʻana) .
- Inā loaʻa iā ʻoe ka preeclampsia (i ka wā e ʻoi aku ka nui o nā kauka e hana i kahi ʻāpana C-section).
He aha nā pilikia o nā ʻāpana C-i hana hou ʻia?
ʻAʻohe helu paʻa o nā ʻoki C-section hiki iā ʻoe ke hana. Eia nō naʻe, ua hōʻike kekahi mau noiʻi he kiʻekiʻe aʻe nā pilikia o ka poʻe i loaʻa i nā ʻoki C-section he nui , e like me:
- Ke kahe koko nui.
- ʻEha o ka ʻōpū a me ka ʻōpū.
- Ka maʻi ʻana.
- ʻO nā kūlana placental i ka hāpai ʻana e hiki mai ana, no ka laʻana, ka hoʻopili ʻana o ka placenta i ka ʻōpū ( placenta previa a i ʻole placenta accreta ).
- Ka haki ʻana o ka ʻōpū.
- Nā hoʻopili ʻana (ka pipili ʻana o nā ʻiʻo palapū).
Hiki ke ʻokoʻa kēia mau pilikia mai kēlā kanaka a kēia kanaka. Aia nui ia i kou mōʻaukala olakino, a me nā kūlana kikoʻī o kēlā me kēia hāpai a me ka hānau ʻana. No laila, ʻo kāu kauka ke kanaka maikaʻi loa e kamaʻilio pū me ia e pili ana i nā pono a me nā pōʻino o ka loaʻa ʻana o kahi ʻoki C-ʻē aʻe a i ʻole ka hoʻāʻo ʻana i kahi VBAC.
He aha nā nīnau āu e nīnau ai i kāu kauka e pili ana i ka VBAC a me ka ʻāpana C-hana hou?
E like me ka VBAC, loaʻa i ka ʻoki C-section nā pono a me nā pilikia. No laila, he mea nui e hoʻomaopopo ʻoe i nā ʻano hānau ʻelua a pehea lākou e pili ai iā ʻoe.
E kūkākūkā i kēia mau pilikia me kāu kauka:
- E pili ana i kou hāpai ʻana a me kou hānau ʻana ma mua .
- He aha nā kumu i alakaʻi iā ʻoe e hana i kahi ʻāpana C-section ?
- Pehea ka palekana o ka VBAC a me ka C-section no ʻoe a me kāu pēpē?
- He aha nā kumu e pono ai ʻoe e noʻonoʻo/ʻaʻole e noʻonoʻo i kahi VBAC ?
- He aha nā kumu e pono ai ʻoe e noʻonoʻo/ʻaʻole e noʻonoʻo hou i ka ʻoki ʻana o kahi ʻāpana C ?
- He hoʻolālā no ka hoʻoulu ʻana i ka hana (inā paha he hoʻokahi a ʻaʻole paha).
- Inā paha e hiki i ka haukapila kahi āu e hānau ai i kāu pēpē ke lawelawe i nā pilikia .
- E pili ana i kāu mau hoʻolālā e loaʻa nā keiki hou aku .
ʻOiai ua loaʻa iā ʻoe kahi ʻoki C ma mua, ʻaʻole ia he manaʻo ʻaʻole hiki iā ʻoe ke loaʻa kahi VBAC i ka wā e hiki mai ana. Ua lohe paha ʻoe a heluhelu paha e hiki i ka ʻōpala ma hope o ka ʻoki C ke hoʻoulu i nā pilikia i nā hāpai ʻana e hiki mai ana. Eia nō naʻe, ʻokoʻa ke kūlana o kēlā me kēia kanaka.
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai
I ka hoʻomaka ʻana o kou hāpai ʻana, e kamaʻilio me kāu kauka e pili ana i kou mau makemake a me kou hopohopo e pili ana i ka VBAC. Hiki iā ia ke wehewehe i nā pono a me nā pōʻino iā ʻoe a kōkua iā ʻoe e hoʻoholo inā palekana ka VBAC iā ʻoe. I ka holomua ʻana o kou hāpai ʻana, he mea nui e hoʻomau i ke kamaʻilio ʻana me kāu kauka a me ka nānā hou ʻana i kāu hoʻolālā hānau. E hoʻomanaʻo, he kū hoʻokahi kēlā me kēia hāpai ʻana, no laila e hana pū me kāu kauka e hana i ka hoʻoholo kūpono loa iā ʻoe.
VBAC , cesarean, ʻoki C, hānau maʻamau, hāpai keiki, haki ʻōpū, hānau keiki
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