Njengoko usondela esiphelweni sokukhulelwa kwakho, umntwana wakho ngoku mkhulu kakhulu. Ngoko ke akanandawo ingako yokuhambahamba njengangaphambili. Kule ndawo, uninzi lweentsana luba kwimeko yentloko ezantsi, lulungiselela ukuzalwa. Ngexesha lokubeleka, bangena entloko yomjelo wokuzalwa kuqala. Kodwa ngamanye amaxesha, intloko yomntwana ingaba phezulu kwaye ezantsi kunye nemilenze isezantsi. Oku sikubiza ngokuba " lusana olungasemva." Kukho iingozi ezithile zokuzala umntwana ngale ndlela, ngoko ke kufuneka ulumke ngakumbi.
Kuthetha ukuthini xa umntwana ekwimo yokurhoxa?
Ngamafutshane, uninzi lweentsana luzalwa iintloko zazo zijonge phantsi. Le ndawo yaziwa ngokwezonyango ngokuba yi-"Vertex Presentation". Le yeyona ndawo ikhuselekileyo nelula yokuzalwa okuqhelekileyo (kwisitho sangasese sowesifazane).
Kodwa xa umntwana elele phantsi, imilenze okanye amazantsi omntwana ajonge kumjelo wokuzala. Emva koko, imilenze yomntwana iphuma kuqala, emva koko umzimba, ize ekugqibeleni intloko iphume. Oku kunzima ngakumbi kugqirha wakho wokuzala kunye nogqirha wezifo zabesifazane. Kwaye iingozi kuwe nakumntwana ziphezulu kancinci kunokuba zinjalo xa ubeleka ngendlela eqhelekileyo.
Kodwa khumbula oku, ukuba umntwana uzelwe ngokukhuselekileyo ekwimo yokukhwehlela, akayi kuba neengxaki ngexesha lobuntwana bakhe. Uphuhliso lwakhe, ubukrelekrele bakhe, kunye nempilo yakhe yonke ayizukuchaphazeleka kukuzalelwa kule ndawo.
Ukongeza kwezi ndawo zimbini, ngamanye amaxesha abantwana banokulala ngokuthe tye ngaphakathi kwesibeleko. Oku kubizwa ngokuba yi-"Transverse Lie". Kwiimeko ezinjalo, utyando lwe-cesarean luhlala luyimfuneko.
Kutheni ezinye iintsana zinje? Zithini izizathu?
Kuqhelekile ukuba iintsana zibe kwindawo yokuqhoqhoqho kwiiveki zokuqala zokukhulelwa. Nangona kunjalo, kwiiveki ezingama-36-37, yi-96% kuphela yeentsana eziza kujika intloko yazo ijonge phantsi. Ukuba azenzi njalo, yipesenti encinci kuphela, malunga ne-3%-4%, eza kuhlala kwindawo yokuqhoqhoqhoqho kude kube sekupheleni kokukhulelwa.
Kudla ngokuba nzima ukukhomba isizathu esithile sokuba umntwana angajiki. Kusenokuba yinto eyenzekileyo ngengozi. Kodwa kukho izinto ezininzi ezibangela ukuba umntwana azalwe enomqala.
| Isizathu | Ingcaciso elula |
|---|---|
| Ukukhulelwa kokuqala | Ukuba ngumntwana wakho wokuqala, kusenokwenzeka ukuba ukhulelwe. |
| Ubungakanani bamanzi esibelekweni | Ulwelo oluncinci kakhulu (oligohydramnios) okanye oluninzi kakhulu (polyhydramnios) lwe-amniotic olujikeleze umntwana lunokuthintela umntwana ekujikeni kakuhle okanye luvumele indawo eninzi kakhulu. |
| I-Placenta Previa | Xa i-placenta ikwizantsi lesibeleko, ivala indawo yokuba umntwana abeke intloko yakhe phantsi. |
| Amawele okanye ngaphezulu | Ngenxa yokuba kukho indawo encinci xa kukho abantwana abangaphezu komnye esibelekweni, umntwana omnye okanye ngaphezulu basenokuba kwindawo yokuqhobosha isisu. |
Uziva njani xa umntwana ekwimo yokurhoxa kwesisu?
