Ezabasebenzi kunye nokuhanjiswa

Umxholo

• Iimpawu zomsebenzi
• Ukuqhawulwa kweBraxton Hicks
• Inqanaba lokuqala labasebenzi
• Umsebenzi kwangoko
• Umsebenzi osebenzayo
• Umsebenzi wexeshana
• Inqanaba lesibini labasebenzi
• Ukuhanjiswa
• Inqanaba lesithathu labasebenzi
• Ukuhanjiswa kweplasenta
• Uncedo lwentlungu
• Iziyobisi
• Initrous oxide
• Epidural
• Izinketho zendalo zokuphucula iintlungu
• Ukwenziwa kwemisebenzi
• Isikhundla somntwana
• Icandelo leKesareya
• Ukuzalwa komfazi emva kwecandelo le-C (VBAC)
• Ukuhanjiswa koncedo
• Episiotomy

Ushwankathelo

Ngelixa kuthatha iinyanga ezilithoba ukukhula umntwana osisigxina, ukubeleka kunye nokuhanjiswa kwenzeka kumcimbi weentsuku okanye iiyure. Nangona kunjalo, yinkqubo yezabasebenzi kunye nokuhanjiswa okuhlala kuhlala kwiingqondo zabazali abalindelekileyo kakhulu.

Funda ukuba unemibuzo kunye neenkxalabo malunga neempawu kunye nobude babasebenzi, kunye nendlela yokulawula iintlungu.

Iimpawu zomsebenzi

Umsebenzi uqalile okanye uyeza kungekudala ukuba ufumana iimpawu ezinje:

• ukwanda koxinzelelo kwisibeleko
• utshintsho kumanqanaba amandla
• ukukhutshwa kwencindi yegazi

Umsebenzi wokwenyani kunokwenzeka ukuba ufike xa ukusikwa rhoqo kuya kuba buhlungu.

Ukuqhawulwa kweBraxton Hicks

Abasetyhini abaninzi bafumana ukungahambelani ngendlela engaqhelekanga ngamanye amaxesha emva kweeveki ezingama-20 bekhulelwe. Eyaziwa ngokuba yi-Braxton Hicks contractions, zihlala zingenabuhlungu. Okona kuninzi, abonwabanga kwaye abaqhelekanga.

Ukuqhawulwa kweBraxton Hicks ngamanye amaxesha kunokubangelwa kukonyuka kukamama okanye umsebenzi wosana, okanye isinyi esipheleleyo. Akukho mntu uyiqondayo ngokupheleleyo indima edlalwa yiBraxton Hicks xa ukhulelwe.

Banokukhuthaza ukuhamba kwegazi, bancede ukugcina impilo yesibeleko ngexesha lokukhulelwa, okanye balungiselele isibeleko sokubeleka.

I-Braxton Hicks contractions ayibangeli ukuba umlomo wesibeleko uvuleke. Iintlungu ezibuhlungu okanye eziqhelekileyo akunakwenzeka ukuba zibe yiBraxton Hicks. Endaweni yoko, ziindidi zekhontrakthi ekufuneka zikhokelele ekubeni ubize ugqirha wakho.

Inqanaba lokuqala labasebenzi

Ezabasebenzi kunye nokuhanjiswa kwahlulwe ngokwamanqanaba amathathu. Inqanaba lokuqala lezabasebenzi libandakanya ukuqala komsebenzi ngokunyusa okupheleleyo komlomo wesibeleko. Eli nqanaba lihlukaniswe ngokwamanqanaba amathathu.

Umsebenzi kwangoko

Eli ngesiqhelo lelona xesha lide kunye nelona lincinci labasebenzi. Umsebenzi kwangoko ukwabizwa ngokuba sisigaba sokugqibela sabasebenzi. Eli xesha libandakanya ukuncipha komlomo wesibeleko kunye nokwanda komlomo wesibeleko ukuya kwi-3-4 cm. Inokwenzeka kwiintsuku ezininzi, iiveki, okanye nje iiyure ezimbalwa.

