Ingaba igxalaba lomntwana wakho libambekile? Masifunde nge-Shoulder Dystocia, enokwenzeka ngexesha lokubeleka!

Kwabo bazakuba ngumama, ukuzala yenye yezona zinto zivuyisayo ebomini bakho, kodwa ngamanye amaxesha kunokuba yinto eyoyikisayo. Uninzi lwexesha, yonke into ihamba kakuhle kwaye ilula, kodwa ngamanye amaxesha iingxaki ezingalindelekanga zinokuvela. Kulungile, le yimeko engaqhelekanga ekufuneka sonke siyiqaphele ngexesha lokubeleka (i-Shoulder Dystocia) . Makhe sithethe ngale nto ngokweenkcukacha, kodwa ngokulula, kulungile?

Yintoni le (i-Shoulder Dystocia), gqirha?

Ngamafutshane, i-Shoulder Dystocia ithetha ukuba elinye okanye omabini amagxa, okanye omabini amagxa, anamathela kwi-pelvis, ifreyimu yethambo ejikeleze isinqe, emva kokuba intloko yomntwana iphume kwilungu lobufazi. Khawuthelekelele ukuba xa umntwana ezama ukuphuma, amagxa anamathela ndaweni ithile, nto leyo eyenza kube nzima ukukhupha wonke umzimba. Igama lesiGrike elithi "dystocia" lithetha "ukuzala okunzima."

Oku kuthathwa njengengxamiseko yezonyango ngoogqirha. Kuba ukuba akunyangwa ngokukhawuleza, umama nomntwana banokuba neengxaki ezithile. Kodwa eyona nto ibalulekileyo kukuba uninzi lwexesha, oogqirha kunye namaqela ezonyango balawula le meko ngobuchule kwaye bagcine umama nomntwana bekhuselekile. Ngoko ke ungoyiki ngokungeyomfuneko.

Kubonakala kangakanani oku?

I-Shoulder Dystocia yimeko engaqhelekanga . Kunzima ukunika iinkcukacha-manani ezichanekileyo, njengoko ngamanye amaxesha inokuxilongwa ngokugqithisileyo okanye ingachongwanga ngokwaneleyo. Kwaye inani liyahluka ngokobunzima bomntwana wokuzalwa.

Ngokomyinge, le meko ichaphazela phakathi kwe-0.6% kunye ne-1.4% yeentsana ezinobunzima obuphakathi kwe-2.5 kunye ne-4 kg (iikhilogram ezi-5 ii-ounces ezi-8 - iikhilogram ezi-8 ii-ounces ezi-13). Nangona kunjalo, ukuba umntwana unobunzima obungaphezulu kweekhilogram ezi-4 (iikhilogram ezi-8 ii-ounces ezi-13), le ngozi inyuka iye kwi-5% kunye ne-9%.

Ngaba singayibona kwangethuba le nto? Zithini iimpawu zayo?

Nantsi into ebalulekileyo, i-Shoulder Dystocia ayibonisi zimpawu zithile . Oko kukuthi, akukho zimpawu ngaphambi kokubeletha ezikwenza ucinge, "Owu, oku kuza kwenzeka kum." Nangona kukho izinto ezithile ezinobungozi, le meko inokwenzeka nakubani na.

Ugqirha uqaphela oku kuphela emva kokuba intloko yomntwana iphumile. Intloko yomntwana ibonakala ngathi iyaphuma ize ibuyele umva kancinci. Kufana nofudo olukhupha intloko yalo luze luyitsale kwakhona xa lusoyika. Oogqirha bakubiza oku ngokuthi "luphawu lwefudo." Kulapho oogqirha baqonda khona ukuba igxalaba lomntwana libambekile.

Kutheni oku kusenzeka? Zithini izizathu?

Eyona nto ibangela i-Shoulder Dystocia kukuba igxalaba lomntwana libambeka ngasemva kwethambo le-pubic, elikwi-front of the pelvis kamama. Kukho izinto ezininzi ezinokubangela oku:

• I-Fetal Macrosomia: Oku kunokwenzeka ukuba umntwana unobunzima obungaphezulu kweekhilogram ezi-4 (iikhilogram ezi-8 kunye nee-ounces ezili-13).
• Indawo engachanekanga yomntwana: Indawo yomntwana esibelekweni nayo inokuba yingxaki.
• Umlomo we-pelvic kaMama umncinci: I-pelvis yomama othile isenokuba mxinwa ngokwendalo.
• Indawo umama ahlala kuyo ngexesha lokubeleka: Ezinye iindawo ahlala kuzo zinokunciphisa indawo efumanekayo kwi-pelvis.

Oogqirha bayibona njani le nto?

