He ʻūhā paha kāu pēpē? (Breech Baby) - E ʻike pono kākou i ke ʻano o kēia

I kou kokoke ʻana i ka hopena o kou hāpai ʻana, ua nui loa kāu pēpē i kēia manawa. No laila, ʻaʻohe ona wahi e neʻe ai e like me ma mua. I kēia manawa, aia ka hapa nui o nā pēpē i ke kūlana poʻo i lalo, e hoʻomākaukau ana e hānau ʻia. I ka wā hānau, komo mua lākou i ke poʻo o ke kahawai hānau. Akā i kekahi manawa, hiki i ke poʻo o ka pēpē ke piʻi aʻe a me ka lalo a me nā wāwae i lalo. Kāhea mākou i kēia he "breech baby ." Aia kekahi mau pilikia i ka hānau ʻana i kahi pēpē ma kēia ʻano, no laila pono ʻoe e makaʻala loa.

He aha ke ʻano o ka wā e noho ana ke pēpē i ke kūlana breech?

I ka ʻōlelo maʻalahi, hānau ʻia ka hapa nui o nā pēpē me ko lākou mau poʻo e kū pono ana i lalo. Ua kapa ʻia kēia kūlana ma ke ʻano lapaʻau ʻo "Vertex Presentation". ʻO kēia ke kūlana palekana a maʻalahi hoʻi no ka hānau maʻamau (vaginal).

Akā ma ke kūlana breech, ke kū pono nei ka hope a i ʻole nā ​​wāwae o ka pēpē i ke kahawai hānau. A laila, puka mua ka hope o ka pēpē, a laila ke kino, a ma hope ke poʻo. He mea paʻakikī iki kēia no kāu kauka hānau keiki a me ke kauka wahine. A ʻoi aku ka kiʻekiʻe o nā pilikia no ʻoe a me ka pēpē ma mua o ka hānau maʻamau.

Ma waho aʻe o kēia mau kūlana ʻelua, i kekahi manawa hiki i nā pēpē ke moe pālahalaha i loko o ka ʻōpū. Ua kapa ʻia kēia he "Transverse Lie". I ia mau hihia, pono pinepine ka ʻoki ʻoki cesarean.

No ke aha i like ai kekahi mau pēpē me kēia? He aha nā kumu?

He mea maʻamau maoli nō ia no nā pēpē ke noho i ke kūlana breech i nā pule mua o ka hāpai ʻana. Eia nō naʻe, i ka hala ʻana o 36-37 mau pule, he 96% wale nō o nā pēpē e huli maoli i ke poʻo i lalo. Inā ʻaʻole lākou e hana pēlā, he hapa liʻiliʻi wale nō, ma kahi o 3%-4%, e noho i ke kūlana breech a hiki i ka pau ʻana o ka hāpai ʻana.

He mea paʻakikī pinepine ke kuhikuhi i kahi kumu kikoʻī i huli ʻole ai kahi pēpē. He mea kūlike paha ia. Akā aia kekahi mau mea e hoʻonui ai i ka likelika o ka hānau ʻana ma ka ʻōpū.

Pehea kou manaʻo i ka wā e noho ana ke pēpē ma ke kūlana breech?

ʻAʻole e loli kāu mau hōʻailona hāpai ʻē aʻe (e laʻa me ka luaʻi ʻana, ka nausea) inā aia kāu pēpē i ke kūlana breech. Eia nō naʻe, hiki iā ʻoe ke manaʻo i nā wāwae o kāu pēpē e kīkē ana i kou ʻōpū lalo . Hiki paha iā ʻoe ke manaʻo i kahi puʻupuʻu paʻakikī a poepoe ma kou ʻōpū luna, ma lalo pono o kou iwi ʻaoʻao . ʻO ia ke poʻo o kāu pēpē.

E loaʻa i kāu kauka kahi manaʻo maikaʻi o ke kūlana o ke pēpē ma ka hoʻopā ʻana i kou ʻōpū, akā ʻoi aku ka maikaʻi o ka hōʻoia ʻana i kēia me kahi scan ultrasound .