Ukuchasana kuyahluka ngeli nqanaba kwaye kunokubakho ukusuka kubumnene ukuya komelele, kwenzeka rhoqo okanye ngokungaqhelekanga. Ezinye iimpawu ngeli xesha lesigaba zinokubandakanya ukubuyela umva komqolo, iicramps, kunye nokukhutshwa kwencindi egazini.

Uninzi lwabasetyhini luya kuba lukulungele ukuya esibhedlele xa sele kubelekisiwe. Nangona kunjalo, uninzi lwabasetyhini luya kufika esibhedlele okanye kwiziko lokubelekisa xa besekwimeko yokuqala yokusebenza.

Umsebenzi osebenzayo

Inqanaba elilandelayo lesigaba sokuqala sabasebenzi senzeka njengoko umlomo wesibeleko usanda ukusuka kwi-3-4 cm ukuya kwi-7 cm. Ukuchasana kuya komelela kwaye ezinye iimpawu zinokubandakanya umqolo obuhlungu kunye negazi.

Umsebenzi wexeshana

Eli lelona xesha linzima labasebenzi kunye nokunyuka okubukhali kokuchasana. Ziyomelela kwaye zenzeka malunga nemizuzu emibini ukuya kwemithathu ngokwahlukana, kunye nomyinge wama-60 ukuya kwimizuzwana engama-90. I-3 cm yokugqibela idla ngokwenzeka ngexesha elifutshane kakhulu.

Inqanaba lesibini labasebenzi

Ukuhanjiswa

Ngexesha lesibini, umlomo wesibeleko ugcwele ngokupheleleyo. Abanye abantu basetyhini banokuziva benomdla wokutyhala ngoko nangoko okanye kwakamsinya emva kokuba behluthwe ngokupheleleyo. Usana lusenokuba phezulu phezulu esinqeni kwabanye abafazi.

Kungathatha ixesha elithile ukuba umntwana ehle kunye nokuncipha ukuze isezantsi ngokwaneleyo ukuba umama aqale ukutyhala.

Abasetyhini abangenayo i-epidural ngokuqhelekileyo banomnqweno omkhulu wokunyusa, okanye banexinzelelo olubalulekileyo xa umntwana ephantsi ngokwaneleyo kwi-pelvis.

Abasetyhini abane-epidural basenokuba nomnqweno wokutyhala kwaye banokuziva beziva uxinzelelo lwe-rectal, nangona kungenjalo ngokungathi kunjalo. Ukutsha okanye ukuhlaba kwilungu lobufazi njengoko isithsaba seentloko zentsana siqhelekile.

Kubalulekile ukuba uzame ukuhlala ukhululekile kwaye uphumle phakathi kwezahlulo. Yilapho umqeqeshi wakho wezabasebenzi okanye i-doula anokunceda kakhulu.

Inqanaba lesithathu labasebenzi

Ukuhanjiswa kweplasenta

Umkhaya uya kuhanjiswa emva kokuba umntwana ezelwe. Ukunciphisa okuncinci kuya kunceda ukwahlula i-placenta eludongeni lwesibeleko kwaye uyihambise iye ezantsi kwilungu lobufazi. Ukugoba ukulungisa iinyembezi okanye ukusikwa kotyando (i-episiotomy) kuya kwenzeka emva kokuhanjiswa kweplacenta.

Uncedo lwentlungu

Amayeza anamhlanje anokubonelela ngeendlela ezahlukeneyo zokulawula iintlungu kunye neengxaki ezinokuthi zenzeke ngexesha lomsebenzi kunye nokuhanjiswa. Amanye amayeza akhoyo abandakanya oku kulandelayo.

