Sokugembula isikhathi sokuqulwa kwecala: ukwelashwa. Olwandulelayo isikhathi - kungcono ...

Olwandulelayo isikhathi - impi esiswini ngesikhathi sokukhulelwa, ephelezelwa ubuhlungu kancane futhi imisipha. Ziyakwazi okungajwayelekile. izimpi ezinjalo kokumethemba ukulethwa. Ngaphansi kwezimo ezivamile, kwangaphambilini esiteji zomsebenzi kufanele izinike isikhathi amahora 6-8. Nokho, kwezinye izimo, le nkathi zingase zephuze. Lokhu kungenzeka ngenxa yezizathu ezihlukahlukene. Kulokhu kukhona okuthile okungavamile zomsebenzi, ezidinga kokungenela ngokushesha odokotela. Njengoba imiphumela okwathatha isikhathi eside kangako isikhathi sokuqulwa kwecala Ingaba yinto engathí sina kakhulu kumama wengane: kusukela unokungaxhumani oqinile unina ziphethe ukufa fetus.

Umqondo sokugembula isikhathi sokuqulwa kwecala

I physiology Yilowo nalowo muntu wesifazane ngamunye. Kwezinye izimo, le nkathi zingase zephuze amahora ambalwa, futhi ngezinye izikhathi izinsuku ezimbalwa. Lokhu kuholela Ukuwohloka abesifazane, ukulahlekelwa ukulala, ekuqongeleleni ngesikhathi kokuzalwa ukukhathala okwedlulele. Kulokhu, kukhona isigaba sokugembula kwangaphambilini zomsebenzi, okungukuthi, isikhathi okufanele kwangaphambi kokubeletha, eyathatha. It libhekene Kufinyeta okungajwayelekile ubuhlungu, okuyinto musa zisenza yezinguquko wesibeletho, kanye kuphela deplete yomzimba wowesifazane.

Ingqikithi yalo ezingasadingeki isikhathi sokuqulwa kwecala

singaveza okushiwo eziyisisekelo zokugula kanje:

• Bokuphila period kwangaphambilini imisiwe.
• Kukhulisa ithoni myometrium.
• wesibeletho Yangaphakathi mfushane.
• Kukhona entengo aphansi lesizalo ingxenye.
• Imicu yotshani Muscle ahlelwe embuthanweni, futhi kuvunguza transversely;

izizathu

Njengoba umthetho, sokugembula isikhathi sokuqulwa kwecala kuba khona ukuphazamiseka omama umzimba. Izizathu eziyinhloko zingahlukaniswa ngamaqembu amathathu:

OB:

• Ukuba khona polyhydramnios noma oligohydramnios.
• nokukhulelwa izingane eziningi ngasikhathi.
• I isithelo sesizalo uthatha isikhundla okungalungile (breech isethulo).
• I-placenta uphansi.

psychoemotional:

• Owesifazane esabe bokubeletha.
• kwemizwelo engakhi.
• Nezifo zengqondo nokucindezeleka okukhulu ngokomzwelo.
• iziguli ukukhathala Physical.
• abesifazane nulliparous Age (Ukwesaba umphumela zomsebenzi ekuqaleni kuka kakhulu noma ukukhulelwa ngasekupheleni).

Ngokwendlela umzimba owakheke ngayo:

• Ingabe omama unciphise ukhalo.
• kwenziwe Ngaphambili ekuhlinzeni utero (nezibazi ngemva caesarean et al.).
• Ukuphazamiseka ohlelweni endocrine (ukukhuluphala, ukudla, njll).
• Labile isimiso sezinzwa.
• Tifo letibangwa izinso, inhliziyo, isibindi, nabanye. Bodies.
• ukuvuvukala kwesibeletho.
• Preeclampsia.
• izisu Multiple.
• Ukuphuphuma Kwesisu umbungu.

izimpawu

Pathology prelimirnogo isikhathi ukuze lisize lezi zimpawu ezilandelayo:

• Kwesibeletho esikhathini wokulungiselela futhi kwangaphambilini kabuhlungu encishisiwe, kuyilapho Kufinyeta akuzona njalo. Abakwazi kwenzeke kokubili emini nasebusuku. Ngo kungaqali lwemishikashika isikhathi eside.
• ithoni Ukwandiswa kwesibeletho futhi excitability yayo.
• wesibeletho is hhayi waphawula, luhlala aminyene futhi eside.
• ingxenye NEKWETFULA umbungu is akucindezelwe ngokumelene encane ukhalo wesifazane.
• Ngenxa lesizalo hypertonus nzima nokuqalisa palpation umbungu.
• Kwesibeletho isikhathi eside incipha monotonically. Amandla kanye nokuvama Kufinyeta musa ukushintsha. Abawandulela nesikhathi kwangaphambilini kukhona eside ngokwemvelo.
• Owesifazane kukhona Oqala ukungezwa aze agcine esimweni sengqondo, waba izinyembezi engaphathekile, enendawo ukungalethembi kokuphothula ukulethwa.

