Inā he makuahine hānau ʻoe, ʻo kekahi o nā nīnau nui a koʻikoʻi loa i kou manaʻo, ʻo ia paha, 'Ke ʻeha nei kaʻu pēpē?' He kumuhana hohonu loa kēia. ʻOiai i loko o ka lāʻau lapaʻau, aia nā manaʻo like ʻole e pili ana i kēia. Wahi a kekahi mau kauka a me nā ʻepekema ʻaʻole ʻeha nā pēpē a hiki i 24 mau pule (6 mau mahina). Akā ʻōlelo kekahi hiki iā lākou ke ʻeha i ka wā mua o 12 mau pule (3 mau mahina). No laila he aha ka mea e hana nei? E kamaʻilio kākou e pili ana i kēia ma ke ʻano maʻalahi e hiki ai iā ʻoe ke hoʻomaopopo.
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He aha nā manaʻo like ʻole no kēia?
He mea paʻakikī ke hāʻawi i kahi pane pololei i kēia nīnau, no ka mea, ʻaʻole hiki iā mākou ke nīnau i kahi pēpē i loko o ka ʻōpū, "He ʻeha anei?" No laila, ua pono nā kānaka noiʻi e noiʻi i ka ulu ʻana o ke kino o ke pēpē, ʻoiai ka ulu ʻana o ka lolo a me ka ʻōnaehana nerve, a hiki i kekahi mau hopena ma o ia mea.
I ka wā ma mua, a hiki i nā makahiki 1980, ua manaʻo nā kauka ʻaʻole hiki i nā pēpē hānau hou ke ʻike i ka ʻeha. ʻO ke kumu, ʻaʻole i ulu piha ko lākou lolo. Akā i kēia manawa ua loli loa kēlā manaʻo.
Ke kamaʻilio nei nā kānaka ʻepekema e pili ana i kahi manaʻo i kapa ʻia ʻo 'nociception.' I ka ʻōlelo maʻalahi, ʻo ia ka hiki ke ʻike i ka pōʻino . He ʻokoʻa iki ia mai ka ʻeha. No ka mea, ʻaʻole pono ka ʻike. Akā ua ʻae ʻia i kēia manawa ʻo ka pane koʻikoʻi a kēia 'nociception' i hana ai i loko o ke kino o ke pēpē hiki ke hoʻopilikia i ka ulu ʻana o kona lolo.
ʻO nā hui lapaʻau alakaʻi o ka honua, no ka laʻana, ʻo nā American and British Colleges of Obstetricians and Gynecologists (ACOG, RCOG), ke manaʻo nei ʻaʻole hiki i ka pēpē ke ʻeha a hiki i nā pule 24-25 . Eia nō naʻe, aia nā manaʻo kūʻē. E nānā pono kākou i nā manaʻo ʻelua.
| Ka Moʻolelo Hoʻopunipuni 1: ʻIke ʻia ka ʻeha ma hope o 24 mau pule | Ka Moʻolelo Hoʻopunipuni 2: Hiki ke ʻike ʻia ka ʻeha i ka wā mua o 12 mau pule |
|---|---|
| Hoʻomohala ʻia nā pilina koʻikoʻi ma waena o ka cortex, ka ʻāpana o ka lolo ke kuleana nui no ka hoʻomanaʻo a me ka noʻonoʻo ʻana, a me ka thalamus, ka ʻāpana o ka lolo e lawe i nā manaʻo e like me ka ʻeha i ka cortex, ma hope o 24 mau pule. | ʻAʻole maopopo inā he mea pono loa ka cortex no ka ʻike ʻana i ka ʻeha. He hiki ke ʻike ʻia ka ʻeha ma o nā ʻāpana mua ʻē aʻe o ka lolo. |
| ʻOiai paha he pane ʻeha ka pēpē ma lalo o 28 mau pule, he pane reflex a hormonal paha ia. ʻAʻole ia he ʻeha maoli. | Hoʻomaka nā mea loaʻa ʻeha e ulu ma ka ʻili o ka ʻili i ka hoʻomaka ʻana o 7 mau pule, a pili i ka lolo i ka 12-15 mau pule. |
| ʻO nā pilina neural e hoʻokaʻawale ma waena o kahi pā ʻino ʻole a me kahi mea ʻeha e ulu aʻe i ka hopena o ka hāpai ʻana. | ʻO nā ʻāpana o ka lolo, e like me ka thalamus a me ke kumu o ka lolo, e pili ana i ka ʻike, e hoʻomaka e ulu i ka trimester mua. |
E noʻonoʻo, ua paʻakikī hou aku kēia hoʻopaʻapaʻa ma muli o ka holomua o ka ʻepekema lapaʻau, hiki i kēia manawa ke mālama i kahi pēpē ola ʻoiai inā hānau ʻia i ka wā mua o 22-23 mau pule. Ke ʻae nei nā kauka i kēia manawa ua ʻeha nā pēpē i hānau ʻia i kēlā makahiki hāpai haʻahaʻa.