Ugqirha uya kugqiba kwelokuba une-Shoulder Dystocia ukuba kukho izinto ezintathu eziphambili ezifezekisiweyo:

1. Intloko yomntwana iphumile, kodwa umama akanakukwazi ukutyhala amagxa omntwana ngaphandle.

2. Kudlule umzuzu ongaphantsi kwentloko yosana iphumile, kodwa umzimba awukaphumi.

3. Ungenelelo lwezonyango luyimfuneko ukuze umntwana abelekwe ngempumelelo.

Zithini iindlela zonyango zoku?

Ukuba ugqirha ucinga kwangaphambili ukuba usemngciphekweni, nokuba kungenxa yokuba unesifo seswekile okanye ngenxa yokuba umntwana mkhulu kakhulu, angacebisa ukuba kwenziwe utyando kwangethuba (C-section) .

Nangona kunjalo, ukuba umntu obeleka ngesisu uvakalelwa kukuba oku kuyingozi, oogqirha banoluhlu lwezinto abamele bazenze xa kukho imeko engxamisekileyo efana nale.

Xa sele kufunyaniswe ukuba une-dystocia emagxeni, umsebenzi kwigumbi lokubeleka uba nzima ngakumbi . Ugqirha kunye neqela labongikazi baza kusebenzisana ukusebenzisa iindlela ezahlukeneyo zokukhupha umntwana. Basenokuzama ukutshintsha indawo ohlala kuyo ukuze benze indawo engakumbi ye-pelvis yakho, okanye banokuzama ukutshintsha indawo yomntwana ukuze akhulule amahlombe akho.

Indlela ye-HELPERR

Indlela elula ukuyikhumbula esetyenziswa ngoogqirha ngamaxesha anje yi -HELPERR . Unobumba ngamnye kuyo ubonisa into ekufuneka yenziwe.

• H — Uncedo: Ugqirha ucela uncedo kwabanye ngoko nangoko. Usebenzisa uluhlu lokhuseleko olukhankanyiweyo ngaphambili. Ucela uncedo lwengcali yokubulala iintlungu, ingcali yosana olusandul’ ukuzalwa, kunye nabongikazi abongezelelweyo. Ukhawuleza azise izixhobo ezifunekayo kwigumbi.
• E — Vavanya i-episiotomy: Ugqirha uya kugqiba ukuba enze i-episiotomy , umngxuma omncinci phakathi komngxuma welungu lobufazi kunye ne-perineum, ukuze kwandiswe umngxuma welungu lobufazi ukuze kuncedwe ekubelekeni umntwana. Oku kwenziwa kuphela ukuba kufuneka indawo engakumbi yokujikeleza.
• L — Imilenze: Ugqirha wakho angasebenzisa indlela kaMcRoberts . Oku kuquka ukucinezela amathanga akho kunye nesisu sakho. Oku kwenza isinqe sibe buthathaka kwaye sijikeleze kancinci, kwandise indawo.
• P — Uxinzelelo: Ugqirha , uxinzelelo oluphezulu kwesisu.Ungayisebenzisa. Oko kukuthi, ucinezela isisu sakho esisezantsi, ngaphezulu nje kwethambo le-pubic. Oku kubeka uxinzelelo egxalabeni lomntwana, uzama ukumjikelezisa aze amkhuphe.
• E — Faka amaqhinga: Ugqirha unokwenza ujikelezo lwangaphakathi . Oku kuthetha ukuba uza kufaka isandla kwisini aze azame ukujika umntwana.
• R — Susa ingalo engasemva: Ugqirha angasebenzisa indlela yokuphakamisa usana . Oku kuquka ukususa enye yeengalo zomntwana kumjelo wokuzala. Oku kuya kwenza kube lula ukuba amahlombe aphume.
• R — Gingqa isigulane: Ugqirha angasebenzisa indlela yeGaskin , equka ukugingqa ezandleni nasemadolweni akho.

Kwiimeko ezinzima ngakumbi

Kwiimeko ezinzima kakhulu apho ezi ndlela zingasentla zingaphumeleli, ugqirha angasebenzisa ezi ndlela:

• Ukuqhekeka kweClavicle: Ithambo lentamo lomntwana liphulwe ngabom ukuze kukhululwe igxalaba.
• I-Zavanelli maneuver: Intloko yomntwana iphindiselwa esibelekweni kwaye kwenziwa i-cesarean section kwangoko (C-section).
• I-Symphysiotomy: Le yinkqubo eyandisa ukuvulwa kwe-pelvic ngokusika i-cartilage phakathi kwamathambo amabini e-pubic. Ezi ziinkqubo ezingaqhelekanga kakhulu kule mihla.