zokugula izinhlobo

Sokugembula isikhathi sokuqulwa kwecala kungaba ezimbili zama:

• Esimweni sokuqala imisipha lesizalo akuzona ekhululekile, le micu imisipha kwesibeletho ufana "abavuthiwe 'entanyeni, oligohydramnios, ulwelwesi flat.
• Esimeni sesibili, wesibeletho kuyinto "beya", ine kobujamo obusaqanda, ethula ingxenye umbungu akuyona eduze emnyango ukuze indishi encane. Ngokuvamile, leso simo ebonwe umbungu perenashivanii.

isikhathi

Ubude besikhathi ezingasadingeki isikhathi sokuqulwa kwecala kuncike izici ngamunye wesifazane ziyahlukahluka kusuka amahora 6 amahora afika ku-24-48. Ngezinga elithile abesifazane, kungathatha izinsuku ezimbalwa.

imiphumela kungenzeka

Sokugembula isikhathi sokuqulwa kwecala ezimweni eziningi kuholela yezinkinga ngesikhathi sokubeletha. imisebenzi eminingi yomama ageleza ngokungavamile. Ikakhulukazi:

• Esekhandleka ababuthakathaka. Kulesi simo, libhekene yokuntuleka ngamandla lesizalo Kufinyeta, ngezikhawu eside phakathi Kufinyeta, wesibeletho dilates kancane, ukukhuthaza fetus imisiwe.
• Diskoordinirovannaya esekhandleka. Kubonakala Kufinyeta abathathela yeminyango kwesibeletho. Ayikho ukuvumelanisa e ukusikwa futhi ukuphumula izigaba zomuntu ngamunye. Ngenxa ukulwa ahambisana sebuhlungwini obunzima, ziyinsakavukela futhi engaphumi njalo, ukuthi emapayipini umama omenza uphumule.
• Umshikashika wabe ngokushesha. Ngenxa yalesi anomaly libhekene Kufinyeta enamandla kakhulu futhi abukhali futhi baphokophelele. Ngenxa yalokho, ukulethwa fast kakhulu (kuze kufike 5:00). Lokhu kungaholela ukudabuka sangasese kanye perineum kwabesifazane abakhulelwe, ukopha okunzima. Ngo-fetus angagcina hypoxia. ukulethwa Rapid kungadala lokuzalwa ukulimala umbungu.
• lesizalo ngqi - a anomaly ezingavamile. Kulokhu, isimo lapho kwesibeletho ekhululekile ngokuphelele. Kuthatha indawo uma kwenzeka elawula ukushaya kwenhliziyo amaningi ezingxenyeni ezahlukene kwesibeletho. It kuholela ukuphazamiseka lesizalo Kufinyeta futhi stop ukulethwa. Ngo-fetus angagcina hypoxia abakho wedwa, okungaholela iziyaluyalu zenhliziyo.

Kwangathi ukuthuthukisa imiphumela emibi ukugeleza normal zomsebenzi:

• ukususwa okungazelele-amniotic fluid.
• Ukuvela e izimpi ekuqaleni we meconium, okusho "yokucindezeleka 'umbungu.
• ukulethwa Steel.
• Esebenzisa.
• Sinzima ukopha ongaphilile.
• Esikhathini esiyiminyaka kwangemva kokubeletha, ukuthuthukisa izifo ubovu-ezithathelwanayo.
• hypoxia kwengane kanye nokuzalwa komntwana ne inhliziyo kahle noma yenhliziyo Umthambo isifo.

ukuhlola

Uma usola ukuthi isikhathi sokuqulwa kwecala siphela engavamile, ngokushesha ubona Udokotela Wabesifazane. Anakho ukwenza kokuxilongwa zangaphandle. Palpation kuyabaveza isikhundla esiphakeme noma eliphansi umbungu. Uma izithelo is hhayi baphonse, kubonisa khona zokugula zomsebenzi. Futhi phezu zokugula kungaba liyokwahlulelwa khona ukungezwani eqinile imisipha sangasese, kwesibeletho sokubelethisa yokungavuthwa futhi zibe.

Ngo nenkathi kwangaphambilini based zokugula Kuhlolisisa izifundo zokwelapha futhi laboratory ukuphetha ekunciphiseni erythrocyte acetylcholinesterase umsebenzi, ukwandisa amazinga egazi amahomoni adrenaline futhi noradrenaline.

Mhlawumbe ithuluzi cwaningo. Ukuze wenze lokhu, wenze cardiotocography. Ngalo ungakwazi ukuqopha amandla kanye nesikhathi Kufinyeta.

