Isibeletho asifinyeleli kahle ngemva kokuthola umntwana? Ake sixoxe (nge-Uterine Atony)!

Ukuba ngumama kungenye yezinto ezinhle kakhulu nezinomthwalo wemfanelo empilweni. Kodwa-ke, ngale njabulo, ngezinye izikhathi kungavela izinkinga zempilo ezingalindelekile. Namuhla, sizokhuluma ngesimo esibucayi kodwa esingelapheka abanye omama ababhekana naso ngemva kokubeletha. Lokhu kubizwa ngokuthi i-uterine atony, noma ngokwezokwelapha , i-uterine atony .

Kuyini i-Uterine Atony? Kalula nje...

Kalula nje, i-Uterine Atony yilapho isibeletho sakho singanciphi kahle noma siqine kahle ngemva kokubeletha. Ngokuvamile, ngemva kokuzalwa komntwana, isibeletho sincipha kahle futhi silawula ukuphuma kwegazi ngemva kokubeletha. Kodwa-ke, kulesi simo, imisipha yesibeletho ayisebenzi kahle, okusho ukuthi ikhululekile futhi ayiqini kangako. Lokhu kuyingozi kakhulu ngoba kungabangela ukuphuma kwegazi okukhulu okungasongela impilo .

Cabanga ngakho, lapho ingane yakho ikhula ngaphakathi kwesibeletho ngesikhathi sokukhulelwa, ingane ithola lonke igazi, umoya-mpilo, kanye nokudla okudingayo nge-placenta. Kunemithambo yegazi eminingi enikeza igazi kule placenta. Ngemva kokuzalwa kwengane, isibeletho siyafinyela ukuze sikhiphe i-placenta. Uma ifinyela, leyo mithambo yegazi iyaqina futhi iyeke ukopha. Ngakho-ke, uma isibeletho singafinyeli kahle, okungukuthi, uma kukhona (i-uterine atony), leyo mithambo yegazi iqala ukopha njalo. Yilokhu esikubiza ngokuthi ukopha ngemva kokubeletha .

Lesi simo (i-uterine atony) singavela ngemva kokuphuphuma kwesisu noma olunye ukuhlinzwa okubandakanya isibeletho. Singavela ngesikhathi sokubeletha okuvamile kanye nangesikhathi sokubeletha ngokuhlinzwa. Nakuba lesi simo senzeka cishe ku-2% wabo bonke abantwana abazalwa, asihlali sibangela ukopha ngokweqile. Kodwa-ke, lesi yisimo esidinga ukunakekelwa kwezokwelapha okusheshayo. Uma selashwa ngokushesha, kululama ngokuphelele.

Kwenzekani uma isibeletho singafinyeleli ngemva kokubeletha umntwana?

Uma imisipha yesibeletho ingafinyeleli kahle ngemva kokubeletha, usengozini enkulu yokopha. Njengoba sishilo ngaphambili, ngemva kokubeletha, i-placenta idinga ukuhlukana nodonga lwesibeletho. Lokhu kuvula imithambo yegazi lapho. Ukufinyela kwesibeletho kuqinisa leyo mithambo yegazi futhi kumise ukopha. Ngakho-ke, uma imisipha ingafinyeleli kahle, ukopha kuzoqhubeka. Lesi yisimo esiphuthumayo sezokwelapha, njengoba kungaba yingozi empilweni.

Yiziphi izinto ezandisa ingozi yalesi simo?

Kunezici eziningana eziyingozi zokungavuvukali kwesibeletho. Lezi zinto zingaphazamisa ukufinyela kwesibeletho sakho ngemva kokubeletha:

• Uma lona kuyingane yakho yokuqala , noma uma unezingane ezingaphezu kwezinhlanu .
• Uma ulindele amawele, amawele amathathu, noma ngaphezulu .
• Ingane yakhoUma inkulu kunejwayelekile (odokotela bayibiza ngokuthi i -Fetal Macrosomia) .
• Uma uneminyaka engaphezu kwengu-35 ubudala .
• Uma une-amniotic fluid eningi kakhulu (amanzi azungeze umntwana) (lokhu kubizwa ngokuthi i-polyhydramnios) .
• Uma ukhuluphele kakhulu .
• Uma une -uterine fibroids .

Futhi, odokotela bakholelwa ukuthi uma lezi zinto zenzeka ngesikhathi sokubeletha, isibeletho singase singanciphi ngemva kokubeletha:

• Uma ube nezinhlungu zokubeletha ezinde kakhulu , noma uma ubeletha ngokushesha kakhulu .
• Uma ube nokubeletha okunzima .
• Uma umsebenzi wakho ubangelwe .
• Uma uke waba nesimo esibizwa ngokuthi i-Chorioamnionitis (ukutheleleka kwezicubu ezizungezile umntwana).
• Uma unikezwe i-anesthesia ejwayelekile .
• Uma unesibeletho esikhulu .

