I naute kekawrte chu a tang em? Nau neih laia lo awm thei Shoulder Dystocia chungchang hi i zir dawn teh ang!

Nu ni tur tan chuan nau neih hi in nun hlimna ber pakhat a ni a, mahse a chang chuan a hlauhawm deuh thei bawk. A tam zawkah chuan engkim hi a thain a kal tluang a, mahse a chang chuan beisei loh harsatna a lo chhuak thei a ni. Chu chu a dik a, hei hi nau neih laiin kan hriat vek a ngai (Shoulder Dystocia) . Hemi chungchang hi chipchiar deuhin han sawi ila, mahse awlsam takin, okay?

Hei hi eng nge ni (Shoulder Dystocia), doctor?

A awlsam zawngin, Shoulder Dystocia chu naute lu chu vagina atanga a chhuah hnua a ke pakhat emaw, a pahnih emaw, a ke pahnih emaw, pelvis, a kawr vel a ruh frame-a a tlakbuak hi a ni. Naute chu chhuah a tum laiin, a kekawrte chu khawi emaw laiah a tang a, chu chuan taksa dang zawng zawng chhuah chhuah a harsat phah niin han mitthla teh. Greek tawng "dystocia" tih awmzia chu "piang harsa" tihna a ni.

Hei hi a takah chuan doctor-te chuan medical emergency-ah an ngai a ni. A chhan chu enkawl vat loh chuan nu leh naute pahnih hian harsatna engemaw zat an nei thei a ni. Mahse a pawimawh ber chu a tam zawkah chuan doctor leh medical team te hian he dinhmun hi thiam takin an enkawl a, nu leh naute hi him takin an vawng reng thin. Chuvangin tul lovah hlau suh.

Hei hi engtiang chiahin nge hmuh theih?

Shoulder Dystocia hi a takah chuan natna hlauhawm tak a ni . Statistics dik tak pek a harsa a, a chang chuan over-diagnose emaw under-diagnose emaw a nih theih avangin. Tin, naute pian rih dan azirin a zat pawh a inang lo.

A vaiin he natna hian naute kilogram 2.5 leh 4 inkar (5 pounds 8 ounces - 8 pounds 13 ounces) 0.6% leh 1.4% inkar a nghawng a ni. Mahse, naute hi kilogram 4 (8 pounds 13 ounces) aia rit a nih chuan he hlauhawmna hi 5% leh 9%-ah a pung a ni.

Hei hi kan hre hmasa thei ang em? Eng nge a lan chhuah dan?

Hetah hian thil pawimawh tak chu, Shoulder Dystocia hian symptoms bik a nei lo . Chu chu, nau neih hma hian, "Aw, hei hi ka chungah a thleng dawn a ni," tih ngaihtuah tir thei tur chhinchhiahna a awm lo tihna a ni. Risk factor engemaw zat awm mahse, he natna hi tu pawhah a awm thei.

Chu chu doctor chuan naute lu a chhuah hnuah chauh a hrechhuak a ni. Naute lu chu a chhuak niin a lang a, chutah chuan tlem a inhnukdawk leh ta a ni. Turtle chuan a lu a chhuah tir a, a hlauhthawn laiin a hruai lut leh ang mai a ni. Doctor-te chuan hei hi "turtle sign" an ti a. Chutah chuan doctor-te chuan naute kekawr ipte chu a tang tih an hrechhuak ta a ni.

Engvangin nge hetiang hi a lo awm? A chhan engte nge ni?

Shoulder Dystocia thlentu ber chu naute ke ruh chu nu pelvis hma lama awm pubic bone hnung lama a tlakbuak vang a ni. Hei hi a thlen thei thil engemaw zat a awm a:

• Fetal Macrosomia: Hei hi naute hi kilogram 4 (8 pounds leh 13 ounces) aia rit a nih chuan a thleng thei a ni.
• Naute dinhmun dik lo: Nausen pum chhunga a dinhmun pawh a buaithlak thei hle.
• Nu pelvic opening hi a te: Nu thenkhat pelvis hi a pianphungah a tawi deuh thei.
• Nau neih laiin nu dinhmun: Dinhmun thenkhatah chuan pelvis-a hmun awm thei chu a tihtlem thei a ni.