Zeziphi iingxaki ezinokubangela oku kumama nomntwana?

I-Shoulder Dystocia inokubangela iingxaki kumama nakumntwana ngexesha lokubeleka. Khumbula, ezi zinto azenzeki kuwo wonke umntu , kodwa kulungile ukuba uqaphele.

Iziphumo kumama:

• Ukopha kakhulu emva kokubeleka (Ukopha emva kokubeletha) .
• Ukukrazuka okukhulu kwendawo ephakathi kwelungu lobufazi kunye ne-anus (perineum).
• I-fistula engasemva: Olu lunxibelelwano olungaqhelekanga phakathi kwelungu lobufazi kunye ne-anus.
• Ukuqhambuka kwesibeleko .
• Ukwahlukana kwamathambo e-pubic kwi-pelvis.

Iziphumo kumntwana:

Eyona ngxaki ixhaphakileyo ye-shoulder dystocia kwiintsana yimeko ebizwa ngokuba yi -brachial plexus palsy . I-brachial plexus liqela lemithambo-luvo eqala kumqolo womntwana entanyeni ukuya engalweni. Le mithambo-luvo inika imvakalelo kunye nentshukumo egxalabeni, engalweni, nasesandleni. Ukuba le mithambo-luvo yonakele, ingalo ekwelo cala inokuba buthathaka okanye ide ingasebenzi.

Ezinye iingxaki:

• Ukwaphuka kwethambo lekhola (i-clavicle) lomntwana kunye/okanye ithambo lengalo engentla (i-humerus).
• Isifo sikaHorner: Yimeko engaqhelekanga echaphazela amehlo nobuso bomntwana.
• Intambo yomlomo ecinezelweyo:Intambo yesisu inokubambeka phakathi kwengalo yomntwana kunye nethambo le-pelvic likamama. Oku kunokukhokelela ekunqongophaleni komoya-mpilo kunye nokuhamba kwegazi kumntwana, nto leyo enokubangela umonakalo engqondweni okanye nokufa. Oku kuyinto engaqhelekanga.

Ngubani osengozini enkulu?

I-Shoulder Dystocia inokwenzeka nakubani na . Ihlala ibonakala kwiintsana ezinobunzima obuqhelekileyo bokuzalwa. Nangona kunjalo, kukho izinto ezithile ezibangela umngcipheko okwandisa amathuba okuba nale meko. Makhe sibone ukuba zithini:

• Isifo seswekile: Nokuba unesifo seswekile esele sikhona okanye isifo seswekile sokukhulelwa, umntwana wakho usenokuba mkhulu kancinci. Malunga nama-20% oomama abanesifo seswekile baneentsana ezinobunzima obungaphezulu kweekhilogram ezi-4 (iikhilogram ezi-8, ii-ounces ezili-13).
• IMacrosomia: Oku kuthetha ukuba umntwana unobunzima obungaphezulu kweekhilogram ezi-4 (iikhilogram ezi-8, ii-ounces ezili-13) xa ezalwa. Ukuba umntwana mkhulu kakhulu, ugqirha unokucebisa ukuba abelekwe ngotyando.
• I-Shoulder Dystocia (ebenomntwana ozelwe ngaphambili).
• Ukuthwala amawele okanye abantwana abangaphezulu esibelekweni.
• Ukutyeba kakhulu okanye ukutyeba kakhulu ngexesha lokukhulelwa.
• Ubude obufutshane bukamama.
• Ukuba nesakhiwo esingaqhelekanga kwi-pelvis.
• Ukuba uneminyaka engaphezu kwama-35 ubudala.
• Ukuzalwa komntwana kwenzeka emva komhla wokugqibela.

Ezinye iimeko ngexesha lokubeleka nokuzala nazo zinokunyusa lo mngcipheko. Enye yezona zinto zibalulekileyo kwezi kukuncedisa ekubelekeni , oko kuthetha ukuba ugqirha kufuneka asebenzise i-vacuum extractor okanye i-forceps ukususa umntwana.

Ezinye izinto ezinobungozi:

• Ukunika iyeza elibizwa ngokuba yi -Oxytocin ukuqala ukuzala.
• Ukufumana i- epidural .
• Inqanaba lokuqala lokubeleka (isigaba sokuqunjelwa) lide kakhulu.
• Isigaba sesibini sokubeleka (isigaba sokutyhala) sifutshane kakhulu okanye side kakhulu.
• Ukusebenzisa uxinzelelo okanye iindlela ezingafanelekanga zokutyhala umntwana ukuba aphume.

Ngaba kukho into esinokuyenza ukuthintela oku?

