Njengoba usondela ekupheleni kokukhulelwa kwakho, ingane yakho isikhule kakhulu. Ngakho-ke ayinaso isikhala esiningi sokuhambahamba njengakuqala. Kuleli qophelo, iningi lezingane lisuke lisesimweni sokubheka phansi, lilungiselela ukuzalwa. Ngesikhathi sokubeletha, zingena ekhanda lomsele wokuzalwa kuqala. Kodwa ngezinye izikhathi, ikhanda lomntwana lingaba phezulu kanti phansi kanye nemilenze iphansi. Lokhu sikubiza ngokuthi " ingane ebheke phansi." Kunezingozi ezithile zokubeletha umntwana ngale ndlela, ngakho-ke udinga ukuqaphela kakhulu.
Kusho ukuthini uma umntwana esesimeni sokukhwehlela?
Kalula nje, iningi lezingane lizalwa amakhanda alo ebheke phansi. Lesi simo saziwa ngokwezokwelapha ngokuthi ``Vertex Presentation''. Lesi yisimo esiphephile nesilula kakhulu sokuzalwa okuvamile (kwesitho sangasese sowesifazane).
Kodwa esimweni sokuvula isifuba, iphansi noma imilenze yomntwana ibheke emgudwini wokubeletha. Bese kuthi iphansi lomntwana liphume kuqala, bese kuba umzimba, bese kuba yikhanda ekugcineni. Lokhu kuyinselele kakhulu kudokotela wakho wezifo zabesifazane kanye nodokotela wezifo zabesifazane. Futhi izingozi kuwe nakumntwana ziphakeme kancane kunokubeletha okuvamile.
Kodwa khumbula nalokhu, uma umntwana ezalwa ephephile ephethe isisu, ngeke abe nezinkinga ngesikhathi esemncane. Intuthuko yakhe, ubuhlakani bakhe, kanye nempilo yakhe yonke ngeke kuthinteke ngokuzalelwa kulesi sikhundla.
Ngaphezu kwalezi zikhundla ezimbili, ngezinye izikhathi izingane zingalala zivundlile ngaphakathi kwesibeletho. Lokhu kubizwa ngokuthi "i-Transverse Lie". Ezimweni ezinjalo, ukuhlinzwa kwesisu cishe njalo kuyadingeka.
Kungani ezinye izingane zinjalo? Yiziphi izizathu?
Empeleni kuvamile ukuthi izingane zibe sesimweni sokufutha isisu emavikini okuqala okukhulelwa. Kodwa-ke, emavikini angu-36-37, ama-96% kuphela ezinsana azophenduka amakhanda ngokwemvelo. Uma zingakwenzi lokho, iphesenti elincane kuphela, cishe u-3%-4%, elizohlala esimweni sokufutha isisu kuze kube sekupheleni kokukhulelwa.
Ngokuvamile kunzima ukukhomba isizathu esithile sokuthi kungani umntwana engaphendukanga. Kungaba yingozi. Kodwa kunezici eziningana ezandisa amathuba okuzalwa kwesisu.
| Isizathu | Incazelo elula |
|---|---|
| Ukukhulelwa kokuqala | Uma kungumntwana wakho wokuqala, kungenzeka kakhulu ukuthi usesimeni sokukhwehlela. |
| Inani lamanzi esibelethweni | Uketshezi oluncane kakhulu (i-oligohydramnios) noma oluningi kakhulu (i-polyhydramnios) oluzungeze umntwana lungavimbela umntwana ukuthi aphenduke kahle noma luvumele isikhala esiningi kakhulu. |
| I-Placenta Previa | Uma i-placenta itholakala phansi kwesibeletho, ivala isikhala sokuba umntwana abeke ikhanda lakhe phansi. |
| Amawele noma ngaphezulu | Ngenxa yokuthi isikhala sincane uma kunezingane ezingaphezu kweyodwa esibelethweni, ingane eyodwa noma ngaphezulu ingaba sesimweni sokukhwehlela isisu. |
Uzizwa kanjani uma umntwana esesimweni sokukhwehlela?