Doctor-te hian engtin nge hei hi an hriat?

Doctor chuan thil pawimawh pathum a tlin chuan Shoulder Dystocia i nei tih a sawi chhuak ang:

1. Naute lu a lo chhuak tawh a, mahse a nu chuan naute kekawrte chu a nawr chhuak thei lo.

2. Naute lu a chhuah atanga minute khat pawh a tling lo, mahse a ruang erawh a la chhuak lo.

3. Hlawhtling taka naute piang tur chuan medical intervention a ngai.

Hei hi eng enkawlna nge ni?

Doctor chuan zunthlum i vei vang emaw, naute a lian em avangin emaw, hlauhawmah i awm tih a ngaihtuah lawk chuan , cesarean section hmasa (C-section) neih a rawt thei a ni.

Mahse, mi pakhatin vaginal delivery neiin hei hi hlauhawm nia a hriat chuan doctor-te chuan safety checklist an nei . Chu chu hetiang emergency a thlen hunah thil tih tur list an nei tihna a ni.

Shoulder dystocia a awm tih hriat a nih chuan delivery room-a hnathawh chu a buaithlak deuh deuh a ni . Doctor leh nursing team te hian naute chhuah tir turin maneuver hrang hrang hmangin an thawkdun dawn a ni. I pelvis tan hmun tam zawk siam turin i dinhmun thlak danglam an tum thei a, i kekawrte zalen turin naute dinhmun thlak danglam an tum thei bawk.

HELPERR tih dan a ni

Hetiang hun laia doctor-te hman dan hriatreng awlsam tak chu HELPERR . A chhunga lehkha tin hian tih tur a sawi vek a.

• H — Ṭanpuina: Doctor chuan midangte tanpuina a dil nghal a. A hmaa kan sawi tawh angin safety list a hmang a ni. Anesthesiologist, neonatologist leh nurse dangte puihna a dil a ni. Rang takin hmanraw mamawh chu pindan chhungah a rawn keng lut a.
• E — Episiotomy awm leh awm loh endik: Doctor chuan episiotomy , vaginal opening leh perineum inkar a cut te tak te, vaginal opening tihzauh nan naute naupai pui turin a siam dawn nge dawn lo tih a rel ang. Hei hi rotation maneuver atan hmun tam zawk mamawh a nih chauhvin tih theih a ni.
• L — Ke: I doctor chuan McRoberts maneuver a hmang thei ang . Hei hian i kekawrte chu i pum chungah i nawr khawm a ngai a ni. Hei hian pelvis a ti flatten a, tlem a ti rotate a, space a tipung bawk.
• P — Pressure: Doctor , a hnuai lam atanga a chhuah.I hmang thei ang. Chu chu i pum hnuai lam, pubic bone chung lam deuhah i press tihna a ni. Hei hian naute kekawrte chu pressure a siam a, rotate a, chhuah tir tum a ni.
• E — Enter maneuvers: Doctor chuan internal rotations a ti thei . Chumi awmzia chu naute chu a kut chu vagina chhungah dahin a herh tir tum dawn tihna a ni.
• R — Posterior arm chu la chhuak rawh: Doctor chuan Jacquemier maneuver a hmang thei . Hei hian naute kut pakhat chu birth canal atanga lakchhuah a huam a ni. Hei hian kekawrte chhuah a awlsam phah ang.
• R — Damlo chu roll rawh: Doctor chuan Gaskin maneuver , i kut leh khup chungah a roll che a ni.

Tlem a buaithlak zawkah chuan

A chunga kan sawi takte hi a hlawhtling lo nasat em em chuan doctor chuan hengte hi a hmang thei bawk ang:

• Clavicle fracture: Naute kawr ruh chu tumruh taka tihchhiat a, a kekawrte chhuah zalen a ni.
• Zavanelli maneuver: Naute lu chu nausen pum chhungah nawr lehin, cesarean section (C-section) nghal a ni.
• Symphysiotomy: Hei hi pubic bones pahnih inkar cartilage chu tan a, pelvic opening tihzauh nan a ni. Tunlai hian hengte hi procedure a tlem hle.