Inyaniso kukuba, kunzima ukuthintela i-shoulder dystocia, ingakumbi ukuba umntwana unobunzima obuqhelekileyo. Oku kwenzeka ngequbuliso. Nangona kunjalo, kukho izinto ezimbalwa onokuzenza ukunciphisa umngcipheko wakho:

• Ukuba unesifo seswekile, silawule kakuhle .
• Gcina ubunzima obusempilweni ngexesha lokukhulelwa.
• Thetha nogqirha wakho uze ubone ukuba ungenza ukuba kube nokwenzeka na ukuba kuzalwe umntwana kwangethuba ukuba kuyimfuneko.
• Ukuba umhla wokugqibela udlulile, yazisa ugqirha wakho ngoko nangoko.
• Xoxa ngotyando lotyando (C-section) nogqirha wakho (ingakumbi ukuba kukho izinto ezinobungozi).
• Cinga kabini ngezinye iipilisi zokuthomalalisa iintlungu ezinikwayo ngexesha lokubeleka, ezifana nee-epidurals (thetha nogqirha wakho ngale nto).

Kuza kwenzeka ntoni emva kwale meko? Liyintoni ikamva?

Usenokuba noloyiko kancinci ukuva oku, kodwa kukho iindaba ezimnandi .

Uphando lubonisa ukuba isiqingatha seentsana ezizalwa zine-Shoulder Dystocia ziqhelekile ngokupheleleyo xa zineenyanga ezintathu ubudala. Xa zineenyanga ezili-18, ama-82% eentsana aphilile ngokupheleleyo.

Ukuba umntwana wakho wenzakele kwi-brachial plexus , isiphumo sihlala silungile. Nangona kunjalo, ezinye iindlela zokungenelela zinokuchaphazela imeko yomntwana yexesha elide. Banokuba nobunzima ngezakhono zokuhamba kakuhle kunye nokusebenzisa ingalo echaphazelekayo. Nangona kunjalo, ngaphezulu kwe-90% yezi nzakala ziphela kwiinyanga ezi-6 ukuya kwezi-12 . Ngaphantsi kwe-10% yamatyala abangela ukukhubazeka okusisigxina.

Ukuba ukhe waba nomntwana one-Shoulder Dystocia, amathuba okuba iphinde yenzeke angama-15%. Ngoko ke ukuba ucinga ngokuba nabantwana abaninzi, thetha nogqirha wakho ngale nto. Ukuba ubelethwe nge-cesarean ngenxa ye-Shoulder Dystocia, ukuzalwa kwesibeleko emva kwe-cesarean (VBAC) akukhuthazwa rhoqo .

I-Shoulder Dystocia yingxaki enokwenzeka ngexesha lokubeleka. Kuqhelekile ukuba uzive uxhalabile malunga nokuba yintoni enokwenzeka ngexesha lokubeleka nokubeletha. Nangona kunjalo, kubalulekile ukukhumbula ukuba ezi meko aziqhelekanga kwaye iqela lakho lezonyango liqeqeshwe kakuhle ukujongana nazo. Ukuba le ngxaki ingaqhelekanga iyenzeka, ungoyiki kwaye ubathembe oogqirha bakho. Baza kwenza konke okusemandleni abo ukugcina wena nomntwana wakho nikhuselekile kwaye bakhuphe umntwana wakho ngaphandle kweengxaki zexesha elide.

Eyona nto ibalulekileyo ekufuneka siyikhumbule (Umyalezo Wokuya Ekhaya)

Ndiyathemba ukuba ngoku uyiqonda ngcono imeko esiyixoxe ngayo namhlanje (i-Shoulder Dystocia). Izinto eziphambili ekufuneka uzikhumbule zezi:

• Le yimeko engxamisekileyo, nangona ingaqhelekanga .
• Uninzi lwexesha, amaqela ezonyango alawula oku kakuhle .
• Nokuba akukho zimpawu zokulumkisa kwangethuba, kubalulekile ukuqaphela izinto ezinokubangela umngcipheko .
• Izinto ezifana nokulawula isifo seswekile kunye nokugcina ubunzima obusempilweni zinokunciphisa umngcipheko kancinci .
• Uninzi lweentsana luyaphila ngokupheleleyo .

Ukuzala yinto emangalisayo. Siyathemba ukuba olu lwazi luya kuba luncedo njengoko ulungiselela olo hambo. Ungaze woyike ukuthetha nogqirha wakho ngayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo. Sikunqwenelela okuhle kodwa wena nomntwana wakho!

"I-Dystocia yamahlombe, ukuzala, ukukrwitshwa komntwana, ukukrwitshwa kwamahlombe, iingxaki zokuzala, ukukhulelwa, iingxaki zokuzala