Ezinye iimpawu zakho zokukhulelwa (umz., ukuhlanza, isicaphucaphu) aziyi kutshintsha ukuba umntwana wakho ukwimeko yokurhoxa. Nangona kunjalo, ungaziva imilenze yomntwana wakho ikhaba esiswini sakho esisezantsi . Ungaziva neqhuma eliqinileyo, elingqukuva esiswini sakho esingaphezulu, ngaphantsi nje kwembambo yakho . Yintloko yomntwana wakho leyo.
Ugqirha wakho uza kufumana umbono olungileyo wendawo yomntwana ngokuziva isisu sakho, kodwa kungcono ukuqinisekisa oku nge-ultrasound scan .
Ngaba umntwana angajikwa? (Inguqulelo yeCephalic yangaphandle - ECV)
Ewe, ikho indlela yokwenza oko. Malunga neeveki ezingama-36 zokukhulelwa kwakho, ugqirha wakho angacebisa inkqubo ebizwa ngokuba yi-" External Cephalic Version (ECV)". Ngamafutshane, oku kuquka ukuba ugqirha abeke izandla zakhe esiswini sakho aze ajikelezise umntwana ngononophelo, ezama ukumthoba intloko.
Usenokuziva ungakhululekanga xa usenza oku, kodwa yindlela ekhuselekileyo kakhulu kumntwana. Ngamanye amaxesha ungathatha amayeza ukuze uphumze isibeleko sakho. Oku kuya kwenza kube lula ukujika umntwana. Le yindlela ephumelela malunga ne-50%. Oku kuthetha ukuba umntu omnye kwabababini abayenzayo uya kukwazi ukujika umntwana. Ukuba oku kuphumelele, uya kuba nethuba lokubeleka umntwana ngokwesiqhelo.
Nangona i-ECV iyinkqubo ekhuselekileyo, kukho iimeko ezingaqhelekanga (malunga ne-1 kwi-200) zeengxaki. Umzekelo, ukuba kukho ukopha okuncinci kwi-placenta okanye ukubetha kwentliziyo yomntwana akuhambelani kakuhle, kunokufuneka ukuba kwenziwe i-cesarean section engxamisekileyo. Ke ngoko, i-ECV yenziwa kuphela esibhedlele esinazo zonke izibonelelo ezifunekayo zotyando olungxamisekileyo.
Ubeleka njani umntwana xa ephuma isisu?
Okwangoku, uneendlela ezimbini onokukhetha kuzo. Enye kukwenza utyando lotyando olucwangcisiweyo . Enye kukuzama ukuzala ngesisu esingaphantsi kwesibeleko . Kufuneka uxoxe nogqirha wakho ngale nto kwangethuba uze wenze isigqibo.
Ngokuqhelekileyo, utyando lotyando olucwangcisiweyo luthathwa njengolona khetho lukhuselekileyo kumntwana okhulelweyo.
Ukuba uzala ngendlela eqhelekileyo (Vaginal Breech Delivery)
Oku kufana kakhulu nokuzala okuqhelekileyo. Akukho mahluko mkhulu kwiindlela zokusebenzisa iintlungu kunye namayeza. Nangona kunjalo, olu vavanyo lwenziwa kuphela esibhedlele esinezixhobo zokwenza utyando olungxamisekileyo lotyando nangaliphi na ixesha . Kuba, nokuba kucetywa ukuzala kwisini, malunga nama-40% eentsana ezisandul’ ukubeleka kufuneka zenziwe utyando olungxamisekileyo ngomzuzu wokugqibela. Kwakhona, ugqirha wezingane ngokuqinisekileyo ukhona xa umntwana ezalwa.
Nangona kunjalo, kwiimeko ezilandelayo, ugqirha wakho unokucebisa ukuba ungazami ukuzala ngesisu:
- Ukuba imilenze yomntwana omnye okanye yomibini isezantsi kuneempundu (ibhulukhwe yeenyawo).
- Ukuba umntwana mkhulu okanye mncinane kunesiqhelo.
- Ukuba intloko yomntwana ityekele ngasemva (hyperextension).
- Ukuba i-placenta isezantsi, ibizwa ngokuba yi-``Placenta Previa```.
- Ukuba unezinye iingxaki ngexesha lokukhulelwa, umzekelo, iimeko ezifana ne-"Pre-eclampsia".
