Uma ulungiselela ukubeletha, ngezinye izikhathi uzizwa wesaba kancane, akunjalo? Ingabe konke kuzolunga, futhi ingabe umntwana uzoba senkingeni? Nakuba ukubeletha kuyinto yemvelo futhi enhle, ngezinye izikhathi kungavela izinkinga ezingalindelekile. Kodwa ungakhathazeki, odokotela nabasebenzi bezokwelapha baqeqeshwe ukubhekana nanoma yisiphi isimo esinjalo. Namuhla, sikhuluma ngendlela ekhethekile nephumelelayo kakhulu esetshenziswa ukuvikela umntwana ngezikhathi ezinjalo.
Kalula nje, iyini i-McRoberts Maneuver?
Cabanga nje, lapho umntwana esezozalwa, ngemva kokuba ikhanda lomntwana liphumile, elinye noma womabili amahlombe abhajwa ngaphakathi kwethanga likamama. Njengokubhajwa ohlakeni lomnyango. Ngenxa yalokhu, umntwana akakwazi ukuphuma ngokuphelele. Lokhu kuyisimo esiphuthumayo. Yilapho odokotela besebenzisa khona le ndlela ebizwa ngokuthi i-McRoberts Maneuver .
Kalula nje, lokhu kuhilela udokotela noma omunye wabasebenzi bezokwelapha abaqeqeshiwe lapho egoba imilenze kamama emadolweni futhi acindezele amathanga akhe ngokuqinile esiswini sakhe. Uma sikhuluma iqiniso, amadolo agobile aze afike cishe emakhwapheni.
Lokhu kubangela ukuthi i-pelvis ijikeleze kancane, ishintshe ukuma kwayo kancane, okuvumela amahlombe omntwana ukuba asuke endleleni. Lesi isenzo esilula esivela ngaphandle, kodwa inqubo ebaluleke kakhulu esiza umntwana ukuba aphume ngaphakathi.
Le ndlela isetshenziswa nini?
Lo mkhuba kaMcRoberts usetshenziswa esimweni esibizwa ngokuthi i-Shoulder Dystocia . Leli igama lezokwelapha kancane, kodwa ngamafuphi, yihlombe lomntwana elibambekayo engikhulume ngalo ekuqaleni.
Kuyini i-Shoulder Dystocia?
Ekubelethweni okuvamile, uma ikhanda lomntwana seliphumile esithweni sangasese sowesifazane, amahlombe aphuma kalula ngokufinyela okulandelayo. Kodwa-ke, ku-Shoulder Dystocia, elinye lamahlombe omntwana (ngokuvamile ihlombe elingaphambili) libhajwa ngemuva kwe-pubic symphysis, etholakala ngaphambili kwe-pelvis kamama. Lokhu kuvimbela wonke umzimba womntwana ukuthi ungaphumi.
Nakuba lokhu kubhekwa njengesimo esiphuthumayo ngesikhathi sokubeletha, asikho isidingo sokwesaba. Ezimweni eziningi, umntwana angasindiswa ngokuphepha ngokungenelela kwezokwelapha.
Ubani osengozini enkulu yokuthola i-Shoulder Dystocia?
Nakuba lesi simo singenzeka kunoma ubani, abanye abantu basengozini enkulu. Kodwa khumbula, ukuba nalezi zici eziyingozi akusho ukuthi uzozithola nakanjani. Futhi, lesi simo singenzeka kumuntu ongenazo lezi zici eziyingozi.
| Isici sengozi | Incazelo elula |
|---|---|
| Ukuba ne-pelvis encane | Amathambo e-pelvis kamama angase abe mancane, okungase kunciphise amathuba omntwana okuphuma. |
| I-Fetal Macrosomia (Isisindo Esikhulu Somntwana) | Uma ingane inesisindo esingaphezu kwamakhilogremu angu-4, amahlombe angase abe banzi. Omama abanesifo sikashukela banamathuba amaningi okuzala izingane ezikhuluphele. |
| Ukuba nomntwana ozelwe enesisindo esiphezulu ekubelethweni kwangaphambilini | Uma uke waba nokuhlangenwe nakho kwangaphambilini, ingozi ingase ibe phezulu kancane futhi. |
| Ukwanda kwesisindo ngesikhathi sokukhulelwa | Ukukhuluphala kukamama nakho kungathinta ukukhuluphala kwengane. |
| Ingane Encane | Lezi zinhlobo zezinkinga zingavela nalapho umntwana ekhwehlela kunokuba aqale ngqo. |
Iphumelela kangakanani le ndlela kaMcRoberts?
Manje ungase uzibuze ukuthi lena yindlela kuphela yokwenza lokhu. Uma wenza i-McRoberts maneuver yodwa, inezinga lempumelelo elingaba ngu- 42% . Lelo iphesenti elihle.
Kodwa-ke, ukuze lokhu kusebenze kangcono, odokotela basebenzisa enye indlela kanye nakho. Kubizwa ngokuthi ingcindezi ye-suprapubic . Okusho ukuthi, ukufaka ingcindezi emnene ngesandla sakho ngaphezu kwethambo le-pubic, ngaphansi kwesisu. Kufana nokucindezela ihlombe elinamathele bese ulikhulula.
Uma lo mkhuba kaMcRoberts kanye nokucindezela kweSuprapubic kwenziwa ndawonye, izinga lempumelelo likhuphuka lifike ku- 90% . Lelo izinga lempumelelo elihle kakhulu, akunjalo? Ngakho-ke lokhu kuyindlela yokwelapha ephumelela kakhulu ye-Shoulder Dystocia.