Hei hian nu leh naute tan eng harsatna nge a thlen theih?

Shoulder Dystocia hian nau neih laiin nu leh naute tan pawh harsatna a thlen thei a ni. Hengte hi mi zawng zawngah a thleng lo tih hre reng ang che , mahse fimkhur a tha.

Nu chunga nghawng a neih dan:

• Nau neih hnua thisen chhuak tam lutuk (Postpartum hemorrhage) .
• Vagina leh anus (perineum) inkar hmun a na hle.
• Rectovaginal fistula: Hei hi hmeichhe hnute leh hnute inzawmna (unnatural connection) a ni.
• Uterine a hring chhuak .
• Pelvis chhunga pubic bones inthen darh.

Naute chunga nghawng a neih dan:

Naute zingah shoulder dystocia natna vei tam ber chu brachial plexus palsy an tih hi a ni . Brachial plexus hi nerve pawl pakhat a ni a, naute kawr chhunga ruhro atanga a kut thlenga kal a ni. Heng nerve te hian kekawr, kut leh kut te chu hriatna leh chetna a pe a. Heng nerve te hi a chhiat chuan chu lam a kut chu a chak lo thei a, a paralyze pawh a ni thei.

Harsatna dangte chu:

• Naute ruh (clavicle) leh/ emaw kut chunglam ruh (humerus) a tliak.
• Horner’s syndrome: Nausen mit leh hmai tichhe thei natna hlauhawm tak a ni.
• Umbilical cord compressed a nih chuan:Naute kut leh nu pelvic bone inkarah hian umbilical cord a tang thei a ni. Hei hian naute oxygen tlakchhamna leh thisen kalna a thlen thei a, chu chuan thluak a tichhe thei a, thihna pawh a thlen thei bawk. Hei hi thil thleng tlem tak a ni.

Tu nge hlauhawm zawk?

Shoulder Dystocia hi tu chungah pawh a thleng thei . Nausen pianpui rihna pangngai neiah hmuh tur a tam ber. Mahse, he natna vei theihna tipungtu risk factor thenkhat a awm. Eng nge an nih i en ang u:

• Diabetes: Diabetes i nei tawh emaw, gestational diabetes emaw i nei emaw, i naute chu a lian deuh thei. Zunthlum vei nu zinga 20% vel chuan naute kilogram 4 (8 pounds, 13 ounces) aia rit an nei a.
• Macrosomia: Chumi awmzia chu naute pian tirh atangin kilogram 4 (8 pound, 13 ounces) aia rit a ni tihna a ni. Naute hi a lian hle a nih chuan doctor chuan cesarean section tih a rawt thei a ni.
• Shoulder Dystocia (a hmaa nau neih tawh avanga natna vei).
• Nausen pum chhunga fapa mal emaw a aia tam emaw phurh.
• Naupai laiin taksa rihna sang lutuk emaw thau lutuk emaw.
• Nu chu a sei tawi hle.
• Pelvis-a structure danglam tak neih.
• Kum 35 chunglam a nih avangin.
• Nau neih hun tur hnua nau neih a ni.

Nau neih leh nau neih laiin dinhmun thenkhat pawh hian he hlauhawmna hi a tipung thei bawk. Chung zinga pawimawh ber pakhat chu assisted vaginal delivery , chu chu doctor chuan naute lakchhuah nan vacuum extractor emaw forceps emaw a hmang tihna a ni.

Risk factor dangte chu:

• Nau neih tan nan damdawi Oxytocin pek.
• Epidural tih a ni .
• Nau neih hmasak ber (contraction phase) hi a rei hle.
• Labour stage hnihna (pushing phase) hi a tawi lutuk emaw, a rei lutuk emaw a ni.
• Naute nawr chhuah nan pressure emaw, method emaw dik lo hmanga nawr chhuah.