Okubalulekile: Uma unezici ezingaphezu kwezimbili zalezi zingozi, usengozini enkulu yokuthola i-uterine atony. Odokotela bathola lezo ezisengozini kusenesikhathi futhi benze amalungiselelo adingekayo ngaphambi kokubeletha, ukuze ziqaliswe ngokushesha.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Ukuvaleka kwesibeletho kwenzeka lapho imisipha yesibeletho ingasabeli kahle ku-hormone (i-oxytocin) ekhiqizwa ngumzimba wakho ukuze ivuselele ukufinyela kwesibeletho ngaphambi nangesikhathi sokubeletha. Kalula nje, kunjengokungathi isibeletho "asilaleli."

Ziyini izimpawu zalokhu?

Isibonakaliso esikhulu nesibaluleke kakhulu sokuvaleka kwesibeletho ukuphuma kwegazi okuqhubekayo noma okweqile esibelethweni . Esikhathini esiningi, udokotela wakho uzobona lesi simo ngokushesha nje ngemva kokubeletha umntwana wakho. Ngaphezu kwalokho, ngemva kokubeletha, isibeletho sakho singase sikhululeke, sibe buthaka, futhi singaqini.

Ezinye izimpawu yilezi:

• Umfutho wegazi ophansi .
• Ukushaya Kwenhliziyo Okusheshayo .
• Ukuzizwa unesizungu noma ubuthakathaka .
• Kubukeka kuphaphathekile .
• Ukulahlekelwa ingqondo .
• Ukungakwazi ukuchama .
• Ubuhlungu, ikakhulukazi ubuhlungu bomhlane .

Odokotela bakubona kanjani lokhu?

Odokotela bethu baqeqeshwe ukuxilonga nokwelapha i-Uterine Atony ngokushesha. Lokhu kuvame ukuxilonga ngokuhlola usayizi kanye nokuthamba kwesibeletho sakho ngemva kokubeletha. Udokotela uzobeka isandla esisodwa esiswini sakho bese efaka iminwe yesinye isandla esithweni sakho sangasese ukuze ahlole isibeletho sakho. Abanye odokotela bazolinganisa nama-pad noma i-gauze esetshenziselwa ukumunca igazi ukuze balinganise ukuthi ulahlekelwe yigazi elingakanani.

Uma une-atony yesibeletho, isibeletho sakho sikhulu, sithambile, futhi sibuthakathaka. Ekubelethweni okuvamile, isibeletho kufanele sifinyele (siqine noma siqine) bese siqala ukufinyela ngemva kokuzalwa komntwana.

Njengoba i-uterine atony iyimbangela ehamba phambili yokopha kakhulu ngemva kokubeletha, udokotela wakho uzohlola nalokhu okulandelayo:

• Ingabe kukhona ukudabuka emlonyeni wakho wesibeletho, esithweni sangasese sowesifazane, noma esibelethweni ?
• Ukuthi izingxenye ze-placenta (i-Retained Placental Tissue) zinamathele yini ngaphakathi kwesibeletho.

Udokotela wakho uzoqhubeka nokuqapha umfutho wegazi lakho kanye nesilinganiso senhliziyo yakho ukuze athole izinguquko. Bangase futhi benze ukuhlolwa kwegazi ukuze bahlole inani lamaseli akho abomvu egazi kanye nesici sokujiya kwegazi.

Yiziphi izindlela zokwelapha?

Ukungapheleli kwesibeletho kuyisimo esiphuthumayo, ngakho-ke kudinga isinyathelo esisheshayo eqenjini lakho lezokwelapha. Umgomo oyinhloko wokwelashwa ukumisa ukopha ngokushesha ngangokunokwenzeka nokubuyisela igazi noma uketshezi olulahlekile . Ngisho nangemva kokuba ukopha sekulawulwe, kungadingeka ukuthi ufakwe igazi noma uketshezi lwe-IV ukuze ufake esikhundleni salokho okulahlekile.

Udokotela wakho wezifo zabesifazane uzoqala ukwelashwa ngokuhlikihla isibeletho ukuze sisisize sinciphe ngamandla. Kuye ngokuthi isimo sibucayi kangakanani, lokhu kungasiza ngisho nokwelapha i-atony yesibeletho.