Sokugembula isikhathi sokuqulwa kwecala: ukwelashwa

Lapho wesibeletho beya futhi ukungabi khona ukuthuthukiswa ezimele zomsebenzi waphawula iphethini perenashivanie sokukhulelwa. Ukwelashwa izobe bemiswa we pathogenesis izifo. Umgomo yokwelashwa ukuphuthumisa inqubo yokuvuthwa kwesibeletho. Angasebenza ngayo lezi zinqubo:

• Elektroanalgeziya.
• Elektrorelaksatsiya kwesibeletho.
• Ukwelashwa nge medikametov: antispasmodics, analgesics, prostaglatinov E2.

Uma isiguli siyenzeka ukukhathala ezinzima bese ukwethuka yanda, yena esemisiwe njengenceku ukwelashwa ubuthongo izidakamizwa olubangelwa. Futhi ebhaliwe ephuma sedatives.

A omuhle ukwelashwa umphumela kubonakala ekuqaleni abukhali Kufinyeta njalo. Noma yokuvuthwa umzimba sokubelethisa. Lapho kwesibeletho iba "abavuthiwe ', isinye fetus ivulekile futhi engakapheli amahora amabili Kufinyeta njalo uqale. Uma lwemishikashika ngeke uqale ke ngemithambo yegazi iqondiswa prostaglandins.

Lapho ukwelashwa ayizwakali kanye nezinye izinkinga (umlando obstetrical, ubukhulu esikhulu umbungu, breech isethulo, OPG-preeclampsia, fetus hypoxia phezulu) wenziwa esiphuthumayo section caesarean.

Tindlelanchubo ekuphathweni abesifazane abakhulelwe ngilugcinile sokugembula isikhathi sokuqulwa kwecala

Kunezinhlobonhlobo zezindlela ezimbili:

• Gcwalisa lonke.
• Lokungeniswa zomsebenzi usebenzisa oxytocin.

Bobabili izindlela enzelwe ukuqeda ukwephula zomsebenzi. umphumela omuhle ebonwe 85% amacala. Lapho ukhetha indlela ucabangela izici ezilandelayo zokugula:

• Izinga ukukhathazeka lesiguli kanye ukukhathala.
• Isizathu okuyiwona kwetintfo.
• Kukhethwa indlela, okuyinto sikuvumela isiguli obelethisayo.

Uma ukhetha indlela ephelele lonke kuncike ukhulelwe, iqondiswa intramuscularly 0,015 g-morphine. Khona-ke secobarbital ku 0.2 g Lokhu kukhetha ngempumelelo ngokwanele. Ngokuvamile, ngemva nokuphathwa morphine nesineke uyalala ngehora elilodwa. Ngemva 4-5 amahora lokuphumula, phakathi kwesikhathi lapho umzimba neligwadulekile lulama, owesifazane uvuka ngaphandle leze izimpawu lokuzalwa, noma emshikashikeni asebenzayo.

Uma ukhetha ithrekhi wesibili, okungukuthi, ukukhuthazwa oxytocin kufanele ugweme ukuvula ulwelwesi. ngokuhlinzwa ulungisiswa kuphela amacala olunzima.

zokuvimbela

Okukhulu izinyathelo ukuvimbela zokugula isikhathi sokuqulwa kwecala yilezi:

• ukubonisana ngesikhathi esifanele obelethisayo.
• Ukuthunyelwa zonke cwaningo kunesidingo.
• Buciko iziqondiso kadokotela mayelana mode namandla.
• ukulungiselela Psychological and ngokomzimba abesifazane abakhulelwe sokubelethisa.

obelethisayo Kuncono kufanele ugcine ukulawula abesifazane abasengozini nesenzakalo yalesi sifo. Okungukuthi nulliparous ngaphansi kweminyaka eyi-17 futhi ngemva kweminyaka engu-30, kanye nabesifazane ababemkhalela banaso lesi sifo kwezitho ezithile (isibindi, izinso, inhliziyo).

Ngakho, sokugembula isikhathi sokuqulwa kwecala ingenye izinhlobo anomalies womsebenzi zabasebenzi. Kwenzeka kaningi. Nokho, ngenxa imithi yesimanje, 85% Ukungenela ngesikhathi esifanele kuka odokotela ukulethwa ekupheleni ngokuphepha. Ngakho-ke, lapho izimpawu zokuqala isifo kufanele axhumane ngokushesha ne a abanekhono Udokotela Wabesifazane. Imiphumela normal isikhathi sokuqulwa kwecala Ingaba yinto engathí sina kakhulu, kuze kube hypoxia fetus yanoma yimuphi ukwehluleka izitho zayo zangaphakathi kanye nokufa. Kahle ebekiwe ukwelashwa ukuze sisindise ukuphila kokubili umama nengane.