Hei hi veng turin eng emaw kan ti thei ang em?

Dik tak chuan shoulder dystocia hi ven a harsa fo thin a , a bik takin naute hi a rihna pangngai a nih chuan. Beisei loh takin a thleng thin. Mahse, i risk tihtlem nan thil tlemte i tih theih a awm a:

• Diabetes i neih chuan control tha rawh .
• Naupai chhung zawngin taksa rihna hrisel tak vawng reng tur a ni .
• I doctor nen inbia la, a tul chuan nau neih tir hma thei em tih en rawh.
• Due date a liam tawh chuan doctor hnenah hriattir nghal rawh.
• I doctor nen cesarean section (C-section) chungchang sawiho rawh (a bik takin risk factors a awm chuan).
• Nau neih laiin natna tidamtu damdawi thenkhat, epidurals ang chi te hi vawi hnih ngaihtuah la (hei chungchang pawh hi i doctor nen sawiho rawh).

Hetiang dinhmun hnu hian eng nge thleng? Nakin hun chu eng nge ni?

He thu hi i hriat chuan i hlau deuh mai thei, mahse thu lawmawm a awm .

Research atanga a lan dan chuan Shoulder Dystocia vei nausen piang zinga a chanve chu thla thum an tlin chuan an normal vek tawh a ni. Thla 18 an tlin chuan naute 82% chu an hrisel vek tawh a ni.

I naute hian brachial plexus injury a neih chuan a rah chhuah chu a tha tlangpui. Mahse, intervention thenkhat chuan naute hun rei tak dinhmun a nghawng thei a ni. Fine motor skill leh kut natna hman danah harsatna engemaw zat an nei thei. Mahse, heng hliam 90% aia tam hi thla 6 atanga thla 12 chhungin a reh thin . 10% aia tlem lo chu permanent disability a ni.

Shoulder Dystocia vei naute i neih tawh chuan a lo awm leh theihna chance chu 15% vel a ni. Chuvangin naute tam zawk neih i ngaihtuah a nih chuan he thu hi i doctor nen sawiho rawh. Shoulder Dystocia avanga cesarean section i neih chuan cesarean hnua vaginal birth (VBAC) hi a tha lo tlangpui .

Shoulder Dystocia hi nau neih laia harsatna awm thei a ni. Nau neih leh nau neih lai hian eng nge dik lo thei tih ngaihtuah buai hi thil pangngai a ni. Mahse, heng dinhmunte hi a awm lo tih hriat reng a pawimawh a, i medical team te pawh hi chutiang thil thleng tur hmachhawn turin an inzir tha hle tih hriat reng a pawimawh. Hetiang harsatna hmuh tur awm lo tak hi a lo awm tak tak a nih chuan hlauthawng suh la, i doctor-te chu ring rawh. Nang leh i naute himna tur leh hun rei tak chhunga harsatna awm lovin i naute chhuah tir turin theihtawp an chhuah ang.

Kan hriat reng tur pawimawh ber (Take-Home Message) .

Tunah chuan vawiin a kan sawiho (Shoulder Dystocia) dinhmun hi in hriatthiam ka beisei. Hriat reng tur pawimawh tak takte chu:

• Hei hi emergency a ni a, a tlem hle nachungin .
• A tam zawkah chuan medical team-te hian hei hi an enkawl tha hle .
• Early warning sign awm lo mah se, a hlauhawmna hriat a pawimawh .
• Diabetes control leh taksa rihna hrisel neih ang chi thilte hian a hlauhawmna chu engemaw chen a tihziaawm thei a ni .
• Naute tam zawk chu an dam chhuak vek .

Nau neih hi thil mak tak a ni. Chu zin ​​chhuahna atana in inbuatsaih hunah chuan he thu hi a \angkai ngei kan beisei. Zawhna emaw, ngaihtuahna emaw i neih chuan doctor nen inbiakna neih hlau ngai suh. Nang leh i naute tan duhsakna kan hlan a che u!

`Shoulder Dystocia, nau neih, naute choking, shoulder choking, nau neih harsatna, naupai, nau neih harsatna