Kwenzeka kanjani ngempela le nqubo?
Lokhu kwenzeka ngokushesha okukhulu futhi kuhleliwe. Ngokuvamile, esimweni esinjengalesi, kunabantu abaningana abakuzungezile, okuhlanganisa odokotela nabahlengikazi.
Isinyathelo 1: Thola isimo
Okokuqala, udokotela udinga ukuqinisekisa ukuthi lesi yisimo se-Shoulder Dystocia. Ukwazi kanjani lokho?
- Uma ikhanda lomntwana seliphumile, kodwa ingxenye esele yomzimba inamathele ngaphakathi kwesitho sangasese sowesifazane.
- Uma ikhanda lomntwana liphuma futhi umzimba ungaphumi ngemva kwesikhathi esingaphezu komzuzu.
Isinyathelo 2: Ukuletha uMcRoberts endaweni efanele
Uma isimo sesiqinisekisiwe, abasebenzi ababili bezokwelapha bazothatha imilenze yakho, bayigobe emadolweni, bese beyicindezela ngokuqinile ngangokunokwenzeka esiswini sakho. Ngesikhathi esifanayo, bazosusa kancane izinqe zakho (ukukhumula i-hip). Lesi simo sizokwandisa isikhala phakathi kwamathambo akho e-pelvic cishe ngamasentimitha amabili. Sizophinde sinciphise ingemuva le-pelvis yakho (sacrum), okwenza kube lula ukuthi amahlombe engane aphume.
Isinyathelo 3: Ukusebenzisa Ukucindezela Kwe-Suprapubic (uma kudingeka)
Uma ihlombe lomntwana lingasakhululeki ngemva kokuma kukaMcRoberts, omunye udokotela noma umhlengikazi uzosebenzisa isandla sakhe noma isandla sakhe esifakwe enkomishini ukufaka ingcindezi esiswini sakho esingezansi, ngaphezu nje kwethambo le-pubic, phansi nasohlangothini. Lokhu kuzosiza ekusunduzeni ihlombe elinamathele. Lokhu kuvame ukwenziwa ngesikhathi sokusikwa.
Yiziphi izinzuzo zale ndlela?
Kunezinzuzo eziningi zokuphumelela kokwenza uMcRoberts.
- Ukukwazi ukuqhubeka nokubeletha okuvamile: Lokhu kunciphisa isidingo sokuhlinzwa okuphuthumayo (C-section).
- Ukuvimbela ingozi enganeni: Uma ihlombe likhulu kakhulu futhi linamathele, ingane ingaba nezinkinga ezinkulu njengokuphuka kwamathambo engalweni, ukulimala kwemizwa, noma ukuntuleka komoya-mpilo (i-asphyxia). Le ndlela iqeda leyo ngozi.
- Isidingo esinciphile se-episiotomy: Ngezinye izikhathi i-episiotomy iyadingeka. Uma le ndlela iphumelela, leso sidingo singancishiswa.
- Kulula Futhi Kuyashesha: Lena indlela elula futhi ephumelela kakhulu engenziwa ngaphandle, futhi iyindlela yokuqala esetshenziswa ezimweni ze-Shoulder Dystocia.
Ingabe izinkinga zingaba khona?
Uma kwenziwa kahle odokotela abaqeqeshiwe, izinkinga ezinkulu azivamile. Okubaluleke kakhulu, iziqondiso zamanje zithi ikhanda lomntwana akufanele lidonswe noma intamo ijijeke . Odokotela bayazi ukuthi ukwenza kanjalo kungalimaza intamo noma umgogodla womntwana. Yingakho beqikelela kakhulu kulokhu.
Akuvamile kakhulu, le nqubo ingabangela ukuhlukana kwesinqe noma i-neuropathy emilenzeni kamama. Kodwa-ke, lokhu akuvamile kakhulu futhi kuvame ukuba okwesikhashana.
Kwenzekani ngemva kokuba le ndlela isiphumelele?
Ngemva kokwenza uMcRoberts ngendlela ephumelelayo, ingane yakho izozalwa ngokuphephile ngesitho sangasese sowesifazane. Uma le ndlela yenziwe kahle, kanye nokucindezeleka kwesisu, amathuba okubeletha okuvamile aphezulu kakhulu.
Le nqubo ingaba yinto engakhululekile kumama. Kodwa into ebaluleke kakhulu ngaleso sikhathi ukuphepha komntwana, ngakho-ke kubalulekile ukulalela okushiwo ngabasebenzi bezokwelapha futhi uhlale uzolile. Ekugcineni, kufanelekile ukubamba umntwana onempilo.
Umlayezo Wokuya Nawe Ekhaya
- I-McRoberts Maneuver iyindlela ekhethekile nelula esetshenziswayo uma ihlombe lomntwana libhajwa ngesikhathi sokubeletha (Shoulder Dystocia).
- Lapha, ngokucindezela amathanga kamama esiswini sakhe, i-pelvis iyavuleka futhi umntwana uvunyelwe ukuphuma.
- Lokhu kusebenza kahle kakhulu (cishe u-90%) uma kusetshenziswa kanye nomfutho wegazi ophakeme.
- Lena inqubo ephephile eyenziwa odokotela abaqeqeshiwe, futhi umgomo oyinhloko ukubeletha umntwana ngokuphephile ngaphandle kokulimaza umama noma umntwana.
- Uma unenkinga noma ukwesaba ngalokhu, khuluma nodokotela wakho ukuze uthole ulwazi olwengeziwe.
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