Kumama okhulelwe, ukubeletha kuyisikhathi sethemba elikhulu kanye nokwesaba okuncane. Wonke umuntu unethemba lokuthi konke kuzohamba kahle futhi uzokwazi ukubamba umntwana onempilo ezandleni zakhe. Esikhathini esiningi, konke kuhamba ngohlelo, kodwa ngezinye izikhathi kungavela izimo eziphuthumayo ezincane. Kodwa ungakhathazeki, odokotela nabahlengikazi abazokunakekela wena nomntwana wakho baqeqeshwe futhi bakulungele konke lokhu. Namuhla, sizokhuluma ngenqubo ekhethekile esetshenziswa esimweni esinjalo.
Iyini ngempela i-McRoberts Maneuver?
Kalula nje, i-McRoberts Maneuver iyindlela ekhethekile esetshenziswa ngesikhathi sokubeletha ukukhulula ihlombe lomntwana noma amahlombe womabili lapho ebhajwa ethangeni likamama. Cabanga ukuthi yize ikhanda lomntwana liphuma esithweni sangasese sowesifazane, umzimba wonke uyalibaziseka. Lokho kungenxa yokuthi ihlombe lomntwana libhajwe.
Ngalesi sikhathi, udokotela noma umbelethisi uzogoba imilenze yakho emadolweni bese eyicindezela ngokuqinile esiswini sakho. Lokhu kunyakaza kuzoshintsha kancane indawo yethambo lakho le-pelvic, okwenza kube lula ngengane ukuphuma endaweni lapho ibambeke khona. Nakuba lokhu kuyisenzo esilula esivela ngaphandle, kuzosiza ingane ukuthi iphume ngaphakathi.
Kusho ukuthini 'ukuqina kwamahlombe'? Ingabe lokho kusho i-Shoulder Dystocia?
Yebo, kunjalo. Ngokwezokwelapha, lokhu sikubiza ngokuthi i-Shoulder Dystocia . Ekubelethweni okuvamile, ngemva kokuba ikhanda lomntwana liphumile, amahlombe aphuma kalula. Kodwa ngezinye izikhathi ihlombe elilodwa noma womabili angabhajwa ngemuva kwe-pubic symphysis , lapho kuhlangana khona amathambo amabili angaphambili esinqe sikamama.
Lokhu kungaba yisimo esibucayi. Ngenxa yokuthi umzimba womntwana uyaphuza ukuphuma, umntwana angase aswele umoya-mpilo. Kodwa into ebalulekile ukuthi ezimweni eziningi, umntwana angasindiswa ngaphandle kokulimala ngenxa yesenzo esisheshayo sodokotela. I-McRoberts maneuver iyindlela yokuqala nephumelela kakhulu esetshenziswa esimweni esinjalo.
Udokotela uzoxilonga i-Shoulder Dystocia uma:
- Uma ikhanda lomntwana liphumile esithweni sangasese sowesifazane, kodwa ingxenye esele yomzimba ingaphumi ngemva komzuzu.
- Uma ikhanda lomntwana libonakala liphuma bese libuyela emuva kancane (lokhu kubizwa ngokuthi 'uphawu lwefudu').
Ubani osengozini enkulu yalokhu?
Nakuba kunzima ukukhomba imbangela eqondile ye-Shoulder Dystocia, abanye abantu basengozini enkulu yokuba nayo. Kodwa-ke, khumbula ukuthi lesi simo singavela ngisho nakubantu abangenazo lezi zici eziyingozi. Futhi akubona bonke abanalezi zici eziyingozi abazoyithola.
| Isici Sengozi | Incazelo elula |
|---|---|
| I-pelvis encane | Uma iphansi le-pelvic likamama lincane uma liqhathaniswa, kungase kungabi nendawo eyanele yokuba umntwana aphume. |
| I-Fetal Macrosomia (Isisindo Esikhulu Somntwana) | Ngokuvamile, uma ulindele umntwana onesisindo esingaphezu kwamakhilogremu angu-4, kunethuba elikhulu lokuthi abhajwe ngenxa yamahlombe amakhulu. |
| Ukuba nomntwana ozelwe enesisindo esiphezulu ekubelethweni kwangaphambilini | Uma kube nomlando wokuba nomntwana okhuluphele ngokweqile, kungenzeka ukuthi kuzophinde kwenzeke. |
| Ukwanda kwesisindo ngesikhathi sokukhulelwa | Ukwanda kwesisindo okungalawulwa kumama nakho kungathinta ukwanda kwesisindo somntwana. |
| Isifo sikashukela | Omama abanesifo sikashukela sokukhulelwa banamathuba amaningi okuzala izingane ezikhuluphele ngokweqile. |
Iphumelela kangakanani i-McRoberts Maneuver?