Pehea e pili ai kēia mea i nā hoʻoholo ʻē aʻe?
Ua hoʻopilikia pololei kēia pilikia o ka ʻeha o ka ʻōpū i nā kānāwai hoʻopau hāpai a me ke ʻoki ʻana i ka ʻōpū a puni ka honua.
Nā hoʻoholo e pili ana i ka hoʻopau ʻana i ka hāpai keiki
Ua hoʻohana ʻia kēia 'fetal distress' e hoʻoholo ai i nā palena manawa no ke kānāwai ʻana i ka hoʻopau ʻana i ka hāpai keiki ma nā ʻāina he nui. Hoʻopaʻa kekahi mau ʻāina i ka hoʻopau ʻana i ka hāpai keiki ma hope o kekahi mau pule o ka hāpai ʻana no kēia kumu.
Akā inā mākou e nānā i ka ʻikepili, ʻo ka hapa nui o nā hoʻopau ʻana ma ka honua e hana ʻia i ka wā hāpai mua loa. No ka laʻana, e like me ka ʻikepili mai ka CDC ma ʻAmelika Hui Pū ʻIa, ʻoi aku ma mua o 93% o nā hoʻopau ʻana e hana ʻia ma mua o 13 mau pule . ʻOi aku ma mua o 1% e hana ʻia ma hope o 21 mau pule. Ke hoʻomau nei ka hoʻopaʻapaʻa ma waena o nā kānaka ʻepekema e pili ana i kēia mau palena manawa.
ʻO ke ʻoki kino ʻana o ka pēpē
I kekahi manawa, pono ke ʻoki kino e mālama i kekahi mau kīnā hānau ʻoiai ke pēpē i loko o ka ʻōpū. ʻO kēia ka mea a mākou e kapa nei he 'ʻoki kino fetal'.
Ke noʻonoʻo nei nā kauka e pili ana i ka ʻeha i ka wā o ke ʻoki kino e like me kēia? ʻAe, ʻoiaʻiʻo nō.
I ka manawa pinepine, ʻo ka anesthesia i hāʻawi ʻia i ka makuahine i ka wā o kēia mau ʻoki ʻana ke hele ma waena o ka placenta a hoʻopilikia i ka pēpē. Akā, wahi a kekahi poʻe ʻepekema ʻaʻole kēia wale nō e hoʻopau loa i ka ʻeha a i ʻole ke kaomi e hiki ai i ka pēpē ke manaʻo.
No laila,I nā ʻoki kino i hana ʻia ma hope o ka lua o ka trimester (ma hope o 13 mau pule), hāʻawi pololei nā kauka i ka pēpē i kahi lāʻau ʻeha. Hāʻawi pū lākou i ka pēpē i kahi lāʻau lapaʻau e hoʻopaʻa iā ia i ka wā o ke ʻoki kino. ʻO ke kumu nui o kēia, ʻo ia ke pale ʻana i ka hopena koʻikoʻi ikaika i hoʻokumu ʻia e ke ʻoki kino mai ka hoʻopilikia maikaʻi ʻole ʻana i ka ulu ʻana o ka lolo a me ka ʻōnaehana nerve o ka pēpē.
ʻO ka hāʻawi pololei ʻana i ka anesthesia i ka pēpē ma kēia ʻano ua manaʻo ʻia he palekana no ka makuahine a me ka pēpē . He mea kākaʻikahi loa nā hopena ʻaoʻao.
Leka Lawe-Home
- ʻAʻohe manaʻo maopopo i ka lāʻau lapaʻau e pili ana i ka wā e ʻeha ai ke pēpē i loko o ka ʻōpū. ʻOiai ke ʻōlelo nei kekahi ma hope o 24 mau pule, ʻōlelo kekahi hiki ke hiki i ka 12 mau pule.
- ʻO ke kumu nui o kēia hoʻopaʻapaʻa ʻana, ʻo ia ka maopopo ʻole e pili ana i nā ʻāpana o ka lolo e pono e hoʻomohala ʻia e ʻike ai i ka ʻeha.
- ʻO
Nociceptionka hiki ke ʻike i ka pōʻino. ʻOiai ʻaʻole pono ka ʻike, hiki i ke kaumaha ke hoʻopilikia i ka ulu ʻana o kahi pēpē. - Inā e hana ʻia ana ke ʻoki ʻana o kahi pēpē i loko o ka ʻōpū, e hoʻohana pono nā kauka i nā lāʻau ʻeha e hōʻemi i ke kaomi ma luna o ka pēpē a hōʻemi i ka hiki ke hōʻino i kona ulu ʻana.
- He kumuhana paʻakikī a koʻikoʻi loa kēia. Inā he mau nīnau a hopohopo paha kāu e pili ana i kēia, ʻoi aku ka maikaʻi o ke kamaʻilio ākea me kāu kauka e pili ana i ia mea.
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