Hiki ke hoʻohuli ʻia ke pēpē? (Mana Cephalic Waho - ECV)

ʻAe, aia kekahi ala e hana ai. Ma kahi o 36 mau pule o kou hāpai ʻana, hiki i kāu kauka ke kuhikuhi i kahi kaʻina hana i kapa ʻia ʻo " External Cephalic Version (ECV)". I ka ʻōlelo maʻalahi, pili kēia i ke kau ʻana o ke kauka i kona mau lima ma kou ʻōpū a hoʻohuli pono i ka pēpē, e hoʻāʻo ana e hoʻohuli i kona poʻo i lalo.

Hiki paha iā ʻoe ke manaʻo iki i ka ʻoluʻolu ʻole i ka hana ʻana i kēia, akā he hana palekana loa ia no ka pēpē. I kekahi manawa hiki iā ʻoe ke lawe i ka lāʻau lapaʻau e hoʻomaha ai i kou ʻōpū. E maʻalahi kēia i ka hoʻohuli ʻana i ka pēpē. He hana kēia me ka nui o ka holomua ma kahi o 50%. ʻO ke ʻano kēia, hoʻokahi i loko o ʻelua mau kānaka e hana ia mea e hiki ke hoʻohuli i ka pēpē. Inā holomua kēia, e loaʻa iā ʻoe ka manawa e hānau ai i ka pēpē ma ke ʻano maʻamau.

ʻOiai he kaʻina hana palekana ka ECV, aia nā hihia kakaikahi (ma kahi o 1 i 200) o nā pilikia. No ka laʻana, inā he wahi liʻiliʻi o ke kahe koko mai ka placenta a i ʻole ka puʻuwai o ka pēpē he ʻano ʻē, pono paha kahi ʻoki cesarean ulia pōpilikia. No laila, hana wale ʻia ka ECV ma kahi haukapila i loaʻa nā pono āpau e pono ai no ke ʻoki ʻana i ka ulia pōpilikia.

Pehea e hānau ai i kahi pēpē inā he ʻōpū ia?

I kēia manawa, ʻelua āu koho. ʻO kekahi, ʻo ia ka hana ʻoki cesarean i hoʻolālā ʻia . ʻO kekahi, ʻo ia ka hoʻāʻo ʻana i ka hānau ʻana ma ke ʻano he breech vaginal . Pono ʻoe e kūkākūkā i kēia me kāu kauka ma mua loa a hoʻoholo.

Inā he hānau maʻamau kāu (Vaginal Breech Delivery)

Ua like loa kēia me ka hānau maʻamau. ʻAʻohe ʻokoʻa koʻikoʻi i nā ʻano o ka hoʻohana ʻana i nā lāʻau ʻeha a me nā lāʻau lapaʻau. Eia nō naʻe, hana wale ʻia kēia hoʻāʻo ʻana ma kahi haukapila i loaʻa nā pono e hana i kahi ʻoki cesarean ulia pōpilikia i kēlā me kēia manawa . No ka mea, inā paha e hoʻolālā ʻia ka hānau ʻana ma ka vaginal, ma kahi o 40% o nā pēpē breech e pono e hana i kahi ʻoki ulia pōpilikia i ka minuke hope loa. Eia kekahi, aia nō kahi pediatrician ma laila i ka wā e hānau ai ka pēpē.

Eia nō naʻe, i nā hihia aʻe, hiki i kāu kauka ke aʻo aku e kūʻē i ka hoʻāʻo ʻana i ka hānau ʻana ma ka vaginal:

• Inā haʻahaʻa kekahi a i ʻole nā ​​wāwae ʻelua o ke pēpē ma mua o nā puʻupuʻu (footling breech).
• Inā ʻoi aku ka nui a i ʻole ka liʻiliʻi o ka pēpē ma mua o ka maʻamau.
• Inā ua hoʻokiʻekiʻe ʻia ke poʻo o ke pēpē i hope (hyperextension).
• Inā haʻahaʻa ka placenta, ua kapa ʻia ia he "Placenta Previa".
• Inā loaʻa iā ʻoe nā pilikia ʻē aʻe i ka wā hāpai, no ka laʻana, nā kūlana e like me ka "Pre-eclampsia".