Iziyobisi

Amayeza e-narcotic asetyenziswa rhoqo ekupheliseni iintlungu ngexesha lomsebenzi. Ukusetyenziswa kunqunyelwe kumanqanaba okuqala kuba atyekele ekubangeleni ukugcwala komama, komntwana, kunye kokuzalwa komntwana.

I-Narcotic zihlala zinikwa abasetyhini abasebenza ngenaliti ye-intramuscular okanye ngomgca we-intravenous. Amanye amaziko anikezela ngolawulo olulawulwa zizigulana. Oko kuthetha ukuba unokukhetha ukuba uza kulifumana nini na ichiza.

Ezinye zeziyobisi eziqhelekileyo zibandakanya:

• Imofini
• imerididi
• fentanyl
• butorphanol
• kunye

Initrous oxide

Ngamanye amaxesha amayeza e-analgesic analgesic asetyenziswa ngexesha lomsebenzi. I-nitrous oxide, edla ngokubizwa ngokuba yigesi yokuhleka, isetyenziswa kakhulu. Inokubonelela ngentlungu eyoneleyo kubafazi abathile xa isetyenziswa rhoqo, ngakumbi kwinqanaba lokuqala lomsebenzi.

Epidural

Eyona ndlela iqhelekileyo yokuthomalalisa iintlungu ngexesha lomsebenzi kunye nokuhanjiswa kukuvalwa kwesifo. Isetyenziselwa ukubonelela nge-anesthesia ngexesha lomsebenzi kunye nokuhanjiswa kunye nexesha lokuhanjiswa kwe-cesarean (C-icandelo).

Uncedo lwentlungu lubangelwa kukujova iziyobisi kwi-epidural space, ebekwe ngaphandle nje kwembombo yomgogodla. Iyeza zithintela ukuhanjiswa kweentlungu ngeemithambo ezidlula kuloo nxalenye yendawo yesithuba ngaphambi kokudibanisa nentambo yomqolo.

Ukusetyenziswa kwe-spinal-epidurals edibeneyo okanye i-epidural ehambahambayo iye yafumana ukuthandwa kwiminyaka yamuva. Oku kubandakanya ukugqithisa inaliti encinci yenqaku lepensile ngenaliti ye-epidural ngaphambi kokubekwa kwe-anesthetic ye-epidural.

Inaliti encinci iqhubele phambili kufutshane nentambo yomqolo kunye nedosi encinci ye-narcotic okanye ye-anesthetic yendawo ifakwe kwisithuba.

Oku kuchaphazela kuphela ukusebenza kweemvakalelo, ekuvumela ukuba uhambe kwaye uhambe ngexesha lomsebenzi. Obu buchule busetyenziswa rhoqo kwinqanaba lokuqala lomsebenzi.

Izinketho zendalo zokuphucula iintlungu

Zininzi iindlela onokukhetha kuzo kwabasetyhini abafuna ukukhululeka kweentlungu ezingasebenziyo kunye nokuhanjiswa. Bajolise ekunciphiseni ukuqonda kwentlungu ngaphandle kokusebenzisa amayeza. Ezinye zezi ziquka:

• ukuphefumla okunepateni
• Lamaze
• Unyango lwamanzi
• ukuvuselelwa kwemithambo-luvo yombane (TENS)
• ngomlingo
• ukutshiza
• ukuphulula

Ukwenziwa kwemisebenzi

Umsebenzi unokwenziwa ngendlela ngeendlela. Indlela ekhethiweyo iya kuxhomekeka kwizinto ezininzi, kubandakanya:

• ulungele kangakanani umlomo wakho wesibeleko kubasebenzi
• ingaba ngumntwana wakho wokuqala na lo
• ukude kangakanani ekumitheni
• ukuba inwebu yakho iqhawukile
• Isizathu sokungeniswa

Ezinye zezinto ugqirha anokucebisa ukuba zenziwe zezi:

• xa ukukhulelwa kungene kwiveki ye-42
• ukuba ukophuka kwamanzi kukamama kunye nokubeleka akuqali kungekudala emva koko
• ukuba kukho iingxaki nomama okanye usana.

