Nu ni tur tan chuan nau neih hi beiseina ropui tak leh hlauhna tlemte hun a ni. Mi zawng zawngin engkim a kal tha ang a, naute hrisel tak an kuah thei ang tih an beisei. A tam zawkah chuan engkim hi ruahmanna angin a kal vek a, mahse a chang chuan emergency tenau te a lo awm thei. Mahse, lungngai suh, nang leh i naute enkawltu tur doctor leh nurse te hi heng zawng zawng atan hian training leh inpeih tawh an ni. Vawiin hian hetiang dinhmunah hian kalphung bik kan sawi dawn a ni.
McRoberts Maneuver hi eng nge ni tak tak?
A awlsam zawngin sawi ila, McRoberts Maneuver hi nau neih laiin naute kekawrte emaw, a ke pahnih emaw chu nu pelvis-a a tlakbuak hunah chhuah zalenna atana hmanraw bik a ni. Naute lu chu vagina atanga chhuak mah se, a taksa dang zawng zawng chu a tlai deuh vek ang tih han ngaihtuah teh. Chu chu naute kekawrte a innghah vang a ni.
Hetih lai hian doctor emaw midwife emaw chuan i ke chu khup thlengin a ben ang a, i pum chhungah nghet takin a nawr ang. Hetianga i chetna hian i pelvic bone awmna chu tlem a tidanglam ang a, naute chu a awmna hmun atanga a chhuah awlsam phah ang. Hei hi pawn lam atanga thiltih awlsam tak ni mahse, naute chu chhung lam atanga chhuak turin a pui dawn a ni.
‘Soulder stiffness’ tih hian eng nge a awmzia? Chu chu Shoulder Dystocia tihna em ni?
Ni e, a dik e. Damdawi lam hawi chuan hei hi Shoulder Dystocia kan ti a ni. Nau neih pangngaiah chuan naute lu a chhuah hnuah a kekawrte chu awlsam takin a chhuak thin. Mahse, a châng chuan a ke pakhat emaw, a pahnih emaw chu nu pelvis hmalam ruh pahnih inzawmna pubic symphysis hnung lamah a tang thei a ni.
Hei hi dinhmun pawi tak a ni thei. Naute taksa chhuah a tlai avangin naute chu oxygen a tlakchham phah thei a ni. Mahse a pawimawh ber chu a tam zawkah chuan Doctor-te chet dan rang tak avang hian naute chu harsatna awm lovin chhanchhuah theih a ni. Chutiang dinhmunah chuan McRoberts maneuver hi hman hmasak ber leh hlawhtling ber a ni.
Doctor chuan Shoulder Dystocia a vei tih a hriat theih chuan:
- Naute lu chu vagina atangin a chhuak tawh a, mahse minute khat vel hnuah a taksa dang a chhuak lo a nih chuan.
- Naute lu chu a rawn chhuak a, chutah tlem a lut leh ang tih a lan chuan (hei hi ‘turtle sign’ an ti a).
Hemi atan hian tu nge hlauhawm zawk?
Shoulder Dystocia awm chhan dik tak hriat chian harsa tak ni mah se, mi thenkhat chuan an vei theihna chance a sang deuh hlek a ni. Mahse, heng risk factors nei loteah pawh he natna hi a awm thei tih hre reng ang che. Tin, heng risk factors nei zawng zawng hian an nei vek dawn lo.
| Risk Factor a ni | Hrilhfiahna awlsam tak |
|---|---|
| Pelvis te tak te | Nu pelvic floor a tlem chuan naute chhuahna tur hmun a awm lo mai thei. |
| Fetal Macrosomia (Naute rihna lian tak) 1.1. | A tlangpuiin naute kilo 4 aia rit i beisei a nih chuan a kekawrte lian tak avang hian a tlakbuak theihna a sang zawk. |
| Nau piang hmasa lama nau piang rit sang tak neih | Naute thau lutuk nei tawh a nih chuan a lo thleng leh theihna chance a awm. |
| Naupai laiin taksa rihna sang lutuk | Nuin a rihna thunun loh chuan naute rihna a tipung thei bawk. |
| Zunthlum | Nu naupai laia zunthlum vei te hian naute thau lutuk an nei tam zawk. |
McRoberts Maneuver hi engtiang chiahin nge a hlawhtlin?