Le ndlela iphumelela kakhulu. Uma ukunyakaza kukaMcRoberts kwenziwa kodwa, kuba nezinga lempumelelo elingaba ngu-42% .
Kodwa kukhona enye indlela esetshenziswa kanye nalokhu. Ibizwa ngokuthi i-Suprapubic Pressure . Lokhu kusho ukuthi udokotela noma umhlengikazi ucindezela ngesandla sakhe, ngaphansi kwenkinobho yesisu sakho, ngaphezu kwethambo lakho le-pelvic. Lokhu kucindezela kusetshenziselwa ukusunduza ihlombe lomntwana elibambekile bese elikhulula.
Into ebalulekile ukuthi uma zombili i-McRoberts Maneuver kanye ne-Suprapubic Pressure zisetshenziswa ndawonye,Izinga lempumelelo lifinyelela ku-90%! Lokhu kukhombisa ukuthi le ndlela iwusizo kangakanani.
Kwenzekani uma wenza lokhu?
1. Ukuxilongwa: Okokuqala, udokotela uyaqinisekisa ukuthi lesi yisimo esibizwa ngokuthi i-Shoulder Dystocia.
2. Ukulungisa isimo: Ngokuvamile abantu ababili (odokotela, abahlengikazi) bazogoba imilenze yakho emadolweni bese beyicindezela eduze kwesisu sakho ngangokunokwenzeka. Ungase uzizwe ungakhululekile okwamanje, kodwa lokhu kwenzelwa ukusindisa ingane, ngakho-ke bekezela.
3. Ukufaka ingcindezi (uma kudingeka): Ngesikhathi esifanayo, omunye umuntu ufaka ingcindezi ye-suprapubic esiswini esivela phezulu.
4. Ukubeletha umntwana: Le nqubo yandisa isikhala ngaphakathi kwe-pelvis, ikhulule ihlombe elibambekile, futhi ivumela wonke umzimba womntwana ukuba uphume ngesitho sangasese sowesifazane.
Yiziphi izinzuzo zale ndlela?
I-McRoberts Maneuver inezinzuzo eziningana ezibalulekile:
- Ukukwazi ukubeletha ngendlela evamile: Lokhu kunciphisa isidingo sokuhlinzwa okuphuthumayo (C-section) .
- Ukunciphisa umonakalo ongaba khona enganeni: Ukushayeka kwamahlombe kunciphisa kakhulu ingozi yezinkinga ezinkulu njengokuphuka kwamathambo engalweni yengane, ukulimala kwemizwa , noma ukuntuleka komoya-mpilo (i-asphyxia) .
- Ingozi yokulimala kumama incishisiwe: Ingozi yokudinga i -episiotomy (ukusikwa phakathi kwesitho sangasese sowesifazane nendunu) incishisiwe.
- Kulula futhi kuyashesha: Lena indlela elula kakhulu engenziwa ngokushesha, ngaphandle kwemishini.
Ingabe lokhu kungabangela izinkinga?
Uma le ndlela yenziwe kahle, izinkinga azivamile. Umthetho obaluleke kakhulu ukuthi ungalokothi udonse ikhanda lomntwana. Ukwenza kanjalo kungalimaza intamo noma umgogodla womntwana. Ithimba lezokwelapha elinekhono liyakwazi lokhu kahle kakhulu.
Akuvamile kakhulu, umama angase abe neqhubu ethangeni noma i-neuropathy yesikhashana emilenzeni. Kodwa-ke, lokhu akuvamile kakhulu.
Ngemva kokwenza i-McRoberts Maneuver ngempumelelo, ingane yakho izalwa iphilile futhi ngokuvamile idlula esithweni sangasese sowesifazane. Udokotela uzobe esehlola ingane ngokucophelela ukuqinisekisa ukuthi akukho monakalo ehlombe noma engalweni. Esikhathini esiningi, konke kuhamba kahle.
Umlayezo Wokuya Nawe Ekhaya
- I-McRoberts Maneuver iyindlela elula, ephephile, futhi ephumelela kakhulu esetshenziselwa ukukhulula ihlombe lomntwana ngesikhathi sokubeletha (Shoulder Dystocia).
- Lokhu kuhilela ukucindezela imilenze kamama esiswini sakhe, ukwandisa isikhala esinqeni kanye nokwenza indlela yokuba umntwana aphume.
- Uma isetshenziswa kanye nendlela ye-Suprapubic Pressure, izinga layo lempumelelo likhuphuka lifike ku-90%.
- Ngisho noma lokhu kuyisimo esiphuthumayo, asikho isidingo sokwesaba njengoba ithimba lakho lezokwelapha liqeqeshwe kahle ngezinto ezinjalo.
- Nakuba kunezici eziyingozi ze-Shoulder Dystocia, izinto eziningi zingaphathwa ngokukhuluma nodokotela wakho ngakho kusenesikhathi nangokulandela imiyalelo edingekayo.
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