Ukwenziwa kwabasebenzi kuhlala kungacetyiswa xa umntu obhinqileyo enecandelo le-C elidlulileyo okanye ukuba usana lupholile (ezantsi ezantsi).

Iyeza lehomoni elibizwa ngokuba yi-prostaglandin, iyeza elibizwa ngokuba yi-misoprostol, okanye isixhobo sinokusetyenziselwa ukuthambisa kunye nokuvula umlomo wesibeleko ukuba inde kwaye ayithambisanga okanye ayiqali ukuthamba.

Ukuhlutha inwebu kunokubangela ukuba abanye abantu basetyhini basebenze. Le yinkqubo apho ugqirha wakho ejonga umlomo wakho wesibeleko. Baza kufaka ngesandla umnwe phakathi kweembumba zeseti ye-amniotic kunye nodonga lwesibeleko.

Ii-prostaglandin zendalo zikhutshwa ngokwahlulahlula okanye ukukhulula icandelo elisezantsi leembumba kuludonga lwesibeleko. Oku kunokuwuthambisa umlomo wesibeleko kwaye kubangele ukusasazeka.

Ukuhlutha inwebu kunokufezekiswa kuphela xa umlomo wesibeleko uvule ngokwaneleyo ukuvumela ugqirha wakho ukuba afake umnwe kwaye enze inkqubo.

Amayeza afana ne-oxytocin okanye i-misoprostol anokusetyenziselwa ukunyanzelisa abasebenzi. I-Oxytocin inikwa ngaphakathi. IMisoprostol yipilisi ebekwe kwilungu lobufazi.

Isikhundla somntwana

Ugqirha wakho uhlala ejonga indawo yomntwana wakho ngexesha lotyelelo lwaphambi kokubeleka. Uninzi lweentsana luguqukela kwindawo yokubekwa entloko phakathi kweveki yama-32 neye-36. Ezinye aziguquli konke, kwaye ezinye zijika zibe ziinyawo- okanye ezantsi kwindawo yokuqala.

Uninzi loogqirha baya kuzama ukuguqula i-breech fetus kwisikhundla sokuhla ngentloko usebenzisa inguqu yangaphandle ye-cephalic (ECV).

Ngexesha le-ECV, ugqirha uya kuzama ukushenxisa ngobumnene umbungu ngokufaka izandla zakhe kwisisu sikanina, esebenzisa i-ultrasound njengesikhokelo. Umntwana uya kubekwa esweni ngexesha lenkqubo. Ii-ECV zihlala ziphumelela kwaye zinokunciphisa amathuba okuhanjiswa kwecandelo le-C.

Icandelo leKesareya

Umndilili wesizwe wokuzalwa ngecandelo le-cesarean ukhuphuke kakhulu kule minyaka imbalwa idlulileyo. Ngokutsho, malunga neepesenti ezingama-32 zoomama eUnited States bazala ngale ndlela, ekwabizwa ngokuba kukunikezelwa ngoqhaqho.

Icandelo le-C lihlala likhuselekileyo kwaye likhawuleza ukhetho lokuhambisa xa kunzima ukuhambisa okanye xa kuvela iingxaki.

Icandelo le-C lithathwa njengotyando olukhulu. Umntwana uhanjiswa ngokusikwa kudonga lwesisu nakwisibeleko kunakwilungu lobufazi. Umama uya kunikwa i-anesthetic ngaphambi kotyando ukuze ndindisholo indawo ukusuka esiswini ukuya ezantsi esinqeni.

Ukuqanjwa kuhlala kuhlala kuthe nkqo, ecaleni kwenxalenye esezantsi yodonga lwesisu. Kwezinye iimeko, ukusikwa kungathi nkqo ukusuka emgceni ukuya ezantsi kwiqhosha lesisu.