Hetiang method hi a hlawhtling hle. McRoberts maneuver chauh tih a nih chuan hlawhtlinna rate chu 42% vel a ni .
Mahse hei nen hian hmanraw dang hman a awm bawk. Suprapubic Pressure an ti a . Chumi awmzia chu doctor emaw nurse emaw chuan an kutphah hmangin pressure an pe tihna a ni a, chu chu i pum hnuai lam chiah, i pelvic bone chung lam chiah a ni. He pressure hmang hian naute kekawr ipte chu nawr a, a chhuah zalen a ni.
Thil pawimawh tak chu McRoberts Maneuver leh Suprapubic Pressure pahnih hi hman dun a nih chuan,Hlawhtlinna rate hi 90% thleng a ni! Hei hian he method hi a tangkai zia a tilang chiang hle.
Hetianga i tih hian eng nge thleng?
1. Diagnosis: A hmasa berin doctor chuan hei hi Shoulder Dystocia an tih condition a nih thu a nemnghet a.
2. A dinhmun siamrem dan: A tlangpuiin mi pahnih (doctor, nurse) te chuan i ke chu khup lamah an ben ang a, i pum hnaih thei ang berah an nawr ang. Hetih lai hian i rilru a hah deuh mai thei a, mahse hei hi naute chhanchhuah nan tih a ni a, chuvangin dawhthei rawh.
3. Pressure pek (a tul chuan): Chutih rual chuan mi dangin chunglam atangin suprapubic pressure chu pum chhungah a hnawih bawk.
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Hetiang hmanrua hi eng nge a thatna?
McRoberts Maneuver hian thatna pawimawh tak tak a nei a, chungte chu:
- Nau neih pangngai neih theihna: Hei hian emergency cesarean section (C-section) neih a ngai lo .
- Naute tana harsatna awm thei tihtlem: Shoulder impingement hian naute kut ruh tliak, nerve tihchhiat, oxygen tlakchham (asphyxia) ang chi harsatna lian tham a thlen theihna a ti tlem hle
- Nu tana chhiatna thlen theihna a tlem: Episiotomy (vagina leh anus inkara incision) neih a ngaihna a tlahniam.
- Simple and quick: Hei hi hmanraw awlsam tak a ni a, rang taka tih theih a ni a, hmanraw engmah awm lovin.
Hei hian harsatna a thlen thei em?
Hetiang method hi dik taka tih a nih chuan complication a awm tlem hle. Dan pawimawh ber chu naute lu chungah hrual ngai lo tur a ni. Chutianga tih chuan naute kawng emaw, ruhro emaw a tichhe thei a ni. Medical team thiam tak chuan hei hi an hre chiang hle.
A tlem hle a, nu hian pelvic bones inzawmna hmunah blockage emaw, keah temporary neuropathy emaw a nei thei. Mahse, hengte hi a tlem hle.
McRoberts Maneuver hlawhtling tak i neih hnuah i naute chu hrisel tak leh pangngai takin vagina hmangin a piang ta a ni. Chumi hnuah doctor chuan naute chu uluk takin a enfiah ang a, a kephah emaw, a kut emaw a chhiatna a awm loh nan a enfiah ang. A tam zawkah chuan engkim a kal tha hle.
Take-Home Thuchah a ni
- McRoberts Maneuver hi naute nau neih laiin (Shoulder Dystocia) a kekawrte chhuahna atana hmanraw awlsam, him leh tangkai tak a ni.
- Hei hian nu ke chu a pum chhungah nawr a, pelvis chhunga hmun zau zawk siam a, naute chhuah theihna tur hmun siam a huam a ni.
- Suprapubic Pressure method nena hman dun a nih chuan a hlawhtlinna rate chu 90%-ah a pung a ni.
- Hei hi emergency ni mahse, i medical team te chu chutiang thil atan chuan an inzir tha hle a, chuvang chuan hlauthawng a ngai lo.
- Shoulder Dystocia vei theihna tur risk factor awm mahse, thil tam tak chu i doctor nen inbiakna neih hmasak a, a tul anga thupek zawm a nih chuan a enkawl theih a ni.
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