Ezinye izimpawu zakho zokukhulelwa (isib. ukuhlanza, isicanucanu) ngeke zishintshe uma ingane yakho isesimweni sokukhwehlela. Kodwa-ke, ungase uzizwe imilenze yengane yakho ikhahlela esiswini sakho esingezansi . Ungase uzizwe neqhubu eliqinile, eliyindilinga esiswini sakho esingenhla, ngaphansi nje kwekheji lakho lezimbambo . Lelo ikhanda lengane yakho.
Udokotela wakho uzothola umbono omuhle ngesimo sengane ngokuzwa isisu sakho, kodwa kungcono ukuqinisekisa lokhu nge-ultrasound scan .
Ingabe ingane ingaphendulwa? (Inguqulo Yangaphandle Ye-Cephalic - ECV)
Yebo, ikhona indlela yokwenza lokhu. Cishe emavikini angu-36 okukhulelwa kwakho, udokotela wakho angase asikisele inqubo ebizwa ngokuthi "i- External Cephalic Version (ECV)". Kalula nje, lokhu kuhilela ukuthi udokotela abeke izandla zakhe esiswini sakho bese ephendula ingane ngokucophelela, ezama ukuyibuyisela phansi.
Ungase uzizwe ungakhululekile kancane lapho wenza lokhu, kodwa kuyindlela ephephile kakhulu enganeni. Ngezinye izikhathi ungathatha nomuthi wokukhulula isibeletho sakho. Lokhu kuzokwenza kube lula ukujikisa ingane. Lena inqubo enezinga lempumelelo elingaba ngu-50%. Lokhu kusho ukuthi umuntu oyedwa kwababili abakwenzayo uzokwazi ukujikisa ingane. Uma lokhu kuphumelele, uzothola ithuba lokubeletha ingane ngendlela evamile.
Nakuba i-ECV iyinqubo ephephile, kunezimo ezingavamile (cishe eyodwa kwezingu-200) zezinkinga. Isibonelo, uma kukhona ukopha okuncane okuvela ku-placenta noma ukushaya kwenhliziyo kwengane kungajwayelekile, kungadingeka ukuhlinzwa okuphuthumayo. Ngakho-ke, i-ECV yenziwa kuphela esibhedlela esinazo zonke izinsiza ezidingekayo zokuhlinzwa okuphuthumayo.
Ubeletha kanjani umntwana uma ephuma esiswini?
Kuleli qophelo, unezinketho ezimbili. Okokuqala ukuba nokuhlinzwa okuhleliwe . Okunye ukuzama ukubeletha ngesisu esivulekile . Kufanele uxoxe ngalokhu nodokotela wakho kusenesikhathi bese uthatha isinqumo.
Ngokuvamile, ukuhlinzwa kokubeletha okuhleliwe kubhekwa njengendlela ephephile kakhulu yomntwana okhulelwe.
Uma ubeletha ngendlela evamile (Vaginal Breech Delivery)
Lokhu kufana kakhulu nokubeletha okuvamile. Akukho mehluko omkhulu ezindleleni zokusebenzisa imithi yobuhlungu nemithi. Kodwa-ke, lo mzamo wenziwa kuphela esibhedlela esinezindawo zokwenza ukuhlinzwa okuphuthumayo nganoma yisiphi isikhathi . Ngoba, noma ngabe ukubeletha kuhlelwa, cishe u-40% wezingane ezine-breech kufanele zihlinzwe ngokuphuthumayo ngomzuzu wokugcina. Futhi, udokotela wezingane ukhona lapho umntwana ezalwa.
Kodwa-ke, ezimweni ezilandelayo, udokotela wakho angase akucebise ukuthi ungazami ukubeletha ngesitho sangasese sowesifazane:
- Uma imilenze yomntwana eyodwa noma yomibili iphansi kunezinqe (ibhulukwe lezinyawo).
- Uma ingane inkulu noma incane kunejwayelekile.
- Uma ikhanda lomntwana libheke emuva (hyperextension).
- Uma i-placenta iphansi, ibizwa ngokuthi ``Placenta Previa``.
- Uma unezinye izinkinga ngesikhathi sokukhulelwa, isibonelo, izimo ezifana ne-"Pre-eclampsia".