Ukuba umntwana uzalwe nge-cesarean section (iCandelo eliCwangcisiweyo lokuKhulisa umntwana)
Amaxesha amaninzi, ugqirha wakho uya kukucebisa ukuba wenze utyando lotyando olucwangcisiweyo kwiiveki ezingama-39. Ngelo xesha, imiphunga yomntwana ikhule ngokupheleleyo. Utyando olucwangcisiweyo lukhuselekile kumntwana kunotyando olwenziwa emva kokuba eqalile ukuzala.
Khawuthelekelele ukuba uza kuhlinzwa ngaloo mini, kodwa ngaphambi koko uqale ukuba nesifo sorhudo. Ukuba oko kuyenzeka , kuya kufuneka uye esibhedlele ngoko nangoko.Ugqirha uza kukuxilonga. Ngamanye amaxesha, ukuba usekude kakhulu ekubelekeni kwaye umntwana usondele kakhulu ekuzalweni, banokugqiba kwelokuba ukuzala okuqhelekileyo kukhuselekile kunokubeletha ngotyando ngelo xesha.
Nangona utyando olucwangcisiweyo lukhuselekile kumntwana, kukho iingozi ezithile kuwe, mama . Ezi ziquka:
- Ukopha ngaphezu kwesiqhelo
- Amahlwili egazi emilenzeni
- Usulelo lwenxeba ngotyando
- Ukonakala kwenkqubo yomchamo ngexesha lotyando
- Amathuba aphezulu okuba kwenziwe utyando lotyando xa ukhulelwe kwixesha elizayo
Ziziphi iingozi ezikhethekileyo zokuzalwa komntwana emva kokuzala?
Eyona nxalenye inkulu yomzimba womntwana yintloko. Ukuba intloko ayikwazi ukuphuma ngexesha lokubeleka okuqhelekileyo (intloko iyaphuma), utyando lunokufuneka ngoko nangoko. Nangona kunjalo, ekubelekeni okunomqala, intloko yomntwana inokubhajwa ngaphakathi emva kokuba umzimba wonke uphumile . Le yimeko eyingozi kakhulu.
Kule ndawo, intambo yomntwana inokunyanzeliswa, ithintele igazi kunye nomoya-mpilo womntwana . Oku kunokubangela umonakalo engqondweni kwimizuzu embalwa.
Enye into kukuba, ukuba amanzi akho ayaphuka ngaphambi kokuba umntwana aqale ukuzala, intambo yosana ingaphuma ngaphambi kokuba umntwana abeleke. Oku kukwayinto engxamisekileyo.
Okokugqibela, iintsana ezizalelwe kwindawo yokuhluma kwesisu zisengozini enkulu yokuba nesiphene sokuzalwa kwithambo lesinqe (Developmental Dysplasia of the Hip - DDH). Le yimeko apho ithambo lesinqe lingalungelelani kakuhle. Ke ngoko, ezi zingane zihlolwa le meko ngokuskena indawo yesinqe nge-ultrasound kwiiveki ezi-4-6 emva kokuzalwa.
Umyalezo Wokuya Ekhaya
- Kuqhelekile ukuba umntwana abe nesisu esibuhlungu kwasekuqaleni kokukhulelwa. Uninzi lweentsana luza kujika iintloko zijonge phantsi ekupheleni kokukhulelwa.
- Ukuba umntwana akajiki, ungazama ukumjikisa umntwana ngaphandle usebenzisa i-ECV malunga neeveki ezingama-36. Thetha nogqirha wakho ngale nto.
- Utyando lotyando olucwangcisiweyo luthathwa njengendlela ekhuselekileyo yokuzala umntwana okhulelweyo, kodwa kwezinye iimeko, ukuzala ngesisu kukwacingelwa.
- Xoxa ngononophelo nogqirha wakho wezifo zabesifazane kunye nogqirha wezifo zabesifazane ukuba yeyiphi indlela efanelekileyo nekhuselekileyo kuwe nakumntwana wakho.
- Qinisekisa ukuba isibhedlele osikhethileyo sokubeleka sinazo zonke izibonelelo ezifunekayo xa kusenziwa utyando olungxamisekileyo kunye neyunithi yabantwana.
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