Inā hānau ʻia ke pēpē ma o ka ʻoki ʻoki cesarean (Planned Cesarean Section)

ʻO ka hapa pinepine, e aʻo aku kāu kauka iā ʻoe e hana i kahi ʻoki cesarean i hoʻolālā ʻia i nā pule 39. I kēlā manawa, ua ulu piha nā māmā o ka pēpē. ʻOi aku ka palekana o nā ʻokiʻoki i hoʻolālā ʻia no ka pēpē ma mua o nā ʻokiʻoki i hana ʻia ma hope o ka hoʻomaka ʻana o ka hānau ʻana.

E noʻonoʻo he hana ʻoki kino kāu i hoʻonohonoho ʻia no ka lā, akā ma mua o kēlā hoʻomaka ʻoe e loaʻa i ka maʻi kahe. Inā hana ʻia kēlā , pono ʻoe e hele koke i ka haukapila.E nānā ke kauka iā ʻoe. I kekahi manawa, inā ua lōʻihi loa kou hānau ʻana a ua kokoke loa ka pēpē i ka hānau ʻana, e hoʻoholo paha lākou he ʻoi aku ka palekana o ka hānau maʻamau ma mua o ka ʻoki caesarean i kēlā manawa.

ʻOiai he palekana ka ʻoki kino i hoʻolālā ʻia no ka pēpē, aia kekahi mau pilikia nou, ka makuahine . ʻO kēia mau mea:

• Ke kahe koko nei ma mua o ka maʻamau
• Nā ʻūpā koko ma nā wāwae
• ʻO ka maʻi ʻeha ʻoki
• Ka hōʻino ʻana i ka ʻōnaehana urinary i ka wā o ke ʻoki ʻana
• ʻO ka hoʻonui ʻia o ka manawa kūpono o ka hana ʻana i ka ʻāpana cesarean i nā hāpai ʻana e hiki mai ana

He aha nā pilikia kūikawā o ka hānau ʻana ma ka ʻōpū?

ʻO ke poʻo ka ʻāpana nui loa o ke kino o ka pēpē. Inā ʻaʻole hiki ke puka i waho ke poʻo i ka wā hānau maʻamau (puka ke poʻo), pono koke ke ʻoki ʻana. Eia nō naʻe, i ka hānau ʻana ma ka ʻūhā, hiki i ke poʻo o ka pēpē ke paʻa i loko ma hope o ka puka ʻana o ke kino holoʻokoʻa . He kūlana weliweli loa kēia.

I kēia manawa, hiki ke ʻūmiʻi ʻia ke kaula umbilical o ka pēpē, e ʻoki ana i ke koko a me ka oxygen o ka pēpē . Hiki i kēia ke hōʻino i ka lolo i loko o nā minuke.

ʻO kekahi mea ʻē aʻe, inā haki kou wai ma mua o ka hoʻomaka ʻana o ka hānau ʻana, hiki i ke kaula umbilical ke puka i waho ma mua o ka pēpē. He pilikia nō hoʻi kēia.

ʻO ka mea hope loa, ʻoi aku ka nui o ka pilikia o nā pēpē i hānau ʻia ma ke kūlana breech i ka loaʻa ʻana o kahi kīnā hānau ma ka iwi ʻūhā (Developmental Dysplasia of the Hip - DDH). He ʻano kēia kahi i kū ʻole ai ke ʻano o ka iwi ʻūhā. No laila, ua nānā ʻia kēlā mau pēpē no kēia ʻano ma ka loaʻa ʻana o kahi scan ultrasound o ka ʻāpana ʻūhā 4-6 mau pule ma hope o ka hānau ʻana.