Uma umntwana ebelethwe ngokuhlinzwa (Isigaba Sokuhlinzwa Esihleliwe)
Ngokuvamile, udokotela wakho uzokweluleka ukuthi wenze ukuhlinzwa okuhleliwe emavikini angu-39. Ngaleso sikhathi, amaphaphu engane asuke esekhule ngokugcwele. Ukuhlinzwa okuhleliwe kuphephile enganeni kunokuhlinzwa okwenziwa ngemva kokuqala kokubeletha.
Ake sithi uhlelelwe ukuhlinzwa ngalolo suku, kodwa ngaphambi kwalokho uqala ukuba nesifo sohudo. Uma lokho kwenzeka , udinga ukuya esibhedlela ngokushesha.Udokotela uzokuxilonga. Ngezinye izikhathi, uma usekude kakhulu nesikhathi sakho sokubeletha futhi umntwana eseseduze kakhulu nokuzalwa, bangase banqume ukuthi ukubeletha okuvamile kuphephile kunokubeletha ngokuhlinzwa ngaleso sikhathi.
Nakuba ukuhlinzwa okuhleliwe kuphephile enganeni, kunezingozi ezithile kuwe, mama . Lokhu kufaka phakathi:
- Ukopha kakhulu kunokujwayelekile
- Amahlule egazi emilenzeni
- Ukutheleleka kwenxeba lokuhlinzwa
- Ukulimala ohlelweni lomchamo ngesikhathi sokuhlinzwa
- Amathuba aphezulu okuthi kudingeke kwenziwe ukuhlinzwa kokubeletha esikhathini esizayo
Yiziphi izingozi ezikhethekile zokuzalwa kwesisu?
Ingxenye enkulu yomzimba womntwana yikhanda. Uma ikhanda lingakwazi ukuphuma ngesikhathi sokubeletha okuvamile (ikhanda liyaphuma), kungadingeka ukuhlinzwa ngokushesha. Kodwa-ke, ekubelethweni kwesisu, ikhanda lomntwana lingabhajwa ngaphakathi ngemva kokuba umzimba wonke uphumile . Lesi yisimo esiyingozi kakhulu.
Kuleli qophelo, intambo yomntwana ingacindezelwa, inqamule igazi nomoya-mpilo womntwana . Lokhu kungabangela ukulimala kobuchopho ngemizuzu embalwa.
Okunye ukuthi, uma amanzi akho ephuka ngaphambi kokuba kuqale ukubeletha, intambo yesisu ingaphuma ngaphambi kokuba umntwana abelethe. Lokhu nakho kuyisimo esiphuthumayo.
Ekugcineni, izingane ezizalwe zisesimweni sokuhudula imilenze zisengozini enkulu yokuba nokukhubazeka kokuzalwa ethanjeni lesinqe (Developmental Dysplasia of the Hip - DDH). Lesi yisimo lapho ithambo lesinqe lingalingani kahle khona. Ngakho-ke, izingane ezinjalo zihlolwa lesi simo ngokuskena indawo yesinqe nge-ultrasound emavikini angu-4-6 ngemva kokuzalwa.
Umlayezo Wokuya Nawe Ekhaya
- Kujwayelekile ukuthi ingane ibe nesisu esiqala ukubeletha. Iningi lezingane lizobheka phansi ekupheleni kokukhulelwa.
- Uma ingane ingaphenduki, ungazama ukuyiphendula ngaphandle usebenzisa i-ECV cishe emavikini angu-36. Khuluma nodokotela wakho ngalokhu.
- Ukubeletha ngokuhlinzwa okuhleliwe kubhekwa njengendlela ephephile kakhulu yokubeletha ingane ekhulelwe, kodwa kwezinye izimo, ukubeletha ngesitho sangasese sowesifazane nakho kuyacatshangelwa.
- Xoxa ngokucophelela nodokotela wakho wezifo zabesifazane kanye nodokotela wezifo zabesifazane ukuthi iyiphi indlela efaneleka kakhulu futhi ephephile kuwe nakumntwana wakho.
- Qiniseka ukuthi isibhedlela osikhethela ukubeletha sinazo zonke izinsiza ezidingekayo zokuhlinzwa okuphuthumayo kanye neyunithi yezingane.
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