Ukuqhekeka esibelekweni kukwenzekile, ngaphandle kwakwiimeko ezithile ezinzima. Ukusikwa okuthe nkqo esibelekweni kubizwa ngokuba yiC-classical C-section. Oku kushiya umsipha wesibeleko ungaphantsi kokunyamezela ukungcola ekukhulelweni okuzayo.

Umlomo kunye nempumlo yomntwana iya kutsalwa emva kokubeleka ukuze bakwazi ukuphefumla okokuqala, kwaye ipascenta ihanjiswe.

Uninzi lwabasetyhini alunokwazi ukuba baya kuba necandelo le-C de kuqale ukubeleka. Amacandelo e-C anokucwangciswa kwangaphambili ukuba kukho iingxaki kumama okanye kusana. Ezinye izizathu zecandelo le-C kunokuba yimfuneko zibandakanya:

• Icandelo elidlulileyo le-C elinomfanekiso weklasikhi, othe nkqo
• ukugula komntwana okanye ukukhubazeka kokuzalwa
• Umama unesifo seswekile kwaye umntwana uqikelelwa ubunzima obungaphezulu kwe-4,500 g
• I-placenta previa
• Usulelo lwe-HIV kumama kunye nomthamo wentsholongwane ephezulu
• breech okanye indawo eguqulweyo yomntwana

Ukuzalwa komfazi emva kwecandelo le-C (VBAC)

Kwakukhe kwacingwa ukuba ukuba unecandelo le-C, uyakuhlala ufuna ukufumana enye yokuhambisa iintsana ezizayo. Namhlanje, ukuphinda amacandelo e-C akusoloko kuyimfuneko. Ukuzalwa komfazi emva kwecandelo le-C (VBAC) kunokuba yinto ekhuselekileyo kwabaninzi.

Abasetyhini abane-low-transverse uterine incision (ethe tye) ukusuka kwicandelo le-C baya kuba nethuba elihle lokuhambisa umntwana kwilungu lobufazi.

Abasetyhini abanesicatshulwa sokuma ngokuthe nkqo akufuneki bavunyelwe ukuba bazame i-VBAC. Ukucanda ngokuthe nkqo kwandisa umngcipheko wokuqhekeka kwesibeleko ngexesha lokuzalwa komfazi.

Kubalulekile ukuba uxoxe ngokukhulelwa kwakho kwangaphambili kunye nembali yonyango nogqirha wakho, ukuze bakwazi ukuvavanya ukuba ngaba i-VBAC lukhetho lwakho.

Ukuhanjiswa koncedo

Kukho amaxesha okufikelela esiphelweni kwinqanaba lokutyhala apho umfazi anokufuna uncedo olongezelelekileyo ekuhambiseni usana lwakhe. Isitshixo sokucoca okanye i-forceps inokusetyenziselwa ukunceda kunikezelo.

Episiotomy

I-episiotomy yinqumle esezantsi kwilungu lobufazi kunye nesihlunu esisiswini ukonyusa ukuvulwa komntwana. Kwakukholelwa ukuba wonke umntu wasetyhini wayefuna i-episiotomy yokuhambisa umntwana.

I-Episiotomies ngoku zenziwa kuphela ukuba umntwana uxinzelelo kwaye ufuna uncedo ukuphuma ngokukhawuleza. Ziyenziwa kwakhona ukuba intloko yosana ihambisa kodwa amagxa abambekile (dystocia).

I-episiotomy nayo inokwenziwa ukuba umntu obhinqileyo ebetyhala ixesha elide kwaye engakwazi ukutyhala usana ngaphaya kwenxalenye esezantsi kakhulu yokuvulwa kwelungu lobufazi.

I-Episiotomies zithintelwa ngokubanzi ukuba kunokwenzeka, kodwa ulusu kwaye ngamanye amaxesha izihlunu zinokukrazuka endaweni yoko. Iinyembezi zolusu azibuhlungu kwaye ziphilisa ngokukhawuleza kune-episiotomy.