Ngaphezu kokuhlikihla isibeletho ngemva kokubeletha, udokotela wakho angasebenzisa imithi eminingana ukusiza isibeletho sakho sifinyele. Le mithi ihlanganisa:

• (I-Oxytocin) (igama lomkhiqizo i-Pitocin®)
• (Methylergonovine) (igama lomkhiqizo iMethergine®)
• Ama-Prostaglandins , isibonelo i-15-methyl-PGF2 (Hemabate®), i-misoprostol (Cytotec®) noma i-dinoprostone .
• Izinhlobo ze- Ergot Alkaloids , isibonelo (i-Ergometrine) .

Ukucindezela odongeni lwesibeletho (Amasu e-Tamponade)

Udokotela wakho kungadingeka afake ingcindezi eyengeziwe esibelethweni sakho ukuze anciphise inani lokopha. Lezi zindlela zifaka phakathi ukupakisha isibeletho nge-gauze noma ukufaka ibhaluni ngaphakathi kwesibeletho. Ngalezi zindlela, udokotela usebenzisa ingcindezi eqondile odongeni lwesibeletho ukuze amise ukopha.

Ukwelashwa ngokuhlinzwa

Uma zonke ezinye izindlela zehluleka ukuvimba ukuphuma kwegazi, kungase kudingeke ukuhlinzwa. Izinqubo zokuhlinzwa ezisetshenziswa ukwelapha i-uterine atony zifaka:

• (Ukwelashwa Kwesibeletho): Kulokhu, udokotela ukhuhla futhi asuse noma yiziphi izingcezu zegazi noma ze-placenta ezivaleleke ngaphakathi kwesibeletho (okufana ne-D&C).
• Ukubopha Imithambo Yesibeletho: Inqubo ebopha imithambo yegazi ehambisa igazi esibelethweni.
• (Ukuhlanganiswa Kwemithambo Yesibeletho): Inqubo esebenzisa izinhlayiya ezincane ezifana nesihlabathi ukuvimba ukuphuma kwegazi esibelethweni.
• Ukususwa kwesibeletho: Njengendlela yokugcina, uma konke okunye kwehluleka, ukususwa kwesibeletho.

Yiziphi ezinye izinkinga lokhu okungazibangela?

Ukuvuvukala kwesibeletho kungabangela izinkinga ezifana nalezi:

• I-anemia - lokho kusho ukuntuleka kwegazi.
• Ukuzizwa ukhathele kakhulu noma usebenza ngokweqile .
• Ukuzizwa unesizungu noma ubuthakathaka ngenxa yomfutho wegazi ophansi.
• Ingozi ekhulayo yokopha ekukhulelweni kwesikhathi esizayo.

Ingabe lokhu kungavinjelwa?

Esikhathini esiningi, ukuvaleka kwesibeletho akukwazi ukuvinjelwa. Kodwa uma usengozini, udokotela wakho angathatha izinyathelo zokulungiselela ukopha okukhulu. Isibonelo, ukuba nabasizi abengeziwe noma imishini egumbini lokubelethisa, noma ukuthi ubelethe ingane yakho esibhedlela esihlukile, kungasiza. Ungathatha izinyathelo zokuba nokukhulelwa okunempilo. Lokhu kufaka phakathi ukuthatha amavithamini okukhulelwa , ukugcina ama-aphoyintimenti akho okukhulelwa , kanye nokugcina isisindo esinempilo ngesikhathi sokukhulelwa.

Uma uke wopha kakhulu ngesikhathi sokubeletha ngaphambilini, sicela uqiniseke ukuthi wazisa udokotela wakho wezifo zabesifazane kanye nodokotela wezifo zabesifazane ngakho.

Ingabe lokhu kungenzeka futhi?

Yebo, kungenzeka ukuthi ube ne-uterine atony izikhathi ezingaphezu kwesisodwa. Uma uke waba nayo ngaphambili, usengozini enkulu yokuba nayo futhi.

Ekugcineni, kufanele ngikutshele... (Umyalezo Wokuya Ekhaya)

I-atony yesibeletho iyinkinga enkulu engenzeka ngemva kokubeletha. Uma unalesi simo, ithimba lakho lezokwelapha kuzodingeka likuphathe ngokushesha ukuze uvimbele ukuphuma kwegazi ngokweqile. Khuluma nodokotela wakho nge-atony yesibeletho nokuthi usengozini yini yokuyithola. Ukuqaphela izingozi kusenesikhathi kuzokusiza ukuthi ulungele ukwelashwa okuphuthumayo uma kudingeka. Khumbula, ukuqaphela lezi zinto akuyona imbangela yokwesaba, kodwa kuyithuba lokuthola usizo ngokushesha uma kudingeka. Awuwedwa, futhi odokotela bahlala bekulungele ukukusiza.

Ukufinyela Kwesibeletho , Ukuncipha Kwesibeletho, Ukopha Ngemva Kokubeletha, Ukubeletha, Isibeletho, Impilo Yabesifazane, I-Placenta